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Lin KC, Huang KJ, Lin MN, Wang CY, Tsai TY. Vitamin D Supplementation for Patients with Dysmenorrhoea: A Meta-Analysis with Trial Sequential Analysis of Randomised Controlled Trials. Nutrients 2024; 16:1089. [PMID: 38613122 PMCID: PMC11013696 DOI: 10.3390/nu16071089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/01/2024] [Accepted: 04/07/2024] [Indexed: 04/14/2024] Open
Abstract
Vitamin D reduces prostaglandin levels and inflammation, making it a promising treatment option for dysmenorrhoea. However, its effects on pain intensity in different types of dysmenorrhoea remain unclear. We examined whether vitamin D supplementation decreases pain intensity in patients with dysmenorrhoea. The Cochrane Library, Embase, Google Scholar, Medline, and Scopus databases were searched from inception to 30 December 2023. Randomised controlled trials (RCTs) evaluating vitamin D supplementation effects on such patients were included. The primary and secondary outcomes were measured by the changes in pain intensity and rescue analgesic use, respectively. Pooled mean differences and rate ratios were calculated using a random-effect model; trial sequential analysis (TSA) was also performed. Overall, 11 studies involving 687 participants were included. Vitamin D supplementation significantly decreased pain intensity in patients with dysmenorrhoea compared with controls (pooled mean difference, -1.64; 95% confidence interval, -2.27 to -1.00; p < 0.001; CoE, moderate; I2 statistic, 79.43%) and indicated substantial heterogeneity among the included studies. TSA revealed that the current RCTs provide sufficient information. In subgroup analyses, vitamin D supplement reduced primary dysmenorrhoea pain but not secondary dysmenorrhoea pain. In conclusion, although substantial heterogeneity persists, vitamin D supplementation decreased pain intensity in patients with dysmenorrhea, especially in those with primary dysmenorrhoea.
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Affiliation(s)
- Kan-Chu Lin
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
| | - Kuan-Ju Huang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital Yunlin Branch, Yunlin 640203, Taiwan;
| | - Ming-Nan Lin
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Cheng-Yu Wang
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
| | - Tou-Yuan Tsai
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Emergency Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 106319, Taiwan
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Mardon AK, Whitaker L, Farooqi T, Girling J, Henry C, Ee C, Tewhaiti-Smith J, Armour M. Investigational drugs for the treatment of dysmenorrhea. Expert Opin Investig Drugs 2024; 33:347-357. [PMID: 38436301 DOI: 10.1080/13543784.2024.2326627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Dysmenorrhea is the most common cause of gynecological pain among women that has considerable impact on quality of life and psychosocial wellbeing. Non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies are most commonly used to treat dysmenorrhea. However, given these drugs are often associated with bothersome side effects and are less effective when there is an underlying cause contributing to dysmenorrhea (e.g. endometriosis), a patient-centered approach to managing dysmenorrhea is important. Various new drugs are currently being investigated for the treatment of primary and secondary dysmenorrhea. AREAS COVERED This review provides an updated overview on new therapeutic targets and investigational drugs for the treatment of primary and secondary dysmenorrhea. The authors describe the clinical development and implications of these drugs. EXPERT OPINION Among the investigative drugs discussed in this review, anti-inflammatories show the most promising results for the treatment of dysmenorrhea. However, given some trials have considerable methodological limitations, many drugs cannot be currently recommended. Research focused on understanding the mechanisms involved in menstruation and its associated symptoms will be important to identify new therapeutic targets for dysmenorrhea. Further robust clinical trials are required to better understand the efficacy and safety of investigational drugs for treating primary and secondary dysmenorrhea.
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Affiliation(s)
- Amelia K Mardon
- NICM Health Research Institute, Western Sydney University, NSW Australia; IIMPACT in Health, University of South Australia, Australia
| | - Lucy Whitaker
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, UK
| | - Toobah Farooqi
- NICM Health Research Institute, Western Sydney University NSW, Australia
| | - Jane Girling
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Claire Henry
- Department of Surgery & Anaesthesia, University of Otago Wellington Aotearoa, New Zealand
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Australia
| | | | - Mike Armour
- Reproductive Health, NICM Health Research Institute, Western Sydney University, Australia
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Ishikura IA, Hachul H, Tufik S, Andersen ML. Dysmenorrhea and Sleep: A Review. Sleep Med Clin 2023; 18:449-461. [PMID: 38501517 DOI: 10.1016/j.jsmc.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
This review encompasses the clinical features and relevance to investigate sleep in women with dysmenorrhea. Dysmenorrhea is a prevalent gynecologic dysfunction that affects the social and professional lives of women. It can occur at every menstrual cycle, depending on the cause and psychologic factors. Studies have reported poor sleep and insomnia symptoms in dysmenorrhea condition, which may intensify the dysmenorrhea manifestation and interfere negatively to its treatment. There is an urgent need to identify the main cause of this dysfunction and provide efficient treatments to minimize the detrimental effects of dysmenorrhea in quality of life of these women.
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Affiliation(s)
- Isabela A Ishikura
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862 - Vila Clementino - 04023062 - São Paulo - SP - Brazil
| | - Helena Hachul
- Departamento de Ginecologia, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, n° 740 - Vila Clementino - 04023-062 - São Paulo - SP - Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862 - Vila Clementino - 04023062 - São Paulo - SP - Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862 - Vila Clementino - 04023062 - São Paulo - SP - Brazil.
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Sinclair J, Abbott J, Proudfoot A, Armour M. The Place of Cannabinoids in the Treatment of Gynecological Pain. Drugs 2023; 83:1571-1579. [PMID: 37831340 PMCID: PMC10693518 DOI: 10.1007/s40265-023-01951-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/14/2023]
Abstract
Cannabis sativa (L), a plant with an extensive history of medicinal usage across numerous cultures, has received increased attention over recent years for its therapeutic potential for gynecological disorders such as endometriosis, chronic pelvic pain, and primary dysmenorrhea, due at least in part to shortcomings with current management options. Despite this growing interest, cannabis inhabits an unusual position in the modern medical pharmacopoeia, being a legal medicine, legal recreational drug, and an illicit drug, depending on jurisdiction. To date, the majority of studies investigating cannabis use have found that most people are using illicit cannabis, with numerous obstacles to medical cannabis adoption having been identified, including outdated drug-driving laws, workplace drug testing policies, the cost of quality-assured medical cannabis products, a lack of cannabis education for healthcare professionals, and significant and persistent stigma. Although currently lacking robust clinical trial data, a growing evidence base of retrospective data, cohort studies, and surveys does support potential use in gynecological pain conditions, with most evidence focusing on endometriosis. Cannabis consumers report substantial reductions in pelvic pain, as well as common comorbid symptoms such as gastrointestinal disturbances, mood disorders such as anxiety and depression, and poor sleep. Substitution effects were reported, with >50% reduction or cessation in opioid and/or non-opioid analgesics being the most common. However, a substantial minority report not disclosing cannabis consumption to their health professional. Therefore, while such deprescribing trends are potentially beneficial, the importance of medical supervision during this process is paramount given the possibility for withdrawal symptoms.
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Affiliation(s)
- Justin Sinclair
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
| | - Jason Abbott
- Division of Obstetrics and Gynaecology, School of Clinical Medicine, Medicine and Health, UNSW, Sydney, NSW, Australia
- Gynaecological Research and Clinical Research (GRACE) Unit, Royal Hospital for Women, UNSW, Sydney, NSW, Australia
| | - Andrew Proudfoot
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
- Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand.
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Norfuad FA, Mokhtar MH, Nur Azurah AG. Beneficial Effects of Probiotics on Benign Gynaecological Disorders: A Review. Nutrients 2023; 15:2733. [PMID: 37375637 DOI: 10.3390/nu15122733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Probiotics are live microorganisms that confer beneficial effects on human health when an adequate dose is administered. Recently, the use of probiotics has gained tremendous interest from the public due to its promising effects in the management of various reproductive diseases. However, the review of probiotics' benefits on benign gynaecological disorders, including vaginal infections, polycystic ovary syndrome (PCOS) and endometriosis, remains scarce. Therefore, this review is built on current knowledge on the beneficial effects of probiotics against selected benign gynaecological disorders. Recent findings point out that probiotics' supplementation in different clinical and in vivo models showed promising health effects and results in the amelioration of disease symptoms. Thus, in this review, we showed the findings of both studies performed in clinical settings and animal studies. However, current information, solely based on clinical trials or animal studies, is inadequate in communicating the excellent findings on the beneficial effects of probiotics on human health. Therefore, future clinical intervention studies are required to further elucidate the evidence of the benefits of probiotics benefits regarding these gynaecological disorders.
