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Nursing Research 2021Dysmenorrhea is a prevalent pain condition among women and a risk factor for other chronic pain conditions. Individuals vary in dysmenorrhea pain severity, the number of...
BACKGROUND
Dysmenorrhea is a prevalent pain condition among women and a risk factor for other chronic pain conditions. Individuals vary in dysmenorrhea pain severity, the number of painful sites, and co-occurring gastrointestinal symptoms. Three dysmenorrhea symptom-based phenotypes were previously identified using latent class analysis; however, there is a need to validate these in an independent sample, so they can be used in mechanistic and interventional research. There is also a need to further characterize dysmenorrhea symptom-based phenotypes in terms of demographic, clinical, and psychobehavioral characteristics so they can be used to inform precision dysmenorrhea treatment.
OBJECTIVES
The study objectives were to (a) determine whether the same dysmenorrhea symptom-based phenotypes would be found in a new sample; (b) determine whether including demographic, clinical, and psychobehavioral covariates in latent class analyses would change individuals' phenotype memberships; and (c) investigate relationships between dysmenorrhea symptom-based phenotypes and demographic, clinical, and psychobehavioral characteristics.
METHODS
This cross-sectional survey study included 678 women (aged 14-42 years) with dysmenorrhea. Participants reported dysmenorrhea symptom severity, demographic, clinical (comorbid chronic pain and gynecological conditions), and psychobehavioral characteristics (perceived stress, anxiety, depression, sleep disturbance, and pain catastrophizing). We used latent class analysis to identify symptom-based phenotypes. We compared analyses with and without covariates (i.e., demographic, clinical, and psychobehavioral characteristics) to determine if individuals' phenotype memberships changed. We then examined associations between phenotypes and demographic, clinical, and psychobehavioral characteristics.
RESULTS
We reproduced three dysmenorrhea symptom-based phenotypes: the "mild localized pain" phenotype (characterized by mild abdominal cramps), the "severe localized pain" phenotype (characterized by severe abdominal cramps), and the "multiple severe symptoms" phenotype (characterized by severe pain at multiple locations and gastrointestinal symptoms). Analyses with and without covariates had little effect on individuals' phenotype membership. Race, comorbid chronic pain condition, endometriosis, and pain catastrophizing were significantly associated with the dysmenorrhea phenotypes.
DISCUSSION
Findings provide a foundation to further study mechanisms of dysmenorrhea symptom heterogeneity and develop dysmenorrhea precision treatments. The three dysmenorrhea symptom-based phenotypes were validated in a second sample. Demographic, clinical, and psychobehavioral factors were associated with dysmenorrhea symptom-based phenotypes.
Topics: Adolescent; Adult; Chronic Pain; Cross-Sectional Studies; Dysmenorrhea; Female; Humans; Phenotype; Severity of Illness Index; Surveys and Questionnaires; Symptom Assessment; United States; Young Adult
PubMed: 32956256
DOI: 10.1097/NNR.0000000000000477 -
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 Jul 2021To compare beliefs about dysmenorrhea and self-management techniques across three dysmenorrhea symptom-based phenotypes.
OBJECTIVES
To compare beliefs about dysmenorrhea and self-management techniques across three dysmenorrhea symptom-based phenotypes.
BACKGROUND
Many reproductive-age women experience dysmenorrhea, with varying symptoms and intensity. Dysmenorrhea symptom-based phenotypes have been identified in previous research, defining distinctive phenotypes of mild localised pain, severe localised pain, and multiple severe symptoms. It is unknown if women from different phenotypes hold different beliefs about dysmenorrhea or if they engage in different self-management techniques.
DESIGN
Quantitative secondary analysis of cross-sectional survey data.
METHODS
This online study surveyed 762 women with dysmenorrhea in the United States. Participants reported their dysmenorrhea symptom intensity, beliefs about dysmenorrhea (i.e. beliefs about consequences, timeline, controllability, symptom severity, normalcy, emotional response to symptoms and treatments) and self-management techniques to prevent or treat symptoms. Beliefs regarding dysmenorrhea and types of self-management techniques used were compared across three phenotypes utilising ANOVA tests and Tukey's HSD for pairwise comparisons. Reporting followed the STROBE guidelines.
