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Gobba S, Kibone W, Kiguba R. Self-reported gastrointestinal adverse effects of non-steroidal anti-inflammatory drugs in female students with dysmenorrhoea at Makerere University: prevalence, discontinuation and associated factors. a cross sectional study. BMJ Open 2024; 14:e079660. [PMID: 38844394 PMCID: PMC11163621 DOI: 10.1136/bmjopen-2023-079660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 05/07/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Primary dysmenorrhoea occurs in up to 50% of menstruating females. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used therapeutic remedies for dysmenorrhoea in Uganda. However, NSAIDs are associated with a 3-5 fold increase in the risk of gastrointestinal (GI) adverse drug effects. OBJECTIVES We aimed to determine the prevalence and associated factors of self-reported NSAID-related GI adverse effects in female students who use NSAIDs in managing dysmenorrhoea-associated pain at Makerere University. DESIGN A cross-sectional study. SETTING Makerere University's main campus, situated North of Kampala, Uganda. PARTICIPANTS 314 female students pursuing an undergraduate programme at Makerere University and residing in different halls of residence and hostels. OUTCOMES Social demographic data, menstrual history and treatment data. RESULTS Overall, 314 valid responses were received from female students with a median age of 22 years (IQR: 18-29 years). The median age at menarche was 13 years (IQR: 9-18 years). 41% (n=129/314) of the respondents had used medication for dysmenorrhoea and 32% (n=41/129) of whom reported NSAID-associated GI adverse effects with nausea being the most frequently reported (44%, n=18/41)Factors independently associated with GI adverse effects were: age at menarche (p=0.026), duration of menstruation (p=0.030) and use of ibuprofen (p=0.005). Females taking ibuprofen for dysmenorrhoea were about four times as likely to have NSAID-associated GI adverse effects (adjusted OR 3.87, 95% CI 1.51 to 9.91) than those who did not receive ibuprofen. Logistic regression was used to determine factors associated with self-reported adverse effects of NSAIDs among the female students. A p<0.05 was considered statistically significant. CONCLUSION We found a considerably high prevalence of NSAID-related GI adverse effects driven by factors such as age at menarche and ibuprofen use.
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Affiliation(s)
| | | | - Ronald Kiguba
- Pharmacology and Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda
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Chen CX, Rogers SK, Li R, Hinrichs RJ, Fortenberry JD, Carpenter JS. Social Determinants of Health and Dysmenorrhea: A Systematic Review. THE JOURNAL OF PAIN 2024:104574. [PMID: 38788887 DOI: 10.1016/j.jpain.2024.104574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Social determinants of health play a key role in health disparities. Dysmenorrhea is a highly prevalent and impactful public health problem affecting reproductive-age females. Systematically examining social determinants of health in dysmenorrhea is important for identifying gaps in the literature and informing research, policy, and clinical practice to reduce the public health burden associated with dysmenorrhea. The purpose of this systematic review was to synthesize the literature on social determinants of health and dysmenorrhea. The review protocol was prospectively registered. We searched Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Google Scholar through February 2024 using search strategies informed by the literature. Screening of the articles, data extraction, and risk of bias assessment were conducted independently by at least two reviewers on the Covidence platform. Among 2594 unique records screened, 166 met eligibility criteria and were included for data extraction and risk of bias assessment. Evidence suggests traumatic experiences, toxic environmental exposures, female genital mutilation, job-related stress, lack of menstrual education, and low social support were associated with worse dysmenorrhea outcomes. However, evidence was equivocal regarding relationships between dysmenorrhea outcomes and social determinants of health factors, including socioeconomic status, geographical location, race/ethnicity, employment, and religion. Nearly all articles (99.4%) had a high or very high overall risk of bias. Relationships between social determinants of health and dysmenorrhea outcomes were often inconsistent and complicated by heterogeneous study populations and methodologies. More rigorous research examining social determinants of health in dysmenorrhea is needed to inform policy and clinical practice. PERSPECTIVE: This systematic review synthesizes evidence linking social determinants of health and dysmenorrhea. Relationships between SDoH and dysmenorrhea were often equivocal and complicated by heterogeneous study populations and methodologies. We identify directions for future research and SDoH factors that could be addressed clinically (e.g., trauma, menstrual education, occupational stress).
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Affiliation(s)
| | - Sarah K Rogers
- Indiana University Purdue University-Indianapolis School of Science Department of Psychology
| | - Rui Li
- Seattle Children's Research Institute; University of Washington School of Medicine Department of Anesthesiology and Pain Medicine
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Cameron L, Mikocka-Walus A, Sciberras E, Druitt M, Stanley K, Evans S. Menstrual pain in Australian adolescent girls and its impact on regular activities: a population-based cohort analysis based on Longitudinal Study of Australian Children survey data. Med J Aust 2024; 220:466-471. [PMID: 38717022 DOI: 10.5694/mja2.52288] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 11/23/2023] [Indexed: 05/20/2024]
Abstract
OBJECTIVES To determine the proportion of Australian adolescent girls who experience menstrual pain (dysmenorrhea); to assess associations of dysmenorrhea and period pain severity with adolescents missing regular activities because of their periods. STUDY DESIGN Prospective, population-based cohort study; analysis of Longitudinal Study of Australian Children (LSAC) survey data. SETTING, PARTICIPANTS Female adolescents in the nationally representative cross-sequential sample of Australian children recruited in 2004 for the Kinder cohort (aged 4-5 years at enrolment). Survey data from waves 6 (mean age 14 years), wave 7 (16 years) and wave 8 (18 years) were analysed. MAIN OUTCOME MEASURES Severity of period pain during the preceding three months (very, quite, a little, or not at all painful); number of activity types missed because of periods; relationship between missing activities and period pain severity. RESULTS Of the 1835 participating female members of the LSAC Kinder cohort at waves 6 to 8, 1600 (87%) responded to questions about menstruation during at least one of waves 6 to 8 of data collection. At wave 6 (14 years), 227 of 644 respondents (35%) reported dysmenorrhea, 675 of 1341 (50%) at wave 6 (16 years), and 518 of 1115 (46%) at wave 8 (18 years). Of the 366 participants who reported period pain severity at all three waves, 137 reported no dysmenorrhea at all three waves (37%), 66 reported dysmenorrhea at all three waves (18%), 89 reported increasing period pain over time (24%), and 38 reported declining pain (10%). At wave 6, 223 of 647 participants reported missing at least one activity because of their periods (34%), 454 of 1341 at wave 7 (34%), and 344 of 1111 at wave 8 (31%). Of the participants who experienced very painful periods, 72% (wave 6), 63% (wave 7), and 65% (wave 8) missed at least one activity type because of their periods, as did 45% (wave 6), 36% (wave 7), and 40% (wave 8) of those who experienced quite painful periods. CONCLUSIONS A large proportion of adolescent girls in Australia experience period pain that affects their engagement in regular activities, including school attendance. Recognising adolescent period pain is important not only for enhancing their immediate quality of life with appropriate support and interventions, but also as part of early screening for chronic health conditions such as endometriosis.
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Affiliation(s)
- Lauren Cameron
- Deakin University, Melbourne, VIC
- Monash University, Melbourne, VIC
| | | | | | - Marilla Druitt
- Deakin University, Geelong, VIC
- University Hospital Geelong, Geelong, VIC
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Mantovan SGDM, de Arruda GT, Da Roza T, da Silva BI, Avila MA, da Luz SCT. Translation, cross-cultural adaptation, and measurement properties of the dysmenorrhea symptom interference (DSI) scale-Brazilian version. Braz J Phys Ther 2024; 28:101065. [PMID: 38848625 DOI: 10.1016/j.bjpt.2024.101065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 04/22/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The Dysmenorrhea Symptom Interference (DSI) scale is a reliable, valid, and responsive tool to assess the interference of menstrual pain in the physical, mental, and social activities of women. OBJECTIVE To translate and cross-culturally adapt the DSI scale into Brazilian-Portuguese (DSI-BrPt) and investigate the measurement properties of this version in on- and off-menses versions. METHODS The original (United States) scale was translated and culturally adapted following existing guidelines. Measurement properties of the DSI-BrPt were investigated in 1387 women with dysmenorrhea. Reliability was analyzed via intraclass correlation coefficients (ICC) and test-retest reliability. Furthermore, structural validity, internal consistency (Cronbach's alpha), cross-cultural validity, construct validity (correlation with WHODAS 2.0 and SPS-6 scores questionnaires), and floor and ceiling effects were determined. RESULTS No significant adaptations were needed during the translation process of the DSI-BrPt. The values of Cronbach's α were adequate (α ≥0.87) for the unidimensional scale. The test-retest reliability was considered adequate (ICC >0.78) and there was no systematic error for both on-menses and off-menses versions. Moreover, the DSI had a positive and strong correlation with WHODAS 2.0. There were no floor and ceiling effects neither for the total sample, nor among off-menses, or on-menses women. CONCLUSION The DSI-BrPt scale has been translated and cross-culturally adapted successfully. The DSI-BrPt scale presented adequate measurement properties. The scale is valid and reliable, and, therefore, an adequate tool for monitoring dysmenorrhea symptoms in Brazilian women during and between menses.
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Affiliation(s)
- Sara Giovanna de Melo Mantovan
- Department of Physical Therapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina, UDESC, Florianópolis, SC, Brazil
| | - Guilherme Tavares de Arruda
- Study Group on Chronic Pain (NEDoC), Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade Federal de São CarlosUFSCar, São Carlos, SP, Brazil
| | - Thuane Da Roza
- Department of Physical Therapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina, UDESC, Florianópolis, SC, Brazil
| | - Barbara Inácio da Silva
- Study Group on Chronic Pain (NEDoC), Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade Federal de São CarlosUFSCar, São Carlos, SP, Brazil
| | - Mariana Arias Avila
- Study Group on Chronic Pain (NEDoC), Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade Federal de São CarlosUFSCar, São Carlos, SP, Brazil.
| | - Soraia Cristina Tonon da Luz
- Department of Physical Therapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina, UDESC, Florianópolis, SC, Brazil
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de Arruda GT, Driusso P, de Godoy AG, Rodrigues JC, Avila MA. Presenteeism and associated factors among women with menstrual symptoms. Arch Gynecol Obstet 2024; 309:2071-2077. [PMID: 38502189 DOI: 10.1007/s00404-024-07425-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 02/10/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE Menstrual characteristics can affect a woman's productivity at work and college, but studies in a general population of adult women are scarce. In addition, it is important to know which menstrual symptoms are most associated with presenteeism in women to promote specific health actions. The present study aimed to assess menstrual symptoms associated with presenteeism in adult women. METHODS Online cross-sectional study in which menstrual characteristics, including menstrual flow, age of menarche, menstrual pain and cycle duration were assessed by a self-report questionnaire. The menstrual pain intensity was assessed by Numerical Rating Scale, and the presenteeism, by the Stanford Presenteeism Scale-6 (SPS-6). Women were divided in two groups, with and without presenteeism, based on the SPS-6 cutoff point. Data were analyzed by binary logistic regression and presented as odds ratios (OR). RESULTS Among the 430 women who participated in the study, 44.2% were classified as with presenteeism. Women with severe menstrual flow were more likely to have presenteeism (OR = 2.12) compared with women with mild and moderate menstrual flow. The higher menstrual pain intensity the higher the chances of a woman presenting with presenteeism (OR = 1.29). CONCLUSIONS These menstrual characteristics (intensity of menstrual flow and menstrual pain) seem to affect women's productivity at work and/or college, and should be assessed in research and clinical practice. Thus, public policies on women's health can be carried out based on these results.
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Affiliation(s)
- Guilherme Tavares de Arruda
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Universidade Federal de São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, ZIP Code 13565-905, Brazil
| | - Patricia Driusso
- Laboratory of Research on Women's Health (LAMU), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Amanda Garcia de Godoy
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Universidade Federal de São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, ZIP Code 13565-905, Brazil
| | - Jéssica Cordeiro Rodrigues
- Laboratory of Research on Women's Health (LAMU), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Mariana Arias Avila
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Universidade Federal de São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, ZIP Code 13565-905, Brazil.
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Oksuz Yalvac C, Akdağ Topal C, Boztepe H. A comprehensive investigation of biopsychosocial determinants influencing primary dysmenorrhea among university students. Women Health 2024; 64:392-403. [PMID: 38720420 DOI: 10.1080/03630242.2024.2349558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 04/24/2024] [Indexed: 05/29/2024]
Abstract
Dysmenorrhea, characterized by pain and related symptoms, significantly impacts women's quality of life in work and education, prompting a comprehensive evaluation of associated factors. The objective of this study was to utilize structural equation modeling (SEM) to analyze and assess the biopsychosocial factors influencing dysmenorrhea among university students. Three hundred and thirty-nine university students were included in this cross-sectional descriptive study. Data were collected using the Participant Information Form, the Beck Anxiety Scale (BAS), the Beck Depression Scale (BDS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Adverse Childhood Experiences Scale (ACES), the Pain Catastrophizing Scale (PCS) and the Visual Analogue Scale (VAS). It was determined that the variables of pain onset (t = 3.24, p < .05) and age at menarche (t = -2.16, p < .05) showed a significant relationship with the model. The variables of the PCS (t = 16.87, p < .001), BDS (t = 3.06, p < .05), and BAS (t = 5.13, p < .001) showed a significant relationship with the model. Social factors in the model were examined, and a family history of dysmenorrhea and the ACES variables did not contribute significantly to the model (p > .05). The study indicates primary dysmenorrhea influenced by biological and psychological factors. Nurses should conduct holistic assessments and provide comprehensive care for affected women.
