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Cureus Apr 2024Endometriosis is a chronic benign inflammatory disease that affects women of reproductive age. The clinical presentations of endometriosis include dysmenorrhea,... (Review)
Review
Endometriosis is a chronic benign inflammatory disease that affects women of reproductive age. The clinical presentations of endometriosis include dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. There is a well-established association between endometriosis and infertility. Therefore, there is a need for an early diagnosis of endometriosis-related infertility. In this study, we aim to identify the role of biomarkers as predictive factors of the presence of the disease and its severity and their correlation with the pregnancy outcome. We performed an electronic database search of all published studies in PubMed and EMBASE from January 2018 to May 2023. Numerous innovative biomarkers identified in cases of endometriosis and infertility have been studied over the past years, including micro-RNAs, BCL6 endometrial expression, cytotoxic T-lymphocyte antigen 4, human leukocyte antigen G, programmed cell death protein 1, programmed cell death ligand 1 immune checkpoint molecules, plasma fibronectin-fibrin complexes, homeobox A10 gene, systemic inflammatory response markers, uterine natural killer cells, and the eutopic endometrium proteome. Considerable research has been done to identify diagnostic biomarkers for the early detection and prevention of endometriosis-associated infertility. However, none of these biomarkers displayed enough diagnostic accuracy to be used in daily clinical practice. Future research is valuable to establish them as reliable diagnostic tools.
PubMed: 38813329
DOI: 10.7759/cureus.59288 -
Clinical and Experimental Reproductive... Jun 2024Diminished ovarian reserve (DOR) is a disorder characterized by impaired ovarian function. Sleep disorders are disruptions of the circadian rhythm, which appears to be...
OBJECTIVE
Diminished ovarian reserve (DOR) is a disorder characterized by impaired ovarian function. Sleep disorders are disruptions of the circadian rhythm, which appears to be closely linked to reproductive systems. This study aimed to investigate the impact of poor sleep quality on the ovarian reserve of childbearing-age women.
METHODS
A cross-sectional study was conducted in China from June 2021 to March 2023. In total, 102 participants diagnosed with chronic insomnia disorder were included in the study. Questionnaires were administered to assess participants' menstrual patterns, insomnia severity, anxiety, and depression. The anti-Müllerian hormone level and the basal antral follicle count were measured for ovarian reserve evaluation. Correlation analysis and ordinal logistic regression analysis were conducted.
RESULTS
The women with insomnia presented high percentages of hypomenorrhea, premenstrual syndrome, and dysmenorrhea (78.4%, 74.5%, and 46.1%, respectively). Severe sleep disorder in the past month was identified as an independent risk factor for hypomenorrhea and premenstrual syndrome (odds ratio [OR], 2.64 and OR, 2.688; p<0.05). The prevalence of DOR among women with insomnia (33.3%) was significantly higher than the average reported in previous studies for young women. Insomnia duration exceeding 1 year was determined to be an independent risk factor for DOR in women aged 36 to 40 years (OR, 4.5; p=0.033).
CONCLUSION
This study highlights the association between sleep disorders and menstrual problems. Prolonged poor sleep quality in women aged 36 to 40 years was identified as a significant risk factor for DOR. We should pay more attention to improving sleep quality in order to maintain normal ovarian function.
PubMed: 38812244
DOI: 10.5653/cerm.2023.06513 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Apr 2024This study aims to identify the active constituents of essential oil from the rhizomes of Curcuma phaeocaulis for the treatment of dysmenorrhea. The compounds were...
This study aims to identify the active constituents of essential oil from the rhizomes of Curcuma phaeocaulis for the treatment of dysmenorrhea. The compounds were separated and purified by molecular distillation, silica gel and Sephadex LH-20 column chromatography, preparative thin layer chromatography, and semi-preparative high performance liquid chromatography. Their structures were identified by mass spectrometry and nuclear magnetic resonance spectroscopy. The animal model of primary dysmenorrhea and the contraction model of isolated uterine smooth muscle of rats were established to examine the active constituents in the essential oil for treating dysmenorrhea. Six sesquiterpenes were isolated and identified as dehydrocommiterpene A(1), comosone Ⅱ(2), 5α(H)-eudesma-3(4),7(11)-dien-9β-ol-6-one(3), guaia-6(7)-en-11-ol(4), curcumenol(5), and isocurcumenol(6), among which compound 1 was a novel compound. The animal experiments showed that the essential oil from C. phaeocaulis significantly lowered the level of PGF_(2α) in uterine tissue compared with the model group. The experiment with the contraction model of isolated uterine smooth muscle demonstrated that the components with high boiling points outperformed those with low boiling points in relaxing the uterine smooth muscle, and compounds 1, 2, 5, and 6 isolated from the fraction with a high boiling point had the effect of relaxing the uterine smooth muscle. Among them, compounds 5 and 6 inhibited the extracellular Ca~(2+) influx and intracellular Ca~(2+) release to relax the uterine smooth muscle. In conclusion, the components with high boiling points and sesquiterpenes are the active components in the essential oil of C. phaeocaulis for treating dysmenorrhea.
