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Pouraliroudbaneh S, Marino J, Riggs E, Saber A, Jayasinghe Y, Peate M. Heavy menstrual bleeding and dysmenorrhea in adolescents: A systematic review of self-management strategies, quality of life, and unmet needs. Int J Gynaecol Obstet 2024; 167:16-41. [PMID: 38654586 DOI: 10.1002/ijgo.15554] [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: 09/07/2023] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Heavy menstrual bleeding (HMB) and dysmenorrhea (DM) are common gynecological problems. OBJECTIVE To systematically review the needs, quality of life (QOL), and effectiveness of self-management strategies among young women (12-25 years) with DM or HMB. SEARCH STRATEGY Relevant terms were searched through PubMed, EBSCO, Google Scholar, ProQuest, and Ovid between 2010 and 2022. SELECTION CRITERIA Qualitative and quantitative studies published in peer-reviewed journals, females aged 12-25, exploring DM or HMB, reporting supportive care needs, quality of life, self-treatment strategies, and/or treatment-seeking behavior. DATA COLLECTION AND ANALYSIS Abstracts were reviewed for eligibility by two researchers. Included studies were extracted and assessed for quality independently by two authors, with discrepancies resolved through consensus or the involvement of a third researcher. Data extracted included study details, menstrual history, symptoms, self-care strategies, and quality of life. The Joanna Briggs Institute checklists were used for quality assessment. MAIN RESULTS The search returned 285 190 studies, of which 55 were eligible for inclusion. Prevalence rates of HMB and DM were in the ranges 4%-63% and 42%-94%, respectively. Over 80% of young women with DM and HMB experienced physical and psychological problems, including pelvic pain, sleep issues, mood disturbance, diarrhea, and nausea. Academic performance and daily activities were severely affected. Most (>62%) named their mothers as their primary source of information, and friends as the secondary source (10%-65%). Few studies explored needs, but they could be inferred and fell under school-related and social needs. QOL was poorer in those who had DM than those who did not. Pain was the most common issue that drove young women to find treatment. More than 70% used medication to reduce pain. More than half chose home remedies (e.g., heat therapy, massages, herbal tea, hot drinks). No studies provided information about the efficacy and dosage of medication and herbal remedies. CONCLUSIONS HMB and DM have a large impact on daily living, with large areas of unmet need. Limited access to information impairs the management of symptoms and consequent QOL.
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Affiliation(s)
- Shiva Pouraliroudbaneh
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer Marino
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Victoria, Australia
- Specialty of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children Research Institute, Parkville, Victoria, Australia
- Department of General Practice, University of Melbourne, Parkville, Victoria, Australia
| | - Ashraf Saber
- Esfarayen Faculty of Medical Sciences, Esfarayen, Iran
| | - Yasmin Jayasinghe
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
- Department of Gynaecology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
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Wang L, Wen S, Li X, Maxwell A, Chi H, Fan S, Wang G, Guo Q, Lu P. Associations between soft drinks intake and primary dysmenorrhea among Chinese undergraduate female students. Sci Rep 2024; 14:21210. [PMID: 39261539 PMCID: PMC11390748 DOI: 10.1038/s41598-024-71802-8] [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: 05/08/2024] [Accepted: 08/30/2024] [Indexed: 09/13/2024] Open
Abstract
Primary dysmenorrhea (PD) is a common global health concern. However, limited studies explored the association between soft drinks intake and PD among female undergraduates in China. To determine the association between soft drinks (carbonated soft drinks, etc.) as well coffee intake and the incidence/severity of PD among female undergraduates in China. We performed a cross-sectional study among 1809 female undergraduates in China from September 29, 2020 to October 22, 2020. The demographic information and menstrual information of the participants were collected by a self-administrated questionnaire. Chi-square test, ANOVA test, and logistic regression test were used to investigate the association between soft drinks intake and the incidence/severity of PD. We also conducted stratification analysis among different locations (rural or urban). The prevalence of PD was 47.1% (n = 852). There were 221 (25.9%) participants suffered from severe pain. In the participants with PD, the OR of carbonated soft drinks intake was 1.244 (95% CI 1.010-1.533). Among the participants with PD from rural areas, the OR of carbonated soft drinks intake was 1.402 (95% CI 1.045-1.881), compared with the non-carbonated soft drink group. In the participants with moderate and severe PD, the OR of coffee intake was 0.451 (95% CI 0.228-0.892), compared with the non-coffee-drinking group. There was a significant association between carbonated soft drinks intake frequency and the severity of PD (P < 0.05). Our study showed that carbonated soft drinks intake is a risk factor for PD, especially in participants from rural areas. Coffee intake is a protective factor for the severity of PD. Periodical awareness programs about adverse effects of excessive soft drink consumption should be introduced to reduce the prevalence and exacerbation of PD. Coffee intake might be helpful to relieve the severity of PD.
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Affiliation(s)
- Lijiao Wang
- School of Public Health, Binzhou Medical University, No. 346 Guanhai Road, Laishan District, Yantai, Shandong, China
| | - Shuo Wen
- School of Public Health, Binzhou Medical University, No. 346 Guanhai Road, Laishan District, Yantai, Shandong, China
| | - Xinyuan Li
- School of Public Health, Binzhou Medical University, No. 346 Guanhai Road, Laishan District, Yantai, Shandong, China
| | - Ahiafor Maxwell
- Tsinghua Medicine - School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hanwei Chi
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Shijie Fan
- School of Public Health, Binzhou Medical University, No. 346 Guanhai Road, Laishan District, Yantai, Shandong, China
| | - Guanghe Wang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qiang Guo
- College of Child Development and Education, Zhejiang Normal University, Hangzhou, China.
| | - Peng Lu
- School of Public Health, Binzhou Medical University, No. 346 Guanhai Road, Laishan District, Yantai, Shandong, China.
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Barbosa-Silva J, Avila MA, de Oliveira RF, Dedicação AC, Godoy AG, Rodrigues JC, Driusso P. Prevalence, pain intensity and symptoms associated with primary dysmenorrhea: a cross-sectional study. BMC Womens Health 2024; 24:92. [PMID: 38311716 PMCID: PMC10840141 DOI: 10.1186/s12905-023-02878-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/31/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD) is an etiological cyclic pelvic pain related to the menstrual period; it can negatively impact women's quality of life and productivity. The aim of the present study was to estimate the prevalence of PD and analyze associated symptoms in Brazilian women. METHODS An online cross-sectional study was carried out in Brazil, with a structured questionnaire regarding dysmenorrhea and associated symptoms. PD intensity was measured with the Numerical Rating Scale for Pain and classified as mild (1-3), moderate (4-7) and severe (> 8). The association between qualitative variables was performed using Pearson's Chi-Square Test. The quantification of this association was measured using multinomial logistic regression models, with calculation of Odds Ratio and confidence interval. A significance level of 5% was considered. RESULTS A total of 10,070 women were included. Most participants classified PD intensity as moderate (40.4%, 41.9% and 49.7%) and severe (21.2%, 24.8% and 28.4%) in the previous month, 3 months and 5 years, respectively. The most common symptoms associated with PD were irritability, abdominal distension sensation, anxiety and feeling more emotional. The increased of the risk (OR > 1.0) for moderate and severe PD-related pain intensity is related to age, nulliparity and presence PD since adolescence. CONCLUSION There is a high prevalence of PD among Brazilian women, and the most common symptoms reported were irritability, abdominal distension sensation, anxiety and feeling more emotional.