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Affiliation(s)
| | - Cansu Akdağ Topal
- Faculty of Health Sciences, Nursing Department, Baskent University, Ankara, Turkey
| | - Handan Boztepe
- Faculty of Health Sciences, Nursing Department, Atilim University, Ankara, Türkiye
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Tu FF, Hellman KM, Darnell SE, Harber KA, Bohnert AM, Singh L, Walker LS. A multidimensional appraisal of early menstrual pain experience. Am J Obstet Gynecol 2024; 230:550.e1-550.e10. [PMID: 38290643 PMCID: PMC11165568 DOI: 10.1016/j.ajog.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/01/2023] [Accepted: 01/21/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Symptomatic dysmenorrhea is a global problem, affecting more than 40% of menstruating persons. Cross-sectional studies have implicated psychosocial, biological, and sensory factors in dysmenorrhea but the mechanisms are not fully understood. Only a few prospective longitudinal studies have evaluated such factors in relation to the emergence and course of dysmenorrhea at menarche. OBJECTIVE This study aimed to describe the initial menstruation experience and to evaluate the association of premenarchal psychosocial and sensory factors with the intensity of dysmenorrhea during the period in the fourth month. STUDY DESIGN This was a prospective cohort study of adolescents who completed premenarchal assessments and postmenarchal daily menstrual diaries for their first (n=149) and fourth month periods (n=114). They were recruited shortly before menarche and completed baseline assessments, including psychosocial questionnaires and experimental pain sensitivity (pressure testing, bladder provocation), and their parents completed related pain questionnaires. The relation between the hypothesized premenarchal factors and month 4 dysmenorrhea intensity was evaluated using Kruskal-Wallis and chi-square tests for low (<3 on a 0-10 scale) vs higher (≥3) menstrual pain groups based on maximal pain ratings recorded in a daily diary. RESULTS Low levels of dysmenorrhea characterized the first (median, 1; interquartile range, 0-2) and fourth month periods (1; 0-3). Maximal pain ratings increased from the first to the fourth period (3; 1-5 vs 4; 1-6; P=.007). The distribution of dysmenorrhea was multimodal at month 4 with 31.6% of the participants having low levels of maximal pain (1; 0-1) and 68.4% having higher levels (5; 4-6; Hartigan's dip test P<.001). The baseline demographic, psychosocial, and parental pain characteristics were not associated with the development of worse dysmenorrhea. The baseline experimental pain sensitivity, based on pressure pain thresholds, did not differ between the low (15.7 N; 12.5-22.3) and higher (15.0 N; 10.9-21.4]) level dysmenorrhea groups. Baseline bladder pain at first urge also did not differ (low, 6; 0-20 vs higher, 7; 0-19). CONCLUSION By their fourth month period, two-thirds of adolescents fell into the higher group for maximal dysmenorrhea, half reported some related impairments in physical activity, and one-seventh reported some related school absence. Premenarchal factors (experimental pain sensitivity, psychosocial profile, parental pain experience) linked to chronic pain emergence in the adult literature did not predict dysmenorrhea intensity, suggesting the dominant factor at menarche may be peripheral afferent activation. Further research is needed to understand the evolution of psychosocial and sensory mechanisms in the development and course of dysmenorrhea.
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Affiliation(s)
- Frank F Tu
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL; Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL.
| | - Kevin M Hellman
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL; Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL
| | - Sarah E Darnell
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL
| | - Kaela A Harber
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL
| | - Amy M Bohnert
- Department of Psychology, Loyola University Chicago, Chicago, IL
| | - Lavisha Singh
- Department of Biostatistics, NorthShore University HealthSystem, Evanston, IL
| | - Lynn S Walker
- Department of Psychology, Vanderbilt University, Nashville, TN
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Yáñez-Sarmiento A, Kiel L, Kaufman R, Abioye O, Florez N. More than Cramps in Scrubs: Exploring Dysmenorrhea among Women Healthcare Workers. Int J Womens Health 2024; 16:749-753. [PMID: 38706690 PMCID: PMC11069112 DOI: 10.2147/ijwh.s452210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/29/2024] [Indexed: 05/07/2024] Open
Abstract
Though understudied, dysmenorrhea, a painful cramping sensation occurring near and during menses, is the most prevalent gynecological disorder among women of reproductive age, affecting 50-90% of the global population. Contributing factors of this disorder include poor medical assessment, lack of consciousness, gender bias, moderate to high levels of stress, and depression and anxiety. Among school students and healthcare trainees, dysmenorrhea contributes to short-term absenteeism, lower productivity, creativity, and job performance. Among medical trainees, dysmenorrhea has been found to impact daily activities to a disabling degree in nearly one third of instances, resulting in difficulties in relationships and even self-isolation. Dysmenorrhea further produces substantial global economic losses and higher healthcare costs. To begin to alleviate the extensive issue of dysmenorrhea, we must increase awareness to fully understand its prevalence, risk factors, and potential for effective, affordable, and accessible treatments. Concurrently, our clinical environment must adopt a standard description and assessment tool to prevent, measure, and monitor dysmenorrhea, while on a global scale, we must develop and widely disseminate nationwide labor regulations that address the workforce impact due to the effects of dysmenorrhea.
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Affiliation(s)
- Anamaría Yáñez-Sarmiento
- Department of Oncology, Universidad Icesi, Perímetro Urbano Santiago de Cali, Valle del Cauca, Colombia
| | - Lauren Kiel
- Department of Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rebekah Kaufman
- Department of Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Oyepeju Abioye
- Department of Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Narjust Florez
- Department of Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Mardon AK, Whitaker L, Farooqi T, Girling J, Henry C, Ee C, Tewhaiti-Smith J, Armour M. Investigational drugs for the treatment of dysmenorrhea. Expert Opin Investig Drugs 2024; 33:347-357. [PMID: 38436301 DOI: 10.1080/13543784.2024.2326627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Dysmenorrhea is the most common cause of gynecological pain among women that has considerable impact on quality of life and psychosocial wellbeing. Non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies are most commonly used to treat dysmenorrhea. However, given these drugs are often associated with bothersome side effects and are less effective when there is an underlying cause contributing to dysmenorrhea (e.g. endometriosis), a patient-centered approach to managing dysmenorrhea is important. Various new drugs are currently being investigated for the treatment of primary and secondary dysmenorrhea. AREAS COVERED This review provides an updated overview on new therapeutic targets and investigational drugs for the treatment of primary and secondary dysmenorrhea. The authors describe the clinical development and implications of these drugs. EXPERT OPINION Among the investigative drugs discussed in this review, anti-inflammatories show the most promising results for the treatment of dysmenorrhea. However, given some trials have considerable methodological limitations, many drugs cannot be currently recommended. Research focused on understanding the mechanisms involved in menstruation and its associated symptoms will be important to identify new therapeutic targets for dysmenorrhea. Further robust clinical trials are required to better understand the efficacy and safety of investigational drugs for treating primary and secondary dysmenorrhea.
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Affiliation(s)
- Amelia K Mardon
- NICM Health Research Institute, Western Sydney University, NSW Australia; IIMPACT in Health, University of South Australia, Australia
| | - Lucy Whitaker
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, UK
| | - Toobah Farooqi
- NICM Health Research Institute, Western Sydney University NSW, Australia
| | - Jane Girling
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Claire Henry
- Department of Surgery & Anaesthesia, University of Otago Wellington Aotearoa, New Zealand
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Australia
| | | | - Mike Armour
- Reproductive Health, NICM Health Research Institute, Western Sydney University, Australia
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van Uden BCD, Timmermans A, van den Boogaard E, Motazedi E, Vrijkotte TGM. Determinants of dysmenorrhoea among female adolescents: results from a community-based cohort study in Amsterdam. Reprod Biomed Online 2024; 48:103700. [PMID: 38367594 DOI: 10.1016/j.rbmo.2023.103700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/17/2023] [Accepted: 11/06/2023] [Indexed: 02/19/2024]
Abstract
RESEARCH QUESTION What is the contribution of sociodemographic, psychosocial, lifestyle and reproductive factors up to the age of 11-12 years to the occurrence of dysmenorrhoea at age 15-16 years within the Amsterdam Born Children and their Development (ABCD) study? DESIGN Data of 1038 female adolescents were used. Participants' baseline characteristics were obtained using self-reported questionnaires up to the age of 11-12 years, as well as the obstetric information of their mothers during pregnancy. Dysmenorrhoea was assessed at the age of 15-16 years, and was deemed to be present if an adolescent reported menstrual abdominal and/or back pain and therefore took medication and/or hormonal contraception. Using a backward selection approach, potential determinants of dysmenorrhoea were selected and multivariable associations were determined. RESULTS The overall prevalence of dysmenorrhoea was 49.5% among the participants. Intake of 3-4.5 sugar-sweetened beverages/day (P = 0.035) and higher gynaecological age (i.e. years since menarche) (P < 0.001) were significantly associated with higher occurrence of dysmenorrhoea in the final model, which explained 8.1% of the total variance in the occurrence of dysmenorrhoea. No significant associations were found between the occurrence of dysmenorrhoea and sociodemographic or psychosocial factors. CONCLUSIONS This investigation of various potential risk factors for dysmenorrhoea suggests that diet and reproductive factors are particularly important predictors of the occurrence of dysmenorrhoea among young adolescents. Specifically, intake of sugar-sweetened beverages and higher gynaecological age were predictive of the occurrence of dysmenorrhoea. Other lifestyle factors were also identified as possible risk factors. Using this knowledge, effective strategies can be developed to reduce the burden of dysmenorrhoea among adolescents, and to provide appropriate care for those suffering from the condition.
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Affiliation(s)
- B C D van Uden
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - A Timmermans
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - E van den Boogaard
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - E Motazedi
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - T G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
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Avila MA, de Arruda GT, de Godoy AG, Driusso P. Translation, cross-cultural adaptation to Brazilian Portuguese and measurement properties of the WaLIDD score. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo16. [PMID: 38765510 PMCID: PMC11075383 DOI: 10.61622/rbgo/2024ao16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 08/08/2023] [Indexed: 05/22/2024] Open
Abstract
Objective Dysmenorrhea is the pain related to menstruation; to screen for the symptoms, a working ability, location, intensity of days of pain, and dysmenorrhea (WaLIDD) score was created. The purpose of this work was to culturally adapt and assess the measurement properties of the WaLIDD score for dysmenorrhea in Brazilian women. Methods In this cross-sectional online study, we evaluated women with and without dysmenorrhea. Criterion validity and construct validity were assessed, respectively, by the Receiver Operator Characteristic (ROC) curve and correlations with the bodily pain and social functioning domains of medical outcomes study 36-item short-form health survey (SF-36), self-report of absenteeism and Stanford Presenteeism Scale for presenteeism. Test-retest reliability and measurement errors were assessed, respectively, by intraclass correlation coefficient (ICC) and Bland and Altman Graph. Results 430 women completed the test, 238 (55.4%) women had dysmenorrhea, and 199 (46.3%) answered the questionnaire twice for the retest. The cutoff points ≥4, ≥5, and ≥5 could discriminate between women with and without dysmenorrhea, absenteeism, and presenteeism related to dysmenorrhea, respectively. Correlations between SF-36 - pain and social functioning domains and WaLIDD score were weak to strong and negative. For WaLIDD total Score, ICC was 0.95 and the limits of agreement were -1.54 and 1.62. Conclusion WaLIDD score is a short, valid and reliable instrument to screen and predict dysmenorrhea and could predict absenteeism and presenteeism related to dysmenorrhea in Brazilian women.
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Affiliation(s)
- Mariana Arias Avila
- Universidade Federal de São CarlosSão CarlosSPBrazilUniversidade Federal de São Carlos, São Carlos, SP, Brazil.
| | - Guilherme Tavares de Arruda
- Universidade Federal de São CarlosSão CarlosSPBrazilUniversidade Federal de São Carlos, São Carlos, SP, Brazil.
| | - Amanda Garcia de Godoy
- Universidade Federal de São CarlosSão CarlosSPBrazilUniversidade Federal de São Carlos, São Carlos, SP, Brazil.
| | - Patricia Driusso
- Universidade Federal de São CarlosSão CarlosSPBrazilUniversidade Federal de São Carlos, São Carlos, SP, Brazil.
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Ghandour R, Hammoudeh W, Stigum H, Giacaman R, Fjeld H, Holmboe-Ottesen G. The hidden burden of dysmenorrhea among adolescent girls in Palestine refugee camps: a focus on well-being and academic performance. BMC Public Health 2024; 24:726. [PMID: 38448826 PMCID: PMC10918951 DOI: 10.1186/s12889-024-18219-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Dysmenorrhea (painful menstruation) is a condition that may have a profound effect on adolescent girls' health status and well-being. It can impede their engagement in daily activities and hamper their regular school attendance. This study aims to explore the relationship between dysmenorrhea, well-being, and academic performance among adolescent girls living in Palestine refugee camps in the West Bank and Jordan. METHODS We conducted a household survey between June and September 2019, with a total sample of 2737 adolescent girls 15 to 18 years old. Dysmenorrhea severity was assessed using the Working Ability, Location, Intensity, Duration of pain Dysmenorrhea scale (WaLIDD). The WHO-5 scale was used to evaluate the girls' overall well-being. Menstrual academic disruption (MAD) was measured using a self-reported scale. Multiple linear regression models were employed to evaluate the association between dysmenorrhea, well-being, and academic performance. Directed Acyclic Graphs (DAGs) were employed to identify variables for control in regression models. RESULTS The mean dysmenorrhea score was 6.6 ± 2.6, with 37.9% and 41.2% expressing moderate and severe symptoms, respectively. The mean WHO-5 score was 58.7 ± 25.1, and 34.9% reported a low well-being status. The mean MAD score was 3.1 ± 3.3. 26% reported missing school due to dysmenorrhea, 36% said dysmenorrhea impacted their ability to concentrate, and 39% were unable to study for tests, and complete homework. The first regression analysis showed a reduction of 1.45 units in WHO-5 score for each unit increase in dysmenorrhea. The second regression analysis showed a non-linear increase in MAD score for increasing dysmenorrhea. For each dysmenorrhea score less than 4 (mild) there was a modest increase in MAD scores (coefficient 0.08, p-value = 0.006), and for each dysmenorrhea score above 4 there was a stronger increase in MAD scores (coefficient 0.95, p < 0.001). CONCLUSION Dysmenorrhea poses significant challenges to the well-being and academic performance of adolescent girls living in Palestine refugee camps. Collaborative efforts and multifaceted approaches are crucial to address dysmenorrhea effectively. This involves research, targeted interventions, culturally sensitive strategies, and fostering a supportive environment that empowers girls to thrive academically and beyond.
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Affiliation(s)
- Rula Ghandour
- Institute of Community and Public Health, Birzeit University, Occupied Palestinian territory (oPt) Said Khoury Building for Development Studies, Birzeit, P.O. Box 14, Palestine.
