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Acta Neurologica Belgica Jun 2024Migraine and endometriosis are chronic disabling pain conditions. There is evidence for a shared genetic background. Migraine phenotype and course in patients with the...
INTRODUCTION
Migraine and endometriosis are chronic disabling pain conditions. There is evidence for a shared genetic background. Migraine phenotype and course in patients with the comorbidity are insufficient investigated. Both conditions can be treated with progestins.
METHODS
For this observational study we included women with migraine and endometriosis, visiting our clinic from 2015 to 2021. We collected available information from charts and complemented these data by a structured phone interview to collect more specific information on migraine and the course of both diseases.
RESULTS
From 344 patients fulfilling the inclusion criteria, 94 suffered from both, endometriosis and migraine. Migraine with aura was reported by 41% of the patients and was associated with earlier onset of migraine (age < 17 years (OR 6.54) and with a history of medication overuse headache (OR 9.9, CI 1.6-59.4). Present monthly migraine frequency (1.5 ± 2.6) was significantly lower than five years before the interview (2.9 ± 4.64). There was a correlation between medication overuse headache and use of analgesics more than 3 days/months for dysmenorrhoea (p < 0.03). ASRM endometriosis score was not associated with migraine characteristics.
CONCLUSIONS
We conclude that the comorbidity of endometriosis is highly linked to migraine with aura. Migraine onset in these patients was earlier. Further studies are needed to explore, if the observed decrease in migraine frequency can be attributed to recent endometriosis surgery and to understand if early diagnosis and treatment of both conditions may contribute to improve the course of both conditions. Trial registration BASEC Nr. 2021-00285.
PubMed: 38878131
DOI: 10.1007/s13760-024-02484-2 -
Frontiers in Endocrinology 2024Graphene-based warm uterus acupoint paste (GWUAP) is an emerging non-drug alternative therapy for the treatment of primary dysmenorrhea (PD), but the underlying...
Graphene-based warm uterus acupoint paste (GWUAP) is an emerging non-drug alternative therapy for the treatment of primary dysmenorrhea (PD), but the underlying mechanism is still unclear. SD female rats were randomly divided into control group, model group and treatment group to explore the mechanism of GWUAP in the treatment of PD. Combined with 16S rDNA and fecal metabolomics, the diversity of microbiota and metabolites in each group was comprehensively evaluated. In this study, GWUAP reduced the torsion score of PD model rats, improved the pathological morphology of uterine tissue, reduced the pathological damage score of uterine tissue, and reversed the expression levels of inflammatory factors, pain factors and sex hormones. The 16 S rDNA sequencing of fecal samples showed that the abundance of Lactobacillus in the intestinal flora of the model group decreased and the abundance of Romboutsia increased, while the abundance of Lactobacillus in the intestinal flora of the treatment group increased and the abundance of Romboutsia decreased, which improved the imbalance of flora diversity in PD rats. In addition, 32 metabolites related to therapeutic effects were identified by metabolomics of fecal samples. Moreover, there is a close correlation between fecal microbiota and metabolites. Therefore, the mechanism of GWUAP in the treatment of PD remains to be further studied.
Topics: Animals; Female; Dysmenorrhea; Rats; Rats, Sprague-Dawley; Metabolomics; Acupuncture Points; Gastrointestinal Microbiome; RNA, Ribosomal, 16S; Feces; DNA, Ribosomal
PubMed: 38872962
DOI: 10.3389/fendo.2024.1397402 -
Frontiers in Neurology 2024Drawing on the principles of wrist-ankle acupuncture (WAA), our research team has developed a portable device for WAA point compression, termed the acupressure...
BACKGROUND
Drawing on the principles of wrist-ankle acupuncture (WAA), our research team has developed a portable device for WAA point compression, termed the acupressure wrist-ankle strap (AWA). The current study aims to evaluate the efficacy of the AWA in alleviating pain associated with primary dysmenorrhea.
