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Özcan H, Burger NB, Dulmen-den Broeder EV, van Baal MW, den Boogaard EV, De Leeuw RA, Huirne JAF. Instruments to Identify Menstrual Complaints and Their Impact on Adolescents: A Systematic Review. J Pediatr Adolesc Gynecol 2024; 37:106-120. [PMID: 38104798 DOI: 10.1016/j.jpag.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
STUDY OBJECTIVE The aim of this review was to create an overview of available instruments used to evaluate the menstrual complaints of dysmenorrhea and heavy menstrual bleeding (HMB) in adolescents. METHODS The search was conducted in PubMed, Web of Science, Embase, and PsycINFO on December 1, 2022. Studies published in English reporting on menstrual complaints among girls aged 10-19 were included. The quality and bias risk was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. RESULTS Of 8994 identified studies, 57 were included. In these studies, 19 instruments were described, of which 8 were validated in adolescents. One was difficult to use in daily practice, 1 had low sensitivity and specificity in the detection of HMB, 2 were validated by face validity, and 2 were not specifically developed to evaluate (the impact of) menstrual complaints. Therefore, only 2 were validated and feasible to measure adolescent menstrual complaints: the Period ImPact and Pain Assessment (PIPPA) and the Adolescent Menstrual Bleeding Questionnaire (aMBQ). Remarkably, the Pictorial Blood Loss Assessment Chart (PBAC) was the most frequently used instrument in adolescents. There was one modified version of the PBAC for adolescents, which had a lower cutoff value for HMB and low sensitivity and specificity. CONCLUSION We found that the PIPPA and aMBQ are suitable for assessing menstrual complaints and their impact on daily activities and health-related quality of life in adolescents. The PBAC, which is used frequently in adults, needs to be further assessed specifically for adolescents. In particular, the clinical relevance of the PBAC cutoff value for HMB should be determined for this age group. Considering the different interpretations, experiences, and limited knowledge of menstrual complaints, instruments suitable for adults may not be suitable for adolescents.
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Affiliation(s)
- Habibe Özcan
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, location AMC and VUmc, Amsterdam, The Netherlands
| | - Nicole B Burger
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, location AMC and VUmc, Amsterdam, The Netherlands
| | - Eline van Dulmen-den Broeder
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, location AMC and VUmc, Amsterdam, The Netherlands
| | - Marchien W van Baal
- Department of Obstetrics and Gynaecology, Flevo Hospital, Almere, The Netherlands
| | - Emmy van den Boogaard
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, location AMC and VUmc, Amsterdam, The Netherlands
| | - Robert A De Leeuw
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, location AMC and VUmc, Amsterdam, The Netherlands
| | - Judith A F Huirne
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, location AMC and VUmc, Amsterdam, The Netherlands.
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Gambadauro P, Hadlaczky G, Wasserman D, Carli V. Menstrual symptoms and subjective well-being among postmenarchal adolescents. AJOG GLOBAL REPORTS 2024; 4:100304. [PMID: 38304304 PMCID: PMC10830861 DOI: 10.1016/j.xagr.2023.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Menstrual symptoms are predominantly studied among adults but may occur directly after menarche. Adolescent menstrual healthcare, however, faces specific obstacles and more research into menstrual symptoms as a determinant of adolescent well-being is therefore advocated. OBJECTIVE This study aimed to investigate menstrual symptoms and their impact on everyday life and well-being among postmenarchal adolescents. STUDY DESIGN A survey was delivered to a random sample of 1644 schoolgirls, drawn from a population-based project involving 116 lower secondary education schools (7th and 8th grade) in Stockholm, Sweden. Menstrual symptoms (ie, dysmenorrhea, heavy bleeding, irregular periods, mood disturbance, other general symptoms) were investigated through multiple choice questions and defined according to their impact on everyday life as mild (seldom affected), moderate (affected but possible to cope) and severe (affected and difficult to cope). Subjective well-being was measured with the World Health Organization Five Well-Being index. Postmenarchal respondents were eligible for analysis; those with incomplete outcome data or using hormonal contraception were excluded. The frequency and severity of symptoms across different postmenarchal years (1st, 2nd, 3rd, 4th, or 5th+ year after menarche) were studied with Chi-square and Kendall's tau statistics. Analysis of variance was used to study the association between menstrual symptoms and World Health Organization Five Well-Being index scores. A composite menstrual health index variable was obtained through principal component analysis and used to study the overall impact of menstrual symptoms on well-being in regression analyses. RESULTS Of 1100 postmenarchal girls (mean age, 14.1±0.7 years), 93.2% reported menstrual symptoms, 81.3% had at least 1 moderate symptom and 31.3% had at least 1 severe symptom. The most frequent symptoms were dysmenorrhea (80.4%) and mood disturbance (81.1%), followed by irregular periods (67.9%), heavy bleeding (60.4%), and other general symptoms (60.4%). Throughout postmenarchal years, there was a significant increase in frequency and severity (P<.001) of dysmenorrhea (τ=0.148), heavy bleeding (τ=0.134), mood disturbance (τ=0.117), and other general symptoms (τ=0.110), but not irregular periods (τ=-0.0201; P=.434). Girls with menstrual symptoms had significantly lower World Health Organization Five Well-Being index scores than those without symptoms (mean difference, -17.3; 95% confidence interval, -22.4 to -12.3). Analysis of variance showed significant associations (P<.001) with World Health Organization Five Well-Being index scores for each of the examined menstrual symptoms. In post hoc pairwise comparisons with peers without symptoms, the greatest reductions in World Health Organization Five Well-Being index score were found among girls with severe symptoms (mean difference for: dysmenorrhea, -20.72; heavy bleeding, -15.75; irregular periods, -13.81; mood disturbance, -24.97; other general symptoms, -20.29), but significant differences were observed even for moderate or mild symptoms. The composite menstrual health index was significantly associated with World Health Organization Five Well-Being index scores in regression analysis, independently of age, age at menarche, body mass index, smoking, physical activity, own and parental country of birth, biparental care, and socioeconomic status. CONCLUSION Despite growing awareness about the relevance of menstruation to women's health, unmet menstrual health needs are a potential threat to the well-being of adolescents. Education, screening, and clinical competence are important tools to reduce the burden of menstrual symptoms during adolescence and to prevent long-term consequences. The development of novel person-centered strategies should be a priority for clinical practice and research in adolescent menstrual health.
