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de Arruda GT, Driusso P, de Godoy AG, Rodrigues JC, Avila MA. Presenteeism and associated factors among women with menstrual symptoms. Arch Gynecol Obstet 2024; 309:2071-2077. [PMID: 38502189 DOI: 10.1007/s00404-024-07425-1] [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: 08/25/2022] [Accepted: 02/10/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE Menstrual characteristics can affect a woman's productivity at work and college, but studies in a general population of adult women are scarce. In addition, it is important to know which menstrual symptoms are most associated with presenteeism in women to promote specific health actions. The present study aimed to assess menstrual symptoms associated with presenteeism in adult women. METHODS Online cross-sectional study in which menstrual characteristics, including menstrual flow, age of menarche, menstrual pain and cycle duration were assessed by a self-report questionnaire. The menstrual pain intensity was assessed by Numerical Rating Scale, and the presenteeism, by the Stanford Presenteeism Scale-6 (SPS-6). Women were divided in two groups, with and without presenteeism, based on the SPS-6 cutoff point. Data were analyzed by binary logistic regression and presented as odds ratios (OR). RESULTS Among the 430 women who participated in the study, 44.2% were classified as with presenteeism. Women with severe menstrual flow were more likely to have presenteeism (OR = 2.12) compared with women with mild and moderate menstrual flow. The higher menstrual pain intensity the higher the chances of a woman presenting with presenteeism (OR = 1.29). CONCLUSIONS These menstrual characteristics (intensity of menstrual flow and menstrual pain) seem to affect women's productivity at work and/or college, and should be assessed in research and clinical practice. Thus, public policies on women's health can be carried out based on these results.
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Affiliation(s)
- Guilherme Tavares de Arruda
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Universidade Federal de São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, ZIP Code 13565-905, Brazil
| | - Patricia Driusso
- Laboratory of Research on Women's Health (LAMU), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Amanda Garcia de Godoy
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Universidade Federal de São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, ZIP Code 13565-905, Brazil
| | - Jéssica Cordeiro Rodrigues
- Laboratory of Research on Women's Health (LAMU), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Mariana Arias Avila
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Universidade Federal de São Carlos, Rodovia Washington Luís, Km 235, São Carlos, SP, ZIP Code 13565-905, Brazil.
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Yáñez-Sarmiento A, Kiel L, Kaufman R, Abioye O, Florez N. More than Cramps in Scrubs: Exploring Dysmenorrhea among Women Healthcare Workers. Int J Womens Health 2024; 16:749-753. [PMID: 38706690 PMCID: PMC11069112 DOI: 10.2147/ijwh.s452210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/29/2024] [Indexed: 05/07/2024] Open
Abstract
Though understudied, dysmenorrhea, a painful cramping sensation occurring near and during menses, is the most prevalent gynecological disorder among women of reproductive age, affecting 50-90% of the global population. Contributing factors of this disorder include poor medical assessment, lack of consciousness, gender bias, moderate to high levels of stress, and depression and anxiety. Among school students and healthcare trainees, dysmenorrhea contributes to short-term absenteeism, lower productivity, creativity, and job performance. Among medical trainees, dysmenorrhea has been found to impact daily activities to a disabling degree in nearly one third of instances, resulting in difficulties in relationships and even self-isolation. Dysmenorrhea further produces substantial global economic losses and higher healthcare costs. To begin to alleviate the extensive issue of dysmenorrhea, we must increase awareness to fully understand its prevalence, risk factors, and potential for effective, affordable, and accessible treatments. Concurrently, our clinical environment must adopt a standard description and assessment tool to prevent, measure, and monitor dysmenorrhea, while on a global scale, we must develop and widely disseminate nationwide labor regulations that address the workforce impact due to the effects of dysmenorrhea.
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Affiliation(s)
- Anamaría Yáñez-Sarmiento
- Department of Oncology, Universidad Icesi, Perímetro Urbano Santiago de Cali, Valle del Cauca, Colombia
| | - Lauren Kiel
- Department of Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rebekah Kaufman
- Department of Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Oyepeju Abioye
- Department of Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Narjust Florez
- Department of Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Lin KC, Huang KJ, Lin MN, Wang CY, Tsai TY. Vitamin D Supplementation for Patients with Dysmenorrhoea: A Meta-Analysis with Trial Sequential Analysis of Randomised Controlled Trials. Nutrients 2024; 16:1089. [PMID: 38613122 PMCID: PMC11013696 DOI: 10.3390/nu16071089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/01/2024] [Accepted: 04/07/2024] [Indexed: 04/14/2024] Open
Abstract
Vitamin D reduces prostaglandin levels and inflammation, making it a promising treatment option for dysmenorrhoea. However, its effects on pain intensity in different types of dysmenorrhoea remain unclear. We examined whether vitamin D supplementation decreases pain intensity in patients with dysmenorrhoea. The Cochrane Library, Embase, Google Scholar, Medline, and Scopus databases were searched from inception to 30 December 2023. Randomised controlled trials (RCTs) evaluating vitamin D supplementation effects on such patients were included. The primary and secondary outcomes were measured by the changes in pain intensity and rescue analgesic use, respectively. Pooled mean differences and rate ratios were calculated using a random-effect model; trial sequential analysis (TSA) was also performed. Overall, 11 studies involving 687 participants were included. Vitamin D supplementation significantly decreased pain intensity in patients with dysmenorrhoea compared with controls (pooled mean difference, -1.64; 95% confidence interval, -2.27 to -1.00; p < 0.001; CoE, moderate; I2 statistic, 79.43%) and indicated substantial heterogeneity among the included studies. TSA revealed that the current RCTs provide sufficient information. In subgroup analyses, vitamin D supplement reduced primary dysmenorrhoea pain but not secondary dysmenorrhoea pain. In conclusion, although substantial heterogeneity persists, vitamin D supplementation decreased pain intensity in patients with dysmenorrhea, especially in those with primary dysmenorrhoea.
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Affiliation(s)
- Kan-Chu Lin
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
| | - Kuan-Ju Huang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital Yunlin Branch, Yunlin 640203, Taiwan;
| | - Ming-Nan Lin
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Cheng-Yu Wang
- Family Medicine Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan; (K.-C.L.); (M.-N.L.)
| | - Tou-Yuan Tsai
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Emergency Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 106319, Taiwan
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Li Y, Kawasaki H, Cui Z, Yamasaki S, Nakaoka S, Shiraishi M. Coping With Women's Menstruation-Related Health Issues in Male-Dominated Companies: A Cross-Sectional Study in Japan. Cureus 2023; 15:e49569. [PMID: 38156186 PMCID: PMC10754090 DOI: 10.7759/cureus.49569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Japanese women face many female-specific health problems in the workplace, especially menstruation-related issues, which can adversely affect their quality of life and productivity. This study aims to examine how female employees in a male-dominated company in Hiroshima, Japan, cope with menstruation-related health issues in the workplace and the factors that influence their coping strategies. MATERIALS AND METHODS This study used a cross-sectional survey research method. The survey investigated age, health, and menstrual-related issues, as well as women's active participation support and health literacy (HL) levels. The sample population included employees of a manufacturer in Hiroshima prefecture. The data were collected from February 20 to March 10, 2023. The analysis subjects were 171 women who had experienced menstruation-related, women-specific health issues in the workplace. Their attitudes toward menstruation-related issues could influence their experiences. They were categorized into positive and negative groups based on their attitudes toward coping with women's health issues. Chi-square tests and logistic regression analysis were used to compare the two groups. RESULTS The study found that 50.3% (N = 296) of female employees had experienced women's menstruation-related health issues at work. As many as 62.6% (N = 171) of female employees showed a positive attitude, and the study also found that female employees with a positive attitude toward menstruation-related health issues had higher HL (odds ratio (OR) = 1.216, 95% CI: 1.007-0.1.468) and were more likely to be able to predict menstruations (OR = 4.528, 95% CI: 1.618-12.670). Conclusions: In male-dominated companies, many female employees are affected by menstruation-related problems in the workplace. A positive attitude toward women's health issues was positively associated with HL and predictive ability. Male-dominated companies should pay attention to women's menstruation-related health issues in the workplace, implement interventions to improve their health literacy and predictive ability, strengthen communication with them, and encourage them to actively participate in women's health initiatives.
