Evaluating Dysmenorrhea in a Sample of Turkish Nursing Students

Period pain presenteeism: investigating associations of working while experiencing dysmenorrhea

Although menstrual pain (dysmenorrhea) is common and can have detrimental effects on work and social functioning, little is known about how people manage it in their professional life. Existing evidence indicates that people with dysmenorrhea often engage in presenteeism, meaning they work despite experiencing symptoms and report perceptions of social stigma around menstruation. In this study, we investigated individual health-related factors, psychosocial factors, and work factors associated with period pain presenteeism in a cross-sectional survey study including N = 668 employed people with experiences of dysmenorrhea. Our results show that symptom severity, disclosure of menstrual pain to the leader, and remote work are directly associated with period pain presenteeism. We further found that the presence of medical diagnosis moderates the association between symptom severity and presenteeism. Disclosure to the leader was associated with leader gender, leader-member exchange (LMX), and the absence of a medical diagnosis, indicating a potential mediating effect. We did not, however, find the perceptions of public beliefs regarding the concealment of menstruation to be related to presenteeism or disclosure. Our findings have important implications for research on menstrual health and occupational health management practice.

The cross-cultural adaptation and psychometric properties of the menstrual symptom questionnaire (MSQ) among Chinese women of reproductive age

Objective

This study reports on a translation of the Menstrual Symptom Questionnaire (MSQ) into Chinese, a cross-cultural adaptation among Chinese women of reproductive age, and an assessment of its reliability and validity.

Methods

Previously published translation guidelines were followed to translate and cross-culturally adapt the English version of MSQ to produce a Chinese version. This Chinese version was then administered to 2800 Chinese women of reproductive age recruited by convenience sampling method. The reliability of the Chinese MSQ was tested for internal consistency and test-retest reliability. The concurrent and construct validity of the questionnaire was evaluated using correlation and factor analysis.

Results

The Chinese version of the MSQ showed no linguistic or semantic issues. The internal consistency of the Chinese MSQ Cronbach'α = 0.912, and the test-retest reliability r = 0.911. The exploratory factor analysis identified four factors. The confirmatory factor analysis demonstrated that the four factor structure of the Chinese version of the MSQ (Pain Experience, Emotional Changes, Pain Coping Strategies, and Other Physical Symptoms) is reasonable among Chinese women of reproductive age. There was a significant correlation found between these four factors and both the Pittsburgh Sleep Quality Index and the SF-8 Health Survey.

Conclusion

The Chinese version of the MSQ achieved semantic equivalence in translation and demonstrated good reliability and validity among Chinese women of reproductive age. Thus, it can serve as an effective tool to assess the experience of menstrual symptoms among Chinese women.

Assessment of neurotransmitter imbalances within the anterior cingulate cortex in women with primary dysmenorrhea: An initial proton magnetic resonance spectroscopy study

PURPOSE

The neural pathophysiology underlying primary dysmenorrhea (PDM), which leads to poor mode and changes in central pain modulatory systems, remains largely unknown. The objective of this study was to investigate the changes in glutamate/glutamine (Glx) and gamma-aminobutyric acid (GABA+) levels within anterior cingulate cortex (ACC), and their associations with clinical indicators in PDM women.

METHODS

Using 3 T proton magnetic resonance spectroscopy (1H-MRS), we acquired and compared ACC-Glx and ACC-GABA+ levels in PDMs (N = 41) and age- and education-matched healthy controls (HCs) (N = 39) during both the menstrual and periovulatory phases, and between menstrual and periovulatory phases within each group. Total creatine (Cr referencing) level was used as an endogenous reference. The correlations of ACC-neurotransmitter levels with clinical characteristics and the correlations of ACC-Glx with ACC-GABA+ levels in the two groups were analyzed.

RESULTS

Compared to HCs or the periovulatory phase, PDMs exhibited significantly increased ACC-Glx levels (p < 0.05) during the menstrual phase. Positive correlations between GABA+ and Glx levels (r = 0.385, p = 0.025) were found in PDMs during the menstrual phase. ACC-GABA+ levels were associated with self-rating distress scale (SDS) scores (GABA+/Cr: r = 0.369, p = 0.045) and pain catastrophizing scale (PCS) scores (GABA+/Cr: r = 0.373, p = 0.042) in PDM group in only the menstrual phase.

