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Acta Obstetricia Et Gynecologica... Feb 2019The objective of this study was to estimate the prevalence of dysmenorrhea among adolescents and its effect on daily life.
INTRODUCTION
The objective of this study was to estimate the prevalence of dysmenorrhea among adolescents and its effect on daily life.
MATERIAL AND METHODS
A web-based questionnaire with questions regarding menstrual symptoms was distributed to all girls born in 2000 and residing in Stockholm City (n = 3998). Questions regarding pain severity, other menstrual-related symptoms, medical treatment, healthcare visits, and social and academic absenteeism were included in the questionnaire.
RESULTS
A total of 1785 (45%) young women responded to the questionnaire. Of these, 1580 (89%, 95% CI 87-90) stated that they had dysmenorrhea. Severe dysmenorrhea, scores 8-10 on the numeric rating scale for pain, was reported by 574 of 1580 women (36%, 95% CI 34-39). Fatigue was reported by 1314 of 1580 women (83%, 95% CI 81-85), headache by 1296 (82%, 95% CI; 80-84), dyschezia by 578 (37%, 95% CI 34-39) and dysuria by 560 (35%, 95% CI 33-38). A suboptimal use of analgesics was reported. Hormonal therapy as pain treatment was used by 10% (157/1580, 95% CI 9-12). Healthcare facilities, including school nurses, had been visited by 525 of 1580 women (33%, 95% CI; 31-36). Doctors had been consulted by 7% (116/1580, 95% CI 6-9). Fifty-nine percent (930/1580, 95% CI 56-61) reported refraining from social activities due to dysmenorrhea. Absenteeism from school was reported to occur monthly by 228 of 1580 women (14%, 95% CI 13-16), and several times per year by 716 (45%, 95% CI 43-48).
CONCLUSIONS
Our findings demonstrate that menstrual pain is prevalent among teenagers in Stockholm. The results indicate that many women are disabled in their daily life and that only a small number of women seek medical attention, although possible selection bias might have affected the results. Information and education are needed to optimize the use of existing treatment options and more awareness is needed to reduce normalization of disabling dysmenorrhea.
Topics: Absenteeism; Adolescent; Analgesics; Cross-Sectional Studies; Dysmenorrhea; Female; Humans; Needs Assessment; Pain Measurement; Prevalence; School Health Services; Sweden; Symptom Assessment
PubMed: 30312470
DOI: 10.1111/aogs.13480 -
Frontiers in Endocrinology 2022Auricular acupressure (AA) is widely used in treatment of dysmenorrhea, but the safety and efficacy of auricular acupressure on dysmenorrhoea are still lack of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Auricular acupressure (AA) is widely used in treatment of dysmenorrhea, but the safety and efficacy of auricular acupressure on dysmenorrhoea are still lack of evidence-based basis.
OBJECTIVE
The purpose of meta-analysis was to evaluate the effects of auricular acupressure on dysmenorrhea.
DATA SOURCES
A systematic search was conducted in six electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials (CINAHL), Weipu (CQVIP), China National Knowledge Infrastructure (CNKI), and Wanfang databases, to retrieve studies published from the inception dates to June 10, 2022.
STUDY SELECTION
Randomized controlled trials (RCTs) that investigated the effectiveness of AA on dysmenorrhea were identified.
DATA EXTRACTION AND SYNTHESIS
The data extraction and quality assessment of the included studies were performed by two reviewers independently. Outcomes were abstracted to determine the effect measure by using mean differences (MD), standardized mean differences (SMD), or odds ratio (OR) from a random effects model.
MAIN OUTCOMES AND MEASURES
Cure rate, total effective rate, and visual analogue scale (VAS) were described as primary outcomes; Short-form Menstrual Distress Questionnaire (MDQs), symptom scores, serum nitric oxide (NO) level, and adverse events were recorded as secondary outcomes.
