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The Effect of Physical Activity on Primary Dysmenorrhea of Female University Students

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Primary dysmenorrhea is one of the most common complains and gynecological problem worldwide among young females. Findings claimed that exercise may positively affect this problem. Therefore, the main purpose of this study was to examine the effect of 8 weeks physical activity on primary dysmenorrhea of female students. Based on McGill's questionnaire 50 students having moderate to severe primary dysmenorrhea took part in this study and randomly were divided into experimental (N=25) and control (N=25) groups. The experimental group participated in a physical activity program for 8 weeks, 3 sessions a week and 90 minutes per session. The results revealed that performing a regular physical activity significantly reduced type of drugs consumed (p# 0.08), number of drugs consumed (p# 0.01), volume of bleeding (p# 0.002), rate of bleeding (p# 0.005), length of menstruation pain (p# 0.001) and total and present pain intensity (p# 0.01, p#0.05) in experimental group when comparing with control group or when comparing pre and post-test findings of experimental group. Overalls, the results of this study indicated that participating in physical activity program is likely an approach to reduce the detrimental effect of primary dysmenorrhea symptoms in young females. INTRODUCTION next day. Dysmenorrhea pains are felt in lower abdomin
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World Applied Sciences Journal 17 (10): 1246-1252, 2012
ISSN 1818-4952
© IDOSI Publications, 2012
Corresponding Author: Noorbakhsh Mahvash, College of Physical Education and Sport Sciences,
Islamic Azad University, Karaj Branch, Iran, POST: 17- Shenasa Street, Valye Asr Ave, Tehran, Iran.
Tel: +021-22058101, Cell: +09166148819, E-mail: mahvashnoorbakhsh@yahoo.com.
1246
The Effect of Physical Activity on Primary Dysmenorrhea
of Female University Students
Noorbakhsh Mahvash, Alijani Eidy, Kohandel Mehdi,
1 1 1
Mehdizadeh Toorzani Zahra, Mirfaizi Mani and Hojat Shahla
2 2 1
College of Physical Education and Sport Sciences, Islamic Azad University - Karaj Branch, Iran
1
Department of Midwifery, Islamic Azad University - Karaj Branch, Iran
2
Abstract: Primary dysmenorrhea is one of the most common complains and gynecological problem worldwide
among young females. Findings claimed that exercise may positively affect this problem. Therefore, the main
purpose of this study was to examine the effect of 8 weeks physical activity on primary dysmenorrhea of female
students. Based on McGill’s questionnaire 50 students having moderate to severe primary dysmenorrhea took
part in this study and randomly were divided into experimental (N=25) and control (N=25) groups. The
experimental group participated in a physical activity program for 8 weeks, 3 sessions a week and 90 minutes
per session. The results revealed that performing a regular physical activity significantly reduced type of drugs
consumed (p# 0.08), number of drugs consumed (p# 0.01), volume of bleeding (p# 0.002), rate of bleeding (p#
0.005), length of menstruation pain (p# 0.001) and total and present pain intensity (p# 0.01, p#0.05) in
experimental group when comparing with control group or when comparing pre and post-test findings of
experimental group. Overalls, the results of this study indicated that participating in physical activity program
is likely an approach to reduce the detrimental effect of primary dysmenorrhea symptoms in young females.
Key words: Physical Activity % Primary Dysmenorrhea % University Students
INTRODUCTION next day. Dysmenorrhea pains are felt in lower abdomin
In the past two decades, the relation betweenpercentage of cases, girls may experience systematic
physical activity and menstrual disorders includingsymptoms such as backache, nausea, vomiting, diarrhea,
primary dysmenorrhea has significantly been studied.fatigue and headache [6]. With severe pain, the suffers
Research findings have indicated that exercise can affectmay be absent from school or work for one or two days [3]
menstruation in many ways including inducingand it could have negative impact on academic, social and
amenorrhea in athletes and it may decrease symptoms ofsports activities of young girls [7].
