Prevalence of Primary Dysmenorrhea and Factors Associated with Its Intensity Among Undergraduate Students: A Cross-Sectional Study

Social Determinants of Health and Dysmenorrhea: A Systematic Review

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).

Wrist-ankle acupuncture for primary dysmenorrhea: a randomized controlled trial evaluating the efficacy of an analgesic strap

Background

Drawing on the principles of wrist-ankle acupuncture (WAA), our research team has developed a portable device for WAA point compression, termed the acupressure wrist-ankle strap (AWA). The current study aims to evaluate the efficacy of the AWA in alleviating pain associated with primary dysmenorrhea.

Methods

A single-blind, randomized clinical trial was conducted from April 1, 2019, to December 31, 2019. 78 participants with primary dysmenorrhea were recruited from Shanghai University of Traditional Chinese Medicine. All participants were treated on the first day of menstruation for 30 min. Participants in the AWA group used the AWA, the internal side of which is equipped with a tip compression component, while participants in the non-acupressure wrist-ankle acupuncture(NAWA)group used the NAWA, with the inside tip pressing parts removed. The main outcome was the difference in visual analogue scale (VAS) score between baseline and 30 minutes after randomization.

Results

A total of 78 participants aged 18 to 30 years were included in the intention-to-treat analyses. The VAS scores (mean [standard deviation]) in the AWA group were significantly lower than those in the NAWA group at each time point of intervention (5 minutes: 95% CI, [-1.27 to -0.68], p < 0.001; 10 minutes: 95% CI, [-2.34 to -1.51], p < 0.001; 30 minutes: 95% CI, [-3.74 to -2.72], p < 0.001). In the AWA group, 16 participants reported "obvious relief" of dysmenorrhea pain while 23 did not; the average onset time of analgesia they reported were (21.50 ± 3.65) min, while no subjects in NAWA group reported obvious pain relief. The pain threshold (mean [standard deviation]) at SP9 of both sides in AWA group decreased significantly after intervention that in NAWA group (Left: 95% CI, [-5.02 to -1.81], p < 0.001; Right: 95% CI, [-7.67 to -4.24], p < 0.001). There was no significant change in the temperature at CV4 in either group (95% CI, [-0.63 to -0.66], p = 0.970).

Conclusion

This trial substantiates our hypothesis that the AWA provides immediate analgesic effects. The AWA represents an effective and safe non-invasive physical therapy option, which patients can self-administer to alleviate abdominal pain.

Evaluation of Electromagnetic Therapy in the Treatment of Severe Dysmenorrhea in Young Women of Basrah

INTRODUCTION

Primary dysmenorrhea (PD) is a public disease of young female worldwide, it affects their daily performances. Severe recurrent uterine cramps are the main complaints in 90% of adolescents and 50% of reproductive-age females. This study aimed to evaluate the use of magnetic field therapy in the treatment of severe dysmenorrhea grade 3 and provide an encouraging goal to continue daily work without pain.

METHODS

Two hundred and fifty female patients were recruited in this study from gynecological clinics in Basrah, southern Iraq. All had severe dysmenorrhea, patients were subjected to a questionnaire form, Visual Analog Scale, and verbal multidimensional scoring system to determine the pain intensity and grade of dysmenorrhea. Only 38 young females had severe dysmenorrhea grade 3 with ages ranging from 16 to 28 years with a mean age of 22.04 ± 1.43 years and body mass index 23.81 ± 1.94, patients subjected to electromagnetic field therapy (EMFT), two sessions per week for 20 min each for 6 weeks. Three categories were assessed, working ability, associated symptoms, and drugs used. Data were collected and statistically analyzed using SPSS version 22.

RESULTS

The present study showed statistically significant progress (P < 0.05) in reducing pain, rare physical and mental complaints, and improved working ability with no need for drugs in majority of patients.

CONCLUSION

EMFT has better results than other methods in relieving pain and symptoms of dysmenorrhea with a settled lifestyle.

The prevalence of menstrual disorders and their association with psychological stress in Syrian students enrolled at health-related schools: A cross-sectional study

OBJECTIVES

Menstrual disorders are among the most prevalent health issues among young female students studying in health science faculties. This study aimed to provide insights into the menstrual patterns among medical faculty students and determine whether stress can be a risk factor for its various disorders.

METHODS

This cross-sectional study was conducted in the Faculties of Medicine, Dentistry, and Pharmacy at the Syrian Private University, Damascus, Syria, between October and November 2022. A total of 980 female students anonymously completed the identification of menstrual problems and the perceived stress scale (PSS) questionnaire. The data were analyzed using SPSS-25.

RESULTS

The mean age of students was 21.52 ± 2.06 years. The most common menstrual disorders in this study were dysmenorrhea (88%), and premenstrual syndrome (87%). A total of 82% had mild to moderate stress, 10% had high stress, and 8% had low stress. Moderate to high perceived stress was associated with an increased risk of PMS (OR = 1.79, P = 0.0037).

CONCLUSION

These findings stress the importance of universities, especially health science faculties, establishing protocols for early detection and intervention in students with stress and menstrual disorders. Implementing stress reduction education and timely counseling, along with preventive measures, is crucial for students' well-being. Further research is needed to refine interventions for this group.

Prevalence, pain intensity and symptoms associated with primary dysmenorrhea: a cross-sectional study

BACKGROUND

Primary dysmenorrhea (PD) is an etiological cyclic pelvic pain related to the menstrual period; it can negatively impact women's quality of life and productivity. The aim of the present study was to estimate the prevalence of PD and analyze associated symptoms in Brazilian women.

METHODS

An online cross-sectional study was carried out in Brazil, with a structured questionnaire regarding dysmenorrhea and associated symptoms. PD intensity was measured with the Numerical Rating Scale for Pain and classified as mild (1-3), moderate (4-7) and severe (> 8). The association between qualitative variables was performed using Pearson's Chi-Square Test. The quantification of this association was measured using multinomial logistic regression models, with calculation of Odds Ratio and confidence interval. A significance level of 5% was considered.

RESULTS

A total of 10,070 women were included. Most participants classified PD intensity as moderate (40.4%, 41.9% and 49.7%) and severe (21.2%, 24.8% and 28.4%) in the previous month, 3 months and 5 years, respectively. The most common symptoms associated with PD were irritability, abdominal distension sensation, anxiety and feeling more emotional. The increased of the risk (OR > 1.0) for moderate and severe PD-related pain intensity is related to age, nulliparity and presence PD since adolescence.

CONCLUSION

There is a high prevalence of PD among Brazilian women, and the most common symptoms reported were irritability, abdominal distension sensation, anxiety and feeling more emotional.

Policies, Guidelines, and Practices Supporting Women's Menstruation, Menstrual Disorders and Menopause at Work: A Critical Global Scoping Review

(1) Objectives: This paper presents a scoping review of global evidence relating to interventions (i.e., policies, practices, guidelines, and legislation) aimed at supporting women to manage menstruation, menstrual disorders, and menopause at work. (2) Methods: Databases including Medline (Ebsco), CINAHL (Ebsco), Scopus, Web of Science, APA PsychInfo (Ebsco), Humanities International Complete (Ebsco), Academic Search Premier (Ebsco), HeinOnline and OSH Update, and Google Scholar were searched in May 2022. (3) Results: Of 1181 unique articles screened, 66 articles are included. Less half of the articles (42%, 28/66) presented/reviewed an intervention related to women's workplace health. A total of 55 out of the 66 articles are set across 13 countries with the remaining 12 articles described as multi-country studies or reviews. Half of the articles presenting/reviewing an intervention were grey literature, with several undertaken in UK and EU member countries. Interventions focusing on supporting women with menopause at work were the most common (43%, 12/28), followed by menstruation (25%, 7/28) and menstrual disorders (7%, 2/28). Across the reviewed articles, recommendations were categorised as adjustments to the physical work environment, information and training needs, and policy and processes. Few articles explicitly presented or affirmed a design-process and/or evaluation tied to their intervention. In lieu of design-process, this review categorises the rationales driving the development of an intervention as: pronatalist, economic rationalism, gendered occupational health concern, cultural shift towards gender equity objectives, and efforts to reduced shame and stigma. (4) Conclusions: There is a growing body of evidence aimed at understanding women's experiences of managing their menstrual and reproductive health in the workplace and how this impacts their work/career trajectories. However, little research is explicitly concerned with exploring or understanding interventions, including their design or evaluation. Most articles report menopause guidelines and are typically confined to the UK and EU-member countries. Despite the prevalence of menstrual disorders (e.g., endometriosis and polycystic ovarian syndrome (PCOS)) there is limited literature focused on how women might be supported to manage symptoms associated with these conditions at work. Accordingly, future policies should consider how women can be better supported to manage menstruation and menstrual disorders at work and recognise the importance of co-design during policy development and post-intervention evaluation. Further research needs to be undertaken on the impact of workplace policies on both employers and employees.