CONCLUSION

Our study represents the first report of ACC-GABA+/Glx imbalances in PDMs during the menstrual phase, which may underlie the mechanisms mediating depression and painful catastrophic symptoms.

Medical care-seeking patterns among women with menstrual syndromes-related diagnoses: a longitudinal population-based study

Background

Many women experience menstruation-related health issues during their child-bearing years. This study aimed to evaluate women’s tendency to seek Traditional Chinese Medicine (TCM) and/or Western Medicine (WM) when newly diagnosed with menstrual syndromes and to identify factors associated with their medical care-seeking behaviors.

Methods

The data of a total of 47,097 women aged between 15 and 50 years with newly diagnosed menstrual syndromes in 2005 were extracted from the Taiwan National Health Insurance Database. The follow-up period was divided equally into 6 month segments over 5 years starting with patients’ first visit for obstetric/gynecologic care. Outcomes were outpatient visits and number of TCM or WM visits during each period. Patients’ tendency for medical care utilization was estimated using Poisson regression analysis.

Results

Number of outpatient visits using TCM was 0.62 (29187/47097), and using WM was 1.67 (78697/47097) within 6 months after the first menstrual syndrome diagnosis. The tendency for TCM utilization increased as follow-up time increased after controlling for potential confounders, while WM utilization decreased as follow-up time increased. Age, economic status, infertility, value of prevention, baby delivery, and obstetric/gynecologic inpatient histories were significantly associated with patients’ medical care-seeking behaviors.

Conclusions

TCM and WM medical care-seeking patterns are significantly different among women with diagnoses associated with menstrual syndromes. Related factors affecting medical care-seeking behavior include age, economic status, infertility, value of prevention, childbirth and Ob/Gyn inpatient histories.

The effect of yoga on pain level in primary dysmenorrhea

This study was conducted to evaluate the effect of yoga on pain levels in female students with primary dysmenorrhea. This study is a randomized experimental study with control group and pretest post-test practice. This study included 60 volunteer female students (30 experimental and 30 control groups). The patients in the experimental group took part in the yoga program a total of 12 sessions, once per week for 12 weeks. "Personal Information Form", "Visual Analog Skala (VAS)" and "Dysmenorrhea Monitoring Form (DMF)" were used in data collection process. To measure dysmenorrhea pain, the students were requested to mark a number between 1 and 10 on the VAS scale according to the severity of their pain on the menstruation starting date. The yoga applications were used for three menstrual cycles. The mean age of the students in the experimental group was 20.30 ± 0.46, while the mean age of the students in the control group was 20.46 ± 0.50. The difference between the pain levels of the students in the experimental group in the first, second, third and fourth measurements was found to be statistically significant (p < 0.001). It was determined that the difference between the pain levels of the students in the control group in the first, second, third and fourth measurements was not statistically significant (p > 0.05). Yoga can be used as an effective intervention in reducing menstrual pain in women with primary dysmenorrhea.

A systematic review of the menstrual experiences of university students and the impacts on their education: A global perspective

Background

Higher education attainment is linked to improved health and employment outcomes but the impact of university students’ experiences of menstruation on their education is less clear. The objective of this review was to synthesise qualitative and quantitative research on university students’ menstrual experiences and educational impacts.

Methods

Eligible studies were identified through systematic searching across eight peer-reviewed databases, websites for menstrual health organisations, grey literature databases, and reference lists of included studies. Eligible studies must have reported on at least one of the antecedents or components of menstrual experience outlined in the integrated model of menstrual experience in relation to university students or reported on the impact of their menstrual experiences on their education. Study characteristics and findings were extracted, analysed and presented as a narrative synthesis. The quality of evidence was assessed with the Mixed Methods Appraisal Tool. This study is registered on PROSPERO, number CRD42020178470.