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Affiliation(s)
- Yuan Li
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Hiromi Kawasaki
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Zhengai Cui
- Department of Epidemiology and Public Health, School of Humanities and Management, Guangdong Medical University, Dongguan, CHN
| | - Satoko Yamasaki
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Sae Nakaoka
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Misaki Shiraishi
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
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Camilo FM, Bossini PS, Driusso P, Ávila MA, Parizotto NA, de Sousa UR, Rodrigo Ramos R. The Effects of Electrode Placement on Analgesia Using Transcutaneous Electrical Nerve Stimulation for Primary Dysmenorrhea: A Single-Blind Randomized Controlled Clinical Trial. Cureus 2023; 15:e39326. [PMID: 37378135 PMCID: PMC10292036 DOI: 10.7759/cureus.39326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/29/2023] Open
Abstract
Background Primary dysmenorrhea (PD) refers to the occurrence of painful menstrual cramps without pathological involvement of the pelvic organs, with considerable morbidity and high prevalence among females of reproductive age. Objective The objective of this study is to present and test the efficacy of an innovative method of interactive transcutaneous electrical nerve stimulation (iTENS) for PD. Methods and materials This study is a single-blind controlled clinical trial. This was conducted at the outpatient clinic of the faculty of physical therapy. Females with PD (n=124) were divided into the treated group (transcutaneous electrical nerve stimulation {TENS} group {TG}, n=62) and the placebo group (PG, n=62). A single session of either iTENS or placebo intervention was used for 35 minutes. Pain, the duration of analgesia, and the use of pain medication were assessed before and after the intervention. Data from before and after the treatment were compared between groups (Student's t-test). The level of significance was set at 5%. Results A significant decrease in pain (p<0.001) was observed after the intervention for the TG, with a more long-lasting analgesia (p<0.001) and decreased need for pain medication (p<0.001). Conclusions The proposed method of transcutaneous electrical nerve stimulation (TENS) application showed positive results for pain management on females with PD, with no reported adverse effects. The new proposed TENS application takes into account the preferences of the patient regarding positioning and the number of channels needed to cause analgesia. This application was able to promote almost complete analgesia in females with primary dysmenorrhea, and the analgesia persisted for more than one menstrual cycle.
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Affiliation(s)
- Fabio Mendes Camilo
- Department of Health Sciences, University Center of Santa Fé do Sul, Santa Fé do Sul, BRA
| | - Paulo Sérgio Bossini
- Department of Biophotonics and Biomaterials, Institute of Research and Education in the Health Area (NUPEN), São Carlos, BRA
| | - Patricia Driusso
- Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, BRA
| | - Mariana Arias Ávila
- Physical Therapy Post-Graduate Program and Research Nucleus on Electrophysical Agents, Federal University of São Carlos, São Carlos, BRA
| | - Nivaldo Antônio Parizotto
- Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, BRA
- Post-Graduate Program of Biotechnology on Regenerative Medicine and Medical Chemistry, University of Araraquara, Araraquara, BRA
| | | | - Rogério Rodrigo Ramos
- Department of Research, Faculty of Roseira (FARO), Roseira, BRA
- Department of Health Sciences, University Center of Santa Fé do Sul, Santa Fé do Sul, BRA
- Department of Health Sciences, Brazil University, Fernandópolis, BRA
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MacGregor B, Allaire C, Bedaiwy MA, Yong PJ, Bougie O. Disease Burden of Dysmenorrhea: Impact on Life Course Potential. Int J Womens Health 2023; 15:499-509. [PMID: 37033122 PMCID: PMC10081671 DOI: 10.2147/ijwh.s380006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
Dysmenorrhea is the most common gynecologic condition among the female population and has a significant impact on life course potential. It has a widespread impact on a female's mental and physical well-being, with longstanding impairments on quality of life, personal relationships, and education and career attainment. Furthermore, untreated dysmenorrhea can lead to hyperalgesic priming, which predisposes to chronic pelvic pain. Primary dysmenorrhea is pain in the lower abdomen that occurs before or during menses and in the absence of pelvic pathology. One possible mechanism is endometrial inflammation and increased prostaglandin release, resulting in painful uterine contractions. Dysmenorrhea may also occur secondary to pelvic pathology, such as endometriosis, adenomyosis or due to cyclic exacerbation of non-gynecologic pain conditions. A thorough patient evaluation is essential to differentiate between potential causes and guide management. Treatment must be tailored to individual patient symptoms. Pharmacologic management with non-steroidal anti-inflammatory medications and/or combined hormonal contraceptives is most common. Heat therapy, exercise, vitamins and dietary supplements have limited evidence and can be offered for patients seeking non-pharmacologic adjunctive or alternative options. Greater awareness for both health-care providers and patients allows for early intervention to reduce impact on quality of life and life course potential.
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Affiliation(s)
- Brittany MacGregor
- Department of Obstetrics and Gynaecology, University of British Columbia, BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, Canada
| | - Catherine Allaire
- Department of Obstetrics and Gynaecology, University of British Columbia, BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, Canada
| | - Mohamed A Bedaiwy
- Department of Obstetrics and Gynaecology, University of British Columbia, BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, Canada
| | - Paul J Yong
- Department of Obstetrics and Gynaecology, University of British Columbia, BC Women’s Centre for Pelvic Pain and Endometriosis, Vancouver, Canada
- Paul J Yong, Department of Obstetrics & Gynecology, University of British Columbia, FRCSC, F2 – 4500 Oak Street, Vancouver, British Columbia, V6H3N1, Canada, Email
| | - Olga Bougie
- Department of Obstetrics and Gynaecology, Queen’s University, Kingston, Canada
- Correspondence: Olga Bougie, 76 Stuart Street, Victory 4, Department of Obstetrics & Gynecology, Queen’s University, Kingston, Ontario, Canada, K7L 2V7, Email
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Harada T, Ota I, Kitawaki J, Momoeda M, Maeda N, Akira S, Umeyama M, Sunaya T, Hirano K. Real-world outcomes of the levonorgestrel-releasing intrauterine system for heavy menstrual bleeding or dysmenorrhea in Japanese patients: A prospective observational study (J-MIRAI). Contraception 2022; 116:22-28. [PMID: 36057322 DOI: 10.1016/j.contraception.2022.08.006] [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: 01/27/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES We collected real-world data on the safety and clinical outcomes of the levonorgestrel-releasing intrauterine system (LNG-IUS) for heavy menstrual bleeding and dysmenorrhea. STUDY DESIGN This was a prospective, multicenter, single-cohort, open-label, post-authorization 12-month follow-up study of Japanese patients initiating the LNG-IUS for heavy menstrual bleeding and/or dysmenorrhea. The primary endpoint was the safety profile based on adverse events and adverse drug reactions (ADRs), including expulsions and abnormal bleeding, within 12 months of LNG-IUS insertion. Secondary endpoints included changes from baseline in menstrual blood loss based on bleeding days and dysmenorrhea graded on a visual analog scale (VAS). RESULTS Of the 595 patients included, many had underlying conditions such as adenomyosis (39.5%), uterine leiomyoma (30.8%), or endometriosis (12.9%). The incidences of ADRs and serious ADRs were 59.7% and 0.3%, respectively. Frequently reported ADRs were metrorrhagia (48.9%), procedural pain (14.1%), and ovarian cyst (6.2%). The cumulative incidence of expulsions at 12 months was 8.7%. Risk factors for expulsion were obesity (body mass index ≥25 kg/m2), adenomyosis, and uterine cavity length ≥8 cm. The median [interquartile range] VAS score for dysmenorrhea improved from 46.5 [13.0-68.0] at insertion to 1.0 [0.0-13.0] at 12 months, and improvements were also observed in chronic pelvic pain and painful defecation. CONCLUSIONS The LNG-IUS safely and effectively reduced dysmenorrhea, chronic pelvic pain, and painful defecation. Risk factors for expulsion suggest that patients with underlying organic disease should be monitored carefully when using the LNG-IUS. IMPLICATIONS The LNG-IUS is an effective treatment for secondary dysmenorrhea with organic disease, and for the reduction of chronic pelvic pain; however, physicians should be aware of the increased risk of expulsion in patients with organic conditions.