METHODS
A single-blind, randomized clinical trial was conducted from April 1, 2019, to December 31, 2019. 78 participants with primary dysmenorrhea were recruited from Shanghai University of Traditional Chinese Medicine. All participants were treated on the first day of menstruation for 30 min. Participants in the AWA group used the AWA, the internal side of which is equipped with a tip compression component, while participants in the non-acupressure wrist-ankle acupuncture(NAWA)group used the NAWA, with the inside tip pressing parts removed. The main outcome was the difference in visual analogue scale (VAS) score between baseline and 30 minutes after randomization.
RESULTS
A total of 78 participants aged 18 to 30 years were included in the intention-to-treat analyses. The VAS scores (mean [standard deviation]) in the AWA group were significantly lower than those in the NAWA group at each time point of intervention (5 minutes: 95% CI, [-1.27 to -0.68], < 0.001; 10 minutes: 95% CI, [-2.34 to -1.51], < 0.001; 30 minutes: 95% CI, [-3.74 to -2.72], < 0.001). In the AWA group, 16 participants reported "obvious relief" of dysmenorrhea pain while 23 did not; the average onset time of analgesia they reported were (21.50 ± 3.65) min, while no subjects in NAWA group reported obvious pain relief. The pain threshold (mean [standard deviation]) at SP9 of both sides in AWA group decreased significantly after intervention that in NAWA group (Left: 95% CI, [-5.02 to -1.81], < 0.001; Right: 95% CI, [-7.67 to -4.24], < 0.001). There was no significant change in the temperature at CV4 in either group (95% CI, [-0.63 to -0.66], = 0.970).
CONCLUSION
This trial substantiates our hypothesis that the AWA provides immediate analgesic effects. The AWA represents an effective and safe non-invasive physical therapy option, which patients can self-administer to alleviate abdominal pain.
PubMed: 38872824
DOI: 10.3389/fneur.2024.1362586 -
Biomedical Reports Jul 2024The present study aimed to investigate the efficacy of hysteroscopic levonorgestrel-releasing intrauterine device (LNG-IUD) fixation surgery in the treatment of...
The present study aimed to investigate the efficacy of hysteroscopic levonorgestrel-releasing intrauterine device (LNG-IUD) fixation surgery in the treatment of adenomyosis through a cohort study. The cohort study was performed at the Affiliated Jinhua Hospital of Wenzhou Medical University (Jinhua, China). A total of 31 women with adenomyosis were initially recruited from June 2020 to June 2022 and divided into an experimental group and a control group. The experimental group underwent hysteroscopic LNG-IUD fixation surgery and the control group underwent conventional implantation of the levonorgestrel-releasing intrauterine system. The assessed efficacy outcomes included the time of LNG-IUD expulsion, postoperative vaginal bleeding time, dysmenorrhea, and the menstrual blood loss score (MBLS). A total of 31 participants completed the research. The LNG-IUD expulsion rate was 6.25 and 60% (P<0.05) in the experimental and control group, respectively. The LNG-IUD in place time was 20.50 months (Q, 15.75; Q, 24.00) in the experimental group and 10.00 months (Q, 6.50; Q, 15.00) in the control group (P<0.05); the time of vaginal bleeding after surgery in the experimental and control groups were 12.50 days (9.25, 16.25) and 120.00 days (75.00, 120.00), respectively (P<0.05). Multiple-factor Cox regression analysis revealed that the LNG-IUD expulsion in patients with adenomyosis is associated with the hysteroscopic LNG-IUD fixation surgery [hazard ratio (HR), 1954.09], uterine cavity depth (HR, 16.63), MBLS (HR, 1.14), history of gonadotropin-releasing hormone agonist treatment in the previous 6 months (HR, 2.10), history of vaginal delivery (HR, 1.79) and history of cervical laceration (HR, 3.69). In conclusion, hysteroscopic LNG-IUD fixation reduces the rate of LNG-IUD expulsion, prolongs the time of LNG-IUD in the uterine cavity, reduces the time of postoperative vaginal bleeding, relieves the symptoms of dysmenorrhea and reduces the menstrual volume in the patients with adenomyosis. The present trial was retrospectively registered in the Chinese Clinical Trial Registry on 28th December 2023 (registration no. ChiCTR2300079233).