Results

Eighty-three studies were eligible for inclusion. Most studies (n = 74; 89%) were quantitative and the highest proportion of studies were conducted in lower-middle-income countries (n = 31; 37%). Self-reported dysmenorrhea, other physical and emotional menstrual-related symptoms, and menstrual stigma contributed to negative menstrual experiences among female students. Very few studies considered the menstrual experiences of non-binary and transgender menstruating students, and culturally diverse students. Dysmenorrhea contributed to university absenteeism, impaired participation and concentration, and declining academic performance. Inadequate sanitation facilities for menstrual management and challenges containing menstruation also negatively impacted education.

Conclusions

Female university students’ experiences of menstruation can negatively impact their education, highlighting the need for program and policy responses at university to improve students’ wellbeing and educational engagement. Further research on the menstrual experiences of gender diverse, migrant and international students is needed as there is insufficient evidence to date.

Nursing Students' Perceptions of Menstrual Distress during Clinical Practice: A Q-Methodology Study

This study aimed to explore the cluster patterns of female nursing students’ perceptions of the effects of menstrual distress during clinical practice. This study adopted the Q-methodology study design. We recruited female nursing students from a college in northern Taiwan. Forty-seven Q-statements were constructed to explore participants’ experiences of the impact of menstrual distress on clinical learning. In total, 58 participants subjectively ranked Q-statements concerning menstrual distress experiences during clinical practice and were classified. After Q-sorting, the subjective ranking process PQ Method (version 2.35, Schmolck, Emmendingen, Germany) was employed for factor analysis. Four patterns of shared perspectives, accounting for 46.6% of the total variance, were identified: (a) influencing clinical learning and making good use of painkillers; (b) responsible attitudes and diversified relief of discomfort; (c) seeking peer support and effect on mood; (d) negative impact on learning ability and conservative self-care. Clinical practice is a major component of nursing education; menstrual distress affects female nursing students’ clinical learning and performance. The exploration of clustering different nursing students’ perceptions may facilitate customized strategies to enable more appropriate assistance.

Physical and Psychological Symptoms Associated With Premenstrual Syndrome and Their Impact on the Daily Routine of Women in a Low Socioeconomic Status Locality

Introduction

The constellation of the physical and psychological symptoms that appear several days before menstrual period is regarded as the premenstrual syndrome (PMS). The current study evaluated the symptoms associated with PMS and their impact on the day-to-day activities of women.

Methodology

An observational cross-sectional study was conducted at a squatter settlement in Karachi, Pakistan, from January 2019 to February 2020. Amenorrheic, pregnant women, and women who were on birth control at the time of data collection were excluded from the study. The demographics, symptoms of PMS experienced by the participants, and the impact of PMS symptoms on the daily lives of women were recorded. Statistical Package for the Social Sciences v.25 (IBM Corp., Armonk, NY) was used for data analysis. 

Results

The mean age ± standard deviation of 23.93 years ± 9.41 years was recorded. As many as 213 (63%) women reported dysmenorrhea, followed by fatigue in 108 (32%), bloating in 64 (18.9%), and back pain in 45 (13.3%) women. Irritability and anxiety were experienced by 134 (39.6%) and 117 (34.6%) women, respectively. When asked about their attitude and perception towards menstruation, more than four-fifth respondents confessed that they feel impure when they are experiencing their monthly period. About 38 women (11.2%) believed that menstruation is God’s way of punishing the womankind. For the question, “Do you feel that your normal routine is significantly disturbed during your period?”, 40% responded in affirmation.

Conclusion

The findings of the current study reflected a generally negative attitude towards menstruation, which significantly affected the routine lives of women in our setting. The study further concluded that dysmenorrhea, fatigue, irritability, and anxiety were the most common symptoms of PMS experienced by women.

Perception of Menstrual Normality and Abnormality in Spanish Female Nursing Students