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Affiliation(s)
- Pietro Gambadauro
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, Wasserman, and Carli)
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden (Dr Gambadauro)
- Stockholm Health Care Services, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, and Carli)
- Res Medica Sweden, Uppsala, Sweden (Dr Gambadauro)
| | - Gergö Hadlaczky
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, Wasserman, and Carli)
- Stockholm Health Care Services, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, and Carli)
| | - Danuta Wasserman
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, Wasserman, and Carli)
| | - Vladimir Carli
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, Wasserman, and Carli)
- Stockholm Health Care Services, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, and Carli)
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Thompson EC, Owen J, Wolfson JA, Arbuckle JL. Menstrual Suppression in the Myelosuppressed: A Retrospective Cohort Study. JCO Oncol Pract 2023; 19:586-594. [PMID: 37220317 DOI: 10.1200/op.22.00841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/01/2023] [Accepted: 03/17/2023] [Indexed: 05/25/2023] Open
Abstract
PURPOSE Adolescent and young adult female patients receiving myelosuppressive cancer treatments are at risk of abnormal uterine bleeding (AUB). The frequency with which patients with cancer receive menstrual suppression and the agents used have not previously been well-characterized. We studied the rate of menstrual suppression, the effect of suppression on bleeding and blood product utilization, and if there were practice pattern differences between adult and pediatric oncologists. METHODS We established a retrospective cohort of 90 females with a diagnosis of Hodgkin or non-Hodgkin lymphoma (n = 25), AML (n = 46), or sarcoma (n = 19) and treated with chemotherapy between 2008 and 2019 at our institutions (University of Alabama at Birmingham [UAB] adult oncology: UAB hospital; UAB pediatric oncology: Children's of Alabama). Data were abstracted from the medical record including sociodemographics, primary oncologist specialty (pediatric v adult), cancer details (diagnosis and treatment) and gynecologic course (documented gynecologic history, menstrual suppression agents used, reported AUB outcomes, and treatments). RESULTS The majority of patients (77.8%) received menstrual suppression. Compared with nonsuppressed patients, suppressed patients had similar rates of packed red blood cell transfusions but higher number of platelet transfusions. Adult oncologists were more likely to document a gynecologic history, consult gynecology, and list AUB as a problem. Among suppressed patients, there was heterogeneity in the agents used for menstrual suppression, with a predilection toward progesterone-only agents; a low rate of thrombotic events was observed. CONCLUSION Menstrual suppression was common in our cohort with variability in agents used. Pediatric and adult oncologists demonstrated different practice patterns.
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Affiliation(s)
- Emma C Thompson
- Department of Medicine, University of North Carolina, Chapel Hill, NC
| | - John Owen
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL
| | - Julie A Wolfson
- Division of Hematology-Oncology, Department of Pediatrics, Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL
| | - Janeen L Arbuckle
- Division of Women's Reproductive Health, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL
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Hobbs AK, Cheng HL, Tee EY, Steinbeck KS. Menstrual Dysfunction in Adolescents with Chronic Illness: A Systematic Review. J Pediatr Adolesc Gynecol 2023:S1083-3188(23)00337-6. [PMID: 37192680 DOI: 10.1016/j.jpag.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/24/2023] [Accepted: 05/08/2023] [Indexed: 05/18/2023]
Abstract
STUDY OBJECTIVE Menstrual dysfunction can impact both the physical and emotional health of young people1. Multiple chronic disease have been associated with menstrual dysfunction in adults2, however there is little research in adolescents, despite non adherence and sub-optimal illness control in this group. We aimed to identify the impact chronic illness has on the age of menarche (AAM) and the menstrual cycle in adolescents. METHODS Studies were extracted of female adolescents aged 10-19 who had a chronic physical illness. Data included outcomes on age of menarche and/or menstrual cycle quality. Exclusion criteria aimed to exclude diseases where menstrual dysfunction was a known part of the disease pathophysiology i.e. polycystic ovarian syndrome3, or in which medications were used that directly impacted gonadal function4. A literature search (to January 2022) was performed on EMBASE, PubMed and Cochrane library databases. Two widely used modified quality analysis tools were used. RESULTS Our initial search netted 1451 articles, of which 95 full texts were examined and 43 met inclusion criteria. 27 papers focussed on Type 1 Diabetes (T1D), with 8 papers examining adolescents with cystic fibrosis (CF) and the remaining studying inflammatory bowel disease (IBD), juvenile idiopathic arthritis (JIA), coeliac disease and chronic renal disease. Metanalysis of 933 patients with T1D versus 5244 controls demonstrated a significantly later AAM in T1D (by 0.42 years; p=<0.00001). There was also a significant association between higher HbA1c and insulin dose (IU/kg) and later age of menarche. Eighteen papers reviewed other aspects of menstruation, including dysmenorrhoea, oligomenorrhoea, amenorrhoea and ovulatory function, with variable findings. CONCLUSION The majority of studies were small and in single populations. Despite this, there was evidence of delayed menarche and some evidence of irregular menses in those with CF and T1D. Further structured studies are needed to evaluate menstrual dysfunction in adolescents and how it relates to their chronic illness.
