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<h4>Aim</h4>Primary dysmenorrhea is highly prevalent and often suboptimally managed, as non-steroidal anti-inflammatory drugs (NSAIDs) fail to provide analgesia in 18% of women. This review therefore aims to evaluate the efficacy and safety of heat therapy-a widely used self-care method-for both preventing and acutely treating primary dysmenorrhea.<h4>Methods</h4>We searched seven databases (CENTRAL, PubMed, Web of Science, EMBASE, CNKI, VIP, Wanfang) from inception to October 28, 2024 and updated to August 03, 2025. Pairs of reviewers independently screened records, extracted data, and assessed risk of bias using a modified Cochrane RoB 1.0 tool. Random-effects meta-analyses were performed for pain intensity (converted to 10-cm VAS) and adverse events. Evidence certainty was graded via GRADE (Grading of Recommendations, Assessment, Development, and Evaluations).<h4>Results</h4>We screened 2,733 citations and included 57 RCTs (involving 5,359 female participants). When compared with no treatment, heat therapy may reduce pain intensity to a greater extent after 3 months (25 RCTs, 2,393 females, WMD -1.85 cm, 95% CI -2.29 to -1.41 cm, RD 21%); it may lead to a greater reduction within 24 h of treatment (3 RCTs, 248 females; WMD -3.52 cm, 95% CI -5.01 to -2.02 cm, RD 45%). When compared to NSAIDs, heat therapy may provide comparable or slightly superior pain relief after 3 months of treatment (22 RCTs, 1,938 females, WMD -1.10 cm, 95% CI -1.51 to -0.70 cm, RD 4%), or within 24 h

Regular exercise and sauna bathing have each been shown to improve cardiovascular function in clinical populations. However, experimental data on the cardiovascular adaptations to regular exercise in conjunction with sauna bathing in the general population are lacking. Therefore, we compared the effects of exercise and sauna bathing to regular exercise using a multi-arm randomized controlled trial. Participants (<i>n</i> = 47) aged 49 ± 9 with low physical activity levels and at least one traditional cardiovascular disease (CVD) risk factor were randomly assigned (1:1:1) to guideline-based regular exercise and 15-min postexercise sauna (EXS), guideline-based regular exercise (EXE), or control (CON) for 8 wk. The primary outcomes were blood pressure (BP) and cardiorespiratory fitness (CRF)_. Secondary outcomes included fat mass, total cholesterol levels, and arterial stiffness. EXE had a greater change in CRF (+6.2 mL/kg/min; 95% CI, +4.2 to +8.3 mL/kg/min) and fat mass but no differences in BP when compared with CON. EXS displayed greater change in CRF (+2.7 mL/kg/min; 95% CI, +0.2 to +5.3 mL/kg/min), lower systolic BP (-8.0 mmHg; 95% CI, -14.6 to -1.4 mmHg), and lower total cholesterol levels compared with EXE. Regular exercise improved CRF and body composition in sedentary adults with CVD risk factors. However, when combined with exercise, sauna bathing demonstrated a substantially supplementary effect on CRF, systolic BP, and total cholesterol levels. Sauna bathi

Lower-extremity peripheral artery disease (PAD) is associated with increased risk of cardiovascular events and impaired exercise tolerance. We have previously reported that leg heat therapy (HT) applied using liquid-circulating trousers perfused with warm water increases leg blood flow and reduces blood pressure (BP) and the circulating levels of endothelin-1 (ET-1) in patients with symptomatic PAD. In this sham-controlled, randomized, crossover study, sixteen patients with symptomatic PAD (age 65 ± 5.7 years and ankle-brachial index: 0.69 ± 0.1) underwent a single 90-min session of HT or a sham treatment prior to a symptom-limited, graded cardiopulmonary exercise test on the treadmill. The primary outcome was the peak walking time (PWT) during the exercise test. Secondary outcomes included the claudication onset time (COT), resting and exercise BP, calf muscle oxygenation, pulmonary oxygen uptake (V̇O₂ ), and plasma levels of ET-1, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Systolic, but not diastolic BP, was significantly lower (~7 mmHg, p < .05) during HT when compared to the sham treatment. There was also a trend for lower SBP throughout the exercise and the recovery period following HT (p = .057). While COT did not differ between treatments (p = .77), PWT tended to increase following HT (CON: 911 ± 69 s, HT: 954 ± 77 s, p = .059). Post-exercise plasma levels of ET-1 were also lower in the HT session (CON: 2.0 ± 0.1, HT: 1.7 ± 0.1, p = .02).