Topics: Dysmenorrhea; Female; Oils, Volatile; Animals; Curcuma; Rats; Rats, Sprague-Dawley; Humans; Drugs, Chinese Herbal; Uterus; Rhizome
PubMed: 38812199
DOI: 10.19540/j.cnki.cjcmm.20231211.201 -
Cureus Apr 2024Primary dysmenorrhea, commonly known as menstrual cramps, is a prevalent gynecological issue that impacts many women in their childbearing age. It manifests as...
BACKGROUND
Primary dysmenorrhea, commonly known as menstrual cramps, is a prevalent gynecological issue that impacts many women in their childbearing age. It manifests as reoccurring, cramp-like lower abdominal pain, usually commencing right prior to or during the menstrual period. These painful sensations can be severe, extending to the lower back and upper thighs can greatly disrupt a woman's daily life and overall well-being. The optimal exercise approach is needed for individuals seeking relief from primary dysmenorrhea, allowing healthcare providers and women themselves to make informed decisions regarding their treatment options. Though many forms of exercise interventions exist in the treatment of primary dysmenorrhea, this study aims to compare two forms of intervention namely pilates and gym ball exercises on pain and menstrual distress among women with Primary Dysmenorrhea.
METHODS
This experimental comparative study was carried out with 30 young female participants over a 12-week period. Participant recruitment was done through a simple random sampling method. The criteria of inclusion encompassed young females aged 17-25 years, those in good health, and those experiencing primary dysmenorrhea. Exclusion criteria included secondary dysmenorrhea, medication use, polycystic ovarian syndrome, bleeding disorders, positive pregnancy tests, breastfeeding, and other medical conditions. Group A received Pilates exercises, while Group B underwent Gym ball exercises. The assessment of both groups' menstrual distress levels was conducted using the Moos Menstrual Distress Questionnaire (MDQ) and pain scores using the Visual Analog Scale (VAS).
RESULT
In the statistical analysis, Group A (Pilates Exercises) showed a significantly lower mean value (2.60) on the VAS compared to Group B (Swiss Ball Exercises) (5.46), with both groups experiencing a notable reduction in post-test scores (p ≤ 0.001). Additionally, on the MOOS MDQ score, Group A (Pilates Exercises) achieved a lower mean value (79.33) compared to Group B (Swiss Ball Exercises) (103.26), with both groups demonstrating a significant decrease in post-test scores (p ≤ 0.001).
CONCLUSION
In conclusion, this study underscores the significance of exercise therapy, particularly Pilates exercises, as a holistic approach to addressing primary dysmenorrhea, improving physical well-being, and enhancing the overall quality of life.
PubMed: 38807793
DOI: 10.7759/cureus.59184 -
Reproductive Sciences (Thousand Oaks,... May 2024Endometriosis is often diagnosed in reproductive aged women with spontaneous ovarian activity. Here we described a case of endometriosis diagnosed in a patient with...
Endometriosis is often diagnosed in reproductive aged women with spontaneous ovarian activity. Here we described a case of endometriosis diagnosed in a patient with premature ovarian insufficiency (POI) due to prepubertal bone marrow transplant (BMT). The patient is a 22-year-old nulligravid female who presented with chronic pelvic pain. She had an inherited bone marrow failure syndrome (Diamond-Blackfan anemia), which required gonadotoxic chemotherapy for BMT at a young age prior to puberty. At age 13, she received hormone therapy with transdermal estrogen with subsequent addition of cyclic progestin and was later transitioned to combined oral contraceptive pills (COC). Endometriosis was suspected due to progressive dysmenorrhea and multiple cyclic systemic symptoms. She underwent a trial of elagolix, but could not tolerate it due to worsened arthralgia. Norethindrone acetate (NET-A) was then started, and she underwent diagnostic laparoscopy. Laparoscopy revealed scattered superficial endometriotic lesions in the pelvis. Histological studies showed florid endometriosis. Patient continues on NET-A 10mg and oral estradiol 0.5mg daily since the surgery and has experienced sustained improvement in her symptoms. Endometriosis should be considered as a possible cause for progressive dysmenorrhea or pelvic pain, even in the setting of POI. The balance between HT for overall health benefits in young women with POI and the risk of endometriosis exacerbation is delicate, but achievable.
