Integrative Management of Primary Dysmenorrhea Using Habbe Hilteet and Dry Cupping: A Case Report Based on Unani Principles

Abstract

Primary dysmenorrhea, defined as painful menstruation without any identifiable pelvic pathology, is one of the most common gynecological conditions affecting women of reproductive age. It often results in impaired daily functioning, reduced productivity, and diminished quality of life. In the Unani system of medicine, this condition is referred to as Waja‘ al-Raḥm, commonly attributed to a Barid Yabis (cold and dry) temperament of the uterus. This case report explores the efficacy of an integrative Unani treatment combining Habbe Hilteet, a traditional polyherbal formulation known for its analgesic and anti-inflammatory properties, and Hijama Bila Shart (dry cupping therapy), in the management of primary dysmenorrhea. A 28-year-old female with a nine-year history of cyclic lower abdominal pain was treated over three consecutive menstrual cycles. The regimen included oral administration of Habbe Hilteet and weekly dry cupping sessions applied to the lumbar and lower abdominal regions. Clinical outcomes were evaluated using standardized tools including the Visual Analog Scale (VAS) for pain intensity, the Menstrual Symptom Questionnaire (MSQ), and WHOQOL-BREF for assessing quality of life. The patient reported a progressive decline in pain severity and symptom burden across treatment cycles, accompanied by noticeable improvement in physical and psychological well-being. The intervention was well-tolerated with no adverse effects reported. These findings suggest that the integrative use of Habbe Hilteet and dry cupping therapy may offer a safe, non-hormonal, and holistic alternative for the management of primary dysmenorrhea. However, further validation through larger, controlled clinical trials is warranted to substantiate its therapeutic potential and reproducibility.