OPRM1 A118G polymorphism modulating motor pathway for pain adaptability in women with primary dysmenorrhea

Introduction

Primary dysmenorrhea (PDM) is a common condition among women of reproductive age, characterized by menstrual pain in the absence of any organic causes. Previous research has established a link between the A118G polymorphism in the mu-opioid receptor (OPRM1) gene and pain experience in PDM. Specifically, carriers of the G allele have been found to exhibit maladaptive functional connectivity between the descending pain modulatory system and the motor system in young women with PDM. This study aims to explore the potential relationship between the OPRM1 A118G polymorphism and changes in white matter in young women with PDM.

Methods

The study enrolled 43 individuals with PDM, including 13 AA homozygotes and 30 G allele carriers. Diffusion tensor imaging (DTI) scans were performed during both the menstrual and peri-ovulatory phases, and tract-based spatial statistics (TBSS) and probabilistic tractography were used to explore variations in white matter microstructure related to the OPRM1 A118G polymorphism. The short-form McGill Pain Questionnaire (MPQ) was used to access participants' pain experience during the MEN phase.

Results

Two-way ANOVA on TBSS analysis revealed a significant main effect of genotype, with no phase effect or phase-gene interaction detected. Planned contrast analysis showed that during the menstrual phase, G allele carriers had higher fractional anisotropy (FA) and lower radial diffusivity in the corpus callosum and the left corona radiata compared to AA homozygotes. Tractographic analysis indicated the involvement of the left internal capsule, left corticospinal tract, and bilateral medial motor cortex. Additionally, the mean FA of the corpus callosum and the corona radiata was negatively correlated with MPQ scales in AA homozygotes, but this correlation was not observed in G allele carriers. No significant genotype difference was found during the pain-free peri-ovulary phase.

Discussion

OPRM1 A118G polymorphism may influence the connection between structural integrity and dysmenorrheic pain, where the G allele could impede the pain-regulating effects of the A allele. These novel findings shed light on the underlying mechanisms of both adaptive and maladaptive structural neuroplasticity in PDM, depending on the specific OPRM1 polymorphism.

Prevalence of Primary Dysmenorrhoea and Its Impact on Academic Performance among Croatian Students during the COVID-19 Pandemic

Background

Dysmenorrhoea is one of the most common gynaecological problems. Therefore, it is important to investigate its impact during the COVID-19 pandemic which has a great impact on the lives of menstruating people all over the world.

Aim

To determine the prevalence and impact of primary dysmenorrhoea on academic performance among students during the pandemic.

Materials and Methods

This cross-sectional study was conducted in April 2021. All data were collected by an anonymous self-assessed web-based questionnaire. Due to voluntary participation in the study, 1210 responses were received, but 956 were left for analysis after exclusion criteria were applied. Descriptive quantitative analysis was performed and Kendall rank correlation coefficient was used.

Results

The prevalence of primary dysmenorrhoea was 90.1%. Menstrual pain was mild in 7.4% of cases, moderate in 28.8%, and severe in 63.8%. The study found that primary dysmenorrhoea has a great perceived impact on all included aspects of academic performance. Most affected were concentration in class in 810 (94.1%) and doing homework and learning in 809 (94.0%) female students. There is also a correlation between menstrual pain intensity and its impact on academic performance (p < 0.001).

Conclusions

Our study found that the prevalence of primary dysmenorrhoea among students at the University of Zagreb is high. Painful menstruation greatly impacts academic performance and therefore it is important to do more research on this topic.

Effect of Guizhi Fuling Wan in primary dysmenorrhea: A randomized controlled trial

ETHNOPHARMACOLOGICAL RELEVANCE

Guizhi Fuling Wan (GFW) is one of the most widely known traditional Chinese medicine (TCM) formulations that has long been used in China for the treatment of primary dysmenorrhea (PD). However, the quality of evidence is limited and there are few studies on specific TCM syndromes of GFW for PD.

AIM OF THE STUDY

To evaluate the efficacy and safety of GFW on PD patients with the heat-burning blood-stasis syndrome.

MATERIALS AND METHODS

This was a randomized, double-blinded, placebo-controlled trial. Eligible patients were recruited and randomly assigned to one of two groups to receive GFW or the placebo twice daily for three menstrual cycles with a 3-month follow-up. The primary outcome was the baseline-to-month 6 change in pain intensity measured by a Visual Analog Scale (VAS). The secondary outcomes included the changes in the Cox Menstrual Symptom Scale (CMSS), the Self-rating Anxiety Scale (SAS), the Self-rating Depression Scale (SDS), and the TCM syndrome scale from baseline to month 6. Additionally, adverse effect was assessed.

RESULTS

A total of 353 patients were screened for eligibility and 128 were randomly assigned, of whom 121 completed all treatments and follow-ups. In both the full analysis (FAS) and the per-protocol analysis (PPS), the VAS score of pain intensity decreased significantly more in the GFW group than in the placebo group from baseline to month 6 (P < 0.01). Similarly, the decrease in CMSS, SAS and TCM syndrome scores was greater in the GFW group compared with the placebo group (P < 0.01). There were no differences in SDS scores between the two groups (P > 0.05). In addition, no serious adverse events were observed.

CONCLUSION

Our findings revealed that GFW significantly alleviated the severity of menstrual pain in PD patients with the heat-burning blood-stasis syndrome without significant adverse effects.

The Effects of Electrode Placement on Analgesia Using Transcutaneous Electrical Nerve Stimulation for Primary Dysmenorrhea: A Single-Blind Randomized Controlled Clinical Trial

Background Primary dysmenorrhea (PD) refers to the occurrence of painful menstrual cramps without pathological involvement of the pelvic organs, with considerable morbidity and high prevalence among females of reproductive age. Objective The objective of this study is to present and test the efficacy of an innovative method of interactive transcutaneous electrical nerve stimulation (iTENS) for PD. Methods and materials This study is a single-blind controlled clinical trial. This was conducted at the outpatient clinic of the faculty of physical therapy. Females with PD (n=124) were divided into the treated group (transcutaneous electrical nerve stimulation {TENS} group {TG}, n=62) and the placebo group (PG, n=62). A single session of either iTENS or placebo intervention was used for 35 minutes. Pain, the duration of analgesia, and the use of pain medication were assessed before and after the intervention. Data from before and after the treatment were compared between groups (Student's t-test). The level of significance was set at 5%. Results A significant decrease in pain (p<0.001) was observed after the intervention for the TG, with a more long-lasting analgesia (p<0.001) and decreased need for pain medication (p<0.001). Conclusions The proposed method of transcutaneous electrical nerve stimulation (TENS) application showed positive results for pain management on females with PD, with no reported adverse effects. The new proposed TENS application takes into account the preferences of the patient regarding positioning and the number of channels needed to cause analgesia. This application was able to promote almost complete analgesia in females with primary dysmenorrhea, and the analgesia persisted for more than one menstrual cycle.

Prevalence of dysmenorrhea and associated risk factors among university students in Zimbabwe

BACKGROUND

Dysmenorrhea is an often incapacitating condition that is characterized by painful menstruation and general body malaise. In Zimbabwe, this condition is understudied, and its associated risk factors are poorly understood.

OBJECTIVES

To investigate the prevalence and associated risk factors of dysmenorrhea among female students at Midlands State University in Zimbabwe.

DESIGN

This is a cross-sectional study that employed simple random sampling technique to obtain data from 382 students using pretested and self-administered questionnaires.

METHODS

Data were analyzed using STATA version 16. Associations between dysmenorrhea, menstrual, sociodemographic, and lifestyle characteristics were measured using chi-square test and logistic regression model.

RESULTS

The prevalence of dysmenorrhea was 75.9%, with 28.6% of sufferers describing their pain as severe. Dysmenorrhea significantly affected the school/daily activities of respondents (χ2 = 18.22, p < 0.001). Family history (χ2 = 4.28, p = 0.04), age of menarche (χ2 = 14.8, p < 0.001), regularity of menstrual cycle (χ2 = 18.1, p < 0.001), and parity (χ2 = 8.8, p = 0.03) were associated with the prevalence of dysmenorrhea. The risk of developing dysmenorrhea almost doubled with positive family history (prevalence odds ratio = 1.68 (95% confidence interval: 1.03 to 2.75, p = 0.040)); increased with decrease in age of menarche (prevalence odds ratio = 0.19 (95% confidence interval: 0.10 to 0.45, p < 0.001)) and decreased with increase in parity (prevalence odds ratio = 0.15 (95% confidence interval: 0.03 to 0.82, p = 0.029)). However, the risk was low among those with irregular menstrual cycles (prevalence odds ratio = 0.14 (95% confidence interval: 0.10 to 0.33, p < 0.001)). Physical exercise, smoking, alcohol, and coffee consumption were not associated with the prevalence of dysmenorrhea (p > 0.05).