<h4>Introduction</h4>Passive heat treatment has been suggested to improve glycemic control in individuals with type 2 diabetes mellitus (T2DM). Previous studies have focused predominantly on hot water immersion and traditional sauna bathing, as opposed to the more novel method of infrared-based sauna bathing. Here, the impact of a single infrared sauna session on post-prandial glycemic control was assessed in older individuals with T2DM.<h4>Methods</h4>In this randomized controlled crossover trial, 12 participants with T2DM (male/female: 10/2, age: 69±7 y, BMI: 27.5±2.9 kg/m²) rested in an infrared sauna twice: once in a heated (60°C) and once in a thermoneutral (21°C) condition for 40 min, immediately followed by a 2-h oral glucose tolerance test (OGTT). Venous blood samples were obtained to assess plasma glucose and insulin concentrations and to determine the whole-body composite insulin sensitivity index.<h4>Results</h4>Body core and leg skin temperature were higher following the heated condition compared to the thermoneutral condition (38.0±0.3 vs. 36.6±0.2°C and 39.4±0.8 vs. 31.3±0.8°C, respectively; P<0.001 for both). The incremental area under the curve (iAUC) of plasma glucose concentrations during the OGTT was higher after the heated condition compared to the thermoneutral condition (17.7±3.1 vs. 14.8±2.8 mmol/L/120 min; P<0.001). No differences were observed in plasma insulin concentrations (heated: 380±194 vs. thermoneutral: 376±210 pmol/L/120 min; P=0.9

Repeated heat exposure like sauna bathing is suggested to beneficially affect against dementia development. The epidemiological evidence is, however, scarce. Therefore, we studied the association between heat exposure during sauna bathing (i.e., the frequency of sauna bathing, frequency of heat sessions, length of stay in heat, sauna temperature) and the subsequent risk of dementia. A prospective cohort study was conducted based on 13,994 men and women aged 30-69 and free from dementia diagnosis from the Finnish Mobile Clinic Follow-up Survey. During a follow-up of 39 years, a total of 1805 dementia patients were diagnosed. The sauna bathing data was gathered from a questionnaire. Analyses based on the Cox model included the sauna bathing variables and the potential confounding factors. Sauna bathing frequency was related to a reduced risk of dementia after adjustment for the potential sociodemographic, lifestyle, and metabolic risk factors of dementia considered. The hazard ratio of dementia between individuals sauna bathing 9-12 times per month in comparison with those not sauna bathing or sauna bathing less than four times per month was 0.47 (95% CI = 0.25-0.88) during the first 20 years of follow-up and 0.81 (95% CI = 0.69-0.97) during the whole follow-up. The results are in line with the hypothesis that sauna bathing provides protection against dementia. Further studies are required to verify the suggested benefits of sauna bathing.

Exercise is painful and difficult to perform for patients with severe lower-limb osteoarthritis; consequently, reduced physical activity contributes to increased cardiometabolic disease risk. The aim of this study was to characterize the acute and adaptive cardiovascular and metabolic effects of two low or no impact therapies in patients with severe lower-limb osteoarthritis: passive heat therapy (Heat) and high-intensity interval training (HIIT) utilizing primarily the unaffected limbs, compared to a control intervention of home-based exercise (Home). Participants completed up to 12 weeks of either Heat (20-30 min immersed in 40°C water followed by ~15-min light resistance exercise), HIIT (6-8 × 60-s intervals on a cross-trainer or arm ergometer at ~90-100% peak V̇$$ \dot{V} $$ O₂ ) or Home (~15-min light resistance exercise); all 3 sessions/week. Reductions in systolic (12 & 10 mm Hg), diastolic (7 & 4 mm Hg), and mean arterial (8 & 6 mm Hg) blood pressure (BP) were observed following one bout of Heat or HIIT exposure, lasting for the duration of the 20-min monitoring period. Across the interventions (i.e., 12 weeks), resting systolic BP and diastolic BP decreased with Heat (-9 & -4 mm Hg; p < 0.001) and HIIT (-7 & -3 mm Hg; p ≤ 0.011), but not Home (0 & 0 mm Hg; p ≥ 0.785). The systolic and diastolic BP responses to an acute exposure of Heat or HIIT in the first intervention session were moderately correlated with adaptive responses across the intervention (r ≥ 