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Affiliation(s)
- Farisha Alia Norfuad
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mohd Helmy Mokhtar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Abdul Ghani Nur Azurah
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
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Holdsworth-Carson SJ, Menkhorst E, Maybin JA, King A, Girling JE. Cyclic processes in the uterine tubes, endometrium, myometrium, and cervix: pathways and perturbations. Mol Hum Reprod 2023; 29:gaad012. [PMID: 37225518 PMCID: PMC10208902 DOI: 10.1093/molehr/gaad012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/01/2023] [Indexed: 05/26/2023] Open
Abstract
This review leads the 2023 Call for Papers in MHR: 'Cyclical function of the female reproductive tract' and will outline the complex and fascinating changes that take place in the reproductive tract during the menstrual cycle. We will also explore associated reproductive tract abnormalities that impact or are impacted by the menstrual cycle. Between menarche and menopause, women and people who menstruate living in high-income countries can expect to experience ∼450 menstrual cycles. The primary function of the menstrual cycle is to prepare the reproductive system for pregnancy in the event of fertilization. In the absence of pregnancy, ovarian hormone levels fall, triggering the end of the menstrual cycle and onset of menstruation. We have chosen to exclude the ovaries and focus on the other structures that make up the reproductive tract: uterine tubes, endometrium, myometrium, and cervix, which also functionally change in response to fluctuations in ovarian hormone production across the menstrual cycle. This inaugural paper for the 2023 MHR special collection will discuss our current understanding of the normal physiological processes involved in uterine cyclicity (limited specifically to the uterine tubes, endometrium, myometrium, and cervix) in humans, and other mammals where relevant. We will emphasize where knowledge gaps exist and highlight the impact that reproductive tract and uterine cycle perturbations have on health and fertility.
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Affiliation(s)
- Sarah J Holdsworth-Carson
- Julia Argyrou Endometriosis Centre, Epworth HealthCare, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne and Gynaecology Research Centre, Royal Women’s Hospital, Melbourne, Australia
| | - Ellen Menkhorst
- Department of Obstetrics and Gynaecology, University of Melbourne and Gynaecology Research Centre, Royal Women’s Hospital, Melbourne, Australia
| | - Jacqueline A Maybin
- Institute for Regeneration and Repair, MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Anna King
- Department of Obstetrics and Gynaecology, NHS Lothian, Edinburgh, UK
| | - Jane E Girling
- Department of Obstetrics and Gynaecology, University of Melbourne and Gynaecology Research Centre, Royal Women’s Hospital, Melbourne, Australia
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
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Kim PW, Kim S, Kim DI, Cha J, Lee HS, Ko MM, Jang S, Yang C, Lee MS. Development of the Korean Medicine Core Outcome Set for Primary Dysmenorrhea (COS-PD-KM) for Herbal Medicine Treatment of Primary Dysmenorrhea in Primary Clinics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15321. [PMID: 36430040 PMCID: PMC9690837 DOI: 10.3390/ijerph192215321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to develop a Korean medicine (KM) core outcome set (COS) for primary dysmenorrhea to evaluate the effectiveness of herbal medicine (HM) in treating primary dysmenorrhea in patients visiting KM primary clinics. Previously reported outcomes were identified through a literature review to define outcomes and effect modifiers (EMs) for the questionnaire. Experts were invited to conduct modified Delphi consensus exercises, and primary care clinicians were invited to conduct Delphi consensus exercises to evaluate suitability and feasibility. Finally, an additional round of a modified Delphi exercise was conducted with experts to obtain a final agreement on the COS. Seventeen outcomes and 15 EMs were included from a literature review, and one effect modifier was suggested by the experts (Phase 1). In Phase 2, after the modified Delphi consensus exercises by experts, 10 outcomes and 11 EMs were included in the COS. The clinicians all agreed on the feasibility of COS (Phase 3). Finally, 10 outcomes and 6 EMs were included in the COS-PD-KM after the final modified Delphi consensus exercise (Phase 4). The effectiveness of HM used in primary clinics could be evaluated with this COS in patients with primary dysmenorrhea. Further studies that involve more relevant stakeholder groups, such as patient representatives and gynecological experts, are needed.
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Affiliation(s)
- Pyung-Wha Kim
- R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Sungha Kim
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Dong-Il Kim
- Department of Obstetrics & Gynecology, College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea
| | - Jiyun Cha
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - He-Sol Lee
- R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Mi Mi Ko
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Soobin Jang
- Department of Preventive Medicine, College of Korean Medicine, Daegu Haany University, Gyeongsan 38610, Republic of Korea
| | - Changsop Yang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
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8
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Chen Z, Peng Y, Qiang X, Song G, Yang F, Pang B, Wang H. Oral traditional Chinese patent medicines combined with non-steroidal anti-inflammatory drugs for primary dysmenorrhea: A protocol for Bayesian network meta-analysis and systematic review. PLoS One 2022; 17:e0276129. [PMID: 36269706 PMCID: PMC9586373 DOI: 10.1371/journal.pone.0276129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 09/29/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Primary dysmenorrhea (PD) was the most common gynecological disorder, with an increasingly high prevalence worldwide. PD often accompanied other dysmenorrhea-associated symptoms to trigger exacerbations, and even cause depression and anxiety for patients. As the effective first-line medication, non-steroidal anti-inflammatory drugs (NSAIDs) have become widespread across China and combined with oral traditional Chinese patent medicines (TCPMs) for PD in clinical practice. We hope to provide better efficacy and safety evidence about oral TCPMs combined with NSAIDs (oral TCPMs+NSAIDs) for patients with PD by this network meta-analysis. METHODS AND ANALYSIS We will perform a Bayesian network meta-analysis of all oral TCPMs+NSAIDs for clinical diagnosis as PD. PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP information resource integration service platform databases, and clinical registers will be searched from the database inception to June 30, 2022 to find randomized controlled trials. Two reviewers will independently screen and check titles and abstracts and read the full text. Data extraction with the same criteria will be conducted by two researchers, including study characteristics, participant characteristics, interventions and comparators, and outcomes. We will perform the network meta-analysis by the Bayesian random method to analyze the direct and indirect comparisons. Meta-regression with multiple covariates will be conducted to find the potential heterogeneity. We will perform the sensitivity analysis to identify the potential effect on the robustness of our results. Evidence certainty of all interventions in outcomes will be identified and assessed by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessment. Funnel plots with Egger test and Begg's test to detect the potential publication bias. TRIAL REGISTRATION PROSPERO registration number: CRD42021265675.
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Affiliation(s)
- Zhe Chen
- Evidence-based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yingying Peng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xiaoyu Qiang
- Evidence-based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Geliang Song
- Evidence-based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Fengwen Yang
- Evidence-based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Bo Pang
- Evidence-based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hui Wang
- Evidence-based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- * E-mail:
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Mohammadzadeh F, Saberi Noghabi E, Noori R, Ahmadi SA, Azarang M, Delshad Noghabi A. Comparing the Effect of Acupressure at the Spleen-10 ( Xuehai) Acupoint and Vitamin E on Primary Dysmenorrhea. Med Acupunct 2022; 34:325-330. [PMID: 36311881 PMCID: PMC9595616 DOI: 10.1089/acu.2021.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective Vitamin E and acupressure are 2 complementary and alternative therapies recommended for primary dysmenorrhea (PD). This study assessed the effect of acupressure at Spleen-10 (SP-10), compared to vitamin E on the pain severity of primary dysmenorrhea (PD). Materials and Methods A quasiexperimental study was conducted on 70 eligible young female students with self-reported primary dysmenorrhea at Gonabad University of Medical Sciences, Gonabad, Iran. Participants were assigned to 2 treatment groups: acupressure or vitamin E. Interventions were implemented at the onset of menstrual pain in each patient, for 2 consecutive periods: acupressure group (n = 35) received 20 minutes of acupressure to SP-10 on both legs; and vitamin E group (n = 35) took 1 capsule of 200 international units of vitamin E. Pain severity was assessed with a visual analogue scale for pain. Data were analyzed with a response-profile analysis in R, version 3.6.1. Significance was P < 0.05. Results Both treatment groups had a similar pattern of change over time. The mean level of response profiles for pain severity was the same for both groups on all occasions. The effect of time was statistically significant (P < 0.001). A decreasing trend was noted in mean severity of pain over time. Changes at the second and third measured times were significant (P < 0.001). Conclusions It seems that acupressure at SP10 point is an efficient nonpharmacologic, cost-effective, easy-to-learn way to treat primary dysmenorrhea, applicable in any time or place.
