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PloS One 2023Considering the pharmacological treatment options for endometriosis-associated pain are confined to hormonal therapy and analgesics, we studied the analgesic effect of... (Randomized Controlled Trial)
Randomized Controlled Trial
Considering the pharmacological treatment options for endometriosis-associated pain are confined to hormonal therapy and analgesics, we studied the analgesic effect of 20 mg melatonin as an adjuvant therapy in women with endometriosis-associated pain. This randomized double-blinded, placebo-controlled trial was conducted at the Research Center for Womens' Health at Södersjukhuset, a university hospital in Stockholm, Sweden. Forty women from 18 to 50 years of age with endometriosis and severe dysmenorrhea with or without chronic pelvic pain were given 20 mg Melatonin or placebo orally daily for two consecutive menstrual cycles or months. The level of pain was recorded daily on the 11-point numeric rating scale, a difference of 1.3 units was considered clinically significant. Clincaltrials.gov nr NCT03782740. Sixteen participants completed the study in the placebo group and 18 in the melatonin group. The difference in endometriosis-associated pain between the groups showed to be non-significant statistically as well as clinically, 2.9 (SD 1.9) in the melatonin group and 3.3 (SD 2.0) in the placebo group, p = 0.45. This randomized, double-blinded, placebo-controlled trial could not show that 20 mg of melatonin given orally at bedtime had better analgesic effect on endometriosis-associated pain compared with placebo. No adverse effects were observed.
Topics: Female; Humans; Infant; Endometriosis; Melatonin; Pain Management; Pelvic Pain; Analgesics; Adjuvants, Pharmaceutic; Double-Blind Method; Dysmenorrhea; Treatment Outcome
PubMed: 37267394
DOI: 10.1371/journal.pone.0286182 -
Physiological Reports Jul 2023Premenstrual syndrome (PMS) and primary dysmenorrhea are common gynecological problems and inflammation may have a role in their etiology. Curcumin is a polyphenolic... (Randomized Controlled Trial)
Randomized Controlled Trial
Premenstrual syndrome (PMS) and primary dysmenorrhea are common gynecological problems and inflammation may have a role in their etiology. Curcumin is a polyphenolic natural product for which there is increasing evidence of anti-inflammatory and iron chelation effects. This study assessed the effects of curcumin on inflammatory biomarkers and iron profile in young women with PMS and dysmenorrhea. A sample of 76 patients was included in this triple-blind, placebo-controlled clinical trial. Participants were randomly allocated to curcumin (n = 38) and control groups (n = 38). Each participant received one capsule (500 mg of curcuminoid+ piperine, or placebo) daily, from 7 days before until 3 days after menstruation for three consecutive menstrual cycles. Serum iron, ferritin, total iron-binding capacity (TIBC) and high-sensitivity C-reactive protein (hsCRP), as well as white blood cell, lymphocyte, neutrophil, platelet counts, mean platelet volume (MPV) and red blood cell distribution width (RDW), were quantified. Neutrophil: lymphocyte ratio (NLR), platelet: lymphocyte ratio (PLR), and RDW: platelet ratio (RPR) were also calculated. Curcumin significantly decreased the median (interquartile range) serum levels of hsCRP [from 0.30 mg/L (0.0-1.10) to 0.20 mg/L (0.0-1.3); p = 0.041] compared with placebo, but did not show any difference for neutrophil, RDW, MPV, NLR, PLR and RPR values (p > 0.05). The treatment schedule was well-tolerated, and none of markers of iron metabolism statistically changed after the intervention in the curcumin group (p > 0.05). Curcumin supplementation may have positive effects on serum hsCRP, a marker of inflammation, with no any changes on iron homeostasis in healthy women with PMS and dysmenorrhea.
Topics: Humans; Female; Curcumin; C-Reactive Protein; Dysmenorrhea; Iron; Biomarkers; Premenstrual Syndrome; Inflammation; Lymphocytes; Neutrophils
PubMed: 37394650
DOI: 10.14814/phy2.15763 -
Frontiers in Endocrinology 2024Observational studies have demonstrated associations between menstrual disorders, dysmenorrhea, and cardiovascular disease (CVD). However, it remains unclear whether...