The thermoneutral zone (TNZ) defines the range of ambient temperatures at which resting metabolic rate (MR) is at a minimum. While the TNZ lower limit has been characterized, it is still unclear whether there is an upper limit, that is, beyond which MR during rest increases, and if so, what physiological upregulations explain this. We take the first step to fill this knowledge gap by measuring MR and multiple physiological variables in participants exposed to ambient heat stress while resting. Thirteen participants were exposed for an hour to 28℃-50% relative humidity (RH) air, and both 40 and 50℃ each in 25% RH and humid (50% RH) conditions. Core and skin temperatures, blood pressure, sweat-, heart-, and breathing-rate, minute ventilation, and movement levels were recorded throughout each condition. MR increased 35% (p = .015) during exposure to 40℃-25% RH compared to baseline and a further 13% (p = .000) at in 50℃-50%RH. This was not explained by increased fidgeting (p = .26), suggesting physiological upregulation. However, while greater heat stress invoked increases in heart rate (64%, p = .000), minute ventilation (78%, p = .000), and sweat rate (74%. p = .000) when comparing 50℃-50% RH with baseline, the exact size of their relative energy cost is unclear and, therefore, so is their contribution to this increase in MR. Our study shows clear evidence that resting MR increases in humans at high temperature-there is a metabolic upper critical temperature, at least as low as

Components of the metabolic syndrome (i.e., hypertension, insulin resistance, obesity, atherosclerosis) are a leading cause of death in the United States and result in low-grade chronic inflammation, excessive oxidative stress, and the eventual development of cardiometabolic diseases (CMD). High-stress occupations (HSO: firefighters, police, military personnel, first responders, etc.) increase the risk of developing CMD because they expose individuals to chronic and multiple stressors (i.e., sleep deprivation, poor nutrition habits, lack of physical activity, psychological stress). Interestingly, heat exposure and, more specifically, sauna bathing have been shown to improve multiple markers of CMD, potentially acting as hormetic stressors, at the cellular level and in the whole organism. Therefore, sauna bathing might be a practical and alternative intervention for disease prevention for individuals with HSO. The purpose of this review is to detail the mechanisms and pathways involved in the response to both acute and chronic sauna bathing and collectively present sauna bathing as a potential treatment, in addition to current standard of care, for mitigating CMD to both clinicians and individuals serving in HSO.

Heat therapy is a historic modality that has been used as a source of lifestyle intervention and community for many different cultures. Over the last ~40 years, heat therapy has gained increasing popularity among scientists and clinicians as a potential therapeutic tool for aging and disease. Recently, several systematic reviews and meta-analyses have sought to encompass specific aspects investigated in the scientific literature surrounding this ancient therapeutic modality, with each review having a primary focus on one beneficial aspect of heat therapy. This review aimed to provide a more comprehensive review of the scientific literature on heat therapy. To accomplish this, we have included studies that demonstrate clear beneficial adaptations (and those that show no effect of heat therapy) on specific organs, crosstalk between different organs and tissues, and integrated physiological systems and pathways. Furthermore, we also discuss what forms of heat therapy confer beneficial adaptations and for which populations these benefits occur. Where possible, we identify specific signaling mechanisms through which heating a tissue or raising internal body temperature results in a multitude of beneficial adaptations. Lastly, this review also emphasizes those investigations that have shown little or no benefit of heat therapy. The overarching aim of this review was to provide scientists, clinicians, and the lay public with a current consensus on the benefits and limitations of hea

Despite compelling evidence supporting the benefits of passive heat therapy in promoting skeletal muscle adaptation and enhancing neuromuscular function, the topic remains debated. Some recent studies report no significant effects on muscle protein synthesis, muscle mass, recovery, strength, or power. This raises critical questions: is passive heat therapy not actually effective? Or do these discrepancies reflect inconsistencies in study protocols and an overgeneralisation of the term passive heating? Despite its growing recognition as a health treatment, exercise mimetic, and tool for sport performance and recovery, the interpretation of outcomes is often simplistic or misinformed. In this opinion article, we discuss the disparities in the literature and highlight the risks of oversimplification, such as the binary view that passive heat therapy either "works" or "does not work." We also propose incorporating the FITT (Frequency, Intensity, Time, and Type) principles from exercise science into thermal therapy research to enhance methodological consistency and clarity. By adopting a more structured and rigorous approach, the field can better realise the potential of passive heat therapy as a scientifically grounded intervention for both health and sport performance applications.