PubMed: 38806998
DOI: 10.1007/s43032-024-01601-z -
BMJ Open May 2024First-generation and second-generation endometrial ablation (EA) techniques, along with medical treatment and invasive surgery, are considered successful lines of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
First-generation and second-generation endometrial ablation (EA) techniques, along with medical treatment and invasive surgery, are considered successful lines of management for abnormal uterine bleeding (AUB). We set out to determine the efficacy of first and second-generation ablation techniques compared with medical treatment, invasive surgery and different modalities of the EA techniques themselves.
DESIGN
Systematic review and network meta-analysis using a frequentist network.
DATA SOURCES
We searched Medline (Ovid), PubMed, ClinicalTrials.gov, Cochrane CENTRAL, Web of Science, EBSCO and Scopus for all published studies up to 1 March 2021 using relevant keywords.
ELIGIBILITY CRITERIA
We included all randomised controlled trials (RCTs) that compared premenopausal women with AUB receiving the intervention of second-generation EA techniques.
DATA EXTRACTION AND SYNTHESIS
49 high-quality RCTs with 8038 women were included. We extracted and pooled the data and then analysed to estimate the network meta-analysis models within a frequentist framework. We used the random-effects model of the netmeta package in R (V.3.6.1) and the 'Meta-Insight' website.
RESULTS
Our network meta-analysis showed many varying results according to specific outcomes. The uterine balloon ablation had significantly higher amenorrhoea rates than other techniques in both short (hydrothermal ablation (risk ratio (RR)=0.51, 95% CI 0.37; 0.72), microwave ablation (RR=0.43, 95% CI 0.31; 0.59), first-generation techniques (RR=0.44, 95% CI 0.33; 0.59), endometrial laser intrauterine therapy (RR=0.18, 95% CI 0.10; 0.32) and bipolar radio frequency treatments (RR=0.22, 95% CI 0.15; 0.31)) and long-term follow-up (microwave ablation (RR=0.11, 95% CI 0.01; 0.86), bipolar radio frequency ablation (RR=0.12, 95% CI 0.02; 0.90), first generation (RR=0.12, 95% CI 0.02; 0.90) and endometrial laser intrauterine thermal therapy (RR=0.04, 95% CI 0.01; 0.36)). When calculating efficacy based only on calculated bleeding scores, the highest scores were achieved by cryoablation systems (p-score=0.98).
CONCLUSION
Most second-generation EA systems were superior to first-generation systems, and statistical superiority between devices depended on which characteristic was measured (secondary amenorrhoea rate, treatment of AUB, patient satisfaction or treatment of dysmenorrhoea). Although our study was limited by a paucity of data comparing large numbers of devices, we conclude that there is no evidence at this time that any one of the examined second-generation systems is clearly superior to all others.
Topics: Humans; Female; Endometrial Ablation Techniques; Network Meta-Analysis; Uterine Hemorrhage; Randomized Controlled Trials as Topic
PubMed: 38806429
DOI: 10.1136/bmjopen-2022-065966 -
The Australian & New Zealand Journal of... May 2024Dysmenorrhoea-Related Pelvic Pain (DRPP) is a common condition, which may or may not include bladder-related symptoms. Primary health care practitioners (PHCP) rely...
BACKGROUND
Dysmenorrhoea-Related Pelvic Pain (DRPP) is a common condition, which may or may not include bladder-related symptoms. Primary health care practitioners (PHCP) rely heavily on language for diagnosis of DRPP-related conditions. However, there are no established pain descriptors to assist PHCP to determine whether an individual's DRPP may include a bladder component.
AIMS
To identify differences in the use of pain descriptors in women with DRPP with and without a co-existing bladder pain component, through an exploratory study of the language of pelvic pain in women.
MATERIALS AND METHODS
A cross-sectional online survey of Australian and New Zealand women (n = 750, ages 18-49) who have self-identified pelvic pain. Free text and predetermined pain descriptors used by women with a self-perceived bladder pain component (DRPPB+, n = 468) were compared to those without bladder pain (DRPPB-, n = 282). Statistical analysis included Pearson χ, logistic regression and analysis of variance tests using StataCorp Stata Statistical Software combined with qualitative data from AntConc concordance software.
RESULTS
Within free-form text, bloating (P = 0.014) and pressure (P = 0.031) were used more commonly to describe dysmenorrhoea in women with DRPPB+, while the word excruciating (P < 0.001) was more commonly used by women with DRPPB-. From a pre-determined list of descriptors, pounding (P < 0.001), tingling (P < 0.001), stabbing (P = 0.010), burning (P = 0.002) and cramping (P = 0.021) were more commonly used by women with DRPPB+, than women with DRPPB-.
CONCLUSIONS
Systematic patterns of word use should encourage practitioners to further enquire about bladder symptoms that may co-exist with dysmenorrhoea. Knowledge of these words may be useful in targeting diagnostic and therapeutic interventions.