RESULTS
Women with multiple severe symptoms had significantly more negative beliefs regarding dysmenorrhea and utilised significantly more self-management techniques than women with severe localised pain and women with mild localised pain. Women with severe localised pain had significantly more negative beliefs regarding dysmenorrhea and utilised significantly more self-management techniques than women with mild localised pain. Negative beliefs regarding dysmenorrhea included: consequences of dysmenorrhea, timeline of symptoms, personal and treatment control, symptom severity, normalcy of symptoms, emotional response to symptoms and willingness to utilise complementary medicine.
CONCLUSION
Results further support the distinction between dysmenorrhea symptom-based phenotypes. Not only do women in different phenotypes experience different severity and number of dysmenorrhea symptoms, they also perceive and manage their dysmenorrhea differently.
RELEVANCE TO CLINICAL PRACTICE
These findings have implications for tailoring interventions to different dysmenorrhea symptom-based phenotypes.
Topics: Cross-Sectional Studies; Dysmenorrhea; Female; Humans; Phenotype; Self-Management; Surveys and Questionnaires
PubMed: 33761154
DOI: 10.1111/jocn.15754 -
The Journal of Maternal-fetal &... Dec 2022Little is known about the association between maternal history of dysmenorrhea and perinatal outcomes. The aim of this study was to investigate the association between...
OBJECTIVE
Little is known about the association between maternal history of dysmenorrhea and perinatal outcomes. The aim of this study was to investigate the association between maternal history of dysmenorrhea and low birth weight (LBW).
METHODS
A total of 6754 pregnant women were recruited from the ongoing prospective cohort study in Guangxi, China, in 2015-2018. Information on the maternal history of dysmenorrhea was obtained by questionnaires including visual analog scale (VAS) questions during the first antenatal care visit. The association of maternal history of dysmenorrhea and LBW was evaluated using logistic regression analyses adjusted for confounding factors (infant sex, maternal age, parity, pre-pregnancy body mass index (BMI) (kg/m), gestational age, alcohol use during pregnancy, passive smoking, and occupational status).
RESULTS
Mothers with a history of dysmenorrhea were more likely to give birth to LBW infants (adjusted odds ratio (OR)=1.44; 95% confidence interval (CI): 1.12, 1.83). Among women with a history of dysmenorrhea, women ≥29 years old (adjusted OR 1.46; 95% CI 1.02, 2.10), multiparous (adjusted OR 1.59, 95% CI 1.12, 2.25), and women gave birth to female infant (adjusted OR = 1.53, 95% CI = 1.11, 2.11) had a higher risk of LBW.
CONCLUSIONS
As the first cohort study to investigate the association between maternal history of dysmenorrhea and LBW, our study shows that dysmenorrhea may increase the risk of LBW.
Topics: Infant, Newborn; Infant; Female; Pregnancy; Humans; Adult; Cohort Studies; Prospective Studies; Dysmenorrhea; Risk Factors; China; Infant, Low Birth Weight; Birth Weight
PubMed: 33899665
DOI: 10.1080/14767058.2021.1914581 -
BMC Women's Health May 2023Dysmenorrhea (i.e., period pain) is common and debilitating. Autistic people are known to experience pain differently, yet little is known about the menstrual pain...
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.
Topics: Female; Humans; Dysmenorrhea; Menstruation; Educational Status; Social Isolation
PubMed: 37231369
DOI: 10.1186/s12905-023-02370-8 -
American Journal of Obstetrics and... Sep 2020The objective of the study was to synthesize the epidemiological findings for the associations between dysmenorrhea, including primary dysmenorrhea and... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The objective of the study was to synthesize the epidemiological findings for the associations between dysmenorrhea, including primary dysmenorrhea and endometriosis-associated dysmenorrhea and any chronic pain conditions, including chronic pelvic pain, and chronic nonpelvic pain.
DATA SOURCES
The data sources included PubMed, Embase, and CINAHL from inception to December 2019.
STUDY ELIGIBILITY CRITERIA
The study criteria included observational population-based studies in which the relationship between dysmenorrhea and the presence or severity of chronic pain was examined.