- Department of Community Medicine and Global Health, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway.
| | - Weeam Hammoudeh
- Institute of Community and Public Health, Birzeit University, Occupied Palestinian territory (oPt) Said Khoury Building for Development Studies, Birzeit, P.O. Box 14, Palestine
| | - Hein Stigum
- Department of Community Medicine and Global Health, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway
| | - Rita Giacaman
- Institute of Community and Public Health, Birzeit University, Occupied Palestinian territory (oPt) Said Khoury Building for Development Studies, Birzeit, P.O. Box 14, Palestine
| | - Heidi Fjeld
- Department of Community Medicine and Global Health, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway
| | - Gerd Holmboe-Ottesen
- Department of Community Medicine and Global Health, University of Oslo, Postboks 1130 Blindern, 0318, Oslo, Norway
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Margueritte F, Fritel X, Serfaty A, Coeuret-Pellicer M, Fauconnier A. Screening women in young adulthood for disabling dysmenorrhoea: a nationwide cross-sectional study from the CONSTANCES cohort. Reprod Biomed Online 2024; 49:103861. [PMID: 38735232 DOI: 10.1016/j.rbmo.2024.103861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/13/2024] [Accepted: 01/30/2024] [Indexed: 05/14/2024]
Abstract
RESEARCH QUESTION How do different warning indicators help to identify disabling dysmenorrhoea among women in young adulthood? DESIGN A nationwide cross-sectional study of women aged 18-25 years from the CONSTANCES cohort was constructed. Disability was assessed with the Global Activity Limitation Indicator question 'For the past 6 months, have you been limited in routine activities?Yes, severely limited/Yes, limited/ No, not limited'. Dysmenorrhoea pain intensity and other chronic pelvic pain symptoms (dyspareunia and non-menstrual pain) were evaluated according to questions from a specific questionnaire. Probability of disability was estimated using a logistic prediction model according to dysmenorrhoea intensity, other indicators of pelvic pain symptoms and other obvious covariates. The results of the predictive model of disabling dysmenorrhoea were presented on a nomogram. RESULTS Among 6377 women, the rate of disability was estimated at 7.5%. Increased intensity of dysmenorrhoea (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04-1.13), increased frequency of dyspareunia (from OR 1.69, 95% CI 1.33-2.14 up to OR 3.41, 95% CI 2.16-5.38) non-menstrual chronic pelvic pain (OR 1.75, 95% CI 1.40-2.19), body mass index over 25 kg/m2 (OR 1.45, 95% CI 1.17-1.80) and non-use of the hormonal contraceptive pill (OR 1.29, 95% CI 1.05-1.59) were significantly associated with disability. According to the nomogram, a predicted probability of 15% or more could be chosen as a threshold. This represents almost 4.6% of young women in this sample being classified at risk of disabling dysmenorrhoea. CONCLUSIONS Dysmenorrhoea pain intensity and associated pelvic pain symptoms are warning indicators that can be measured to help screen young women who may suffer from disabling dysmenorrhoea.
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Affiliation(s)
- François Margueritte
- Team RISCQ 'Clinical risk and security on women's health and perinatal health', Université Paris-Saclay, UVSQ, Montigny-le-Bretonneux, France; Primary Care and Prevention Team, CESP, INSERM, Villejuif, France; Department of Gynecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France.
| | - Xavier Fritel
- Department of Obstetrics and Gynaecology, La Miletrie University Hospital, Poitiers, France; INSERM CIC 1402, Poitiers University, Poitiers, France
| | - Annie Serfaty
- Team RISCQ 'Clinical risk and security on women's health and perinatal health', Université Paris-Saclay, UVSQ, Montigny-le-Bretonneux, France; Department of Medical Information, Territorial Hospital Group (GHT), Aisne-Nord/Haute-Somme, Saint Quentin Hospital, Aisne, France
| | - Mireille Coeuret-Pellicer
- Population-Based Epidemiological Cohorts, UMS 11, Paris-Saclay University, Versailles St Quentin University, Université de Paris, INSERM, Villejuif, France
| | - Arnaud Fauconnier
- Team RISCQ 'Clinical risk and security on women's health and perinatal health', Université Paris-Saclay, UVSQ, Montigny-le-Bretonneux, France; Department of Gynecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France
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Dai Y, Luo H, Zhu L, Yang W, Xiang H, Shi Q, Jin P. Dysmenorrhea pattern in adolescences informing adult endometriosis. BMC Public Health 2024; 24:373. [PMID: 38317119 PMCID: PMC10840152 DOI: 10.1186/s12889-024-17825-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Endometriosis (EMs) is a chronic and progressive disease that, if diagnosed late, can lead to infertility and deep infiltrating endometriosis (DIE). Dysmenorrhea is the most prominent symptom of EMs. However, limited research exists on the specific correlation between dysmenorrhea patterns and EMs. Early prevention of EMs is essential to effectively manage the progression of the disease, and is best detected during adolescence. Our objective was to associate the development of EMs with dysmenorrhea patterns during adolescence and quantify the risk of adult EMs for adolescent girls, with the aim of supporting primary intervention strategy planning. METHODS This case-control study examined predictors for adult EMs based on dysmenorrhea patterns in adolescents. We collected 1,287 cases of 641 EMs and 646 healthy females regarding their basic demographic information, adolescent menstrual characteristics, adolescent dysmenorrheal patterns, and adolescent lifestyles. Age-matching (1-to-1) was employed to control for the confounding effect of age between the groups. Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression models were utilized to identify predictors for adult EMs. The predictive value of the model was evaluated using the area under the receiver operating characteristic curve (AUC) and the C-index, while Hosmer-Lemeshow Test assessed the goodness of fit of the model. Data from one additional cohort in Shenzhen hospitalized with EMs were used to external validation were analyzed. RESULTS Individuals who always experienced dysmenorrhea had a risk of adult endometriosis 18.874 (OR = 18.874; 95%CI = 10.309-34.555) times higher than those occasional dysmenorrhea, The risk of developing EMs was 5.257 times higher in those who experienced dysmenorrhea more than 12 months after menarche than in those who experienced dysmenorrhea less than 6 months after menarche (OR = 5.257, 95% CI = 3.343-8.266), AUC in the external validation cohort was 0.794(95%CI: 0.741-0.847). We further found that high-intensity physical activity and sun-sensitive skin of burning were influential factors in high-frequency dysmenorrhea. The AUC value for the internal evaluation of the model was 0.812 and the AUC value for the external validation was 0.794. CONCLUSION Our findings revealed that the frequency of dysmenorrhea during adolescence contributed to the development of adult endometriosis. The frequency and onset of dysmenorrhea in adolescence were promising predictors for adult EMs. Both internal and external validation proved the model's good predictive ability. TRIAL REGISTRATION http://www.chictr.org.cn/ , TRN: ChicTR2200060429, date of registration: 2022/06/01, retrospectively registered.
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Affiliation(s)
- Yu Dai
- Department of Gynecology, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Huangjin Luo
- Department of Gynecology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China
| | - Litong Zhu
- Department of Gynecology, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Weichun Yang
- Department of Gynecology, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Haishan Xiang
- Department of Gynecology, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Qiuling Shi
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People's Republic of China.
| | - Ping Jin
- Department of Gynecology, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People's Republic of China.
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Medina-Perucha L, López-Jiménez T, Pujolar-Díaz G, Martínez-Bueno C, Munrós-Feliu J, Valls-Llobet C, Jacques-Aviñó C, Holst AS, Pinzón-Sanabria D, Vicente-Hernández MM, García-Egea A, Berenguera A. Menstrual characteristics and associations with sociodemographic factors and self-rated health in Spain: a cross-sectional study. BMC Womens Health 2024; 24:88. [PMID: 38310222 PMCID: PMC10838449 DOI: 10.1186/s12905-023-02840-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/12/2023] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Evidence on how menstrual characteristics may differ based on socioeconomic factors and self-rated health is significantly scarce. The main aim of this study was to investigate the associations between menstrual characteristics, sociodemographic factors and self-rated health among women and people who menstruate (PWM) aged 18-55 in Spain. METHODS This cross-sectional study includes data from an online survey collected in March-July 2021 across Spain. Descriptive statistical analyses and multivariate logistic regression models were performed. RESULTS The analyses included a total of 19,358 women and PWM. Mean age at menarche was 12.4 (SD = 1.5). While 20.3% of our participants experienced a menstrual abundance over 80 ml, 64.1% reported having menstrual blood clots; 6.4% menstruated for longer than 7 days. 17.0% had menstrual cycles that were shorter than 21 days or longer than 35 days. Reports of moderate (46.3%) and high (22.7%) intensity menstrual pain were common. 68.2% of our participants experienced premenstrual symptoms in all or most cycles. The odds for lighter menstrual flow, shorter bleeding days and menstrual cycles were higher as age increased, and amongst participants with less educational attainment. Caregivers presented higher odds for abundant menstrual flow and longer menstruations. Reporting financial constraints and a poorer self-rated health were risk factors for abundant menstrual flow, menstrual blood clots, shorter/longer menstruations and menstrual cycles, premenstrual symptoms, moderate and intense menstrual pain. CONCLUSIONS This study suggests that age, educational attainment, caregiving, experiencing financial hardship and a poorer self-rated health may shape or mediate menstrual characteristics. It thus highlights the need to investigate and address social inequities of health in menstrual research.
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Affiliation(s)
- Laura Medina-Perucha
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
- Universitat Autonoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain.
| | - Tomàs López-Jiménez
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autonoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain
| | - Georgina Pujolar-Díaz
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autonoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain
| | - Cristina Martínez-Bueno
- Servei d'Atenció a la Salut Sexual i Reproductiva (ASSIR). Direcció Assistencial d'Atenció Primària, Institut Català de la Salut, Barcelona, Spain
- Sexual and Reproductive Health Care Research Group (GRASSIR), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Jordina Munrós-Feliu
- Sexual and Reproductive Health Care Research Group (GRASSIR), Barcelona, Spain
- Atenció a la Salut Sexual i Reproductiva (ASSIR) Muntanya/La Mina, Institut Català de la Salut, Barcelona, Spain
| | | | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autonoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain
| | - Anna Sofie Holst
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | | | | - Andrea García-Egea
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autonoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain
| | - Anna Berenguera
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autonoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Spain
- Departament d'Infermeria, Universitat de Girona, Girona, Spain
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16
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Defert C, Cousin I, Marchand ICL, Burgazzi C, Pabic EL, Arnaud AP. Dysmenorrhea among 12-year-old teenagers from different socioeconomic backgrounds. Arch Pediatr 2024; 31:141-147. [PMID: 38267345 DOI: 10.1016/j.arcped.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/16/2023] [Accepted: 09/17/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND The age of menarche has been gradually declining since the end of the 20th century. Few studies have been carried out about dysmenorrhea in Europe and they mainly included girls over the age of 15 years. METHODS We conducted an observational study among sixth-grade schoolgirls (usually 11-12 years) during the 2020 academic year in 72 randomly selected public schools in a French region (approval number #20.94). RESULTS Among 1712 girls interviewed, 257 (23 %) had reached menarche. Overall, 83 % of these teenagers had dysmenorrhea. Symptoms were reported to occur since the first periods in 59 % of the girls. School absenteeism was positively correlated with severe abdominal pain (p = 0.001). Median age at menarche was 11 years (10.7-11.5). Periods lasted less than 3 days, 3-8 days, and more than 8 days in, respectively, 18 %, 70 %, and 7 % of the girls. Symptoms were significantly more frequent and more severe in the urban group than the rural group (p = 0.005). Symptoms were abdominal pain (70 %), fatigue (48 %), difficulty in concentrating (26 %), headache (25 %), digestive disorders (16 %), and breast discomfort (11 %). Of the girls with dysmenorrhea, 61 % took painkillers; 10 % were uncomfortable despite taking painkillers. Sport exemption was more frequent in the urban group (p = 0.003) and among girls with severe abdominal pain (p = 0.001). CONCLUSIONS The duration of the menstrual cycle was similar between the various socioeconomic groups, but symptoms and ways of coping were significantly different. Dysmenorrhea is definitely an issue that has to be raised with teenagers as soon as menarche occurs or even before that. Easy access to skilled health practitioners should be widespread.
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Affiliation(s)
- Coralie Defert
- Department of Pediatric Surgery, University Hospital of Rennes, Brittany, France.
| | - Ianis Cousin
- Department of Pediatric Surgery, University Hospital of Brest, Brittany, France
| | | | - Catherine Burgazzi
- School Health Service, Board Education of the Academy of Brittany, Rennes, France
| | | | - Alexis P Arnaud
- Department of Pediatric Surgery, University Hospital of Rennes, Brittany, France
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Kovács Z, Atombosiye E, Hegyi G, Szőke H. The Effect of Aviva Exercise Intervention on Pain Level and Body Awareness in Women with Primary Dysmenorrhea. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:184. [PMID: 38276063 PMCID: PMC10821191 DOI: 10.3390/medicina60010184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
Background and Objective: Primary dysmenorrhea (PD) is one of the most common clinical disorders in women of reproductive age. Our aim was to examine whether a twice-weekly thirty-minute Aviva exercise intervention could result in improvements in pain level and body awareness in patients with PD. Materials and Methods: In our prospective observational trial, the observation period included two consecutive menstrual cycles and the period of the next menstrual bleeding. The first menstrual bleeding period was the first measurement time (T1), the second was the second measurement time (T2), and the third was the third measurement time (T3) in a total of 78 volunteers. The primary endpoint was the change in the level of menstrual pain according to the Numeric Rating Scale (NRS) questionnaire between the intervention group (IG) and the control group (CG) at T1, T2, and T3. In this study, the secondary outcomes were the differences between the IG and CG regarding the different subscales of the Hungarian version of the Body Awareness Questionnaire (BAQ-H) at T1, T2, and T3; the Borg scale results of the IG; and adherence to the intervention. Statistical tests such as independent-sample t-tests, chi-square tests, Pearson's linear correlation coefficient, and repeated-measure ANCOVA were used for the analyses. Results: In total, 78 volunteers were enrolled: 40 persons in the IG and 38 in the CG. There was a significant change in the level of menstruation pain according to the NRS questionnaire between the IG and CG (p < 0.001). There was no significant difference between the IG and CG regarding the different subscales of the BAQ-H. Only in the case of the "Note responses or changes in body process" subscale of the BAQ-H was there a trend-like effect from the Aviva exercises (p = 0.086). Conclusions: The Aviva exercise could contribute to pain relief from PD. Regarding body awareness, no significant difference was found between the two groups. Due to the short detection period and prospective observational design, our results are preliminary and need to be confirmed in larger clinical trials.