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Affiliation(s)
- Fatemeh Mohammadzadeh
- Department of Epidemiology and Biostatistics, School of Health, Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Khorasan Razavi Province, Iran
| | - Elham Saberi Noghabi
- Department of Community Health Nursing and Nursing Management, School of Nursing, Social Development and Health Promotion Research Center, Gonabad University, Gonabad, Khorasan Razavi Province, Iran
| | - Reza Noori
- Department of Community Health Nursing and Nursing Management, School of Nursing, Social Development and Health Promotion Research Center, Gonabad University, Gonabad, Khorasan Razavi Province, Iran
| | - Seyedeh Akram Ahmadi
- Student Research Committee, School of Nursing, Gonabad University of Medical Sciences, Gonabad, Khorasan Razavi Province, Iran
| | - Maryam Azarang
- Student Research Committee, School of Nursing, Gonabad University of Medical Sciences, Gonabad, Khorasan Razavi Province, Iran
| | - Ali Delshad Noghabi
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Khorasan Razavi Province, Iran
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10
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Wang L, Yan Y, Qiu H, Xu D, Zhu J, Liu J, Li H. Prevalence and Risk Factors of Primary Dysmenorrhea in Students: A Meta-Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1678-1684. [PMID: 35523614 DOI: 10.1016/j.jval.2022.03.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/25/2022] [Accepted: 03/30/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Primary dysmenorrhea (PD), as the most common complaint among students, is also one of the public problems worldwide. Prevalence and risk factors of PD were variant between studies; as the main population, no meta-analysis for PD has hitherto been conducted in students. METHODS We searched the published literature in PubMed, Embase, the Cochrane Library, Web of Science, National Knowledge Infrastructure, WANFANG, and VIP database. After screening and assessing the quality of studies, data from eligible studies were extracted for meta-analysis via the R language. RESULTS A total of 96 studies published from 1991 to 2021 with 78 068 students were included, the mean age of participants was 19.4, and 79.9% were university students. The pooled overall prevalence of PD was 66.1% (95% confidence interval [CI] 63.4-68.9), and 31.1% (CI 28.1-34.3), 25.7% (CI 23.4-28.0), and 8.3% of students (CI 7.4-9.3) reported mild, moderate, and severe PD, respectively. Besides, the prevalence of PD was estimated at 58.8% (CI 54.3-63.7) before 2010, but ascended to 68.5% (CI 65.5-71.6) after 2010 and rose to 71.5% (CI 65.8-76.6) in 2015 to 2021. About risk factors for PD, underweight, skipping breakfast, poor sleep quality, staying up late, lack of physical exercise, exposure to cold and eating cold or spicy foods during menstruation, dietary bias, prefer snacks, family history of dysmenorrhea, irregular menstrual cycle, heavy stress, negative emotion during menstruation, and anxiety were significantly related to PD. CONCLUSIONS The overall prevalence of PD among students was 66.1% and had a rising tendency in the last 10 years. Our findings helped understand the current prevalence and improve the administration of PD among students.
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Affiliation(s)
- Liwen Wang
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China; The Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha, Hunan Province, China; Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yuhan Yan
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Huiyu Qiu
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China; The Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha, Hunan Province, China
| | - Datong Xu
- Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Jiaqi Zhu
- Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Jing Liu
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
| | - Hui Li
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China; The Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha, Hunan Province, China.
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11
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Itani R, Soubra L, Karout S, Rahme D, Karout L, Khojah HMJ. Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates. Korean J Fam Med 2022; 43:101-108. [PMID: 35320895 PMCID: PMC8943241 DOI: 10.4082/kjfm.21.0103] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/06/2021] [Indexed: 11/05/2022] Open
Abstract
Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. It is characterized by painful cramps in the lower abdomen, which start shortly before or at the onset of menses and which could last for 3 days. In particular, PD negatively impacts the quality of life (QOL) of young females and is the main reason behind their absenteeism from school or work. It is suggested that increased intrauterine secretion of prostaglandins F2α and E2 are responsible for the pelvic pain associated with this disorder. Its associated symptoms are physical and/or psychological. Its physical symptoms include headache, lethargy, sleep disturbances, tender breasts, various body pains, disturbed appetite, nausea, vomiting, constipation or diarrhea, and increased urination, whereas its psychological symptoms include mood disturbances, such as anxiety, depression, and irritability. While its diagnosis is based on patients’ history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). Patients must be monitored to measure their response to treatment, assess their adherence, observe potential side effects, and perform further investigations, if needed.
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Affiliation(s)
- Rania Itani
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
- Corresponding Author: Rania Itani https://orcid.org/0000-0003-4316-3224 Tel: +961-70-614-735, Fax: +961-1-300110 Ext: 2627, E-mail:
| | - Lama Soubra
- Pharmacology and Therapeutics Department, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
| | - Samar Karout
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
| | - Deema Rahme
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
| | - Lina Karout
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani M J Khojah
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Madinah, Kingdom of Saudi Arabia
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12
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Bann S, Goshtasebi A, Shirin S, Prior JC. A one-year observational cohort study of menstrual cramps and ovulation in healthy, normally ovulating women. Sci Rep 2022; 12:4738. [PMID: 35304559 PMCID: PMC8933502 DOI: 10.1038/s41598-022-08658-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
This is a prospective, observational community cohort study with the objective of investigating menstrual cramp occurrence related to ovulatory characteristics. Women reported cramp intensity on daily Menstrual Cycle Diary© records over one year. Ovulation and luteal phase lengths were assessed by validated Quantitative Basal Temperature© (QBT) analysis. Healthy, normal-weight, non-smoking community dwelling premenopausal women ages 21-41 years with two consecutive, normally ovulatory, normal-length menstrual cycles were enrolled. All 53 women, with 13.6 ± 2.8 cycles per woman, reported at least one cramp episode of median intensity 1.5 [0-4 scale; range 1.0-3.5], and 2.2 days' [range 1.0-10.2] duration. Within the 49 women who experienced all ovulatory cycle types (normal, short luteal length [SLL < 10 days] and anovulatory), median cramp intensity was greater in normal-length cycles having subclinical ovulatory disturbances (SLL and anovulatory; median 1.4 [range 0.0-2.8]) than in normally ovulatory cycles (median 1.2 [range 0.0-2.3]) (P = 0.023). Cramp Scores did not differ by ovulatory status within the 19 women having both normally ovulatory and anovulatory cycles (P = 0.222). Within-woman 1-year Cramp Scores were not different in anovulatory and normally ovulatory menstrual cycles but were more intense with ovulatory disturbances.
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Affiliation(s)
- Sewon Bann
- MD Internal Medicine Postgraduate Program (2023), University of British Columbia, Vancouver, Canada
- Endocrinology and Metabolism, Centre for Menstrual Cycle and Ovulation Research (CeMCOR), University of British Columbia, 2775 Laurel Street, 4th Floor, Vancouver, BC, V5Z 1M9, Canada
| | - Azita Goshtasebi
- Endocrinology and Metabolism, Centre for Menstrual Cycle and Ovulation Research (CeMCOR), University of British Columbia, 2775 Laurel Street, 4th Floor, Vancouver, BC, V5Z 1M9, Canada
- BC Women's Health Research Institute, Vancouver, Canada
| | - Sonia Shirin
- Endocrinology and Metabolism, Centre for Menstrual Cycle and Ovulation Research (CeMCOR), University of British Columbia, 2775 Laurel Street, 4th Floor, Vancouver, BC, V5Z 1M9, Canada
- BC Women's Health Research Institute, Vancouver, Canada
| | - Jerilynn C Prior
- Endocrinology and Metabolism, Centre for Menstrual Cycle and Ovulation Research (CeMCOR), University of British Columbia, 2775 Laurel Street, 4th Floor, Vancouver, BC, V5Z 1M9, Canada.
- Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, Canada.
- BC Women's Health Research Institute, Vancouver, Canada.
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.
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13
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Sima RM, Sulea M, Radosa JC, Findeklee S, Hamoud BH, Popescu M, Gorecki GP, Bobircă A, Bobirca F, Cirstoveanu C, Ples L. The Prevalence, Management and Impact of Dysmenorrhea on Medical Students' Lives-A Multicenter Study. Healthcare (Basel) 2022; 10:healthcare10010157. [PMID: 35052320 PMCID: PMC8775858 DOI: 10.3390/healthcare10010157] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction: Dysmenorrhea is defined as the presence of painful menstruation, and it affects daily activities in different ways. The aims of this study were to assess the prevalence and management of dysmenorrhea and to determine the impact of dysmenorrhea on the quality of life of medical students. Material and methods: The study conducted was prospective, analytical and observational and was performed between 7 November 2019 and 30 January 2020 in five university centers from Romania. The data was collected using an original questionnaire regarding menstrual cycles and dysmenorrhea. The information about relationships with family or friends, couples’ relationships and university activity helped to assess the effects of dysmenorrhea on quality of life. The level of significance was set at p < 0.05. Results: The study comprised 1720 students in total. The prevalence of dysmenorrhea was 78.4%. During their menstrual period, most female students felt more agitated or nervous (72.7%), more tired (66.9%), as if they had less energy for daily activities (75.9%) and highly stressed (57.9%), with a normal diet being difficult to achieve (30.0%). University courses (49.4%), social life (34.5%), couples’ relationships (29.6%), as well as relationships with family (21.4%) and friends (15.4%) were also affected, depending on the duration and intensity of the pain. Conclusion: Dysmenorrhea has a high prevalence among medical students and could affect the quality of life of students in several ways. During their menstrual period, most female students feel as if they have less energy for daily activities and exhibit a higher level of stress. The intensity of the symptoms varies considerably and, with it, the degree of discomfort it creates. Most student use both pharmacological and non-pharmacological methods to reduce pain (75.7%). University courses, social life, couples’ relationships, as well as relationships with family and friends are affected, depending on the duration and intensity of the pain.