Menstrual problems are usually taboo; and often, some, such as dysmenorrhea, are presumed normal. This study seeks to compare the menstrual characteristics and symptoms of female university students reporting self-perceived normality concerning their cycles and menstruation with those who perceive their menstruation as being abnormal. A cross-sectional descriptive study was conducted among 270 nursing students using a self-report questionnaire that included sociodemographic and gynecological issues, together with Visual Analog Scale, the Andersch and Milsom Scale, and the Spanish version of the EuroQol-5 Dimension (EuroQol-5D) to measure self-perceived health status. A bivariate analysis was performed using the chi-square test, linear trend chi-square, and Student's t-test, and a multivariate analysis of stepwise binary logistic regression was performed to predict the perception of cycle abnormality. In total, 77.4% of participants displayed normality; however, in self-reporting of menstrual characteristics, 67.4% identified alterations. Young women suffering from menstrual dizziness were 1.997 (CI95% = 1.010-3.950; p = 0.047) more likely to manifest abnormal menstruation, 4.518 (CI95% = 1.239-16.477; p = 0.022) more likely if they suffered from Grade 3 menstrual pain, and 2.851 (CI95% = 1.399-5.809; p = 0.004) more likely if they perceived that menstruation interfered with their daily lives. Many menstrual changes and symptoms are still considered normal, making it difficult to identify and address these issues. Therefore, it is necessary to develop health policies and strategies to improve menstrual health literacy for increased knowledge and earlier diagnosis.

Association between cigarette smoking and the risk of dysmenorrhea: A meta-analysis of observational studies

BACKGROUND

Emerging studies have found inconsistent results on the potential relationship between cigarette smoking and dysmenorrhea. Therefore, the aim of this study was to quantitatively synthesize the previous findings on the preceding relationship using meta-analysis.

METHODS

Previous studies on the association between cigarette smoking and dysmenorrhea, published not later than November 2019, were systematically searched, using MeSH heading and/or relevant terms, in the electronic databases of PubMed, Medline, Web of Science and EMBASE. The I2 statistic was used to assess heterogeneity, whose source was explored using subgroup analysis. A pooled effect size was obtained using random effects model, and sensitivity analysis was performed to assess the consistency of the pooled effect size.

RESULTS

After a rigorous screening process, 24 studies involving 27,091 participants were included in this meta-analysis. The results indicated that smokers were 1.45 times more likely to develop dysmenorrhea than non-smokers (odds ratio (OR) = 1.45, 95% confidence interval (CI): 1.30-1.61). In addition, individuals classified as currently smoking were 1.50 times more likely to develop dysmenorrhea than those who were classified as never smoking (OR = 1.50, 95% CI: 1.33-1.70), whereas being a former smoker was 1.31 times more likely to develop dysmenorrhea than being a never smoker (OR = 1.31, 95% CI: 1.18-1.46). Sensitivity analysis showed that exclusion of any single study did not materially alter the overall combined effect.

CONCLUSION

The evidence from this meta-analysis indicated a significant association between cigarette smoking (both current and former smoking) and dysmenorrhea. The adverse effects of smoking provide further support for prevention of dysmenorrhea and emphasize the need to target women.

Risk factors for dysmenorrhea among Ghanaian undergraduate students

BACKGROUND

Menstrual pain is one of the common gynaecological presentations of women of reproductive age to health care physicians. In Ghana, there exist a paucity of research on the risk factors of dysmenorrhea among older females.

OBJECTIVES

Very few studies in Ghana have addressed the risk factors for severe dysmenorrhea among University students. This study aims to identify the common risk factors and associated symptoms of menstrual pain which have been previously not caught the attention of researchers in Ghana.

METHODOLOGY

The study was a descriptive cross-sectional study involving to two hundred female undergraduate students of the University of Cape Coast (UCC), Ghana. Data collected and analysed using standardized and acceptable statistical tools. Verbal multidimensional scoring system for assessment of dysmenorrhoea severity was used in this study to assess the severity of dysmenorrhoea.

RESULTS

More than half (57.3%) of the respondents having pain beginning within the first two days of their menses. The common risk factors that predicted severity of dysmenorrhea (p<0.05) were quantity of menstrual flow and family history of menstrual pain. The common symptoms that accompanied dysmenorrhea were tiredness, loss of appetite, backache, dizziness, diarrhoea and mood changes (p<0.05).

CONCLUSION

Dysmenorrhea is a serious public health problem which can be incapacitating. We advocate for more attention to reduce the burden of its negative consequences.

Dysmenorrhoea among students aged 18-45 years attending University in Uganda: A cross-sectional multicenter study of three Universities in Uganda

AIM

Dysmenorrhoea presents as pain associated with menstruation. It is often an issue discussed privately, yet it continues to affect girls and women with grave impact on their education, social activities and work. This study sought to assess the factors associated with dysmenorrhoea among female students aged 18-45 years in three selected universities in Kampala Capital city, Uganda.