BACKGROUND
Observational studies have demonstrated associations between menstrual disorders, dysmenorrhea, and cardiovascular disease (CVD). However, it remains unclear whether these associations are causal. This study is to investigate whether menstrual disorders and dysmenorrhea causally affect the risk of CVD.
METHODS
The summary data for menstrual disorders (excessive menstruation and irregular menses) and dysmenorrhea were obtained from FinnGen study, summary data for CVD were obtained from UK Biobank and meta-analysis. The inverse-variance-weighted method was mainly used in the Mendelian randomization for causality analysis. Sensitivity analyses were performed by several methods under different model assumptions.
RESULTS
Genetic liability to excessive menstruation was associated with higher risk of atrial fibrillation (odds ratio (OR), 1.078 [95% confidence interval (CI), 1.015-1.145]; =0.014), but a lower risk of hypertension (OR, 0.994 [95% CI: 0.989-0.999]; =0.016). Irregular menses was associated with higher risk of atrial fibrillation (OR, 1.095 [95% CI: 1.015-1.182]; =0.02), hypertension (OR, 1.007 [95% CI: 1.000-1.013]; =0.047), myocardial infarction (OR, 1.172 [95% CI: 1.060-1.295]; =0.02), ischemic heart disease, (OR, 1.005 [95% CI: 1.000-1.010]; =0.037) and coronary heart disease (OR, 1.004 [95% CI: 1.001-1.008]; =0.026). Dysmenorrhea was associated with higher risk of atrial fibrillation (OR, 1.052 [95% CI: 1.014-1.092]; =0.008) and Ischemic stroke (cardioembolic) (OR, 1.122 [95% CI: 1.002-1.257]; =0.046). After Benjamini-Hochberg correction, irregular menses was associated with higher risk of myocardial infarction.
CONCLUSION
We confirmed a causal relationship of excessive menstruation, irregular menses and dysmenorrhea on cardiovascular outcomes independent of sex hormone levels, with an emphasis on the link between irregular menses and myocardial infarction. These clinical features can be utilized as markers to identify women at higher risk of developing CVD in the future, recommending early clinical intervention of menstrual diseases.
Topics: Female; Humans; Atrial Fibrillation; Cardiovascular Diseases; Dysmenorrhea; Hypertension; Mendelian Randomization Analysis; Menstruation Disturbances; Myocardial Infarction
PubMed: 38375191
DOI: 10.3389/fendo.2024.1302312 -
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 -
BMJ Clinical Evidence Mar 2007Dysmenorrhoea may begin soon after the menarche, after which it often improves with age, or it may originate later in life after the onset of an underlying causative... (Review)
Review
INTRODUCTION
Dysmenorrhoea may begin soon after the menarche, after which it often improves with age, or it may originate later in life after the onset of an underlying causative condition. Dysmenorrhoea is common, and in up to 20% of women it may be severe enough to interfere with daily activities.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for dysmenorrhoea? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 34 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupressure, acupuncture, aspirin, behavioural interventions, combined oral contraceptives, compound analgesics, fish oil, herbal remedies, magnesium, magnets, non-steroidal anti-inflammatory drugs, paracetamol, spinal manipulation, surgical interruption of pelvic nerve pathways, thiamine, toki-shakuyaku-san, topical heat, transcutaneous electrical nerve stimulation (TENS), vitamin B12, and vitamin E.
Topics: Dysmenorrhea; Humans
PubMed: 19454059
DOI: No ID Found -
BMJ Clinical Evidence Mar 2007Ectopic endometrial tissue is found in up to 20% of asymptomatic women, up to 60% of those with dysmenorrhoea, and up to 30% of women with subfertility, with a peak... (Review)
Review
INTRODUCTION
Ectopic endometrial tissue is found in up to 20% of asymptomatic women, up to 60% of those with dysmenorrhoea, and up to 30% of women with subfertility, with a peak incidence at around 40 years of age. However, symptoms may not correlate with laparoscopic findings.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of hormonal treatments given at diagnosis of endometriosis? What are the effects of hormonal treatments before surgery for endometriosis? What are the effects of non-hormonal medical treatments for endometriosis? What are the effects of surgical treatments for endometriosis? What are the effects of hormonal treatment after conservative surgery for endometriosis? What are the effects of hormonal treatment after oophorectomy (with or without hysterectomy) for endometriosis? What are the effects of treatments for ovarian endometrioma? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 32 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: combined oral contraceptives; danazol; dydrogesterone; gestrinone; gonadorelin analogues; hormonal treatment before surgery; hormonal treatment; laparoscopic cystectomy; laparoscopic removal of endometriotic deposits (alone or with uterine nerve ablation); laparoscopic removal plus presacral neurectomy; laparoscopic uterine nerve ablation; non-steroidal anti-inflammatory drugs; presacral neurectomy alone; and progestogens other than dydrogesterone.
