Prevalence of Primary Dysmenorrhoea and Its Impact on Academic Performance among Croatian Students during the COVID-19 Pandemic

Efficacy and safety of therapeutic exercise for primary dysmenorrhea: a systematic review and meta-analysis

Objective

A growing number of research papers have looked at the influence of exercise on pain severity in people with primary dysmenorrhea, but the findings have been inconsistent. The purpose of this research was to thoroughly evaluate the impact of exercise on pain severity in individuals with primary dysmenorrhea and to find the best exercise regimen for these patients.

Methods

All randomized controlled trials (RCTs) of exercise for patients with primary dysmenorrhea were searched in the Embase, PubMed, Cochrane, Web of Science, EBSCO, and CINAHL databases. The search time limit was set from the establishment of each database to 28 January 2025. Control groups included those receiving usual care, only providing health education, or no intervention at all. The outcome measure was pain intensity. The effect size was aggregated using the mean difference (MD) and 95% confidence interval (CI). The methodological quality of the included studies was evaluated using the Cochrane risk-of-bias tool. Stata 15 software was used for meta-analysis, sensitivity analysis, and assessment of potential publication bias. R 4.4.1 software was used for network meta-analysis, area under curve ranking (SUCRA), league plot, and meta-regression.

Results

The analysis included a total of 29 studies that satisfied the criteria. Exercise decreased the visual analog scale (VAS, WMD = -2.62, 95% CI [-3.29, -1.95], p < 0.001) score in individuals with primary dysmenorrhea. Strength training (WMD = -1.76, 95% CI [-2.03, -1.48], p < 0.001), exercise duration of ≥8 weeks (WMD = -1.77, 95% CI [-1.87, -1.66], p < 0.001), frequency of >3 times per week (WMD = -1.60, 95% CI [-1.75, -1.45], p < 0.001), session length of >30 min (WMD = -2.20, 95% CI [-2.38, -2.02], p < 0.001), and a total of ≥90 min per week (WMD = -2.04, 95% CI [-2.19, -1.89], p < 0.001) showed superior efficacy in enhancing VAS (subgroup analyses).

Conclusion

Engaging in physical activity may reduce the intensity of discomfort encountered by individuals afflicted with primary dysmenorrhea, with strength training potentially emerging as the most efficacious alternative. The meta-analysis presents evidence that supports clinicians' advice to patients with primary dysmenorrhea, recommending that they exercise for a minimum of 8 weeks, with sessions occurring more than three times weekly and lasting longer than 30 min each. The goal is to achieve a minimum weekly total of 90 min by increasing the frequency of workouts.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024581879, CRD42024581879.

The influence of physical activity, body mass index and urinary levels of prostaglandin (PGF2α) with the incidence of primary dysmenorrhea in adolescents

OBJECTIVE

This study aims to investigate the effect of physical activity, body mass index (BMI), and levels of prostaglandins (PGF2α) urine on the occurrence of dysmenorrhea in adolescents.

METHODS

A total of 128 female students included in the study. The study was conducted from January to March 2023 using a cross-sectional design. This study utilized the Menstrual Symptom Questionnaire (MSQ) and gynecological examination with ultrasonography. The urinary prostaglandin (PGF2α) was measured using the enzyme linked immuno sorbent assay (ELISA). Data were analyzed using the chi-square test and logistic regression test.

RESULTS

The age range of the participants included in the study was 14-17, with a mean age of 15.85 ± 0.65. There was an correlation between physical activity, BMI, and urinary prostaglandin (PGF2α) levels with the incidence of dysmenorrhea in adolescents (p < 0.001). In multivariate analysis, it revealed that underweight, and had a high urinary prostaglandin significant correlated to primary dysmenorrhea with odds ratio 4.78 (95% confidence interval [CI] 1.98-11.54) and 4.88 (95% CI 1.98-12.08), respectively. High physical activity and overweight was not associated with incidence of dysmenorrhea in adolescents.

CONCLUSION

This study provides valuable insights into the correlation between physical activity, BMI, and levels of prostaglandins (PGF2α) in urine. A high level of urinary prostaglandin was found to be the most influential factor in the incidence of primary dysmenorrhea in adolescents. By addressing factors associated with dysmenorrhea in adolescents, healthcare professionals can potentially enhance well-being by reducing menstrual pain and encouraging a healthy lifestyle to prevent dysmenorrhea.

The impact of COVID-19 on menstrual cycle's alterations, in relation to depression and sleep disturbances: a prospective observational study in a population of medical students

BACKGROUND

The sars-Cov-2 pandemic has determined psychological stress, particularly in the young population of medical students. We studied the impact of the pandemic on menstrual cycle alteration in relation to psychological stress, presence of depression, sleep disturbances and post-traumatic stress, on a population of medical students.

METHODS

293 female students at the Faculty of Medicine and Psychology of the Sapienza University of Rome (23.08 years old ± 3.8) were enrolled. In March 2021, one year after quarantine, a personal data sheet on menstrual cycle, examining the quality of the menstrual cycle during the pandemic, compared to the previous period. Concomitantly, the Beck Depression Inventory and the Impact of Event Scale have been administered. A Pearson chi-square test was assessed to evaluate the difference between the characteristics of the menstrual cycle and the scores obtained with the questionnaires.

RESULTS

A statistically significant association between menstrual alterations and stress during pandemic had been found. The onset of depressive symptoms and sleep disturbances was observed in 57.1% and in 58.1% of young women with cycle's alterations, respectively. Amenorrhea was three times more common in female students with depressive symptoms, premenstrual syndrome had a significant correlation with both depression and sleep disturbances. The pandemic has been related to menstrual alterations, with depressive symptoms and sleep disorders. Amenorrhea is connected to depression, as observed on the functional hypothalamic amenorrhea.

CONCLUSIONS

The pandemic affected the menstrual cycle as well as the depressive symptoms and sleep. Practical implications of the study lead to the development of strategies for psychological intervention during the pandemic experience, in order to help medical trainees, with specific attention to women's needs. Future studies should analyze the impact of other types of social stress events, on sleep, depression and the menstrual cycle beside the pandemic.