PubMed: 38868528
DOI: 10.3892/br.2024.1797 -
Journal of the Turkish German... Jun 2024Premenstrual syndrome (PMS) is a common condition among women during their menstrual cycle. PMS can negatively affect a woman's daily life and function. Nurses, as an...
OBJECTIVE
Premenstrual syndrome (PMS) is a common condition among women during their menstrual cycle. PMS can negatively affect a woman's daily life and function. Nurses, as an important and substantial segment of healthcare staff, are affected by the demanding environment of work place. Since PMS, as a prevalent counterproductive condition, has not been studied in this population in Iran, we assessed the prevalence of PMS and its associated factors among nurses aged 23 to 49 in teaching hospitals of the Tehran province of Iran.
MATERIAL AND METHODS
In this cross-sectional study from April 2021 to January 2022, 280 participants from teaching hospitals were enrolled. Simple random sampling was used to determine the sample size of the study. Two validated questionnaires and a data gathering sheet were used to collect information. The premenstrual symptoms screening tool was used to determine PMS severity and the Copenhagen Psychosocial Questionnaire to evaluate the associated job demands. Demographic data and work-related data included: night shift, shift type, monthly COVID-19 care and gynecologic and past medical history were gathered. Then data were analyzed using logistic regression analysis, chi-square and t-test.
RESULTS
The severity of PMS was: mild (42.5%); moderate (30%); and severe (27.5%). Regular menstruation and dysmenorrhea were reported by 84.6% and 72.3%, respectively. Moderate to severe PMS was associated with: monthly COVID shift (p=0.02); emotional (p<0.01) and quantitative (p<0.01) demands; regular caffeine intake (p=0.01); education level (p=0.005); regular exercise (p=0.003); regular fiber intake (p=0.08); and irregular menstrual cycles (p=0.007). In logistic regression only quantitative (p=0.003) and emotional (p=0.018) job demands were significant.
CONCLUSION
Results showed that the prevalence of PMS was high among Iranian nurses and was associated with quantitative and emotional job demands. We suggest further studies focusing on preventative and effective interventions to diminish the consequences of PMS in this population. We also suggest investigating the practical application of the findings of this study for healthcare professionals and policymakers.
PubMed: 38867710
DOI: 10.4274/jtgga.galenos.2024.2023-3-1 -
BMJ Open Jun 2024Primary dysmenorrhoea (PD) is a common menstrual concern with significant physical and psychosocial impacts. The effectiveness and safety of transcutaneous electrical... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Primary dysmenorrhoea (PD) is a common menstrual concern with significant physical and psychosocial impacts. The effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) in alleviating PD symptoms remain uncertain due to insufficient evidence. This single-centre, parallel, randomised controlled study intends to evaluate the efficacy and safety of TEAS for PD management.
METHODS AND ANALYSIS
60 participants aged 18-40 years diagnosed with moderate to severe PD will be recruited from Tai'an Hospital of Traditional Chinese Medicine (TCM) and randomly assigned to either a TEAS group or a TEAS-sham group (1:1). The TEAS group will undergo 12 sessions of TEAS treatment over two menstrual cycles, with 30 min per session, three sessions weekly. Participants in the TEAS-sham group will receive TEAS stimulation using identical devices and protocols but without current output. The primary outcome is the Visual Analogue Scale (VAS) for pain assessment. Secondary outcomes are Short-Form McGill Pain Questionnaire, total effective rate, uterine artery haemodynamics, prostaglandin and β-endorphin level, mental well-being and quality of life. Adverse events and their potential reasons and the use of analgesics will also be recorded.
ETHICS AND DISSEMINATION
This study was approved by the Medical Ethics Committee of Tai'an Hospital of TCM. Written informed consent will be obtained from each participant. The results will be submitted for publication in a peer-reviewed journal.
TRIAL REGISTRATION NUMBER
ChiCTR2300071686.