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Affiliation(s)
- Tasuku Harada
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Tottori 683-8503, Japan.
| | - Ikuko Ota
- Department of Gynecology, Kurashiki Heisei Hospital, Okayama 710-0826, Japan
| | - Jo Kitawaki
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan
| | - Mikio Momoeda
- Department of Integrated Women's Health, St. Luke's International Hospital, Tokyo 104-8560, Japan
| | - Nagamasa Maeda
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi 783-8505, Japan
| | - Shigeo Akira
- Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo 113-8603, Japan
| | - Mikiko Umeyama
- Medical Affairs Women's Health & Established Products, Bayer Yakuhin, Ltd., Osaka 530-0001, Japan
| | - Toshiyuki Sunaya
- Statistics & Data Insights, Data Sciences & Analytics, Research & Development Japan, Bayer Yakuhin, Ltd., Osaka 530-0001, Japan
| | - Kazufumi Hirano
- PMS, Pharmacovigilance Monitoring & Governance, Bayer Yakuhin, Ltd., Osaka 530-0001, Japan
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Yöndem ZN, Çıtak Bilgin N. Dysmenorrhea among hospital nurses and its effects on work life*,**,***. Health Care Women Int 2022; 43:997-1014. [DOI: 10.1080/07399332.2020.1800015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Nevin Çıtak Bilgin
- Faculty of Health Sciences, Department of Obstetrics and Gynecology Nursing, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Park J, Lim YC, Hwang DS, Ha IH, Lee YS. Analysis of Healthcare Utilization for Primary Dysmenorrhea in Korea: A Retrospective, Cross-Sectional Study. Int J Womens Health 2022; 14:1015-1027. [PMID: 35959202 PMCID: PMC9359788 DOI: 10.2147/ijwh.s366386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/23/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose This study is a retrospective, cross-sectional study aiming to present basic data on the treatment modalities and cost of care for primary dysmenorrhea (PD) by analyzing healthcare utilization and patient distributions using the 2010 to 2018 Health Insurance Review and Assessment Service (HIRA) data. Patients and Methods We used the HIRA-National Patient Sample (NPS) data to analyze medical service utilization for PD (ICD-10 code: N94.4, N94.6) in Western medicine (WM) or Korean medicine (KM) care between January 2010 and December 2018. Results There were 41,139 patients diagnosed with PD who utilized Western medicine (WM) or Korean medicine (KM) care at least once during the study period. The number of claims and patients steadily rose over the years from 7430 claims for 3989 patients in 2010 to 11,523 claims for 6226 patients in 2018. The predominant age group was 15 to 24 years. Regarding the frequency of service categories for PD in the claims, consultation was the most common and costly service category in WM (72,120 cases, 47.89%; 631,912 USD, 69.74%), while injection and analogous treatments was the most common and costly service category in KM (97,157 cases, 72.41%; 314,696 USD, 55.86%). Regarding the drug prescriptions, nonsteroidal anti-inflammatory drugs (NSAIDs) (26,617 cases, 40.47%) were the most frequently prescribed drug for PD in pharmacies and hospitals. Conclusion The result shows an annual increase in healthcare utilization for PD with the fastest rate in individuals aged 15 to 24 years. This study provides data on the current utilization of WM and KM care for PD for policymakers. Furthermore, we analyzed the frequency and cost of common treatment modalities in WM and KM, which would be useful data for clinicians and researchers.
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Affiliation(s)
- Jinhun Park
- Department of Internal Medicine, Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Yu-Cheol Lim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Deok-Sang Hwang
- Department of OB & GY in Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
- Correspondence: In-Hyuk Ha; Ye-Seul Lee, Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 2F, 540 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea, Tel +82-2-2222-2740, Fax +82-2-2222-2737, Email ;
| | - Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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Dysmenorrhea across the lifespan: a biopsychosocial perspective to understanding the dysmenorrhea trajectory and association with comorbid pain experiences. Pain 2022; 163:2069-2075. [PMID: 35420567 DOI: 10.1097/j.pain.0000000000002649] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/01/2022] [Indexed: 11/26/2022]
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11
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Genome-wide association study of primary dysmenorrhea in the Taiwan Biobank validates associations near the NGF and IL1 gene loci. J Hum Genet 2022; 67:449-458. [PMID: 35351958 DOI: 10.1038/s10038-022-01023-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 01/22/2022] [Accepted: 02/04/2022] [Indexed: 11/08/2022]
Abstract
Using the Taiwan Biobank, we aimed to identify traits and genetic variations that could predispose Han Chinese women to primary dysmenorrhea. Cases of primary dysmenorrhea included those who self-reported "frequent dysmenorrhea" in a dysmenorrhea-related Taiwan Biobank questionnaire, and those who have been diagnosed with severe dysmenorrhea by a physician. Controls were those without self-reported dysmenorrhea. Customized Axiom-Taiwan Biobank Array Plates were used to perform whole-genome genotyping, PLINK was used to perform association tests, and HaploReg was used to conduct functional annotations of SNPs and bioinformatic analyses. The GWAS analysis included 1186 cases and 24,020 controls. We identified 53 SNPs that achieved genome-wide significance (P < 5 × 10-8, which clustered in 2 regions. The first SNP cluster was on chromosome 1, and included 24 high LD (R2 > 0.88) variants around the NGF gene (lowest P value of 3.83 × 10-13 for rs2982742). Most SNPs occurred within NGF introns, and were predicted to alter regulatory binding motifs. The second SNP cluster was on chromosome 2, including 7 high LD (R2 > 0.94) variants around the IL1A and IL1B loci (lowest P value of 7.43 × 10-10 for rs11676014) and 22 SNPs that did not reach significance after conditional analysis. Most of these SNPs resided within IL1A and IL1B introns, while 2 SNPs may be in the promoter histone marks or promoter flanking regions of IL1B. To conclude, data from this study suggest that NGF, IL1A, and IL1B may be involved in the pathogenesis of primary dysmenorrhea in the Han Chinese in Taiwan.
