Factors Related to Primary Dysmenorrhea in Turkish Women: a Multiple Multinomial Logistic Regression Analysis

The influence of physical activity, body mass index and urinary levels of prostaglandin (PGF2α) with the incidence of primary dysmenorrhea in adolescents

OBJECTIVE

This study aims to investigate the effect of physical activity, body mass index (BMI), and levels of prostaglandins (PGF2α) urine on the occurrence of dysmenorrhea in adolescents.

METHODS

A total of 128 female students included in the study. The study was conducted from January to March 2023 using a cross-sectional design. This study utilized the Menstrual Symptom Questionnaire (MSQ) and gynecological examination with ultrasonography. The urinary prostaglandin (PGF2α) was measured using the enzyme linked immuno sorbent assay (ELISA). Data were analyzed using the chi-square test and logistic regression test.

RESULTS

The age range of the participants included in the study was 14-17, with a mean age of 15.85 ± 0.65. There was an correlation between physical activity, BMI, and urinary prostaglandin (PGF2α) levels with the incidence of dysmenorrhea in adolescents (p < 0.001). In multivariate analysis, it revealed that underweight, and had a high urinary prostaglandin significant correlated to primary dysmenorrhea with odds ratio 4.78 (95% confidence interval [CI] 1.98-11.54) and 4.88 (95% CI 1.98-12.08), respectively. High physical activity and overweight was not associated with incidence of dysmenorrhea in adolescents.

CONCLUSION

This study provides valuable insights into the correlation between physical activity, BMI, and levels of prostaglandins (PGF2α) in urine. A high level of urinary prostaglandin was found to be the most influential factor in the incidence of primary dysmenorrhea in adolescents. By addressing factors associated with dysmenorrhea in adolescents, healthcare professionals can potentially enhance well-being by reducing menstrual pain and encouraging a healthy lifestyle to prevent dysmenorrhea.

A comprehensive investigation of biopsychosocial determinants influencing primary dysmenorrhea among university students

Dysmenorrhea, characterized by pain and related symptoms, significantly impacts women's quality of life in work and education, prompting a comprehensive evaluation of associated factors. The objective of this study was to utilize structural equation modeling (SEM) to analyze and assess the biopsychosocial factors influencing dysmenorrhea among university students. Three hundred and thirty-nine university students were included in this cross-sectional descriptive study. Data were collected using the Participant Information Form, the Beck Anxiety Scale (BAS), the Beck Depression Scale (BDS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Adverse Childhood Experiences Scale (ACES), the Pain Catastrophizing Scale (PCS) and the Visual Analogue Scale (VAS). It was determined that the variables of pain onset (t = 3.24, p < .05) and age at menarche (t = -2.16, p < .05) showed a significant relationship with the model. The variables of the PCS (t = 16.87, p < .001), BDS (t = 3.06, p < .05), and BAS (t = 5.13, p < .001) showed a significant relationship with the model. Social factors in the model were examined, and a family history of dysmenorrhea and the ACES variables did not contribute significantly to the model (p > .05). The study indicates primary dysmenorrhea influenced by biological and psychological factors. Nurses should conduct holistic assessments and provide comprehensive care for affected women.

Dysmenorrhea and psychological distress: a meta-analysis

Dysmenorrhea is characterized by pelvic pain associated with menstruation. Similar to people with other pain conditions, females who experience dysmenorrhea report increased psychological distress. However, the pooled magnitude of this association has not been quantified across studies. Accordingly, this meta-analytic review quantifies the magnitude of the associations between dysmenorrhea severity and psychological distress. We conducted a systematic search of the literature using PsycINFO, PubMed, CINHAL, Embase, and Web of Science. Analyzed studies provided observational data on dysmenorrhea severity and anxiety symptoms, depressive symptoms, and/or global psychological distress. A total of 44 studies were included, and three random-effects meta-analyses were conducted, with average pooled effect sizes calculated using Person's r. We found significant, positive associations between measures of dysmenorrhea severity and measures of depressive symptoms (r = 0.216), anxiety symptoms (r = 0.207), and global psychological distress (r = 0.311). Our review suggests that females with greater dysmenorrhea severity experience greater psychological distress. Future directions include defining a clinically meaningful dysmenorrhea severity threshold, understanding the mechanisms and directionality underlying the dysmenorrhea-psychological distress relationship, and designing and testing interventions to jointly address dysmenorrhea and psychological distress.