Topics: Humans; Dysmenorrhea; Female; Transcutaneous Electric Nerve Stimulation; Acupuncture Points; Adult; Young Adult; China; Adolescent; Pain Measurement; Treatment Outcome; Randomized Controlled Trials as Topic; Quality of Life
PubMed: 38866569
DOI: 10.1136/bmjopen-2023-078895 -
Turkish Journal of Obstetrics and... Jun 2024Endometriosis is a common condition among women and can cause complications such as abdominal pain, dysmenorrhea, and infertility. One of the potential causes of this...
Endometriosis is a common condition among women and can cause complications such as abdominal pain, dysmenorrhea, and infertility. One of the potential causes of this disease is autoimmunity. However, evidence regarding the role of autoimmunity is conflicting and inconclusive. The aim of this study was to investigate whether autoantibodies, a sign of autoimmunity, are present in people suffering from endometriosis. Relevant studies up to April 14, 2023 were identified by systematically searching Scopus, PubMed, Web of Science, Embase, and Google Scholar. This meta-analysis includes all qualified case-control studies of human populations that analyzed the association between serum autoantibodies and endometriosis. The odd ratios and 95% confidence intervals were calculated. In addition, heterogeneity and publication bias were examined, and subgroup analyses were performed based on region and target antigens. Forty-one studies were included, comparing 2,825 endometriosis patients with 4,158 healthy controls. The meta-analysis findings indicated a significant association between the presence of autoantibodies in the serum and an increased susceptibility to endometriosis (odds ratio: 4.242, confidence interval 95%: 3.824-4.706, p<0.001). In addition, there was a significant correlation between the presence of endometriosis and serum levels of anti-nuclear antibodies, B2 glycoprotein 1, CA125, carbonic anhydrase 1, cardiolipin, endometrial, laminin-1, smooth muscle, and syntaxin autoantibodies. Upon further analysis, it was found that the serum levels of these autoantibodies were higher in patients with endometriosis from North America than in those from other regions (p=0.001). The study revealed a significant correlation between serum autoantibodies and susceptibility to endometriosis, highlighting autoimmunity as a potential cause.
PubMed: 38853493
DOI: 10.4274/tjod.galenos.2024.77489 -
Turkish Journal of Obstetrics and... Jun 2024Adenomyosis is a chronic inflammatory illness that depends on estrogen. In addition to its immune regulatory effects in chronic diseases, vitamin D also plays roles in...
OBJECTIVE
Adenomyosis is a chronic inflammatory illness that depends on estrogen. In addition to its immune regulatory effects in chronic diseases, vitamin D also plays roles in regulating normal cell growth. In the present study, the purpose was to evaluate the possible relationships between serum 25-OH vitamin D levels and clinical and laboratory parameters in patients who were histopathologically diagnosed with adenomyosis.
MATERIALS AND METHODS
A total of 168 females with a history of hysterectomy between January 2019 and November 2022 who were histopathologically diagnosed with adenomyosis and 168 women who were not diagnosed with adenomyosis were retrospectively evaluated in the present study. Demographic, clinical, and laboratory data were recorded at the time of admission. Visual analogue scale (VAS) scores were calculated for each patient to evaluate the severity of dysmenorrhea.
RESULTS
There was a significant difference between the groups in terms of VAS: the adenomyosis group scored an average of 6, whereas the control group scored an average of 3 (p<0.001). The average platelet volume value of the patients was 8.6 fL in the adenomyosis group, and that of the control group was 7.2 fL, and it was detected to be significantly elevated in the adenomyosis group (p<0.001). The CA-125 value of the patients was 63.5 U/mL in the adenomyosis group, and that of the control group was 15.6 U/mL and it was detected to be significantly rised in the adenomyosis group (p<0.001). The 25-OH vitamin D level of the patients was 12.6 ng/mL in the adenomyosis group and that of the control group was 19.1 ng/mL and it was detected to be significantly elevated in the control group.
CONCLUSION
The current investigation provides compelling evidence for the association between low vitamin D levels and adenomyosis, which agrees with other research in the field. The current study's findings agree with other research that suggests vitamin D regulates cellular and signaling networks, including those that control cytokines and gene expression during adenomyosis. However, further studies are needed because data assassing the therapeutic efficacy of vitamin D in adenomyosis are questionable.