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Affiliation(s)
- Jordana Barbosa-Silva
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Mariana Arias Avila
- Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Federal University of São Carlos, São Carlos, Brazil
| | - Raissa Fernanda de Oliveira
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Anny Caroline Dedicação
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
- Multiprofessional Residency Program, Hospital Israelita Albert Einstein (HIAE), São Paulo, Brazil.
| | - Amanda Garcia Godoy
- Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Federal University of São Carlos, São Carlos, Brazil
| | - Jessica Cordeiro Rodrigues
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Patricia Driusso
- Women's Health Research Laboratory (LAMU), Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
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Wu T, Doyle C, Ito J, Ramesh N, Ernest DK, Crespo NC, Hsu FC, Oren E. Cold Exposures in Relation to Dysmenorrhea among Asian and White Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:56. [PMID: 38248521 PMCID: PMC10815354 DOI: 10.3390/ijerph21010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/06/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024]
Abstract
Dysmenorrhea is highly prevalent, ranging from 16% to 91% among women, and it can lead to multiple reproductive disorders. However, risk factors associated with dysmenorrhea remain unexamined. Cold exposures can significantly disturb blood circulation and prostaglandin production in the uterus, leading to dysmenorrhea. This study investigated the relationship between cold exposures and dysmenorrhea, as well as potential disparities between Asians and Whites and the potential cultural influences on these associations. This was a cross-sectional survey among 197 Asian and 222 non-Asian women recruited from the U.S., with more than 40% from California. We assessed cold exposures, such as the frequency of consumption of cold water/drinks and ice cream, as well as room temperatures at home and public places, for both summer and winter over the past 12 months. The type of cold exposure associated with dysmenorrhea differs between Asian and White women. We found that among Asian women, a higher frequency of ice cream consumption in winter (beta = 1.19, p = 0.0002 when comparing high to low categories) was associated with dysmenorrhea; however, among White women, increased consumption of cold water/drinks in winter (beta = 0.49, p = 0.04 when comparing high to low categories) was also associated with dysmenorrhea. Higher home room temperatures in winter were associated with reduced severity of dysmenorrhea among White women but not among Asian women. All these associations supported our hypothesis and were stronger among women who lived in states with colder winters. However, there are a few exceptions. For instance, women who drank cold water/drinks less frequently during their menstrual period were more likely to experience more severe dysmenorrhea. In conclusion, this study provides crucial evidence to support the link between cold exposures and dysmenorrhea among Asians and Whites. The associations contradictory to our hypothesis are likely due to reserved causation influenced by Asian cultural practice. This paper sheds light on an understudied area that profoundly affects women's quality of life.
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Affiliation(s)
- Tianying Wu
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (C.D.); (J.I.); (N.R.); (E.O.)
- Moores Cancer Center, School of Medicine, University of California, San Diego, CA 92037, USA
| | - Cassie Doyle
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (C.D.); (J.I.); (N.R.); (E.O.)
| | - Joy Ito
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (C.D.); (J.I.); (N.R.); (E.O.)
| | - Neeraja Ramesh
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (C.D.); (J.I.); (N.R.); (E.O.)
| | - Deepali Karina Ernest
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Noe C. Crespo
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, CA 92182, USA;
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA;
| | - Eyal Oren
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (C.D.); (J.I.); (N.R.); (E.O.)
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Mück F, Scotti F, Mauvisseau Q, Raclariu-Manolică AC, Schrøder-Nielsen A, Wangensteen H, de Boer HJ. Complementary authentication of Chinese herbal products to treat endometriosis using DNA metabarcoding and HPTLC shows a high level of variability. Front Pharmacol 2023; 14:1305410. [PMID: 38116075 PMCID: PMC10728824 DOI: 10.3389/fphar.2023.1305410] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/14/2023] [Indexed: 12/21/2023] Open
Abstract
Traditional Chinese Medicine (TCM) is popular for the treatment of endometriosis, a complex gynecological disease that affects 10% of women globally. The growing market for TCMs has yielded a significant incentive for product adulteration, and although emerging technologies show promise to improve their quality control, many challenges remain. We tested the authenticity of two traditional Chinese herbal formulae used in women's healthcare for the treatment of endometriosis, known as Gui Zhi Fu Ling Wan (FL) and Ge Xia Zhu Yu Tang (GX). Dual-locus DNA metabarcoding analysis coupled with high-performance thin-layer chromatography (HPTLC) were used to authenticate 19 FL and six GX commercial herbal products, as well as three ad hoc prepared artificial mixtures. HPTLC was able to detect most of the expected ingredients via comparative component analysis. DNA metabarcoding was able to detect an unexpected species diversity in the products, including 38 unexpected taxa. Chromatography has a resolution for all species indirectly through the identification of marker compounds for the different species ingredients. Metabarcoding on the other hand yields an overview of species diversity in each sample, but interpretation of the results can be challenging. Detected species might not be present in quantities that matter, and without validated quantification, some detected species can be hard to interpret. Comparative analysis of the two analytical approaches also reveals that DNA for species might be absent or too fragmented to amplify as the relevant chemical marker compounds can be detected but no amplicons are assigned to the same species. Our study emphasizes that integrating DNA metabarcoding with phytochemical analysis brings valuable data for the comprehensive authentication of Traditional Chinese Medicines ensuring their quality and safe use.
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Affiliation(s)
- Felicitas Mück
- Section for Pharmaceutical Chemistry, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Francesca Scotti
- Department of Pharmaceutical and Biological Chemistry, UCL School of Pharmacy, University College London, London, United Kingdom
| | | | - Ancuţa Cristina Raclariu-Manolică
- Natural History Museum, University of Oslo, Oslo, Norway
- Stejarul Research Centre for Biological Sciences, National Institute of Research and Development for Biological Sciences, Piatra Neamț, Romania
| | | | - Helle Wangensteen
- Section for Pharmaceutical Chemistry, Department of Pharmacy, University of Oslo, Oslo, Norway
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Dong Y, Li MJ, Hong YZ, Li WJ. Insight into Dysmenorrhea Research from 1992 to 2022: A Bibliometric Analysis. J Pain Res 2023; 16:3591-3611. [PMID: 37915864 PMCID: PMC10617534 DOI: 10.2147/jpr.s430233] [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: 08/04/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
Dysmenorrhea, classified as primary dysmenorrhea and secondary dysmenorrhea, is a common gynecological symptom that seriously affects female daily life. At present, studies on dysmenorrhea are numerous and complex. To better reflect the trend and innovative progress of dysmenorrhea-related research, this study screened papers on the Web of Science from January 1, 1992, to December 31, 2022. A total of 1012 papers were selected and analyzed for their affiliated countries, institutions, authors, keywords, etc. China is the country with the most academic output, Beijing University of Traditional Chinese Medicine is the most influential institution, and Yang Jie, from Chengdu University of Traditional Chinese Medicine, China, is the scholar with the most papers. We consider that the current research focus is on pathogenesis, treatment, epidemiology, and self-management. With increasing research on functional connectivity between dysmenorrhea and various brain regions, functional connectivity has gradually become the forefront of research. We hope our study can promote the further study of dysmenorrhea.
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Affiliation(s)
- Yin Dong
- Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Ming-Jing Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Yan-Zhu Hong
- School of Medicine, Xiamen University, Xiamen, People’s Republic of China
| | - Wen-Jie Li
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
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Jiang J, Zhuang Y, Si S, Cheng H, Alifu X, Mo M, Zhou H, Liu H, Yu Y. The Association of Reproductive Hormones During the Menstrual Period with Primary Dysmenorrhea. Int J Womens Health 2023; 15:1501-1514. [PMID: 37840555 PMCID: PMC10573379 DOI: 10.2147/ijwh.s421950] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/30/2023] [Indexed: 10/17/2023] Open
Abstract
Objective This study aimed to investigate the association of reproductive hormones with primary dysmenorrhea in Chinese women. Methods A case-control study was conducted and patients with primary dysmenorrhea and non-dysmenorrhea participants were recruited. Oxytocin, PGF2α, vasopressin, estriol and estradiol were respectively measured in plasma collected three to five days after menstruation. Restricted cubic spline and multiple logistic regression models were adopted to analyze the association between hormones and primary dysmenorrhea. Results There were 604 participants enrolled in our study including 300 patients with primary dysmenorrhea. After adjustment for the potential confounders, oxytocin levels (Q3: OR (95% CI) = 0.50 (0.27~0.95) (p=0.035); Q4: 0.34 (0.17~0.66) (p=0.001)) and PGF2α levels (Q3: 0.45 (0.24~0.87) (p=0.017); Q4: 0.43 (0.22~0.84) (p=0.013)) were respectively associated with an decreased risk of primary dysmenorrhea, but estradiol (Q2: 2.18 (1.13~4.19) (p=0.020); Q3: 2.17 (1.12~4.19) (p=0.022)) and vasopressin (Q3: 2.88 (1.48~5.63) (p=0.002); Q4: 3.20 (1.65~6.22) (p<0.001)) with an increased risk of primary dysmenorrhea, respectively. Among patients with primary dysmenorrhea, the higher estriol level was associated with higher frequent dysmenorrhea (Q2: 3.12 (1.32~7.34) (p=0.009); Q3: 4.97 (2.08~11.85) (p<0.001)) and always dysmenorrhea (Q2: 2.51 (1.03~6.11) (p=0.041); Q3: 3.10 (1.25~7.73) (p=0.015)). Similarly, high estriol levels were associated with the higher degree of pain significantly only when hormone levels were at a high level (Q3: 2.06 (1.03~4.18) (p=0.043)). Conclusion Higher serum vasopressin and estradiol concentrations as well as lower oxytocin and PGF2α levels were associated with higher risk of primary dysmenorrhea. Estrogen showed a reverse U-shape association on the frequency and degree of pain among patients with primary dysmenorrhea.
