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European Journal of Clinical... May 2022Primary dysmenorrhea is one of the most common complaints in women. To date, no definitive results have been reported on the effect of omega-3 polyunsaturated fatty... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Primary dysmenorrhea is one of the most common complaints in women. To date, no definitive results have been reported on the effect of omega-3 polyunsaturated fatty acids (n-3 PUFAs) on primary dysmenorrhea. Therefore, this study aimed to determine the effect of n-3 PUFAs on primary dysmenorrhea using a systematic review and meta-analysis.
METHODS
This study is a systematic review and meta-analysis in which the electronic databases of PubMed, Scopus, Web of Science, ProQuest, Google Scholar, and SID were searched. In this regard, randomized controlled trials (RCTs) conducted to investigate the effect of n-3 PUFAs on primary dysmenorrhea were included. The quality of the studies was assessed using the Cochrane Collaboration's Risk of Bias Tool. Meta-analysis was performed based on the random-effects model using CMA software version 2.
RESULTS
The results of the meta-analysis showed that n-3 PUFAs reduce the severity of primary dysmenorrhea in women (SMD = -1.075, 95% CI: -1.871 to -0.279); meta-regression showed that the daily intake of n-3 PUFAs (β = 0.005, 95% CI 0.003 to 0.008, p < 0.001) and age of women (β = 0.256, 95% CI -0.157 to -0.354, p < 0.001) had a significant effect on the severity of primary dysmenorrhea.
CONCLUSION
The present study showed that n-3 PUFAs could have a mild effect on the severity of primary dysmenorrhea in women. Furthermore, the highest effectiveness of treatment was seen at low doses of n-3 PUFAs, and with increasing daily intake, the effectiveness of treatment with n-3 PUFAs decreased. Another finding indicated that with the increasing age of women, n-3 PUFAs showed lesser effectiveness in reducing the severity of primary dysmenorrhea. The results of the present study provide valuable evidence to primary healthcare providers and health policymakers in the treatment of primary dysmenorrhea.
Topics: Dysmenorrhea; Fatty Acids, Omega-3; Female; Humans; Randomized Controlled Trials as Topic
PubMed: 35059756
DOI: 10.1007/s00228-021-03263-1 -
Scientific Reports May 2022Primary dysmenorrhea (PD) is a common gynecological condition among adolescent and adult women. Several pharmacological and alternative therapies (e.g. therapeutic... (Meta-Analysis)
Meta-Analysis
Primary dysmenorrhea (PD) is a common gynecological condition among adolescent and adult women. Several pharmacological and alternative therapies (e.g. therapeutic taping) have been used to treat PD, with varying effect. This systematic review and meta-analysis was performed to evaluate the safety and efficacy of therapeutic taping on clinical symptoms of PD, considering pain as the primary outcome. MEDLINE, Cochrane Library, Embase, PEDro, CINAHL and gray literature sources were searched from inception to February 2022 for randomized controlled trials (RCTs) that assessed the effect of therapeutic taping for PD. The language was restricted to English. A total of ten studies were included in the systematic review, involving 685 participants. Eight studies were included in quantitative analysis. The quality of the studies ranged from 4 to 7 with a median of 5 as assessed by PEDro scale. Meta-analyses indicated short-term improvements of pain compared to sham and no interventions. Elastic therapeutic taping (ETT) indicated short term improvements in anxiety associated with PD. Moderate to high quality of evidence suggested that ETT is an effective intervention in improving pain, anxiety, and quality of life of women with PD. A scarcity of evidence on the long-term effects of therapeutic taping in PD is observed.
