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BMC Public Health Feb 2024Endometriosis (EMs) is a chronic and progressive disease that, if diagnosed late, can lead to infertility and deep infiltrating endometriosis (DIE). Dysmenorrhea is the...
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.
Topics: Adult; Female; Adolescent; Humans; Endometriosis; Dysmenorrhea; Case-Control Studies; Menstruation; Menarche
PubMed: 38317119
DOI: 10.1186/s12889-024-17825-2 -
Journal of Obstetrics and Gynaecology... Jul 2017
Topics: Consensus; Dysmenorrhea; Female; Humans; Patient Education as Topic; Practice Guidelines as Topic
PubMed: 28625285
DOI: 10.1016/j.jogc.2017.03.093 -
Journal of Pediatric and Adolescent... Oct 2020To study the presentation of dysmenorrhea and endometriosis in transmasculine adolescents and review their treatment outcomes.
STUDY OBJECTIVE
To study the presentation of dysmenorrhea and endometriosis in transmasculine adolescents and review their treatment outcomes.
DESIGN
A retrospective review.
SETTING
Boston Children's Hospital.
PARTICIPANTS
Transmasculine persons younger than 26 years old who were diagnosed with dysmenorrhea and treated between January 1, 2000 and March 1, 2020.
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
An electronic medical record review of the clinical characteristics, transition-related care, and treatment outcomes.
RESULTS
Dysmenorrhea was diagnosed in 35 transmasculine persons. Mean age was 14.9 years ± 1.9 years. Twenty-nine (82.9%) were diagnosed after social transition. Twenty-three of 35 (65.7%) were first treated with combined oral contraceptives, but 14/23 (61%) discontinued or transitioned to alternative therapy. Twelve patients with dysmenorrhea alone initiated testosterone treatment, and 4/12 (33.3%) experienced persistent symptoms. Seven of 35 patients with dysmenorrhea (20.0%) were laparoscopically evaluated for endometriosis, and it was confirmed in all seven. Six had stage I disease, and one had stage II. Three of the 7 (42.9%) were diagnosed after social transition, with one diagnosed 20 months after initiating testosterone treatment. Their endometriosis was treated with combined oral contraceptives, danazol, or progestins; four experienced suboptimal response during treatment with these therapies alone. Two of those with suboptimal response subsequently resolved their dysmenorrhea when using testosterone. Five patients with endometriosis initiated testosterone treatment, and of the 5 (40%) experienced persistent symptomatology with combined testosterone and progestin therapies.
CONCLUSION
To our knowledge, this is the first study to characterize endometriosis in transmasculine persons. Evaluation for endometriosis was underutilized in transmasculine persons with dysmenorrhea, despite those who underwent laparoscopic evaluation and had disease confirmation. Although testosterone treatment can resolve symptoms in some, others might require additional suppression. Endometriosis should be considered in transmasculine persons with symptoms even when they are using testosterone.
Topics: Adolescent; Adult; Boston; Contraceptives, Oral, Combined; Danazol; Dysmenorrhea; Endometriosis; Female; Humans; Male; Retrospective Studies; Testosterone; Transgender Persons; Treatment Outcome; Young Adult
PubMed: 32535219
DOI: 10.1016/j.jpag.2020.06.001 -
Schmerz (Berlin, Germany) Dec 2023The pain phenomena caused by endometriosis are manifold. In addition to nociceptive pain there is also a nociplastic reaction with central sensitization. Atypical... (Review)
Review
BACKGROUND
The pain phenomena caused by endometriosis are manifold. In addition to nociceptive pain there is also a nociplastic reaction with central sensitization. Atypical symptoms, such as acyclic lower abdominal pain, radiating pain, nonspecific bladder and intestinal complaints or even depression increasingly occur in addition to the classical cyclic complaints, such as severe dysmenorrhea, cyclic lower abdominal pain, dyspareunia, dysuria and dyschezia. Due to the diffuse range of symptoms, affected patients often consult not just gynecologists but also specialists from other disciplines (internal medicine, gastroenterology, orthopedics, pain therapy, psychology etc.).
OBJECTIVE
The complexity of endometriosis is presented. The resulting approaches to multimodal interdisciplinary holistic treatment are described.