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Affiliation(s)
- Junying Jiang
- Department of Women’s Health, Yiwu Maternity and Children Hospital, Yiwu, People’s Republic of China
| | - Yan Zhuang
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou City, People’s Republic of China
| | - Shuting Si
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou City, People’s Republic of China
| | - Haoyue Cheng
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou City, People’s Republic of China
| | - Xialidan Alifu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou City, People’s Republic of China
| | - Minjia Mo
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou City, People’s Republic of China
| | - Haibo Zhou
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou City, People’s Republic of China
| | - Hui Liu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou City, People’s Republic of China
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou City, People’s Republic of China
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Liu L, Hu J, Lu J, Yang J. Clinical Observation on Auricular Acupressure for Primary Dysmenorrhea: A Study Protocol for a Randomized Clinical Trial. J Pain Res 2023; 16:3217-3225. [PMID: 37753489 PMCID: PMC10519210 DOI: 10.2147/jpr.s414416] [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: 05/14/2023] [Accepted: 08/12/2023] [Indexed: 09/28/2023] Open
Abstract
Purpose The objective of this study is to evaluate the immediate and time-dependent effects of AA in treating PD and assess its safety. Methods/Design This study is a randomized, single-blinded, controlled trial that will enroll 92 patients in a 1:1 allocation ratio. Patients will be assigned to either the treatment group (n=46) or the control group (n=46). During the first menstrual period, the treatment group will receive AA treatment, while the control group will receive sham AA treatment for 7 days. The second menstrual period will serve as the follow-up period. The primary outcome measure is the Visual Analog Scale (VAS) score 30 min after the first treatment. Secondary outcome measures include the VAS score immediately after the first treatment, onset time of analgesic effect, duration of pain, extra dosing rate of ibuprofen, and change of the Menstrual Distress Questionnaire (MDQ) score. The outcomes will be assessed at baseline, during the intervention period, and during the follow-up period. Conclusion The study results will provide evidence on the efficacy and safety of AA in managing PD by analyzing its immediate effect, time-effect relationship, and reduction of painkiller use. Trial Registration Chinese Clinical Trial Registry (ChiCTR2300069741).
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Affiliation(s)
- Lumin Liu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Junwei Hu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Junjie Lu
- Department of Social and Behavioral Sciences, Harvard University T.H. Chan School of Public Health, Boston, MA, USA
| | - Jiaxin Yang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
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Wuni A, Abena Nyarko B, Mohammed Ibrahim M, Abdulai Baako I, Mohammed IS, Buunaaisie C. Prevalence, Management, and Impact of Dysmenorrhea on the Lives of Nurse and Midwife Trainees in Northern Ghana. Obstet Gynecol Int 2023; 2023:8823525. [PMID: 37608871 PMCID: PMC10442185 DOI: 10.1155/2023/8823525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/28/2023] [Accepted: 07/26/2023] [Indexed: 08/24/2023] Open
Abstract
Background Dysmenorrhea is the most common gynecological problem affecting the majority of female students in the nursing profession today. They often experience severe pain that is not only incapacitating but also has a significant impact on their day-to-day college life, academic, and clinical performance. Aim This study was conducted to assess the prevalence, management, and impact of dysmenorrhea on the lives of nurse and midwife trainees in northern Ghana. Methods A descriptive cross-sectional design with a quantitative approach to data collection was employed to collect data from nurse and midwife trainees in three colleges of nursing and/or midwifery in the northern region of Ghana. A proportionate stratified random sampling technique was used to recruit 303 respondents for the study. After gaining permission from various institutions, data were collected by using a structured questionnaire from 13th September to 28th October, 2022. Stata (special edition) for Windows version 17.0 was used for the statistical analyses. Results The study revealed a high prevalence of dysmenorrhea among female nursing students (66.7% and 95% CI: 0.611-0.720). More than half of the respondents (67.3%) experienced loss of appetite for food. The most common site of most intense pain was the pelvis and lower abdomen (98.0%). A greater proportion of students (65.8%) used antispastic drugs to reduce pain. The respondents' concentration in the classroom was greatly affected (77.2%) as well as normal physical activities (58.4%). A multivariable logistic regression analysis revealed that the odds of dysmenorrhea are 2.67 times higher when the duration of menstruation is 4-5 days (AOR = 1.82, 95% CI = 1.13-6.28, and p = 0.024) than a duration of 1-3 days. Having urinary tract infections was associated with 3.56 times higher odds of dysmenorrhea (AOR = 3.56, 95% CI = 0.98-12.86, and p = 0.053). Again, the odds of dysmenorrhea were also four times higher among respondents with a family history of the same condition (AOR = 4.05, 95% CI = 2.16-7.61, and p = 0.001). Conclusion The current study revealed a high prevalence of dysmenorrhea among nurse and midwife trainees in the northern part of Ghana. The majority of the respondent experienced loss of appetite and intense pain in the pelvis and lower abdomen, and their concentration during lectures was also significantly affected. The most predominant nonpharmacological method used for reducing the pain was sleep and the application of warm objects on the abdomen.
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Affiliation(s)
- Abubakari Wuni
- Department of Medicine for the Elderly (C6), Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital, Cambridge, UK
- Nurses' and Midwives' Training College, Tamale, Ghana
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Luo Y, Mao P, Chen P, Li C, Fu X, Zhuang M. Effect of Guizhi Fuling Wan in primary dysmenorrhea: A randomized controlled trial. JOURNAL OF ETHNOPHARMACOLOGY 2023; 307:116247. [PMID: 36746293 DOI: 10.1016/j.jep.2023.116247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/16/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Guizhi Fuling Wan (GFW) is one of the most widely known traditional Chinese medicine (TCM) formulations that has long been used in China for the treatment of primary dysmenorrhea (PD). However, the quality of evidence is limited and there are few studies on specific TCM syndromes of GFW for PD. AIM OF THE STUDY To evaluate the efficacy and safety of GFW on PD patients with the heat-burning blood-stasis syndrome. MATERIALS AND METHODS This was a randomized, double-blinded, placebo-controlled trial. Eligible patients were recruited and randomly assigned to one of two groups to receive GFW or the placebo twice daily for three menstrual cycles with a 3-month follow-up. The primary outcome was the baseline-to-month 6 change in pain intensity measured by a Visual Analog Scale (VAS). The secondary outcomes included the changes in the Cox Menstrual Symptom Scale (CMSS), the Self-rating Anxiety Scale (SAS), the Self-rating Depression Scale (SDS), and the TCM syndrome scale from baseline to month 6. Additionally, adverse effect was assessed. RESULTS A total of 353 patients were screened for eligibility and 128 were randomly assigned, of whom 121 completed all treatments and follow-ups. In both the full analysis (FAS) and the per-protocol analysis (PPS), the VAS score of pain intensity decreased significantly more in the GFW group than in the placebo group from baseline to month 6 (P < 0.01). Similarly, the decrease in CMSS, SAS and TCM syndrome scores was greater in the GFW group compared with the placebo group (P < 0.01). There were no differences in SDS scores between the two groups (P > 0.05). In addition, no serious adverse events were observed. CONCLUSION Our findings revealed that GFW significantly alleviated the severity of menstrual pain in PD patients with the heat-burning blood-stasis syndrome without significant adverse effects.
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Affiliation(s)
- Yanan Luo
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved By State Administration of Traditional Chinese Medicine, College of Medical and Health Science, China Three Gorges University, Yichang, Hubei, 443302, China
| | - Ping Mao
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved By State Administration of Traditional Chinese Medicine, College of Medical and Health Science, China Three Gorges University, Yichang, Hubei, 443302, China
| | - Peipei Chen
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved By State Administration of Traditional Chinese Medicine, College of Medical and Health Science, China Three Gorges University, Yichang, Hubei, 443302, China
| | - Chenjie Li
- The Second People's Hospital of Yichang & the Second People's Hospital of China Three Gorges University, Yichang, Hubei, 443302, China
| | - Xianyun Fu
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved By State Administration of Traditional Chinese Medicine, College of Medical and Health Science, China Three Gorges University, Yichang, Hubei, 443302, China.
| | - Mingyan Zhuang
- The Maternity and Child Health Care Hospital, Three Gorges University, Yichang, 443302, China.