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Affiliation(s)
- Zoltán Kovács
- Department of Obstetrics, Robert Hospital, 1135 Budapest, Hungary;
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
| | - Ekine Atombosiye
- Department of Obstetrics, Robert Hospital, 1135 Budapest, Hungary;
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
| | - Gabriella Hegyi
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
| | - Henrik Szőke
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
- Department of Integrative Medicine, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
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18
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Shafrir AL, Wallace B, Laliberte A, Vitonis AF, Sieberg CB, Terry KL, Missmer SA. Pelvic pain symptoms and endometriosis characteristics in relation to oxidative stress among adolescents and adults with and without surgically-confirmed endometriosis. F1000Res 2024; 13:34. [PMID: 38495219 PMCID: PMC10940847 DOI: 10.12688/f1000research.141793.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 03/19/2024] Open
Abstract
Background: While the majority of reproductive-aged females will experience pelvic pain during their lives, biological mechanisms underlying pelvic pain are not well understood. We investigated associations between pelvic pain symptoms and oxidative stress among people with and without surgically-confirmed endometriosis. Methods: Using an enzyme-linked immunosorbent assay, we measured 8-Hydroxy-2'-deoxyguanosine (8-OHdG) in urine samples and corrected for creatinine levels in 434 surgically-confirmed endometriosis participants compared to 605 participants never diagnosed with endometriosis. At enrollment, participants reported details of their pelvic pain symptoms. Linear regression was used to compute geometric mean (GM) creatinine-corrected 8-OHdG levels with 95% confidence intervals (CI) among all participants and those with and without endometriosis separately, adjusting for potential confounders. Interactions by surgically-confirmed endometriosis status were tested by Wald statistics. Results: No trends in 8-OHdG were observed among those with or without endometriosis for severity or frequency of dysmenorrhea, acyclic pelvic pain, dyspareunia or pain with bowel movements. Among endometriosis participants, lower 8-OHdG levels were observed for participants with any white, blue/black, or brown lesions (GM=76.7 versus 82.9 ng/mg; p=0.10), which was primarily driven by lower levels of 8-OHdG for any blue/black lesions (GM=72.8 versus 81.6 ng/mg; p=0.05). Conclusion: While no associations were observed between 8-OHdG and pelvic pain symptoms, future research is needed to assess how other pathways of oxidative damage, e.g. through proteins or lipids, may affect endometriosis-associated symptoms. Additionally, further research is needed to understand differences in oxidative stress among endometriosis lesion sub-phenotypes.
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Affiliation(s)
- Amy L Shafrir
- Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts, 02115, USA
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Britani Wallace
- Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts, 02115, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Ashley Laliberte
- Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts, 02115, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Allison F Vitonis
- Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts, 02115, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Christine B Sieberg
- Department of Pyschiatry, Harvard Medical School, Boston, MA, 02115, USA
- Pain & Affective Neuroscience Center, Department of Anesthesiology, Boston Children's Hospital, Boston, MA, 02115, USA
- Biobehavioral Pain Innovations Lab, Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, MA, 02115, USA
| | - Kathryn L Terry
- Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts, 02115, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Stacey A Missmer
- Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts, 02115, USA
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, 49503, USA
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Belayneh W, Kassaye Z, Arusi T, Abera N, Hantalo A, Melkamu B, Gutulo M. Prevalence of dysmenorrhea and associated factors and its effect on daily academic activities among female undergraduate students of Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1244540. [PMID: 38162010 PMCID: PMC10757849 DOI: 10.3389/frph.2023.1244540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/01/2023] [Indexed: 01/03/2024] Open
Abstract
Background Dysmenorrhea is pain during menstrual flow and is the most common gynecologic complaint in reproductive-age girls. The severity of dysmenorrhea ranges from mild to severe pain during menstruation, which affects their academic activities. Objective To assess the prevalence and associated risk factors of dysmenorrhea and its effects on academic activities among Hawassa University students from April 1-30/2021. Methods A cross-sectional study was conducted and a systematic random sampling technique was used to select 348 study participants. Standardized self-administered questionnaires were used to obtain relevant data. The severity of pain was assessed using a verbal multidimensional scoring system and Numerical Pain Rating Scale (NPRS) methods. The collected data was entered into Epi info version 7 and exported to SPSS version 21 for analysis and then descriptive statistics and logistic regression analysis were performed. Results The prevalence of dysmenorrhea was 80% (277). Of those affected by dysmenorrhea, using the verbal multidimensional scoring system, 47.6% (132) were found to have mild pain, 39.7% (110) had moderate pain, and 12.6% (35) had severe pain. However, using the Numeric Pain Rating Scale (NPRS), 21.7% (60) were found to have mild pain, 33.2% (92) had moderate pain, 37.5% (104) had severe pain, and 7.6% (21) had very severe pain. It was found to have a negative effect on academic activity, such as loss of concentration in class (p = 0.00), disruption of study time (p = 0.00), sleep disturbances (p = 0.00), issues in personal relationships (p = 0.00), and absenteeism (p = 0.00). Associated factors included being sexually active, having a family history of dysmenorrhea, and the presence of depression. Conclusion Dysmenorrhea is prevalent in this study and has a significant impact on academic activities. Family history of dysmenorrhea, being sexually active, and the presence of depression are associated factors.
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Affiliation(s)
- Wondu Belayneh
- Department of Gynecology and Obstetrics, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Zerai Kassaye
- Obstetrics and Gynecology, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Temesgen Arusi
- Obstetrics and Gynecology, Wolkite University College of Medicine and Health Sciences, Wolkite, Ethiopia
| | - Netsanet Abera
- Department of Public Health, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Admassu Hantalo
- Department of Medical Laboratory Sciences, Wolkite University College of Medicine and Health Sciences, Wolkite, Ethiopia
| | - Biruk Melkamu
- Wachamo University College of Medicine and Health Sciences, Hosanna, Ethiopia
| | - Muluken Gutulo
- CDC Coordinator, Wolaita Health Department, Wolaita Sodo, Ethiopia
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20
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Ishikura IA, Hachul H, Tufik S, Andersen ML. Dysmenorrhea and Sleep: A Review. Sleep Med Clin 2023; 18:449-461. [PMID: 38501517 DOI: 10.1016/j.jsmc.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
This review encompasses the clinical features and relevance to investigate sleep in women with dysmenorrhea. Dysmenorrhea is a prevalent gynecologic dysfunction that affects the social and professional lives of women. It can occur at every menstrual cycle, depending on the cause and psychologic factors. Studies have reported poor sleep and insomnia symptoms in dysmenorrhea condition, which may intensify the dysmenorrhea manifestation and interfere negatively to its treatment. There is an urgent need to identify the main cause of this dysfunction and provide efficient treatments to minimize the detrimental effects of dysmenorrhea in quality of life of these women.
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Affiliation(s)
- Isabela A Ishikura
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862 - Vila Clementino - 04023062 - São Paulo - SP - Brazil
| | - Helena Hachul
- Departamento de Ginecologia, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, n° 740 - Vila Clementino - 04023-062 - São Paulo - SP - Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862 - Vila Clementino - 04023062 - São Paulo - SP - Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862 - Vila Clementino - 04023062 - São Paulo - SP - Brazil.
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21
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Seidman LC, Handy AB, Temme CR, Greenfield SF, Payne LA. Reflections on the group dynamic in a group cognitive behavioral therapy intervention for young adult women with moderate to severe dysmenorrhea: a qualitative analysis. J Psychosom Obstet Gynaecol 2023; 44:2264486. [PMID: 37800565 PMCID: PMC10640904 DOI: 10.1080/0167482x.2023.2264486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/24/2023] [Indexed: 10/07/2023] Open
Abstract
A recent group cognitive behavioral therapy (gCBT) intervention for dysmenorrhea conducted by our team demonstrated feasibility, acceptability, and preliminary efficacy at reducing menstrual pain. This study aimed to use qualitative analyses to explore participants' reflections about the intervention's group dynamic. Participants included 20 young women ages 18-24 years with average menstrual pain of 8.0 (SD = 1.1) on a 0-10 (0 = none, 10 = worst pain possible) numeric rating scale. Semi-structured individual and group interviews were conducted after the intervention. Researchers then conducted deductive, iterative thematic analysis using a template analysis approach. Two themes were generated: benefit and logistics. The benefit theme included two sub-themes: (1) camaraderie (an emotional, psychological, or social connection between participants); and (2) sharing (information, advice, or experiences). The logistics theme highlighted how the structure of the group influenced the dynamic and was divided into two sub-themes according to the time frame being described: (1) reactions (participants' experiences with how the group dynamic was facilitated); and (2) future (how the group structure could be improved). Results of this study contribute to the growing body of literature related to gCBT for pain conditions. Future research is needed to optimize the group dynamic and evaluate its specific therapeutic role in the treatment.
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Affiliation(s)
| | | | | | | | - Laura A. Payne
- McLean Hospital, Belmont, MA
- Harvard Medical School, Boston, MA
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22
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Jones SC, Boniface ER, Boehnlein C, Jones Packham A, Baldwin MK. Menstrual Health Literacy among Adolescents and Young Adults Who Menstruate: Impact of Christian Family Background and United States Region. J Pediatr Adolesc Gynecol 2023; 36:518-524. [PMID: 37482080 DOI: 10.1016/j.jpag.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
STUDY OBJECTIVE To compare menstrual health literacy among adolescents and young adults on the basis of family religious background and United States region METHODS: We conducted a cross-sectional online survey of post-menarcheal US adolescents and young adults aged 14-24 years who identified their family religious background, including Christian or non-religious, with recruitment via the social media platform TikTok. We asked participants several questions to assess their health literacy regarding common myths about the use of gonadal steroid hormones for menstrual suppression. RESULTS From 3250 online survey respondents, 2997 met the criteria for analysis, with 1989 identifying their family as Christian (66.4%) and 1008 identifying their family as non-religious (33.6%), with equal representation by US region. Health literacy was lower among those with a Christian family background, with concerns that menstrual suppression is unhealthy (16.4% vs 10.5% with non-religious background, P < .01), is unsafe (31.4% vs 24.2%, P < .01), and could lead to infertility (32.6% vs 20.0%, P < .01). Similarly, adolescents and young adults from the US South were worried that menstrual suppression is unhealthy (31.5%; P < .01) and would lead to infertility (33.8%; P < .01). CONCLUSION Health literacy is lower among adolescents and young adults with a Christian family background and those who live in the South. These results demonstrate a need for an evidence-based national curriculum that addresses the safe and effective use of hormonal medications for menstrual suppression.
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23
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Howe D, Duffy S, O’Shea M, Hawkey A, Wardle J, Gerontakos S, Steele L, Gilbert E, Owen L, Ciccia D, Cox E, Redmond R, Armour M. Policies, Guidelines, and Practices Supporting Women's Menstruation, Menstrual Disorders and Menopause at Work: A Critical Global Scoping Review. Healthcare (Basel) 2023; 11:2945. [PMID: 37998437 PMCID: PMC10671631 DOI: 10.3390/healthcare11222945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
(1) Objectives: This paper presents a scoping review of global evidence relating to interventions (i.e., policies, practices, guidelines, and legislation) aimed at supporting women to manage menstruation, menstrual disorders, and menopause at work. (2) Methods: Databases including Medline (Ebsco), CINAHL (Ebsco), Scopus, Web of Science, APA PsychInfo (Ebsco), Humanities International Complete (Ebsco), Academic Search Premier (Ebsco), HeinOnline and OSH Update, and Google Scholar were searched in May 2022. (3) Results: Of 1181 unique articles screened, 66 articles are included. Less half of the articles (42%, 28/66) presented/reviewed an intervention related to women's workplace health. A total of 55 out of the 66 articles are set across 13 countries with the remaining 12 articles described as multi-country studies or reviews. Half of the articles presenting/reviewing an intervention were grey literature, with several undertaken in UK and EU member countries. Interventions focusing on supporting women with menopause at work were the most common (43%, 12/28), followed by menstruation (25%, 7/28) and menstrual disorders (7%, 2/28). Across the reviewed articles, recommendations were categorised as adjustments to the physical work environment, information and training needs, and policy and processes. Few articles explicitly presented or affirmed a design-process and/or evaluation tied to their intervention. In lieu of design-process, this review categorises the rationales driving the development of an intervention as: pronatalist, economic rationalism, gendered occupational health concern, cultural shift towards gender equity objectives, and efforts to reduced shame and stigma. (4) Conclusions: There is a growing body of evidence aimed at understanding women's experiences of managing their menstrual and reproductive health in the workplace and how this impacts their work/career trajectories. However, little research is explicitly concerned with exploring or understanding interventions, including their design or evaluation. Most articles report menopause guidelines and are typically confined to the UK and EU-member countries. Despite the prevalence of menstrual disorders (e.g., endometriosis and polycystic ovarian syndrome (PCOS)) there is limited literature focused on how women might be supported to manage symptoms associated with these conditions at work. Accordingly, future policies should consider how women can be better supported to manage menstruation and menstrual disorders at work and recognise the importance of co-design during policy development and post-intervention evaluation. Further research needs to be undertaken on the impact of workplace policies on both employers and employees.
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Affiliation(s)
- Danielle Howe
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia; (D.H.)
| | - Sarah Duffy
- School of Business, Western Sydney University, Sydney 2751, Australia
| | - Michelle O’Shea
- School of Business, Western Sydney University, Sydney 2751, Australia
| | - Alex Hawkey
- Translational Research Institute (THRI), School of Medicine, Western Sydney University, Sydney 2145, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore 2480, Australia
| | - Sophia Gerontakos
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore 2480, Australia
| | - Linda Steele
- Law Health Justice Research Centre, Faculty of Law, University of Technology Sydney, Sydney 2007, Australia;
| | - Emilee Gilbert
- School of Psychology, Western Sydney University, Sydney 2751, Australia
| | - Lara Owen
- School of Modern Languages, University of St Andrews, St. Andrews KY16 9PH, UK
| | - Donna Ciccia
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia; (D.H.)
- Endometriosis Australia, Sydney 2000, Australia
| | - Emma Cox
- Endometriosis UK, London SE1 1SZ, UK
| | - Rebecca Redmond
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore 2480, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia; (D.H.)