RESULTS
Thirty-five RCTs involving 3960 participants were included in this study. Our findings indicated that, overall, AA was associated with a significant benefit in cured rate (OR = 1.95, 95%CI: [1.34, 2.83], P=0.0004, I = 75%), total effective rate (OR = 3.58, 95%CI: [2.92, 4.39], P<0.00001, I = 67%), VAS score (MD = -1.45, 95%CI: [-1.73, -1.17], P<0.00001, I = 67%), and symptom scores compared to the control group (SMD = -0.85, 95%CI: [-1.28, -0.43], P<0.0001, I = 91%). However, no difference in serum NO (SMD = 0.77, 95%CI: [-0.39, 1.92], P = 0.19, I = 89%) and MDQs (SMD = -0.58, 95%CI: [-1.26, 0.10], P = 0.10, I = 79%) was found between the two groups. Furthermore, subgroup analysis results indicated that AA showed significant superiorities in increasing cured rate and total effective rate, and reducing VAS score and symptom scores when compared to analgesics and non-intervention. Moreover, AA presented the same superiorities when used as an adjunctive strategy to other therapy. However, these benefits were not detected in AA used alone when compared to the therapies, including Chinese herbs, acupuncture, external application of Chineseherbal medicine, moxibustion, auricular needle, and health education.
CONCLUSIONS
Overall, AA, as a potential safety therapy, is effective for the management of dysmenorrhea, such as increasing cured rate, total effective rate, VAS, and symptom scores. Nevertheless, AA showed no significant improvement in serum NO and MDQs. It is furtherly found that AA used alone is superior to analgesics and non-intervention regarding cured rate, total effective rate, VAS, and symptom scores. Furthermore, the same superiorities are observed when AA serves as an adjunctive strategy to other therapy. However, AA alone has little effect on them compared to other therapies, and there is no definite conclusion on the benefits of AA compared to placebo for patients with dysmenorrhea. Rigorous RCTs with blind method and placebo control are warranted to confirm these findings.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42022338524.
Topics: Female; Humans; Dysmenorrhea; Acupressure; Randomized Controlled Trials as Topic; Acupuncture Therapy; Analgesics; Nitric Oxide
PubMed: 36686444
DOI: 10.3389/fendo.2022.1016222 -
Reproductive Sciences (Thousand Oaks,... Aug 2021Adenomyosis is associated with dysmenorrhea, infertility, and lesional fibrosis. The pathogenesis of adenomyosis is still unclear. Plasminogen activator inhibitor 1...
Adenomyosis is associated with dysmenorrhea, infertility, and lesional fibrosis. The pathogenesis of adenomyosis is still unclear. Plasminogen activator inhibitor 1 (PAI-1) plays important roles in pathological activities like tumor metastasis and endometriosis. Our objective was to investigate the expression and localization of PAI-1 in eutopic and ectopic endometrium with adenomyosis and in endometrium without adenomyosis. We also sought to determine the relationship between PAI-1 immunoreactivity and the severity of dysmenorrhea and the extent of lesional fibrosis in adenomyosis. PAI-1 expression was significantly higher in the ectopic endometrium of patients with adenomyosis than in both the eutopic endometrium of patients with adenomyosis and the endometrium of controls. Ectopic PAI-1 expression correlated positively with dysmenorrhea visual analog scale (VAS) scores and the extent of lesional fibrosis in adenomyosis. High PAI-1 expression increased the likelihood of moderate to severe dysmenorrhea in adenomyosis. These results suggest that PAI-1 is involved in the adenomyosis-associated dysmenorrhea and lesional fibrosis, which provide a potential target in treating symptomatic adenomyosis.
Topics: Adenomyosis; Adult; Dysmenorrhea; Endometrium; Female; Fibrosis; Humans; Immunohistochemistry; Middle Aged; Plasminogen Activator Inhibitor 1
PubMed: 33683668
DOI: 10.1007/s43032-021-00513-6 -
Women's Health (London, England) 2023COVID-19 vaccines have provided fertile ground for research, especially with the unprecedented spread of misinformation about this disease and its vaccines. Among women,... (Observational Study)
Observational Study
Dysmenorrhea, intermenstrual bleeding, menstrual flow volume changes, and irregularities following COVID-19 vaccination and the association with vaccine skepticism: A retrospective observational study.
