-
Handbook of Clinical Neurology 2024The disability of migraine, a highly prevalent condition, is worsened by a second comorbid chronic pain condition. There is evidence of a relationship between migraine... (Review)
Review
The disability of migraine, a highly prevalent condition, is worsened by a second comorbid chronic pain condition. There is evidence of a relationship between migraine and several visceral pain conditions including irritable bowel syndrome, endometriosis, and dysmenorrhoea, as well as nonvisceral conditions including temporomandibular dysfunction, fibromyalgia, and lower back pain. While the mechanisms linking these conditions are inadequately surmised, a two-way relationship between migraine and these comorbidities likely exists. The progression and chronification of migraine is associated with peripheral and central sensitization, which may predispose to other conditions. Conversely, aspects of the mechanism of each comorbid condition may promote further migraine attacks. This chapter introduces each comorbidity, briefly summarizes the existing evidence, and discusses implications for treatment.
Topics: Female; Humans; Chronic Pain; Fibromyalgia; Comorbidity; Migraine Disorders; Irritable Bowel Syndrome
PubMed: 38307668
DOI: 10.1016/B978-0-12-823357-3.00027-6 -
Zhonghua Fu Chan Ke Za Zhi Jul 2023To investigate the familial heritability of endometriosis and to compare the clinical characteristics of patients with or without a family history of endometriosis....
To investigate the familial heritability of endometriosis and to compare the clinical characteristics of patients with or without a family history of endometriosis. From January 2020 to June 2022, 850 patients with endometriosis confirmed by laparotomy or laparoscopy in Peking University Third Hospital were included in this study. Clinical data were collected, family history was followed up, and the differences of clinical indicators between patients with and without family history of endometriosis were compared. A total of 850 patients were enrolled, with an average age of (33.8±7.0) years old, 315 (37.1%, 315/850) patients in stage Ⅲ and 496 (58.4%, 496/850) patients in stage Ⅳ. There were 100 patients with family history of endometriosis, accounting for 11.8% (100/850). Most of the 113 relatives involved were mothers, daughters and sisters (76.1%, 86/113), 81.5% (22/27) of the second and third degree relatives were maternal relatives. The median ages of patients with and without family history of endometriosis were 30 and 33 years old respectively at the time of diagnosis. The unmarried rate of patients with family history was higher [42.0% (42/100) vs 26.3% (197/750)]. The percentage of dysmenorrhea patients with family history was higher [89.0% (89/100) vs 55.5% (416/750)]. The medians of dysmenorrhea score in patients with and without family history were 6 and 2, and the median durations of dysmenorrhea were 10 and 1 years. There were significant differences in age, marital status, percentage of dysmenorrhea, dysmenorrhea score and duration (all <0.001). The median levels of serum cancer antigen (CA) 125 in patients with family history and patients without family history at the time of diagnosis were 57.5 and 46.9 kU/L respectively, with a statistically significant difference (<0.05). However, there were no significant differences between the two groups in nationality, bady mass index, menarche age, menstrual cycle, menstrual period, menstrual volume, serum CA level, cyst location and size, stage, history of adverse pregnancy and childbirth, infertility, adenomyosis and deep infiltrating endometriosis (all >0.05). By comparing the specific conditions of dysmenorrhea patients with and without family history of endometriosis, there were no significant differences between the two groups in terms of the age of onset of dysmenorrhea, duration of dysmenorrhea, primary and secondary dysmenorrhea, and progressive aggravation of dysmenorrhea (all >0.05). The difference in the degree of dysmenorrhea in dysmenorrhea patients with family history of endometriosis was significant (<0.001). The incidence of endometriosis has a familial tendency, and most of the involved relatives are the first degree relatives. Compared with patients without family history of endometriosis, endometriosis patients with family history are diagnosed at an earlier age, with higher percentage of dysmenorrhea, had more severe dysmenorrhea and higher serum CA level.
Topics: Pregnancy; Female; Humans; Adult; Endometriosis; Dysmenorrhea; Menstruation; Menstrual Cycle; Adenomyosis
PubMed: 37474323
DOI: 10.3760/cma.j.cn112141-20221222-00768 -
JNMA; Journal of the Nepal Medical... Dec 2023Herlyn-Werner-Wunderlich syndrome is a rare congenital malformation of the Mullerian ducts characterized by uterine didelphys with obstructed hemivagina and ipsilateral...