DESIGN AND METHODS

The study was a cross-sectional study conducted among 351 female students of three Universities in Kampala, Uganda. Purposive sampling methods were used. A self-administered questionnaire was used for data collection, a 95% confidence interval was considered and analysis was done using SPSS version 20.

RESULTS

Respondents (N = 351) fully completed the study out of 383 invited participants. The prevalence of dysmenorrhoea was 75.8%. Associated factors included having children (p < 0.05), daily consumption of sugary foods (p < 0.05) and family history of dysmenorrhoea (p < 0.01).

CONCLUSION

As nursing professionals, we believe comfort is a fundamental determinant of health. Therefore, evidence suggesting a high prevalence of dysmenorrhoea as revealed in this study is concerning. We recommend schools to have school clinics and school nurses who could help students during such days of discomfort. Further studies assessing the casual relationships of various correlates to dysmenorrhoea and the impact of dysmenorrhoea specifically on academic life of the students should be conducted.

The effect of diet on primary dysmenorrhea in university students: A randomized controlled clinical trial

OBJECTIVE

To evaluate the effect of diet therapy on primary dysmenorrhea in female university students.

METHODS

A randomized controlled pre and post-test design was used to verify the effects of diet therapy on primary dysmenorrhea. The study was conducted on 67 female students who were suffering from primary dysmenorrhea. The participants were divided into diet and control groups. The intensity of dysmenorrhea was determined using Visual Analogue Scale and a modified questionnaire assessing several symptoms of dysmenorrhea. The intervention group received the diet therapy for three months. The assessments were made before intervention and three months later.

RESULTS

Before the intervention, the mean intensity of dysmenorrhea was found to be 7.14 ± 1.3, 7.09 ± 1.4, in diet groups and control groups, respectively, but the difference was not statistically significant. After the diet therapy, a significant difference was found among the two groups regarding the mean intensity of dysmenorrhea after three months and the average score of pain score of diet group was significantly lower (Diet group:5.15±1.15, Control group: 6.74±1.97).

CONCLUSION

Diet therapy was found to be effective in reducing pain in female university students with primary dysmenorrhea complaints.

The prevalence and risk factors of menstrual pain of married women in Anhui Province, China

PURPOSE

To investigate the prevalence and the associated risk factors for menstrual pain in a sample of rural married women of reproductive age in Anhui Province of China.

METHODS

A cross-sectional study was conducted among married women (n = 14,828) aged 18-45 years. Data were collected through self-reported questionnaires. Mann Whitney U, Kruskal-Walls H tests and ordinal logistic regression models were used to analyze the data.

RESULTS

The prevalence of no, moderate, severe menstrual pain was 80.1%, 18.7%, 1.2%, respectively. Lower educational level, lower stress level and earlier age at menarche were protective factors for menstrual pain while women with longer duration of menstrual flow tended to have menstrual pain. Compared to women with a normal body mass index (BMI), significantly higher odds of reporting menstrual pain were detected for women who were lower BMI or higher BMI. Age, length of menstrual cycle, blood type, anemia and previous pregnancy were not significantly associated with dysmenorrhea after controlling for potential confounding factors.

CONCLUSIONS

There is high prevalence of dysmenorrhea among women in China. Our results suggest that reduction of stress and maintaining a normal BMI may be important for women to have pain-free periods.

Relationship of premenstrual and menstrual symptoms to alexithymia among nursing students

PURPOSE

The aim of this study is to determine the relationship of premenstrual and menstrual symptoms to alexithymia among nursing students.

DESIGN AND METHODS

This descriptive study was conducted with 284 undergraduate nursing students. Data were collected using Premenstrual Syndrome Scale (PMSS), Menstrual Symptom Scale (MSQ), and Toronto Alexithymia Scale-20 (TAS-20).

FINDINGS

The PMSS, MSQ, and TAS-20 mean scores were 103.56 ± 35.08, 2.92 ± 0.8, and 45.22 ± 9.17, respectively. There was statistically significant positive correlation between TAS-20 and PMSS and MSQ mean scores (p < .05).