CONCLUSION

Dysmenorrhea is common among female students at Midlands State University, and it significantly affects their academic activities. Family history, regular menstrual cycle, nulliparity, and lower age of menarche were risk factors. More awareness is recommended including studies on impact and management strategies.

The Effect of Yoga on Pain and Quality of Life in Primary Dysmenorrhea: A Cross Sectional Survey

Dysmenorrhea is a painful syndrome that accompanies the menstrual cycles. Objectives: The main objective of this research was to determine the effects of yoga exercises on pain and quality of life in female undergraduate students suffering from primary dysmenorrhea. Methods: After taking approval from Ethical review committee of Rawal Institute of Health Sciences, an observation type of cross-section survey was conducted in 470 young undergraduate female students of age between 17-26, suffering from primary dysmenorrhea. By non-probability sampling participants were divided into two groups. Group-1 was of those females who had active lifestyle and doing yoga exercises and group-2 were of those who had sedentary lifestyle and didn’t do any kind of exercise. To measure the outcome variables, EQ-5D-5L questionnaire was used to measure QoL & NPRS to measure pain. Data were taken at baseline and after 12th week. Wilcoxon rank test was used for within group analysis and Mann Whitney U test was used to compare mean between groups. Data was analyzed in SPSS software version 21 along with Microsoft Excel 2019. Results: 21.16+2.66 &22.27+2.53 was the Mean+SD of age of group-1 & group-2 respectively. Between groups analysis revealed that p-value for NPRS was <0.05 but was >0.05 in quality of life. Conclusion: Yoga exercises are safer and easiest way to manage pain of primary dysmenorrhea in undergraduate females without any drug use.

Investigation of Laboratory and Clinical Features of Primary Dysmenorrhea: Comparison of Magnesium and Oral Contraceptives in Treatment

Background The goal of this study was to identify the demographic, clinical, and laboratory characteristics of primary dysmenorrhea (PD) patients, as well as to compare the treatment options of 200 mg magnesium citrate (MgS) and combination oral contraceptive (COC) therapy. Methods This is a case-controlled prospective study consisting of 172 women with PD and a control group consisting of age-matched 172 without PD. The cases in the primary dysmenorrhea group were randomly divided into two groups, with 86 patients in the first group receiving 200 mg MgS, and 86 patients in the second group receiving COC treatment. The Visual Analogue Scale (VAS) was used to measure the severity of dysmenorrhea. VAS scoring was performed on the control group subjects included in the study at their first evaluation and the PD group subjects before treatment and at the third month of treatment (after three menstrual cycles). Results When compared to healthy controls, the PD patients had significantly more menstrual bleeding (p = 0.005), more history of maternal dysmenorrhea (p < 0.001), lower serum calcium (p < 0.001), lower serum 25-hydroxyvitamin D3 (p < 0.001) and more 25-hydroxyvitamin D deficiency (p < 0.001). When compared to the MgS group, the patients in the COC group had significantly lower VAS scores and less need for painkillers following treatment (p < 0.001). The MgS treatment group had significantly lower post-treatment VAS values than pre-treatment VAS values. Conclusion Lower serum calcium and 25-hydroxyvitamin D levels were found in the presence of PD. In addition, it was observed that the administration of 200 mg MgS to PD patients significantly reduced pelvic pain in dysmenorrhea, although not as much as COC administration, and caused significant reductions in the need for painkillers.

Prevalence of Primary Dysmenorrhea, Its Intensity and Associated Factors Among Female Students at High Schools of Wolaita Zone, Southern Ethiopia: Cross-Sectional Study Design

Introduction

Primary dysmenorrhea is a highly prevalent gynecological problem and one of the most common causes of school absenteeism among school adolescents. Nearly, half of females with primary dysmenorrhea missed school or work at least once per cycle. Therefore, this study aimed to assess the prevalence of primary dysmenorrhea and its associated factors among female students in Wolaita soddo town high schools.

Methods

An institution-based cross-sectional study was conducted among female students at Wolaita soddo town high schools from October 1–30/2021. A total of 733 students were selected using a simple random sampling technique. The data were entered using Epi data version 3.1 and exported to SPSS version 25 for analysis. Binary logistic regression analysis was used. Variables with a p-value of <0.05 in the multivariable logistic regression analysis model were considered statistically significant.

Results

The prevalence of primary dysmenorrhea was 70% (95% CI (66.6%, 73.4%)). Factors such as age <18 years (AOR 2.55; 95% CI (1.77, 3.68)), long duration of menstrual flow (AOR 2.72; 95% CI (1.42, 5.17)), irregular menstrual cycle (AOR 2.39; 95% CI (1.68, 3.41)), family history of dysmenorrhea (AOR 2.46; 95% CI (1.67, 3.64)) and skipping breakfast (AOR 1.62; 95% CI (1.13, 2.33)) were associated with primary dysmenorrhea.

Conclusion

The prevalence of primary dysmenorrhea was high among high school students in the study area. Being younger age, long menstrual flow duration, irregular monthly menstrual cycle, family history of dysmenorrhea, and skipping breakfast were determinants of primary dysmenorrhea.

The effects of Rosa foetida extract along with self-care education on primary dysmenorrhea: study protocol for a randomized clinical trial

Background

Dysmenorrhea is one of the most common disorders among young women. Medicinal herbs are one of the alternative methods for the treatment of dysmenorrhea. This study will investigate the effect of Rosa foetida extract, along with self-care behavior education on primary dysmenorrhea among female students of Babol University of medical sciences.

Methods/design

A randomized clinical trial will be performed on single students, aged 18 to 24 years. The research samples will be divided into three groups. The students will receive self-care behavior education on dysmenorrhea. Following the education, two of the groups will receive Rosa foetida extract capsules and placebo capsules in two consecutive cycles every 8 h for two successive days, respectively. The capsules will have similar physical appearance. The third group will not receive any medication. Data will be collected through demographic characteristic questionnaire, visual analog scale, dysmenorrhea self-care behaviors scale questionnaire, pictorial chart, and menstrual distress scale questionnaire. In order to determine and compare the effect of pharmacological and educational interventions on the severity of dysmenorrhea in groups, an ANOVA analysis of variance test with repeated measures will be used by SPSS software version 22.

Discussion

The results will show the effects of Rosa foetida extract along with self-care behavior education on primary dysmenorrhea, and beneficial effects that may be found in the trial of this plant may be of use for women with the same problem.

Ethics and dissemination

The study is approved by the Ethics Committee of Babol University of Medical Sciences (IR.MUBABOL.REC.1397.059).

Trial registration

IRCT 20190318043086N1. Registered on 14 June 2019.

Diagnostic value of oxidative stress markers in patients presenting with primary dysmenorrhea to the emergency department

Background and Aim

Primary dysmenorrhea (PD) is a common presentation for emergency departments. This study investigates the diagnostic value of oxidative stress and ischemia markers in patients with PD.

Materials and Methods

The participants were classified into the PD group (patients with PD) and the control group (healthy volunteers). Thiol/Disulfide Homeostasis (TDH) parameters (Ds, Disulfide; NT, Native Thiol; TT, Total Thiol) and serum ischemia modified albumin (IMA) levels of the groups were measured. The Numeric Rating Scale (NRS) was used for pain assessment. Bivariate correlation analysis was performed to test the relationship between NRS and oxidative stress parameters. A P < 0.05 was considered significant.

Results

A total of 135 patients (PD group, n = 83; Control group, n = 52) were included in the study. PD group had statistically higher oxidant biomarkers (Ds level, Ds/NT ratio and Ds/TT ratio) and lower antioxidant biomarkers (NT/TT ratio) compared to the control group (p = 0.001; 0.003; 0.002, and 0.002, respectively). Serum IMA level in the PD group was higher than in the control group (P = 0.000). There was a positive correlation between IMA and NRS score (r = 0.342, P < 0.01), but no correlation was found between the other oxidative stress parameters and NRS.

Conclusions

PD is characterized by increased oxidative stress and ischemia in the endometrium, which can be detected by TDH parameters and serum IMA. NRS score in PD patients is positively correlated with serum IMA level, which suggests IMA level can be valuable to determine the severity of endometrial ischemia and pain in patients with PD.

Prevalence of Dysmenorrhea and Associated Factors Among Haramaya University Students, Eastern Ethiopia

Purpose

Dysmenorrhea is the most common gynecological problem among adolescents and a common cause of school absenteeism. Previously, there was no study conducted on prevalence of dysmenorrhea and associated factors among university students in Ethiopia. Therefore, the aim of this study was to assess prevalence and associated factors of dysmenorrhea among Haramaya university undergraduate regular students in Eastern Ethiopia.