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Affiliation(s)
- Annabelle K Hobbs
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia; Department of Endocrinology and Diabetes, Queensland Children's Hospital, Brisbane, QLD 4101.
| | - Hoi Lun Cheng
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Elizabeth Yf Tee
- The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Katharine S Steinbeck
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
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Pringle D, Suliman S, Seedat S, van den Heuvel LL. The impact of childhood maltreatment on women's reproductive health, with a focus on symptoms of polycystic ovary syndrome. CHILD ABUSE & NEGLECT 2022; 133:105831. [PMID: 35985071 DOI: 10.1016/j.chiabu.2022.105831] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childhood maltreatment leads to lifelong health risks, particularly in women. Although reproductive health has been linked to such maltreatment, limited literature exists on its association with polycystic ovary syndrome (PCOS). OBJECTIVES In a sample of psychiatrically healthy women, we evaluated the impact of child maltreatment (subtypes of abuse and neglect) on women's reproductive health outcomes, specifically PCOS. PARTICIPANTS AND SETTING The 237 psychiatrically healthy women, aged between 18 and 79 years, were control participants in a case-control study (SHARED ROOTS), conducted in Cape Town, South Africa, between May 2014 and June 2017. METHODS Probable PCOS was based on a history of symptoms of ovulatory dysfunction and hyperandrogenism or a diagnosis of PCOS. We conducted hierarchical logistic regression models to assess which child maltreatment subtypes (emotional, physical and sexual abuse and emotional and physical neglect) were significantly associated with PCOS, controlling for sociodemographic and clinical factors. RESULTS Probable PCOS was present in 29 (12.2 %) women. Emotional abuse (31.6 %) was the most frequent type of child maltreatment and was significantly associated with PCOS (OR = 5.11, CI 1.87; 13.98), including when other maltreatment types were accounted for (OR = 3.90, CI 1.27; 12.02). Physical abuse was associated with PCOS (OR = 4.21, CI 1.43; 12.38), but was not significant when other maltreatment types were factored in. CONCLUSIONS Child maltreatment is independently associated with PCOS in women without psychiatric disorders. In the context of all maltreatment subtypes, emotional abuse remained associated with PCOS, suggesting its unique effect on this endocrinopathy.
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Affiliation(s)
- Deirdre Pringle
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, Cape Town, South Africa
| | - Sharain Suliman
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa.
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa.
| | - Leigh Luella van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg 7505, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Stellenbosch University, Cape Town, South Africa.
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Chao M, Menon C, Elgendi M. Menstrual cycles during COVID-19 lockdowns: A systematic review and meta-analysis. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:949365. [PMID: 36303682 PMCID: PMC9580671 DOI: 10.3389/frph.2022.949365] [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: 05/23/2022] [Accepted: 07/21/2022] [Indexed: 12/03/2022] Open
Abstract
Coronavirus disease 2019 lockdowns produced psychological and lifestyle consequences for women of reproductive age and changes in their menstrual cycles. To our knowledge, this is the first systematic review to characterize changes in menstrual cycle length associated with lockdowns compared to non-lockdown periods. A search on 5 May 2022 retrieved articles published between 1 December 2019, and 1 May 2022, from Medline, Embase, and Web of Science. The included articles were peer-reviewed observational studies with full texts in English, that reported menstrual cycle lengths during lockdowns and non-lockdowns. Cross-sectional and cohort studies were appraised using the Appraisal tool for Cross-Sectional Studies and the Cochrane Risk of Bias Tool for Cohort Studies, respectively. Review Manager was used to generate a forest plot with odds ratios (OR) at the 95% confidence interval (CI), finding a significant association between lockdown and menstrual cycle length changes for 21,729 women of reproductive age (OR = 9.14, CI: 3.16-26.50) with a significant overall effect of the mean (Z = 4.08, p < 0.0001). High heterogeneity with significant dispersion of values was observed (I 2 = 99%, τ = 1.40, χ2 = 583.78, p < 0.0001). This review was limited by the availability of published articles that favored high-income countries. The results have implications for adequately preparing women and assisting them with menstrual concerns during lockdown periods.