PubMed: 38803121
DOI: 10.1111/ajo.13833 -
Taiwanese Journal of Obstetrics &... May 2024We describe a rare case of uterine mesothelial cysts mimicking ovarian cysts in a primipara patient with a history of Cesarean section. (Review)
Review
OBJECTIVE
We describe a rare case of uterine mesothelial cysts mimicking ovarian cysts in a primipara patient with a history of Cesarean section.
CASE REPORT
A 39-year-old female patient with history of Cesarean section presented with dysmenorrhea. Sonography revealed that a hypoechoic and anechoic multicystic complex, which was located on the right side of the pelvic cavity, had infiltrated the adjacent posterior wall of the uterus, and it was preoperatively misdiagnosed as ovarian cysts with suspected endometrioma. Laparoscopic surgery revealed multiple cystic lesions filled with clear yellow fluid on the posterior uterine wall instead of the adnexa. Laparoscopic uterine cystectomy was performed, and the patient's recovery was uneventful. Pathohistological and immunohistochemical examinations confirmed the diagnosis of uterine mesothelial cysts.
CONCLUSION
Uterine mesothelial cysts should be considered in the differential diagnosis of pelvic lesions. Increasing the awareness of this rare disease can contribute to improved evaluation, decision-making, and disease management.
Topics: Humans; Female; Adult; Ovarian Cysts; Cesarean Section; Diagnosis, Differential; Cysts; Ultrasonography; Laparoscopy; Uterine Diseases; Pregnancy; Endometriosis
PubMed: 38802210
DOI: 10.1016/j.tjog.2023.09.025 -
Taiwanese Journal of Obstetrics &... May 2024To examine the effects of Jacobson's Progressive Muscle Relaxation Technique (JPMRT) on menstrual pain and symptoms, anxiety, quality of life (QoL), social activity, and... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To examine the effects of Jacobson's Progressive Muscle Relaxation Technique (JPMRT) on menstrual pain and symptoms, anxiety, quality of life (QoL), social activity, and work/school performance in primary dysmenorrhea (PD).
MATERIALS AND METHODS
Women with PD were randomly divided into two groups as relaxation and control groups. JPMRT was applied three times a week from the estimated date of ovulation to the onset of the next menstruation. No treatment was performed in the control group. Pain intensity, menstrual symptoms, anxiety, impacts on QoL, social activity, and work/school performance were assessed before and after the interventions.
RESULTS
After the interventions, there was a further decrease in menstrual pain intensity, menstrual symptoms, anxiety level, the impact of QoL, and the work/school performance scores in the relaxation group than in the control group (p < 0.05).
CONCLUSION
JPMRT might be used as an alternative method in the treatment of PD.
Topics: Humans; Female; Dysmenorrhea; Quality of Life; Adult; Young Adult; Treatment Outcome; Anxiety; Relaxation Therapy; Pain Measurement; Muscle Relaxation
PubMed: 38802195
DOI: 10.1016/j.tjog.2023.10.016 -
Narra J Apr 2024The initial physiological change in adolescent girls is the onset of menstruation. The most prevalent challenge they face regarding menstruation is primary dysmenorrhea,...
The initial physiological change in adolescent girls is the onset of menstruation. The most prevalent challenge they face regarding menstruation is primary dysmenorrhea, characterized by persistent or intermittent pelvic pain in the lower abdomen. The aim of this study was to investigate the influences of stress levels and physical activities on primary dysmenorrhea. A cross-sectional was conducted in Cirebon, Indonesia, in 2023 included young women who had never given birth (nullipara), aged 17-25 years old, had menstruated, and had no history of smoking and alcohol. The data were collected using a set of questionnaires consisting of the Numeric Rating Scale (NRS) to determine primary dysmenorrhea pain, the Depression Anxiety Stress Scales 42 (DASS 42) to determine the level of stress and the International Physical Activity Questionnaire (IPAQ) to determine physical activity. Pearson's correlation test was used to assess the correlation between the variables (stress levels, physical activity, and dysmenorrhea). A total of 150 young women were included in the study. Moderate stress levels (23.3%) and high physical activity (90.7%) were the most prevalent category observed among studied participants. Approximately 42% of them experienced mild dysmenorrhea pain. Our analysis indicated that stress levels and physical activities had strong positive and negative correlations with dysmenorrhea pain levels, with =0.782 and =-0.748, respectively, with both had <0.001. This highlights that controlling stress could be beneficial in preventing dysmenorrhea pain among young women.
Topics: Humans; Dysmenorrhea; Female; Cross-Sectional Studies; Exercise; Adolescent; Adult; Stress, Psychological; Young Adult; Surveys and Questionnaires; Indonesia; Pain Measurement
PubMed: 38798864
DOI: 10.52225/narra.v4i1.685