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American Family Physician Aug 1999Primary dysmenorrhea is defined as cramping pain in the lower abdomen occurring just before or during menstruation, in the absence of other diseases such as... (Review)
Review
Primary dysmenorrhea is defined as cramping pain in the lower abdomen occurring just before or during menstruation, in the absence of other diseases such as endometriosis. Prevalence rates are as high as 90 percent. Initial presentation of primary dysmenorrhea typically occurs in adolescence. It is a common cause of absenteeism and reduced quality of life in women. The problem is often underdiagnosed and undertreated. Women with primary dysmenorrhea have increased production of endometrial prostaglandin, resulting in increased uterine tone and stronger, more frequent uterine contractions. A diagnostic evaluation is unnecessary in patients with typical symptoms and no risk factors for secondary causes. Nonsteroidal anti-inflammatory medications are the mainstay of treatment, with the addition of oral contraceptive pills when necessary. About 10 percent of affected women do not respond to these measures. It is important to consider secondary causes of dysmenorrhea in women who do not respond to initial treatment. Many alternative treatments (ranging from acupuncture to laparoscopic surgery) have been studied, but the supporting studies are small, with limited long-term follow-up.
Topics: Algorithms; Dysmenorrhea; Female; Humans
PubMed: 10465224
DOI: No ID Found -
The Cochrane Database of Systematic... Feb 2017Dysmenorrhoea is characterised by cramping lower abdominal pain that may radiate to the lower back and upper thighs and is commonly associated with nausea, headache,... (Review)
Review
BACKGROUND
Dysmenorrhoea is characterised by cramping lower abdominal pain that may radiate to the lower back and upper thighs and is commonly associated with nausea, headache, fatigue and diarrhoea. Physical exercise has been suggested as a non-medical approach to the management of these symptoms.
OBJECTIVES
To assess the evidence for the effectiveness of exercise in the treatment of dysmenorrhoea.
SEARCH METHODS
A search was conducted using the methodology of the Menstrual Disorders and Subfertility Group (August 2009). CENTRAL (The Cochrane Library), MEDLINE, EMBASE, AMED and PsycINFO electronic databases were searched. Handsearching of relevant bibliographies and reference lists was also conducted.
SELECTION CRITERIA
Randomised controlled trials comparing exercise with a control or no intervention in women with dysmenorrhoea.
DATA COLLECTION AND ANALYSIS
Trials were independently selected and data extracted by two review authors.
MAIN RESULTS
Four potential trials were identified of which one was included in the review. The available data could only be included as a narrative description. There appeared to be some evidence from the trial that exercise reduced the Moos' Menstrual Distress Questionnaire (MDQ) score during the menstrual phase (P < 0.05) and resulted in a sustained decrease in symptoms over the three observed cycles (P < 0.05).
AUTHORS' CONCLUSIONS
The results of this review are limited to a single randomised trial of limited quality and with a small sample size. The data should be interpreted with caution and further research is required to investigate the hypothesis that exercise reduces the symptoms associated with dysmenorrhoea.
Topics: Dysmenorrhea; Exercise; Female; Humans; Randomized Controlled Trials as Topic
PubMed: 28194755
DOI: 10.1002/14651858.CD004142.pub3 -
American Family Physician May 2021
Topics: Dysmenorrhea; Exercise; Exercise Therapy; Female; Humans
PubMed: 33929165
DOI: No ID Found -
Revista Da Associacao Medica Brasileira... Jan 2022This study aimed to assess the prevalence and factors associated with primary dysmenorrhea in a sample of adult women.
OBJECTIVE
This study aimed to assess the prevalence and factors associated with primary dysmenorrhea in a sample of adult women.
METHODS
A cross-sectional study was carried out with women aged between 19 and 49 years from a city of northeastern Brazil. Sociodemographic, gynecological, and obstetric variables were assessed by questionnaires and interviews. Dysmenorrhea was measured by self-report, and the Numerical Pain Rating Scale measured the intensity of pain. Statistical analyses included χ2 test, ANOVA, and logistic regression.