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Affiliation(s)
- Romina-Marina Sima
- Department of Obstetrics and Ginecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-M.S.); (M.S.); (L.P.)
- The “Bucur” Maternity, “Saint John” Hospital, 040294 Bucharest, Romania;
| | - Mihaela Sulea
- Department of Obstetrics and Ginecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-M.S.); (M.S.); (L.P.)
| | - Julia Caroline Radosa
- Department for Gynaecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Kirrberger Straße 100, Building 9, 66421 Homburg, Germany; (J.C.R.); (S.F.); (B.H.H.)
| | - Sebastian Findeklee
- Department for Gynaecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Kirrberger Straße 100, Building 9, 66421 Homburg, Germany; (J.C.R.); (S.F.); (B.H.H.)
| | - Bashar Haj Hamoud
- Department for Gynaecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Kirrberger Straße 100, Building 9, 66421 Homburg, Germany; (J.C.R.); (S.F.); (B.H.H.)
| | - Mihai Popescu
- Department of Anaesthesia and Critical Care, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Gabriel Petre Gorecki
- The “Bucur” Maternity, “Saint John” Hospital, 040294 Bucharest, Romania;
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
| | - Anca Bobircă
- Department of Internal Medicine and Rheumatology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: ; Tel.: +40-07-2615-7827
| | - Florin Bobirca
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Catalin Cirstoveanu
- Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Pediatrics Department, ‘Maria Sklodowska Curie’ Emergency Children Clinical Hospital, 041451 Bucharest, Romania
| | - Liana Ples
- Department of Obstetrics and Ginecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-M.S.); (M.S.); (L.P.)
- The “Bucur” Maternity, “Saint John” Hospital, 040294 Bucharest, Romania;
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Koçoğlu F, Zincir H. The Effect of Reiki on Pain, Fatigue, and Quality of Life in Adolescents With Dysmenorrhea. Holist Nurs Pract 2021; 35:306-314. [PMID: 34647912 DOI: 10.1097/hnp.0000000000000477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This randomized, single-blind, placebo-controlled study was conducted to evaluate the effect of Reiki applications on pain, fatigue, and quality of life in adolescents with dysmenorrhea. There were 38 patients in the Reiki group and 37 in the placebo-controlled group. Reiki was found to be effective on pain and fatigue in adolescents with dysmenorrhea but with no effect on the quality of life.
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Affiliation(s)
- Ferdane Koçoğlu
- Nursing Department, Department of Public Health Nursing, Niğde Zübeyde Hanım School of Health, Niğde Ömer Halisdemir University, Niğde, Turkey (Dr Koçoğlu); and Nursing Department, Public Health Nursing, Erciyes University Health Sciences Faculty, Kayseri, Turkey (Dr Zincir)
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TAŞ F, ZİNCİR H. Effect of dysmenorrhea severity on social and school lives of high school students. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.910344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ciebiera M, Esfandyari S, Siblini H, Prince L, Elkafas H, Wojtyła C, Al-Hendy A, Ali M. Nutrition in Gynecological Diseases: Current Perspectives. Nutrients 2021; 13:1178. [PMID: 33918317 PMCID: PMC8065992 DOI: 10.3390/nu13041178] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/11/2022] Open
Abstract
Diet and nutrition are fundamental in maintaining the general health of populations, including women's health. Health status can be affected by nutrient deficiency and vice versa. Gene-nutrient interactions are important contributors to health management and disease prevention. Nutrition can alter gene expression, as well as the susceptibility to diseases, including cancer, through several mechanisms. Gynecological diseases in general are diseases involving the female reproductive system and include benign and malignant tumors, infections, and endocrine diseases. Benign diseases such as uterine fibroids and endometriosis are common, with a negative impact on women's quality of life, while malignant tumors are among the most common cause of death in the recent years. In this comprehensive review article, a bibliographic search was performed for retrieving information about nutrients and how their deficiencies can be associated with gynecological diseases, namely polycystic ovary syndrome, infertility, uterine fibroids, endometriosis, dysmenorrhea, and infections, as well as cervical, endometrial, and ovarian cancers. Moreover, we discussed the potential beneficial impact of promising natural compounds and dietary supplements on alleviating these significant diseases.
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Affiliation(s)
- Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-809 Warsaw, Poland;
| | - Sahar Esfandyari
- Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.E.); (H.E.)
| | - Hiba Siblini
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (H.S.); (A.A.-H.)
| | - Lillian Prince
- Biological Sciences Division, Public Health Sciences, University of Chicago, Chicago, IL 60637, USA;
| | - Hoda Elkafas
- Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.E.); (H.E.)
- Department of Pharmacology and Toxicology, Egyptian Drug Authority (EDA), Cairo 15301, Egypt
| | - Cezary Wojtyła
- International Prevention Research Institute-Collaborating Centre, Calisia University, 62-800 Kalisz, Poland;
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (H.S.); (A.A.-H.)
| | - Mohamed Ali
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo 11566, Egypt
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Roomruangwong C, Sirivichayakul S, Matsumoto AK, Michelin AP, de Oliveira Semeão L, de Lima Pedrão JV, Barbosa DS, Moreira EG, Maes M. Menstruation distress is strongly associated with hormone-immune-metabolic biomarkers. J Psychosom Res 2021; 142:110355. [PMID: 33444909 DOI: 10.1016/j.jpsychores.2020.110355] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/25/2020] [Accepted: 12/28/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To examine the associations between menstruation features and symptoms and hormone-immune-metabolic biomarkers. METHODS Forty-one women completed questionnaires assessing characteristic menstruation symptoms, duration of menstrual cycle and number of pads used/day and completed the Daily Record of Severity of Problems (DRSP) during the consecutive days of their menstrual cycle. Menses-related symptoms (MsRS) were computed from the sum of 10 pre- and post-menses symptoms and the menstruation blood and duration index (MBDI) was computed based on the daily number of pads and duration of menses. We assayed serum levels of various biomarkers at days 7, 14, 21, and 28 of the subjects' menstrual cycle. RESULTS MBDI was significantly associated with a) MsRS including low abdominal cramps, and gastro-intestinal (GI) and pain symptoms (positively); b) plasma levels of haptoglobin (Hp), CCL5, insulin growth factor (IGF)-1, and plasminogen activator inhibitor (PAI)1 (all positively); and c) estradiol and paraoxonase (PON)1 arylesterase activity (both inversely). MsRS were significantly predicted by CCL5 and IGF-1 (both positively) and progesterone (inversely). Low-abdominal cramps, and gastro-intestinal and pain symptoms were associated with lower progesterone levels. The MBDI+MsRS score was significantly predicted by the cumulative effects of (in descending order of importance): Hp, IGF-1, PON1 arylesterase, estradiol and PAI. CONCLUSION Menstruation-related features including estimated blood loss, duration of menses, cramps, pain, and gastro-intestinal symptoms are associated with hormone-immune-metabolic biomarkers, which mechanistically may explain those features. Future research should construct a cross-validated algorithm using MBDI+MsRS features in a larger study group to delineate a useful case-definition of menstruation-related distress.
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Affiliation(s)
- Chutima Roomruangwong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sunee Sirivichayakul
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Andressa Keiko Matsumoto
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, PR, Brazil
| | - Ana Paula Michelin
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, PR, Brazil
| | - Laura de Oliveira Semeão
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, PR, Brazil
| | - João Victor de Lima Pedrão
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, PR, Brazil
| | - Decio S Barbosa
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, PR, Brazil
| | - Estefania G Moreira
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, PR, Brazil
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Medical University Plovdiv, Plovdiv, Bulgaria; IMPACT Strategic Research Center, Deakin University, Geelong, Australia.