- Translational Research Institute (THRI), School of Medicine, Western Sydney University, Sydney 2145, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington 6242, New Zealand
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24
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Kovács Z, Hegyi G, Szőke H. The Effect of Exercise on Pulsatility Index of Uterine Arteries and Pain in Primary Dysmenorrhea. J Clin Med 2023; 12:7021. [PMID: 38002635 PMCID: PMC10671949 DOI: 10.3390/jcm12227021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/14/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD) is one of the most common diseases in women of reproductive age. Our aim was to examine whether a twice-weekly thirty-minute exercise intervention could result in a difference in the pulsatility index (PI) of the uterine arteries (UAs) and level of menstrual pain in patients with PD. METHODS In our prospective observational trial, the observation period included one spontaneous menstrual cycle and the consecutive time of the next menstruation of all participants, aged 18-44, with no extensive sports experience. In total, 73 volunteers were enrolled: 38 persons in the intervention group (IG) and 35 in the control group (CG). The intervention program was accompanied by music, performed in groups under the supervision of a qualified instructor in Hungary. The primary outcome was the difference between the IG and CG regarding the PI values of UAs at the 1st and the 2nd ultrasound (US) Doppler flowmetry. The secondary outcome was the difference between the IG and CG regarding the PI of UAs and menstrual pain measured by using the Numeric Rating Scale and adherence to the intervention. Statistical tests such as an independent-samples t-test, chi-square test, Mann-Whitney test and analysis of covariance (ANCOVA) were used during the analyses. RESULTS Examining the mean of the PI of UAs in the IG and the CG at the 1st and the 2nd US measurement, a significant difference was found in the change in the measured value (Z = -2.545; p = 0.011). The IG showed a significantly higher increase in the mean of the PI of UAs (Median = 0.825) than the CG (Median = 0.130). The difference in the PI of the UAs of the IG and the CG is not related to the level of pain in any group (p = 0.336) and not related to the whole sample (p = 0.354); furthermore, the level of pain did not significantly differ between the two groups. CONCLUSIONS Our study is the first to document the significant effects of mild-to-moderate exercise training on the change in the PI of the UAs in individuals with PD. The IG had a reduced blood flow due to circulatory redistribution after exercise. The level of menstrual pain of primary dysmenorrhea patients is independent of the level of blood circulation regarding the PI of the UAs. Randomized controlled studies with more participants and a longer research period are needed to confirm our findings regarding the association between regular exercise and the PI of UAs. The study was registered at clinicaltrials.gov: NCT04618172.
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Affiliation(s)
- Zoltán Kovács
- Department of Obstetrics, Robert Hospital, 1135 Budapest, Hungary
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
| | - Gabriella Hegyi
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
| | - Henrik Szőke
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (G.H.); (H.S.)
- Department of Integrative Medicine, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
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25
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Reinhardt A, Eitze S. Breaking the endometriosis silence: a social norm approach to reducing menstrual stigma and policy resistance among young adults. Psychol Health 2023:1-23. [PMID: 37921431 DOI: 10.1080/08870446.2023.2277838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/26/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Endometriosis is a menstrual disorder that affects one in ten women. Diagnosis often takes several years due to low awareness and menstrual stigma. In this study, we employed a social norm approach (SNA) to investigate the effects of an educational leaflet on endometriosis knowledge, menstrual stigma, and acceptance of paid menstrual leave among women and men. METHODS The 3 × 2 online experiment tested the influence of either descriptive norm messages or both descriptive and injunctive norm messages (compared to a control group, factor 1) in an educational leaflet by taking the role of addressee's sex into account (quasi-experimental factor 2). The study included 796 German participants aged 16-35. RESULTS Men exhibited significantly poorer knowledge, stronger menstrual stigma, and weaker policy acceptance compared to women. No significant main effect of the social norm messages on menstrual stigma was found. In contrast, the combined norm messages seem to be beneficial when addressing policy acceptance. Moreover, compared to the control group, the intervention material indirectly influenced stigma and policy acceptance through increased knowledge. CONCLUSIONS Providing information about social norms appears to be an effective strategy for educating not only women but especially men about menstrual disorders like endometriosis.
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Affiliation(s)
- Anne Reinhardt
- Department of Communication, University of Vienna, Vienna, Austria
| | - Sarah Eitze
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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26
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Fooladi E, Bell RJ, Robinson PJ, Skiba M, Davis SR. Dysmenorrhea, Workability, and Absenteeism in Australian Women. J Womens Health (Larchmt) 2023; 32:1249-1256. [PMID: 37651151 DOI: 10.1089/jwh.2023.0199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Background: This study determined the prevalence of bothersome menstrual symptoms and their association with workability in naturally menstruating women not using hormonal contraception. Materials and Methods: A representative sample of community-dwelling Australian women aged 18-39 years selected from two large national electronic databases responded to a survey on general health. This study focuses on self-reported dysmenorrhea and menstrual bleeding and their association with workability and absenteeism in working women, assessed by the Workability Index. Results: Of 3,555 women, 1,573 (44.2% [95% CI: 42.6%-45.9%]) reported moderate to severe dysmenorrhea and 774 (21.8% [95% CI: 20.4%-23.2%]) reported heavy to very heavy bleeding. Women with dysmenorrhea were 50% more likely to report poorer work performance and twice as likely to report more days of sick leave in the past year (absenteeism) than other women. Conclusions: Despite the availability of safe and effective management options, Australian working women aged 18-39 years continue to experience bothersome dysmenorrhea and menstrual bleeding. Dysmenorrhea is associated with increased absenteeism and poorer workability. Therefore, awareness needs to be raised among women and health care providers of ways to manage dysmenorrhea and heavy bleeding and the unmet need for intervention in the community, respectively.
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Affiliation(s)
- Ensieh Fooladi
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Robin J Bell
- Women's Health Research Program and School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Penelope J Robinson
- Women's Health Research Program and School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Marina Skiba
- Monash University Clinical Trial Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Susan R Davis
- Women's Health Research Program and School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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27
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Sinclair J, Abbott J, Proudfoot A, Armour M. The Place of Cannabinoids in the Treatment of Gynecological Pain. Drugs 2023; 83:1571-1579. [PMID: 37831340 PMCID: PMC10693518 DOI: 10.1007/s40265-023-01951-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/14/2023]
Abstract
Cannabis sativa (L), a plant with an extensive history of medicinal usage across numerous cultures, has received increased attention over recent years for its therapeutic potential for gynecological disorders such as endometriosis, chronic pelvic pain, and primary dysmenorrhea, due at least in part to shortcomings with current management options. Despite this growing interest, cannabis inhabits an unusual position in the modern medical pharmacopoeia, being a legal medicine, legal recreational drug, and an illicit drug, depending on jurisdiction. To date, the majority of studies investigating cannabis use have found that most people are using illicit cannabis, with numerous obstacles to medical cannabis adoption having been identified, including outdated drug-driving laws, workplace drug testing policies, the cost of quality-assured medical cannabis products, a lack of cannabis education for healthcare professionals, and significant and persistent stigma. Although currently lacking robust clinical trial data, a growing evidence base of retrospective data, cohort studies, and surveys does support potential use in gynecological pain conditions, with most evidence focusing on endometriosis. Cannabis consumers report substantial reductions in pelvic pain, as well as common comorbid symptoms such as gastrointestinal disturbances, mood disorders such as anxiety and depression, and poor sleep. Substitution effects were reported, with >50% reduction or cessation in opioid and/or non-opioid analgesics being the most common. However, a substantial minority report not disclosing cannabis consumption to their health professional. Therefore, while such deprescribing trends are potentially beneficial, the importance of medical supervision during this process is paramount given the possibility for withdrawal symptoms.
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Affiliation(s)
- Justin Sinclair
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
| | - Jason Abbott
- Division of Obstetrics and Gynaecology, School of Clinical Medicine, Medicine and Health, UNSW, Sydney, NSW, Australia
- Gynaecological Research and Clinical Research (GRACE) Unit, Royal Hospital for Women, UNSW, Sydney, NSW, Australia
| | - Andrew Proudfoot
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
- Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand.
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28
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Duijster JW, Schoep ME, Nieboer TE, Jajou R, Kant A, van Hunsel F. Menstrual abnormalities after COVID-19 vaccination in the Netherlands: A description of spontaneous and longitudinal patient-reported data. Br J Clin Pharmacol 2023; 89:3126-3138. [PMID: 37222170 DOI: 10.1111/bcp.15799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/06/2023] [Accepted: 05/16/2023] [Indexed: 05/25/2023] Open
Abstract
AIMS During the COVID-19 vaccination campaigns, the number of reports of menstrual abnormalities increased rapidly. Here, we describe the nature and potential risk factors associated with menstrual abnormalities based on spontaneously reporting data as well as data from a prospective cohort event monitoring (CEM) study as these are poorly studied. METHODS Reports of menstrual abnormalities received by the Netherlands Pharmacovigilance Centre Lareb in the spontaneous reporting system between February 2021 and April 2022 were summarized. In addition, logistic regression analysis was performed on the reported menstrual abnormalities in the CEM study to assess the association between person characteristics, prior SARS-CoV-2 infection and use of hormonal contraceptives and the occurrence of menstrual abnormalities after vaccination. RESULTS We analysed over 24 000 spontaneous reports of menstrual abnormalities and over 500 episodes (among 16 929 included women) of menstrual abnormalities in the CEM study. The CEM study showed an incidence of 41.4 per 1000 women aged ≤54 years. Amenorrhoea/oligomenorrhoea and heavy menstrual bleeding collectively accounted for about half of all abnormalities reported. Significant associations were observed for the age group 25-34 years (odds ratio 2.18; 95% confidence interval 1.45-3.41) and the Pfizer vaccine (odds ratio 3.04; 95% confidence interval 2.36-3.93). No association was observed for body mass index and presence of most comorbidities assessed. CONCLUSION The cohort study showed a high incidence of menstrual disorders among women aged ≤54 years, and this observation was supported by the analysis of spontaneous reports. This suggests that a relation between COVID-19 vaccination and menstrual abnormalities is plausible and should be further investigated.
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Affiliation(s)
- Janneke W Duijster
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Mark E Schoep
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Theodoor E Nieboer
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rana Jajou
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Agnes Kant
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Florence van Hunsel
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
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29
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Matsuura Y, Tran NH, Yasui T. The Changes in Menstrual and Menstrual-Related Symptoms among Japanese Female University Students: A Prospective Cohort Study from Three Months to Nine Months after Admission. Healthcare (Basel) 2023; 11:2557. [PMID: 37761754 PMCID: PMC10531057 DOI: 10.3390/healthcare11182557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Menstrual and menstrual-related symptoms can significantly impact an individual's physical and psychological health. Understanding how these symptoms evolve over time is crucial to provide appropriate support and healthcare services to young women. This study aimed to investigate changes in menstrual and menstrual-related symptoms among first-year female university students. A prospective longitudinal design was used to compare the symptom profiles between two time points (three and nine months after admission). Out of 100 female university students, 30 responses were analyzed. Data on menstrual and menstrual-related symptoms were collected using standardized questionnaires focusing on menstrual status and the Menstrual Distress Questionnaire (MDQ); no notable changes occurred between the time points. Approximately half reported having irregular menstruation during the three time periods. Among the sub-scales, premenstrual "impaired concentration" showed a tendency to be lower, whereas menstrual "water retention" tended to be higher in timepoint 2 compared to timepoint 1. "Distractible" was found to be significantly lower in timepoint 2 compared to timepoint 1. There was a significant association between a sleep duration of <7 h and worsened MDQ scores. These findings may underscore the importance of providing comprehensive lifestyle and menstrual education to new university students, along with access to appropriate medical care.
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Affiliation(s)
- Yukie Matsuura
- Department of Reproductive and Menopausal Medicine, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
| | - Nam Hoang Tran
- Research Center for Higher Education, Tokushima University, Tokushima 770-8502, Japan
| | - Toshiyuki Yasui
- Department of Reproductive and Menopausal Medicine, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
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Sundstrom B, Dempsey A, Finke S, Maness SB, Delay C, Hayes N, DuBose-Morris R, Lazenby GB. "Do you want a period?" Launching and evaluating a brief contraceptive decision-making educational intervention. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 37:100887. [PMID: 37454586 DOI: 10.1016/j.srhc.2023.100887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/13/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Do you want a period? empowers people who menstruate to better understand their reproductive health and contraceptive choices through informed patient-centered contraceptive decision-making. METHODS Researchers partnered with the WISE (Women in the South-East) Telehealth Network to design, implement and evaluate the Do you want a period? brief educational intervention. Participants completed a longitudinal research study, including a web-based survey at baseline and a mobile-optimized text-based survey up to 6 weeks following baseline. RESULTS Do you want a period? was believable (93%, n = 79), informative (89%, n = 76), and helpful (85%, n = 72). Participants who reported that the intervention was helpful were significantly more likely to be satisfied with the usefulness of information provided (OR 5.61 [95% CI 1.65-19.12]), the overall quality of services (OR 3.39 [95% CI 1.04-11.08)], and obtaining necessary medical care (OR 2.40 [95% CI 1.08-5.33)]. At longitudinal follow-up, participants who received contraceptive services reported high acceptability of intervention (4.51 (±0.53) out of 5). CONCLUSIONS Do you want a period? envisions a new dialogue between women and clinicians, family, and friends. This brief educational intervention supports people who menstruate to determine if a safe and effective tailored contraceptive regimen is right for them.