Topics: Adolescent; Adult; Dysmenorrhea; Female; Humans; Pain Measurement; Quality of Life
PubMed: 35504906
DOI: 10.1038/s41598-022-11034-w -
Journal of Minimally Invasive Gynecology 2016The objective of this study was to evaluate the prevalence of cesarean scar defects and its clinical manifestations in reproductive-aged women. We performed a systematic... (Review)
Review
The objective of this study was to evaluate the prevalence of cesarean scar defects and its clinical manifestations in reproductive-aged women. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement using keywords of "cesarean scar defect, uterine scar defect, uterine diverticulum niche, isthmocele, pouch, or sacculation" and their combination. Thirty-two trials met the inclusion criteria. Cesarean scar defects are commonly found on ultrasound examination (24%-88%). Their presence could be asymptomatic or related to postmenstrual spotting, postmenstrual bleeding, or infertility. The prevalence of this condition is related to the number of cesarean deliveries. Hysteroscopic repair of a cesarean scar defect or isthmoplasty is associated with an improvement in uterine bleeding in 59% to 100% of cases and a pregnancy rate of 77.8% to 100%. An improvement in uterine bleeding after vaginal repair occurred in 89% to 93.5% of cases. Laparoscopic repair led to uterine bleeding improvement in 86% of cases and a pregnancy rate of 86%. The association between cesarean scar defect and infertility, pelvic pain, and dysmenorrhea require more studies. Treatment of uterine scar defects should be performed after eliminating other causes of postmenstrual bleeding or infertility. Hysteroscopic isthmoplasty appears to be the most popular treatment. However, in the absence of randomized trials, the efficacy of different surgical approaches remains to be seen. Until we have concrete evidence, the treatment should be reserved for selective cases.
Topics: Adult; Cesarean Section; Cicatrix; Dysmenorrhea; Female; Humans; Infertility, Female; Laparoscopy; Metrorrhagia; Pelvic Pain; Postoperative Complications; Pregnancy; Prevalence; Ultrasonography; Uterine Diseases; Uterine Hemorrhage; Wound Healing
PubMed: 27393285
DOI: 10.1016/j.jmig.2016.06.020 -
Frontiers in Global Women's Health 2022To compare efficacy and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) with systemic medication or blank control in the treatment of dysmenorrhea. (Review)
Review
Levonorgestrel-releasing intrauterine system vs. systemic medication or blank control for women with dysmenorrhea: Systematic review and meta-analysis of randomized controlled trials.
AIMS
To compare efficacy and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) with systemic medication or blank control in the treatment of dysmenorrhea.
METHODS
PubMed, EMBASE, the China National Knowledge Infrastructure (CNKI) and Wanfang Data were searched to collect randomized controlled trials (RCTs) comparing LNG-IUS with systemic medication or blank control among women diagnosed with primary dysmenorrhea or secondary dysmenorrhea (adenomyosis or endometriosis) from inception to 2020.04. Der Simonian-Laird random-effect model was used to pool data.
RESULTS
Seventy-one RCTs (6551 patients) were included. Overall bias risk was medium. Sixty-two articles enrolled patients with adenomyosis; LNG-IUS significantly reduced the visual analogue scale (VAS) score compared with the systemic medication group among adenomyosis women at 3 months (standardized mean difference (SMD) = -0.81, 95% confidence interval (CI) -1.22 to -0.40); 6 months (SMD = -1.25, 95%CI: -1.58 to -0.92); 9 months (SMD = -1.23, 95%CI: -1.63 to -0.83); 12 months (SMD = -1.66, 95%CI: -2.14 to -1.18). No difference was found in the incidence of irregular vaginal bleeding (16 RCTs; RR = 0.91, 95%CI: 0.62-1.33, = 0.63, = 4%) and other adverse outcomes. Sensitivity analysis regarding randomization methods was robust. Nine RCTs enrolled endometriosis women. Pooling results showed no significant difference between LNG-IUS and systemic medication treatment in terms of VAS at 6 months (SMD = -0.27, 95% CI: -0.97-0.43). Moreover, LNG-IUS was associated with higher risk of irregular vaginal bleeding (26.8% vs. 0).
CONCLUSIONS
LNG-IUS was associated with a reduced severity of dysmenorrhea compared with systemic medication; it was also beneficial for better control of menstrual blood loss and fewer adverse outcomes. Owing to small sample sizes, further well-designed RCTs are warranted to confirm these findings and long-term effects of LNG-IUS in the treatment of dysmenorrhea.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier: CRD42021228343.