STUDY APPRAISAL AND SYNTHESIS METHODS
Each study was double coded and evaluated for bias based on the modified Newcastle and Ottawa Scale. Random-effect meta-analyses were conducted to quantify the associations between dysmenorrhea and the presence of chronic pelvic and nonpelvic pain.
RESULTS
Out of 9452 records, 32 studies were included, with 14 reporting associations between dysmenorrhea and chronic pelvic pain, and 20 for dysmenorrhea and chronic nonpelvic pain. Primary dysmenorrhea and endometriosis-associated dysmenorrhea were examined in 7 studies, respectively. More than 30% of the studies were categorized as poor quality, 56% as moderate, and 12.5% as high. Dysmenorrhea was positively associated with both the presence and severity of chronic pelvic and nonpelvic pain conditions. Based on 6689 women from 8 studies, those with chronic pelvic pain had 2.43 (95% confidence interval, 1.98-2.99, I, 42%) times the odds of having dysmenorrhea compared with those without. Based on 3750 women from 11 studies, those with chronic nonpelvic pain had 2.62 (95% confidence interval, 1.84-3.72, I, 72%) times the odds of having dysmenorrhea compared with those without. Overall, dysmenorrhea was associated with 2.50 (95% confidence interval, 2.02-3.10) times the odds of chronic pain, which did not differ by chronic pelvic vs chronic nonpelvic pain, community vs clinical populations, or different geographical regions.
CONCLUSIONS
Dysmenorrhea may be a general risk factor for chronic pain, although whether primary dysmenorrhea increases the risk for chronic pain is unclear. Given that adolescence is a sensitive period for neurodevelopment, elucidating the role of primary dysmenorrhea in pain chronicity in future longitudinal studies is important for preventing both chronic pelvic and nonpelvic pain.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Chronic Pain; Dysmenorrhea; Endometriosis; Female; Humans; Middle Aged; Pain Measurement; Pelvic Pain; PubMed; Young Adult
PubMed: 32151612
DOI: 10.1016/j.ajog.2020.03.002 -
Western Journal of Nursing Research Apr 2021Dysmenorrhea affects most reproductive-age women and increases the risk of future pain. To evaluate dysmenorrhea interventions, validated outcome measures are needed. In...
Dysmenorrhea affects most reproductive-age women and increases the risk of future pain. To evaluate dysmenorrhea interventions, validated outcome measures are needed. In this two-phase study, we developed and tested the dysmenorrhea symptom interference scale. During the scale-development phase ( = 30), we created a nine-item scale based on qualitative data from cognitive interviews. During the scale-testing phase ( = 686), we evaluated reliability, validity, and responsiveness to change. The scale measures how dysmenorrhea symptoms interfere with physical, mental, and social activities. Internal consistency was strong with Cronbach's > 0.9. Test-retest reliability was acceptable ( = 0.8). The scale showed satisfactory content validity, construct validity (supported by confirmatory factor analysis), concurrent validity, and responsiveness to change. The minimally important difference was 0.3 points on a scale with a possible total score ranging from 1 to 5. This new psychometrically sound scale can be used in research and clinical practice to facilitate the measurement and management of dysmenorrhea.
Topics: Dysmenorrhea; Factor Analysis, Statistical; Female; Humans; Psychometrics; Reproducibility of Results; Surveys and Questionnaires
PubMed: 32680445
DOI: 10.1177/0193945920942252 -
Pain Medicine (Malden, Mass.) Dec 2023Primary dysmenorrhea (PD) is 1 of the most prevalent gynecologic conditions. The main aim of this umbrella review was to assess the effects of therapeutic exercise (TE)... (Review)
Review
PURPOSE
Primary dysmenorrhea (PD) is 1 of the most prevalent gynecologic conditions. The main aim of this umbrella review was to assess the effects of therapeutic exercise (TE) on PD.
METHODS
A systematic search was carried out in PubMed, Embase, SPORTDiscus, CINAHL, and PEDro (December 10, 2022). The outcome measures assessed were menstrual pain intensity, menstrual pain duration, and quality of life. Methodological quality was analyzed using the AMSTAR and ROBIS scales, and the strength of evidence was established according to the advisory committee grading criteria guidelines.