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Affiliation(s)
- Beth Sundstrom
- Department of Communication, College of Charleston, Charleston, SC, USA.
| | - Angela Dempsey
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Shira Finke
- Women's Health Research Team, College of Charleston, Charleston, SC, USA
| | - Sarah B Maness
- Women's Health Research Team, College of Charleston, Charleston, SC, USA
| | - Cara Delay
- Women's Health Research Team, College of Charleston, Charleston, SC, USA
| | - Natalia Hayes
- WISE Telehealth Network, Charleston County Public Library (CCPL) System, USA
| | - Ragan DuBose-Morris
- Center for Telehealth, Medical University of South Carolina, Charleston, SC, USA
| | - Gweneth B Lazenby
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
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Jeong D, Lee H, Kim J. Effects of sleep pattern, duration, and quality on premenstrual syndrome and primary dysmenorrhea in korean high school girls. BMC Womens Health 2023; 23:456. [PMID: 37641079 PMCID: PMC10464156 DOI: 10.1186/s12905-023-02600-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Sleep deprivation is known to be a risk factor for premenstrual syndrome and primary dysmenorrhea in adults. However, it has rarely been investigated in adolescents. The aim of this study was to investigate whether sleep pattern, duration, and quality independently affect premenstrual syndrome and primary dysmenorrhea in adolescent girls. An additional purpose was to investigate the sleep status in Korean adolescent girls during the COVID-19 pandemic. METHODS A cross-sectional survey study was conducted in 519 high school girls aged 15 to 18 years in Gyeonggido, South Korea, in 2021 during the COVID-19 lockdown. Menstrual pain intensity and menstrual symptoms were assessed using the visual analogue scale (VAS) and Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed by the premenstrual symptoms screening tool (PSST). Sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). The known risk factors of dysmenorrhea, including menstrual and lifestyle characteristics and stress, were assessed as covariates. RESULTS During the pandemic, approximately 68% of girls slept 7 h or less, while about 60% reported poor sleep quality. Additionally, 64% of participants had a bedtime later after 1AM, and 34% woke up later after 8AM. Late bedtime significantly affected VAS (P = 0.05), CMSS severity and frequency (both P < 0.01), and PSST symptom (P < 0.01). Waking up late affected CMSS severity (P < 0.05), PSST symptom (P = 0.05), and PSST function (P < 0.05). However, the significance of these effects disappeared after controlling for covariates. Sleeping less than 5 h affected CMSS frequency (P < 0.05) and PSST symptoms (P < 0.001). After controlling for covariates, the significance of the effect on PSST symptom remained (P < 0.05). General sleep quality and PSQI components, including subjective sleep quality, sleep latency, sleep disturbance, use of sleeping medication, and daytime dysfunction, significantly affected CMSS frequency and severity and PSST symptom after controlling for covariates (P < 0.05, P < 0.01, or P < 0.001). The multiple regression analysis revealed that among sleep characteristics, sleep quality was the most important risk factor of premenstrual syndrome and dysmenorrhea. CONCLUSION Our study result heightens the importance of healthy sleep hygiene, especially sleep quality in the management of premenstrual syndrome and dysmenorrhea in adolescent girls.
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Affiliation(s)
- Daye Jeong
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea
| | - Heakyong Lee
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea
| | - Jaehee Kim
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea.
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Fang X, Liu H, Wang M, Wang G. Scientific Knowledge Graph of Dysmenorrhea: A Bibliometric Analysis from 2001 to 2021. J Pain Res 2023; 16:2883-2897. [PMID: 37638206 PMCID: PMC10460176 DOI: 10.2147/jpr.s418602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/05/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose This study aims to help researchers master the most active hotspots and trends quickly through bibliometric analysis in the field of dysmenorrhea. Methods We retrieved literature on Web of Science from 2001 to 2021, and bibliometric analysis software CiteSpace was used in combination with VOSviewer. Results We finally acquired 944 papers and an upward trend in articles continued in this field overall. Through the map, China contributed the most, followed by the USA and Turkey. For institutions, Beijing University of Chinese Medicine in China contributed the most, followed by National Yang-Ming University in Taiwan, China. Hsieh JC and Hellman KM were both the most prolific authors with 14 articles. Five major research groups, respectively, with Hsieh JC, Hellman KM, Zhu J, Liang F and Dun W were the key group. Dawood MY was the most dominant author and most frequently cited author. The Cochrane Database of Systematic Reviews Journal was the most productive, and the Fertility and Sterility Journal was the most cited. Advances in pathogenesis and management for primary dysmenorrhea written by Dawood MY was most cited and influential. Pathophysiology, the potential central mechanism, syndrome, evaluation index, diagnosis of adenomyosis-associated dysmenorrhea, treatment, etc., were the main trends and hotspots. Conclusion Dysmenorrhea research has received a lot of attention from scholars. Strengthening international cooperation may promote the development of this field. The pathophysiology of dysmenorrhea, its impact on public health and its treatment are current research hotspots and are likely to be the focus of future study.
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Affiliation(s)
- Xiaoting Fang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Haijuan Liu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Mina Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Guohua Wang
- Gynecology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
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Wuni A, Abena Nyarko B, Mohammed Ibrahim M, Abdulai Baako I, Mohammed IS, Buunaaisie C. Prevalence, Management, and Impact of Dysmenorrhea on the Lives of Nurse and Midwife Trainees in Northern Ghana. Obstet Gynecol Int 2023; 2023:8823525. [PMID: 37608871 PMCID: PMC10442185 DOI: 10.1155/2023/8823525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/28/2023] [Accepted: 07/26/2023] [Indexed: 08/24/2023] Open
Abstract
Background Dysmenorrhea is the most common gynecological problem affecting the majority of female students in the nursing profession today. They often experience severe pain that is not only incapacitating but also has a significant impact on their day-to-day college life, academic, and clinical performance. Aim This study was conducted to assess the prevalence, management, and impact of dysmenorrhea on the lives of nurse and midwife trainees in northern Ghana. Methods A descriptive cross-sectional design with a quantitative approach to data collection was employed to collect data from nurse and midwife trainees in three colleges of nursing and/or midwifery in the northern region of Ghana. A proportionate stratified random sampling technique was used to recruit 303 respondents for the study. After gaining permission from various institutions, data were collected by using a structured questionnaire from 13th September to 28th October, 2022. Stata (special edition) for Windows version 17.0 was used for the statistical analyses. Results The study revealed a high prevalence of dysmenorrhea among female nursing students (66.7% and 95% CI: 0.611-0.720). More than half of the respondents (67.3%) experienced loss of appetite for food. The most common site of most intense pain was the pelvis and lower abdomen (98.0%). A greater proportion of students (65.8%) used antispastic drugs to reduce pain. The respondents' concentration in the classroom was greatly affected (77.2%) as well as normal physical activities (58.4%). A multivariable logistic regression analysis revealed that the odds of dysmenorrhea are 2.67 times higher when the duration of menstruation is 4-5 days (AOR = 1.82, 95% CI = 1.13-6.28, and p = 0.024) than a duration of 1-3 days. Having urinary tract infections was associated with 3.56 times higher odds of dysmenorrhea (AOR = 3.56, 95% CI = 0.98-12.86, and p = 0.053). Again, the odds of dysmenorrhea were also four times higher among respondents with a family history of the same condition (AOR = 4.05, 95% CI = 2.16-7.61, and p = 0.001). Conclusion The current study revealed a high prevalence of dysmenorrhea among nurse and midwife trainees in the northern part of Ghana. The majority of the respondent experienced loss of appetite and intense pain in the pelvis and lower abdomen, and their concentration during lectures was also significantly affected. The most predominant nonpharmacological method used for reducing the pain was sleep and the application of warm objects on the abdomen.
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Affiliation(s)
- Abubakari Wuni
- Department of Medicine for the Elderly (C6), Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital, Cambridge, UK
- Nurses' and Midwives' Training College, Tamale, Ghana
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Matsuura Y, Abe Y, Motoki Y, Tran NH, Yasui T. Menstrual Abnormalities in Female International Students in Japan: Changes during Pre-Arrival, Difficult, and Current Periods. Eur J Investig Health Psychol Educ 2023; 13:1362-1377. [PMID: 37504490 PMCID: PMC10378279 DOI: 10.3390/ejihpe13070099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
The number of Japan's international students has rapidly increased in the last decade. This study examines the relationship between menstrual abnormalities in cycle and symptoms, stress level, and lifestyle of female international students in Japan across three time periods, namely pre-arrival, difficult, and current time periods. A cross-sectional design was employed, and data were collected through a self-administered questionnaire, including the menstrual distress questionnaire (MDQ), between December 2022 and February 2023. The questionnaire was distributed to 56 female international students from two universities in Japan, and a total of 29 valid responses were collected. We found varying menstrual cycle abnormalities and severity of menstrual symptoms across three time periods, with the difficult period after arrival in Japan displaying the highest symptom severity. Higher stress levels were significantly associated with more severe menstrual symptoms. Lifestyle habits such as alcohol consumption were also linked to menstrual symptoms. The current study emphasizes the importance of providing menstrual education, support, and resources to address international students' unique challenges in managing their menstrual health while studying abroad. By promoting awareness, education, and access to healthcare services, universities may contribute to international students' well-being and academic success.
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Affiliation(s)
- Yukie Matsuura
- Department of Reproductive and Menopausal Medicine, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
| | - Yoko Abe
- Department of Intercultural Studies, Faculty of Literature, Shikoku University, Tokushima 771-1192, Japan
| | - Yoshie Motoki
- Center for Faculty-Wide General Education, Shikoku University, Tokushima 771-1192, Japan
| | - Nam Hoang Tran
- Research Center for Higher Education, Tokushima University, Tokushima 770-8502, Japan
| | - Toshiyuki Yasui
- Department of Reproductive and Menopausal Medicine, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
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Ciccia D, Doyle AK, Ng CHM, Armour M. Indigenous Peoples' Experience and Understanding of Menstrual and Gynecological Health in Australia, Canada and New Zealand: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6321. [PMID: 37444168 PMCID: PMC10341312 DOI: 10.3390/ijerph20136321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/13/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
There are a variety of cultural and religious beliefs and customs worldwide related to menstruation, and these often frame discussing periods and any gynecological issues as taboo. While there has been previous research on the impact of these beliefs on menstrual health literacy, this has almost entirely been confined to low- and middle-income countries, with very little information on high-income countries. This project used the Joanna Briggs Institute (JBI) scoping review methodology to systematically map the extent and range of evidence of health literacy of menstruation and gynecological disorders in Indigenous people in the colonized, higher-income countries of Australia, Canada, and New Zealand. PubMed, CINHAL, PsycInfo databases, and the grey literature were searched in March 2022. Five studies from Australia and New Zealand met the inclusion criteria. Only one of the five included studies focused exclusively on menstrual health literacy among the Indigenous population. Despite considerable research on menstrual health globally, studies focusing on understanding the menstrual health practices of the Indigenous populations of Australia, New Zealand, and Canada are severely lacking, and there is little to no information on how Indigenous beliefs of colonized people may differ from the broader society in which they live.
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Affiliation(s)
- Donna Ciccia
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia
| | - Aunty Kerrie Doyle
- School of Medicine, Western Sydney University, Campbelltown 2560, Australia
| | - Cecilia H. M. Ng
- School of Clinical Medicine, Health and Medicine, Division of Obstetrics and Gynaecology, University of New South Wales, Sydney 2052, Australia
- Gynaecological Research and Clinical Evaluation (GRACE) Unit, Royal Hospital for Women and University of New South Wales, Randwick 2031, Australia
- Jean Hailes for Women’s Health, Melbourne 3002, Australia
- Global Women’s Health, The George Institute for Global Health, Sydney 2042, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington 6021, New Zealand
- Translational Health Research Institute (THRI), Western Sydney University, Sydney 2145, Australia
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de Arruda GT, de Melo Mantovan SG, Da Roza T, Silva BID, Tonon da Luz SC, Avila MA. WHODAS measurement properties for women with dysmenorrhea. Health Qual Life Outcomes 2023; 21:55. [PMID: 37280634 DOI: 10.1186/s12955-023-02140-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/29/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND There is an association of dysmenorrhea with human functioning and disability. However, no patient-reported outcome measure has been developed to assess this construct in women with dysmenorrhea. WHODAS 2.0 has been recognized as an important generic patient-reported outcome information of physical function and disability. Thus, the aim of this study was to assess the measurement properties of the WHODAS 2.0 in women with dysmenorrhea. METHODS This is an online and cross-sectional study conducted with Brazilian women aged 14 to 42 years with self-report of dysmenorrhea in the last three months. According to COSMIN, structural validity was evaluated by exploratory and confirmatory factor analysis; internal consistency by Cronbach's Alpha; measurement invariance by multigroup confirmatory factor analysis between geographic regions of Brazil; and construct validity by correlating WHODAS 2.0 to the Numerical Rating Scale for pain severity. RESULTS One thousand three hundred and eighty-seven women (24.7 ± 6.5 years) with dysmenorrhea participated in the study. WHODAS 2.0 presented a single factor by exploratory factor analysis and adequate model by confirmatory factor analysis (CFI = 0.924, TLI = 0.900, RMSEA = 0.038), excellent internal consistence (α = 0.892) for all items and an invariancy across geographic regions (ΔCFI ≤ 0.01 and ΔRMSEA < 0.015). Correlation between WHODAS 2.0 and numerical rating scale was positive and moderate (r = 0.337). CONCLUSION WHODAS 2.0 has a valid structure to assess functioning and disability related to dysmenorrhea in women.
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Affiliation(s)
- Guilherme Tavares de Arruda
- Study Group on Chronic Pain (NEDoC), Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, São Carlos, Brazil
| | - Sara Giovanna de Melo Mantovan
- Department of Physiotherapy, College of Health and Sport Science, Santa Catarina State University, UDESC, Florianópolis, Brazil
| | - Thuane Da Roza
- Department of Physiotherapy, College of Health and Sport Science, Santa Catarina State University, UDESC, Florianópolis, Brazil
| | - Barbara Inácio da Silva
- Study Group on Chronic Pain (NEDoC), Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, São Carlos, Brazil
| | - Soraia Cristina Tonon da Luz
- Department of Physiotherapy, College of Health and Sport Science, Santa Catarina State University, UDESC, Florianópolis, Brazil
| | - Mariana Arias Avila
- Study Group on Chronic Pain (NEDoC), Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, São Carlos, Brazil.
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Horvat M, Pavan Jukić D, Marinović L, Bursać D, Ribić R, Neuberg M, Bursać D. Prevalence of Primary Dysmenorrhoea and Its Impact on Academic Performance among Croatian Students during the COVID-19 Pandemic. Obstet Gynecol Int 2023; 2023:2953762. [PMID: 37304995 PMCID: PMC10257551 DOI: 10.1155/2023/2953762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/21/2023] [Accepted: 05/16/2023] [Indexed: 06/13/2023] Open
Abstract
Background Dysmenorrhoea is one of the most common gynaecological problems. Therefore, it is important to investigate its impact during the COVID-19 pandemic which has a great impact on the lives of menstruating people all over the world. Aim To determine the prevalence and impact of primary dysmenorrhoea on academic performance among students during the pandemic. Materials and Methods This cross-sectional study was conducted in April 2021. All data were collected by an anonymous self-assessed web-based questionnaire. Due to voluntary participation in the study, 1210 responses were received, but 956 were left for analysis after exclusion criteria were applied. Descriptive quantitative analysis was performed and Kendall rank correlation coefficient was used. Results The prevalence of primary dysmenorrhoea was 90.1%. Menstrual pain was mild in 7.4% of cases, moderate in 28.8%, and severe in 63.8%. The study found that primary dysmenorrhoea has a great perceived impact on all included aspects of academic performance. Most affected were concentration in class in 810 (94.1%) and doing homework and learning in 809 (94.0%) female students. There is also a correlation between menstrual pain intensity and its impact on academic performance (p < 0.001). Conclusions Our study found that the prevalence of primary dysmenorrhoea among students at the University of Zagreb is high. Painful menstruation greatly impacts academic performance and therefore it is important to do more research on this topic.
