1
|
Chen CX, Rogers SK, Li R, Hinrichs RJ, Fortenberry JD, Carpenter JS. Social Determinants of Health and Dysmenorrhea: A Systematic Review. THE JOURNAL OF PAIN 2024; 25:104574. [PMID: 38788887 PMCID: PMC11347097 DOI: 10.1016/j.jpain.2024.104574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Social determinants of health play a key role in health disparities. Dysmenorrhea is a highly prevalent and impactful public health problem affecting reproductive-age females. Systematically examining social determinants of health (SDoH) in dysmenorrhea is important for identifying gaps in the literature and informing research, policy, and clinical practice to reduce the public health burden associated with dysmenorrhea. The purpose of this systematic review was to synthesize the literature on SDoH and dysmenorrhea. The review protocol was prospectively registered. We searched Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Google Scholar through February 2024 using search strategies informed by the literature. Screening of the articles, data extraction, and risk-of-bias (RoB) assessment were conducted independently by at least 2 reviewers on the Covidence platform. Among 2,594 unique records screened, 166 met eligibility criteria and were included for data extraction and RoB assessment. Evidence suggests traumatic experiences, toxic environmental exposures, female genital mutilation, job-related stress, lack of menstrual education, and low social support were associated with worse dysmenorrhea outcomes. However, evidence was equivocal regarding the relationships between dysmenorrhea outcomes and SDoH factors, including socioeconomic status, geographical location, race/ethnicity, employment, and religion. Nearly all articles (99.4%) had a high or very high overall RoB. The relationships between SDoH and dysmenorrhea outcomes were often inconsistent and complicated by heterogeneous study populations and methodologies. More rigorous research examining SDoH in dysmenorrhea is needed to inform policy and clinical practice. PERSPECTIVE: This systematic review synthesizes evidence linking SDoH and dysmenorrhea. The relationships between SDoH and dysmenorrhea were often equivocal and complicated by heterogeneous study populations and methodologies. We identify directions for future research and SDoH factors that could be addressed clinically (eg, trauma, menstrual education, and occupational stress).
Collapse
Affiliation(s)
- Chen X Chen
- Indiana University School of Nursing, Indianapolis, Indiana.
| | - Sarah K Rogers
- Department of Psychology, School of Science, Indiana University Purdue University-Indianapolis, Indianapolis, Indiana
| | - Rui Li
- Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Rachel J Hinrichs
- Indiana University Indianapolis, University Library, Indianapolis, Indiana
| | - J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | | |
Collapse
|
2
|
Ghosh S, Ravindra RK, Modak A, Maiti S, Nath A, Koley M, Saha S. Efficacy of individualized homeopathic medicines in primary dysmenorrhea: a double-blind, randomized, placebo-controlled, clinical trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:258-267. [PMID: 34085495 DOI: 10.1515/jcim-2020-0512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Homeopathic treatment is claimed to be beneficial for primary dysmenorrhoea (PD); still, systematic research evidences remain compromised. This study was undertaken to examine the efficacy of individualized homeopathic medicines (IH) against placebo in the treatment of PD. METHODS A double-blind, randomized, placebo-controlled trial was conducted at the gynecology outpatient department of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, West Bengal, India. Patients were randomized to receive either IH (n=64) or identical-looking placebo (n=64). Primary and secondary outcome measures were 0-10 numeric rating scales (NRS) measuring intensity of pain of dysmenorrhea and verbal multidimensional scoring system (VMSS) respectively; all measured at baseline, and every month, up to 3 months. Group differences and effect sizes (Cohen's d) were calculated on intention-to-treat (ITT) sample. RESULTS Groups were comparable at baseline (all p>0.05). Attrition rate was 10.9% (IH: 7, placebo: 7). Differences between groups in both pain NRS and VMSS favoured IH over placebo at all time points (all p<0.001, unpaired t-tests and two-ways repeated measures analysis of variance) with medium to large effect sizes. Natrum muriaticum and Pulsatilla nigricans (n=20 each; 15.6%) were the most frequently prescribed medicines. No harms, serious adverse events and intercurrent illnesses were recorded in either of the groups. CONCLUSIONS Homeopathic medicines acted significantly better than placebo in the treatment of PD. Independent replication is warranted. Trial registration: CTRI/2018/10/016013.