RESULTS
The average age was 33.2±9.1 years and the prevalence of primary dysmenorrhea was 56% for the whole sample. The average duration of symptoms was 2.7±1.8 days and the mean intensity was 6.1±2.6. The previous cesarean section was associated with a higher rate of primary dysmenorrhea (PR=2.33; 95%CI 1.11-4.90) when considering the whole sample. Women who aged 25-39 years and are insufficiently active had higher rates of primary dysmenorrhea (PR=5.24; 95%CI 1.08-27.31).
CONCLUSION
Primary dysmenorrhea has a high prevalence in young adults, adults, and middle-aged women. Cesarean section and being physically inactive was associated with increased rates of dysmenorrhea among adult women.
Topics: Adult; Cesarean Section; Cross-Sectional Studies; Dysmenorrhea; Female; Humans; Middle Aged; Pregnancy; Prevalence; Surveys and Questionnaires; Young Adult
PubMed: 35239934
DOI: 10.1590/1806-9282.20210341 -
Acta Bio-medica : Atenei Parmensis Jan 2016Dysmenorrhea is still an important public health problem which may have a negative impact on female health, social relationships, school or work activities and... (Review)
Review
BACKGROUND
Dysmenorrhea is still an important public health problem which may have a negative impact on female health, social relationships, school or work activities and psychological status.
METHODS
The aim of this review is a better understanding of the epidemiology of dysmenorrhoea and its effect on public health. Published studies in English providing relevant information on dysmenorrhea were identified by searching PubMed, Embase and Google; restricting the population to adolescents and young adult women and the year of publishing from 2010 to August 2015, based on the keywords 'dysmenorrhea', 'adolescents' and 'epidemiology'. In addition, the reference lists of the selected articles were examined.
RESULTS
We found 50 studies that met our inclusion criteria. The majority were cross-sectional studies on 41,140 adolescents and young women published from 2010 onward. The prevalence of dysmenorrhea varied from 34 % (Egypt) to 94% (Oman) and the number of participants, reporting very severe pain varied from 0.9 % (Korea) to 59.8% (Bangladesh). Adolescents who missed school due to dysmenorrhoea ranged from 7.7% to 57.8% and 21.5% missed social activities. About 50% of students (53.7%-47.4%) reported a family history of dysmenorrhea. Incidence of dysmenorrhea was 0.97 times lower as age in-creased (p <0.006). Despite the high prevalence of dysmenorrhea in adolescents, many girls did not receive professional help or treatment. Mothers were the most important persons the girls turned to for answers regarding menstruation, followed by peers (52.9%) and school nurse. From 21% to 96% practised self-medication either by pharmacological or non pharmacological interventions. The limitation of these studies was that they did not distinguish between primary dysmenorrhea and secondary dysmenorrhea.
CONCLUSIONS
The main gynecological complaint of adolescents is dysmenorrhea. Morbidity due to dysmenorrhea represents a substantial public health burden. It is one of the leading causes of absenteeism from school and work and is responsible for significant diminished quality of life. Despite its high prevalence and associated negative effects, many adolescents do not seek medical care for this condition. Appropriate counselling and management should be instituted among female students to help them cope with the challenges of dysmenorrhea. Information, education and support should also be extended to parents, school peer leaders, and hostel administrators in order to address the reproductive health needs of the female students.