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Affiliation(s)
| | - Doroteja Pavan Jukić
- Department of Obstetrics and Gynecology, University Hospital Merkur, Zagreb, Croatia
| | - Lovro Marinović
- Department of Pathology, University Hospital Merkur, Zagreb, Croatia
| | - Dina Bursać
- Department of Oral Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | | | - Danijel Bursać
- Department of Obstetrics and Gynecology, University Hospital Merkur, Zagreb, Croatia
- University North, Varaždin, Croatia
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Gray LJ, Durand H. Experiences of dysmenorrhea and its treatment among allistic and autistic menstruators: a thematic analysis. BMC Womens Health 2023; 23:288. [PMID: 37231369 DOI: 10.1186/s12905-023-02370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Dysmenorrhea (i.e., period pain) is common and debilitating. Autistic people are known to experience pain differently, yet little is known about the menstrual pain experiences of autistic menstruators relative to non-autistic peers. This study aimed to explore the experience of period pain and treatment uptake for period pain among allistic and autistic populations. METHODS This study used a qualitative design and opportunity sampling approach. Thirty-seven participants (of whom 17 were autistic) were interviewed via video-conferencing software using a semi-structured topic guide. Transcriptions of interviews were analysed using Braun and Clarke's Reflexive Thematic Analysis. Data were initially analysed together for common themes. Autistic menstruators' data was subsequently analysed separately to elucidate the unique experiences of this group. RESULTS A total of six themes were constructed from the data. Initial analysis determined three themes related to experiences of period pain and treatment uptake in both allistic and autistic menstruators. Social perception of menstruation was discussed, highlighting the normalisation of pain, the taboo nature, and gendered experience of menstruation, contributing to untreated menstrual pain. Issues within menstrual healthcare were also shared, including experiences of ineffective treatment, dismissive interactions, and insufficient menstrual education. Impaired functionality was repeatedly highlighted, with menstruators detailing significant limitations to their usual functioning due to menstrual pain and ineffective treatment. Three further themes were constructed from separate analysis of data from autistic menstruators. Autistic menstruators discussed the impact of menstruation on their sensory experiences and needs, with many identifying overstimulation during menstruation. Social exclusion was discussed as a factor contributing to the experience of menstrual pain and poor treatment uptake. The final theme identified pain communication differences between autistic and allistic menstruators resulting in reports of ineffective treatment and challenges in healthcare interactions. CONCLUSIONS Communication differences, sensory aspects, and social factors contributed to the experience of period pain and treatment uptake for autistic menstruators. The perception of menstruation within society was highlighted by allistic and autistic menstruators as influential to their pain experience and engagement with treatment. Functionality was significantly impacted by pain for this sample. The study highlights societal and healthcare factors that could be improved to ensure accessibility of support and treatment for menstrual issues.
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Affiliation(s)
- Lauren J Gray
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Hannah Durand
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland.
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Han K, Lim NK, Choi H, Song BM, Park HY. Weight Changes and Unhealthy Weight Control Behaviors Are Associated With Dysmenorrhea in Young Women. J Korean Med Sci 2023; 38:e136. [PMID: 37158772 PMCID: PMC10166698 DOI: 10.3346/jkms.2023.38.e136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/18/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the prevalence of dysmenorrhea and to investigate the effect of weight changes or unhealthy weight control behaviors on dysmenorrhea in young Korean women. METHODS We used large-scale data of women, aged 14 to 44 years, who participated in the Korean Study of Women's Health-Related Issues. Dysmenorrhea was measured using a visual analog scale and was categorized as none, mild, moderate, and severe according to the severity. Weight changes and unhealthy weight control behaviors (any of the behaviors, fasting/meal skipping, drugs, the use of unapproved dietary supplements, and one-food diets) over the past year were self-reported. We used multinomial logistic regression to investigate the association between weight changes or unhealthy weight control behaviors and dysmenorrhea. RESULTS Of the 5,829 young women participating in the study, 5,245 (90.0%) participants experienced dysmenorrhea [2,184 (37.5%) had moderate and 1,358 (23.3%) had severe]. After adjusting for confounders, the odds ratios for moderate and severe dysmenorrhea in participants with weight changes ≥ 3 kg (vs. < 3 kg) were 1.19 (95% confidence interval: 1.05-1.35) and 1.25 (95% confidence interval: 1.08-1.45), respectively. The odds ratios in participants with any unhealthy weight control behaviors were 1.22 (95% confidence interval: 1.04-1.42) and 1.41 (95% confidence interval: 1.19-1.67) for those with moderate and severe dysmenorrhea, respectively. CONCLUSION Weight changes (≥ 3 kg) or unhealthy weight control behaviors are common among young women, which may adversely affect dysmenorrhea. Therefore, attention needs to be paid to excessive weight changes and unhealthy weight control behaviors to improve dysmenorrhea in young women.
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Affiliation(s)
- Kyunghee Han
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Nam-Kyoo Lim
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Hansol Choi
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Bo Mi Song
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Hyun-Young Park
- Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea.
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MacGregor B, Allaire C, Bedaiwy MA, Yong PJ, Bougie O. Disease Burden of Dysmenorrhea: Impact on Life Course Potential. Int J Womens Health 2023; 15:499-509. [PMID: 37033122 PMCID: PMC10081671 DOI: 10.2147/ijwh.s380006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
Dysmenorrhea is the most common gynecologic condition among the female population and has a significant impact on life course potential. It has a widespread impact on a female's mental and physical well-being, with longstanding impairments on quality of life, personal relationships, and education and career attainment. Furthermore, untreated dysmenorrhea can lead to hyperalgesic priming, which predisposes to chronic pelvic pain. Primary dysmenorrhea is pain in the lower abdomen that occurs before or during menses and in the absence of pelvic pathology. One possible mechanism is endometrial inflammation and increased prostaglandin release, resulting in painful uterine contractions. Dysmenorrhea may also occur secondary to pelvic pathology, such as endometriosis, adenomyosis or due to cyclic exacerbation of non-gynecologic pain conditions. A thorough patient evaluation is essential to differentiate between potential causes and guide management. Treatment must be tailored to individual patient symptoms. Pharmacologic management with non-steroidal anti-inflammatory medications and/or combined hormonal contraceptives is most common. Heat therapy, exercise, vitamins and dietary supplements have limited evidence and can be offered for patients seeking non-pharmacologic adjunctive or alternative options. Greater awareness for both health-care providers and patients allows for early intervention to reduce impact on quality of life and life course potential.
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Affiliation(s)
- Brittany MacGregor
- Department of Obstetrics and Gynaecology, University of British Columbia, BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, Canada
| | - Catherine Allaire
- Department of Obstetrics and Gynaecology, University of British Columbia, BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, Canada
| | - Mohamed A Bedaiwy
- Department of Obstetrics and Gynaecology, University of British Columbia, BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, Canada
| | - Paul J Yong
- Department of Obstetrics and Gynaecology, University of British Columbia, BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, Canada
- Paul J Yong, Department of Obstetrics & Gynecology, University of British Columbia, FRCSC, F2 – 4500 Oak Street, Vancouver, British Columbia, V6H3N1, Canada, Email
| | - Olga Bougie
- Department of Obstetrics and Gynaecology, Queen’s University, Kingston, Canada
- Correspondence: Olga Bougie, 76 Stuart Street, Victory 4, Department of Obstetrics & Gynecology, Queen’s University, Kingston, Ontario, Canada, K7L 2V7, Email
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Liu Z, Li Z, Meng Q, Gu Z, Cui J. Bibliometric Analysis of Global Research Landscape and Hotspots on Dysmenorrhea: Where are We Now? J Pain Res 2023; 16:269-285. [PMID: 36744113 PMCID: PMC9891078 DOI: 10.2147/jpr.s396083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/04/2023] [Indexed: 02/07/2023] Open
Abstract
Purpose Dysmenorrhea is the most common gynecological condition among women of childbearing age and remains a challenging public health issue. This study aimed to visualize profiles and hotspots in dysmenorrhea research through a bibliometric analysis to deepen the understanding of knowledge in this field. Methods Articles and reviews on dysmenorrhea published from 2000 to 2021 were collected. We summarized standard bibliometric indicators. Publications were systematically assessed in terms of country, institution, author, journal, reference, and keywords using Citespace, VOSviewer, Bibliometric, and an online platform. Besides, correlation analyses of country-specific characteristics and bibliometric indicators were performed. Results 3407 publications were included. Dysmenorrhea-related publications have been increasing steadily annually. China and the United States were the most productive and academically influential countries, respectively. Correlation analysis revealed that economic power is an essential factor influencing scientific activity. However, collaboration in dysmenorrhea research remained weak. Natl Yang Ming Univ and Vercellini P were the most productive institution and influential author, respectively. A significant proportion of dysmenorrhea research was published in high-impact journals and it was explored at a multidisciplinary level. Current research topics focus on two primary areas: (1) pathophysiology, such as pathogenesis, oxidative stress, and functional connectivity, and (2) public health impacts, such as quality of life, burden, depression, and exercise. Conclusion Dysmenorrhea research has received extensive attention from scholars and is rapidly evolving. Improved collaboration and interdisciplinary exploration may advance this field. Public health research and pathophysiological exploration of dysmenorrhea are current research hotspots and may also be a focus of research in the coming years.
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Affiliation(s)
- Zhihui Liu
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zhuo Li
- School of Medicine, Nankai University, Tianjin, People’s Republic of China
| | - Qian Meng
- Department of Obstetrics and Gynecology, Zibo Maternal and Child Health Hospital, Zibo, People’s Republic of China
| | - Zhenpeng Gu
- Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, People’s Republic of China
| | - Jinxiu Cui
- Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, People’s Republic of China,Correspondence: Jinxiu Cui, Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou, Shandong Province, 256603, People’s Republic of China, Email
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Li R, Kreher DA, Gubbels AL, Palermo TM, Benjamin AR, Irvine CS, Hart A, Jusko TA, Seplaki CL. Dysmenorrhea catastrophizing and functional impairment in female pelvic pain. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2023; 3:1053026. [PMID: 36688085 PMCID: PMC9853896 DOI: 10.3389/fpain.2022.1053026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023]
Abstract
Background Dysmenorrhea is suggested to increase the risk of chronic pain by enhancing central sensitization. However, little is known about whether emotional and cognitive responses induced by dysmenorrhea contribute to chronic pain interference. This study examined the association between catastrophizing specific to dysmenorrhea and both dysmenorrhea and chronic pelvic pain (CPP)-associated pain interference. Methods Women (N = 104) receiving care for CPP through a tertiary gynecological pain clinic between 2017 and 2020 were recruited. They completed the Pain Catastrophizing Scale, the Brief Pain Inventory-pain interference, and a separate questionnaire regarding dysmenorrhea symptoms and treatment preceding the development of CPP. Dysmenorrhea catastrophizing and interference measures were developed and tested for internal consistency and construct validity. Multiple linear regression models examined dysmenorrhea catastrophizing in association with dysmenorrhea interference and CPP-associated pain interference. Results Dysmenorrhea catastrophizing and interference measures demonstrated excellent internal consistency (Cronbach's Alpha = 0.93 and 0.92 respectively) and evidence of construct validity (correlated with dysmenorrhea severity and treatment, Ps < 0.01). Dysmenorrhea catastrophizing was moderately correlated with pain catastrophizing (ρ = 0.30, P = 0.003), and was associated with greater dysmenorrhea interference (P < 0.001) and CPP-associated pain interference (P = 0.032) accounting for general pain catastrophizing and other outcome-specific confounders. Dysmenorrhea intensity was most predictive of dysmenorrhea catastrophizing. Conclusion Among our clinical sample of women with CPP, dysmenorrhea catastrophizing was associated with greater dysmenorrhea interference and subsequent CPP-associated pain interference. More research is needed to determine whether reduction in dysmenorrhea catastrophizing leads to reduced pain interference associated with female pelvic pain.
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Affiliation(s)
- Rui Li
- Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, United States,Correspondence: Rui Li
| | - Donna A. Kreher
- Department of Psychiatry, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
| | - Ashley L. Gubbels
- Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, OH, United States
| | - Tonya M. Palermo
- Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, United States,Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Amy R. Benjamin
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
| | - Carrie S. Irvine
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
| | - Andrea Hart
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
| | - Todd A. Jusko
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
| | - Christopher L. Seplaki
- Department of Psychiatry, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States,Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States
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Mizuta R, Maeda N, Tashiro T, Suzuki Y, Oda S, Komiya M, Urabe Y. Quality of life by dysmenorrhea severity in young and adult Japanese females: A web-based cross-sectional study. PLoS One 2023; 18:e0283130. [PMID: 36928823 PMCID: PMC10019623 DOI: 10.1371/journal.pone.0283130] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/03/2023] [Indexed: 03/18/2023] Open
Abstract
Dysmenorrhea is a monthly menstrual pain that can limit a woman's quality of life (QOL). The relationship between dysmenorrhea severity and QOL has been reported in several countries; however, the results cannot be generalized because lifestyle and cultural background affect menstrual pain. This study sought to uncover whether 1) different factors, such as emotions and ways of coping with symptoms, vary with the severity of dysmenorrhea and 2) the severity of dysmenorrhea ultimately affects QOL in Japan. A web-based cross-sectional survey was sent to 1000 Japanese females aged 16-30 years. The respondents were divided into two groups: those without dysmenorrhea (n = 24) and those with dysmenorrhea (n = 471). The severity of dysmenorrhea was classified using the Numerical Rating Scale as either mild (1-3), moderate (4-7), or severe (8-10). In total, 156 respondents reported mild dysmenorrhea, 249 reported moderate dysmenorrhea, and 66 reported severe dysmenorrhea. QOL was measured using the 26-item World Health Organization Quality of Life scale. One-way ANOVA and Kruskal-Wallis tests were used to compare QOL across different levels of dysmenorrhea severity, depending on normality. Ultimately, significant differences in QOL scores (p<0.001) were observed based on dysmenorrhea severity, with respondents with severe dysmenorrhea reporting the lowest QOL scores. Meanwhile, significant differences were observed in the physical, psychological, and environmental subscales (p<0.001, p<0.001, p = 0.019) across respondents with different levels of dysmenorrhea severity; notably, respondents with severe dysmenorrhea demonstrated a negative spiral of chronic pain, which may significantly impact QOL, and, relatedly, a relatively low psychological QOL. This study is the first to show the relationship between dysmenorrhea severity and QOL in Japanese females, who are more likely to experience negative feelings during menstruation.