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11
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Tang H, Guan L. DANCE SPORTS INFLUENCE FEMALE UNIVERSITY STUDENTS’ PHYSICAL HEALTH IN ETHNIC UNIVERSITIES. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Introduction Ensuring healthy growth with high cultural quality in the population is an important part of Chinese revitalization. University students, as a group of high cultural quality, have the mission and responsibility entrusted by the state and the people. It is believed that these goals can be achieved by using sports dance, which has a wide range and high demands; dancers should have motor skills, physical qualities, understanding of the art of dress, and psychological balance as basic requirements. Objective To test and evaluate whether sports dance activities in physical education students are conducive to promoting students’ healthy physical development. Methods This paper examines the influence of teaching sports dance on the physical health of female college students in Ethnic Colleges and its countermeasures. It also discusses the strategies for teaching sports dance to provide viable suggestions for follow-up dance instruction. Conclusion The combination of sports and femininity in exercise has a good fitness effect, improves the artistic feelings of college women, and is conducive to the healthy development of the physical quality of college women. Level of evidence III; Analysis based on alternatives and limited costs.
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12
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Zaman AY, Alameen AM, Alreefi MM, Kashkari ST, Alnajdi SA, Shararah AA, Alzolaibani SM, Mahrous FA. Comparison of herbal medicines and pain relief medications in the treatment of primary dysmenorrhoea among female medical students at Taibah University. J Taibah Univ Med Sci 2022; 18:455-460. [PMID: 36818168 PMCID: PMC9932468 DOI: 10.1016/j.jtumed.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/19/2022] [Accepted: 10/25/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives Dysmenorrhoea is a common gynaecological problem that affects many women during their reproductive years. The objectives of this study were to describe the different treatments used for primary dysmenorrhoea (PD) among medical students at Taibah University, and to investigate the link between pain severity and daily life activities in relation to the type of dysmenorrhoea treatment. Methods A cross-sectional study was conducted on 301 female medical students through an 18-item self-administered electronic questionnaire to screen for students with PD. The questionnaire included sociodemographic characteristics, details of self-management methods (types and adverse events), daily life domains affected by pain, and the Visual Analogue Scale score for the pain (wherein a score ≥7 indicated severe pain). Chi-square test, a multivariate regression model, and correlation analysis were used for data analysis. Results The prevalence of PD among respondents was 71.8%. Medications were used by more than half of the respondents (51.9%), and were mainly non-steroidal anti-inflammatory drugs (53.5%) and paracetamol (47.5%). Among the participants, 14.1% used herbal medicines, cinnamon (55.7%), chamomile (40.7%), and ginger (33.3%). Other pain relief modalities were used by 34% of participants. Most students with a history of PD (80.6%) reported effects on their daily activities, mainly mood disturbance. Students using medications were more likely to have severe pain (72.7%) and an affect on daily activities (92.9%) than those using herbal medicines (44.4% and 88.9%, respectively) and other treatments (47.7% and 70.8%, respectively) (p < 0.001). Conclusions Medications were more commonly used than herbal medicines and other relief methods. Effects of PD on daily life activities were observed among most students treated with medications. We recommend health promotion programmes to increase the awareness regarding different pain relief methods.
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Affiliation(s)
- Amal Yaseen Zaman
- Department of Obstetrics and Gynecology, Faculty of Medicine, Taibah University, Almadinah Almunawwarah, KSA
| | - Afrah M. Alameen
- Faculty of Medicine, Taibah University, Almadinah Almunawwarah, KSA
| | | | | | | | | | | | - Fai A. Mahrous
- Faculty of Medicine, Taibah University, Almadinah Almunawwarah, KSA,Corresponding address: Faculty of Medicine, Taibah University, 2339 Oas bin Malk- Al-badrani, Almadinah Almunawwarah 7546–42364, KSA.
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13
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Unnisa H, Annam P, Gubba NC, Begum A, Thatikonda K. Assessment of quality of life and effect of non-pharmacological management in dysmenorrhea. Ann Med Surg (Lond) 2022; 81:104407. [PMID: 36147090 PMCID: PMC9486665 DOI: 10.1016/j.amsu.2022.104407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 10/31/2022] Open
Abstract
Background Materials & methods Results Conclusion This study outlines the effect of dysmenorrhea by assessing factors contributing to discomfort and pain during menstruation. It also adds to the literature by proving that dysmenorrhea affects the quality of life. It indicates that non-pharmacological measures are both safe and effective in treating dysmenorrhea. It reflects the need for more research and the application of alternate approaches for alleviating menstrual pain. This research also aided in educating young generations on the myths and truths surrounding menstruation and its management.
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14
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Mesele TT, Dheresa M, Oljira L, Wakwoya EB, Gemeda GM. Prevalence of Dysmenorrhea and Associated Factors Among Haramaya University Students, Eastern Ethiopia. Int J Womens Health 2022; 14:517-527. [PMID: 35440875 PMCID: PMC9013413 DOI: 10.2147/ijwh.s333447] [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: 08/21/2021] [Accepted: 03/21/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Dysmenorrhea is the most common gynecological problem among adolescents and a common cause of school absenteeism. Previously, there was no study conducted on prevalence of dysmenorrhea and associated factors among university students in Ethiopia. Therefore, the aim of this study was to assess prevalence and associated factors of dysmenorrhea among Haramaya university undergraduate regular students in Eastern Ethiopia. Materials and Methods An institution-based cross-sectional study design was conducted from February to March 2020. A multistage random sampling technique was applied and a total of 569 participants were included into the study. The total sample size was proportionally allocated based on the total number of students in each departments, and simple random sampling technique was employed to select participants. The data were entered to EPI‑info version 3.5.4 and then exported to Statistical Package for Social Science version 23.0 software for analysis. The associations between independent variables and outcome variable were explored using bivariate and multivariable logistic regression models. The results of these analysis were reported as odds ratios with 95% confidence intervals. Results The prevalence of dysmenorrhea in this study was 356 (64.7%) 95% CI [60.7%, 68.7%]. Premenstrual syndrome (AOR = 5.20:95% CI [2.82, 9.61]), early menarche (AOR = 4.67:95% CI [2.33, 9.37]), history of anxiety (AOR = 4.08:95% CI [2.31, 7.19]), taking of ≥4 glass of tea per day (AOR = 5.69:95% CI [1.49, 21.77]), usually eating fat and oil (AOR = 2.03:95% CI [1.15, 3.59]) and usual use of meat food (AOR = 3.61:95% CI [2.03, 6.39]) were positively and independently associated with the occurrence of dysmenorrhea. Conclusion Dysmenorrhea was a common problem among Haramaya University female students. History of anxiety, early menarche, premenstrual syndrome, tea consumption, usual use of fat and oil containing food and usual use of meat food were significantly associated to dysmenorrhea. We recommend Haramaya University to provide accessible and appropriate medical treatment and counseling service for dysmenorrhea affected students.