PRACTICAL IMPLICATIONS

Women should be evaluated for alexithymia to prevent the adverse effects of premenstrual and menstrual symptoms.

Association of primary dysmenorrhea with anthropometrical and socio-economic factors in Polish university students

AIMS

To examine the prevalence and factors correlated with primary dysmenorrhea in young female subjects.

METHODS

Cross-sectional research was conducted among 1305 female university students aged 19-25 years. The following measurements were taken: height, body mass, waist circumference, hip circumference, the length of index and ring finger. A questionnaire was used to obtain information on menstrual pains, the characteristics of the menstrual cycles (regularity, duration), the number of the days of menstrual bleeding, age at menarche, overall health and socio-economic status of the subjects.

RESULTS

The prevalence of primary dysmenorrhea (PD) in the group was 64.85%, of which 69.60% reported mild pain, and 30.40% moderate and severe pain. PD occurs more frequently both in women with excess and insufficient level of abdominal adiposity. PD occurred more frequently in women who experience first menstruation at earlier age than in women with average and late age at menarche. The prevalence of PD grew along with mother's education and fell along with father's education. Painful menstruations occurred most commonly in women from large families. The impact of the age at menarche and the presence of abnormal body mass and abnormal level of abdominal adiposity on the prevalence of painful menstruation was also confirmed by the results of logistic regression analysis. The risk of PD is the highest in women whose finger 4 is longer than finger 2.

CONCLUSION

The results suggest that healthy body mass and lack of abdominal obesity may reduce the risk of PD.

Cyclic Perimenstrual Pain and Discomfort and Australian Women's Associated Use of Complementary and Alternative Medicine: A Longitudinal Study

OBJECTIVE

To examine the longitudinal change in Australian women's prevalence of cyclic perimenstrual pain and discomfort and the association between their symptoms and use of complementary and alternative medicine (CAM).

METHOD

Data on endometriosis, premenstrual syndrome (PMS), irregular periods, heavy periods, and severe period pain were collected over a 7-year period from the Australian Longitudinal Study on Women's Health, for women aged 28 to 33 years in 2006, and at 3-year follow-ups. Changes in symptoms and patterns of CAM practitioner and therapy/product use associated with these symptoms were analyzed using longitudinal regression modeling.

RESULTS

Over the 7-year period, prevalence rates of PMS and heavy periods increased, while prevalence rates of endometriosis, irregular periods, and severe period pain remained stable. The most common use of CAM longitudinally associated with the perimenstrual symptoms was use of vitamins/minerals, yoga/meditation, massage therapy, herbal medicine, and aromatherapy. Excluding consultation with a naturopath/herbalist, over the 7-year survey women's use of all other CAM practitioners increased as did their use of vitamin/minerals, yoga/meditation, and Chinese medicines, while aromatherapy use declined.

CONCLUSION

Only the prevalence of PMS and heavy periods increased with aging in this sample of women. While overall use of CAM practitioner and self-prescribed products/therapies increased over time, CAM was chosen by women mainly to treat endometriosis and PMS. The extent to which this use reflects treatment efficacy is uncertain.

Prevalence and Factors Affecting Dysmenorrhea in Female University Students: Effect on General Comfort Level

The purpose of this study was to investigate the prevalence and the affecting factors of dysmenorrhea and its effects on overall comfort among female university students. This was a cross-sectional study. The research was carried out between October and November 2013 at a university in Ankara. This study was conducted with 200 female students. The data were analyzed using frequencies, means, SD, χ(2) tests, independent t tests and analysis of variance. Data were collected using an interview questionnaire, the visual analog scale (VAS) and the General Comfort Questionnaire. The mean age of students in this study group was 20.85 ± 2.15 years. The prevalence of dysmenorrhea in the students was 84%. The mean severity of pain was 5.78 ± 2.45 on the VAS. The present study found that 45.8% of female students experienced moderate menstrual pain and the most common co-occurring symptoms were irritability (34.6%) and fatigue (21.5%). One-fourth of the students with dysmenorrhea consulted the advice of a physician and the most commonly used methods for pain were analgesics (69%), heat application (56.5%), and rest (71.4%). Family history of dysmenorrhea, education about menstruation, and frequency of menstrual cycle were identified as important factors in the development of dysmenorrhea (p < .05). The mean general comfort score for students with dysmenorrhea (2.57 ± 0.25) was lower than that of students without the condition (2.65 ± 0.23). Also, use of the methods for management of dysmenorrhea was found to increase students' general comfort levels. Therefore, it is important for nurses to educate and advise adolescents and young women about dysmenorrhea.