premenstrual syndrome and dysmenorrhea [1]. PrimaryAlthough primary dysmenorrhea is not a real threat
dysmenorrhea or painful menstruation, in absence of anyof life, but can impact on the quality of female life and in
specific pelvic diseases, is one of the most commoncase of severity it may lead to disability and inefficiency
complaints of women and is also the most common[8, 9]. On the other hand, dysmenorrhea can cause
gynecological problem worldwide [2, 3]. Primarypsychological problems in some of the females resulting
dysmenorrhea begins when young girls first experiencein their loneliness and inactive participation in different
the ovulatory cycles and its prevalence increases duringsocial activities [10]. The detrimental impact of
adolescence (15-17 years) and reaches to its highest in 20- dysmenorrhea on the lives of women has been considered
24 years and decreases progressively thereafter [4, 5]. In by most of the researchers in this area. In many countries,
primary dysmenorrhea pain begins few hours before orprimary dysmenorrhea is the leading cause of recurrent
after the onset of menstruation and lasts for 24-48 hours.short-term school and work absenteeism in young girls
The pain is more in the first day and rarely continues toand women [7, 11]. Data from few longitudinal studies
and may radiate into inner parts of thighs. In a high
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1247
showed that the absenteeism from school due to primaryIn spite of the fact that many findings
dysmenorrhea is 34 to 50 percent [12, 13]. Indeed, as
reported by many studies, there is a considerable cost to
both the individual and society as a result of
dysmenorrhea.
It is believed that symptoms of primary dysmenorrhea
stem from raised concentrations of prostaglandins F2"
(PGF2") resulting in uterine contractions and ischemia
[14]. One likely mechanism for increasing prostaglandins
is that, during premenstrual phase, progesterone
decreases which results in the synthesis of
prostaglandins in endometrial cells by membrane
phospholipids. This process is supported by the ability of
prostaglandin synthesis inhibitors in pain relief. As these
inhibitors only provide pain relief in 70% to 75% of
women, other factors may also be involved [1]. The
results of studies carried out in North America, China,
Australia, Turkey and Iran have shown that the
prevalence of primary dysmenorrhea and percentage of
women involved are different from society to society [15-
19]. Based on findings of these and other studies,
dysmenorrhea is one of the most important health issues
of young girls which must be considered because many
researchers claimed that primary dysmenorrhea affects
between 50 to 90% of general population [7, 13, 20- 25].
Due to its importance, different treatments including
medical and non-medical treatment such as taking non-
steroidal anti-Inflammatory drugs (NSAIDS), herbal,
dietary therapies, yoga, meditation and acupuncture have
been used to reduce the effects of dysmenorrhea [18, 21,
26- 28].
Although these treatments are generally thought to
reduce the discomfort associated with dysmenorrhea, it is
believed that participation in regular physical activity is
another positive way of dysmenorrhea treatment by which
it may diminish the symptoms of dysmenorrhea in
exercising young girls and women. Shavandi et al. (2009)
studied the effect of 8 weeks isometric exercise on primary
dysmenorrhea and reported that intensity and duration of
pain-induced by primary dysmenorrhea are reduced and
less medicine is taken, but it has no effect on the amount
of bleeding [19]. Shahrjerdi and Sheikh Hoseini (2010)
reported that the severity and length of pain due to
primary dysmenorrhea in young girls following 8 weeks
stretching exercises are diminished and they take
significantly less medicine [29]. However, a number of
studies have shown a correlation between life stress and
gynecological symptoms. Similarly, women who train
intensively have been found to experience fewer
symptoms than women who take part in physical activities
occasionally or not taking part at all [30].
support the positive effect of physical activities on
primary dysmenorrhea few studies results showed no
effect of physical activities on primary dysmenorrhea
[31, 32].
Due to the fact that dysmenorrhea has been treated
successfully with stress reduction techniques [33, 34],
physical activities and exercise are widely accepted as
a means of moderating stress and stress- related
symptoms. Exercise is known to cause the release of
endorphins hormones in brain that raise the pain
threshold and is shown to improve mood of
exercising subjects. However, because of high
prevalence of primary dysmenorrhea in different
societies and the potential benefits of exercise found
in treating dysmenorrhea and also existence of few
studies which claimed that physical activity has no
effect on primary dysmenorrhea the purpose of this
study was to investigate the effects of physical activities
on primary dysmenorrhea of Iranian female university
students.