RESULTS
Interdisciplinary concepts should be involved in the optimal treatment of endometriosis patients along with hormonal and surgical treatment, mostly under the supervision of a gynecologist and pain management, dietary changes, psychological support and physiotherapeutic management should also be included. This article provides an overview of possible treatment strategies for chronic symptomatic endometriosis.
CONCLUSION
Based on multimodal treatment strategies and regarding the complex pathophysiological alterations of this disease, the complex complaints that significantly impair the quality of life of endometriosis patients can be greatly improved.
Topics: Female; Humans; Endometriosis; Pelvic Pain; Dysmenorrhea; Quality of Life; Abdominal Pain
PubMed: 37626190
DOI: 10.1007/s00482-023-00747-0 -
AMA Journal of Ethics Aug 2022Many patients face years of recurrent and debilitating menstrual pain that affects their ability to work and study. Patients often normalize their severe pain as an...
Many patients face years of recurrent and debilitating menstrual pain that affects their ability to work and study. Patients often normalize their severe pain as an expected part of menses. Both underrecognition and lack of awareness of available therapies for this remediable condition serve as a quintessential example of hermeneutic injustice. Hermeneutic injustice describes a structural lack of access to epistemic resources, such as shared concepts and knowledge. Pervasive menstrual stigma further discourages people with dysmenorrhea from discussing their symptoms and seeking health care. A lack of respect for women's experiences of pain in clinical encounters acts to worsen these issues and should be considered a source of iatrogenic harm. Health care workers can promote hermeneutic justice by preemptively destigmatizing discussions about menstruation and validating patients' concerns. On a systemic level, there should be greater awareness of dysmenorrhea and the various treatments availabe for it.
Topics: Dysmenorrhea; Female; Humans; Iatrogenic Disease; Menstruation; Social Justice
PubMed: 35976930
DOI: 10.1001/amajethics.2022.740 -
American Journal of Reproductive... Feb 2023Endometriosis is a public health disorder affecting ∼ 247 million women globally and ∼ 42 million women in India. Women with endometriosis suffer from dysmenorrhea,... (Review)
Review
Endometriosis is a public health disorder affecting ∼ 247 million women globally and ∼ 42 million women in India. Women with endometriosis suffer from dysmenorrhea, chronic pelvic pain, dyspareunia, dyschezia, fatigue, depression, and infertility leading to significant socioeconomic impact and morbidity. The etiology of endometriosis is not understood well even after 100 years of research. Currently, there is no permanent cure for endometriosis. The inflammatory immune response is one of the important features of etiopathogenesis of endometriosis and therefore understanding the inflammatory immune response would lead to a better understanding of this enigmatic disorder and may also lead to biomarker discovery for diagnosis of endometriosis. We investigated the autoimmune etiology of endometriosis in the Indian population. Using the proteomics approach, anti-endometrial antibodies (AEAs) were detected in Indian women with endometriosis [anti-endometrial antibodies - tropomyosin 3 (TPM3), stomatin-like protein2 (SLP-2), and tropomodulin 3 (TMOD3)]. The studies on AEAs provided a better understanding of autoimmune mechanisms in endometriosis. All three subtypes of endometriosis; superficial peritoneal, ovarian endometrioma, and deep infiltrating endometriosis were reported in Indian women. In this review, we discuss our experiences of the inflammatory immune response, autoimmunity, comorbidities, and clinical phenotypes in women with endometriosis in India.
Topics: Humans; Female; Endometriosis; Pelvic Pain; Dysmenorrhea; Immunity; India
PubMed: 35751585
DOI: 10.1111/aji.13590 -
Duodecim; Laaketieteellinen... 2017Dysmenorrhea affects quality of life, but is often inadequately treated in teenagers. The mainstay of treatment is NSAID, which must be started pre-emptively and in...
Dysmenorrhea affects quality of life, but is often inadequately treated in teenagers. The mainstay of treatment is NSAID, which must be started pre-emptively and in adequate dose. If NSAID provides insufficient pain relief, or when contraception is required, combined oral contraceptives can be prescribed concomitantly. Hormonal IUD can also be used in teenagers. If dysmenorrhea persists despite appropriate treatment, the patient must be referred to a gynecologist. Endometriosis, the most common cause of severe dysmenorrhea, can manifest already during adolescence.