Materials and Methods

An institution-based cross-sectional study design was conducted from February to March 2020. A multistage random sampling technique was applied and a total of 569 participants were included into the study. The total sample size was proportionally allocated based on the total number of students in each departments, and simple random sampling technique was employed to select participants. The data were entered to EPI‑info version 3.5.4 and then exported to Statistical Package for Social Science version 23.0 software for analysis. The associations between independent variables and outcome variable were explored using bivariate and multivariable logistic regression models. The results of these analysis were reported as odds ratios with 95% confidence intervals.

Results

The prevalence of dysmenorrhea in this study was 356 (64.7%) 95% CI [60.7%, 68.7%]. Premenstrual syndrome (AOR = 5.20:95% CI [2.82, 9.61]), early menarche (AOR = 4.67:95% CI [2.33, 9.37]), history of anxiety (AOR = 4.08:95% CI [2.31, 7.19]), taking of ≥4 glass of tea per day (AOR = 5.69:95% CI [1.49, 21.77]), usually eating fat and oil (AOR = 2.03:95% CI [1.15, 3.59]) and usual use of meat food (AOR = 3.61:95% CI [2.03, 6.39]) were positively and independently associated with the occurrence of dysmenorrhea.

Conclusion

Dysmenorrhea was a common problem among Haramaya University female students. History of anxiety, early menarche, premenstrual syndrome, tea consumption, usual use of fat and oil containing food and usual use of meat food were significantly associated to dysmenorrhea. We recommend Haramaya University to provide accessible and appropriate medical treatment and counseling service for dysmenorrhea affected students.

Dysmenorrhea and associated symptoms in Ethiopia: A systematic review and meta-analysis

Introduction:

Dysmenorrhea is the most common gynecologic compliant and reproductive health problem among adolescents, young, and reproductive age group. Dysmenorrhea has psychological, physical, and behavioral impact on adolescent girls in different regions.

Objective:

This systematic review and meta-analysis aimed to assess the overall prevalence of dysmenorrhea, its pain intensity and associated symptoms in Ethiopia and compare with other countries.

Methods:

Literatures from PubMed, MEDLINE, EMABSE, CINHAL, SCOPUS, Hinari, Africa journals, and Google scholar were retrieved. Eligible cross-sectional studies were included for meta-analysis. I2 statistics was calculated to check heterogeneity. Subgroup analysis based on outcome of interest was performed. Sensitivity analysis was undertaken to examine the level of heterogeneity.

Results:

The prevalence of overall and primary dysmenorrhea in Ethiopia was 72% (95%CI 68–77) and 72.27% (95%CI 69.8–75.33) respectively. Back pain 56.62% (95%CI 46.68–66.57) and fatigue 51.51% (95%CI 40.08–62.94) were more common than headache 29.15% (95%CI 18.16–40.14) whereas moderate pain 41.03% (95%CI 33.98–48.07) was more common than mild 31.83% (95%CI 21.61–42.05) and severe pain intensity 21.57% (95%CI 14.24–28.89). The prevalence between small and large samples, Northern and South/West Ethiopia, and school girls and university students were nearly similar. Positive family history (OR = 4.05; 95%CI 3.15–5.20), early menarche (OR = 2.91; 95%CI 2.00–4.24) and irregular monthly menstrual cycle (OR = 1.87, 95%CI 1.23–2.84) were the predictors of dysmenorrhea.

Conclusion:

Compared with other countries, the prevalence of dysmenorrhea in Ethiopia is moderate, presenting as mainly back pain and fatigue with moderate pain intensity. Positive family history, early menarche, and irregular menstrual cycle are the positive contributing factors.

Prevalence of dysmenorrhea among reproductive age group in Saudi Women

BACKGROUND

The condition of recurrent, crampy, lower abdominal pain during menses is defined as dysmenorrhea. The study aims to assess the factors affecting the prevalence of primary and secondary dysmenorrhea among Saudi women from the reproductive age group.

METHODS

A cross-sectional survey-based study recruited 1199 participants through a systematic random sampling technique. The study was carried out among the reproductive age group in Saudi women (total number of 1199) who are more than 18-year-old and less than 45-year-old in Riyadh, King Dom of Saudi Arabia, using an electronic questionnaire.

RESULTS

The observed dysmenorrhea in the study; 1107 (92.3%) women had non-pathological dysmenorrhea (primary) while 92 (7.7%) women had pathological dysmenorrhea (secondary) respectively.

CONCLUSION

In the present study, the prevalence of dysmenorrhea was high among the recruited Saudi women. The study suggests the inclusion of health education programs for students at the school and university level to deal with problems associated with dysmenorrhea that limit their interference with the student's life.

Prevalence of dysmenorrhea and associated factors among students in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Dysmenorrhea is one of the most common gynecological complaints among adolescent women. It has been associated with short-term absenteeism in school and has a negative impact on academic and daily activities. Therefore, the aim of the study was to show the evidence on the magnitude and correlates of dysmenorrhea in Ethiopia.

METHOD

In this systematic review and meta-analysis, we searched the literature from different databases such as PubMed/Medline, Science Direct, PsycINFO, and Cochrane library. We also used unpublished literature from Google, Google Scholar. The quality of the included articles was assessed using the Newcastle-Ottawa Scale. Data were extracted using a Microsoft Excel data extraction format. STATA version 14 statistical software was used for data analysis. To assess the heterogeneity of the primary articles, the Cochrane Q test statistics and the I² test were carried out. Publication bias was inspected by funnel plot, and Egger's test was performed to confirm the presence of publication bias. A random-effects meta-analysis was used to estimate the pooled prevalence of dysmenorrhea and its associated factors.

RESULT

A total of 12 studies were included in the final meta-analysis. The pooled prevalence estimate of dysmenorrhea among female students in Ethiopia is 71.69% (66.82%-76.56%). In our systematic review, among factors associated with dysmenorrhea, the family history of dysmenorrhea was frequently reported in included studies. Therefore, dysmenorrhea was significantly associated with a family history of dysmenorrhea (adjusted odds ratio = 4.69 (95% confidence interval: 2.80-7.85)).

CONCLUSION

The pooled prevalence estimate of dysmenorrhea among students was much higher in Ethiopia. Health professionals and teachers should educate and support students to follow their menstrual cycle regularly in the event of irregular periods. There should be an awareness of the negative consequences of dysmenorrhea to reduce the physical and psychological stresses that affect women and their families.

The Effect of Aromatherapy Alone or in Combination with Massage on Dysmenorrhea: A Systematic Review and Meta-analysis

OBJECTIVE

 The aim of the present systematic review meta-analysis is to assess the effect of olfactory stimulation on reducing dysmenorrhea. METHODS:  Systematic search was conducted in several databases, such as PubMed, Web of Science, Cochrane, and Scopus, to identify relevant research up to October 26, 2019. The identified studies were evaluated based on a modified Jadad scale. The intervention involves aromatherapy alone or in combination with essential oils. There was no restriction for the control group such as a placebo group or other common treatments. The Comprehensive Meta-Analysis Version 2 (Bio stat, Englewood, NJ, USA) was used for meta-analysis. Cochran's Q and I2 tests were utilized.

RESULTS

 The findings of our meta-analysis, which contained 13 trials (15 data), showed that dysmenorrhea decreased significantly in the group receiving aromatherapy with herbal compared with the control group (standardized mean difference [SMD] = -0.795; 95% confidence interval [CI]: -0.922 to- 0.667; 17 trials O < 0.001); heterogeneity; I2 = 19.47%; p = 0.236). In addition, four studies with insufficient data were not included in our meta-analysis. The results of all studies suggested that aromatherapy with herbal medicine group compared with control group is effective.

CONCLUSION

 Aromatherapy with herbal medicine decreased dysmenorrhea. This treatment was particularly effective when aroma oil was combined with massage or when a mixture of aroma oil was used for the treatment of dysmenorrhea.

Prevalence of Dysmenorrhea and Determinants of Pain Intensity Among University-Age Women

OBJECTIVE

The study was conducted to determine the prevalence of dysmenorrhea and investigate factors associated with dysmenorrhic pain among university students in Lahore, Pakistan.

DESIGN AND SETTING

A cross-sectional study was conducted across various public and private sector universities in Lahore.

METHODS

A self-administered structured questionnaire was used to collect data from 600 randomly selected female university students.