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Affiliation(s)
- Melissa Chao
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Carlo Menon
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, Zurich, Switzerland
| | - Mohamed Elgendi
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, Zurich, Switzerland
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Pogodina A, Dolgikh O, Astakhova T, Klimkina J, Khramova E, Rychkova L. Health-related quality of life and menstrual problems in adolescents. J Paediatr Child Health 2022; 58:1028-1032. [PMID: 35141982 DOI: 10.1111/jpc.15895] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/29/2021] [Accepted: 01/04/2022] [Indexed: 11/28/2022]
Abstract
AIM To evaluate whether the health-related quality-of-life (HRQoL) scores would be different for adolescents with menstrual problems as compared to those with normal menstruation after taking into account clinical, socio-demographic and life-style factors. METHODS The Paediatric Quality of Life Inventory 4.0 scale was used to assess HRQoL in 126 schoolgirls of 16 ± 0.4 years old. The adolescents completed semi-structured questionnaires containing information on social and demographic characteristics, life-style features and menstrual questionnaires that included the following: age of menstruation, menstrual cycle length, duration of production, the number of pads used per day, menstrual pain and drug administration to relieve dysmenorrhea. The menstrual problems were classified into three main groups: dysmenorrhoea, oligomenorrhoea, and heavy menstrual bleeding. Anthropometric measurements were performed by a physician. Medical history was obtained from school medical charts. RESULTS Ninety-seven (77%) girls had menstrual problems. Dysmenorrhoea (n = 92, 73%) was the most frequent of these, followed by oligomenorrhoea (n = 13, 10.3%) and heavy menstrual bleeding (n = 6, 4.8%). Thirteen (10.3%) girls had combined disorders. A multivariate analysis adjusted for life-style factors found an independent association of any menstrual problems, oligomenorrhoea and dysmenorrhoea with low HRQoL scores in the emotional functioning domain. For adolescents with oligomenorrhoea, an association with low total scale scores was also shown but it did not reach statistical significance. CONCLUSION The prevalence of menstrual problems is high among schoolgirls. Medical professionals working with adolescents should know that girls with menstrual problems are highly likely to have a poor quality of life, especially those with oligomenorrhoea.
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Affiliation(s)
- Anna Pogodina
- Pediatric Department, Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - Olga Dolgikh
- Pediatric Department, Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - Tatyana Astakhova
- Pediatric Department, Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - Juliana Klimkina
- Pediatric Department, Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - Elena Khramova
- Pediatric Department, Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - Lyubov Rychkova
- Pediatric Department, Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
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Edens C. Early Sexual Health and Reproductive Implications in Pediatric Rheumatic Diseases. Rheum Dis Clin North Am 2021; 48:91-112. [PMID: 34798961 DOI: 10.1016/j.rdc.2021.09.015] [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: 11/29/2022]
Abstract
A comprehensive review of reproductive health subtopics, including puberty, menarche, sexual orientation, gender identity, and gynecologic cancers as they pertain to patients with pediatric rheumatic diseases and those who care for them. Rheumatic disease medications and their effect on reproductive health across childhood and adolescence are also reviewed.
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Affiliation(s)
- Cuoghi Edens
- Department of Pediatrics, Section Pediatric Rheumatology, University of Chicago Medicine, 5841 South Maryland Avenue, C104-A, MC5044, Chicago, IL 60637, USA; Department of Internal Medicine, Section of Rheumatology, University of Chicago Medicine, 5841 South Maryland Avenue, C104-A, MC5044, Chicago, IL 60637, USA.
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Vannuccini S, Rossi E, Cassioli E, Cirone D, Castellini G, Ricca V, Petraglia F. Menstrual Distress Questionnaire (MEDI-Q): a new tool to assess menstruation-related distress. Reprod Biomed Online 2021; 43:1107-1116. [PMID: 34753680 DOI: 10.1016/j.rbmo.2021.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 08/15/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
RESEARCH QUESTION Menstruation is a physiological event often associated with subjective distress. Is there a tool that assesses and objectively evaluates the global distress experienced by women during their period? DESIGN An observational cross-sectional study conducted between June 2019 and May 2020 at Careggi University Hospital, Florence, Italy. A new questionnaire, The Menstrual Distress Questionnaire (MEDI-Q), was developed and administered to a group of healthy women (n = 418) of fertile age (18-50 years), without known uterine, psychiatric disorders, or both. The MEDI-Q investigated 25 items, covering the following areas: pain, discomfort, psychic or cognitive changes, gastrointestinal symptoms and changes in physiological functions. MEDI-Q Total Score and the three sub-scales, Menstrual Symptoms (MS), Menstrual Symptoms Distress (MSD) and Menstrual Specificity Index (MESI) were evaluated. The validation of MEDI-Q was achieved by testing test-retest reliability and internal consistency, convergent and concurrent validity. RESULTS The MEDI-Q produced reliable results with good internal consistency, convergent and concurrent validity. MEDI-Q Total Score, MS and MSD all positively correlated with general psychopathology and premenstrual symptoms. A receiver operating characteristic analysis was used to determine the cut-off value of 20 (inclusive) and to identify the women with clinically relevant menstrual distress (area under the curve 0.90, 95% CI 0.86 to 0.93; P < 0.001). CONCLUSION MEDI-Q is a new tool for evaluating menstruation-related distress, and provides a representative score of stress perception. MEDI-Q may be added to routine women's healthcare to help identify and adequately monitor menstruation-related disorders, and their effect on wellbeing, promptly.
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Affiliation(s)
- Silvia Vannuccini
- Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Careggi University Hospital Florence, Italy
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence Florence, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence Florence, Italy
| | - Donatello Cirone
- General Management Staff, Careggi University Hospital Florence, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence Florence, Italy
| | - Felice Petraglia
- Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Careggi University Hospital Florence, Italy.