UNLABELLED
Herlyn-Werner-Wunderlich syndrome is a rare congenital malformation of the Mullerian ducts characterized by uterine didelphys with obstructed hemivagina and ipsilateral renal agenesis. Commonly, such patients present with pelvic pain, dysmenorrhea following menarche, and an abdominal mass secondary to hematometrocolpos. In this report, a case of a 14-year-old female presented with abdominal pain, back pain and acute urinary retention. She attained menarche at the age of 10 years; however, symptoms of dysmenorrhea only appeared 4 years later. She was eventually diagnosed with the help of ultrasound and computed tomography urogram. She was managed conservatively with an incision and drainage procedure and was also advised for resection of vaginal septum. The nonspecific nature of symptoms such as regular menstruation with cyclical abdominal pain impedes the diagnosis which can lead to an array of complications. Awareness of this syndrome can help avoid misdiagnosis and allow for early surgical intervention.
KEYWORDS
case reports; dysmenorrhea; uterine didelphys.
Topics: Female; Humans; Child; Adolescent; Dysmenorrhea; Vagina; Uterine Didelphys; Kidney; Kidney Diseases; Abnormalities, Multiple; Abdominal Pain; Urogenital Abnormalities; Uterus
PubMed: 38289750
DOI: 10.31729/jnma.8376 -
International Journal of Molecular... Jul 2023Phytoestrogens (PEs) are estrogen-like nonsteroidal compounds derived from plants (e.g., nuts, seeds, fruits, and vegetables) and fungi that are structurally similar to... (Review)
Review
Phytoestrogens (PEs) are estrogen-like nonsteroidal compounds derived from plants (e.g., nuts, seeds, fruits, and vegetables) and fungi that are structurally similar to 17β-estradiol. PEs bind to all types of estrogen receptors, including ERα and ERβ receptors, nuclear receptors, and a membrane-bound estrogen receptor known as the G protein-coupled estrogen receptor (GPER). As endocrine-disrupting chemicals (EDCs) with pro- or antiestrogenic properties, PEs can potentially disrupt the hormonal regulation of homeostasis, resulting in developmental and reproductive abnormalities. However, a lack of PEs in the diet does not result in the development of deficiency symptoms. To properly assess the benefits and risks associated with the use of a PE-rich diet, it is necessary to distinguish between endocrine disruption (endocrine-mediated adverse effects) and nonspecific effects on the endocrine system. Endometriosis is an estrogen-dependent disease of unknown etiopathogenesis, in which tissue similar to the lining of the uterus (the endometrium) grows outside of the uterus with subsequent complications being manifested as a result of local inflammatory reactions. Endometriosis affects 10-15% of women of reproductive age and is associated with chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. In this review, the endocrine-disruptive actions of PEs are reviewed in the context of endometriosis to determine whether a PE-rich diet has a positive or negative effect on the risk and course of endometriosis.
Topics: Female; Humans; Receptors, Estrogen; Endometriosis; Phytoestrogens; Diet; Endocrine System
PubMed: 37569571
DOI: 10.3390/ijms241512195 -
Plastic and Reconstructive Surgery Aug 2023International migration from high-prevalence regions has increasingly confronted non-endemic countries with female genital mutilation/cutting (FGM/C). Correspondingly,...
BACKGROUND
International migration from high-prevalence regions has increasingly confronted non-endemic countries with female genital mutilation/cutting (FGM/C). Correspondingly, Western-based health care providers have seen a greater demand for surgical reconstruction of female anatomical units. We introduce novel surgical techniques developed by the first author for clitoral and vulvovestibular reconstruction and examine operative outcomes.
METHODS
We performed a retrospective cohort study of operative outcomes of the Omega-Domed (OD) flap, Neurotizing and Molding of the Clitoral Stump (NMCS procedure) and anterior Obturator Artery Perforator (aOAP) flap for preputial, clitoral and vulvovestibular reconstruction respectively. Between 2014 and 2021 we treated patients with all types of FGM/C and analyzed various data, including demographics, clitoral sensation, and symptoms such as dysmenorrhea, dysuria, dyspareunia, and anorgasmia. We aimed to examine the efficacy and safety of these techniques in improving clitoral sensation and reducing symptoms.