Effects of a Yoga Program on Menstrual Cramps and Menstrual Distress in Undergraduate Students with Primary Dysmenorrhea: A Single-Blind, Randomized Controlled Trial

OBJECTIVES

To investigate the effects of a yoga program on menstrual cramps and menstrual distress in undergraduate students with primary dysmenorrhea.

DESIGN

Single-blind, randomized controlled trial.

PARTICIPANTS

40 randomly selected undergraduate nursing students, with 20 each assigned to an exercise or a control group.

INTERVENTION

The participants engaged in a yoga program for 60 minutes once a week for 12 weeks. The program consisted of physical exercise combined with relaxation and meditation.

OUTCOME MEASURES

Menstrual cramps and menstrual distress levels were measured by using the Visual Analogue Scale for Pain and the Menstrual Distress Questionnaire, respectively. Data were analyzed by using the Kolmogorov-Smirnov and Shapiro-Wilk normality tests, t-test, chi-square test, logistic regression analysis, and multivariate analysis of variance (SPSS program).

RESULTS

Menstrual pain intensity (group difference, -0.94; 95% confidence interval [CI], -1.47 to -0.42; p = 0.001) and menstrual distress (group difference, -1.13; 95% CI, -1.43 to -0.82; p < 0.0001) scores decreased significantly in the experimental group compared with the control group.

CONCLUSIONS

These findings indicate that yoga interventions may reduce menstrual cramps and menstrual distress in female undergraduate students with primary dysmenorrhea.

Self-Care Strategies among Chinese Adolescent Girls with Dysmenorrhea: A Qualitative Study

Little is known about how Chinese adolescent girls manage dysmenorrhea. This study aims to explore self-care strategies among Chinese adolescent girls with dysmenorrhea. The study uses a mixed methods design with two phases: a cross-sectional survey in phase I and semistructured interviews in phase II. This paper reports phase II. In line with the phase I findings, 28 adolescent girls with different characteristics (high or low levels of self-care behavior and pain intensity, who did or did not self-medicate, and who had or had not received menstrual education) were recruited for interviews. Content analysis was used for data analysis. Four categories emerged from the data: lifestyle changes, symptom management, communicating dysmenorrhea with others, and seeking medical advice. Girls selected their diets carefully and reduced physical activity during menstruation to avoid aggravating symptoms. Heat therapy commonly was employed for symptom management. A few girls self-medicated to obtain immediate relief from pain, but the majority expressed reservations about using medication because they worried about dependence and side effects. Some girls communicated dysmenorrhea with their family and friends, but the majority did not seek medical advice. The present study showed that girls employed various self-care strategies for dysmenorrhea, including some strategies stemming from traditional Chinese medicine. The findings revealed menstrual etiquette among Chinese adolescent girls with dysmenorrhea, and demonstrated that self-medication was not part of most girls' self-care. Understanding the self-care strategies of these girls is important, as it can help nurses develop a culturally-specific intervention to promote self-care among adolescent girls with dysmenorrhea.

A critical review of complementary and alternative medicine use by women with cyclic perimenstrual pain and discomfort: a focus upon prevalence, patterns and applications of use and users' motivations, information seeking and self-perceived efficacy

INTRODUCTION

Complementary and alternative medicine (CAM) is used for treating cyclic perimenstrual pain and discomfort. This critical review examines women's reported CAM use, its perceived effectiveness and information relating to women's attitudes, behaviors, motivations and patterns of CAM use in its treatment.

MATERIAL AND METHODS

An extensive search of the main medical databases EBSCO, CINAHL, Medline, AMED and SCOPUS, as well as additional hand searches, was conducted. Papers included were confined to those that had been peer-reviewed, written in English and that contained original research into CAM use for cyclic perimenstrual pain and discomfort among adult women.