RESULTS

The prevalence of dysmenorrhea was 91.5%. Age at menarche (odds ratio [OR] = 1.96, 95% confidence interval [CI] = 1.10-3.50) was the only significant factor associated with dysmenorrhea. The mean pain severity score among dysmenorrhic students was 5.62 ± 2.28. Most of the participants (65.8%) were experiencing moderate/severe pain. Univariate analysis showed that irregular cycle (OR [95% CI] = 1.62 [1.13-2.33]), age at menarche of ≤14 years (OR [95% CI] = 1.46 [1.05-2.04]), duration of menses of more than 5 days (OR [95% CI] = 1.42 [1.02-1.99]), stress (OR [95% CI] = 2.16 [1.54-3.03]), moderate meat/protein consumption (OR [95% CI] = 1.55 [1.08-2.21]), and medical specialization (OR [95% CI] = 1.72 [1.17-2.52]) were significantly associated with pain severity among dysmenorrhic female students. Multivariate binary logistic regression analysis revealed that medical specialization (OR [95% CI] = 1.83 [1.22-2.73]), age at menarche (OR [95% CI] = 0.603 [0.42-0.86]), regularity of menses (OR [95% CI] = 1.52 [1.04-2.22]), moderate meat/protein consumption (OR [95% CI] = 1.69 [1.16-2.45]), and stress (OR [95% CI] = 1.87 [1.32-2.66]) were independent predictors of moderate/severe dysmenorrhic pain.

CONCLUSION

The study revealed an alarmingly high prevalence of dysmenorrhea among university students. High levels of stress and early menarche were the potent determinants of moderate/severe dysmenorrhea that disturbs quality of life.

Expenditure on complementary and alternative medicine and productivity losses in patients with primary dysmenorrhea: a survey of women in Korea

In women with primary dysmenorrhea (PD), the use of complementary and alternative medicine (CAM) and productivity losses at both workplaces and schools have not been comprehensively assessed. In this study, researchers evaluated the disease burden in women with PD in patients' perspective in two categories: direct cost (the use of CAM and associated costs) and indirect cost (productivity losses). Women with PD aged 16-49 years were asked to fill an online survey in 2017. The survey consisted of 49 questions. CAM included traditional Korean medicines, over-the-counter products, dietary supplements, and traditional remedies. All costs were expressed in US dollars in this study. The survey data from 86 patients with PD were analyzed. The total mean annual cost per patient with PD was $4053, comprising direct costs ($1245) and indirect costs ($2807). PD causes considerable expenditure on CAM and impairs work productivity (especially in presenteeism).

Prevalence of dysmenorrhoea, associated risk factors and its relationship with academic performance among graduating female university students in Ethiopia: a cross-sectional study

OBJECTIVES

The study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.

DESIGN AND METHOD

Institution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.

SETTING AND PARTICIPANTS

Ethiopia (2019: n=647 female university students).

OUTCOMES

The primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.

RESULTS

The prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).

CONCLUSIONS

Dysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.

Primary dysmenorrhea in adolescents: Association with attention deficit hyperactivity disorder and psychological symptoms

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.

Effects of a dietary modification intervention on menstrual pain and urinary BPA levels: a single group clinical trial

BACKGROUND

Exposure to endocrine-disrupting chemicals (EDCs) occurs mainly through dietary intake. Due to current lifestyle trends, young people tend to consume fast food, to use disposable products, and to utilize convenient household items, all of which are major sources of EDCs. This study aimed to investigate the effects of a dietary modification intervention on menstrual pain and urinary bisphenol A (BPA) levels throughout three menstrual cycles in female college students who experienced severe menstrual pain. We also analyzed participants' adherence to the intervention and examined whether their level of adherence was associated with differences in the effects of the intervention.

METHODS

A single-group pretest and repeated posttest experimental design was employed. Thirty female college students with a score of 5 or higher on a menstrual pain scale were recruited through convenience sampling. During three menstrual cycles, menstrual pain was scored on a 10-point scale after each cycle, and urinary BPA levels were measured from the first morning urine collected after each cycle. The intervention involved three components: small-group education, follow-up monitoring, and peer support via social network communication. Statistical analyses were conducted using Friedman one-way repeated-measure analysis of variance by ranks, non-parametric two-way analysis of variance, and the Wilcoxon signed-rank test as a post-hoc test.

RESULTS

The dietary modification intervention had significant effects on menstrual pain at all three time points of menstrual cycles (χ2 = 119.64, p = 0.000) and on urinary BPA levels until the 2nd menstrual cycle (χ2 = 205.42, p = 0.000). Slightly fewer than half (43.3%) of the participants were highly adherent. Menstrual pain differed according to adherence level (F = 4.67, p = 0.032) and decreased over time through the third cycle post-intervention (F = 18.30, p = 0.000). Urinary BPA levels also decreased significantly (F = 7.94, p = 0.000), but did not differ according to adherence level.

CONCLUSIONS

The dietary modification intervention was effective and sustainable for reducing menstrual pain and urinary BPA levels. Detailed information about EDCs and dietary experiences seemed to encourage the young women to become more concerned about EDCs and to perform self-protective actions. Further experimental research is suggested to examine the relationships of EDCs with various health indicators in women.

TRIAL REGISTRATION

KCT0005472 at 2020-9-24 retrospectively registered.

Effect of fennel on primary dysmenorrhea: a systematic review and meta-analysis

BACKGROUND

One of the most common complaints for women is dysmenorrhea. Several studies investigated the treatment effects of medicinal plants on primary dysmenorrhea.

OBJECTIVES

This systematic review and meta-analysis investigates the effect of Foeniculum vulgare (Fennel) on pain in primary dysmenorrhea in comparison to non-steroidal anti-inflammatory drugs such as mefenamic acid.

METHODS

PubMed, EMBASE, EBSCO Web of Science, Scopus, Cochrane library, Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, ProQuest, ISI Web of Science, Google Scholar, Magiran, SID, Iran Medex, and Irandoc were searched up to January 2019. Quality assessment of clinical trials was conducted using Jadad scoring system. Totally, 12 studies were entered in the meta-analysis. I ² was calculated to determine heterogeneity. Fixed effects and/or random effects models were applied.

RESULTS

Meta-analysis of these trials showed that F. vulgare intake decreased significantly the intensity of dysmenorrhea compared to the placebo (SMD -0.632; CI: -0.827 to -0.436; p<0.001; heterogeneity p=0.807; I ²=0%; fixed effect model; seven articles). However, the effect of Mefenamic acid with F. vulgare was not different from each other (SMD=-0.214; CI: -0.446 to 0.017; p=0.07; heterogeneity p=0.58; I ²=0%; fixed effect model; six trials).

CONCLUSION

The F. vulgare alleviates dysmenorrhea. Regarding the same effect of F. vulgare with NSAIDs, it is highly recommend to the women suffered from dysmenorrhea specifically the ones who have high tendency toward herbal medicine.

Role of vitamin D and calcium in the relief of primary dysmenorrhea: a systematic review

Dysmenorrhea is one of the well-established problems among women of reproductive age and can have adverse effects on the quality of life of the individual. Some studies suggest a relationship between vitamin D (Vit D) and calcium deficiency and the emergence of early dysmenorrhea. Accordingly, a systematic study was performed to investigate the role of calcium and Vit D in the relief of primary dysmenorrhea. A systematic literature search was performed in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar for papers published between 2010 and 2020. The Consolidated Standards of Reporting Trials and Strengthening the Reporting of Observational Studies in Epidemiology checklists were used to assess the quality of the studies. The risk of bias was assessed using the Cochrane risk-of-bias assessment tool. Low calcium levels lead to an increase in uterine muscle contraction and can cause pain after decreased uterine blood flow. Furthermore, low levels of Vit D can increase primary dysmenorrhea by increasing prostaglandin production or reducing intestinal calcium absorption. That being the case, Vit D and calcium intake can be effective in reducing the severity of primary dysmenorrhea and in reducing the rate of analgesic use. Low levels of Vit D and calcium are inversely related to the severity of primary dysmenorrhea, and Vit D and calcium intake can reduce the severity of primary dysmenorrhea and its associated systemic symptoms. Therefore, the use of calcium and Vit D supplements can be recommended to relieve dysmenorrhea.

Living with Restrictions. The Perspective of Nursing Students with Primary Dysmenorrhea

Primary dysmenorrhea (PD) affects a large number of female university students, diminishing their quality of life and hindering academic performance, representing a significant cause of absenteeism. The purpose of our study was to determine how nursing students experienced restrictions as a result of primary dysmenorrhea. A qualitative exploratory study was conducted among 33 nursing students with primary dysmenorrhea. A purposeful sampling strategy was applied. Data were collected from five focus groups (two sessions each) and the field notes of 10 researchers. A video meeting platform was used to conduct the focus groups. A thematic inductive analysis was performed. Thirty-three female nursing students participated in the study with a mean age of 22.72 (SD 3.46) years. Three broad themes emerged: (a) restrictions on daily activities and sports; (b) academic restrictions, and (c) restrictions on social and sexual relationships. The students described restrictions in performing everyday activities, such as carrying weight, and shopping. Some students even gave up the practice of sports and were absent from classes at the university, and from clinical practices at the hospital. The pain affected their ability to maintain and create new social relationships. Primary dysmenorrhea caused restrictions in the personal, social and academic life of the nursing students.