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Bellis EK, Li AD, Jayasinghe YL, Girling JE, Grover SR, Peate M, Marino JL. Exploring the Unmet Needs of Parents of Adolescent Girls with Heavy Menstrual Bleeding and Dysmenorrhea: A Qualitative Study. J Pediatr Adolesc Gynecol 2020; 33:271-277. [PMID: 31874316 DOI: 10.1016/j.jpag.2019.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVE To provide insight into the unmet needs of parents of adolescents with heavy menstrual bleeding or dysmenorrhea, in the context of their daughters' menstrual concerns. DESIGN Qualitative interview study using semi-structured interviews. SETTING Gynecology outpatient clinic at The Royal Children's Hospital, Melbourne, Australia. PARTICIPANTS Parents of adolescent girls with heavy menstrual bleeding or dysmenorrhea recruited from an adolescent gynecology clinic between May and August 2018. INTERVENTIONS In depth, semi-structured interviews with 24 parents whose daughters had heavy menstrual bleeding or dysmenorrhea. Data were analyzed using a grounded theory approach. MAIN OUTCOME MEASURES Themes derived from interview transcripts about the supportive care needs of parents. RESULTS Thirteen themes emerged in the interviews across 4 areas of need: (1) experiences with healthcare, (2) informational needs, (3) support and acceptance, and (4) financial impacts. Across the interviews, parents identified a need for greater awareness and education among parents and daughters, health professionals, and the broader community. CONCLUSION This research confirmed that parents play a significant role in daughters' menstrual health care and have a series of unmet needs. Strategies and interventions specifically targeting these parents may be warranted.
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Affiliation(s)
- Emily K Bellis
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Anna D Li
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Yasmin L Jayasinghe
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Parkville, VIC, Australia; Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, VIC, Australia
| | - Jane E Girling
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Parkville, VIC, Australia; Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Sonia R Grover
- Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Parkville, VIC, Australia.
| | - Jennifer L Marino
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, The University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
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Li AD, Bellis EK, Girling JE, Jayasinghe YL, Grover SR, Marino JL, Peate M. Unmet Needs and Experiences of Adolescent Girls with Heavy Menstrual Bleeding and Dysmenorrhea: A Qualitative Study. J Pediatr Adolesc Gynecol 2020; 33:278-284. [PMID: 31765795 DOI: 10.1016/j.jpag.2019.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/05/2019] [Accepted: 11/14/2019] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE To identify and examine the key areas of need and explore the experiences of adolescent girls with heavy menstrual bleeding and/or dysmenorrhea. DESIGN AND SETTING Qualitative interview study using semi-structured interviews. Gynaecology outpatient clinic at The Royal Children's Hospital, Melbourne, Australia. PARTICIPANTS Adolescent girls (12-18 years; mean age, 14.8 ± 1.5 years) presenting with heavy menstrual bleeding and/or dysmenorrhea at the clinic (N = 30). INTERVENTIONS AND MAIN OUTCOME MEASURES In-depth semi-structured interviews were conducted between May and August 2018. Interview data were thematically analyzed using a grounded theory approach. Themes covered experiences and unmet needs of adolescent girls with heavy menstrual bleeding and/or dysmenorrhea. RESULTS A total of 12 themes were identified, and covered the impact of symptoms, experiences, and/or unmet needs of these adolescents. Key themes highlighting experiences and unmet needs related to (1) coordination of healthcare, (2) day-to-day coping, (3) school, and (4) information surrounding menstrual issues. From these themes, 7 unmet needs emerged and were organized under 3 key areas of need: (1) treatment, management, and care, (2) improvements in the school environment, and (3) menstrual health as a gendered issue. CONCLUSION Menstrual concerns can have a profound physical and psychosocial impact on adolescents. Effective school-based menstrual education programs may be key in reducing stigma, fear, and shame surrounding menstruation, in teaching positive management strategies and in encouraging adolescents to seek help for their menstrual concerns.
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Affiliation(s)
- Anna D Li
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, The Royal Women's Hospital, Parkville, VIC, Australia
| | - Emily K Bellis
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, The Royal Women's Hospital, Parkville, VIC, Australia
| | - Jane E Girling
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, The Royal Women's Hospital, Parkville, VIC, Australia; Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Yasmin L Jayasinghe
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, The Royal Women's Hospital, Parkville, VIC, Australia; Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Sonia R Grover
- Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Jennifer L Marino
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, The Royal Women's Hospital, Parkville, VIC, Australia; Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital, Melbourne, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, The Royal Women's Hospital, Parkville, VIC, Australia.
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Arafa A, Mahmoud O, Abu Salem E, Mohamed A. Association of sleep duration and insomnia with menstrual symptoms among young women in Upper Egypt. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-019-0011-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Disturbed sleep and menstrual symptoms are prevalent health conditions with limited successful treatments. This study aimed to detect the association between sleep problems and menstrual symptoms among young women in Upper Egypt. In this cross-sectional study, 4122 young women aged 12 to 25 years and residing in Beni-Suef City were recruited using a multi-stage random method. The participants were interviewed for their premenstrual disorders, dysmenorrhea, average daily hours of sleep, and insomnia during the previous 6 months.
Results
Young women who reported sleep < 8 and < 7 h/day had more premenstrual spasm than those who slept ≥ 8 h/day: OR 1.3, 95% CI 1.1–1.5 and OR 1.3, 95% CI 1.1–1.6, respectively. Hours of sleep were not associated with other menstrual symptoms. Compared with those without insomnia, young women with insomnia were more likely to report premenstrual spasm (OR 2.3, 95% CI 18–2.8), nervousness (OR 2.3, 95% CI 1.9–2.8), fatigue (OR 2.9, 95% CI 2.4–3.6), headache (OR 2.6, 95% CI 2.2–3.2), breast pain (OR 1.9, 95% CI 1.5–2.3), weight gain (OR 2.6, 95% CI 2.0–3.3), GIT disturbance (OR 2.8, 95% CI 2.2–3.6), and dysmenorrhea (OR 2.6, 95% CI 1.6–4.3).
