Primary Dysmenorrhea

Pain management and coping strategies for primary dysmenorrhea: A qualitative study among female nursing students

AIM

Primary dysmenorrhea is a problem that affects both young and adult women, with a significant impact on their daily lives. This pain is primarily managed through the consumption of non-steroidal anti-inflammatories and non-pharmacological approaches such as exercise, acupressure and heat. The present study aimed to describe how Spanish university students manage dysmenorrhea.

DESIGN

Qualitative case study.

METHODS

Nursing students (N = 33) from the region of Andalusia (Spain) participated in focus groups. A purposive sampling method was used, and the data were collected through videoconferencing and subsequently analysed thematically. The guidelines for conducting qualitative studies established by the consolidated criteria for reporting qualitative research (COREQ) and the standards for reporting qualitative research (SRQR) were followed.

RESULTS

Four principal themes were identified: (a) Strategies for pain management; (b) using painkillers; (c) choosing the ideal treatment; (d) non-pharmacological interventions.

CONCLUSIONS

The nursing students experienced difficulties in managing primary dysmenorrhea, they self-medicated, expressed reluctance to seek professional medical advice, used non-pharmacological strategies and seeked advice from other women within their family/social circle.

Assessment of clinical efficacy of traditional Chinese medicine for the management of primary dysmenorrhea in the UK: A protocol of systematic review

BACKGROUND

This study aims to appraise the clinical efficacy of traditional Chinese medicine (TCM) for the management of patients with primary dysmenorrhea (PD) in the UK.

METHODS

We will comprehensively search electronic databases (Cochrane Library, PUBMED/MEDLINE, EMBASE, PsycINFO, AMED, Web of Science, and CNKI) and additional resources for original articles on randomized controlled trials published in English, Chinese, German, Spanish, Korean and Japanese. Outcomes will be the pain intensity, pain duration, menstrual cramps, amount of bleeding, and severity of dysmenorrhea symptoms, quality of life, and adverse events. Two authors will independently check all citations, extract data, and assess study quality. All potential conflicts will be solved through discussion by consulting another experienced author. A narrative synthesis will summarize the characteristics and findings of eligible trials. If it is possible, we will also pool the data and carry out meta-analysis.

RESULTS

The available evidence of the clinical efficacy of TCM for the treatment of PD in UK will be assessed through outcome measurements.

CONCLUSION

The findings of this study will determine whether or not TCM is effective and safe for the treatment of PD in UK. OSF REGISTRATION NUMBER:: osf.io/jyc95.

Efficacy of herbal medicine (cinnamon/fennel/ginger) for primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

To assess the efficacy of herbal medicine (cinnamon/fennel/ginger) for treating primary dysmenorrhea.

METHODS

Relevant studies were searched in multiple databases. The weighted mean difference (WMD) was used as the effect indicator for measurement data, and each effect size was given estimates and 95% confidence intervals (CIs).

RESULTS

Nine studies with 647 patients were selected. Compared with the results in the control group, pain intensity was significantly relieved in the trial group when assessed by the intervention (cinnamon vs. placebo: WMD = 1.815, 95% CI = 1.330-2.301; fennel vs. placebo: WMD = 0.528, 95% CI = 0.119-6.829; ginger vs. placebo: WMD = 2.902, 95% CI = 2.039-3.765), observation period (one cycle: WMD = 2.061, 95% CI = 0.815-3.307; one cycles: WMD = 1.831, 95% CI = 0.973-2.690), and study quality (high quality: WMD = 2.224, 95% CI = 1.488-2.960). Pain duration was significantly shorter in the trial group (cinnamon vs. placebo: WMD = 16.200, 95% CI = 15.271-17.129). No publication bias was observed for either outcome.

CONCLUSIONS

For primary dysmenorrhea, cinnamon/fennel/ginger effectively reduced pain intensity, and cinnamon shortened the duration of pain. Further studies are needed to confirm our results.

Cyclooxygenase-2 in Endometriosis

Endometriosis (EMS) is the most common gynecological disease in women of reproductive age, and it is associated with chronic pelvic pain, dyspareunia and infertility. As a consequence of genetic, immune and environmental factors, endometriotic lesions have high cyclooxygenase (COX)-2 and COX-2-derived prostaglandin E₂ (PGE₂) biosynthesis compared with the normal endometrium. The transcription of the PTGS2 gene for COX-2 is associated with multiple intracellular signals, which converge to cause the activation of mitogen-activated protein kinases (MAPKs). COX-2 expression can be regulated by several factors, such as estrogen, hypoxia, proinflammatory cytokines, environmental pollutants, metabolites and metabolic enzymes, and platelets. High concentrations of COX-2 lead to high cell proliferation, a low level of apoptosis, high invasion, angiogenesis, EMS-related pain and infertility. COX-2-derived PGE₂ performs a crucial function in EMS development by binding to EP2 and EP4 receptors. These basic findings have contributed to COX-2-targeted treatment in EMS, including COX-2 inhibitors, hormone drugs and glycyrrhizin. In this review, we summarize the most recent basic research in detail and provide a short summary of COX-2-targeted treatment.

Effect of chlorella supplementation on systematic symptoms and serum levels of prostaglandins, inflammatory and oxidative markers in women with primary dysmenorrhea

OBJECTIVE

Primary dysmenorrhea is one of the most commonly reported disorders for women that have unfavorable effects on patient's quality of life. Based on the evidences that suggest the anti-inflammatory and analgesic properties of chlorella, this double-blind, randomized, placebo controlled clinical trial aimed to evaluate the effects of Chlorella supplementation on the severity of menstrual pain in a group of young women with primary dysmenorrhea.

STUDY DESIGN

In this clinical trial, 44 girls with primary dysmenorrhea were randomly divided into intervention and control groups. Patients in the intervention group received 1500 mg/day of chlorella as 5 soft gel and the control group received placebo soft gels for eight weeks. Menstrual and food information were collected using a previously validated and published questionnaire. Anthropometric measurements and biochemical parameters including prostaglandin E2 (PGE2), ProstaglandinF2a (PGF2a), high-sensitivity C-reactive protein (hs-CRP) and malondialdehyde (MDA) were assessed at baseline and end of week eight.

RESULTS

In chlorella supplemented group the PGE2, PGF2a, hs-CRP and MDA decreased significantly (P < 0.05). The severity and duration of dysmenorrheal pain were significantly reduced in the intervention group compared to the control group (p < 0.05). Systemic symptoms of dysmenorrhea (fatigue, headache, nausea, vomiting, lack of energy) decreased in the chlorella group (p < 0.05). The mean of menstrual characteristics, anthropometric indices and daily energy and macronutrient intake in both intervention and control groups were not changed significantly.

CONCLUSION

This study showed that chlorella supplementation could decrease the severity of pain and systemic symptoms and improve serum levels of prostaglandins, inflammatory and oxidative markers in women with primary dysmenorrhea.