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Affiliation(s)
- Tiruye Tilahun Mesele
- School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Haramaya, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Science, Haramaya University, Haramaya, Ethiopia
| | - Elias Bekele Wakwoya
- Department of Midwifery, College of Health Science, Arsi University, Asella, Ethiopia
| | - Getu Megersa Gemeda
- Department of Midwifery, College of Health Science, Arsi University, Asella, Ethiopia
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15
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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: 5] [Impact Index Per Article: 2.5] [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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Xuan Y, Zhang H, Liu D, Huang Y, Li L, Cao Q, Fu Y. The efficacy and safety of simple-needling for the treatment of primary dysmenorrhea compared with ibuprofen: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28919. [PMID: 35363216 PMCID: PMC9281921 DOI: 10.1097/md.0000000000028919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/01/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Needling and ibuprofen are often used clinically to treat primary dysmenorrhea (PD). However, the difference between the efficacy and safety of the treatment of PD is not clear. This study evaluates the efficacy and safety of simple-needling for PD patients through a comparison with ibuprofen. METHODS A comprehensive search of 7 electronic databases and relevant medical journals, from the establishment of the publication to December 2020. The Cochrane risk of bias tool was used to evaluate the methodological quality of randomized clinical trials (RCTs) that met the inclusion criteria, and a meta-analysis was performed with the Review Manager version (RevMan version 5.3). RESULTS Twenty three RCTs were included. The meta-analysis reported that simple-needling groups had better than ibuprofen groups on cure rate (relative risk = 2.29, 95% CI [1.96, 2.68], P < .00001) and total effective rate (relative risk = 1.24, 95% CI [1.19, 1.29], P < .00001) and VAS score (MD = -1.24, 95% CI [-1.92, -0.55], P = .0004). Seven studies reported adverse events, of which 4 studies had mild adverse events. CONCLUSION Simple-needling is superior to ibuprofen treatment in terms of clinical efficacy and improvement of pain symptoms. A small number of studies reported whether simple-needling produced adverse events, so there is not enough evidence to support the safety of simple-needling in the treatment of PD. PROSPERO REGISTRATION NUMBER CRD42021233403.
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Affiliation(s)
- Yichen Xuan
- Nanchang Medical College, Nanchang, China
- Science and Technology College of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Haifeng Zhang
- Department of Tuina, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Duanyong Liu
- Science and Technology College of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yiyong Huang
- Nanchang Medical College, Nanchang, China
- Science and Technology College of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Linhui Li
- Department of Acupuncture, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Qianan Cao
- Graduate School of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yong Fu
- Department of Acupuncture, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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17
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Differences in Menstruation-Related Symptoms of University Students Depending on Their Living Status in Japan. Healthcare (Basel) 2022; 10:healthcare10010131. [PMID: 35052295 PMCID: PMC8775912 DOI: 10.3390/healthcare10010131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 11/25/2022] Open
Abstract
Mothers and family members of young female students play important roles for guiding their self-care strategies for menstruation-related symptoms; which often affect their daily life and academic life. The aim of this study is to clarify the differences in menstruation-related symptoms before and during menstruation in university students living alone and university students living with their family in Japan. We conducted a cross-sectional online survey to assess menstruation-related symptoms before and during menstruation using the menstrual distress questionnaire (MDQ). Among 135 students; the proportion of students living alone was 60.7% and the proportion of students living with their family was 39.3%. Before menstruation; the MDQ total score and the scores for negative affect and behavior change were significantly higher in students living alone than in students living with their family. During menstruation; scores for negative affect and impaired concentration were also significantly higher in students living alone. In addition; before menstruation; scores for an increase in appetite and craving for sweets were significantly higher in students living alone. Thus; living alone affected the psychological aspects of menstruation-related symptoms in young women. The results suggest that university students who live alone should be aware of the importance of talking about their menstruation problems with family members and seeking their advice
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Du Y, Li Y, Fu X, Li C, Yanan L. Efficacy of Guizhi Fuling Wan for primary dysmenorrhea: protocol for a randomized controlled trial. Trials 2021; 22:933. [PMID: 34922588 PMCID: PMC8684114 DOI: 10.1186/s13063-021-05834-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023] Open
Abstract
Background Primary dysmenorrhea (PD) is one of the main gynecological complaints in women of child-bearing age, but limited effective treatments are available. Guizhi Fuling Wan (GFW), one of the most widely known traditional Chinese medicine (TCM) formulations, has been commonly used in clinical practice to treat gynecological disorders in China. In recent years, a growing number of studies have shown that GFW is beneficial for patients with PD. However, the quality of evidence is limited, and there are few studies on specific TCM syndromes of GFW for PD. Therefore, we plan to conduct a randomized controlled trial to explore the efficacy and safety of GFW for PD patients with heat-burning blood-stasis syndrome. Methods and analysis The clinical study is a randomized, double-blinded, placebo-controlled trial. Eligible patients will be randomly assigned to the GFW group (treated with GFW) and the control group (treated with a matching placebo) in a 1:1 ratio for three menstrual cycles with a 3-month follow-up. The primary outcome will be the mean change of pain intensity measured by the visual analog scale (VAS). The secondary outcomes will include the Cox Menstrual Symptom Scale (CMSS), the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), and the TCM syndrome scale. Adverse events will also be reported. Discussion This randomized trial will be the first rigorous study designed to assess the efficacy and safety of GFW in treating PD with heat-burning blood-stasis syndrome. The finding of this study will provide an objective clinical basis for the use of GFW for PD in the future. Trial registration Chinese Clinical Trial Registry ChiCTR2000034118. Registered on 24 June 2020 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05834-0.
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Affiliation(s)
- Yun Du
- The Second people's Hospital of Yichang, China Three Gorges University, Yichang, Hubei, China.,The Department of Traditional Chinese Medicine, Medical College of China, Three Gorges University, Yichang, 443003, Hubei, China
| | - Yatong Li
- The Second people's Hospital of Yichang, China Three Gorges University, Yichang, Hubei, China.,The Department of Traditional Chinese Medicine, Medical College of China, Three Gorges University, Yichang, 443003, Hubei, China
| | - Xianyun Fu
- The Department of Traditional Chinese Medicine, Medical College of China, Three Gorges University, Yichang, 443003, Hubei, China
| | - Chenjie Li
- The Second people's Hospital of Yichang, China Three Gorges University, Yichang, Hubei, China.
| | - Lou Yanan
- The Department of Traditional Chinese Medicine, Medical College of China, Three Gorges University, Yichang, 443003, Hubei, China.
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Ullah A, Fayyaz K, Javed U, Usman M, Malik R, Arif N, Kaleem A. Prevalence of Dysmenorrhea and Determinants of Pain Intensity Among University-Age Women. PAIN MEDICINE 2021; 22:2851-2862. [PMID: 34505897 DOI: 10.1093/pm/pnab273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The study was conducted to determine the prevalence of dysmenorrhea and investigate factors associated with dysmenorrhic pain among university students in Lahore, Pakistan. DESIGN AND SETTING A cross-sectional study was conducted across various public and private sector universities in Lahore. METHODS A self-administered structured questionnaire was used to collect data from 600 randomly selected female university students. RESULTS The prevalence of dysmenorrhea was 91.5%. Age at menarche (odds ratio [OR] = 1.96, 95% confidence interval [CI] = 1.10-3.50) was the only significant factor associated with dysmenorrhea. The mean pain severity score among dysmenorrhic students was 5.62 ± 2.28. Most of the participants (65.8%) were experiencing moderate/severe pain. Univariate analysis showed that irregular cycle (OR [95% CI] = 1.62 [1.13-2.33]), age at menarche of ≤14 years (OR [95% CI] = 1.46 [1.05-2.04]), duration of menses of more than 5 days (OR [95% CI] = 1.42 [1.02-1.99]), stress (OR [95% CI] = 2.16 [1.54-3.03]), moderate meat/protein consumption (OR [95% CI] = 1.55 [1.08-2.21]), and medical specialization (OR [95% CI] = 1.72 [1.17-2.52]) were significantly associated with pain severity among dysmenorrhic female students. Multivariate binary logistic regression analysis revealed that medical specialization (OR [95% CI] = 1.83 [1.22-2.73]), age at menarche (OR [95% CI] = 0.603 [0.42-0.86]), regularity of menses (OR [95% CI] = 1.52 [1.04-2.22]), moderate meat/protein consumption (OR [95% CI] = 1.69 [1.16-2.45]), and stress (OR [95% CI] = 1.87 [1.32-2.66]) were independent predictors of moderate/severe dysmenorrhic pain. CONCLUSION The study revealed an alarmingly high prevalence of dysmenorrhea among university students. High levels of stress and early menarche were the potent determinants of moderate/severe dysmenorrhea that disturbs quality of life.