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18
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Njoku UC, Amadi PU, Amadi JA. Nutritional modulation of blood pressure and vascular changes during severe menstrual cramps. J Taibah Univ Med Sci 2021; 16:93-101. [PMID: 33603637 PMCID: PMC7858019 DOI: 10.1016/j.jtumed.2020.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/18/2020] [Accepted: 10/26/2020] [Indexed: 11/02/2022] Open
Abstract
Objectives This study examined the influence of nutrition on the severity of menstrual pains and associated transient changes in blood pressure (BP) and vascular-health indicators. It has also investigated the influence of nutrition on angiotensin (ANG II) and vascular cell adhesion molecules (VCAM-1). Methods A total of 207 university students, aged between 18 and 25 years, were grouped into three groups: a no-dysmenorrhoea (control) group, a moderate dysmenorrhoea (MDys) group, and a severe dysmenorrhoea (SDys) group, using the NRS-11 scale and initial contactin-1 (CNTN-1) levels. The groups were separately fed vegetable, protein, and carbohydrate meals. The meal plan involved three different types of food served three times a day (for breakfast, lunch, and dinner), beginning 48 h before menstruation. Results We found that 73.9% and 100% of the MDys patients on the protein and carbohydrate diets, respectively, had severe dysmenorrhoea. As many as 69.6% of the SDys patients on vegetable diets experienced no dysmenorrhoea; the BP of 61% of SDys normalised to the standard values of 120/80. The BP of 87% MDys had systolic BP ≥ 130 and ≥90 diastolic BP after carbohydrate meals. On the other hand, 30% of SDys had higher BP after protein meals. With respect to the choice of food, the severity of menstrual pain was positively correlated with ANG II (r = 0.5158) and VCAM-1 (r = 0.5849). ANG-II. Similarly, VCAM-1 were significantly elevated (p < 0.05) in the dysmenorrhoeal participants. The mean VCAM-1 and ANG-II levels of dysmenorrhoeal participants placed on vegetable meals were comparable to the control baseline levels. Conclusions This study recommends the intake of a vegetable meal at least 48 h before menstruation as an effective nutritional approach to preventing and managing severe menstrual cramps. This approach can also prevent associated vascular changes. Carbohydrate meals should be avoided at least 48 h before menstruation.
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Affiliation(s)
- Uche C Njoku
- Department of Biochemistry, University of Port Harcourt, Choba, Rivers State, Nigeria
| | - Peter U Amadi
- Department of Biochemistry, Imo State University Owerri, Imo State, Nigeria
| | - Joy A Amadi
- Department of Nutrition and Dietetics, Imo State University Owerri, Imo State, Nigeria
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Manouchehri E, Alirezaei S, Roudsari RL. Compliance of Published Randomized Controlled Trials on the Effect of Physical Activity on Primary Dysmenorrhea with the Consortium's Integrated Report on Clinical Trials Statement: A Critical Appraisal of the Literature. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:445-454. [PMID: 33747832 PMCID: PMC7968594 DOI: 10.4103/ijnmr.ijnmr_223_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 08/03/2020] [Accepted: 09/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Randomized Controlled Trials (RCTs) are reliable methods for the evaluation of treatment effectiveness, which should be rigorous and must report with clarity. This study aimed to assess the compliance of published RCTs about the effect of physical activity on primary dysmenorrhea with the CONSORT 2017 statement. MATERIALS AND METHODS In this study, the review of literature was carried out based on Consolidated Standards Of Reporting Trials (CONSORT). All the clinical trials focused on the effect of the physical activity on primary dysmenorrhea indexed in Web of Science, Pubmed, Scopus, Google Scholar, Science Direct, Embase, Magiran and Scientific Information Database (SID) were searched using keywords of dysmenorrhea, randomized clinical trial, physical activity and exercise from 2000 to 2019. Out of 1423 articles, 30 RCTs were critically appraised using CONSORT 2017 checklist. The reporting quality score of articles was identified between zero and 43. RESULTS The compliance rate with the CONSORT checklist was 55.58%. The mean (SD) score of the reporting quality was 23.37 (-5.15) with a minimum of 16 and a maximum of 37. The maximum weakness was in reporting the sample size and full trial protocol 23.33% and 6.67% respectively. Regarding new items of the consort 2017, if the blinding was not possible, the description of any attempts to limit bias was not described in 70% of articles. CONCLUSIONS Reporting sample size, trial protocol, method of blinding, and control of bias are issues that require more attention in reporting of RCT studies. We recommend that the authors use the CONSORT 2017 statement for conducting and reporting the clinical trials.
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Affiliation(s)
- Elham Manouchehri
- Student in Reproductive Health, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somayeh Alirezaei
- Student in Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Professor, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Rondanelli M, Fossari F, Vecchio V, Gasparri C, Peroni G, Spadaccini D, Riva A, Petrangolini G, Iannello G, Nichetti M, Infantino V, Perna S. Clinical trials on pain lowering effect of ginger: A narrative review. Phytother Res 2020; 34:2843-2856. [PMID: 32436242 PMCID: PMC7754412 DOI: 10.1002/ptr.6730] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 04/08/2020] [Accepted: 04/23/2020] [Indexed: 01/01/2023]
Abstract
Ginger has a pain-reducing effect and it can modulate pain through various mechanisms: inhibition of prostaglandins via the COX and LOX-pathways, antioxidant activity, inibition of the transcription factor nf-kB, or acting as agonist of vanilloid nociceptor. This narrative review summarizes the last 10-year of randomized controlled trials (RCTs), in which ginger was traditionally used as a pain reliever for dysmenorrhea, delayed onset muscle soreness (DOMS), osteoarthritis (AO), chronic low back pain (CLBP), and migraine. Regarding dysmenorrhea, six eligible studies suggest a promising effect of oral ginger. As concerned with DOMS, the four eligible RCTs suggested a reduction of inflammation after oral and topical ginger administration. Regarding knee AO, nine RCTs agree in stating that oral and topical use of ginger seems to be effective against pain, while other did not find significant differences. One RCT considered the use of ginger in migraine and suggested its beneficial activity. Finally, one RCT evaluated the effects of Swedish massage with aromatic ginger oil on CLBP demonstrated a reduction in pain. The use of ginger for its pain lowering effect is safe and promising, even though more studies are needed to create a consensus about the dosage of ginger useful for long-term therapy.
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Affiliation(s)
- Mariangela Rondanelli
- IRCCS Mondino FoundationPaviaItaly
- Department of Public Health, Experimental and Forensic MedicineUniversity of PaviaPaviaItaly
| | - Federica Fossari
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Viviana Vecchio
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Daniele Spadaccini
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | | | | | - Giancarlo Iannello
- General ManagementAzienda di Servizi alla Persona “Istituto Santa Margherita”PaviaItaly
| | - Mara Nichetti
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Vittoria Infantino
- Department of Biomedical Science and Human OncologyUniversity of Bari Aldo MoroBariItaly
| | - Simone Perna
- Department of Biology, College of ScienceUniversity of BahrainZallaqBahrain
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Wu Z, Yang Y, Xiong J, Yu X, Zuo Z, Xie Q. Which acupuncture and moxibustion technique is more effective for primary dysmenorrhea: A protocol for a network meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e21713. [PMID: 32871889 PMCID: PMC7458225 DOI: 10.1097/md.0000000000021713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD), also called functional dysmenorrhea, refers to a woman's menstrual period in genital no organic disease, abdominal pain, under the belly and other discomfort for the characteristics of disease of department of gynecology. Acupuncture and moxibustion have been accepted as treatment options for PD. So far, there are so many therapies for PD and their efficacy has been assessed by several systematic reviews. Therefore, this study aims at evaluating the effectiveness which acupuncture and moxibustion technique is more effective for primary dysmenorrhea. METHODS AND ANALYSIS The following electronic databases will be searched in this study: the Cochrane Central Register of Controlled Trials (CENTRAL);PubMed; EMBASE; China National Knowledge Infrastructure (CNKI); Chinese Biomedical Literature Database (CBM);Chinese Scientific Journal Database (VIP database); and Wan-Fang Database(WF). More than two authors independently assessed the quality of the evidence by AMSTAR2, PRISMA, PRISMA-A, and GRADE approach. Two of our researchers will use the bias risk tool provided by the Cochrane Collaboration to evaluate the quality of the literature using WinBUGS 1.4.3 and STATA softwares. The primary outcomes include the extent of pain in the lower abdomen measured by visual analog scale (VAS) and relief from symptoms. The quality of life (QoL) and Adverse events will be considered as Additional outcome(s). Their reference lists and the citation lists of studies meeting the inclusion criteria and relevant systematic reviews will also be searched to identify further studies for inclusion. Before this review completed, the 2 reviewers will conduct the search once again to ensure the latest studies could be included. ETHICS AND DISSEMINATION This review does not require ethical approval. RESULTS The results will be published in a peer-reviewed journal. CONCLUSION This study will provide comprehensive evidence of acupuncture and moxibustion for patients with PD. INPLASY REGISTRATION NUMBER INPLASY2020500106.
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Affiliation(s)
- Zenan Wu
- Jiangxi University of Traditional Chinese Medicine
| | - Yi Yang
- Jiangxi University of Traditional Chinese Medicine
| | - Jun Xiong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Xinyu Yu
- Jiangxi University of Traditional Chinese Medicine
| | - Zhengyun Zuo
- Jiangxi University of Traditional Chinese Medicine
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Guimarães I, Póvoa AM. Primary Dysmenorrhea: Assessment and Treatment. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2020; 42:501-507. [PMID: 32559803 PMCID: PMC10309238 DOI: 10.1055/s-0040-1712131] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Primary dysmenorrhea is defined as menstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain. It is the most common gynecological illness in women in their reproductive years and one of the most frequent causes of pelvic pain; however, it is underdiagnosed, undertreated, and even undervalued by women themselves, who accept it as part of the menstrual cycle. It has major implications for quality of life, such as limitation of daily activities and psychological stress, being one of the main causes of school and work absenteeism. Its diagnosis is essentially clinical, based on the clinical history and normal physical examination. It is important to exclude secondary causes of dysmenorrhea. The treatment may have different approaches (pharmacological, non-pharmacological and surgical), but the first line of treatment is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and, in cases of women who want contraception, the use of hormonal contraceptives. Alternative treatments, such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure, may be an option in cases of conventional treatments' contraindication. Surgical treatment is only indicated in rare cases of women with severe dysmenorrhea refractory to treatment.