PubMed: 36405811
DOI: 10.3389/fgwh.2022.1013921 -
Evidence-based Complementary and... 2016This systematic review examines the efficacy of oral ginger for dysmenorrhea. Key biomedical databases and grey literature were searched. We included randomized... (Review)
Review
This systematic review examines the efficacy of oral ginger for dysmenorrhea. Key biomedical databases and grey literature were searched. We included randomized controlled trials comparing oral ginger against placebo or active treatment in women with dysmenorrhea. Six trials were identified. Two authors independently reviewed the articles, extracted data, and assessed risk of bias. Discrepancies were resolved by consensus with a third reviewer. We completed a narrative synthesis of all six studies and exploratory meta-analyses of three studies comparing ginger with placebo and two studies comparing ginger with a nonsteroidal anti-inflammatory drug (NSAID). Ginger appeared more effective for reducing pain severity than placebo. The weighted mean difference on a 10 cm visual analogue scale was 1.55 cm (favoring ginger) (95% CI 0.68 to 2.43). No significant difference was found between ginger and mefenamic acid (an NSAID). The standardized mean difference was 0 (95% CI -0.40 to 0.41). Available data suggest that oral ginger could be an effective treatment for menstrual pain in dysmenorrhea. Findings, however, need to be interpreted with caution because of the small number of studies, poor methodological quality of the studies, and high heterogeneity across trials. The review highlights the need for future trials with high methodological quality.
PubMed: 27274753
DOI: 10.1155/2016/6295737 -
Journal of Pediatric and Adolescent... Aug 2023Menstrual dysfunction can impact both the physical and emotional health of young people. Multiple chronic diseases have been associated with menstrual dysfunction in... (Review)
Review
STUDY OBJECTIVE
Menstrual dysfunction can impact both the physical and emotional health of young people. Multiple chronic diseases have been associated with menstrual dysfunction in adults; however, there is little research in adolescents, despite nonadherence and suboptimal illness control in this group. We aimed to identify the impact of chronic illness on the age of menarche and the menstrual cycle in adolescents.
METHODS
Studies were extracted of female adolescents aged 10-19 who had a chronic physical illness. Data included outcomes on age of menarche and/or menstrual cycle quality. Exclusion criteria aimed to exclude diseases where menstrual dysfunction was a known part of the disease pathophysiology (ie, polycystic ovarian syndrome) or in which medications were used that directly impacted gonadal function. A literature search (to January 2022) was performed on the EMBASE, PubMed, and Cochrane library databases. Two widely used modified quality analysis tools were used.
RESULTS
Our initial search netted 1451 articles, of which 95 full texts were examined and 43 met the inclusion criteria. Twenty-seven papers focused on type 1 diabetes (T1D), with 8 papers examining adolescents with cystic fibrosis and the remaining studying inflammatory bowel disease, juvenile idiopathic arthritis, coeliac disease, and chronic renal disease. Metanalysis of 933 patients with T1D vs 5244 controls demonstrated a significantly later age of menarche in T1D (by 0.42 years; P ≤ .00001). There was also a significant association between higher HbA1c and insulin dose (IU/kg) and later age of menarche. Eighteen papers reviewed other aspects of menstruation, including dysmenorrhea, oligomenorrhoea, amenorrhea, and ovulatory function, with variable findings.
CONCLUSION
Most studies were small and in single populations. Despite this, there was evidence of delayed menarche and some evidence of irregular menses in those with cystic fibrosis and T1D. Further structured studies are needed to evaluate menstrual dysfunction in adolescents and how it relates to their chronic illness.
Topics: Adult; Female; Humans; Adolescent; Menstruation; Diabetes Mellitus, Type 1; Cystic Fibrosis; Menstruation Disturbances; Menarche; Menstrual Cycle; Chronic Disease
PubMed: 37192680
DOI: 10.1016/j.jpag.2023.05.005 -
Frontiers in Psychiatry 2021Women with primary dysmenorrhea are vulnerable to develop a depressive disorder, which is a common form of psycho-disturbance. However, clinical findings are...