Topics: Adolescent; Anti-Inflammatory Agents, Non-Steroidal; Contraceptives, Oral; Dysmenorrhea; Endometriosis; Female; Humans; Pain Management; Quality of Life
PubMed: 29205027
DOI: No ID Found -
The Cochrane Database of Systematic... Feb 2017Dysmenorrhoea is characterised by cramping lower abdominal pain that may radiate to the lower back and upper thighs and is commonly associated with nausea, headache,... (Review)
Review
BACKGROUND
Dysmenorrhoea is characterised by cramping lower abdominal pain that may radiate to the lower back and upper thighs and is commonly associated with nausea, headache, fatigue and diarrhoea. Physical exercise has been suggested as a non-medical approach to the management of these symptoms.
OBJECTIVES
To assess the evidence for the effectiveness of exercise in the treatment of dysmenorrhoea.
SEARCH METHODS
A search was conducted using the methodology of the Menstrual Disorders and Subfertility Group (August 2009). CENTRAL (The Cochrane Library), MEDLINE, EMBASE, AMED and PsycINFO electronic databases were searched. Handsearching of relevant bibliographies and reference lists was also conducted.
SELECTION CRITERIA
Randomised controlled trials comparing exercise with a control or no intervention in women with dysmenorrhoea.
DATA COLLECTION AND ANALYSIS
Trials were independently selected and data extracted by two review authors.
MAIN RESULTS
Four potential trials were identified of which one was included in the review. The available data could only be included as a narrative description. There appeared to be some evidence from the trial that exercise reduced the Moos' Menstrual Distress Questionnaire (MDQ) score during the menstrual phase (P < 0.05) and resulted in a sustained decrease in symptoms over the three observed cycles (P < 0.05).
AUTHORS' CONCLUSIONS
The results of this review are limited to a single randomised trial of limited quality and with a small sample size. The data should be interpreted with caution and further research is required to investigate the hypothesis that exercise reduces the symptoms associated with dysmenorrhoea.
Topics: Dysmenorrhea; Exercise; Female; Humans; Randomized Controlled Trials as Topic
PubMed: 28194755
DOI: 10.1002/14651858.CD004142.pub3 -
American Family Physician May 2021
Topics: Dysmenorrhea; Exercise; Exercise Therapy; Female; Humans
PubMed: 33929165
DOI: No ID Found -
Cellular and Molecular Biology... Mar 2023Dysmenorrhea is the combination of cramps and pain associated with the menstrual period, and the symptoms affect at least 30% of women worldwide. Tolerance to symptoms... (Review)
Review
Dysmenorrhea is the combination of cramps and pain associated with the menstrual period, and the symptoms affect at least 30% of women worldwide. Tolerance to symptoms depends on each person's pain threshold; however, dysmenorrhea seriously affects daily activities and chronically reduces the quality of life. Some dysmenorrhea cases even require hospitalization due to unbearable symptoms of severe pain. Dysmenorrhea is an underestimated affectation and remains even in different first-world countries as a taboo subject, promoted by the establishment of an apparent policy of gender equality. A person with primary or secondary dysmenorrhea requires medical assistance in choosing the best treatment and an integral approach. This review intends to demonstrate the impact of dysmenorrhea on quality of life. We describe the pathophysiology of this disorder from a molecular point of view and perform a comprehensive compilation and analysis of the most critical findings in the therapeutic management of dysmenorrhea. Likewise, we propose an interdisciplinary approach to the phenomenon of dysmenorrhea at the cellular level in a concise way and the botanical, pharmacological, and medical applications for its management. Since dysmenorrhea symptoms can vary between individuals, medical treatment cannot be generalized and depends on each patient. Therefore, we hypothesized that a suitable strategy could result from the combination of pharmacological therapy aided by a non-pharmacological approach.
Topics: Female; Humans; Dysmenorrhea; Quality of Life; Pain Measurement
PubMed: 37300689
DOI: 10.14715/cmb/2023.69.3.7