BACKGROUND
COVID-19 vaccines have provided fertile ground for research, especially with the unprecedented spread of misinformation about this disease and its vaccines. Among women, one of the most frequently reported side effects of the vaccine has been menstrual disturbance.
OBJECTIVE
To investigate the perceived impact of COVID-19 vaccines on the menstrual cycle. In addition, the research seeks to identify factors that could predispose certain individuals to experience these effects, thereby contributing to a deeper understanding of the interplay between vaccines and menstrual health.
DESIGN
We conducted a retrospective observational cross-sectional study.
METHODS
Any woman of menstruating age who received at least one dose of the COVID-19 vaccine and currently resides in Saudi Arabia was invited to complete an online questionnaire. The questionnaire compared menstruation characteristics-regularity, volume, intermenstrual bleeding, and dysmenorrhea-before and after receiving the COVID-19 vaccine, taking into consideration possible predisposing factors such as polycystic ovarian syndrome, contraceptives, or period-blocking pills.
RESULTS
Women without polycystic ovarian syndrome experienced less change in dysmenorrhea post-vaccine compared to those with polycystic ovarian syndrome (23.88% versus 37.78%, = 0.045). Women using hormonal contraceptives were about two times more likely to experience changes in volume compared to those not using contraceptives (odds ratio = 2.09, 95% confidence interval = 1.23-3.57, = 0.006). COVID-19 vaccine skeptics were about three times more likely to perceive changes in regularity post-vaccine compared to non-skeptics (odds ratio = 2.96, 95% confidence interval = 1.79-4.90, < 0.001). They were also three times more likely to perceive changes in volume post-vaccine (odds ratio = 3.04, 95% confidence interval = 1.95-4.74, < 0.001).
CONCLUSION
Our data suggest significant associations between COVID-19 skepticism, the use of hormonal contraceptives, and the reported post-vaccine menstrual disturbances. This underscores the importance of public education efforts aimed at dispelling misinformation and addressing controversies related to these vaccines.
Topics: Female; Humans; Contraceptives, Oral; COVID-19; COVID-19 Vaccines; Cross-Sectional Studies; Dysmenorrhea; Menstruation; Menstruation Disturbances; Metrorrhagia; Polycystic Ovary Syndrome; Retrospective Studies; Vaccination
PubMed: 37966030
DOI: 10.1177/17455057231210094 -
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 -
Nursing ResearchDysmenorrhea is highly prevalent; it places women at risk for other chronic pain conditions. There is a high degree of individual variability in menstrual pain severity,...
BACKGROUND
Dysmenorrhea is highly prevalent; it places women at risk for other chronic pain conditions. There is a high degree of individual variability in menstrual pain severity, the number of painful sites, and co-occurring gastrointestinal symptoms. Distinct dysmenorrhea symptom-based phenotypes were previously identified, but the biological underpinnings of these phenotypes are less known. One underexplored contributor is the vaginal microbiome. The vaginal microbiota differs significantly among reproductive-age women and may modulate as well as amplify reproductive tract inflammation, which may contribute to dysmenorrhea symptoms.
OBJECTIVES
The objective of this study was to examine associations between dysmenorrhea symptom-based phenotypes and vaginal microbiome compositions on- and off-menses.
METHODS
We conducted a prospective, longitudinal, pilot study of 20 women (aged 15-24 years) grouped into three dysmenorrhea symptom-based phenotypes: "mild localized pain," "severe localized pain," and "severe multiple pain and gastrointestinal symptoms." Over one menstrual cycle, participants provided vaginal swabs when they were on- and off-menses. We assayed the vaginal microbiome using 16S rRNA gene sequencing. Permutational multivariate analysis of variance tests were used to compare microbiome compositions across phenotypes, with heat maps generated to visualize the relative abundance of bacterial taxa.
RESULTS
The vaginal microbiome compositions (n = 40) were different across the three phenotypes. After separating the on-menses (n = 20) and off-menses (n = 20) specimens, the statistically significant difference was seen on-menses, but not off-menses. Compared to the "mild localized pain" phenotype, participants in the "multiple severe symptoms" phenotype had a lower lactobacilli level and a higher abundance of Prevotella, Atopobium, and Gardnerella when on-menses. We also observed trends of differences across phenotypes in vaginal microbiome change from off- to on-menses.