Collapse
Affiliation(s)
- Shubhamoy Ghosh
- Dept. of Pathology & Microbiology, Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Rai Khushboo Ravindra
- Dept. of Repertory , Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Amila Modak
- Dept. of Obstetrics & Gynecology, Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Shukdeb Maiti
- Dept. of Repertory , Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Howrah, West Bengal, India
| | - Arunava Nath
- Dept. of Forensic Medicine & Toxicology, Pratap Chandra Memorial Homoeopathic Hospital and College, Kolkata, West Bengal, India
| | - Munmun Koley
- Dept. of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Subhranil Saha
- Dept. of Repertory, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India
| |
Collapse
|
3
|
Xiao SQ, Xing LL, Wu QJ, Xia TH, Fu TT, Guo Y, Yu XY, Sun XH, Feng HL, Gai L, Xu YW, Xia CL, Fan L. Association Between Passive Smoking and Menstrual Discomfort: A Cross-Sectional Study of 2,571 Non-smoking Chinese Nurses. Front Public Health 2022; 10:889254. [PMID: 35719676 PMCID: PMC9204475 DOI: 10.3389/fpubh.2022.889254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/27/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Menstrual discomfort affects women's quality of life, which is an important public health issue. Evidence confirming the link between passive smoking and menstrual discomfort is limited. Therefore, the aim of this study is to investigate the aforementioned topic on the basis of a cross-sectional study of 2,571 non-smoking Chinese nurses. Methods Demographic information and passive smoking were assessed using a self-administered questionnaire. Menstrual discomfort was characterized as dysmenorrhea, illness or weakness, bed rest, and restlessness during menstruation, which was assessed using a modified version of the Cornell Medical Index-Health Questionnaire. Multivariate-adjusted odds ratio (OR) and 95% confidence intervals (CIs) were estimated using the logistic regression model. Results A total of 1:195 nurses (46.48%) were exposed to passive smoking. Compared with non-passive smoking nurses, passive smoking nurses were more likely to have menstrual discomfort symptoms (72.38 vs. 64.39%), especially symptoms of dysmenorrhea (49.54 vs. 42.08%), illnesses or weakness (48.28 vs. 42.08%), and restlessness during menstruation (53.05 vs. 46.22%). Exposure to passive smoking was significantly associated with menstrual discomfort (OR = 1.41, 95%CI: 1.19–1.67), especially symptoms of dysmenorrhea (OR = 1.32, 95%CI: 1.13–1.56), illness or weakness (OR = 1.24, 95%CI: 1.06–1.46), and restlessness (OR = 1.26, 95%CI: 1.08–1.48) during menstruation. The subgroup analyses, stratified by age, children, and marital status, agreed with the main findings. Conclusions Exposure to passive smoking was related to symptoms of dysmenorrhea and menstrual discomfort.
Collapse
Affiliation(s)
- Shi-qi Xiao
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lin-lin Xing
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tian-hui Xia
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tong-tong Fu
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ying Guo
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin-ying Yu
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiang-hong Sun
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hui-ling Feng
- Department of Nursing, China Medical University, Shenyang, China
- Department of Nursing, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Li Gai
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-wei Xu
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chun-ling Xia
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
- Chun-ling Xia
| | - Ling Fan
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Nursing, China Medical University, Shenyang, China
- *Correspondence: Ling Fan
| |
Collapse
|
4
|
Hailemeskel S, Demissie A, Assefa N. Primary dysmenorrhea magnitude, associated risk factors, and its effect on academic performance: evidence from female university students in Ethiopia. Int J Womens Health 2016; 8:489-496. [PMID: 27695366 PMCID: PMC5034908 DOI: 10.2147/ijwh.s112768] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD) is the most common gynecologic compliant among adolescent females. There is a wide variation in the estimate of PD, which ranges from 50% to 90%, and the disorder is the most common cause of work and school absenteeism in adolescent females. OBJECTIVE To assess the prevalence and associated risk factors of PD among female university students and understand its effects on students' academic performance. METHODS A cross-sectional study was employed in 440 research participants. A multistage stratified sampling technique was employed to select the study units. Structured and pretested self-administered questionnaires were used and weight and height measurements were conducted. The severity of dysmenorrheal pain was assessed by using a verbal multidimensional scoring system and visual analog scale. The data were double entered in Epi Info version 3.1 and analyzed using SPSS version 17. Descriptive statistics, chi-square test, and logistic regression analysis were performed. RESULTS A total of 440 students participated in this study. The prevalence of PD was 368 (85.4%). Of these, 123 (28.5%) had mild, 164 (38.1%) moderate, and 81 (18.8%) severe primary dysmenorrheal pain. Among students with PD, 88.3% reported that PD had a negative effect on their academic performance. Of these, 80% reported school absence, 66.8% reported loss of class concentration, 56.3% reported class absence, 47.4% reported loss of class participation, 37.8% reported limited sport participation, 31.7% reported limitation in going out with friends, and 21% reported inability to do homework. Based on the multivariate logistic regression, PD was statistically significant with those who had lower monthly stipends, a history of attempt to lose weight, a history of depression or anxiety, disruption of social network of family, friends or people they love, who consumed more than four glasses of tea per day, who drunk one or more Coca-Cola or Pepsi per day, in nullipara, and students with a family history of dysmenorrhea. CONCLUSION PD is more prevalent among female students attending university. It has a significant negative impact on students' academic performance. Thus, it needs medical attention. There are various identified associated risk factors and considering them in the management of the disorder is fundamental. It is also wise to recommend future studies to better identify risk factors for PD and lighten its effect on students' academic performance at a larger scale in the country.