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Affiliation(s)
- Inês Guimarães
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Ana Margarida Póvoa
- Faculty of Medicine, Universidade do Porto, Porto, Portugal.,Department of Gynecology, Unit of Reproductive Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal
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Lee D, Kim SK. A comprehensive review and the pharmacologic management of primary dysmenorrhea. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.3.171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Dayong Lee
- Department of Obstetrics and Gynecology, Kyungpook National University Hospital, Daegu, Korea
| | - Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Han F, Liu H, Wang K, Yang J, Yang L, Liu J, Zhang M, Dun W. Correlation Between Thalamus-Related Functional Connectivity and Serum BDNF Levels During the Periovulatory Phase of Primary Dysmenorrhea. Front Hum Neurosci 2019; 13:333. [PMID: 31632254 PMCID: PMC6779153 DOI: 10.3389/fnhum.2019.00333] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 09/09/2019] [Indexed: 01/30/2023] Open
Abstract
The thalamus is a key region for the transmission of nociceptive information in the central modulation of pain and has been studied in the setting of numerous chronic pain conditions. Brain-derived neurotrophic factor (BDNF) is considered an important modulator for mediating nociceptive pathways in chronic pain. The present study aimed to investigate whether there was thalamus-related abnormal functional connectivity or relevant serum BDNF level alterations during periovulation in long-term primary dysmenorrhea (PDM). Thalamic subregions were defined according to the Human Brainnetome Atlas. Functional connectivity analyses were performed in 36 patients in the periovulatory phase and 29 age-, education-, and gender-matched healthy controls. Serum BDNF levels were evaluated by enzyme-linked immunosorbent assay and a significantly higher BDNF level was detected in PDM patients. Compared with HCs, PDM patients had abnormal functional connectivity of thalamic-subregions, mainly involving with prefrontal cortex, sensorimotor cortex, and temporal cortex. In addition, the functional connectivity of thalamic-subregions showed significant interactive effect correlated with serum BDNF level between PDM and HCs. It has been suggested that there were maladaptive or adoptive alteration associated with chronic menstrual pain even without the ongoing menstrual pain. BDNF might play a role in the development and chronicity of central nervous system dysfunction. These findings provided more accurate information about the involvement of the thalamus in the pathophysiology of PDM.
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Affiliation(s)
- Fang Han
- Department of Rehabilitation Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hongjuan Liu
- Department of Intensive Care Unit, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ke Wang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jing Yang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ling Yang
- Department of Medical Imaging, Chong Qing Medical University, Chong Qing, China
| | - Jixin Liu
- School of Life Science and Technology, Xidian University, Xi'an, China
| | - Ming Zhang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wanghuan Dun
- Department of Rehabilitation Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Yousefi M, Kavianpour M, Hesami S, Rashidi Nooshabadi M, Khadem Haghighian H. Effect of alpha-lipoic acid at the combination with mefenamic acid in girls with primary dysmenorrhea: randomized, double-blind, placebo-controlled clinical trial. Gynecol Endocrinol 2019; 35:782-786. [PMID: 30957578 DOI: 10.1080/09513590.2019.1590544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Primary dysmenorrhea is a common gynecologic disorder and is one of the main causes for referral to the gynecology clinic. This study aimed to determine the effects of alpha-lipoic acid (ALA) and mefenamic acid and a combination compared with placebo on the girls with primary dysmenorrhea. This double-blind, placebo-controlled clinical trial done on population consisted of female students living in dormitories of Qazvin University of Medical Sciences who had moderate to severe dysmenorrhea using the Visual Analog Scale (VAS) questionnaire. Participants were randomly divided into four groups (n = 100): ALA, mefenamic acid, ALA + mefenamic acid and placebo groups. ALA and mefenamic acid were administrated in 600 mg and 250 mg, respectively. The severity of the pain was measured in the beginning and the end of the study. Statistical analysis was performed using SPSS software (SPSS Inc., Chicago, IL). Our final results suggested that, although mefenamic acid significantly decreased the menstrual pain, ALA supplementation, 600 mg, would be more efficient than mefenamic acid in 250 mg. Also, the combination of ALA and mefenamic acid significantly has been far. Considering the ALA supplementation effect on pain relief in patients with primary dysmenorrhea, this antioxidant can be recommended for the healing of symptoms of these patients.
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Affiliation(s)
- Mojgan Yousefi
- a Student Research Committee, School of Health, Qazvin University of Medical Sciences , Qazvin , Iran
- b Metabolic Diseases Research Center, Qazvin University of Medical Sciences , Qazvin , Iran
| | - Maria Kavianpour
- c Department of Tissue Engineering and Applied Cell Sciences, Faculty of Advanced Technologies in Medicine, Tehran University of Medical Sciences , Tehran , Iran
| | - Sepideh Hesami
- a Student Research Committee, School of Health, Qazvin University of Medical Sciences , Qazvin , Iran
- b Metabolic Diseases Research Center, Qazvin University of Medical Sciences , Qazvin , Iran
| | | | - Hossein Khadem Haghighian
- a Student Research Committee, School of Health, Qazvin University of Medical Sciences , Qazvin , Iran
- b Metabolic Diseases Research Center, Qazvin University of Medical Sciences , Qazvin , Iran
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Akiyama S, Goren A, Basurto E, Komori T, Harada T. Treatment preferences among Japanese women with dysmenorrhea: results from a discrete choice experiment study. Patient Prefer Adherence 2018; 12:1627-1640. [PMID: 30214165 PMCID: PMC6124802 DOI: 10.2147/ppa.s166332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To examine patient preferences for oral and intrauterine system treatments for dysmenorrhea in Japan. PATIENTS AND METHODS A discrete choice experiment was conducted to assess the willingness to accept trade-offs among hypothetical treatment profiles. An internet-based survey was administered to women 18-49 years of age who self-reported a dysmenorrhea diagnosis or experienced dysmenorrhea at least once in the past 6 months (N=309). Choice questions included pairs of treatments presented with different attributes: mode of administration, reduction in bleeding after 6 months, chance of symptoms becoming "improved", nausea, weight gain, irregular bleeding, and risk of venous thromboembolism. Relative importance (RI) estimates were computed. RESULTS The mean respondent age was 35.8 years (standard deviation =7.0), and 85 women (27.5%) reported that they had previously used hormonal therapy for dysmenorrhea. Treatment preference was most strongly associated with mode of administration (RI=49.8%), followed by chance of irregular bleeding (RI=17.3%). In contrast, treatment preference was most weakly associated with chance of weight gain (RI=2.4%) and reduction in bleeding after 6 months (RI=0.8%). Respondents preferred oral treatments: for twice-daily regimen, odds ratio (OR)=4.90; for once-daily fixed cyclic regimen, OR=4.20; and for once-daily flexible extended regimen, OR=2.44; whereas for intrauterine system, OR=0.02 (p<0.001 for all). Those with prior hormonal therapy experience exhibited the same pattern. CONCLUSION Mode of administration factored heavily in dysmenorrhea treatment preferences. Women of reproductive age preferred oral medication, especially twice-daily regimen and once-daily fixed cyclic regimen. Findings can potentially help to improve physician-patient communication and treatment decision making. Physicians should consider factors that can influence patient preference to optimize treatment acceptance and adherence.
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Affiliation(s)
| | - Amir Goren
- Health Outcomes Practice, Kantar Health, New York, NY, USA
| | | | | | - Tasuku Harada
- Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan
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Orhan C, Çelenay ŞT, Demirtürk F, Özgül S, Üzelpasacı E, Akbayrak T. Effects of menstrual pain on the academic performance and participation in sports and social activities in Turkish university students with primary dysmenorrhea: A case control study. J Obstet Gynaecol Res 2018; 44:2101-2109. [PMID: 30043399 DOI: 10.1111/jog.13768] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/29/2018] [Indexed: 01/28/2023]
Abstract
AIM The primary aim of this study was to investigate the pain characteristics, academic performance and participation in sports and social activities among students with primary dysmenorrhea (PD) who have different pain intensities and to compare dysmenorrhea-related life impact with pain-free students. METHODS The present study was conducted on 471 university students with and without PD. Based on Visual Analog Scale score, participants were categorized into four groups: no-pain (n = 60), mild pain (n = 83), moderate pain (n = 165) and severe pain (n = 163). Data on the pain characteristics, impact of dysmenorrhea on university absence, class concentration, participation in sports and social activities were obtained and analyzed with the Kruskal-Wallis, Mann-Whitney U and chi-square tests. RESULTS University absence, loss of class concentration and the impact on sports and social activities were higher in severe pain group than in no-pain, mild and moderate pain groups (P < 0.001). There were statistically significant differences in the duration of pain, the pattern of pain and the day when maximum pain is perceived among mild, moderate and severe pain groups (P < 0.05). CONCLUSION The results of the present study present that PD negatively influences academic performance and participation in sports and social activities. Furthermore, pain characteristics differed among the patients with mild, moderate and severe pain. There is a need for further studies that improve treatment options for PD in order to minimize the influence of pain on academic performance and social activities.