RESULTS
A total of 119 women (mean age of 31.0 ± 10.4) were included. We performed the OD-flap (85%), the NMCS procedure (82%) and the aOAP-flap (36%) and had a 1-year follow-up period which was attended by 94.1% of patients. Patients significantly reported post-operative reduction of dysmenorrhea, dysuria, and dyspareunia as well as significant improvement of clitoral sensation and ability to achieve orgasm (p<0.001). There was one major complication (loss of flap) to report. Secondary ambulatory interventions were performed in 10 patients (8.4%).
CONCLUSIONS
By allowing for safe and effective anatomical reconstruction of the female genitalia, the described surgical techniques represent a new stage of treatment possibilities for women affected by FGM/C.
PubMed: 37647530
DOI: 10.1097/PRS.0000000000011026 -
BMC Women's Health Aug 2023Sleep 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...
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.
Topics: Female; Adolescent; Adult; Humans; Dysmenorrhea; Cross-Sectional Studies; Pandemics; COVID-19; Communicable Disease Control; Premenstrual Syndrome; Sleep; Republic of Korea
PubMed: 37641079
DOI: 10.1186/s12905-023-02600-z -
PLOS Global Public Health 2023Dysmenorrhea (menstrual pain) is common among adolescent girls globally, but many girls in Sub-Saharan Africa do not receive effective treatment. Qualitative interviews...
Dysmenorrhea (menstrual pain) is common among adolescent girls globally, but many girls in Sub-Saharan Africa do not receive effective treatment. Qualitative interviews were used to describe adolescent girls' experiences of dysmenorrhea and identify sociocultural barriers to dysmenorrhea management in Moshi, Tanzania. From August to November 2018, in-depth interviews were conducted with 10 adolescent girls and 10 adult experts (e.g., teachers, medical providers) who have experience working with girls in Tanzania. Thematic content analysis identified themes related to dysmenorrhea, including descriptions of dysmenorrhea and the impact of dysmenorrhea on well-being, as well as factors influencing the use of pharmacological and behavioral pain management strategies. Potential barriers to dysmenorrhea management were identified. Dysmenorrhea negatively impacted the physical and psychological well-being of girls and hindered girls' ability to participate in school, work, and social events. The most common pain management strategies were resting, drinking hot water, engaging in physical activity, and taking paracetamol. Barriers to dysmenorrhea management included beliefs that medications are harmful to the body or can hinder fertility, limited knowledge about the benefits of hormonal contraceptives to manage menstruation, little continuing education for healthcare providers, and a lack of consistent access to effective medications, medical care, or other supplies necessary for pain management. Medication hesitancy and inconsistent access to effective medication and other menstrual supplies must be addressed to improve girls' ability to manage dysmenorrhea in Tanzania.
PubMed: 37410763
DOI: 10.1371/journal.pgph.0001544 -
BMC Women's Health Nov 2023Premenstrual syndrome (PMS) affects women's physical and mental health. Depression, stress, sleep disturbance, and eating attitude problems have been known to influence...
BACKGROUND
Premenstrual syndrome (PMS) affects women's physical and mental health. Depression, stress, sleep disturbance, and eating attitude problems have been known to influence PMS. Furthermore, restrictions of daily life due to the COVID-19 pandemic have led to changes in sleep patterns and eating attitudes. Thus, it is necessary to closely examine how these factors affect PMS. This study aimed to examine the levels of PMS, stress, depression, sleep disturbance, and eating attitude problems among female college students who experience dysmenorrhea and determine the factors associated with PMS.
METHODS
A cross-sectional online survey design was conducted using a convenience sample of 143 female college students in C City, South Korea. Data were collected from September 1 to 19, 2021 in South Korea using an online self-administered survey. Differences in participants' level of PMS according to physical health variables (e.g., smoking, water intake, menstrual pain intensity) and psychological issues (i.e., stress, depression, sleep disturbances, and eating attitude problems) were assessed with independent sample t-tests and one-way ANOVAs. Correlational analyses between these variables were also conducted. Additionally, multiple regression was performed to identify the factors influencing PMS.
RESULTS
PMS severity was between normal (27.3%) and premenstrual dysphoric disorder (PMDD) (72.7%). PMS was associated positively with depression (r = .284, p = 001), stress (r = .274, p = .001), sleep disturbance (r = .440, p < .001), and eating attitude problems (r = .266, p = .001). Additionally, menstrual pain intensity (β = 0.204), sleep disturbances (β = 0.375), and eating attitude problems (β = 0.202) were found to influence PMS. The regression model was significant (F = 16.553, p < .001) with an explanatory power of 24.7%.