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Parker MA, Kent AL, Sneddon A, Wang J, Shadbolt B. The Menstrual Disorder of Teenagers (MDOT) Study No. 2: Period ImPact and Pain Assessment (PIPPA) Tool Validation in a Large Population-Based Cross-Sectional Study of Australian Teenagers. J Pediatr Adolesc Gynecol 2022; 35:30-38. [PMID: 34171477 DOI: 10.1016/j.jpag.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/09/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE To validate the Period ImPact and Pain Assessment (PIPPA) self-screening tool for menstrual disturbance in teenagers. DESIGN Cross-sectional study. SETTING Three senior high schools in the Australian Capital Territory (ACT), Australia. PARTICIPANTS A total of 1066 girls between 15 and 19 years of age. INTERVENTIONS AND MAIN OUTCOME MEASURES A quantitative paper survey collected self-reports of menstrual bleeding patterns, typical and atypical symptoms, morbidities, and interference with daily activities. Multiple correspondence analysis was used to examine associations between PIPPA questions. Generalized linear models compared total score and subscores by validation criteria: pain, school absence, and body mass index (BMI). Receiver operating characteristic curves were used to evaluate the predictiveness of menstrual disturbance indicators by total PIPPA score. RESULTS Reports of pain, interference, and concern within the PIPPA items and between both the MDOT and PIPPA questionnaires were significantly correlated (P < .0001). The indicator "missing school" was highly associated (P < .0001) with pain and interference. Obesity (BMI ≥30) was associated with higher PIPPA scores, as was underweight (BMI≤18.4). Where 0 = no disturbance, 5 = high disturbance, aggregated PIPPA scores found 75% scoring 0-2 (out of 5) and 25% scoring 3-5 (257/1037). High scores of 4 or 5 (out of 5) were 7% (72/1037) and 3.7% (38/1037), respectively. CONCLUSION PIPPA is a valid screening tool for pain-related menstrual disturbance that affects functioning in young women. PIPPA subdomains of pain/interference have good validity relative to indicators of pain and interference and are responsive to age, BMI, and school absence differences.
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Affiliation(s)
- M A Parker
- Canberra Endometriosis Centre, Department of Obstetrics and Gynaecology, ACT Health, Canberra, ACT, Australia.
| | - A L Kent
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York; Australian National University, College of Health and Medicine, Canberra, ACT, Australia
| | - A Sneddon
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
| | - J Wang
- Ocular Genomics Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - B Shadbolt
- ACT Centre for Health and Medical Research, ACT Health, Canberra, ACT, Australia
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Han S, Park KS, Lee JM, Suh HS. Expenditure on complementary and alternative medicine and productivity losses in patients with primary dysmenorrhea: a survey of women in Korea. Health Care Women Int 2021; 43:1120-1130. [PMID: 34846274 DOI: 10.1080/07399332.2021.2007250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In women with primary dysmenorrhea (PD), the use of complementary and alternative medicine (CAM) and productivity losses at both workplaces and schools have not been comprehensively assessed. In this study, researchers evaluated the disease burden in women with PD in patients' perspective in two categories: direct cost (the use of CAM and associated costs) and indirect cost (productivity losses). Women with PD aged 16-49 years were asked to fill an online survey in 2017. The survey consisted of 49 questions. CAM included traditional Korean medicines, over-the-counter products, dietary supplements, and traditional remedies. All costs were expressed in US dollars in this study. The survey data from 86 patients with PD were analyzed. The total mean annual cost per patient with PD was $4053, comprising direct costs ($1245) and indirect costs ($2807). PD causes considerable expenditure on CAM and impairs work productivity (especially in presenteeism).
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Affiliation(s)
- Sola Han
- College of Pharmacy, Kyung Hee University, Seoul, South Korea
| | | | - Jin Moo Lee
- Department of Korean Medicine Obstetrics & Gynecology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Hae Sun Suh
- College of Pharmacy, Kyung Hee University, Seoul, South Korea
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Yu SC, Hsu HP, Guo JL, Chen SF, Huang SH, Chen YC, Huang CM. Exploration of the experiences of working stressors and coping strategies associated with menstrual symptoms among nurses with shifting schedules: a Q methodology investigation. BMC Nurs 2021; 20:238. [PMID: 34823511 PMCID: PMC8620663 DOI: 10.1186/s12912-021-00759-0] [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: 11/24/2020] [Accepted: 11/09/2021] [Indexed: 12/05/2022] Open
Abstract
Background The essence and workload of nursing can easily lead to burdens associated with female nurses’ menstrual symptoms, and consequently, result in decreased working performance. Without effective support this can lead to resignation due to maladaptation. This study adopted Q methodology to explore the experience of working stressors and coping strategies associated with menstrual symptoms among nurses with shifting schedules. Methods Data were collected in two stages. First, in-depth interviews were conducted to collect nurses’ experiences. Sentences that best fit the study’s purpose were extracted for the construction of Q statements. Second, nurses were allowed to subjectively rank these Q statements by using Q-sorts. A total of 90 participants ranked the designed Q statements. The Q factor analysis revealed a five-factor solution that accounted for 48.90% of the total variance. Results The five evident factors included: menstrual symptoms interfering in collaboration with colleagues, deficiency of professional function and stress due to symptoms burden, diverse experiences without a clear pattern, adapted self-management with and without medication use, and stress due to symptoms burden and using medication for self-management. Conclusions The identification of these five groups may facilitate the development of responsive strategies to meet nurses’ preferences. Furthermore, identifying workplace factors that are associated with the adverse effects of menstrual symptoms on nurses will be helpful for nursing supervisors and hospital managers. Additionally, strategies that can be implemented to create supportive work environments are discussed.
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Affiliation(s)
- Shu-Chuan Yu
- Department of Nursing, Yonghe Cardinal Tien Hospital, Yonghe Dist., New Taipei, Taiwan
| | - Hsiao-Pei Hsu
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jong-Long Guo
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
| | - Shu-Fen Chen
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shu-He Huang
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yin-Chen Chen
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chiu-Mieh Huang
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, 155, Sec.2, Li-Nong Street, 11221, Taipei, Taiwan.
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Huang G, Le AL, Goddard Y, James D, Thavorn K, Payne M, Chen I. A Systematic Review of the Cost of Chronic Pelvic Pain in Women. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2021; 44:286-293.e3. [PMID: 34587539 DOI: 10.1016/j.jogc.2021.08.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/16/2021] [Accepted: 08/16/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To systematically summarize the evidence on costs related to chronic pelvic pain (CPP) for women. DATA SOURCES Electronic databases (MEDLINE, EMBASE, PubMed, and Cochrane Library) were searched for English and French articles published from 1990 to January 2021 STUDY SELECTION: Of 1304 articles screened, 67 were screened in full-text form, and a total of 13 articles were included in the final analysis. Articles included involved cost studies that estimated hospital or health system costs for pelvic pain, dysmenorrhea, dyspareunia, endometriosis with pain, interstitial cystitis, or painful bladder syndrome. DATA EXTRACTION AND SYNTHESIS A standardized form was created to extract study setting, design, and population; patient demographics; study duration; and reported costs of CPP components and amounts. Two independent reviewers completed the data extraction, and discrepancies were resolved through discussion with a third reviewer. CONCLUSION Estimated health care costs ranged from US$1367 to US$7043 per woman per year. Prescription costs ranged from US$193 to US$2457 per woman per year. Indirect costs ranged from US$4216 to US$12 789 per woman per year. Combined costs ranged from US$1820 to US$20 898 per woman per year. The yearly costs of CPP varied according to country; yearly costs were estimated to be $2.8 billion, ¥191,680 to ¥246,488, and $16 970 to $20 898 per woman per year in the United Sates, Japan, and Australia, respectively. The literature suggests that CPP represents a considerable economic burden on women and health care systems internationally, with indirect costs contributing a significant portion of total costs.