MATERIALS AND METHODS
All single and non-athlete female university students
from Islamic Azad University-Karaj Branch aged 23.34 ±
2.35 years who enrolled in Physical Education Courses of
the first semester of academic year of 2010-2011 (N=256)
as research population took part in this semi-experimental
study. Using Mc Gill’s questionnaire [35], 50 students
with moderate to severe primary dysmenorrhea were
selected as samples and based on their menstrual history
and data obtained from this questionnaire, were randomly
divided into experimental (N=25) and control (N=25)
groups. After obtaining ethical clearance from
University’s committee for research on human subjects all
subjects participated in an introductory session. Purposes
and methods of study were explained. Thereafter, all
subjects completed the different parts of questionnaire. In
the first part of the questionnaire demographic
characteristics regarding age, mass body index and
university subject were assessed. In the second part of
the questionnaire menstrual characteristics including type
and number of drugs consumed, volume (quality and
quantity) and rate of bleeding and onset of menstruation
and length of menstruation pain were evaluated. In the
third part, female students were asked to quantify their
menstrual characteristics including pain intensity by Pain
Rate Index (PRI), Visual Analog Scale (VAS) and Present
Pain Intensity (PPI) and total pain according to Mc Gill’s
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short form questionnaire. Total pain score is equal to thePhysical Activities-Induced Changes in Primary
total scores obtained from all dimensions of pain. FinalDysmenorrhea Symptoms: When comparing different
scores calculated from the third part of questionnaire were types of drugs consumed by experimental and control
from 0 to 60; from 0 to 45 was considered for PRI, from 0 group, significant difference was found between two
to 10 was considered for VAS and from 0 to 5 wasgroups (p=0.057). In pre-test Ibuprofen as a drug was
considered for PPI. The reliability of McGill questionnaire used by most subjects in both groups. But when
was confirmed (r = 0.93). comparing the findings of post-test after 8 weeks of
Physical Activity Protocol: Experimental group took part experimental group (p=0.08) and type of drug consumed
in training program for 8 weeks, 3 sessions a week, 90was changed from Ibuprofen to Acetaminophen in
minutes in a session in two cycles under supervision ofexperimental group without change in control group
Physical Education experts. Control group only took part(Table 2).
in ordinary class which was one session a week. PhysicalWhen comparing the volume of bleeding in both
activity program included 5-10 minutes warm up, 30-45groups no significant difference was found in pre-test
minutes progressive stretching exercises specified for(p=0.1) but a significant decrease was seen in post-test
pelvic region, 10-15 minutes stretching exercises usingcomparing experimental and control groups (p=0.002)
partner, 10-15 minutes resistant exercises focusing on hip (Table 2).
girdle muscles and 5-10 minutes cool down. At the end of In relation to the onset of menstruation pain, the
program, the questionnaires were completed by subjectsfindings showed no significant differences between two
as post- test by both groups. Subjects in control groupgroups in pre-test (p=0.43) and post-test (p=0.27)
were requested not to take part in any regular exercise(Table 2).
program except their one university session up to the endWhen comparing the number of drugs consumed by
of the study. both groups, there were no significant differences
To check the normality of data Kolmogorov-Smirnov between experimental and control groups in pre-test
test was used in order to analyze the findings [36]. Chi-(p=0.754) and post-test (p=0.175) (Table 3).
square and independent and dependent t-test atBut comparing number of drugs used by experimental
significant level of P#0.05 were also used. group in pre and post-test, significant difference was
RESULTS When comparing the rate of bleeding based on the
Demographic Characteristics of Subjects: As shown in experimental and control groups was found (p=0.005)
Table 1, there were no significant differences in the(Table 3).The findings also showed a significant
demographic characteristics between subjects of thedifference between pre and post-test of experimental
experimental and control groups. group (p=0.05) (Table 4).
physical activities, no significant difference was found in
found (p=0.01) (Table 4).
number of pads used, a significant difference between
Table 1: Comparison of characteristics between experimental and control groups
Variables Experimental Group N=25 Control Group P-value N=25 W
Age (years, Mean±SD) 22.84 ± 1.79 23.8 4 ± 2.91 p> 0.05
Weight (Kg, Mean±SD) 56.39 ± 9.05 60.63 ± 9.27 p> 0.05
Height (Cm, Mean±SD) 169.26 ± 5.53 163.86 ± 4.64 p> 0.05
Body Mass Index (K g/m², Mean±SD) 22.07 ± 3.61 22.64 ± 3.37 p>0.05
Age at onset of menstruation (years, Mean±SD) 13.43 ± 1.8 12.77 ± 1.47 p> 0.05
Length of menstruation cycle (days, Mean±SD) 6.78 ± 1.27 5.86 ± 1.28 p> 0.05
Length of menstruation phase (days, Mean±SD) 25.87 ± 3.68 26.54 ± 3.93 p> 0.05
Table 2: Comparison of primary dysmenorrhea characteristics between experimental and control groups based on Chi-square analysis
Variables df p-value
Type of drugs consumption Pre-test 2.9 40.57
Post-test 8.1 40.08
Volume of bleeding (quality) Pre-test 4.604 20.10
Post-test 15.21 30.002
Onset of menstruation pain Pre-test 2.74 30.43
Post-test 3.85 30.27
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Table 3: Comparison of primary dysmenorrhea characteristics of experimental and control groups based on independent t-test analysis
Variables Mean Diff. df tp-value