DISCUSSION
The study provides proof-of-concept data to support larger studies on associations between dysmenorrhea symptom-based phenotypes and vaginal microbiome that might lead to new intervention targets and/or biomarkers for dysmenorrhea. This line of research has the potential to inform precision dysmenorrhea treatment that can improve women's quality of life.
Topics: Adolescent; Adult; Chronic Pain; Dysmenorrhea; Female; Humans; Longitudinal Studies; Menstruation; Microbiota; Phenotype; Pilot Projects; Prospective Studies; RNA, Ribosomal, 16S; Surveys and Questionnaires; Vagina; Young Adult
PubMed: 33813547
DOI: 10.1097/NNR.0000000000000510 -
Australian Family Physician Nov 2006Menstruation has dual significance for women. From one perspective it defines the start and end of reproductive potential, an affirmation of womanhood. On the other,... (Review)
Review
BACKGROUND
Menstruation has dual significance for women. From one perspective it defines the start and end of reproductive potential, an affirmation of womanhood. On the other, just as the ancients observed taboos of menstruation, many women (and men) today are still influenced by outdated negative messages.
OBJECTIVE
This article discusses an approach to assessment and management of dysmenorrhoea that considers the cultural, social and personal significance of symptoms and management choices.
DISCUSSION
Cultural influences, such as a woman's status within society, her life stage, religion, education and employment, determine whether a woman seeks medical help for menstrual problems, and the personal significance of dysmenorrhoea. Assessment involves consideration of pain, associated symptoms, effect on lifestyle and activities of daily living, and a psychosocial and cultural assessment. Management involves specific treatment of underlying pathology, psychosocial support and individualising treatment according to impact of the pain, associated symptoms, reproductive stage, cost, and the woman's personal values and attitudes.
Topics: Culture; Dysmenorrhea; Female; Humans; Life Style; Practice Guidelines as Topic
PubMed: 17099800
DOI: No ID Found -
Complementary Therapies in Medicine Dec 2022Acupuncture and moxibustion have promising effects in managing primary dysmenorrhea. However, some evidence from clinical trials remains controversial due to... (Review)
Review
BACKGROUND
Acupuncture and moxibustion have promising effects in managing primary dysmenorrhea. However, some evidence from clinical trials remains controversial due to methodological flaws in study designs that involve acupuncture and its related modalities and require urgent attention and dialogue.
METHODS
Allied and Complementary Medicine Database (AMED), Cochrane Library, Excerpta Medica database (EMBASE), PubMed, Web of Sciences, Chinese Biological Medicine (CBM), China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP), and Wanfang database were searched from their inception to July 2021. Data were extracted based on the types of study design, primary outcome measures, adverse events (AEs), and participants' subjective views.
RESULTS
Most studies (n = 282, 93 %) were published in Chinese and 21 (7 %) in English. Among these, there were 209 (69 %) randomized controlled trials (RCTs), 39 (13 %) non-randomized controlled trials (nRCTs), 30 (10 %) case-series reports, 15 (5 %) cohort studies, and 10 (3 %) case reports. The most frequent reported outcome was pain, followed by emotion, sleeping quality, quality of life, skin temperature, changes in brain function, uterine and ovarian blood flow, and reproductive endocrine level. AEs were reported in 37 studies with mild events, and all recovered without actions taken; 31 trials reported no AEs; 235 failed to report any AEs. One RCT found that the satisfaction rate of the intervention group was statistically significantly higher than the control group.
CONCLUSION
Clinical studies on acupuncture and its related modalities face methodological challenges and require urgent attention. RCT with blinding and sham control might be the gold standard trial design. However, it may not be the most suitable research method for these modalities. We recommend using pragmatic RCTs in this field, where trial protocol registration on the trial registry platforms and detailed safety reporting should be mandatory.