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Affiliation(s)
| | - Ai-Lien Le
- University of Ottawa, Ottawa, ON; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON.
| | - Yvette Goddard
- Department of Anesthesiology, The Ottawa Hospital, Ottawa, ON
| | - Daniel James
- Department of Anesthesiology, The Ottawa Hospital, Ottawa, ON
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON; School of Epidemiology and Public Health, Ottawa, ON
| | - Magdalene Payne
- Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa, ON
| | - Innie Chen
- University of Ottawa, Ottawa, ON; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON; Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa, ON
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Elbandrawy AM, Elhakk SM. Comparison between the effects of aerobic and isometric exercises on primary dysmenorrhea. ACTA GYMNICA 2021. [DOI: 10.5507/ag.2021.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Rodrigues JC, Avila MA, Driusso P. Transcutaneous electrical nerve stimulation for women with primary dysmenorrhea: Study protocol for a randomized controlled clinical trial with economic evaluation. PLoS One 2021; 16:e0250111. [PMID: 34014922 PMCID: PMC8136645 DOI: 10.1371/journal.pone.0250111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 03/29/2021] [Indexed: 12/02/2022] Open
Abstract
Primary dysmenorrhea (PD) is a common gynecological disorder characterized by cramping pain in the lower abdomen during menstruation, in the absence of identifiable pathology. While Transcutaneous Electrical Nerve Stimulation (TENS) is used to promote PD pain relief, there is still a need to understand the parameters and cost-effectiveness of this intervention. As such, this study aims to disclose a study that will evaluate the effectiveness and cost-effectiveness of TENS on pain intensity in women with PD. This is a protocol for an assessor-blinded randomized controlled trial that includes 174 women with PD, >18 years old, with menstrual pain greater than or equal to four points in the Numerical Rating Scale. Participants will be randomized into three groups (active TENS, placebo TENS, and educational booklet). Participants allocated to the active TENS group will receive electrical stimulation (F = 100 Hz, pulse duration = 200 μs, for 30 min). In contrast, the placebo TENS group will receive placebo stimulation (same parameters, but for only 30 s, and then the current will be ramped off over a 15-s time frame) for three consecutive months during menstruation. Participants allocated to the educational booklet group will receive instructions about health promotion and education actions related to PD. A blinded assessor will evaluate the pain intensity (Numerical Rating Scale), presenteeism (Stanford Presenteeism Scale), Health-Related Quality of Life (Short-Form 6 dimensions and SF-36), and health costs of menstrual pain. This is the first study to propose a health economic evaluation while assessing the benefits of using TENS to treat PD symptoms. It is hypothesized that active TENS will be more effective than placebo TENS or the educational booklet in improving clinical outcomes in the short-, medium- and long-term. The study will also provide information about the cost-effectiveness of TENS, which can be used by policy makers to improve PD care in public and private health systems.
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Affiliation(s)
- Jéssica Cordeiro Rodrigues
- Women’s Health Research Laboratory (LAMU), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Mariana Arias Avila
- Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Patricia Driusso
- Women’s Health Research Laboratory (LAMU), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
- * E-mail:
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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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Momoeda M, Akiyama S, Tanaka K, Suzukamo Y. Quality of Life in Japanese Patients with Dysmenorrhea Treated with Ethinylestradiol 20 μg/Drospirenone 3 mg in a Real-World Setting: An Observational Study. Int J Womens Health 2020; 12:327-338. [PMID: 32440228 PMCID: PMC7210450 DOI: 10.2147/ijwh.s238460] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/26/2020] [Indexed: 11/23/2022] Open
Abstract
Background Dysmenorrhea affects approximately 80% of women in Japan and has a negative impact on health-related quality of life (HRQoL). Low-dose estrogen/progestin combined oral contraceptives have been shown to reduce the severity of dysmenorrhea symptoms. This study characterized HRQoL in Japanese women with dysmenorrhea before and after ethinylestradiol/drospirenone (EE/DRSP) treatment. Methods This prospective, observational study recruited 531 patients, of which 186 were evaluated after treatment with EE 20 μg/DRSP 3 mg for dysmenorrhea in a 24/4 cyclic regimen. The primary endpoints were mean baseline and post-treatment 36-Item Short-Form Health Survey version 2.0 (SF-36v2) scores for study patients compared with the general female population of Japan (calculated using norm-based scoring), and mean changes in study patient SF-36v2 scores between baseline and 6 to 8 treatment cycles. Results Compared with Japanese norms, women with dysmenorrhea had lower pre-treatment SF-36v2 scores, except for the physical functioning domain. After 6-8 cycles of EE/DRSP treatment, all 8 SF-36v2 domain scores were significantly higher than baseline. The greatest improvements were observed in bodily pain and social functioning (mean change [standard deviation (SD)]: physical functioning: 1.4 [5.7], role physical: 3.2 [8.1], bodily pain: 7.8 [10.0], general health: 3.0 [7.0], vitality: 2.7 [8.1], social functioning: 3.5 [9.8], role emotional: 3.3 [9.2], and mental health: 3.0 [7.3]; p< 0.001 for all). Compared with the Japanese general population, study patients' post-treatment scores were significantly higher for the general health domain (p= 0.008) and physical summary scores (p= 0.033). Conclusion Dysmenorrhea has a profound impact on all aspects of functioning and well-being. This study, conducted in a real-world setting, found that physical, social, and mental HRQoL improved significantly after a cyclic regimen of EE/DRSP in Japanese patients with dysmenorrhea. This regimen may have the potential to provide an effective option to improve patient HRQoL. Trial Registration Study sample was drawn from patients enrolled in a post-marketing surveillance study, registered June 20, 2011 (NCT01375998).
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Affiliation(s)
- Mikio Momoeda
- Department of Integrated Women's Health, St. Luke's International Hospital, Tokyo, Japan
| | | | - Kota Tanaka
- Statistics Analysis Department 2, EPS Corporation, Osaka, Japan
| | - Yoshimi Suzukamo
- Department of Physical Medicine and Rehabilitation, Tohoku University, Sendai, Japan
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20
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Momoeda M, Akiyama S, Yamamoto S, Kondo M, Fukai T. Burden of Menstrual Pain Measured by Heatmap Visualization of Daily Patient-Reported Data in Japanese Patients Treated with Ethinylestradiol/Drospirenone: A Randomized Controlled Study. Int J Womens Health 2020; 12:175-185. [PMID: 32210639 PMCID: PMC7071861 DOI: 10.2147/ijwh.s242864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/03/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose Dysmenorrhea negatively affects women’s quality of life and poses a considerable economic burden. A recent study in Japanese patients with dysmenorrhea (NCT01892904) reported a significant reduction in the number of days with menstrual pain after treatment with a flexible extended regimen of ethinylestradiol (EE)/drospirenone (DRSP) compared with a cyclic regimen. However, individual patients’ menstrual pain patterns and intensities were not indicated. Heatmapping was used to visualize menstrual pain patterns and intensities by re-evaluating the previously published data from NCT01892904. Patients and Methods NCT01892904 was a Phase III, multicenter, randomized, open-label, active-control study of 212 women aged ≥20 years randomized 1:1 to receive flexible extended or 28-day cyclic EE/DRSP treatment. Daily pain levels were recorded in patient diaries, and menstrual pain patterns and intensities were visualized using heatmapping. Patients were stratified by baseline dysmenorrhea scores and primary or secondary dysmenorrhea. Results The heatmap data demonstrated that EE/DRSP reduced the degree of menstrual pain. Regular peaks of menstrual pain were alleviated in the extended regimen group but were still observed in the cyclic regimen group. While a decrease in the days with menstrual pain was observed in patients with higher baseline dysmenorrhea scores (5–6), those with lower baseline scores (3–4) were more likely to experience lower intensities of menstrual pain. Although pain relief was less likely in patients with secondary dysmenorrhea, those who had lower baseline dysmenorrhea scores (3–4) and received the flexible extended regimen experienced a greater reduction in the number of days with menstrual pain than those who received the cyclic regimen. Conclusion Heatmapping effectively visualized the daily burden of menstrual pain in Japanese patients with dysmenorrhea. The analysis using heatmaps suggested that the flexible extended EE/DRSP treatment regimen was more likely to alleviate the regular occurrence of menstrual pain peaks compared with the cyclic regimen.