Number of drugs consumed Pre-test 0.16 48 0.315 0.754
Post-test 0.73 48 1.315 0.175
Rate of bleeding Pre-test 0.96 48 1.58 0.12
Post-test 1.92 48 4.18 0.005
Length of menstruation pain Pre-test 0.17 48 -0.39 0.69
Post-test 1.74 48 3.28 0.001
Volume of bleeding(quantity) Pre-test 0.18 48 0.33 0. 75
Post-test 0.50 48 -0.35 0.72
Table 4: Comparison of primary dysmenorrhea characteristics between pre and post-test of experimental group based on dependent t-test analysis
Variables Mean diff. df tp-value
Number of drugs consumed 1.040 24 2.68 0.01
Rate of bleeding 0.84 24 3.05 0.005
Length of menstruation pain(days) 0.6 24 2.05 0.05
Volume of bleeding(quantity/CC) 2 24 2.87 0.008
Table 5: Comparison of primary dysmenorrheal pain between experimental and control groups assessed by Mc Gill’s questionnaire based on independent
t-test analysis
Variables Mean diff. df tp-value
Pain Rate Index (PRI) -6.56 48 -6.56 0.01
Visual Analog Scale(VAS) -0.84 48 -1.97 0.05
Present Pain Intensity (PPI) -1.04 48 -4.9 0.05
Total Pain 8.37 48 -9.21 0.01
When comparing the length of menstruation pain itThe results of the study also showed that the total
was found that this item is significantly decreased inamount of pain reduction was significantly more in
experimental group (p=0.05) (Table 4). experimental group (p=0.01) in comparison with control
The results also showed that the differencegroup (Table 5).
between the length of menstruation pain of
experimental and control groups was significant (p=0.001) DISCUSSION AND CONCLUSION
(Table 3).
When comparing the volume of bleeding, there was The main findings of this study indicated that
no significant difference between data of control group in physical activity had a positive impact on the most of
pre and post-test (p=0.22), but this difference wasprimary dysmenorrhea symptoms in such a way that type
significant in experimental group (p=0.008) (Table 4).of drugs consumption changed from Ibuprofen to
When the findings of two groups regarding the volume of Acetaminophen (p#0.05). Volume and rate of bleeding
bleeding was compared, no significant difference wasdecreased (p#0.002, p#0.05). Length of menstruation pain
observed (p=0.72) (Table 3). reduced (p#0.05), number of drugs consumed reduced,
In regard to Pain Rate Index (PRI), the findingsbut not significantly and finally Pain Rate Index and Total
showed no significant difference in pre and post-test ofand Present Pain Intensity reduced (p#0.01, p#0.05).
control group (p=0.14), but this difference was significant Regarding type of drugs used by subjects prior to
comparing pre and post-test of experimental groupstudy, it was found that experimental group participating
(p=0.01). PRI was also significantly different betweenin physical activity protocol replaced Acetaminophen
experimental and control groups (p=0.01) (Table 5). with Ibuprofen which is a strong pain relief meaning that
Findings from Visual Analog Scale (VAS) and thephysical activity resulted in more tolerable menstruation
Present Pain Intensity (PPI) which assess the total andthereafter. This finding is in line with Thirza et al. [17].
present intensity of pain, showed that significantDue to the fact that painful menstruation may limit
reduction was found between experimental and controlsocial activities and may also lead to school missing
groups (p=0.05) in both cases in favor of experimental[15, 17, 18, 21, 37] young girls try to use strong drugs
group (Table 5). such as Ibuprofen to prevent these problems.
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Our findings also showed that the number of drugsnumber of studies have failed to find any relation between
consumed by experimental group decreased comparingintensity of primary dysmenorrhea pain and physical
pre and post-test data. This result is in agreement withactivity [31, 32], other studies such as Smith et al. [27],
Shavandi et al. [19], Abbaspour et al. [38] and Shahrjerdi Iorno et al. [28], Abbaspour et al. [38], Shahrjerdi and
and Sheikh Hoseini [29]. The reasons for this reductionSheikh Hoseini [29] and Izzo and Labriola [30] support our
might be due to that when menstruation is veryresults. One possible mechanism explaining the positive
painful, the suffers use more drugs and prefer to take anti- effect of physical activity on intensity of primary
inflammatory type such as Ibuprophen or other strongdysmenorrhea pain is associated with stress. It has been
drugs. accepted that exercise is used as a mean of moderating
When volume of bleeding was studied, our resultsstress. Menstrual pain may be resulted from increased
indicated that volume of bleeding was significantlycontraction of uterine muscle which is innervated by the
lowered in post- exercise group. In addition to thesympathetic nervous system. Stress is supposed to
evidence that experimental group had lower volume ofincrease the sympathetic activity which may lead to the
bleeding after 8 weeks of physical activity, it is suggested increase of menstrual pain by enhancing the intensity of
that physical activity might reduce, in some degree, theuterine contraction. So, due to the fact that exercise
magnitude of bleeding, because it may lead to a betterreduce and moderate stress, the sympathetic activity
hormonal balance. On the other hand, evidence showsmay be decreased. Thereby, intensity of menstrual pain
that anti diuretic hormone is active during physicaland other related symptoms may be reduced as well.
activity and the vasoconstriction action of this hormoneAnother possible dilemma in this respect is that, because
and variations in pelvic blood flow may influence thedoing physical activity leads to the release of endorphins
synthesis or breakdown of prostaglandins [1]. Thiswhich are produced by brain may enhance the pain
finding is not in line with the results obtained fromthreshold.