Topics: Administration, Oral; Anti-Inflammatory Agents, Non-Steroidal; Contraceptives, Oral; Danazol; Dysmenorrhea; Endometriosis; Female; Humans; Laparoscopy; Progestins
PubMed: 19454060
DOI: No ID Found -
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 -
Women's Health (London, England) 2022Dysmenorrhea is one of the most common gynecological complaints among adolescent women. It has been associated with short-term absenteeism in school and has a negative... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dysmenorrhea is one of the most common gynecological complaints among adolescent women. It has been associated with short-term absenteeism in school and has a negative impact on academic and daily activities. Therefore, the aim of the study was to show the evidence on the magnitude and correlates of dysmenorrhea in Ethiopia.
METHOD
In this systematic review and meta-analysis, we searched the literature from different databases such as PubMed/Medline, Science Direct, PsycINFO, and Cochrane library. We also used unpublished literature from Google, Google Scholar. The quality of the included articles was assessed using the Newcastle-Ottawa Scale. Data were extracted using a Microsoft Excel data extraction format. STATA version 14 statistical software was used for data analysis. To assess the heterogeneity of the primary articles, the Cochrane Q test statistics and the I test were carried out. Publication bias was inspected by funnel plot, and Egger's test was performed to confirm the presence of publication bias. A random-effects meta-analysis was used to estimate the pooled prevalence of dysmenorrhea and its associated factors.
RESULT
A total of 12 studies were included in the final meta-analysis. The pooled prevalence estimate of dysmenorrhea among female students in Ethiopia is 71.69% (66.82%-76.56%). In our systematic review, among factors associated with dysmenorrhea, the family history of dysmenorrhea was frequently reported in included studies. Therefore, dysmenorrhea was significantly associated with a family history of dysmenorrhea (adjusted odds ratio = 4.69 (95% confidence interval: 2.80-7.85)).
CONCLUSION
The pooled prevalence estimate of dysmenorrhea among students was much higher in Ethiopia. Health professionals and teachers should educate and support students to follow their menstrual cycle regularly in the event of irregular periods. There should be an awareness of the negative consequences of dysmenorrhea to reduce the physical and psychological stresses that affect women and their families.
Topics: Adolescent; Dysmenorrhea; Ethiopia; Female; Humans; Odds Ratio; Prevalence; Students
PubMed: 35168425
DOI: 10.1177/17455057221079443 -
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 -
Gaceta Sanitaria 2021The purpose of this review is to determine the use of aromatherapy in primary dysmenorrhea. (Review)
Review
OBJECTIVE
The purpose of this review is to determine the use of aromatherapy in primary dysmenorrhea.
METHOD
This is a literature review by searching article databases through Google Scholar, PubMed, ScienceDirect, Microsoft Academic, ProQuest, Semantic Scholar. The selection period for article publication is from 2015 to 2021. A total of 96 articles were obtained, and 30 articles could be entered according to the inclusion criteria.
RESULTS
Thirty articles were analyzed, it is shown that aromatherapy effectively reduces the intensity of primary dysmenorrheal pain. The sample size of the 30 articles varied from 16 samples to 200 research samples, and the research design used experiments, clinical trials, and ex vivo, in vivo, and in vitro studies.
CONCLUSION
Aromatherapy is an effective alternative intervention that can be used to reduce the intensity of primary dysmenorrhea pain.
Topics: Aromatherapy; Dysmenorrhea; Female; Humans
PubMed: 34929908
DOI: 10.1016/j.gaceta.2021.10.090