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Affiliation(s)
- Mikio Momoeda
- Department of Integrated Women's Health, St Luke's International Hospital, Tokyo, Japan
| | | | | | - Masami Kondo
- Product Development, Bayer Yakuhin Ltd., Osaka, Japan
| | - Takeshi Fukai
- Product Development, Bayer Yakuhin Ltd., Osaka, Japan
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Saei Ghare Naz M, Kiani Z, Rashidi Fakari F, Ghasemi V, Abed M, Ozgoli G. The Effect of Micronutrients on Pain Management of Primary Dysmenorrhea: a Systematic Review and Meta-Analysis. J Caring Sci 2020; 9:47-56. [PMID: 32296659 PMCID: PMC7146731 DOI: 10.34172/jcs.2020.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 01/21/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction: Primary dysmenorrhea is considered as one of the main problems in women. This review study aimed to characterize the effect of micronutrients on primary dysmenorrhea. Methods: In this systematic and meta‐analysis study, the articles were searched at Cochrane library, PubMed, Scopus, Web of Science databases. The searching process was conducted with the key terms related to dysmenorrhea and micronutrients. Risk of bias assessment was performed, using Rev Man 5.3 software. In view of the heterogeneity of some of the studies, they were analyzed, using a qualitative method (n=10), and only 6 studies were included in Meta analyze. STATA statistical software version 11 was used for the analysis. Results: In this study, finally 16 clinical trials were investigated. Most micronutrients studied in the relevant articles had anti-inflammatory and analgesic properties with a desirable effect on dysmenorrhea pain relief. Vitamins (K, D, B1, and E) and calcium, magnesium, zinc sulfate and boron contributed effectively to dysmenorrhea pain management. Two months after the intervention, there was a significant mean decrease in the pain score for the vitamin D intervention group (SMD: -1.02, 95% CI: -1.9 to – 0.14, P =0.024) , as well as in the vitamin E intervention group compared to placebo group (SMD: -0.47,95% CI:-0.74 to – 0.2, P = 0.001). Conclusion: Despite the paucity of related research, the studies indicated the potential effects of micronutrients on reducing the pain severity in primary dysmenorrhea. But more studies are needed to confirm the safety and effectiveness of various types of micronutrients on primary dysmenorrhea.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Department of Midwifery, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Kiani
- Department of Midwifery, Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vida Ghasemi
- Department of Midwifery, Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Abed
- Department of Gynecology and Obstetrics, School of Medicine, Alborz University of Medical Sciences, Alborz, Iran
| | - Giti Ozgoli
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Azagew AW, Kassie DG, Walle TA. Prevalence of primary dysmenorrhea, its intensity, impact and associated factors among female students' at Gondar town preparatory school, Northwest Ethiopia. BMC Womens Health 2020; 20:5. [PMID: 31906945 PMCID: PMC6945628 DOI: 10.1186/s12905-019-0873-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 12/24/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Primary dysmenorrhea is defined as a crampy pain in the lower abdomen before or during the menstrual period in the absence of any pelvic pathology. It is the leading motherhood problem worldwide but there is limited evidence on the prevalence of primary dysmenorrhea in the study area as well in Ethiopia. Researching primary dysmenorrhea helps to focus on the treatment plan. The study aimed to assess the prevalence, intensity, impact, and associated factors of primary dysmenorrhea among female students at Gondar town preparatory school. METHODS A cross-sectional study design conducted among female students at Gondar town Preparatory School from May 1-10/2017. A total of 459 study participants were used. A simple random sampling technique was used to select study participants. A self-administered structured questionnaire was employed. Epi Info version 7 and SPSS version 20 were used for data entry and analysis respectively. A binary logistic regression model was computed. Variables having a p-value < 0.05 in the multivariate logistic regression model were considered as statistically significant. RESULTS A total of 459 female students participated in the study with a response rate of 96.29%. The prevalence of primary dysmenorrhea among female students was found to be 64.7% (95% CI; 60.2-69.2%). Around 61% reported moderate intensity of menstrual pain and 50.7% complain about lower abdominal pain. Sixty-five percent of study participants reported that absenteeism from school was the impact of menstrual pain. Having irregular monthly menstrual cycle (AOR = 1.70, 95% CI; 1.02, 2.84) and positive family history of dysmenorrhea (AOR = 5.19, 95% CI: 3.21, 8.37) were significantly associated with primary dysmenorrhea. CONCLUSIONS The prevalence of primary dysmenorrhea was found to be high. Having an irregular monthly menstrual cycle and a positive family history of dysmenorrhea were determinants of primary dysmenorrhea.
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Affiliation(s)
- Abere Woretaw Azagew
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Destaye Guadie Kassie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tarkie Abebe Walle
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Yousefi M, Kavianpour M, Hesami S, Rashidi Nooshabadi M, Khadem Haghighian H. Effect of alpha-lipoic acid at the combination with mefenamic acid in girls with primary dysmenorrhea: randomized, double-blind, placebo-controlled clinical trial. Gynecol Endocrinol 2019; 35:782-786. [PMID: 30957578 DOI: 10.1080/09513590.2019.1590544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Primary dysmenorrhea is a common gynecologic disorder and is one of the main causes for referral to the gynecology clinic. This study aimed to determine the effects of alpha-lipoic acid (ALA) and mefenamic acid and a combination compared with placebo on the girls with primary dysmenorrhea. This double-blind, placebo-controlled clinical trial done on population consisted of female students living in dormitories of Qazvin University of Medical Sciences who had moderate to severe dysmenorrhea using the Visual Analog Scale (VAS) questionnaire. Participants were randomly divided into four groups (n = 100): ALA, mefenamic acid, ALA + mefenamic acid and placebo groups. ALA and mefenamic acid were administrated in 600 mg and 250 mg, respectively. The severity of the pain was measured in the beginning and the end of the study. Statistical analysis was performed using SPSS software (SPSS Inc., Chicago, IL). Our final results suggested that, although mefenamic acid significantly decreased the menstrual pain, ALA supplementation, 600 mg, would be more efficient than mefenamic acid in 250 mg. Also, the combination of ALA and mefenamic acid significantly has been far. Considering the ALA supplementation effect on pain relief in patients with primary dysmenorrhea, this antioxidant can be recommended for the healing of symptoms of these patients.