Shavandi et al. [19] which indicated that there is noIn conclusion, the results of the present study
change in the volume of bleeding in post-exercise youngsuggested that performing regular physical activity
girls. reduced the primary dysmenorrhea symptoms. As a factor
Our results also depicted that rate of bleeding basedit has been accepted that in developing countries such as
on the number of pads changed per day, was reducedIran, participating in regular physical activity programs
significantly in experimental group. This finding supports are limited by social, cultural and religious factors.
the notion that doing exercise may reduce the volume ofTherefore, because of high potential benefits of physical
bleeding and suggested that exercise may actually beactivity and exercise in reducing the detrimental effects of
associated with higher level of menstrual discomfort. primary dysmenorrhea symptoms, young girls are
Regarding the length of menstruation pain, therecommended to take part in such physical activity
finding of this study showed that the length ofprograms in order to help them to decrease the negative
menstruation pain was reduced significantly in ourimpact of these symptoms on their academic, social and
experimental group after 8 weeks training. Thiseven personal life.
finding is supported by previous studies carried out by
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16(65): 49-60.
... [30] Regular physical activity helps to increase the circulation rate and alleviates PD symptoms by increasing uterine perfusion. [31,32] Some studies reported that physical exercise reduces the symptoms of dysmenorrhea. [31,32] It was reported that there is a general benefit of exercise, especially in women younger than 25 years of age who exercise for 45-60 min at least 3 times a week. ...
... [31,32] Some studies reported that physical exercise reduces the symptoms of dysmenorrhea. [31,32] It was reported that there is a general benefit of exercise, especially in women younger than 25 years of age who exercise for 45-60 min at least 3 times a week. [32] Mahvash et al. examined the effect of 8-week physical activity on PD, and physical activity significantly reduced the severity of PD, the duration of dysmenorrhea, and the consumption of drugs used during PD. ...
... [32] Mahvash et al. examined the effect of 8-week physical activity on PD, and physical activity significantly reduced the severity of PD, the duration of dysmenorrhea, and the consumption of drugs used during PD. [31] In addition, in our study too, the prevalence of PD was found to be lower in students who did regular physical activity for 30 min every day compared to those who did not (P < 0.05). ...
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Objective: Dysmenorrhea is defined as menstrual pain that develops due to uterine menstrual contractions. When the literature is examined, there are a limited number of studies about the frequency of primary dysmenorrhea (PD), influencing factors, and complementary and alternative treatment methods (CAMs) in Turkey. In this study, the aim was to determine the risk factors for PD and the effect of CAM use on PD in female university students. Methods: The sample for this descriptive study consisted of 180 female students who met the inclusion criteria and agreed to participate in the study. Data were collected using a questionnaire. Data were evaluated using SPSS v.21 and are presented as frequency, percentage, mean, and standard deviation with Chi-square and Kruskal-Wallis analyses performed. Results: The prevalence of PD was found to be high in students (83.3%). When the distribution of students is examined according to risk factors affecting dysmenorrhea, the relationships between the history of early menstruation, history of menorrhagia, family history of dysmenorrhea, and the occurrence of dysmenorrhea were found to be statistically significant (P < 0.05). In addition, the relationships between smoking, regular consumption of caffeinated beverages, regular physical activity, and emotional problems with the prevalence of dysmenorrhea were found to be statistically significant (P < 0.05). The mean VAS score of the students was 5.99 ± 2.06. When the distribution of VAS mean scores according to CAM used by the students is examined, the most effective CAM in reducing PD was mind-body techniques (4.20±1.56) (P < 0.05). According to the students' VAS score averages, the most effective mind-body techniques used to reduce PD were applying heat to the abdomen (4.33 ± 1.98) and taking a hot shower (4.61 ± 2.13); the most effective nutritional supplement and healthy lifestyle behavior was omega 3 supplementation (4.20 ± 1.56); and the most effective herbal drink was ginger (4.88 ± 1.61) (P < 0.05). Conclusion: Risk factors for PD included early menarche, menorrhagia, family history of PD, smoking, regular consumption of caffeinated beverages, and emotional problems. The most effective methods to reduce pain in PD were applying heat to the abdomen, taking a hot shower, omega 3 supplements, and ginger.