PubMed: 38853492
DOI: 10.4274/tjod.galenos.2024.41662 -
Turkish Journal of Obstetrics and... Jun 2024To evaluate the clinical outcomes of laparoscopic and hysteroscopic surgical approaches for treating symptomatic isthmocele and identify their associated factors.
OBJECTIVE
To evaluate the clinical outcomes of laparoscopic and hysteroscopic surgical approaches for treating symptomatic isthmocele and identify their associated factors.
MATERIALS AND METHODS
Forty-six patients with symptomatic isthmocele diagnosed using transvaginal saline infusion sonohysterography were enrolled in this prospective cohort study. Patients underwent either laparoscopic or hysteroscopic isthmoplasty based on their residual myometrial thicknesses and fertility desires and were subsequently followed by clinical and ultrasonographic examinations.
RESULTS
Twenty-two patients underwent laparoscopy and 24 underwent hysteroscopic surgery. At baseline, there was no significant difference in the mean age and years since the last cesarean section between the two groups. However, the hysteroscopy group had a higher mean parity and previous cesarean sections (p=0.00, 0.03). The most common symptoms were abnormal uterine bleeding, infertility, and dysmenorrhea. The mean baseline residual myometrial thickness was significantly higher in the laparoscopy group (p=0.00), and only laparoscopic surgery led to a significant increase in residual myometrial thickness in patients (p=0.00). Both procedures significantly reduced abnormal uterine bleeding (p=0.00), but only laparoscopy reduced infertility (p=0.00) and hysteroscopy reduced dysmenorrhea (p=0.03). Hysteroscopy showed better symptom resolution in younger patients (p=0.01), whereas age did not affect laparoscopy outcomes.
CONCLUSION
Both approaches showed similar effectiveness in resolving abnormal uterine bleeding, with laparoscopy excelling in infertility resolution and hysteroscopy excelling in dysmenorrhea resolution.
PubMed: 38853455
DOI: 10.4274/tjod.galenos.2024.54006 -
Brazilian Journal of Physical Therapy 2024The Dysmenorrhea Symptom Interference (DSI) scale is a reliable, valid, and responsive tool to assess the interference of menstrual pain in the physical, mental, and...
BACKGROUND
The Dysmenorrhea Symptom Interference (DSI) scale is a reliable, valid, and responsive tool to assess the interference of menstrual pain in the physical, mental, and social activities of women.
OBJECTIVE
To translate and cross-culturally adapt the DSI scale into Brazilian-Portuguese (DSI-BrPt) and investigate the measurement properties of this version in on- and off-menses versions.
METHODS
The original (United States) scale was translated and culturally adapted following existing guidelines. Measurement properties of the DSI-BrPt were investigated in 1387 women with dysmenorrhea. Reliability was analyzed via intraclass correlation coefficients (ICC) and test-retest reliability. Furthermore, structural validity, internal consistency (Cronbach's alpha), cross-cultural validity, construct validity (correlation with WHODAS 2.0 and SPS-6 scores questionnaires), and floor and ceiling effects were determined.
RESULTS
No significant adaptations were needed during the translation process of the DSI-BrPt. The values of Cronbach's α were adequate (α ≥0.87) for the unidimensional scale. The test-retest reliability was considered adequate (ICC >0.78) and there was no systematic error for both on-menses and off-menses versions. Moreover, the DSI had a positive and strong correlation with WHODAS 2.0. There were no floor and ceiling effects neither for the total sample, nor among off-menses, or on-menses women.
CONCLUSION
The DSI-BrPt scale has been translated and cross-culturally adapted successfully. The DSI-BrPt scale presented adequate measurement properties. The scale is valid and reliable, and, therefore, an adequate tool for monitoring dysmenorrhea symptoms in Brazilian women during and between menses.
Topics: Humans; Dysmenorrhea; Brazil; Female; Surveys and Questionnaires; Cross-Cultural Comparison; Reproducibility of Results; Psychometrics
PubMed: 38848625
DOI: 10.1016/j.bjpt.2024.101065