Myofascial Pain Syndrome in Women with Primary Dysmenorrhea: A Case-Control Study

There is limited information on myofascial trigger points (MTrPs) and specific symptoms of chronic pelvic pain and, more specifically, dysmenorrhea. The objective of this study was to determine whether patients suffering from primary dysmenorrhea present alterations in mechanosensitivity and pain patterns, and greater presence of MTrPs in the abdominal and pelvic floor muscles. A case-control study was carried out with a total sample of 84 participants distributed based on primary dysmenorrhea and contraceptive treatment. The sample was divided into four groups each comprising 21 women. Data on pain, quality of life, and productivity and work absenteeism were collected; three assessments were made in different phases of the menstrual cycle, to report data on pressure pain threshold, MTrP presence, and referred pain areas. One-way ANOVA tests showed statistically significant differences (p < 0.01) between the groups, for the Physical Health domain and the total score of the SF-12 questionnaire, and for all the domains of the McGill questionnaire; but no significant differences were found in the data from the WPAI-GH questionnaire. Statistically significant data (p < 0.01) were found for mechanosensitivity in the abdominal area and limbs, but not for the lumbar assessment, within the group, with very few significant intergroup differences. The frequency of active MTrPs is higher in the groups of women with primary dysmenorrhea and during the menstrual phase, with the prevalence of myofascial trigger points of the iliococcygeus muscle being especially high in all examination groups (>50%) and higher than 70% in women with primary dysmenorrhea, in the menstrual phase, and the internal obturator muscle (100%) in the menstrual phase. Referred pain areas of the pelvic floor muscles increase in women with primary dysmenorrhea.

Prevalence and Risk Factors of Primary Dysmenorrhea in Students: A Meta-Analysis

OBJECTIVES

Primary dysmenorrhea (PD), as the most common complaint among students, is also one of the public problems worldwide. Prevalence and risk factors of PD were variant between studies; as the main population, no meta-analysis for PD has hitherto been conducted in students.

METHODS

We searched the published literature in PubMed, Embase, the Cochrane Library, Web of Science, National Knowledge Infrastructure, WANFANG, and VIP database. After screening and assessing the quality of studies, data from eligible studies were extracted for meta-analysis via the R language.

RESULTS

A total of 96 studies published from 1991 to 2021 with 78 068 students were included, the mean age of participants was 19.4, and 79.9% were university students. The pooled overall prevalence of PD was 66.1% (95% confidence interval [CI] 63.4-68.9), and 31.1% (CI 28.1-34.3), 25.7% (CI 23.4-28.0), and 8.3% of students (CI 7.4-9.3) reported mild, moderate, and severe PD, respectively. Besides, the prevalence of PD was estimated at 58.8% (CI 54.3-63.7) before 2010, but ascended to 68.5% (CI 65.5-71.6) after 2010 and rose to 71.5% (CI 65.8-76.6) in 2015 to 2021. About risk factors for PD, underweight, skipping breakfast, poor sleep quality, staying up late, lack of physical exercise, exposure to cold and eating cold or spicy foods during menstruation, dietary bias, prefer snacks, family history of dysmenorrhea, irregular menstrual cycle, heavy stress, negative emotion during menstruation, and anxiety were significantly related to PD.

CONCLUSIONS

The overall prevalence of PD among students was 66.1% and had a rising tendency in the last 10 years. Our findings helped understand the current prevalence and improve the administration of PD among students.