Conclusion
Insomnia has been shown to be significantly associated with premenstrual symptoms and dysmenorrhea, but no substantial relationship has been indicated between hours of sleep and most menstrual symptoms.
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13
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Close AG, Ghuman A, Friehling E, Hamm M, Frederick NN, Miller E, Kazmerski TM. Experiences with Menses and Menstrual Suppression of Young Women with a History of Cancer. J Adolesc Young Adult Oncol 2019; 9:23-29. [PMID: 31592736 DOI: 10.1089/jayao.2019.0077] [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
Background: Adolescent and young adult (AYA) women undergoing multiagent chemotherapy are at risk for heavy menstrual bleeding (HMB). There is a paucity of data on the experiences with menses of AYA women with cancer, their risk for HMB, and how they perceive menstrual suppression. Objective: This study aimed to (1) describe the attitudes and experiences of AYA women with a history of cancer regarding their menses and menstrual suppression and to (2) investigate facilitators and barriers to improve this aspect of oncologic care. Design/Methods: AYA women with a history of cancer completed individual semistructured interviews regarding their experiences, attitudes, and preferences around menstrual health. Two independent reviewers conducted a thematic analysis of transcribed interviews to elicit major themes. Results: We interviewed 20 young women with a history of cancer (mean age 19.9 years) who were treated with chemotherapy within the past 5 years. Themes included the following: (1) negative feelings and worry about menstrual bleeding; (2) positive attitudes toward menstrual suppression; (3) misconceptions about menstrual health; and (4) desire for tailored discussions about menstrual suppression. Conclusions: AYA women with a cancer history elucidate clear opinions regarding menstruation during chemotherapy, and many hold misconceptions regarding menses and menstrual suppression. Enhanced patient-provider communication and patient educational resources around menstrual health and menstrual suppression are needed to improve comprehensive oncologic care during chemotherapy.
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Affiliation(s)
- Allison G Close
- Division of Hematology/Oncology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Amita Ghuman
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erika Friehling
- Division of Hematology/Oncology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Megan Hamm
- Director of Qualitative, Evaluation, and Stakeholder Engagement Research Services, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Natasha N Frederick
- Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Traci M Kazmerski
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh, Pittsburgh, Pennsylvania
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14
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Knox B, Ong YC, Bakar MA, Grover SR. A longitudinal study of adolescent dysmenorrhoea into adulthood. Eur J Pediatr 2019; 178:1325-1332. [PMID: 31292729 DOI: 10.1007/s00431-019-03419-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/23/2019] [Accepted: 06/25/2019] [Indexed: 12/17/2022]
Abstract
Dysmenorrhoea is the most common gynaecological symptom in adolescents. Secondary dysmenorrhoea is mostly due to endometriosis. There are no known follow-up studies of dysmenorrhoea into adulthood. Cases of endometriosis often have a long history of dysmenorrhea; however, studies to date have been retrospective. This longitudinal cohort study aimed at analysing the long-term outcomes of dysmenorrhoea and associated rate of endometriosis identified in this cohort. Participants of a study of adolescents seen for dysmenorrhoea were followed-up at an average of 10.24 years. Of those contactable (74), 70 (94.6%) were included. As adults, 19 (27.1%) had slight or no pain with menstruation. Increased age of menarche was found to be associated with no menstrual pain in adulthood (OR 2.10, p = 0.034). No adolescent characteristic studied was found to be associated with severe or very severe dysmenorrhoea as an adult. At follow-up, 13 young women (18.6%) had been diagnosed with endometriosis. All cases of endometriosis were mild. The use of the oral contraceptive pill as an adolescent and feeling an improvement in symptoms with treatment as an adolescent were found to be associated with a diagnosis of endometriosis.Conclusion: These findings are important for counselling adolescents regarding this common presentation. What is Known: •Dysmenorrhoea is the most common gynaecological complaint for adolescents What is New: •Dysmenorrhoea from adolescence resolves in 1 in 4 of young women and no adolescent characteristics predict severe or very severe pain with menstruation in adults. •Only 1 in 5 of women were found to have endometriosis (all mild disease), despite a mean of 10 years of preceding dysmenorrhoea.
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Affiliation(s)
- Benita Knox
- Department Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, Parkville, Melbourne, 3052, Australia
| | - Yi Chen Ong
- Department Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, Parkville, Melbourne, 3052, Australia.,The University of Melbourne, Parkville, Melbourne, Australia
| | | | - Sonia R Grover
- Department Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, Parkville, Melbourne, 3052, Australia. .,The University of Melbourne, Parkville, Melbourne, Australia.