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Affiliation(s)
- Ceren Orhan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Şeyda Toprak Çelenay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yıldırım Beyazıt University, Ankara, Turkey
| | - Funda Demirtürk
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gaziosmanpaşa University, Tokat, Turkey
| | - Serap Özgül
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Esra Üzelpasacı
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Türkan Akbayrak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Teherán AA, Piñeros LG, Pulido F, Mejía Guatibonza MC. WaLIDD score, a new tool to diagnose dysmenorrhea and predict medical leave in university students. Int J Womens Health 2018; 10:35-45. [PMID: 29398923 PMCID: PMC5775738 DOI: 10.2147/ijwh.s143510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Dysmenorrhea is a frequent and misdiagnosed symptom affecting the quality of life in young women. A working ability, location, intensity, days of pain, dysmenorrhea (WaLIDD) score was designed to diagnose dysmenorrhea and to predict medical leave. Methods This cross-sectional design included young medical students, who completed a self-administered questionnaire that contained the verbal rating score (VRS; pain and drug subscales) and WaLIDD scales. The correlation between scales was established through Spearman test. The area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, and likelihood ratio (LR +/-) were evaluated to diagnose students availing medical leave due to dysmenorrhea; moreover, to predict medical leave in students with dysmenorrhea, a binary logistic regression was performed. Results In all, 585 students, with a mean age of 21 years and menarche at 12 years, participated. Most of them had regular cycles, 5 days of menstrual blood flow and 1-2 days of lower abdominal pain. The WaLIDD scale presented an adequate internal consistency and strong correlation with VRS subscales. With a cutoff of >6 for WaLIDD and 2 for VRS subscales (drug subscale and pain subscale) to identify students with dysmenorrhea, these scales presented an area under the curve (AUC) ROC of 0.82, 0.62, and 0.67, respectively. To identify students taking medical leave due to dysmenorrhea, WaLIDD (cutoff >9) and VRS subscales (cutoff >2) presented an AUC ROC of 0.97, 0.68, and 0.81; moreover, the WaLIDD scale showed a good LR +14.2 (95% CI, 13.5-14.9), LR -0.00 (95% CI, undefined), and predictive risk (OR 5.38; 95% CI, 1.78-16.2). Conclusion This research allowed a comparison between two multidimensional scales regarding their capabilities, one previously validated and a new one, to discriminate among the general population of medical students, among those with dysmenorrhea or those availing medical leave secondary to dysmenorrhea. WaLIDD score showed a larger effect size than the pain and drug score in the students. In addition, this study demonstrated the ability to predict this combination of events.
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Affiliation(s)
| | | | - Fabián Pulido
- University Hospital San José of Bogotá, Bogotá, Colombia
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The Efficacy of Thai Herbal Prasaplai Formula for Treatment of Primary Dysmenorrhea: A Short-Term Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:2096797. [PMID: 27829860 PMCID: PMC5088276 DOI: 10.1155/2016/2096797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/26/2016] [Indexed: 11/17/2022]
Abstract
This study aims to compare the efficacy of pain relief between a specific Thai herbal Prasaplai formula (PPF) and placebo in patients with primary dysmenorrhea. Forty women with primary dysmenorrhea symptoms were randomized into two groups. The experimental group received PPF capsules 1000 mg orally three times per day before meals for three days starting from the first day of menstruation. The placebo group received placebo as the same dose and time. Average pain intensity from the first day to the third day of cycle significantly decreased in both groups (p < 0.001), but with no statistically significant difference between groups. Using a pre- and posttreatment difference in NRS of at least 2, a greater proportion of patients in PPF group experienced pain relief compared to placebo during the first and second day of period. A greater proportion of PPF group also experienced no pain compared to the placebo group on day 1 and day 3 by using multidimensional scoring. The PPF demonstrates pain relief activity when used during menstruation in primary dysmenorrhea patients, with no adverse effects. However, further studies are needed in order to assess the value of PPF as a long-term prophylaxis for primary dysmenorrhea.
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Dun WH, Yang J, Yang L, Ding D, Ma XY, Liang FL, von Deneen KM, Ma SH, Xu XL, Liu J, Zhang M. Abnormal structure and functional connectivity of the anterior insula at pain-free periovulation is associated with perceived pain during menstruation. Brain Imaging Behav 2016; 11:1787-1795. [DOI: 10.1007/s11682-016-9646-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Kim MJ, Baek IH, Goo BO. The relationship between pelvic alignment and dysmenorrhea. J Phys Ther Sci 2016; 28:757-60. [PMID: 27134354 PMCID: PMC4842435 DOI: 10.1589/jpts.28.757] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/25/2015] [Indexed: 11/29/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the relationship between pelvic alignment and dysmenorrhea in general women. [Subjects and Methods] One hundred two females participated in this study. They were divided into a dysmenorrhea group and a normal group based on the results of a Visual Analogue Scale (VAS) assessment of pain and the Menstrual Distress Questionnaire (MDQ). The survey data was collecting from 5th July to 20th September, 2014. Formetric 4D was used to measure the pelvic alignment, including the values of Trunk Imbalance, Pelvic Tilt, Surface Rotation, Lateral Deviation, Kyphosis Angle, Lordosis Angle. [Results] There was a difference in the spine alignments of each group. The value of pelvic torsion was 2.4 ± 1.8 degree in those with dysmenorrhea, while it was 1.7 ± 1.1 degree in those without. [Conclusion] In conclusion, the results suggest that there is a relationship between menstrual pain and pelvic torsion.
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Affiliation(s)
- Moon-jeong Kim
- Department of Physical Therapy, College of Health Sciences,
Catholic University of Pusan, Republic of Korea
| | - Il-hun Baek
- Department of Physical Therapy, Dong-Eui Institute of
Technology, Republic of Korea
| | - Bong-oh Goo
- Department of Physical Therapy, College of Health Sciences,
Catholic University of Pusan, Republic of Korea
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Stressful Parental-Bonding Exaggerates the Functional and Emotional Disturbances of Primary Dysmenorrhea. Int J Behav Med 2015; 23:458-63. [PMID: 26309099 DOI: 10.1007/s12529-015-9504-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kannan P, Chapple CM, Miller D, Claydon LS, Baxter GD. Menstrual pain and quality of life in women with primary dysmenorrhea: Rationale, design, and interventions of a randomized controlled trial of effects of a treadmill-based exercise intervention. Contemp Clin Trials 2015; 42:81-9. [PMID: 25839713 DOI: 10.1016/j.cct.2015.03.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/23/2015] [Accepted: 03/24/2015] [Indexed: 11/18/2022]
Abstract
Dysmenorrhea in the absence of pelvic abnormality is termed primary dysmenorrhea (PD). The health burden and social and economic costs of PD are high as it is reported to be the leading cause of recurrent absenteeism from school or work in adolescent girls and young adults. The belief that exercise works for relieving symptoms in women with PD is based on anecdotal evidence and non-experimental studies. There is very limited evidence from randomized controlled trials (RCTs) to support the use of exercise to reduce the intensity of menstrual pain. The objective of this study is to evaluate the effectiveness of exercise to reduce intensity of pain and improve quality of life in women with PD. We describe the study design of a single-blind (assessor), prospective, two-arm RCT, and the participant characteristics of the 70 women recruited in the age-group 18 to 43 years. The primary outcome of the study is pain intensity. The secondary outcomes of the study are quality of life, functional limitation, sleep, global improvement with treatment, and protocol adherence. The outcomes assessments are done at first menstrual period (baseline, Week 0), 2nd menstrual period (Week 4) and at two additional time points (Week 16 and Week 28) during the trial. The results of the study will provide physiotherapists, medical practitioners, and researchers as well as the women who have PD with new insights, knowledge, and evidence about the use of exercise to manage pain in women with PD.