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Affiliation(s)
- Rami Mizuta
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noriaki Maeda
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsubasa Tashiro
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuta Suzuki
- Department of Physical Therapy, Faculty of Rehabilitation, Kyusyu Nutrition Welfare University, Fukuoka, Japan
| | - Sakura Oda
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Komiya
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Urabe
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- * E-mail:
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Gurung A, Khatiwada B, Kayastha B, Parsekar S, Mistry SK, Yadav UN. Effectiveness of Zingiber Officinale(ginger) compared with non-steroidal anti-inflammatory drugs and complementary therapy in primary dysmenorrhoea: A systematic review. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Muacevic A, Adler JR. Investigation of Laboratory and Clinical Features of Primary Dysmenorrhea: Comparison of Magnesium and Oral Contraceptives in Treatment. Cureus 2022; 14:e32028. [PMID: 36600872 PMCID: PMC9800031 DOI: 10.7759/cureus.32028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
Background The goal of this study was to identify the demographic, clinical, and laboratory characteristics of primary dysmenorrhea (PD) patients, as well as to compare the treatment options of 200 mg magnesium citrate (MgS) and combination oral contraceptive (COC) therapy. Methods This is a case-controlled prospective study consisting of 172 women with PD and a control group consisting of age-matched 172 without PD. The cases in the primary dysmenorrhea group were randomly divided into two groups, with 86 patients in the first group receiving 200 mg MgS, and 86 patients in the second group receiving COC treatment. The Visual Analogue Scale (VAS) was used to measure the severity of dysmenorrhea. VAS scoring was performed on the control group subjects included in the study at their first evaluation and the PD group subjects before treatment and at the third month of treatment (after three menstrual cycles). Results When compared to healthy controls, the PD patients had significantly more menstrual bleeding (p = 0.005), more history of maternal dysmenorrhea (p < 0.001), lower serum calcium (p < 0.001), lower serum 25-hydroxyvitamin D3 (p < 0.001) and more 25-hydroxyvitamin D deficiency (p < 0.001). When compared to the MgS group, the patients in the COC group had significantly lower VAS scores and less need for painkillers following treatment (p < 0.001). The MgS treatment group had significantly lower post-treatment VAS values than pre-treatment VAS values. Conclusion Lower serum calcium and 25-hydroxyvitamin D levels were found in the presence of PD. In addition, it was observed that the administration of 200 mg MgS to PD patients significantly reduced pelvic pain in dysmenorrhea, although not as much as COC administration, and caused significant reductions in the need for painkillers.
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Armour M, Parry K, Curry C, Ferfolja T, Parker MA, Farooqi T, MacMillan F, Smith CA, Holmes K. Evaluation of a web-based resource to improve menstrual health literacy and self-management in young women. J Psychosom Res 2022; 162:111038. [PMID: 36179421 DOI: 10.1016/j.jpsychores.2022.111038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/07/2022] [Accepted: 09/10/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Menstrual cycle-related conditions, such as dysmenorrhea and heavy bleeding, are common amongst those under 25 years. Despite having significant impact on work, education, and social activities, most do not seek medical advice, preferring to self-manage their symptoms. We aimed to determine if access to a web-based resource was a feasible and acceptable method for improving menstrual health literacy and encouraging health seeking behavior. METHODS People were eligible to participate if they were currently living in Australia, aged 14-25 years, and had menstruated for at least 12 months. Access to the resource, comprising evidence-based information on the menstrual cycle, the Period ImPact and Pain Assessment (PIPPA) tool, and guidance on self-management options, was provided for three menstrual cycles. RESULTS Seventy-five participants with a mean age of 20.4 years were enrolled with 56 (75%) providing pre and post measures. Recruitment rate and retention rates met pre-specified criteria for feasibility. Eighty five percent of the participants reported the web-based resource was easy to use, and 90% reported they found the information provided 'very helpful'. Just under half (48%) reported the resource changed what they thought was a 'normal' period. Forty-three percent visited their doctor regarding their menstrual symptoms during the study period, with 84% indicating that they made the appointment due to the resource; over half (56%) who visited their doctor received a referral to a gynecologist. CONCLUSION Access to a web-based resource on menstrual health literacy was found to be acceptable and feasible to young people and may encourage health-seeking behavior.
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Affiliation(s)
- Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia; Translational Health Research Institute (THRI), Western Sydney University, Penrith, New South Wales, Australia; Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand.
| | - Kelly Parry
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Christina Curry
- Centre for Educational Research, Western Sydney University, Penrith, New South Wales, Australia
| | - Tania Ferfolja
- Centre for Educational Research, Western Sydney University, Penrith, New South Wales, Australia
| | - Melissa A Parker
- Canberra Endometriosis Centre, Department of Obstetrics and Gynaecology, ACT Health, Canberra, Australian Capital Territory, Australia
| | - Toobah Farooqi
- School of Medical Sciences, The University of New South Wales, Kensington, New South Wales, Australia
| | - Freya MacMillan
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, New South Wales, Australia; School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia; Translational Health Research Institute (THRI), Western Sydney University, Penrith, New South Wales, Australia
| | - Kathryn Holmes
- Centre for Educational Research, Western Sydney University, Penrith, New South Wales, Australia
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Ní Chéileachair F, McGuire BE, Durand H. Coping with dysmenorrhea: a qualitative analysis of period pain management among students who menstruate. BMC Womens Health 2022; 22:407. [PMID: 36199106 PMCID: PMC9533282 DOI: 10.1186/s12905-022-01988-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dysmenorrhea, or period pain, affects up to 95% of menstruating individuals and is a common cause of educational absenteeism among students who menstruate worldwide. Evidence suggests that students may lack sufficient knowledge about their menstrual health, which may impede self-management. The aim of the current study was to explore pain management strategies used by students in Ireland with painful periods and to identify their unaddressed needs across physical, psychological, educational, and social domains. METHODS This study used a qualitative, interpretive design and opportunity sampling approach to collect and interpret individual accounts of dysmenorrhea from third-level students in Ireland. Data from 21 students were collected using semi-structured online one-to-one interviews and analysed using reflexive thematic analysis. RESULTS Analysis resulted in the construction of five themes: (1) Pain management is self-directed trial-and-error, (2) Home as safe haven, (3) Prioritising productivity over pain, (4) We're missing an option between 'normalise' and 'medicalise', and (5) Cycle of censorship and concealment. Overall, limited formal education on dysmenorrhea and prevailing negative attitudes towards menstruation create an unsupportive environment for students to learn adequate coping skills. Beyond education, menstrual stigma may also restrict the availability of clear management guidance in domestic and medical spheres. Experiences of dysmenorrhea were also influenced by the COVID-19 pandemic, where work-from-home measures were viewed favourably by individuals with dysmenorrhea. CONCLUSIONS This study indicates that students in Ireland are inadequately prepared to cope with dysmenorrhea. The current findings have substantial implications for evaluating and reforming current menstrual education standards, in addition to clarifying the negative effects of social stigma on menstrual health literacy.
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Affiliation(s)
- Fódhla Ní Chéileachair
- School of Psychology, University of Galway, Galway, Ireland ,Centre for Pain Research, University of Galway, Galway, Ireland
| | - Brian E. McGuire
- School of Psychology, University of Galway, Galway, Ireland ,Centre for Pain Research, University of Galway, Galway, Ireland
| | - Hannah Durand
- School of Psychology, University of Galway, Galway, Ireland ,Centre for Pain Research, University of Galway, Galway, Ireland ,grid.11918.300000 0001 2248 4331Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland, UK
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Wang L, Yan Y, Qiu H, Xu D, Zhu J, Liu J, Li H. Prevalence and Risk Factors of Primary Dysmenorrhea in Students: A Meta-Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1678-1684. [PMID: 35523614 DOI: 10.1016/j.jval.2022.03.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/25/2022] [Accepted: 03/30/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Primary dysmenorrhea (PD), as the most common complaint among students, is also one of the public problems worldwide. Prevalence and risk factors of PD were variant between studies; as the main population, no meta-analysis for PD has hitherto been conducted in students. METHODS We searched the published literature in PubMed, Embase, the Cochrane Library, Web of Science, National Knowledge Infrastructure, WANFANG, and VIP database. After screening and assessing the quality of studies, data from eligible studies were extracted for meta-analysis via the R language. RESULTS A total of 96 studies published from 1991 to 2021 with 78 068 students were included, the mean age of participants was 19.4, and 79.9% were university students. The pooled overall prevalence of PD was 66.1% (95% confidence interval [CI] 63.4-68.9), and 31.1% (CI 28.1-34.3), 25.7% (CI 23.4-28.0), and 8.3% of students (CI 7.4-9.3) reported mild, moderate, and severe PD, respectively. Besides, the prevalence of PD was estimated at 58.8% (CI 54.3-63.7) before 2010, but ascended to 68.5% (CI 65.5-71.6) after 2010 and rose to 71.5% (CI 65.8-76.6) in 2015 to 2021. About risk factors for PD, underweight, skipping breakfast, poor sleep quality, staying up late, lack of physical exercise, exposure to cold and eating cold or spicy foods during menstruation, dietary bias, prefer snacks, family history of dysmenorrhea, irregular menstrual cycle, heavy stress, negative emotion during menstruation, and anxiety were significantly related to PD. CONCLUSIONS The overall prevalence of PD among students was 66.1% and had a rising tendency in the last 10 years. Our findings helped understand the current prevalence and improve the administration of PD among students.
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Affiliation(s)
- Liwen Wang
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China; The Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha, Hunan Province, China; Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yuhan Yan
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Huiyu Qiu
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China; The Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha, Hunan Province, China
| | - Datong Xu
- Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Jiaqi Zhu
- Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Jing Liu
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
| | - Hui Li
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China; The Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha, Hunan Province, China.
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Alhammadi MH, Albogmi AM, Alzahrani MK, Shalabi BH, Fatta FA, AlBasri SF. Menstrual cycle irregularity during examination among female medical students at King Abdulaziz University, Jeddah, Saudi Arabia. BMC Womens Health 2022; 22:367. [PMID: 36068523 PMCID: PMC9446759 DOI: 10.1186/s12905-022-01952-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Menstrual irregularity is defined as any differences in the frequency, irregularity of onset, duration of flow, or volume of blood from the regular menstrual cycle. It is an important medical issue that many medical students suffer from. The study aimed to determine the menstrual cycle abnormalities women experienced during exams and to investigate the most common types of irregularities among female medical students at King Abdulaziz University in Jeddah, Saudi Arabia.
Methods
A cross-sectional study was conducted among female medical students between September and October 2021 at King Abdulaziz University in Jeddah, Saudi Arabia. For this study, the estimated sample size (n = 450) was derived from the online Raosoft sample size calculator. Thus, 450 female medical students from second to sixth year were selected through stratified random sampling. A validated online questionnaire collected data about demographics, menstrual irregularities during exams, type of irregularities, menstrual history, family history of menstrual irregularities, premenstrual symptoms, medication use, medical and family consultations, and absenteeism. The chi-squared test (χ2) was used to analyze the associations between variables.
Results
A total of 48.2% of participants had menstrual irregularities during exams. The most common irregularity was dysmenorrhea (70.9%), followed by a lengthened cycle (45.6%), and heavy bleeding (41.9%). A total of 93% of medical students suffered from premenstrual symptoms and 60.4% used medication such as herbal medication and home remedies to relieve menstrual irregularities, and 12.1% of the students missed classes due to menstrual irregularities. A non-significant relationship was found between menstrual irregularities during exams and students’ demographics, academic year, and age at menarche, while oligomenorrhea, a heavier than normal bleed, a longer than normal cycle, and missing classes due to menstrual irregularities were significantly higher among single students as opposed to married students.
Conclusion
The results showed that female medical students have a significant frequency of menstruation abnormalities during exams period. Colleges should raise awareness among medical students about coping with examination stress and seeking medical care for menstrual abnormalities.
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Ortiz MI, Espinoza-Ramírez AL, Cariño-Cortés R, Moya-Escalera A. [Impact of primary dysmenorrhea on the academic performance of university students]. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32:351-357. [PMID: 36085001 DOI: 10.1016/j.enfcle.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/18/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Primary dysmenorrhea has a high prevalence among the student population. The objective of this study was to determine the prevalence of dysmenorrhea, its severity and its impact on academic performance in Mexican university students. METHODS Cross-sectional study. An anonymous multiple-choice questionnaire was applied in class hours in the classrooms. The visual pain scale (VAS) was used for the measurement of pain. A descriptive and inferential analysis of the variables studied was carried out using the program SPSS® IBM. RESULTS A total of 2154 (n=2154) students were surveyed. The average age of the women was 20.4 ±1.9years. The general prevalence of dysmenorrhea was 78.9%, with psychology students having the highest value (83.7%). The VAS mean pain score was of 64.0. The severity of menstrual pain in students was reported as mild in 9.0%, and moderate-severe in 91.0%. The VAS mean pain scores and intensity of pain of gerontology students were significantly higher than those reported by dentistry and medicine students (P<.05). Limitation of daily activities was reported in 90.4% of women, with medical students reporting the highest percentage (93.3%). Women reported school absenteeism in 37.0%, with medical students presenting the highest percentage (41.4%). The severity of menstrual pain as a risk factor (independent variable) positively influenced various dependent variables involved in students' academic performance (P<.05), including: stop doing their activities due to pain in 1 to 6 menstruations a year, minor concentration, absenteeism, low school performance, and lower grades during dysmenorrhea. CONCLUSION A high prevalence of dysmenorrhea was observed and it is concluded that the severity of the symptomatology significantly interferes with the academic performance of the participants.
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Affiliation(s)
- Mario I Ortiz
- Área Académica de Medicina del Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, México.
| | - Ana L Espinoza-Ramírez
- Área Académica de Medicina del Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, México
| | - Raquel Cariño-Cortés
- Área Académica de Medicina del Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, México
| | - Adrián Moya-Escalera
- Área Académica de Medicina del Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, México
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