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15
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Schoep ME, Adang EMM, Maas JWM, De Bie B, Aarts JWM, Nieboer TE. Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women. BMJ Open 2019; 9:e026186. [PMID: 31248919 PMCID: PMC6597634 DOI: 10.1136/bmjopen-2018-026186] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To evaluate age-dependent productivity loss caused by menstruation-related symptoms, measured in absenteeism (time away from work or school) and presenteeism (productivity loss while present at work or school). METHODS Design/setting: internet-based, cross-sectional survey conducted in the Netherlands from July to October 2017. PARTICIPANTS 32 748 women aged 15-45 years, recruited through social media. OUTCOME MEASURES self-reported lost productivity in days, divided into absenteeism and presenteeism; impact of menstrual symptoms; reasons women give when calling in sick; and women's preferences regarding the implications of menstruation-related symptoms for schools and workplaces. RESULTS A total of 13.8% (n=4514) of all women reported absenteeism during their menstrual periods with 3.4% (n=1108) reporting absenteeism every or almost every menstrual cycle. The mean absenteeism related to a woman's period was 1.3 days per year. A total of 80.7% (n=26 438) of the respondents reported presenteeism and decreased productivity a mean of 23.2 days per year. An average productivity loss of 33% resulted in a mean of 8.9 days of total lost productivity per year due to presenteeism. Women under 21 years were more likely to report absenteeism due to menstruation-related symptoms (OR 3.3, 95% CI 3.1 to 3.6). When women called in sick due to their periods, only 20.1% (n=908) told their employer or school that their absence was due to menstrual complaints. Notably, 67.7% (n=22 154) of the participants wished they had greater flexibility in their tasks and working hours at work or school during their periods. CONCLUSIONS Menstruation-related symptoms cause a great deal of lost productivity, and presenteeism is a bigger contributor to this than absenteeism. There is an urgent need for more focus on the impact of these symptoms, especially in women aged under 21 years, for discussions of treatment options with women of all ages and, ideally, more flexibility for women who work or go to school.
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Affiliation(s)
- Mark E Schoep
- Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands
- Department of Obstetrics and Gynaecology, Hospital Rijnstate, Arnhem, The Netherlands
| | - Eddy M M Adang
- Department of Health Evidence, Radboudumc, Nijmegen, The Netherlands
| | - Jacques W M Maas
- Obstetrics & Gynaecology, Maxima Medical Centre locatie Veldhoven, Veldhoven, The Netherlands
| | - Bianca De Bie
- Dutch Patient Endometriosis Foundation, Numansdorp, The Netherlands
| | - Johanna W M Aarts
- Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands
| | - Theodoor E Nieboer
- Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands
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16
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Arafa A, Saleh L, Shawky S. Association between menstrual disorders and school absenteeism among schoolgirls in South Egypt. Int J Adolesc Med Health 2019; 34:ijamh-2019-0081. [PMID: 31203260 DOI: 10.1515/ijamh-2019-0081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/25/2019] [Indexed: 01/27/2023]
Abstract
Background Menstrual disorders are highly prevalent among girls and may interrupt school attendance. This study aimed to investigate the association between menstrual disorders and school absenteeism among schoolgirls in South Egypt. Subjects and methods A multi-stage random sampling method was adopted to select 930 schoolgirls. A self-administered questionnaire composed of 3 sections (socio-demographic characteristics, menstrual disorders, and school absenteeism) was used to assess the relationship between different menstrual disorders and school absenteeism during the previous 6 months. Results The mean age of the participating schoolgirls was 15.5 ± 0.8 years, age of menarche 13.2 ± 1.2 years, menstrual cycle duration 28.8 ± 7.3 days with average flow days 5 ± 1.3. During the previous 6 months, 43.9% of schoolgirls reported school absenteeism. Dysmenorrhea (89.1%) and premenstrual symptoms, especially abdominal spasm (62.2%), fatigue (32%), and headache (22.7%) were heavily reported during the same period. Menstrual flow >4 days [odds ratio (OR) 1.37, 1.04-1.80], premenstrual abdominal spasm (OR 1.60, 1.22-2.11), fatigue (OR 1.69, 1.27-2.24), breast tenderness (OR 1.67, 1.17-2.38), insomnia (OR 1.92, 1.31-2.80), abdominal bloating (OR 2.29, 1.34-3.91), dysmenorrhea (OR 4.44, 2.58-7.62), dysmenorrhea for more than 1 day (OR 1.38, 1.03-1.84), menstrual acne flare (OR 2.23, 1.68-2.97), dysuria (OR 1.96, 1.31-2.93), and facial hair (OR 2.59, 1.26-5.31) were significantly associated with school absenteeism. Conclusion Premenstrual and menstrual disorders are associated with school absenteeism among schoolgirls in South Egypt. Future research should focus on the effect of school counseling on reducing the absenteeism rate attributed to menstrual disorders.
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Affiliation(s)
- Ahmed Arafa
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Lamiaa Saleh
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Sherwet Shawky
- Department of Obstetrics and Gynecology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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17
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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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18
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Bleeding out the quality-adjusted life years: evaluating the burden of primary dysmenorrhea using time trade-off and willingness-to-pay methods. Pain 2018; 158:2259-2267. [PMID: 28767507 DOI: 10.1097/j.pain.0000000000001028] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary dysmenorrhea (PD), or painful menstruation in the absence of identified uterine pathology, affects 5 to 9 in every 10 reproductive-aged women. Despite its high prevalence, just a few studies with very small patient numbers have focused on health-related quality of life impairment in PD. We aimed to assess health-related quality of life values for a severe and a mild hypothetical PD health state using 10-year time trade-off and willingness-to-pay methods. In 2015, a nationwide convenience sample of women, aged between 18 and 40 years, was recruited using an Internet-based cross-sectional survey in Hungary. Respondents with a known history of secondary dysmenorrhea were excluded. Data on 1836 and 160 women, with and without a history of PD, respectively, were analysed. Mean utility values for the severe and mild health states were 0.85 (median 0.95) and 0.94 (median 1), respectively. Participants were willing to pay a mean of &OV0556;1127 (median &OV0556;161) and &OV0556;142 (median &OV0556;16) for a complete cure from the severe and mild PD health states. Compared with the non-PD group, women with PD valued both health states worse according to willingness to pay (P < 0.05) but similar in the time trade-off. It seems that PD substantially contributes to the quality-adjusted life year loss in this age group, which is comparable with losses from chronic diseases such as type 1 diabetes, asthma, atopic eczema, or chronic migraine. Our findings provide a useful input to cost-effectiveness and cost-benefit analyses of PD treatments.