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Affiliation(s)
- Azmat Ullah
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Khadijah Fayyaz
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Uswa Javed
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Usman
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Rameesha Malik
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Nafeesa Arif
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Amna Kaleem
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
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20
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Karout S, Soubra L, Rahme D, Karout L, Khojah HMJ, Itani R. Prevalence, risk factors, and management practices of primary dysmenorrhea among young females. BMC Womens Health 2021; 21:392. [PMID: 34749716 PMCID: PMC8576974 DOI: 10.1186/s12905-021-01532-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 11/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary dysmenorrhea (PD) is one of the most common gynecological conditions among young females, which has a significant negative impact on health-related quality of life and productivity. Despite its high prevalence, the evidence is limited regarding the management-seeking practices and its perceived effectiveness among females with PD. METHODS This is a cross-sectional study conducted among 550 female students in six universities across Lebanon. The prevalence of PD, associated risk factors, and management-seeking practices were assessed using a self-administered questionnaire. RESULTS The prevalence of PD was 80.9%. Most of the females with PD described their menstrual pain as moderate (56%) to severe (34.6%), which significantly affected their daily activities and studying ability (P < 0.001). The major risk factors associated with PD included heavy menstrual flow (adjusted odds ratio [AOR] = 10.28), family history of PD (AOR = 2.52), history of weight loss attempt (AOR = 2.05), and medical specialization (AOR = 1.663). Only 36.9% of females with PD sought formal medical advice. Most dysmenorrheic females (76.4%) received medications for the management of PD, and remarkably none of them took hormonal contraceptives. Drugs commonly used for PD were mefenamic acid (26.2%), ibuprofen (25%), and paracetamol (11.5%), which were administered when the pain started (58.2%). All medications were significantly effective in reducing the pain score (P = 0.001), and most NSAIDs were more potent than paracetamol in managing PD (P = 0.001). However, no significant difference in adverse effects among medications was revealed. Moreover, no superiority of any individual NSAID for pain relief was established. Nevertheless, mefenamic acid was associated with the lowest risk of abdominal pain (OR: 0.03, P = 0.005) and the highest risk of flank pain (OR = 12, P = 0.02). CONCLUSIONS Suboptimal management of PD is practiced among university students in Lebanon. Therefore, health care providers should educate dysmenorrheic females to optimize the self-management support of PD. Furthermore, future research is required to investigate females' misconceptions about hormonal contraceptives in the management of PD, aiming to raise awareness and correct misconceptions.
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Affiliation(s)
- Samar Karout
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, P.O. Box 11-5020, Beirut, 1107 2809, Lebanon
| | - Lama Soubra
- Pharmacology and Therapeutics Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, P.O. Box 11-5020, Beirut, 1107 2809, Lebanon
| | - Deema Rahme
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, P.O. Box 11-5020, Beirut, 1107 2809, Lebanon
| | - Lina Karout
- Department of Radiology, American University of Beirut Medical Center, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon
| | - Hani M J Khojah
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Madinah, Kingdom of Saudi Arabia
| | - Rania Itani
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, P.O. Box 11-5020, Beirut, 1107 2809, Lebanon.
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Munro AK, Hunter EC, Hossain SZ, Keep M. A systematic review of the menstrual experiences of university students and the impacts on their education: A global perspective. PLoS One 2021; 16:e0257333. [PMID: 34506544 PMCID: PMC8432759 DOI: 10.1371/journal.pone.0257333] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/29/2021] [Indexed: 12/05/2022] Open
Abstract
Background Higher education attainment is linked to improved health and employment outcomes but the impact of university students’ experiences of menstruation on their education is less clear. The objective of this review was to synthesise qualitative and quantitative research on university students’ menstrual experiences and educational impacts. Methods Eligible studies were identified through systematic searching across eight peer-reviewed databases, websites for menstrual health organisations, grey literature databases, and reference lists of included studies. Eligible studies must have reported on at least one of the antecedents or components of menstrual experience outlined in the integrated model of menstrual experience in relation to university students or reported on the impact of their menstrual experiences on their education. Study characteristics and findings were extracted, analysed and presented as a narrative synthesis. The quality of evidence was assessed with the Mixed Methods Appraisal Tool. This study is registered on PROSPERO, number CRD42020178470. Results Eighty-three studies were eligible for inclusion. Most studies (n = 74; 89%) were quantitative and the highest proportion of studies were conducted in lower-middle-income countries (n = 31; 37%). Self-reported dysmenorrhea, other physical and emotional menstrual-related symptoms, and menstrual stigma contributed to negative menstrual experiences among female students. Very few studies considered the menstrual experiences of non-binary and transgender menstruating students, and culturally diverse students. Dysmenorrhea contributed to university absenteeism, impaired participation and concentration, and declining academic performance. Inadequate sanitation facilities for menstrual management and challenges containing menstruation also negatively impacted education. Conclusions Female university students’ experiences of menstruation can negatively impact their education, highlighting the need for program and policy responses at university to improve students’ wellbeing and educational engagement. Further research on the menstrual experiences of gender diverse, migrant and international students is needed as there is insufficient evidence to date.
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Affiliation(s)
- Alana K. Munro
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- * E-mail:
| | - Erin C. Hunter
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Syeda Z. Hossain
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Melanie Keep
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Prabha Bharati J, Ulak S, Vaidya Shrestha M, Mani Dixit S, Acharya A, Bhattarai A. Self-medication in Primary Dysmenorrhea among Medical and Nursing Undergraduate Students of a Tertiary Care Hospital: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2021; 59:537-541. [PMID: 34508409 PMCID: PMC8369555 DOI: 10.31729/jnma.6397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/28/2021] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Primary dysmenorrhea is one of the most common gynecological problems among adolescent females. It is defined as painful menses in women with normal pelvic anatomy, usually beginning during adolescence. This study aims to find out prevalence of self-medication practice in primary dysmenorrhea among medical and nursing undergraduate students. METHODS A descriptive cross-sectional study was conducted in a tertiary care hospital from November 2020 to March 2021 after taking ethical approval from the Institutional Review Committee. Convenient sampling technique was used. A total of 269 female medical and nursing students with complaints of dysmenorrhea were enrolled and the remedial methods used by them such as self-medication, medical advice and home remedies for dysmenorrhea were asked using an online questionnaire delivered to participants. Data analysis was done in the Statistical Package of Social Sciences. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS Self-medication practice for dysmenorrhea was reported in 175 (65%) of students. The prevalence of mild or moderate pain was commonly present in age group 21-25 years. commonly used for self-medication was mefenamic acid 121 (48%), followed by ibuprofen 51 (20.3%) and paracetamol 41 (16.3%). CONCLUSIONS Self- medication practice among medical and nursing undergraduate students is high despite awareness of adverse effects.
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Affiliation(s)
- Jyoti Prabha Bharati
- Department of Pharmacology, Kathmandu Medical College Teaching Hospital, Duwakot, Bhaktapur, Nepal
| | - Sanjay Ulak
- Department of Paediatrics, Bhaktapur Hospital, Bhaktapur, Nepal
| | - Merina Vaidya Shrestha
- Department of Community medicine, Kathmandu Medical College Teaching Hospital, Duwakot, Bhaktapur, Nepal
| | - Sanjay Mani Dixit
- Department of Pharmacology, Kathmandu Medical College Teaching Hospital, Duwakot, Bhaktapur, Nepal
| | - Anna Acharya
- Department of Pharmacology, Kathmandu Medical College Teaching Hospital, Duwakot, Bhaktapur, Nepal
| | - Ashish Bhattarai
- Department of Pharmacology, Kathmandu Medical College Teaching Hospital, Duwakot, Bhaktapur, Nepal
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Effectiveness and Safety of Moxibustion Robots on Primary Dysmenorrhea: A Randomized Controlled Pilot Trial. Chin J Integr Med 2021; 27:578-584. [PMID: 33837481 DOI: 10.1007/s11655-021-3287-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To conduct a pilot trial to explore the effectiveness and safety of moxibustion robots in treating primary dysmenorrhea (PD) and evaluate its feasibility in clinic. METHODS A total of 70 participants with PD were allocated to either moxibustion robot (MR) group (35 cases) or manual moxibustion (MM) group (35 cases) using computer-generated randomization. One acupoint Guanyuan (CV 4) was selected to receive moxa heat stimulation. Two groups of participants were given 3 menstrual cycles of MM and MR treatment respectively (once a day, 5 days a session) and received another 3 menstrual cycles follow-up. The degree of pain was evaluated by short-form McGill pain questionnaire (SF-MPQ) and the symptoms of dysmenorrhea were evaluated by Cox Menstrual Symptom Scale (CMSS). The safety was measured by the occurrence rate of adverse events (AEs), including burns (blisters, red and swollen), itching, bowel changes, menstrual cycle disorder, menorrhagia and fatigue, etc. RESULTS: A total of 62 patients completed the trial, 32 in MR group and 30 in MM group. Compared with baseline, scores of SF-MPQ and CMSS significantly decreased in both groups (P<0.05), and no significant difference was observed between the two groups in the 3rd and 6th menstrual cycles (P>0.05). The total occurrence rate of AEs in MR group was 2.1%, which was significantly lower than MM group (7.2%, P<0.05). CONCLUSIONS MR has the same effect as MM at SF-MPQ and CMSS in patients with PD. However, MR is safer than MM (Trial registration No. ChiCTR1800018236).