... Women who do not exercise regularly are 14 times more likely to develop PD, and our findings are consistent with other studies. 3,36 Intervention studies by Ortiz et al. 37 and Mahvash et al. 38 found that regular physical exercise can lower the severity of PD and can even cure it. It was postulated that the endorphin hormone released during physical exercise could inhibit pain perception and improve mood among the exercisers. ...
... It was postulated that the endorphin hormone released during physical exercise could inhibit pain perception and improve mood among the exercisers. 38 Other modifiable factors, such as second-hand smoking and frequent fast-food consumption, were unrelated to PD. Regarding second-hand smokers, the findings are different from those of Amini et al. 27 and Chen et al. 39 Both studies, however, did not define second-hand smokers clearly including the frequency and the duration of tobacco smoke in the surroundings. Even though more than three-quarters of our sample group consumed fast food regularly, we discovered no evidence of a link between this factor and PD. ...
Article
Introduction: Primary dysmenorrhoea (PD) is a frequent gynaecological condition in adolescents and adult women worldwide, affecting their daily activity and leading to a lower quality of life. The purpose of this study is to determine the prevalence, severity, and factors associated with PD among reproductive-age women at Kuala Selangor Health Clinic. Materials and methods: This cross-sectional study used systematic random sampling at the Kuala Selangor Health Clinic from 3rd July to 29th September 2017. This study included 213 women between the age of 18 and 35 years old. The questionnaires consist of sociodemographic, lifestyle activities, and menstrual history components with Numerical Rating Scale (NRS) for menstrual pain as well as the Pictorial Blood Assessment Chart (PBAC) to quantify the blood loss during menstruation. Results: A total of 210 women participated in this study with a response rate of 98.6%. The prevalence of PD was 60.5% with 13.4%, 75.6%, and 11.0% for mild, moderate, and severe in intensity, respectively. Nulliparous (OR: 5.1, CI: 1.508, 17.277, p = 0.009), first-degree family history of dysmenorrhoea (OR: 4.431, CI: 1.727, 11,368, p = 0.002), heavy menstrual blood flow (OR: 11.6, CI: 2.849, 47.53, p <0.001), and lack of regular physical exercise (OR: 14.037, CI: 5.161, 38.183, p < 0.001) were found as the significant association for PD. Meanwhile, having a short menstruation reduces the risk of PD during menstruation (OR: 0.04, CI: 0.004, 0.391, p = 0.006). Conclusion: PD is prevalent among reproductive-age women. Physical exercise is a protective factor for PD, hence health care providers particularly those in primary care settings should regularly counsel and encourage women to be physically active.
... High incidence of dysmenorrhea among subjects i.e, in our study is consistent with previous studies reporting rates between 28%-89.5% (14,15,16).This indicates that dysmenorrhea is still an important public health problem. As Zondervan in 1998 indicated that dysmenorrhea is responsible for school absenteeism (12)and other studies from 2000-2007 also confirm that female absenteeism in adolescent was common due to excessive pain due (3,19,20,) to dysmenorrhea . ...
... These results are not in agreement with findings ofShavandi et al, Shahrjerdi and Sheik Hoseini (11,18). Research findings by Noorbaksh Mahvash et al in 2012 (14)showed that physical activity reduced the symptoms of primary dysmenorrhea. These findings are in contrast to the finding of the study done by Fatai et al in 2013 (15) in adolescent girls. ...
... Several studies have shown that physical activity affects menstruation on many aspects including inducing amenorrhea on athletes and decreasing the pre-menstruation symptoms and dysmenorrhea. 7 A randomized controlled trial of 68 Shiraz University students with dysmenorrhea was conducted to discover the effect of eight-week isometric exercises on dysmenorrhea, the result was a reduced intensity and duration of pain caused by dysmenorrhea, less drug consumption, and a reduced duration of bleeding. 8 There is a positive correlation between the reduced risk from dysmenorrhea with doing regular and healthy physical activity. ...