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Affiliation(s)
- Mojgan Yousefi
- a Student Research Committee, School of Health, Qazvin University of Medical Sciences , Qazvin , Iran
- b Metabolic Diseases Research Center, Qazvin University of Medical Sciences , Qazvin , Iran
| | - Maria Kavianpour
- c Department of Tissue Engineering and Applied Cell Sciences, Faculty of Advanced Technologies in Medicine, Tehran University of Medical Sciences , Tehran , Iran
| | - Sepideh Hesami
- a Student Research Committee, School of Health, Qazvin University of Medical Sciences , Qazvin , Iran
- b Metabolic Diseases Research Center, Qazvin University of Medical Sciences , Qazvin , Iran
| | | | - Hossein Khadem Haghighian
- a Student Research Committee, School of Health, Qazvin University of Medical Sciences , Qazvin , Iran
- b Metabolic Diseases Research Center, Qazvin University of Medical Sciences , Qazvin , Iran
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Zhang X, Zhang R, Chen D, Huang R, Tian Y, Zhang P, Zhang J. Association of tea drinking and dysmenorrhoea among reproductive-age women in Shanghai, China (2013-2015): a cross-sectional study. BMJ Open 2019; 9:e026643. [PMID: 30962237 PMCID: PMC6500245 DOI: 10.1136/bmjopen-2018-026643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To investigate the association between tea drinking and dysmenorrhoea among women of reproductive age. DESIGN A cross-sectional study based on Shanghai Birth Cohort Study. SETTING Two preconceptional care clinics in Shanghai, China. PARTICIPANTS 1183 women of reproductive age who sought preconceptional care were recruited from August 2013 to April 2015. PRIMARY AND SECONDARY OUTCOME MEASURES Participants were asked if they had pelvic pain associated with menstrual bleeding during the past 12 months and to further grade the intensity of menstrual cramp as mild, moderate and severe. Multinomial logistic regression was performed to assess the association of tea drinking and dysmenorrhoea. Other information, such as demographic and lifestyle factors, was also collected and assessed in relation to dysmenorrhoea. RESULTS The prevalence of dysmenorrhoea was 57.8%, among whom 10.4% and 3.5% had moderate and severe dysmenorrhoea, respectively. Tea drinking was associated with a lower prevalence of dysmenorrhoea (adjusted OR [aOR]=0.68, 95% CI 0.50 to 0.93 for mild dysmenorrhoea; aOR=0.59 (95% CI 0.32 to 1.04) for moderate-to-severe dysmenorrhoea). Green tea and oolong tea appeared to have most reduction in the prevalence of dysmenorrhoea (for mild dysmenorrhoea: green tea: aOR=0.63 (95% CI 0.44 to 0.90) and oolong tea: aOR=0.60 (95% CI 0.35 to 1.03); for moderate-to-severe dysmenorrhoea: green tea: aOR=0.42 (95% CI 0.20 to 0.85) and oolong tea: aOR=0.34 (95% CI 0.11 to 1.09)). CONCLUSIONS Consumptions of green tea and possibly oolong tea were associated with a lower prevalence of dysmenorrhoea.
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Affiliation(s)
- Xiaoyu Zhang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Rongrong Zhang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Department of Obstetrics and Gynecology, Shanghai, China
| | - Dan Chen
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Rong Huang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Ying Tian
- Shanghai Jiao Tong University, School of Public Health, Shanghai, China
| | - Ping Zhang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Department of Obstetrics and Gynecology, Shanghai, China
| | - Jun Zhang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
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Al-Matouq S, Al-Mutairi H, Al-Mutairi O, Abdulaziz F, Al-Basri D, Al-Enzi M, Al-Taiar A. Dysmenorrhea among high-school students and its associated factors in Kuwait. BMC Pediatr 2019; 19:80. [PMID: 30885151 PMCID: PMC6421654 DOI: 10.1186/s12887-019-1442-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 02/26/2019] [Indexed: 11/16/2022] Open
Abstract
Background Although dysmenorrhea is not a life-threatening condition, it can cause a substantial burden on individuals and communities. There is no data on the prevalence of dysmenorrhea in Kuwait. This study aimed to estimate the prevalence of dysmenorrhea among female public high-school students in Kuwait and investigate factors associated with dysmenorrhea. Methods A cross-sectional study using multistage cluster sampling with probability proportional to size method was conducted on 763 twelfth grade female public high-school students (aged 16–21 years). We used face-to-face interview with a structured questionnaire to collect data on dysmenorrhea and presumed risk factors. Weight and height of the students were measured using appropriate weight and height scales in a standardized manner. The association between dysmenorrhea and potential risk factors was assessed using multiple logistic regression. Results The one-year prevalence of dysmenorrhea was found to be 85.6% (95%CI: 83.1–88.1%). Of the participants with dysmenorrhea, 26% visited a public or a private clinic for their pain and 4.1% were hospitalized for their menstrual pain. Furthermore, 58.2% of students with dysmenorrhea missed at least one school day and 13.9% missed at least one exam. Age of menarche (p-value = 0.005), regularity and flow of the menstrual period (p-value = 0.025, p-value = 0.009; respectively), and drinking coffee (p-value = 0.004) were significantly associated with dysmenorrhea in multivariable analysis. Conclusion Dysmenorrhea seems to be highly prevalent among female high-school students in Kuwait, resembling that of high-income countries. Because of the scale of the problem, utilizing school nurses to reassure and manage students with primary dysmenorrhea and referring suspected cases of secondary dysmenorrhea is recommended.
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Affiliation(s)
- Sharefah Al-Matouq
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Box: 24923, 13110, Safat, Kuwait
| | - Hessah Al-Mutairi
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Box: 24923, 13110, Safat, Kuwait
| | - Ohood Al-Mutairi
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Box: 24923, 13110, Safat, Kuwait
| | - Fatima Abdulaziz
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Box: 24923, 13110, Safat, Kuwait
| | - Dana Al-Basri
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Box: 24923, 13110, Safat, Kuwait
| | - Mona Al-Enzi
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Box: 24923, 13110, Safat, Kuwait
| | - Abdullah Al-Taiar
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Box: 24923, 13110, Safat, Kuwait.
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Akiyama S, Tanaka E, Cristeau O, Onishi Y, Osuga Y. Treatment patterns and healthcare resource utilization and costs in heavy menstrual bleeding: a Japanese claims database analysis. J Med Econ 2018; 21:853-860. [PMID: 29770717 DOI: 10.1080/13696998.2018.1478300] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
AIMS Heavy menstrual bleeding (HMB) is a highly prevalent condition, characterized by excessive menstrual blood loss and cramping, that interferes with activities of daily life. The aim of this study was to investigate treatment patterns in HMB in Japan, and to assess healthcare resource utilization and costs among women newly-diagnosed with the condition. MATERIALS AND METHODS This study retrospectively analyzed health insurance data available in the Japan Medical Data Center (JMDC) database on women aged 18-49 years who were newly-diagnosed with primary or secondary HMB. Treatment patterns were analyzed, and healthcare utilization and costs were evaluated and compared to matched controls. RESULTS The study included a total of 635 patients, 210 with primary HMB and 425 with secondary HMB. In the primary HMB cohort, 60.0% of patients received one or more pharmacological or surgical treatments, compared with 76.2% in the secondary HMB cohort. The most commonly prescribed medications in all patients were hemostatic agents (28.7%), traditional Chinese medicine (TCM) (12.1%), and low-dose estrogen progestins (LEPs) (10.1%). After adjustment for patient baseline characteristics, healthcare costs were 1.93-times higher in primary HMB cases (p < .0001) and 4.44-times higher in secondary HMB cases (p < .0001) vs healthy controls. Outpatient care was the main cost driver. LIMITATIONS The main limitations of this study are related to its retrospective nature, and the fact that only reimbursed medications were captured in the source database. CONCLUSIONS A substantial proportion of HMB patients did not receive the recommended treatments. Healthcare costs were considerably increased in the presence of an HMB diagnosis.