Topics: Adolescent; Dysmenorrhea; Female; Global Health; Humans; Public Health; Young Adult
PubMed: 28112688
DOI: No ID Found -
Women's Health (London, England) Aug 2015Endometriosis is classically defined as the presence of endometrial glands and stroma in outside the uterine cavity. As the definition suggests that confirming the... (Review)
Review
Endometriosis is classically defined as the presence of endometrial glands and stroma in outside the uterine cavity. As the definition suggests that confirming the ectopic endometrial stroma and glands in ectopic location histopathologically should be necessary for the diagnosis of endometriosis. Therefore, this situation leads to the need for surgery like laparoscopy for diagnosis. However, this surgical diagnostic approach will not be reliable for all patients with suspected endometriosis. It seems to be an important problem that there is still no reliable clinically diagnostic method or pathognomonic clinical finding, which may allow accurate diagnosis of endometriosis without the need for surgery or histopathologic evaluation. While these clinical features are not pathognomonic for the endometriosis, they should be used as markers for creating high-risk population for endometriosis. Clinical features and the available diagnostic methods, their advantages and limitations for the endometriosis will be discussed in this article. The different options for clinical assessment, laboratory tests and imaging techniques will be summarized and the advantages and disadvantages of these methods will be evaluated. We will also discuss the gold standard definitive diagnostic options with their problematic aspects.
Topics: Diagnostic Imaging; Dysmenorrhea; Dyspareunia; Endometriosis; Female; Humans; Ovarian Cysts; Ovarian Diseases; Pelvic Pain
PubMed: 26389666
DOI: 10.2217/whe.15.44 -
Sultan Qaboos University Medical Journal Aug 2017
Topics: Adult; Dysmenorrhea; Endometriosis; Female; Humans; Ovarian Cysts; Progestins; Umbilicus
PubMed: 29062568
DOI: 10.18295/squmj.2017.17.03.023 -
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 -
Fertility and Sterility Mar 2023To diagnose endometriosis in young patients ≤25y with severe dysmenorrhea through specific ultrasonographic examination findings and to correlate the symptoms to its... (Observational Study)
Observational Study
OBJECTIVES
To diagnose endometriosis in young patients ≤25y with severe dysmenorrhea through specific ultrasonographic examination findings and to correlate the symptoms to its different forms: ovarian, deep infiltrating endometriosis, and adenomyosis.
DESIGN
A retrospective observational study.
SETTING
University Hospital.
PATIENT(S)
Women aged 12-25 years with severe dysmenorrhea and a visual analog scale score ≥7.
INTERVENTION(S)
This study included 371 women aged 12-25 years referred to our gynecological ultrasound (US) Unit between January 2016 and December 2021 with severe dysmenorrhea and a visual analog scale score ≥7. Two dimensional, 3 dimensional, and power Doppler US pelvic examinations (transvaginal or transrectal in presexually active girls) were performed on all patients. Medical history and symptoms were collected routinely for each patient before the scan.
MAIN OUTCOME MEASURE(S)
All possible locations of endometriosis, isolated or combined occurrence, were evaluated, and recorded using an US dedicated mapping sheet. Painful symptoms were evaluated by visual analog scale and correlated to the different endometriosis forms.
RESULT(S)
At least one US endometriosis feature was identified in 131 (35.3%) patients, whereas the US findings of 170 (45.8%) were normal despite the referred dysmenorrhea. Of the 131 patients with endometriosis, ovarian endometrioma was found in 54 (41.2%), and 22 (16.8%) had an isolated endometrioma. Adenomyosis was detected in 67 (51.1%) patients, and 28 (21.4%) showed its isolated indications. Posterior deep infiltrating endometriosis was found in 70 (53.4%) patients, and uterosacral ligament (USL) fibrotic thickening was found in 63 (48.1%). In 23 patients, the USL lesion was completely isolated. The combined occurrence of dysmenorrhea with dyspareunia, bowel symptoms, and heavy menstrual bleeding increases the presence of endometriosis up to 59%, 63%, and 45%, respectively.
CONCLUSION(S)
In young patients with severe dysmenorrhea, the US-based detection rate of pelvic endometriosis was one-third. USL fibrotic thickening and mild adenomyosis are often the only findings, so an accurate pelvic US scan can provide an early diagnosis by identifying small endometriotic lesions. Young patients with dysmenorrhea should be referred to an expert sonographer to minimize the delay between the onset of symptoms and diagnosis.
Topics: Female; Humans; Dysmenorrhea; Endometriosis; Adenomyosis; Ultrasonography; Ovary
PubMed: 36493871
DOI: 10.1016/j.fertnstert.2022.12.004 -
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