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Tsonis O, Gkrozou F, Barmpalia Z, Makopoulou A, Siafaka V. Integrating Lifestyle Focused Approaches into the Management of Primary Dysmenorrhea: Impact on Quality of Life. Int J Womens Health 2021; 13:327-336. [PMID: 33762855 PMCID: PMC7982556 DOI: 10.2147/ijwh.s264023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/04/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE This narrative review aims to identify alternative ways to improve the symptoms of primary dysmenorrhea (PD). BACKGROUND PD refers to endometrial painful cramps during the premenstrual period. This condition affects a lot of women worldwide and is accompanied with absenteeism and high economic costs, thus, risk-free, and effective therapeutic approaches are needed. Pharmacological agents such as non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptive pills (OCPs), which are widely prescribed for these women, demonstrate adequate efficacy in alleviating pain and discomfort. The long natural course of the disease dictates remedies that focus on lifestyle changes and on improvement of Quality-of-Life (QoL) for women suffering with PD. MATERIALS AND METHODS Five major search engines, namely MEDLINE, PubMed, EMBASE, and Cochrane Library were searched for articles published prior to October 2020 focused in PD. A total of 74 paper were included. DISCUSSION Physical activity, for instance yoga, aromatherapy massage, and other forms of relaxation, vitamins and dietary changes, acupressure and acupuncture,a and some psychological interventions are just few of the proposed health behavior targeted approaches in cases of PD. This review focuses on lifestyle changes and alternative methods that could potentially result in minimizing symptoms of PD and in improving overall QoL for these patients, by providing current scientific evidence on their efficacy. CONCLUSION Complementary and alternative medicine practices (CAM) are widely accepted by women. International literature provides controversial scientific evidence, thus further studies need to be conducted in order to prove or disregard their efficacy in cases of PD.
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Affiliation(s)
- Orestis Tsonis
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Ioannina, Greece
| | - Fani Gkrozou
- Department of Obstetrics and Gynaecology, University Hospitals of Birmingham, Birmingham, UK
| | - Zoi Barmpalia
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Ioannina, Greece
| | - Annamaria Makopoulou
- School of Psychology, College of Human Sciences, Bangor University, Bangor, Wales, UK
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Role of vitamin D and calcium in the relief of primary dysmenorrhea: a systematic review. Obstet Gynecol Sci 2021; 64:13-26. [PMID: 33406811 PMCID: PMC7834752 DOI: 10.5468/ogs.20205] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/11/2020] [Indexed: 01/09/2023] Open
Abstract
Dysmenorrhea is one of the well-established problems among women of reproductive age and can have adverse effects on the quality of life of the individual. Some studies suggest a relationship between vitamin D (Vit D) and calcium deficiency and the emergence of early dysmenorrhea. Accordingly, a systematic study was performed to investigate the role of calcium and Vit D in the relief of primary dysmenorrhea. A systematic literature search was performed in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar for papers published between 2010 and 2020. The Consolidated Standards of Reporting Trials and Strengthening the Reporting of Observational Studies in Epidemiology checklists were used to assess the quality of the studies. The risk of bias was assessed using the Cochrane risk-of-bias assessment tool. Low calcium levels lead to an increase in uterine muscle contraction and can cause pain after decreased uterine blood flow. Furthermore, low levels of Vit D can increase primary dysmenorrhea by increasing prostaglandin production or reducing intestinal calcium absorption. That being the case, Vit D and calcium intake can be effective in reducing the severity of primary dysmenorrhea and in reducing the rate of analgesic use. Low levels of Vit D and calcium are inversely related to the severity of primary dysmenorrhea, and Vit D and calcium intake can reduce the severity of primary dysmenorrhea and its associated systemic symptoms. Therefore, the use of calcium and Vit D supplements can be recommended to relieve dysmenorrhea.
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Araújo AHVD, Santos LS, Neves VA, Da Silva Júnior RA, Lopes Gama G. Estimulação elétrica nervosa transcutânea e crioterapia no tratamento de estudantes com dismenorreia primária: estudo piloto. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i4.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objetivo: Comparar os efeitos da Estimulação Elétrica Nervosa Transcutânea (TENS) e da crioterapia no alívio da sintomatologia dolorosa de estudantes com dismenorreia primária (DP). Métodos: Estudo transversal e quantitativo, com 20 mulheres universitárias aleatoriamente divididas em dois grupos: Grupo TENS (GT) cujas participantes foram submetidas a uma sessão de 45 min de TENS com frequência de 120 Hz e duração de pulso de 100 µs e Grupo Crioterapia (GC) cujas participantes foram submetidas a sessão de crioterapia por 20 min. Foram incluídas mulheres com ciclos menstruais regulares, nuligestas, sem relato de doença pélvica e com dismenorreia com nível de dor entre 4 e 10 durante os três primeiros dias de menstruação. Foram excluídas aquelas com contraindicação ao uso da TENS e crioterapia ou que fizeram uso de medicamentos até 24 h antes da intervenção. Foi registrado o nível de dor das participantes antes e logo depois da intervenção. Resultados: Foram avaliadas mulheres com idade variando entre 18 e 27 anos (média 22,8 ± 2,4 anos). Todas apresentaram além dos sintomas dolorosos algum outro sintoma associado, sendo os mais comuns diarreia e fadiga (80%, cada). O teste ANOVA two-way de medidas repetidas considerando como fatores grupo e avaliação, revelou efeito apenas para o fator avaliação (p < 0,001), não apresentando efeito para a interação grupo/avaliação (p = 0,09). Conclusão: TENS e crioterapia são recursos eficientes para o alívio dos sintomas álgicos de mulheres com DP, não havendo superioridade entre as abordagens.
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Living with Restrictions. The Perspective of Nursing Students with Primary Dysmenorrhea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228527. [PMID: 33212985 PMCID: PMC7698483 DOI: 10.3390/ijerph17228527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 12/30/2022]
Abstract
Primary dysmenorrhea (PD) affects a large number of female university students, diminishing their quality of life and hindering academic performance, representing a significant cause of absenteeism. The purpose of our study was to determine how nursing students experienced restrictions as a result of primary dysmenorrhea. A qualitative exploratory study was conducted among 33 nursing students with primary dysmenorrhea. A purposeful sampling strategy was applied. Data were collected from five focus groups (two sessions each) and the field notes of 10 researchers. A video meeting platform was used to conduct the focus groups. A thematic inductive analysis was performed. Thirty-three female nursing students participated in the study with a mean age of 22.72 (SD 3.46) years. Three broad themes emerged: (a) restrictions on daily activities and sports; (b) academic restrictions, and (c) restrictions on social and sexual relationships. The students described restrictions in performing everyday activities, such as carrying weight, and shopping. Some students even gave up the practice of sports and were absent from classes at the university, and from clinical practices at the hospital. The pain affected their ability to maintain and create new social relationships. Primary dysmenorrhea caused restrictions in the personal, social and academic life of the nursing students.