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Affiliation(s)
- Priya Kannan
- Centre for Health, Activity and Rehabilitation Research, University of Otago, New Zealand.
| | - Cathy M Chapple
- Centre for Health, Activity and Rehabilitation Research, University of Otago, New Zealand
| | - Dawn Miller
- Department of Women's and Children's Health, Dunedin School of Medicine, New Zealand
| | - Leica S Claydon
- Department of Allied and Public Health, Anglia Ruskin University, Chelmsford, UK
| | - G David Baxter
- Centre for Health, Activity and Rehabilitation Research, University of Otago, New Zealand
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Fang L, Dai N, Wang L, Zhang X, Liu X, Wang Y, Li Y. Urine metabolomic study of primary dysmenorrhea patients during menstrual period using an ultra performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS). RSC Adv 2014. [DOI: 10.1039/c4ra06860b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Witt J, Strickland J, Cheng AL, Curtis C, Calkins J. A randomized trial comparing the VIPON tampon and ibuprofen for dysmenorrhea pain relief. J Womens Health (Larchmt) 2013; 22:702-5. [PMID: 23799280 DOI: 10.1089/jwh.2012.4180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study was conducted to evaluate the therapeutic efficacy of a device designed to deliver high-frequency vibratory stimulation through direct intravaginal tampon application (VIPON) compared with a low-dose over-the-counter pharmacologic treatment of dysmenorrhea. METHODS A randomized, open-label, prospective study comparing the investigational device to an oral self-administration of the over-the-counter dose of 200-400 mg of ibuprofen with the onset of menstrual discomfort was conducted at two academic medical centers in the Midwest region of the United States. Women age 18 and older with self-reported dysmenorrhea were treated with either VIPON or a single dose of 200-400 mg of ibuprofen, randomized for each of the next four menstrual cycles, and pain reduction from baseline was measured according to the Melzack-McGill pain scale. RESULTS Overall, both ibuprofen and VIPON have significant effects on pain reduction according to the Melzack-McGill pain scale. However, the VIPON group achieved statistically significant greater, and more rapid, pain relief at every time point when compared with the ibuprofen. CONCLUSION VIPON tampon is a viable, nonpharmacologic option to traditional low-dose over-the-counter pharmacologic therapies for menstrual pain management with more rapid onset of action.
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Affiliation(s)
- Jacki Witt
- School of Nursing, University of Missouri-Kansas City, Kansas City, Missouri 64108, USA.
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Gagua T, Tkeshelashvili B, Gagua D. Primary dysmenorrhea: prevalence in adolescent population of Tbilisi, Georgia and risk factors. J Turk Ger Gynecol Assoc 2012; 13:162-8. [PMID: 24592031 DOI: 10.5152/jtgga.2012.21] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Accepted: 04/14/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The study aimed to determine the prevalence of dysmenorrhea in female adolescents living in Tbilisi, Georgia; find possible risk factors and establish an association, if any, with nutrition and sleep hygiene. MATERIAL AND METHODS A cross-sectional study was used. A retrospective case control study was used to identify risk factors. PARTICIPANTS A total of 2561 women consented to participate in the research. 431 participants were included in the case-control study. INTERVENTIONS Detailed questionnaire included: reproductive history, demographic features, menstrual pattern, severity of dysmenorrhea and associated symptoms; information about nutrition and sleep hygiene. RESULTS The prevalence of dysmenorrhea was 52.07%. Due to pain, 69.78% reported frequent school absenteeism. The risk of dysmenorrhea in students who had a family history of dysmenorrhea was approximately 6 times higher than in students with no prior history. The prevalence of dysmenorrhea was significantly higher among smokers compared with non-smokers 3.99% vs. 0.68% (p=.0.05 OR:6.102). Those women reporting an increased intake of sugar reported a marked increase of dysmenorrhea compared to women reporting no daily sugar intake (55.61% vs. 44.39%, p=.0023 LR:0.0002). However, alcohol, family atmosphere and nationality showed no correlation with dysmenorrhea. Our study revealed two most important risk factors of dysmenorrhea: meal skipping 59.78% vs. 27.03%, p=.00000 LR: 0.00000 OR:4.014 and sleep hygiene-receiving less sleep 38.77% vs. 19.59%, p=0.000055 LR: 0.000036 OR:2.598. CONCLUSION Primary dysmenorrhea is a common problem in the adolescent population of Tbilisi Geogia. It adversely affects their educational performance. Meal skipping and sleep quantity are associated with dysmenorrhea and may cause other reproductive dysfunctions.
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Affiliation(s)
- Tinatin Gagua
- Department of Gynecology and Obstetrics, Medical University "aeti" Tbilisi, Georgia
| | | | - David Gagua
- Department of Gynecology and Obstetrics, Medical University "aeti" Tbilisi, Georgia
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Abstract
Primary dysmenorrhea is one of the most common health problems in women of reproductive age; however, it remains the most underdiagnosed gynecologic condition. This article will increase nurse practitioners' knowledge of primary dysmenorrhea, which is essential for diagnosing, providing evidence-based education and treatment, and enhancing patient quality of life.
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Ou MC, Hsu TF, Lai AC, Lin YT, Lin CC. Pain relief assessment by aromatic essential oil massage on outpatients with primary dysmenorrhea: a randomized, double-blind clinical trial. J Obstet Gynaecol Res 2012; 38:817-22. [PMID: 22435409 DOI: 10.1111/j.1447-0756.2011.01802.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This study assessed the effectiveness of blended essential oils on menstrual cramps for outpatients with primary dysmenorrhea and explored the analgesic ingredients in the essential oils. MATERIAL AND METHODS A randomized, double-blind clinical trial was conducted. Forty-eight outpatients were diagnosed with primary dysmenorrhea by a gynecologist and had 10-point numeric rating scales that were more than 5. The patients were randomly assigned to an essential oil group (n = 24) and a synthetic fragrance group (n = 24). Essential oils blended with lavender (Lavandula officinalis), clary sage (Salvia sclarea) and marjoram (Origanum majorana) in a 2:1:1 ratio was diluted in unscented cream at 3% concentration for the essential oil group. All outpatients used the cream daily to massage their lower abdomen from the end of the last menstruation continuing to the beginning of the next menstruation. RESULTS Both the numeric rating scale and the verbal rating scale significantly decreased (P < 0.001) after one menstrual cycle intervention in the two groups. The duration of pain was significantly reduced from 2.4 to 1.8 days after aromatherapy intervention in the essential oil group. CONCLUSION Aromatic oil massage provided relief for outpatients with primary dysmenorrhea and reduced the duration of menstrual pain in the essential oil group. The blended essential oils contain four key analgesic components that amount to as much as 79.29%; these analgesic constitutes are linalyl acetate, linalool, eucalyptol, and β-caryophyllene. This study suggests that this blended formula can serve as a reference for alternative and complementary medicine on primary dysmenorrhea.
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Affiliation(s)
- Ming-Chiu Ou
- Department of Applied Cosmetology, Hungkuang University, Taichung, Taiwan.
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Abstract
PURPOSE In this study the impact of pro-environmental behavior, well-being oriented behavior, and use of cloth menstrual pads on dysmenorrhea in Korean female adults was examined according to the theory of reasoned action. METHODS A cross-sectional study was conducted with 195 Korean female adults. Data were collected from June to August, 2010 using self-report questionnaires. Data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficients, multiple regression, and logit regression with STATA 10.0. RESULTS Pro-environmental behavior explained 48% of well-being oriented behavior. Well-being oriented behavior explained 10% of cloth pad use. Use of cloth pad explained 4% of dysmenorrhea and 5% of menstrual pain. The path through well-being oriented behavior had a significant effect from pro-environmental behavior to cloth pad use. CONCLUSION Use of cloth pad was significantly related with well-being oriented behavior, pro-environmental behavior, social influence, dysmenorrhea, and menstrual pain. The results of this study suggest that pro-environmental strategies can help health care providers diminish clients' menstrual symptoms. Nursing intervention can support pro-environmental behavioral strategies.
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Stoelting-Gettelfinger W. A case study and comprehensive differential diagnosis and care plan for the three Ds of women's health: primary dysmenorrhea, secondary dysmenorrhea, and dyspareunia. ACTA ACUST UNITED AC 2010; 22:513-22. [PMID: 21040084 DOI: 10.1111/j.1745-7599.2010.00544.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To provide a case study for the discussion, diagnosis, management, and comprehensive plan of care for primary dysmenorrhea, secondary dysmenorrhea, and dyspareunia for the advanced practice registered nurse (APRN) working in primary care. DATA SOURCES Selected text, research, clinical articles, and personal communication with expert APRNs. CONCLUSIONS Three of the most commonly presenting women's health related conditions include primary dysmenorrhea, secondary dysmenorrhea, and dyspareunia. These conditions can present a challenge in developing an accurate differential diagnosis and appropriate plan of care. This article presents the reader with a detailed case study that provides an analysis of each potential differential diagnosis with rationale. A recommended diagnostic and therapeutic plan of care is included for the reader's review. IMPLICATIONS FOR PRACTICE If left untreated, primary dysmenorrhea, secondary dysmenorrhea, and dyspareunia can result in pain, suffering, and impaired fertility and sexual function. Patients frequently experience symptoms for months to years prior to accurate diagnosis.
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