Collapse
Affiliation(s)
- Solomon Hailemeskel
- Department of Midwifery, College of Health Science, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Asrate Demissie
- Department of Nursing and Midwifery, School of Allied Health Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nigussie Assefa
- Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
5
|
Inanmdar W, Sultana A, Mubeen U, Rahman K. Clinical efficacy of Trigonella foenum graecum (Fenugreek) and dry cupping therapy on intensity of pain in patients with primary dysmenorrhea. Chin J Integr Med 2016:10.1007/s11655-016-2259-x. [PMID: 27225291 DOI: 10.1007/s11655-016-2259-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine the effificacy and safety of fenugreek seed and dry cupping on intensity of pain in primary dysmenorrhea. METHODS Sixty patients with primary dysmenorrhea were enrolled in this prospective, open-labeled, randomized, standard-controlled study, conducted in the National Institute of Unani Medicine Hospital between February 2010 and April 2011. In group A (20 cases), 3 g powder of fenugreek seed (3 capsules, 1 g each) was given orally twice daily from day 1 to 3 of menstrual cycle. Group B (20 cases) received the same dose of fenugreek seed as group A along with dry cupping therapy [two 4.2-cm and one 2.5-cm cups (internal diameter)], which was applied below the umbilicus for 15 min on day 1 and day 3 of menstrual cycle for 3 consecutive months. The control group C (20 cases) was given mefenamic acid, 500 mg twice daily, on the same protocol. The reduction in menstrual pain intensity was measured with well validated Visual Analogue Scale and safety of fenugreek seed was evaluated by clinical examination and laboratory investigations. RESULTS Baseline characteristics and biochemical parameters were comparable and homogenous among all groups (P>0.05). The percentage reduction in lower abdominal pain was 66.89%, 66.49%, and 62.88% in A, B and C groups respectively at the end of the treatment. No adverse drug effects were noticed. CONCLUSION The fenugreek seed and dry cupping are effificacious, safe, cost effective, and well tolerated.
Collapse
Affiliation(s)
- Wajida Inanmdar
- Department of Obstetrics and Gynecology, National Institute of Unani Medicine, Post Graduate Institute of Research, Bangalore, Karnataka, 560091, India
| | - Arshiya Sultana
- Department of Obstetrics and Gynecology, National Institute of Unani Medicine, Post Graduate Institute of Research, Bangalore, Karnataka, 560091, India.
| | - Umraz Mubeen
- Department of Obstetrics and Gynecology, National Institute of Unani Medicine, Post Graduate Institute of Research, Bangalore, Karnataka, 560091, India
| | - Khaleequr Rahman
- Department of Pharmacy, National Institute of Unani Medicine, Post Graduate Institute of Research, Bangalore, Karnataka, 560091, India
| |
Collapse
|
6
|
Zahradnik HP, Hanjalic-Beck A, Groth K. Nonsteroidal anti-inflammatory drugs and hormonal contraceptives for pain relief from dysmenorrhea: a review. Contraception 2010; 81:185-96. [PMID: 20159173 DOI: 10.1016/j.contraception.2009.09.014] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Accepted: 09/28/2009] [Indexed: 11/25/2022]
|