Women with primary dysmenorrhea are vulnerable to develop a depressive disorder, which is a common form of psycho-disturbance. However, clinical findings are inconsistent across studies, and the evidence has not been previously synthesized. This study aims to investigate whether primary dysmenorrhea is associated with a higher risk of depression via a cumulative analysis. Four electronic databases were systematically searched for the eligible studies. The combined effect was assessed by analyzing the relative risk (RR) and standard mean differences (SMD) with a 95% confidence interval (CI). This cumulative analysis was registered on the PROSPERO (ID: CRD42020169601). Of 972 publications, a total of 10 studies involving 4,691 participants were included. Pooled results from six included studies showed that primary dysmenorrhea was associated with a significant depressive disorder ( = 1.72, 95%CI: 1.44 to 2.0, < 0.001; heterogeneity: = 0%, = 0.544). In addition, synthesis results from two studies provided the BDI scores suggested that dysmenorrhea had significantly higher scores when compared to non-dysmenorrhea ( = 0.47, 95% CI: 0.31-0.62, < 0.001; heterogeneity: = 0%, = 0.518). However, in the two studies providing the PROMIS T-Score, the pooled result showed that there was no significant difference between women with dysmenorrhea and those without dysmenorrhea ( = 0.466). The overall quality of the evidence in our study was judged to MODERATE. The present study has confirmed the positive relationship between primary dysmenorrhea and depression. Social supports and medical help from pain management physicians or psychologists are important interventions for women with dysmenorrhea-suffering depressive disorder.
PubMed: 34421672
DOI: 10.3389/fpsyt.2021.686514 -
Korean Journal of Family Medicine Mar 2024Dysmenorrhea and premenstrual syndrome (PMS) are common periodic and frequent complications in women of reproductive age that can negatively affect health and quality of...
BACKGROUND
Dysmenorrhea and premenstrual syndrome (PMS) are common periodic and frequent complications in women of reproductive age that can negatively affect health and quality of life. The present study examined the effects of curcumin on the severity of dysmenorrhea and PMS symptoms.
METHODS
A systematic review and meta-analysis of randomized controlled trials was conducted by searching databases such as the Cochrane Library, EMBASE, Scopus, PubMed, and Web of Science from inception to January 2023. Article screening was performed using Endnote ver. X8 (Clarivate). Review Manager (RevMan ver. 5.3; Cochrane) was used for the quality assessment and meta-analysis. A total of 147 studies were screened, of which five were finally selected for quantitative and qualitative analyses. The studies were conducted between 2015 and 2021, and a total of 379 participants with a mean age of 23.33±5.54 years had been recruited in these studies.
RESULTS
The meta-analysis showed that curcumin consumption could significantly reduce the severity of dysmenorrhea (mean difference, -1.25; 95% confidence interval [CI], -1.52 to -0.98; three studies; I2=31%) and the overall score of PMS (standardized mean difference, -1.41; 95% CI, -1.81 to -1.02; two studies; I2=0%).
CONCLUSION
The reduction in the severity of PMS and dysmenorrhea has been attributed to curcumin's anti-inflammatory and antidepressant activities. Although the findings suggest that curcumin may be an effective treatment for reducing the severity of PMS and dysmenorrhea, further research with a larger number of participants from various socioeconomic levels and a longer duration of treatment is needed to evaluate the effective dose of curcumin.
PubMed: 38266637
DOI: 10.4082/kjfm.23.0184 -
Acta Obstetricia Et Gynecologica... Aug 2020Epidemiological studies have shown that some hormonal contraceptive methods are associated with increased breast cancer risk, especially if used over long periods. Our... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Epidemiological studies have shown that some hormonal contraceptive methods are associated with increased breast cancer risk, especially if used over long periods. Our objective was to conduct a systematic review and meta-analysis of the literature on the risk of breast cancer development in women using the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS).