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Yu L, Liu S, Zheng C, Liu W, Wang H, Liang F, Lu W, Xu S, Wang W. Manual acupuncture versus sham acupuncture and usual care for the prevention of primary dysmenorrhea (PD): study protocol for a randomized controlled trial. Trials 2020; 21:818. [PMID: 32993752 PMCID: PMC7525957 DOI: 10.1186/s13063-020-04720-5] [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: 02/06/2020] [Accepted: 09/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background Primary dysmenorrhea (PD) is a leading cause of dysmenorrhea among adolescent girls. Manual acupuncture may be considered as an effective treatment for PD, but high-quality evidence remains limited. This trial aims to evaluate the efficacy and safety of acupuncture for the prevention of PD as compared with sham acupuncture and usual care. Methods/design This is a three-arm, randomized, controlled clinical trial in which the patients, assessors, and statisticians will be blinded. A total of 300 acupuncture-naive patients who were diagnosed as PD will be randomly allocated to the verum acupuncture, sham acupuncture, or usual care groups in a 2:2:1 ratio. Patients in the verum acupuncture group will receive manual acupuncture at specific acupuncture points with penetrating needling, while those in the sham acupuncture group will receive non-penetrating needling at non-acupuncture points. They will be given five sessions over a menstrual cycle for 3 menstrual cycles. Patients in the usual care group will receive health education and informed to receive manual acupuncture for free after waiting for 7 menstrual cycles. The primary outcome will be the change from baseline in the Cox Menstrual Symptom Scale Score (CMSS). The secondary outcomes will be the changes in Massachusetts General Hospital Acupuncture Sensation Scale (MASS), visual analog scale (VAS), Short-Form McGill Pain Questionnaire 2 (SF-MPQ-2), Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), Beck Depression Inventory II (BDI- II), Acupuncture Expectancy Scale (AES), 60-item NEO Personality Inventory-Short Form (NEO-FFI), and acute medication intake. The adverse events will be recorded at every visit. The analyses will be performed base on a full analysis set (FAS) and a per-protocol set (PPS). Discussion This study may provide high-quality evidence regarding the efficacy and safety of manual acupuncture for PD. In addition, the results of this study will help to identify the efficacy of acupuncture due to the specific effects of acupuncture or placebo effects of acupuncture ritual. Trial registration Clinical Trials.gov NCT02783534. Registered on 26 May 2016
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Affiliation(s)
- Lingling Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Shiqin Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Cuihong Zheng
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Wenhua Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Hua Wang
- Acupuncture and Moxibustion Institution, College of Acupuncture and Moxibustion, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, 1 Tanhualin Road, Wuhan, 430030, Hubei, China
| | - Fengxia Liang
- Acupuncture and Moxibustion Institution, College of Acupuncture and Moxibustion, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, 1 Tanhualin Road, Wuhan, 430030, Hubei, China
| | - Wei Lu
- Acupuncture and Moxibustion Institution, College of Acupuncture and Moxibustion, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, 1 Tanhualin Road, Wuhan, 430030, Hubei, China
| | - Shabei Xu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
| | - Wei Wang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
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Type of Dysmenorrhea, Menstrual Characteristics and Symptoms in Nursing Students in Southern Spain. Healthcare (Basel) 2020; 8:healthcare8030302. [PMID: 32858887 PMCID: PMC7551507 DOI: 10.3390/healthcare8030302] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/12/2020] [Accepted: 08/21/2020] [Indexed: 02/07/2023] Open
Abstract
Dysmenorrhea is a form of chronic pain associated with menstruation that affects a high percentage of young people. This study sought to determine the prevalence of primary and secondary dysmenorrhea among female nursing students in southern Spain and to compare their menstrual characteristics and symptoms. A cross-sectional observational study was conducted using a self-report questionnaire that included sociodemographic variables, menstrual characteristics and related symptoms. Descriptive bivariate analysis and binary logistic regression were performed in which the dependent variable was secondary dysmenorrhea. The prevalence of dysmenorrhea was 73.8% (of which 63.3% had primary dysmenorrhea and 10.5% had secondary dysmenorrhea), and was more likely in women with longer periods, heavier bleeding and those not using oral hormonal contraception (OCP). Secondary dysmenorrhea was 31.75, (confidence interval (CI)95% = 4.44–238.59; p < 0.01) times more likely among those with menstrual headache, 8.37 (CI95% = 2.35–19.80; p < 0.01), times greater among those suffering nausea during menstruation, 6.60 (CI95% = 1.42–30.67; p < 0.01), times greater among those suffering from menstrual vomiting, it was also 1.17 (CI95% = 1.08–1.26; p < 0.01) times more likely for each day that the period was prolonged and 6.63 (CI95% = 1.47–30.01; p = 0.014) times more likely in women with a heavy menstrual flow. These findings may help guide professionals towards the prescription of additional tests in certain cases in which secondary dysmenorrhea is suspected.
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Parra-Fernández ML, Onieva-Zafra MD, Abreu-Sánchez A, Ramos-Pichardo JD, Iglesias-López MT, Fernández-Martínez E. Management of Primary Dysmenorrhea among University Students in the South of Spain and Family Influence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155570. [PMID: 32752254 PMCID: PMC7432638 DOI: 10.3390/ijerph17155570] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023]
Abstract
The present study analyses the management of primary dysmenorrhea by university students in the south of Spain. In this cross-sectional observational study, 224 women participated, using an ad hoc self-report questionnaire about menstrual pain and self-care and including sociodemographic and gynecological variables. Some 76.8% of participants consumed analgesics and the majority self-medicated with non-steroidal anti-inflammatory drugs (NSAIDs) without consulting a health professional, with a correlation between pain intensity and the number of pills ingested during menstruation (r = 0.151, p < 0.05). The higher proportion of women who found their analgesia effective were those who took medication after being prescribed by a health care provider (60.8%) compared to those who self-medicated (40%; p < 0.01). Only 43.8% employed non-pharmaceutical methods, most commonly antalgic positions, massages and local heat. These choices were not related to the intensity of menstrual pain nor with the severity of the dysmenorrhea, nor did these most common methods prove to be the most effective. However, a higher percentage of women using non-pharmacological methods was identified in women with family members suffering from dysmenorrhea (73.2%) compared to those without (60%; p = 0.040), which may indicate that the choice of remedies is more related to learning self-care in the family context. This study identifies the need for education on self-care and management of menstrual pain.
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Affiliation(s)
- María Laura Parra-Fernández
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Ciudad Real, 13071 Ciudad Real, Spain; (M.L.P.-F.); (M.D.O.-Z.)
| | - María Dolores Onieva-Zafra
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Ciudad Real, 13071 Ciudad Real, Spain; (M.L.P.-F.); (M.D.O.-Z.)
| | - Ana Abreu-Sánchez
- Department of Nursing, University of Huelva, 21071 Huelva, Spain; (A.A.-S.); (J.D.R.-P.)
| | | | - María Teresa Iglesias-López
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Crta. Pozuelo-Majadahonda Km 1,800, 28223 Pozuelo de Alarcón, Madrid, Spain;
| | - Elia Fernández-Martínez
- Department of Nursing, University of Huelva, 21071 Huelva, Spain; (A.A.-S.); (J.D.R.-P.)
- Correspondence:
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De Sanctis V, Soliman AT, Daar S, Di Maio S, Elalaily R, Fiscina B, Kattamis C. Prevalence, attitude and practice of self-medication among adolescents and the paradigm of dysmenorrhea self-care management in different countries. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:182-192. [PMID: 32191679 PMCID: PMC7569583 DOI: 10.23750/abm.v91i1.9242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 11/23/2022]
Abstract
Self-medication (SM) is an important worldwide public health issue affecting children and adolescents. The pattern of SM varies in different communities, affected by factors such as age, sex, income, expense, self-care orientation, educational level and medical knowledge. It is a fairly common practice: for minor health problems, it often provides cheap, rapid, and convenient solutions, outside of the health care system of many countries. Painkillers, antipyretics, cough medicines, cold preparations, dermatological products, nutritional supplements and antibiotics are the drugs most frequently used. Potential risks include incorrect self-diagnosis, improper dosage, inappropriate choice of therapy, masking of severe disease and drug interactions. Lack of awareness of warnings and precautions, storage conditions, the recommended shelf-life and adverse reactions increase the risk of side effects. Little is known about the SM of dysmenorrhea by adolescent girls. Attitudes towards treatment are influenced by cultural, ethnic, and religious factors. Some girls discuss dysmenorrhea with family and friends, and the majority may not seek medical advice. As dysmenorrhea is a common problem for adolescents, it is essential that these girls be aware of the normal and abnormal symptoms of menstruation. In the light of these findings, the roles of family, school, health professionals and health authorities are of utmost importance for the implementation of measures to approach this health problem in a more efficient way. (www.actabiomedica.it)
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Affiliation(s)
- Vincenzo De Sanctis
- Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy.
| | - Ashraf T Soliman
- Department of Pediatrics, University of Alexandria, Alexandria, Egypt.
| | - Shahina Daar
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman.
| | - Salvatore Di Maio
- Emeritus Director in Pediatrics, Children's Hospital "Santobono-Pausilipon," Naples, Italy.
| | - Rania Elalaily
- Department of Primary Health Care, Abu Nakhla Hospital, Doha, Qatar.
| | | | - Christos Kattamis
- First Department of Paediatrics, National Kapodistrian University of Athens, Athens, Greece.
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