<h4>Introduction</h4>FM is characterized by widespread musculoskeletal pain and associated somatic symptoms including fatigue, cognitive difficulties, and problems with sleeping. Multidisciplinary treatment of fibromyalgia including pharmacologic and non-pharmacologic interventions are recommended to improve symptoms and physical functioning. The goal of the present pilot investigation was to evaluate the effects of heat therapy via hot water immersion on clinical and objective pain measures in addition to blood measurements of heat shock proteins (HSPs) and inflammatory markers in patients with FM.<h4>Methods</h4>After screening, informed consent, and enrollment into the study, all subjects underwent a baseline pre-intervention evaluation which included a battery of pain phenotyping questionnaires, quantitative sensory testing, and collection of blood for measurements of HSPs and inflammatory markers. Subjects received heat therapy three times a week for four weeks, where they were immersed in hot water for 45 min. After four weeks, participants completed the same battery of testing done at baseline.<h4>Results</h4>We found that four weeks of heat therapy via hot water immersion in patients with FM showed statistically significant reductions in average and worst pain NRS severity scores when compared to baseline. There was also statistically significant improvement in overall impact of fibromyalgia symptoms, physical function, and sleep-related impairment. Regarding heat sho

People with symptomatic lower extremity peripheral artery disease (PAD) suffer from severe leg pain, walking impairment, and reduced quality of life, but few effective treatments are available. Emerging evidence suggests that regular heat therapy (HT) may improve cardiovascular and physical function in patients with PAD. However, the lack of accessible, practical modalities for unsupervised HT, especially for elderly individuals, has hindered clinical implementation. The goals of this study were to design and assess the feasibility of a portable leg HT system for elderly patients with PAD. Building on a cryotherapy water-circulating device used in sports recovery, we developed a new prototype system consisting of a single-touch controller unit integrating a heater, water pump, and air pump, and leg sleeves with inner-layer water-circulating pads and an outer layer of inflatable bladders. The system was designed to ensure efficient heat transfer through gentle pneumatic inflation, adapting to varying limb dimensions. Safety features included temperature sensors with auto shut-off and a built-in timer. The prototype's feasibility and safety were evaluated in a single-arm pilot trial with six symptomatic patients with PAD, who were asked to apply the therapy daily for 90 minutes for 12 weeks. Primary outcomes included completion rates, safety, and device usability. Secondary outcomes were changes in blood pressure, 6-minute walk distance, calf strength, sit-to-stand performance,

<h4>Purpose</h4>Heat therapy is recognised to promote cardiovascular health, and whilst most recent heat therapy investigations have focussed on continuous heat exposure, traditional sauna use often includes recovery periods. This study compared the acute effects of continuous versus intermittent whole-body heating on cardiovascular function markers in males and females.<h4>Methods</h4>Twenty healthy participants (25 ± 3 years; 10 males, 10 females) were exposed to 2 passive heating regimens: continuous heating (CH) for 60 min and intermittent heating (IH) comprised of 3 × 20-min blocks interspersed by 15-min cooling breaks. Skin perfusion, blood pressure (BP), plasma nitrite, interleukins, body temperature, and thermal perceptual responses were assessed.<h4>Results</h4>Greater increases in rectal temperature (T_rec) (CH: 1.2 ± 0.1 °C; IH: 0.5 ± 0.1 °C), skin perfusion, systolic blood pressure (SBP), heart rate (HR), interleukin-6 (IL-6) and plasma nitrite were found in CH compared to IH (p ≤ 0.01), but the thermal perceptual response was more unfavourable during CH (p < 0.01). Females had higher skin perfusion and plasma nitrite concentrations (p ≤ 0.04), but lower brachial and central BP than males in both conditions (p ≤ 0.01). Furthermore, females reached a higher T_rec and more unfavourable thermal perception in CH (p ≤ 0.02).<h4>Conclusion</h4>More pronounced cardiovascular responses were associated with higher T_rec and discomfort. Females