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Maslyanskaya S, Talib HJ, Northridge JL, Jacobs AM, Coble C, Coupey SM. Polycystic Ovary Syndrome: An Under-recognized Cause of Abnormal Uterine Bleeding in Adolescents Admitted to a Children's Hospital. J Pediatr Adolesc Gynecol 2017; 30:349-355. [PMID: 27903446 DOI: 10.1016/j.jpag.2016.11.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/14/2016] [Accepted: 11/19/2016] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE To evaluate whether ovulatory dysfunction due to polycystic ovary syndrome (PCOS) is a common underlying etiology of abnormal uterine bleeding (AUB) in adolescents who require hospitalization and to explore etiology, treatment, and complications of AUB with severe anemia in adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We identified female patients aged 8-20 years admitted to a children's hospital for treatment of AUB from January 2000 to December 2014. Our hospital protocol advises hormonal testing for PCOS and other disorders before treatment for AUB. We reviewed medical records and recorded laboratory evaluations, treatments, and final underlying diagnoses as well as recurrences of AUB and readmissions in the subsequent year. RESULTS Of the 125 subjects, the mean age was 16.5 ± 2.9 years; mean hemoglobin level was 7.0 ± 1.8 g/dL; 54% were overweight/obese; and 41% sexually active. PCOS accounted for 33% of admissions; hypothalamic pituitary ovarian axis immaturity 31%; endometritis 13%; bleeding disorders 10%. Girls with PCOS were more likely to be overweight/obese (74% vs 46%; P < .01) and girls with hypothalamic pituitary ovarian axis immaturity had lower hemoglobin levels (6.4 g/dL vs 7.4 g/dL; P < .05), than girls with all other etiologies of AUB. Treating physicians failed to diagnose endometritis as the etiology for AUB in 4 of 8 girls with positive tests for sexually transmitted infection and no other etiology. CONCLUSION PCOS was the most common underlying etiology in adolescents hospitalized with AUB. Screening for hyperandrogenemia is important for early diagnosis of PCOS to allow ongoing management and prevention of comorbidities. Endometritis was frequently underestimated as an etiology for AUB.
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Affiliation(s)
- Sofya Maslyanskaya
- Pediatrics, Albert Einstein College of Medicine, Bronx, New York; Division of Adolescent Medicine, Children's Hospital at Montefiore, Bronx, New York.
| | - Hina J Talib
- Pediatrics, Albert Einstein College of Medicine, Bronx, New York; Division of Adolescent Medicine, Children's Hospital at Montefiore, Bronx, New York
| | - Jennifer L Northridge
- Pediatrics, Albert Einstein College of Medicine, Bronx, New York; Division of Adolescent Medicine, Children's Hospital at Montefiore, Bronx, New York
| | - Amanda M Jacobs
- Pediatrics, Albert Einstein College of Medicine, Bronx, New York; Division of Adolescent Medicine, Children's Hospital at Montefiore, Bronx, New York
| | - Chanelle Coble
- Pediatrics, Albert Einstein College of Medicine, Bronx, New York; Division of Adolescent Medicine, Children's Hospital at Montefiore, Bronx, New York
| | - Susan M Coupey
- Pediatrics, Albert Einstein College of Medicine, Bronx, New York; Division of Adolescent Medicine, Children's Hospital at Montefiore, Bronx, New York
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20
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Koikawa N, Shimada S, Suda S, Murata A, Kasai T. Sex differences in subjective sleep quality, sleepiness, and health-related quality of life among collegiate soccer players. Sleep Biol Rhythms 2016; 14:377-386. [DOI: 10.1007/s41105-016-0068-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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21
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Su JJ, Lindell D. Promoting the menstrual health of adolescent girls in China. Nurs Health Sci 2016; 18:481-487. [PMID: 27325429 DOI: 10.1111/nhs.12295] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 04/24/2016] [Accepted: 04/26/2016] [Indexed: 01/04/2023]
Abstract
In China, nurses have limited presence in schools, thus, adolescent girls often lack accurate information about menstrual health, which may lead to incorrect and unhealthy menstrual-related behavior. This study investigated the effects of a culturally and developmentally tailored nursing intervention on the menstrual health of adolescent girls in China. Following institutional review board approval, adolescent girls aged 12-15 were recruited from two schools. A quasi-experimental, pretest-posttest design examined the effects of five interactive education sessions on menstrual health. The final sample included 116 adolescent girls. Significant improvement was observed in the intervention group regarding menstrual knowledge, confidence in performing menstrual healthcare behavior, and dysmenorrhea related self-care behavior. A nurse-managed education program improved adolescent girls' menstrual knowledge, promoted a more positive attitude, encouraged confidence, and improved pain relief practice. We recommend that professional nurses globally advocate for school nursing and routine menstrual health education for adolescent girls.
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Affiliation(s)
- Jing Jing Su
- HOPE School of Nursing, Wuhan University, Wuhan, China
| | - Deborah Lindell
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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