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Objective : To determine whether or not there is a relationship between lifestyle and dysmenorrhea intensity in FKIK Atma Jaya students. Methods : This research is a cross sectional analytic descriptive study with a minimum sample size of 196 students of the FKIK Atma Jaya class 2017-2019. The degree of pain was assessed using the Verbal Multidimensional Scoring System pain scale. Frequency of fast food consumption were assessed with Food Frequency Questionnaire. Frequency of physical activity were assessed with International Physical Activity Questionnaire. The datas were analyzed using the Kolmogorov-Smirnov normality test, the Mann-Whitney U test, and the Kruskal-Wallis test. Results : The highest percentage of menstrual pain was at grade 1 (painful menstruation; rarely disturbed activity; no systemic symptoms; rarely required analgesics) for the VMSS scale (46.3%). The percentage of fast food consumption in this study was 86.1%. The highest percentage of physical activity in the category of moderate physical activity was 56.2%. The results of this study indicates a significant relationship between consumption of fast food and the intensity of dysmenorrhea with p = 0.017. There were no significant relationship between physical activity and the intensity of dysmenorrhea with p = 0.225 Conclusion : Consumption of fast food were related to the intensity of dysmenorrhea, whereas physical activity was not related with the intensity of dysmenorrhea. Keywords : dysmenorrhea, , fast food consumption, lifestyle, physical activity Abstrak Tujuan : Untuk mengetahui ada tidaknya hubungan gaya hidup dengan intensitas dismenore pada mahasiswa FKIK Atma Jaya. Metode : Penelitian ini merupakan penelitian deskriptif analitik cross sectional dengan jumlah sampel minimal 196 mahasiswa FKIK Atma Jaya angkatan 2017-2019. Derajat nyeri dinilai dengan menggunakan skala nyeri Verbal Multidimensional Scoring System. Frekuensi konsumsi makanan cepat saji dinilai dengan Food Frequency Questionnaire. Frekuensi aktivitas fisik dinilai dengan International Physical Activity Questionnaire. Data dianalisis menggunakan uji normalitas Kolmogorov-Smirnov, uji Mann-Whitney U, dan uji Kruskal-Wallis. Hasil : Persentase nyeri haid tertinggi pada derajat 1 (nyeri haid; aktivitas jarang terganggu; tidak ada gejala sistemik; jarang memerlukan analgesik) untuk skala VMSS (46,3%). Persentase konsumsi fast food dalam penelitian ini adalah 86,1%. Persentase aktivitas fisik tertinggi pada kategori aktivitas fisik sedang adalah 56,2%. Hasil penelitian ini menunjukkan adanya hubungan yang signifikan antara konsumsi fast food dengan intensitas dismenore dengan p = 0,017. Tidak ada hubungan yang bermakna antara aktivitas fisik dengan intensitas dismenore dengan p=0,225 Kesimpulan : Konsumsi fast food berhubungan dengan intensitas dismenore, sedangkan aktivitas fisik tidak berhubungan dengan intensitas dismenore. Kata kunci : aktivitas fisik, dismenore, gaya hidup, konsumsi fast food
... Common symptoms of dysmenorrhea include severe, intermittent painful spasms, typically in the suprapubic area. It is usually associated with other systematic symptoms sudich as backache, nausea, vomiting, diarrhea, sweating, syncope, tachycardia, malaise, exhaustion, and headache [8]. ...
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Article
Background Dysmenorrhea refers to a cyclical lower abdomen or pelvic discomfort that commonly radiates to the back or thighs. It has a significant influence on women's quality of life (QOL), social duties, and career roles. As pain relief without or with minimal use of medication is a primary health care target, usage of non-pharmacological measures is the most prominent way of managing dysmenorrhea. In this study, we explored the quality of life and the importance of non-pharmacological treatment of dysmenorrhea. Materials & methods A prospective, cross-sectional, and interventional study was conducted on general residents of India for six months. Women who gave consent to participate in the study and were suffering from primary dysmenorrhea were included in the study. All relevant and necessary information was collected using online questionnaire forms and interviews with the subjects. Results Out of a total of 517 individuals, 348 completed the study, with 51.1% having an average QOL, 33.3% having a bad QOL, and 14.9% having a good QOL. After the intervention, individuals' attitudes toward the role of non-pharmacological care in dysmenorrhea shifted significantly, with 96% of subjects believing that the actions taken were beneficial, compared to just 77% previously. Conclusion The current study suggests that the negative effect on health-related problems can be managed by following non-pharmacological measures regularly. Further research is needed to uncover new alternatives and offer a wider choice of treatments.
... (Liu et al., 2013) A study reported that dysmenorrhea is the reason for 34-50% of adolescent girls to be absent from school. (Mahvash et al., 2012). ...
... This study's results showed that the majority (57.8%) of the participating students were aged 18-20 years old, had a normal BMI, and did not smoke or drink alcohol, which is similar to results from national and international studies 4,5,21-25 . The reported menarche age, menarche pain age, and dysmenorrhea according to the students' VAS scores were also similar to extant studies [21][22][23][25][26][27][28][29] , as were the students' menstruation period, menstrual cycles, and their pain before menstrual bleeding 20,25,[29][30] . The majority of students with primary dysmenorrhea in the study reported that they felt pain mostly in the abdominal, inguinal, and waist regions before and during menstruation, chilling increased the pain more, and they had complaints such as nausea, fatigue, vomiting, and depression along with the pain. ...