<h4>Background and aims</h4>Sauna bathing and aerobic exercise have each been shown to affect cardiovascular function. However, direct comparisons between standalone sauna bathing and a combination of exercise and sauna on vascular indices remain limited. Therefore, we conducted a cross-over study using matched durations to explore the hemodynamic changes of sauna exposure when compared to a combination of aerobic exercise and sauna exposure.<h4>Methods</h4>Participants (N = 72) with at least one cardiovascular risk factor underwent, on two separate occasions: (a) a 30-minute sauna at 75°C (SAUNA) and (b) the combination of a 15-minute cycling exercise at 75% maximum heart rate followed by 15-minute sauna exposure (EX+SAUNA). Relative changes to arterial stiffness (PWV), augmentation index (Alx), brachial systolic and diastolic blood pressure (SBP and DBP), central SBP (cSBP), mean arterial pressure (MAP), and heart rate (HR) were compared PRE-POST and pre- to 30-minutes post-intervention (PRE-POST30).<h4>Results</h4>Baseline SBP and DBP were 143 (SD 18) mmHg and 86 (SD 10) mmHg, respectively. From PRE-POST, SAUNA had lower DBP (mean difference [95% CI] 2.5 [1.0, 4.1], <i>P</i> = .002) and MAP (2.5 [0.6, 4.3], <i>P</i> = .01). However, EX+SAUNA had lower SBP (-2.7 [-4.8, -0.5], <i>P</i> = .02), DBP (-1.8 [-3.3, -0.4], <i>P</i> = .01), and MAP (-2.0 [-3.5, -0.5], <i>P</i> = .009) PRE-POST30. There were no statistically significant differences between SAUNA and EX+SAUNA for oth

Inflammation and sauna bathing are each related to the risk of all-cause mortality. The interplay between inflammation, sauna bathing and all-cause mortality is not well understood. We aimed to evaluate the separate and joint associations of inflammation (high sensitivity C-reactive protein, hsCRP) and frequency of sauna bathing (FSB) with all-cause mortality in a cohort of Caucasian men. We used the Kuopio Ischaemic Heart Disease Study cohort comprising 2575 men aged 42-61 years at baseline. Serum hsCRP was measured using an immunometric assay and sauna bathing habits were assessed by a self-administered questionnaire. High sensitivity CRP was categorized as normal and high (≤ 3 and > 3 mg/L, respectively) and FSB as low and high (defined as ≤ 2 and 3-7 sessions/week respectively). A total of 1618 deaths occurred during a median follow-up of 27.8 years. Comparing high vs normal hsCRP levels, the multivariable-adjusted HR (95% CI) for all-cause mortality was 1.27 (1.13-1.44). Comparing high vs low FSB, the multivariable-adjusted HR (95% CI) for all-cause mortality was 0.86 (0.76-0.97). Compared with normal hsCRP-low FSB, high hsCRP-low FSB was associated with an increased risk of all-cause mortality 1.28 (1.12-1.47), with no evidence of an association for high hsCRP-high FSB and all-cause mortality risk 1.06 (0.81-1.40). Positive additive and multiplicative interactions were found between hsCRP and FSB in relation to mortality. In a general Finnish male population, both hsCRP

<h4>Objectives</h4>Elevated systolic blood pressure (SBP) is associated with an increased risk of cardiovascular disease (CVD) mortality, whereas frequent sauna bathing reduces the risk. Whether frequent sauna bathing mitigates CVD mortality among adults with elevated SBP has not been previously investigated.<h4>Design and setting</h4>We examined the interactions between SBP and frequency of sauna bathing (FSB) with the risk of CVD mortality in a cohort of Caucasian men.<h4>Participants</h4>The Kuopio Ischaemic Heart Disease Study cohort comprising of 2,575 men aged 42-61 years at baseline was employed for this prospective study analysis.<h4>Measurements</h4>Resting blood pressure was measured using a standardized protocol and sauna bathing habits were assessed by a self-administered questionnaire. Systolic blood pressure was categorized as normal and high (<140 and ≥140 mmHg, respectively) and FSB as low and high (defined as ≤ 2 and 3-7 sessions/week, respectively).<h4>Results</h4>A total of 744 CVD deaths were recorded during a median follow-up of 27.8 yr. Comparing high vs normal SBP, the multivariable-adjusted HR (95% CI) for CVD mortality was 1.44 (1.23-1.68). Comparing low vs high FSB, the multivariable-adjusted HR (95% CI) for CVD mortality was 1.24 (1.03-1.51). The associations persisted following mutual adjustment for each exposure. Compared with men with normal SBP-high FSB, high SBP-low FSB was associated with an increased risk of CVD mortality 1.81 (1.39-2.36), wi