MATERIAL AND METHODS
We performed a thorough review of peer-reviewed publications from 10 January 1999, through 31 July 2019, using combinations of search terms for breast cancer risk and LNG-IUS in the Medline, EMBASE, LILACS (Latin American and Caribbean Health Sciences Literature), and Scielo databases. This review was registered in PROSPERO (CRD42017059076). Studies reporting breast cancer risk estimates among healthy users of LNG-IUS were included according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) criteria. Two authors performed data extraction, and a third author resolved disagreements. The quality of evidence was evaluated using the Downs and Black instrument. A funnel plot was generated, and a linear regression test of funnel plot asymmetry was used to assess publication bias. Finally, we performed a random-effects model (owing to high study heterogeneity) meta-analysis of seven suitable studies, stratified by the age distribution of patients (<50 years, ≥50 years, and mixed).
RESULTS
We identified 96 studies and manually cross-referenced and excluded duplicate articles. Seventy articles were excluded on the basis of the inclusion and exclusion criteria, resulting in the assessment of 26 full-text articles. Eight articles were considered adequate for inclusion in this systematic review, and seven studies were included in the meta-analysis. Three publications were case-control studies and five were cohort studies. According to the Downs and Black instrument, 5 studies were rated as "good" and 3 studies were deemed "fair". Our meta-analysis results indicated increased breast cancer risk in LNG-IUS users: for all women, odds ratio (OR) = 1.16 (95% CI 1.06-1.28, I = 78%, P < .01); for women aged <50 years, OR = 1.12 (95% CI 1.02-1.22, I = 66%, P = .02); and for women aged ≥50 years, OR = 1.52 (95% CI 1.34-1.72, I = 0%, P = .84).
CONCLUSIONS
Current evidence suggests that LNG-IUS users have an increased breast cancer risk regardless of age and indication. The effect of LNG-IUS on breast cancer risk seems to be larger in older users. However, our systematic review detected methodological issues across the available studies, and confounding factors may be responsible for at least a fraction of the risk effects associated with LNG-IUS use. Nevertheless, users of LNG-IUS should be aware of these trends. We believe that caution is needed, and risks should be balanced against proven health benefits (eg effective treatment of heavy menstrual bleeding and avoidance of surgical interventions), when prescribing LNG-IUS for long periods of use, especially in women with other known breast cancer risk factors such as old age, obesity, and familial predisposition.
Topics: Breast Neoplasms; Contraceptive Agents, Female; Female; Humans; Intrauterine Devices, Medicated; Levonorgestrel; Risk Factors
PubMed: 31990981
DOI: 10.1111/aogs.13817 -
Journal of Women's Health (2002) Jan 2024Endometriosis is a common chronic disorder, which leads to dysmenorrhea, dyspareunia, pelvic chronic pain, and infertility. It affects ∼6% to 10% of the general... (Meta-Analysis)
Meta-Analysis
Endometriosis is a common chronic disorder, which leads to dysmenorrhea, dyspareunia, pelvic chronic pain, and infertility. It affects ∼6% to 10% of the general female population. However, the etiology of endometriosis remained unclear. We aimed to systematically assess the association between pelvic inflammatory disease (PID) and the risk of endometriosis. Eligible studies published until May 21, 2022, were retrieved from the PubMed, EMBASE, and Web of Science databases. The studies were included based on the following criteria: (1) original articles on the association between PID and risk of endometriosis; (2) randomized controlled trials and cross-sectional, case-control, and cohort studies; and (3) studies involving humans. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the studies included in this systematic review. The association between PID and risk of endometriosis was evaluated using the overall odds ratio (OR) and correlative 95% confidence interval (CI). The meta-analysis included 14 studies with 747,733 patients. The mean prevalence of PID in women with endometriosis was 33.80%. Our quantitative synthesis revealed that endometritis was associated with a significantly increased risk of endometriosis (OR: 1.63, 95% CI: 1.53-1.74, = 59%). We study a statistically significant association between PID and the risk of endometriosis. In particular, endometritis might play an important role in endometriosis, based on the lower heterogeneity of the subgroup analysis. This finding suggests that reducing the incidence of endometritis might aid in the prevention and treatment of endometriosis.
Topics: Female; Humans; Endometriosis; Pelvic Inflammatory Disease; Endometritis; Cross-Sectional Studies; Pelvic Pain
PubMed: 37851499
DOI: 10.1089/jwh.2023.0300