Topics: Female; Humans; Research Design; Moxibustion; Acupuncture Therapy; Quality of Life; China; Dysmenorrhea
PubMed: 35998757
DOI: 10.1016/j.ctim.2022.102874 -
Taiwanese Journal of Obstetrics &... Mar 2021No prior study has investigated the relation of primary dysmenorrhea (PD) with attention deficit hyperactivity disorder (ADHD) symptoms in adolescent age groups. This...
OBJECTIVE
No prior study has investigated the relation of primary dysmenorrhea (PD) with attention deficit hyperactivity disorder (ADHD) symptoms in adolescent age groups. This study aimed to investigate the relationship of PD with ADHD and psychological symptoms among adolescents. Another objective was to examine the PD related non-psychogenic factors and sleep quality.
MATERIALS AND METHODS
Two hundred nine adolescent girls who applied to policlinics for various reasons were enrolled. All participants completed self-report questionnaires. Questionnaire for sociodemographic data, menstrual pattern and dysmenorrhea in adolescents, Visual analog scale, Pittsburgh Sleep Quality Index, DSM-5 Level 2 Sleep Disorders Scale, Brief Symptom Inventory, and the Turgay Diagnostic and Statistical Manual of Mental Disorders, 4th edition-Based Child and Adolescent Disruptive Behavior Disorders Screening and Rating Scale were used to measure outcomes.
RESULTS
A hundred and four (49.8%) adolescents reported having pain that affects daily activities during menstruation. These adolescents had worse sleep quality, more inattention and hyperactivity-impulsivity problems, and other psychological symptoms of anxiety, depression, somatization, negative self-perception, and hostility in comparison to others (P < 0.05). The menstrual pain severity, measured by VAS, was positively correlated with ADHD symptoms and all other psychological parameters (P < 0.05).
CONCLUSION
PD affecting daily-activities may be related to ADHD symptoms and psychiatric distress. Future studies are needed to support the association between ADHD and PD. Assessing the psychiatric problems of adolescents with dysmenorrhea is important.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Dysmenorrhea; Female; Humans; Mental Disorders; Pain Measurement; Psychiatric Status Rating Scales; Psychological Distress; Self Report; Severity of Illness Index
PubMed: 33678333
DOI: 10.1016/j.tjog.2021.01.033 -
Fertility and Sterility Jul 2022To investigate whether lesional immunostaining of putative biomarkers of recurrence and the extent of lesional and cortical fibroses are correlated with the severity of...
OBJECTIVE
To investigate whether lesional immunostaining of putative biomarkers of recurrence and the extent of lesional and cortical fibroses are correlated with the severity of dysmenorrhea and serum antimüllerian hormone (AMH) levels in women with ovarian endometriomas (OEs).
DESIGN
Retrospective cohort study.
SETTING
Academic hospital.
PATIENT(S)
A total of 313 women with histologically confirmed OEs were recruited. Their demographic and clinical information and data on their preoperative AMH levels were collected. Additionally, samples of their lesional tissues and ovarian cortex tissues adjacent to the OE lesions were procured for histologic and immunohistochemistry analyses.
INTERVENTION(S)
None.
MAIN OUTCOME MEASURE(S)
All OE tissue samples were stained for phosphorylated nuclear factor κB p65 subunit, progesterone receptor isoform B, Slit2, and α-smooth muscle actin. In addition, the extent of lesional and cortical fibroses was quantitated by Masson trichrome staining. We evaluated the relationship between the lesion size; laterality; extent of lesional and cortical fibroses, along with the putative markers of recurrence; and severity of dysmenorrhea and preoperative serum AMH levels in patients with OE.
RESULT(S)
We found that the extent of lesional fibrosis was positively correlated with the severity of dysmenorrhea but had no impact on the AMH levels. On the other hand, the extent of cortical fibrosis, along with age, was negatively correlated with the AMH levels.
CONCLUSION(S)
The correlation between lesional fibrosis and the severity of dysmenorrhea and between cortical fibrosis and the AMH levels would call an early intervention once OE is diagnosed or suspected to prevent further pain and diminished ovarian reserve.
Topics: Anti-Mullerian Hormone; Dysmenorrhea; Endometriosis; Female; Fibrosis; Humans; Retrospective Studies
PubMed: 35641324
DOI: 10.1016/j.fertnstert.2022.04.016