CONCLUSIONS
Considering the influencing factors of PMS identified in this study, interventions for participants experiencing PMS should be made. We propose that further study should be conducted to examine whether the severity of PMS changes according to menstrual pain, the pattern and degree of its change, and the paths through which sleep quality and eating attitude problems affect PMS.
Topics: Female; Humans; Dysmenorrhea; Cross-Sectional Studies; Pandemics; Premenstrual Syndrome; Students
PubMed: 37950208
DOI: 10.1186/s12905-023-02752-y -
Journal of Clinical Nursing May 2024Dysmenorrhea, or menstrual pain, is a subjective experience, and can only be assessed by patient-reported outcomes. These instruments should be reliable, valid and... (Review)
Review
BACKGROUND
Dysmenorrhea, or menstrual pain, is a subjective experience, and can only be assessed by patient-reported outcomes. These instruments should be reliable, valid and responsive.
AIM
To identify and critically appraise the available evidence for the measurement properties of specific patient-reported outcome measures used for dysmenorrhea.
METHODS
The PRISMA statement was used to report this systematic review. Databases searched were PubMed, SCOPUS, CINAHL, Web of Science, ScienceDirect and Google Scholar (April 2021; updated on February 2023). Original studies with primary data collection, with no restriction on language and publication date that reported psychometric properties of one or more dysmenorrhea-related patient-reported outcome measure. The literature searches, selection of studies, data extraction and assessment of the risk of bias were performed independently by two reviewers and followed the COSMIN guidelines.
RESULTS
Thirty studies were analysed in this review, and 19 patient-reported outcome measures were evaluated. The instruments varied in relation to the measured construct and measurement properties (validity, reliability and responsiveness). The methodological quality of the studies and the quality of evidence of the patient-reported outcome measures were variable. Among the 13 studies that reported the development of patient-reported outcome measures, most had inadequate methodological quality, and the overall rating was insufficient or inconsistent.
CONCLUSIONS
The Dysmenorrhea Symptom Interference (DSI) scale was the only identified patient-reported outcome measure that has the potential to be recommended because of its sufficient rating combined with moderate quality of evidence for content validity. Future studies should further evaluate the measurement properties of the existing patient-reported outcome measures, or develop new patient-reported outcome measures following the COSMIN methodology.
PATIENT OR PUBLIC CONTRIBUTION
Not applicable as this is a systematic review.
TRIAL REGISTRATION
PROSPERO protocol: CRD42021244410. Registration on April 22, 2021.
PubMed: 38797927
DOI: 10.1111/jocn.17293 -
Drugs Apr 2024An oral fixed-dose combination of relugolix/estradiol/norethisterone (also known as norethindrone) acetate [Myfembree (USA); Ryeqo (EU)] (hereafter referred to as... (Review)
Review
An oral fixed-dose combination of relugolix/estradiol/norethisterone (also known as norethindrone) acetate [Myfembree (USA); Ryeqo (EU)] (hereafter referred to as relugolix combination therapy) has been approved in the USA for the management of moderate to severe pain associated with endometriosis in premenopausal women and in the EU for the symptomatic treatment of endometriosis in adult women of reproductive age with a history of previous medical or surgical treatment for their endometriosis. The gonadotropin-releasing hormone (GnRH) receptor antagonist relugolix decreases estradiol and progesterone levels, while the addition of estradiol/norethisterone acetate mitigates hypoestrogenic effects including bone mineral density (BMD) loss and vasomotor symptoms. In two pivotal phase III trials, relugolix combination therapy significantly improved dysmenorrhoea and non-menstrual pelvic pain in premenopausal women with moderate to severe endometriosis. The combination also reduced overall pelvic pain and dyspareunia, reduced analgesic and opioid use, and improved health-related quality of life. The efficacy of relugolix combination therapy was sustained over the longer term (up to 2 years). Relugolix combination therapy was generally well tolerated and BMD loss over time was minimal. With the convenience of a once daily oral dosing regimen, relugolix combination therapy is a valuable addition to the options currently available for the management of endometriosis-associated pain.
Topics: Humans; Female; Endometriosis; Norethindrone; Estradiol; Drug Combinations; Norethindrone Acetate; Pelvic Pain; Quality of Life; Dysmenorrhea; Phenylurea Compounds; Pyrimidinones
PubMed: 38592603
DOI: 10.1007/s40265-024-02018-3