RESULTS
Nine systematic reviews were included. The results showed that TE, regardless of the exercise model and intensity, has a clinical effect in improving menstrual pain intensity in women with PD with moderate quality of evidence. In addition, the results showed that TE has a clinical effect in improving the duration of menstrual pain in women with PD with a limited quality of evidence. However, the results are controversial on the improvement of quality of life in women with PD with a limited quality of evidence.
CONCLUSIONS
TE seems an effective option to implement in women with PD to improve the intensity and duration of menstrual pain. We cannot draw robust results for quality of life due to the low number of primary studies. More research in this field can help us establish more robust conclusions, as well as to assess whether there is one exercise model or intensity of training that is more effective than others.PROSPERO number: This review was previously registered in PROSPERO (CRD42022371428).
Topics: Female; Humans; Dysmenorrhea; Exercise; Exercise Therapy; Quality of Life; Systematic Reviews as Topic
PubMed: 37555833
DOI: 10.1093/pm/pnad104 -
Biomolecules May 2024Thomas Cullen described bleeding abnormalities and dysmenorrhea as the "expected" presentations of adenomyomas. Adenomyosis is included within the FIGO classification of... (Review)
Review
BACKGROUND
Thomas Cullen described bleeding abnormalities and dysmenorrhea as the "expected" presentations of adenomyomas. Adenomyosis is included within the FIGO classification of structural causes of abnormal uterine bleeding (AUB). Nevertheless, this long-standing association has been questioned by some authors who reported a high incidence of adenomyosis in uteri removed for indications other than AUB or dysmenorrhea. Here, we examine evidence for the link between adenomyosis and AUB.
METHODS
A comprehensive Medline literature review of all publications to October 2023.
RESULTS
Sixty-three articles were identified and included in the review. Despite a large body of studies, the available literature does not provide conclusive evidence of a link between adenomyosis and AUB. This is because of unsuitable study design, or poor characterization of the study population or of the inclusion or exclusion criteria. Additional challenges arise because of the lack of agreed criteria for diagnosing adenomyosis and the often absence of detailed assessment of menstrual blood loss. Adenomyosis often coexists with other conditions that have also been linked to similar symptoms, and many cases of adenomyosis are asymptomatic.
CONCLUSION
Most of the existing literature and studies that addressed treatment outcome of adenomyosis started from the premise that a link between the condition and AUB had been proven. Yet, published information shows that aspects such a relationship is still uncertain. Further research is needed to address the relation between AUB and adenomyosis burden (or subtypes), distribution, and concomitant pathology.
Topics: Humans; Adenomyosis; Female; Uterine Hemorrhage; Dysmenorrhea
PubMed: 38927019
DOI: 10.3390/biom14060616 -
Gynecological Endocrinology : the... Aug 2022To evaluate the numerical rating scale (NRS) measurement properties in women with dysmenorrhea. This was an online clinimetric study. Brazilian women aged over...
To evaluate the numerical rating scale (NRS) measurement properties in women with dysmenorrhea. This was an online clinimetric study. Brazilian women aged over 18 years old with internet access to respond to online instruments were included in the study. We evaluated criterion validity (comparing women with and without dysmenorrhea), construct validity between the NRS and the bodily pain domain of the SF-36, test-retest reliability, and measurement errors (in women with dysmenorrhea). Two hundred thirty-eight women with and 192 without dysmenorrhea participated in the study. For criterion validity, the area under the receiver operating characteristic curve was 0.902 (95%CI, 0.873-0.931), and a cutoff point of 3 was considered to have the best sensitivity (83%) and specificity (86%). For construct validity, the NRS showed a moderate negative correlation with the SF-36 bodily pain domain (r=-0.46; < 0.001). For test-retest reliability and measurement errors, 105 women whose symptoms did not change between 7 and 10 days of retest, with intraclass correlation coefficient = 0.90, standard error of measurement = 0.97, and smallest detectable change = 2.76 points. The NRS can be considered a valid and reliable patient-reported outcome measure for assessing dysmenorrhea-related pain intensity.
Topics: Adult; Disability Evaluation; Dysmenorrhea; Female; Humans; Middle Aged; Pain Measurement; Patient Reported Outcome Measures; Psychometrics; Reproducibility of Results; Surveys and Questionnaires
PubMed: 35850576
DOI: 10.1080/09513590.2022.2099831