The relation between body mass index and primary dysmenorrhea: A systematic review and meta-analysis

INTRODUCTION

The relation between body mass index (BMI) categories and the occurrence of primary dysmenorrhea has been investigated, but the results of these studies are inconsistent and controversial. The aim of our study was to systematically review the literature and investigate the association between each category of BMI and the occurrence of primary dysmenorrhea.

MATERIAL AND METHODS

We conducted a systematic review and meta-analysis of observational studies related to BMI and primary dysmenorrhea. Eleven databases-PubMed, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical Literature Database (CBM), and Wanfang database-were systematically searched from inception to March 2022. We used the 11 items recommended by the Agency for Healthcare Research and Quality to assess the quality of included studies. The Q test and the I² test were used to evaluate the heterogeneity among studies. Odds ratios (OR) and their 95% confidence intervals (CI) were pooled by fixed-effects models or random-effects models. Stata software version 16.0 was used to complete the statistical analyses.

RESULTS

A total of 4181 articles were collected from the database, and 12 studies were included based on inclusion and exclusion criteria. A total of 29 647 participants were included in the study, with a mean baseline age of 17-45 years. All included literature was published between 2017 and 2021 and was conducted in six countries. Eleven included studies were of medium quality and one included study was of high quality. Being underweight may be related to the occurrence of primary dysmenorrhea (12 studies, n = 6545, OR 1.43, 95% CI 1.18-1.73). Being overweight (12 studies, n = 3098) and obesity (four studies, n = 94) may not be associated with the development of primary dysmenorrhea.

CONCLUSIONS

Being underweight may increase the risk of the occurrence of primary dysmenorrhea, whereas overweight and obesity might not be associated with primary dysmenorrhea. Due to the limitations of the meta-analysis, more studies are needed to investigate the relation between each category of BMI and the occurrence of primary dysmenorrhea. To maintain a balanced diet and an appropriate lifestyle is beneficial for people to have the normal category of BMI and live a healthy life, which may play a role in preventing the occurrence of primary dysmenorrhea.

The Influence of Lifestyle Variables on Primary Dysmenorrhea: A Cross-Sectional Study

Background

Primary dysmenorrhea is a common and often debilitating, gynaecological condition.

Objective

To investigate the effects of specific lifestyle variables on the prevalence and severity of primary dysmenorrhea.

Materials and Methods

A cross-sectional study of Jordanian women aged between 18-25 years old utilized a questionnaire as the main instrument of the study.

Results

Primary dysmenorrhea was reported by 660 women out of 1988. It was found that approximately two thirds of them were students. Overall, 54.5% of the participants reported severe dysmenorrhea. A statistically significant correlation was found between severe dysmenorrhea and smoking at p value ˂0.001, sleeping less than 7 hours per 24 hours at p = 0.005, holding a university degree at p = 0.032, non-alcohol consumption at p = 0.044, frequent energy, fizzy, tea, coffee drinks and sugar intake. Interestingly, we found that severe dysmenorrhea was statistically significantly associated with women who never eat meat at p ˂0.001, cereals and fish consumers and with those who take less than 3 servings of fruit or none at all per week at p = 0.006. In addition to the previous variables, water intake of less than 1.0 litre a day, irregular cycles, non-OCP use and positive family history were found significantly associated with severe dysmenorrhea. Severe dysmenorrhea was significantly related to working less hours per week, higher stress level and longer bleeding duration at p = 0.021, 0.017 and 0.008, respectively. On the other hand, there was no statistically significant difference found between severe dysmenorrhea and the following variables: age, body mass index (BMI), weekly studying hours and age of menarche.

Conclusion

Primary dysmenorrhea is prevalent in the Jordanian population. To overcome severe dysmenorrhea, women should increase their intake of fish and fresh fruits, drinking water and use of oral contraceptive pills. The study concluded that smoking, frequent sugar intake, fizzy drinks, coffee, tea and energy drinks were associated with severe dysmenorrhea. It is also worth mentioning that alcohol consumption had a positive impact on dysmenorrhea.

Trial Registration

Registered in Clinicaltrial.gov (ID: NCT04583943).