RESULTS

CAM, particularly herbal medicine, nutritional supplements and massage, is widely used for a range of cyclic perimenstrual pain and discomfort symptoms. A large number of CAM modalities are adopted, often simultaneously and with little professional oversight. Women's assessment of efficacy of different CAM modalities is positive, though the majority of users are self-prescribing apparently without professional guidance. Although the uptake of CAM for cyclic perimenstrual pain and discomfort is widespread, few empirical data are available regarding which women are using CAM, their motivations for doing so and, importantly, the sources through which women receive information about CAM.

CONCLUSIONS

This review highlights the extensive use of (often self-prescribed) CAM in a number of countries to alleviate the widespread symptoms of cyclic perimenstrual pain and discomfort. An understanding of all health care use by women with perimenstrual pain and discomfort is vital to help ensure safe, effective and coordinated health care that can lead to optimal patient outcomes.

The use of complementary and alternative medicine by 7427 Australian women with cyclic perimenstrual pain and discomfort: a cross-sectional study

BACKGROUND

To assess the prevalence of cyclic perimenstrual pain and discomfort and to detail the pattern of complementary and alternative (CAM) use adopted by women for the treatment of these symptoms.

METHODS

Data from the 2012 national Australian Longitudinal Study of Women's Health (ALSWH) cross-sectional survey of 7427 women aged 34-39 years were analysed to estimate the prevalence of endometriosis, premenstrual syndrome (PMS), irregular or heavy periods and severe dysmenorrhoea and to examine the association between their symptoms and their visits to CAM practitioners as well as their use of CAM therapies and products in the previous 12 months.

RESULTS

The prevalence of endometriosis was 3.7 % and of the perimenstrual symptoms assessed, PMS was most prevalent at 41.2 % whilst irregular bleeding (22.2 %), heavy periods (29.8 %) and severe period pain (24.1 %) were reported at lower levels. Women with endometriosis were more likely than non-sufferers to have consulted with a massage therapist or acupuncturist and to have used vitamins/minerals, yoga/meditation or Chinese medicines (p < 0.05). PMS sufferers were more likely to consult with an osteopath, massage therapist, naturopath/herbalist or alternative health practitioner and to have used all forms of CAM therapies except Chinese medicines than women who had infrequent PMS (all p < 0.05). Women with irregular periods did not have different patterns of CAM use from non-sufferers and those with heavy periods did not favour any form of CAM but were less likely to visit a massage therapist or use yoga/meditation than non-sufferers (p < 0.05). For women with severe dysmenorrhoea there was no difference in their visits to CAM practitioners compared to non-sufferers but they were more likely to use aromatherapy oils (p < 0.05) and for more frequent dysmenorrhoea also herbal medicines, Chinese medicines and other alternative therapies compared to non-sufferers (all p < 0.05).

CONCLUSIONS

There is a high prevalence of cyclic perimenstrual pain and discomfort amongst women in this age group. Women were using CAM differentially when they had specific symptoms of cyclic perimenstrual pain and discomfort. The use of CAM needs to be properly assessed to ensure their safe, effective use and to ascertain their significance as a treatment option enabling women with menstrual problems and their care providers to improve their quality of life.

Dysmenorrhea Characteristics of Female Students of Health School and Affecting Factors and Their Knowledge and Use of Complementary and Alternative Medicine Methods

The purpose of this study was to examine the menstruation and dysmenorrhea characteristics and the factors affecting dysmenorrhea of health school students, and the knowledge and use of the methods of complementary and alternative medicine (CAM) on the part of those students with dysmenorrhea. This is a descriptive study. A descriptive analysis was made by calculating the number, percentage, mean, Pearson χ, and logistic regression analysis. A total of 488 female students participated in the research and 87.7% (n = 428) of all students experienced dysmenorrhea. It was detected that a family history of dysmenorrhea and regular menstrual cycles of the students were dysmenorrhea-affecting factors (P < .05). Seven of 10 students with dysmenorrhea used CAM methods. Heat application of CAM methods for dysmenorrhea management was the most commonly used and also known by the students. The students who experienced severe pain used analgesics (P < .05) and CAM methods (P < .05).