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Affiliation(s)
- Sayako Akiyama
- a Market Access , Bayer Yakuhin, Ltd , Chiyoda-ku , Tokyo , Japan
| | - Erika Tanaka
- a Market Access , Bayer Yakuhin, Ltd , Chiyoda-ku , Tokyo , Japan
| | | | | | - Yutaka Osuga
- d Obstetrics and Gynecology, Graduate School of Medicine , The University of Tokyo , Bunkyo-ku , Tokyo , Japan
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Akiyama S, Goren A, Basurto E, Komori T, Harada T. Treatment preferences among Japanese women with dysmenorrhea: results from a discrete choice experiment study. Patient Prefer Adherence 2018; 12:1627-1640. [PMID: 30214165 PMCID: PMC6124802 DOI: 10.2147/ppa.s166332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To examine patient preferences for oral and intrauterine system treatments for dysmenorrhea in Japan. PATIENTS AND METHODS A discrete choice experiment was conducted to assess the willingness to accept trade-offs among hypothetical treatment profiles. An internet-based survey was administered to women 18-49 years of age who self-reported a dysmenorrhea diagnosis or experienced dysmenorrhea at least once in the past 6 months (N=309). Choice questions included pairs of treatments presented with different attributes: mode of administration, reduction in bleeding after 6 months, chance of symptoms becoming "improved", nausea, weight gain, irregular bleeding, and risk of venous thromboembolism. Relative importance (RI) estimates were computed. RESULTS The mean respondent age was 35.8 years (standard deviation =7.0), and 85 women (27.5%) reported that they had previously used hormonal therapy for dysmenorrhea. Treatment preference was most strongly associated with mode of administration (RI=49.8%), followed by chance of irregular bleeding (RI=17.3%). In contrast, treatment preference was most weakly associated with chance of weight gain (RI=2.4%) and reduction in bleeding after 6 months (RI=0.8%). Respondents preferred oral treatments: for twice-daily regimen, odds ratio (OR)=4.90; for once-daily fixed cyclic regimen, OR=4.20; and for once-daily flexible extended regimen, OR=2.44; whereas for intrauterine system, OR=0.02 (p<0.001 for all). Those with prior hormonal therapy experience exhibited the same pattern. CONCLUSION Mode of administration factored heavily in dysmenorrhea treatment preferences. Women of reproductive age preferred oral medication, especially twice-daily regimen and once-daily fixed cyclic regimen. Findings can potentially help to improve physician-patient communication and treatment decision making. Physicians should consider factors that can influence patient preference to optimize treatment acceptance and adherence.
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Affiliation(s)
| | - Amir Goren
- Health Outcomes Practice, Kantar Health, New York, NY, USA
| | | | | | - Tasuku Harada
- Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan
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Gaubeca-Gilarranz A, Fernández-de-Las-Peñas C, Medina-Torres JR, Seoane-Ruiz JM, Company-Palonés A, Cleland JA, Arias-Buría JL. Effectiveness of dry needling of rectus abdominis trigger points for the treatment of primary dysmenorrhoea: a randomised parallel-group trial. Acupunct Med 2018; 36:302-310. [PMID: 29720379 DOI: 10.1136/acupmed-2017-011566] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To compare the effectiveness of trigger point dry needling (TrP-DN) versus placebo needling, relative to an untreated control group, on pain and quality of life in primary dysmenorrhoea. METHODS In this randomised, single blind, parallel-group trial, 56 females with primary dysmenorrhoea were randomly allocated to TrP-DN (n=19), placebo needling (n=18) or no treatment (n=19). Patients in both groups were asked to undertake a stretching exercise of the rectus abdominis daily. The needling group received a single session of TrP-DN to trigger points (TrPs) in the rectus abdominis, and the placebo group received placebo needling. The primary outcome was pain intensity (visual analogue scale). Secondary outcomes were quality of life, use of non-steroidal anti-inflammatory drugs, the number of days with pain, and self-perceived improvement, measured using a Global Rate of Change. Outcomes were assessed at baseline, and 1 and 2 months after the treatment. RESULTS Females receiving TrP-DN exhibited greater decreases (P<0.001) in pain than those receiving placebo (1 month: Δ-19.8 mm, 25.9 to -13.7; 2 months: Δ-26.0 mm, -33.1 to -18.9) or assigned to the untreated control group (1 month: Δ-26.0mm, -32.5 to -19.5; 2 months: Δ-20.1 mm, -26.4 to -13.8). Females in the TrP-DN group also exhibited a greater decrease in the amount of medications (P<0.001). No differences in the number of days with pain or quality of life were found (all P>0.1). CONCLUSIONS This trial suggests that a single session of TrP-DN of the rectus abdominis combined with stretching was more effective than placebo needling and stretching alone at reducing pain and the amount of medication used in primary dysmenorrhoea. TRIAL REGISTRATION NUMBER ACTRN12616000170426 .
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Affiliation(s)
| | - César Fernández-de-Las-Peñas
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcon, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | | | | | - Joshua A Cleland
- Department of Physical Therapy, Franklin Pierce University, Manchester, New Hampshire, USA.,Physical Therapist, Rehabilitation Servicesv, Concord Hospital, Concord, New Hampshire, USA.,Faculty, Manual Therapy Fellowship Program, Regis University, Denver, Colorado, USA
| | - Jose L Arias-Buría
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcon, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
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Travers M, Moss P, Gibson W, Hince D, Yorke S, Chung C, Langford R, Tan EEW, Ng J, Palsson TS. Exercise-induced hypoalgesia in women with varying levels of menstrual pain. Scand J Pain 2018; 18:303-310. [DOI: 10.1515/sjpain-2018-0020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/05/2018] [Indexed: 11/15/2022]
Abstract
Abstract
Background and aims:
Exercise-induced hypoalgesia (EIH) is a well-established phenomenon in pain-free individuals that describes a decrease in pain sensitivity after an acute bout of exercise. The EIH response has been demonstrated to be sub-optimal in the presence of persisting pain. Menstrual pain is a common recurrent painful problem with many women experiencing high levels of pain each cycle. However, the EIH response has not been examined in a cohort of women with high levels of menstrual pain. This research aimed to examine whether EIH manifests differently in women with varying levels of menstrual pain. The primary hypothesis was that women with high levels of menstrual pain would demonstrate compromised EIH. Secondary aims were to explore relationships between EIH and emotional state, sleep quality, body mass index (BMI) or physical activity levels.
Methods:
Pressure pain thresholds (PPT) were measured in 64 participants using a digital handheld algometer before and after a submaximal isometric-handgrip exercise. EIH index was compared between low (VAS 0–3), moderate (VAS 4–7) and high (VAS 8–10) pain groups, using a linear mixed model analysis with participant as a random effect, and site, menstrual pain category and the interaction between the two, as fixed effects.
Results:
EIH was consistently induced in all groups. However, there was no statistically significant difference between the pain groups for EIH index (p=0.835) or for any co-variates (p>0.05).
Conclusions:
EIH was not found to differ between women who report regular low, moderate or high levels of menstrual pain, when measured at a point in their menstrual cycle when they are pain free.
Implications:
This study provides insight that EIH does not vary in women with differing levels of menstrual pain when they are not currently experiencing pain. The current findings indicate that, although menstrual pain can involve regular episodes of high pain levels, it may not be associated with the same central nervous system dysfunctions as seen in sustained chronic pain conditions.
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Affiliation(s)
- Mervyn Travers
- School of Physiotherapy and Exercise Science , Curtin University , Bentley , Western Australia, Australia
- School of Physiotherapy , University of Notre Dame Australia , Fremantle , Western Australia , Australia
| | - Penny Moss
- School of Physiotherapy and Exercise Science , Curtin University , Bentley , Western Australia, Australia
| | - William Gibson
- School of Physiotherapy , University of Notre Dame Australia , Fremantle , Western Australia , Australia
| | - Dana Hince
- Institute of Health Research , University of Notre Dame Australia , Fremantle , Western Australia , Australia
| | - Sheree Yorke
- School of Physiotherapy and Exercise Science , Curtin University , Bentley , Western Australia, Australia
| | - Connie Chung
- School of Physiotherapy and Exercise Science , Curtin University , Bentley , Western Australia, Australia
| | - Rebecca Langford
- School of Physiotherapy and Exercise Science , Curtin University , Bentley , Western Australia, Australia
| | - Esther Ee Woon Tan
- School of Physiotherapy and Exercise Science , Curtin University , Bentley , Western Australia, Australia
| | - Jolene Ng
- School of Physiotherapy and Exercise Science , Curtin University , Bentley , Western Australia, Australia
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