Efficacy and Safety of Intravenous Tramadol versus Intravenous Paracetamol for Relief of Acute Pain of Primary Dysmenorrhea: A Randomized Controlled Trial

INTRODUCTION

Many pharmaceutical, surgical, and complementary medical interventions are used for primary dysmenorrhea treatment. However, no consensus has been reached about the most effective intervention.

OBJECTIVE

To compare the efficacy and safety of IV tramadol versus IV paracetamol in relieving acute pain of primary dysmenorrhea.

METHODS

This randomized controlled trial was conducted in a tertiary referral hospital and included 100 patients between 18 and 35 years old diagnosed with primary dysmenorrhea. Patients received either 1-g paracetamol or 100-mg tramadol in 100-mL normal saline as an IV infusion over 10 min. Pain intensity was measured by using a visual analog scale at 15, 30, 60 min, and 2 h. We recorded drug side effects and requirements for rescue analgesics.

RESULTS

Pain scores were significantly lower in the tramadol group compared with the paracetamol group at 15, 30, 60 min, and 2 h (p < 0.001). Fewer patients in the tramadol group needed rescue analgesics compared with the paracetamol group (p = 0.04). No significant differences were reported in side effects between both groups.

CONCLUSIONS

IV tramadol is superior to IV paracetamol in relieving acute pain of primary dysmenorrhea with a comparable side effect profile.

Menstrual Problems and Lifestyle among Spanish University Women

Menstrual problems affect many young women worldwide, conditioning both their academic performance and quality of life. This study sought to analyse the prevalence of menstrual problems and their possible relationship with lifestyle among Spanish university women, as part of a research project (UniHcos Project) involving a cohort of 11 Spanish universities with 7208 university students. A descriptive analysis was performed using the bivariate chi-square test and the Student’s t-test together with a binary logistic regression, in which the dependent variable was ‘suffering from menstrual problems’. Menstrual problems were identified in 23.8% of the students, representing women who paid more visits to the doctor and to emergency rooms, and who consumed more painkillers and contraceptives. In relation to dietary preferences, menstrual problems were 1.39 (CI 95% 1.22–1.61; p = 0.000) times more likely among women classified as high-risk alcohol users according to the AUDIT questionnaire, and 1.187 (CI 95% 1.029–1.370; p = 0.019) times greater among those who consumed sweets daily, 1.592 (CI 95% 1.113–2.276; p = 0.011) times more frequent among those who eat fish daily, and 1.199 (CI 95% 1.004–1.432; p = 0.045) times greater among those who were dieting. Menstrual problems affect many college students and potentially modifiable lifestyle variables exist which may influence their prevalence. It would be interesting to develop programmes to promote women’s health in the university context.

Living with Pain and Looking for a Safe Environment: A Qualitative Study among Nursing Students with Dysmenorrhea

Dysmenorrhea refers to chronic pain associated with menstruation that is often accompanied by other symptoms. Primary dysmenorrhea (PD) occurs without any associated pelvic disease. Nonetheless, it may negatively affect women's quality of life. Among university students, dysmenorrhea decreases academic performance and is a cause of absenteeism. The purposes of our study were to describe how nursing students experienced PD and the changes affecting their body and mood. A qualitative case study was performed among 33 nursing students with PD. Data were collected through five focus groups (with two sessions each) and 10 researchers' field notes. We used a video meeting platform to conduct the focus groups. A thematic analysis was performed, and the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines were followed. Three main themes emerged from the data: (a) living with dysmenorrhea, with two subthemes: menstruation and pain; (b) body changes and mood swings; and (c) seeking a safe environment, with three subthemes: safe environment, unsafe environment, and key safety aspects. Students considered menstruation to be negative and limiting, causing physical and mood changes, making them feel less attractive, and conditioning their way of dressing and relating.

Intradermal acupuncture for primary dysmenorrhea: A protocol of systematic review and meta-analysis of randomized clinical trials

BACKGROUND

Primary dysmenorrhea (PD) is one of the common gynecological diseases, the incidence of PD is on the rise and young women are more likely to have it, which seriously affects women's physical, mental health and work life. Intradermal acupuncture is effective in treating PD. However, due to the lack of evidence, there is no specific method or suggestion, so it is necessary to carry out systematic evaluation on intradermal acupuncture and provide effective evidence for further research.

METHODS

We will search the following electronic databases from their inception to July 2020: Electronic database includes PubMed, Embase, Cochrane Library, Chinese Biomedical Database WangFang, VIP medicine information, and CNKI (China National Knowledge Infrastructure). Primary outcomes: the overall effective rate, VAS score.

SECONDARY OUTCOMES

blood serum estradiol (E2), progesterone (P), prostaglandin F2α (PGF-2α), adverse events Data will be extracted by 2 researchers independently, risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3. and Stata V.12.0.

RESULTS

The results of this study will systematically evaluate the effectiveness and safety of intradermal acupuncture in the treatment of primary dysmenorrhea.

CONCLUSION

The systematic review of this study will summarize the currently published evidence of intradermal acupuncture therapy for primary dysmenorrhea to further guide its promotion and application.

Management of Primary Dysmenorrhea among University Students in the South of Spain and Family Influence

The present study analyses the management of primary dysmenorrhea by university students in the south of Spain. In this cross-sectional observational study, 224 women participated, using an ad hoc self-report questionnaire about menstrual pain and self-care and including sociodemographic and gynecological variables. Some 76.8% of participants consumed analgesics and the majority self-medicated with non-steroidal anti-inflammatory drugs (NSAIDs) without consulting a health professional, with a correlation between pain intensity and the number of pills ingested during menstruation (r = 0.151, p < 0.05). The higher proportion of women who found their analgesia effective were those who took medication after being prescribed by a health care provider (60.8%) compared to those who self-medicated (40%; p < 0.01). Only 43.8% employed non-pharmaceutical methods, most commonly antalgic positions, massages and local heat. These choices were not related to the intensity of menstrual pain nor with the severity of the dysmenorrhea, nor did these most common methods prove to be the most effective. However, a higher percentage of women using non-pharmacological methods was identified in women with family members suffering from dysmenorrhea (73.2%) compared to those without (60%; p = 0.040), which may indicate that the choice of remedies is more related to learning self-care in the family context. This study identifies the need for education on self-care and management of menstrual pain.

Dysmenorrhea and Associated Factors among Polish Women: A Cross-Sectional Study

Purpose

The aim of the research was to conduct an assessment of the prevalence of dysmenorrhea and associated factors among Polish women. Patients and Methods. A cross-sectional study was conducted among Polish women using an online questionnaire. The mean age of the participants was 23 ± 4 years. Out of the total of 1,317 women who took part in the study, 1,127 were included in the analysis, and 190 were excluded due to incomplete answers. The questionnaire consisted of 19 questions that were grouped into three parts. The first concerned sociodemographic data such as age, weight, education, and residence (urban or rural). The second part of the questionnaire pertained to the factors of dysmenorrhea (premenstrual syndrome, age of menarche, and family history of dysmenorrhea.). In the third part, the women were asked about their diet, alcohol intake, cigarette smoking, and physical activity.

Results

Dysmenorrhea affected 94% of the interviewed women. Dysmenorrhea was most likely to occur among respondents whose mothers had a history of dysmenorrhea (p < 0.005). Significant relationship between the occurrence of dysmenorrhea among respondents and their sisters was also observed (p < 0.005). The prevalence of premenstrual syndrome (PMS) was significantly higher in women reporting dysmenorrhea (p < 0.005). Other significant factors associated with dysmenorrhea were age of menarche (p < 0.005), stress frequency (p=0.005), lack of physical activity (p=0.037), and self-esteem (p=0.042). However, in the respondents, no significant relationship was observed between dysmenorrhea and diet, smoking, body mass index, and alcohol intake.

Conclusion

The study points to the fact that the problem of dysmenorrhea affects many Polish women. Women with dysmenorrhea were characterized with a family history of dysmenorrhea, occurrence of PMS, early age of menarche, stressful lifestyle, lack of physical activity, and low self-esteem. We suggest that further assessment of factors contributing for dysmenorrhea among women is necessary.

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.

Prevalence and Risk Factors Associated with Primary Dysmenorrhea among Chinese Female University Students: A Cross-sectional Study

STUDY OBJECTIVE

To examine prevalence and risk factors associated with primary dysmenorrhea among Chinese female university students in Hunan province, China.

