This research employed a quasi-experimental design, using pretest-posttest approach, with a control group. A total of 36 participants were recruited through purposive sampling, and divided into three groups: massage therapy, combination therapy (massage and green coconut water), and a control group. Levels of menstrual pain were gauged using the Numeric Rating Scale, while anxiety was measured via the Zung Self rating Anxiety Scale, and ß-endorphin levels were determined through the ELISA test. One-way ANOVA test and repeated ANOVA were applied for a bivariate analysis, while MANCOVA and post hoc ANOVA were utilised for the multivariate analysis.

Discussion of the results revealed that the combination therapy of effleurage massage and green coconut water was more successful than massage therapy alone in combating the symptoms of dysmenorrhea. Specifically, the combination therapy was found to offer a superior reduction in pain and anxiety levels, plus a more noticeable increase in ß-endorphin levels. This suggests that these two methods, when combined, can offer significant benefits to women suffering from menstrual pain.