DESIGN

A cross-sectional study.

SETTING

Female university students in Changsha city, Hunan province, China.

PARTICIPANTS

Four thousand six hundred six female individuals selected using a multistage cluster random sampling method.

INTERVENTIONS

A self-administered questionnaire, which included sociodemographic information, lifestyle habits, emotional characteristics, and menstruation pattern, was used to collect data.

MAIN OUTCOME MEASURES

Information about menarche, body mass index, cycle length and regularity, primary dysmenorrhea, physical exercise, depression, and anxiety.

RESULTS

The prevalence of primary dysmenorrhea was 41.7% (1921/4606) among Chinese female university students. Multivariate binary logistic regression indicated that being a minority (odds ratio [OR], 1.335; 95% confidence interval [CI], 1.083-1.646), underweight (OR, 1.249; 95% CI, 1.08-1.42), annual household income less than 80,000 CNY (OR, 1.169; 95% CI, 1.018-1.342), maternal history of dysmenorrhea (OR, 2.553; 95% CI, 2.236-2.915), age at menarche younger than 12 years (OR, 1.161; 95% CI, 1.013-1.329), irregular menstrual cycle (OR, 1.216; 95% CI, 1.063-1.391), and skipping breakfast (OR, 1.294; 95% CI, 1.124-1.490) were associated risk factors of primary dysmenorrhea.

CONCLUSION

The prevalence of primary dysmenorrhea among Chinese university students is relatively high. Various risk factors were identified that associated with primary dysmenorrhea. More effort and attention should therefore be directed toward this health problem in China.

Prevalence of primary dysmenorrhea, its intensity, impact and associated factors among female students' at Gondar town preparatory school, Northwest Ethiopia

BACKGROUND

Primary dysmenorrhea is defined as a crampy pain in the lower abdomen before or during the menstrual period in the absence of any pelvic pathology. It is the leading motherhood problem worldwide but there is limited evidence on the prevalence of primary dysmenorrhea in the study area as well in Ethiopia. Researching primary dysmenorrhea helps to focus on the treatment plan. The study aimed to assess the prevalence, intensity, impact, and associated factors of primary dysmenorrhea among female students at Gondar town preparatory school.

METHODS

A cross-sectional study design conducted among female students at Gondar town Preparatory School from May 1-10/2017. A total of 459 study participants were used. A simple random sampling technique was used to select study participants. A self-administered structured questionnaire was employed. Epi Info version 7 and SPSS version 20 were used for data entry and analysis respectively. A binary logistic regression model was computed. Variables having a p-value < 0.05 in the multivariate logistic regression model were considered as statistically significant.

RESULTS

A total of 459 female students participated in the study with a response rate of 96.29%. The prevalence of primary dysmenorrhea among female students was found to be 64.7% (95% CI; 60.2-69.2%). Around 61% reported moderate intensity of menstrual pain and 50.7% complain about lower abdominal pain. Sixty-five percent of study participants reported that absenteeism from school was the impact of menstrual pain. Having irregular monthly menstrual cycle (AOR = 1.70, 95% CI; 1.02, 2.84) and positive family history of dysmenorrhea (AOR = 5.19, 95% CI: 3.21, 8.37) were significantly associated with primary dysmenorrhea.

CONCLUSIONS

The prevalence of primary dysmenorrhea was found to be high. Having an irregular monthly menstrual cycle and a positive family history of dysmenorrhea were determinants of primary dysmenorrhea.

Socioeconomic factors and lifestyle affecting the variability of menstrual cycle characteristics in women from Central Poland

Regularity, length of the cycle and duration of menstrual flow are a reflection of women health. The purpose of the research was to assess the relationships between socioeconomic status, cycle length, duration of menses, regularity and dysmenorrhea. A survey was conducted among 896 healthy women from Łódź and Warsaw (Poland), aged 15.71–26.98. Women who were menarche at least 3 years ago were asked to complete the survey. Women were asked about cycle length (number of days), duration of menstrual flow, regularity of the cycle, dysmenorrhea, birth place, parental education level, attendance at physical education classes, participation in additional sports activities, self-assessment of stress levels at home and at school/university, and smoking. For data analysis, t-test, analysis of variance, and chi-square were used, and p<0.05 was considered to be statistically significant. There were no significant relationships between the mean cycle length, regularity and the environmental factors, except for differences in the average length of the menstrual cycle in women from Łódź who attend additional sports activities. Women who are more physically active are characterized by a shorter menstrual cycle. In terms of the length of the menstrual flow, daughters of better educated fathers were characterized by longer menses. In contrast, dysmenorrhea was associated with longer menstrual periods and longer menstrual bleeding, as well as with higher levels of stress, both at home and at school. Environmental factors affected the features of menstruation cycles in women from Central Poland.

Absenteeism during Menstruation among Nursing Students in Spain

Absenteeism can clearly have a negative impact on academic performance among university students. Certain experiences or symptoms such as menstrual pain are very common in women and can lead to absenteeism. The current study was aimed at examining the presence of menstrual experiences or symptoms and their impact upon absenteeism among healthy (illness-free) female university nursing students in Spain. A total of 299 students participated in this research, which was a descriptive cross-sectional, observational study. An ad hoc online questionnaire was used based on sociodemographic and gynecological data, together with the noted menstrual experiences; the most prevalent of which were bloating, which affected 87.3% of students; dysmenorrhea and irritability, which affected 76.3%; and fatigue, which affected 70.6%. Students with dysmenorrhea had a 6.95 higher (odds ratio (OR) 6.95; 95% confidence interval (CI) 3.39-14.25) odds of absenteeism; in those who reported dizziness, the odds of absenteeism was 4.82 times higher (OR 4.82; 1.76-13.23); in those who manifested nausea and vomiting, the percentage of absenteeism was 3.51 higher (OR 3.51; 95% CI 1.51-8.15); in those who presented sleep alterations, the odds were 2.95 higher (OR 2.95; 95% CI 1.39-6.25); and for those who felt depressed the odds were 2.18 times higher (OR 2.18; 95% CI 1.21-3.94) Absenteeism was found to be more likely in women with dysmenorrhea. However, in addition, higher odds of absenteeism were also found in women with nausea and vomiting, dizziness, sleep disorders, and those who feel depressed. These menstrual experiences can be considered a relevant problem among young women, leading to absenteeism, and a negative influence on academic performance. It is essential to raise awareness of the socioeconomic impact of absenteeism and establish new strategies for improving menstrual experiences.

Stroke risks in women with dysmenorrhea by age and stroke subtype

BACKGROUND

Dysmenorrhea and stroke are health problems affecting women worldwide in their day-to-day lives; however, there is limited knowledge of the stroke risk in women with dysmenorrhea, and there have been no studies assessing the specific distribution of stroke subtypes. This case-control study assessed stroke subtypes by age and the role of comorbidities in women with dysmenorrhea.

METHODS AND FINDINGS

Data obtained between 1997 and 2013 from Taiwan's health insurance database identified 514 stroke cases and 31,201 non-stroke controls in women with dysmenorrhea aged 15-49 years. Proportional distributions of subtypes and odds ratios (ORs) of stroke associated with comorbidities by age and subtype were measured. We found that the stroke risk in dysmenorrheal patients increased with age, and that hypertension was nine-fold more prevalent in the stroke cases than in the controls and was associated with an adjusted OR of 4.53 (95% confidence interval (CI) = 3.46-5.92) for all stroke cases. Moreover, the proportion of hemorrhagic stroke was greater than that of ischemic stroke in younger dysmenorrheal patients between 15-24 years old (50.5% vs. 11.4%), whereas this was reversed in those aged 30-49 years old (16.1% vs. 21.0%). Overall, 25.3% of the stroke cases consisted of transient cerebral ischemia and 31.3% were other acute but ill-defined cerebrovascular diseases, in which the prevalence increased with age for both types of strokes. Hypertension was the comorbidity with the highest OR associated with each subtype stroke; diabetes, hyperlipidemia, arrhythmia, and thyroid disease were also comorbidities that were significantly associated with ill-defined cerebrovascular diseases.

CONCLUSIONS

The stroke type varies by age in dysmenorrheal patients, and hypertension is the most important comorbidity associated with all types of stroke; therefore, more attention for stroke prevention must be paid to women with dysmenorrhea, particularly when combined with comorbidities.

Therapeutic Exercise in the Treatment of Primary Dysmenorrhea: A Systematic Review and Meta-Analysis

BACKGROUND

Dysmenorrhea is a health problem with a high impact on health and society. Some drugs have been shown to be effective at treating dysmenorrhea. Therapeutic exercise is another option for reducing the symptomatology of this health problem, with a low cost and the absence of side effects.

PURPOSE

The purposes of this review were to study the efficacy of physical exercise for pain intensity in primary dysmenorrhea and to assess its effectiveness in decreasing the duration of pain and improving quality of life.

DATA SOURCES

Searches were conducted between February 2017 and May 2017 in the databases Web of Science, Physiotherapy Evidence Database (PEDro), PubMed, Scopus, CINAHL, and Dialnet, using the terms dysmenorrhea, exercise therapy, exercise movement technique, exercise, physical therapy, physical therapy speciality, treatment, primary dysmenorrhea, prevention, etiology, epidemiology, and pain.

STUDY SELECTION

We included randomized controlled trial studies conducted on women who were 16 to 25 years old and had primary dysmenorrhea, studies that included exercise as a type of therapy, studies that assessed the intensity and duration of pain and quality of life, and studies published in English or Spanish. Studies that included women with irregular cycles, women diagnosed with a gynecological disease, women who had had surgery, women with serious diseases, or women who used intracavitary or oral contraceptives were excluded. We started with 455 studies; 16 were included in the systematic review, and 11 were included in the 3 meta-analyses that were carried out.

DATA EXTRACTION

Two authors selected the studies and extracted their characteristics (participants, intervention, comparators, and outcomes) and results. The evaluation of the methodological quality of the studies was carried out by PEDro scale.

DATA SYNTHESIS

There was moderate evidence that therapeutic exercise can be considered a useful tool in the treatment of primary dysmenorrhea in terms of a reduction in pain intensity. Regarding the duration of pain and quality of life, there was low evidence and very low evidence, respectively. In the 3 meta-analyses, the results were significantly positive in favor of exercise for decreases in both the intensity and the duration of pain.

LIMITATIONS

Limitations of this study include the great heterogeneity of the interventions applied in the studies in terms of type of exercise, in combination or alone, and dosage. This review includes a small number of studies with risk of bias, so the present findings must be interpreted with caution.

CONCLUSIONS

Therapeutic exercise reduces pain intensity in patients with primary dysmenorrhea.

The prevalence of primary dysmenorrhea among students and its association with musculoskeletal and myofascial pain

OBJECTIVES

To examine the association between dysmenorrhea and musculoskeletal pain amongst university students aged 20-35 and the association between dysmenorrhea and the occurrence of MTrPs.

METHODS

The study comprised two stages: a cross-sectional study evaluated the association between dysmenorrhea and musculoskeletal pain and a case-control study evaluated the association between dysmenorrhea and the occurrence of MTrPs in the abdominal and pelvic area. Initially, questionnaires such as demographics, menstruation characteristics, Numeric Pain Rating Scale (NPRS), measuring the average pain during menstruation and Nordic, were distributed to female students. Twenty subjects who suffered from menstrual pain of >3 on the NPRS (ones with the highest scores) were included in the second stage as cases. An additional 20 who had not suffered from menstrual pain (NPRS ≤3) were considered controls. All 40 subjects underwent an assessment of MTrPs by two examiners blinded to each other's results and to the group allocation of the subjects.

RESULTS

We found that dysmenorrhea is a very prevalent condition among young female students. Most frequent complaints were: lower abdomen and back pain, tiredness, breast tenderness, mood changes, and an increased appetite. Pain during menstruation indicated a significant positive association with neck, low back, and hip/thigh pain during the last 12 months. The results of the palpitation conclusively showed more active MTrPs in the rectus abdominis, quadratus lumborum and paraspinal muscles in women suffering from pain during menstruation than in those who were not in pain.

CONCLUSION

Our data provide an initial basis for the inclusion of a myofascial examination when evaluating women with dysmenorrhea.

Dysmenorrhea among high-school students and its associated factors in Kuwait

Background

Although dysmenorrhea is not a life-threatening condition, it can cause a substantial burden on individuals and communities. There is no data on the prevalence of dysmenorrhea in Kuwait. This study aimed to estimate the prevalence of dysmenorrhea among female public high-school students in Kuwait and investigate factors associated with dysmenorrhea.

Methods

A cross-sectional study using multistage cluster sampling with probability proportional to size method was conducted on 763 twelfth grade female public high-school students (aged 16–21 years). We used face-to-face interview with a structured questionnaire to collect data on dysmenorrhea and presumed risk factors. Weight and height of the students were measured using appropriate weight and height scales in a standardized manner. The association between dysmenorrhea and potential risk factors was assessed using multiple logistic regression.

Results

The one-year prevalence of dysmenorrhea was found to be 85.6% (95%CI: 83.1–88.1%). Of the participants with dysmenorrhea, 26% visited a public or a private clinic for their pain and 4.1% were hospitalized for their menstrual pain. Furthermore, 58.2% of students with dysmenorrhea missed at least one school day and 13.9% missed at least one exam. Age of menarche (p-value = 0.005), regularity and flow of the menstrual period (p-value = 0.025, p-value = 0.009; respectively), and drinking coffee (p-value = 0.004) were significantly associated with dysmenorrhea in multivariable analysis.

Conclusion

Dysmenorrhea seems to be highly prevalent among female high-school students in Kuwait, resembling that of high-income countries. Because of the scale of the problem, utilizing school nurses to reassure and manage students with primary dysmenorrhea and referring suspected cases of secondary dysmenorrhea is recommended.

Factors associated with pain in the pelvic girdle in pregnant adolescents: A case-control study

BACKGROUND

Due to biological immaturity and unfavorable psychosocial conditions, it is conjectured that teenage pregnancy may be associated with disorders such as pelvic girdle pain. The evidence for risk factors for pelvic girdle pain in pregnant adolescents remains unclear.

OBJECTIVES

To evaluate the factors associated with pelvic girdle pain related to pregnancy in adolescents.

DESIGN

Case-control study.

METHOD

Seventy three pregnant women with presence of pelvic girdle pain (case group) and 331 pregnant women without pelvic girdle pain (control group) aged between 10 and 19 years, with gestational age between 28 and 40 weeks were included.

RESULTS/FINDINGS

A logistic regression model was used to identify factors associated with the occurrence of pelvic girdle pain. The following aspects were considered for the model: sociodemographic, anthropometric, gynecological and obstetrical, related to lifestyle, musculoskeletal and psychosocial factors. The results showed that suspected common mental disorder (OR: 2.27; 95% CI: 1.23 to 4.18), low back pain during menstruation (OR: 2.10; 95% CI: 1.16 to 3.80) and strenuous work (OR: 1.95; 95% CI: 1.13 to 3.35) were associated with pelvic girdle pain among pregnant adolescents.

CONCLUSIONS

Attention must be given to pregnant adolescents with suspected common mental disorder, low back pain during menstruation and strenuous work in order to ensure referral to the appropriate healthcare professional for early prevention of pelvic girdle pain.

A randomized comparative study of herbal decoction of Cassia fistula Linn pod's pericarp and Myristica fragrans Houtt arils vs. mefenamic acid in spasmodic dysmenorrhoea

Background To compare the efficacy and safety of herbal decoction (pods of Cassia fistula Linn. and Arils of Myristica fragrans Houtt) with mefenamic acid in spasmodic dysmenorrhoea. Methods In this single-blind, prospective, parallel, standard controlled study, dysmenorrheic patients (n=64) were randomly allocated to receive herbal decoction (n=31) or mefenamic acid (n=33) for two consecutive menstrual cycles. Treatment group received 180 mL herbal decoction of post amaltas (Cassia fistula L pod's pericarp) (21 g), bisbasah (Myristica fragrans Houtt arils) (3 g) and qand siyah (jaggery) (30 g) which were orally administered at morning for 3 days before the expected start of menstruation. The control group received mefenamic acid 500 mg orally twice daily between day 1 and day 3 of menstruation. The primary outcomes were visual analog scale (VAS) for pain intensity, pain relief scale and the safety assessment by clinical examination and biochemical parameters. The secondary outcomes included health-related quality of life (HRQoL) determined by SF-12 health survey questionnaire, duration of pain and pictorial blood assessment chart score for menstrual blood loss. The data were statistically interpreted with 5% level of significance. Results At the baseline, on day 1, pain severity for VAS score between the groups [7.09 ± 1.07 vs. 6.75 ± 1.09] had no significant difference (p>0.05). However, during the second menstrual cycle, a significant reduction [0.03 + 0.17 vs. 0.42 + 1.44] in pain severity on day 1 was noted in both groups (p<0.001). During the second menstrual cycle, improvement in HRQoL health survey [SF-12 total score: 85.88 ± 5.99 vs 74.83 ± 15.9] and reduction in pain duration were significantly higher in the treatment group compared to the control group. No side effects were reported. Conclusion Herbal decoction was effective to relieve pain and to improve HRQoL in spasmodic dysmenorrhoea.