... In addition, endorphins can also increase pain thresholds. This causes a person to be more resistant to pain and not quickly perceive that feeling as pain (Mahvash et al. 2012). The results of this study are not significant and assumed. ...
Article
A total of 97 female students, 50 in the intervention group and 47 in the control group, were included in this pretest-posttest design randomized controlled study. Massage and progressive relaxation exercises are self-administered practices that are easy to adopt, with no side effects, and have beneficial effects on pain, sweating, fatigue, and gastrointestinal and central nervous system signs. So, it can be asserted that when applied together, massage and progressive relaxation exercises could be more effective in reducing menstrual symptoms than applying them separately.
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Background: Dysmenorrhea is one of the most common gynecological complaints among adolescent women. It has been associated with short-term absenteeism in school and has a negative impact on academic and daily activities. Therefore, the aim of the study was to show the evidence on the magnitude and correlates of dysmenorrhea in Ethiopia. Method: In this systematic review and meta-analysis, we searched the literature from different databases such as PubMed/Medline, Science Direct, PsycINFO, and Cochrane library. We also used unpublished literature from Google, Google Scholar. The quality of the included articles was assessed using the Newcastle-Ottawa Scale. Data were extracted using a Microsoft Excel data extraction format. STATA version 14 statistical software was used for data analysis. To assess the heterogeneity of the primary articles, the Cochrane Q test statistics and the I2 test were carried out. Publication bias was inspected by funnel plot, and Egger's test was performed to confirm the presence of publication bias. A random-effects meta-analysis was used to estimate the pooled prevalence of dysmenorrhea and its associated factors. Result: A total of 12 studies were included in the final meta-analysis. The pooled prevalence estimate of dysmenorrhea among female students in Ethiopia is 71.69% (66.82%-76.56%). In our systematic review, among factors associated with dysmenorrhea, the family history of dysmenorrhea was frequently reported in included studies. Therefore, dysmenorrhea was significantly associated with a family history of dysmenorrhea (adjusted odds ratio = 4.69 (95% confidence interval: 2.80-7.85)). Conclusion: The pooled prevalence estimate of dysmenorrhea among students was much higher in Ethiopia. Health professionals and teachers should educate and support students to follow their menstrual cycle regularly in the event of irregular periods. There should be an awareness of the negative consequences of dysmenorrhea to reduce the physical and psychological stresses that affect women and their families.
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This study aimed to investigate the prevalence of dysmenorrhea in a prospective approach. Menstruation-related diary data were obtained from 2640 female college students in North Sichuan Medical College; dysmenorrhea and related factors were analyzed. Dysmenorrhea occurred in 56.4% of students; 6.5% of dysmenorrheal students suffered from “hard to bear” (unbearable) menstrual pain, and 6.5% had pre-menstrual dysmenorrhea. The more severe dysmenorrhea was, the longer dysmenorrhea lasted, and the longer the duration of menstruation and the larger the amount of menstrual blood flow appeared to be. Dysmenorrhea occurred on 37% of the menstrual dates on average and was unrelated to irregularity of menstrual cycles. The percentages of students taking medicine with mild, moderate and unbearable dysmenorrhea were 4.0%, 13.3% and 23.7%, respectively.
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Background: Dysmenorrhea is a painful syndrome that accompanies the menstrual cycles. Although exercise is generally though to alleviate the dysmenorrhea, the scientific literature display mixed evidence. The main objective of this research was to determine the effects of exercise on primary dysmenorrhea. Methods: This study was a randomized clinical trial of 150 high school girl students in Masged Solayman city that suffering from severe dysmenorrhea. Students were separated in two "exercise "and "non exercise" groups. Then the "exercise" group was given some exercises and the results of the two periods after the exercise were registered. The descriptive statistics and repeated measure design were used for analyzing the statistical information. Results: The results showed that the intensity of the pain in the exercise group declined from 8.59 to 4.63 in the third period and 2.84 in the forth period ( P ). The average of the duration pain declined from 7.15 to 4.12 in the third period and 2.23 in the forth period ( P ). The average of using sedative tablets also decreased from 1.13 to 0.35 tablets in the third period and 0.0 tablets in the forth period ( P Conclusion: The exercise can decrease the duration and severity of dysmenorrhea and also using of the sedative tablets in high school girls.
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Article
We examined the effectiveness of acupuncture to reduce the severity and intensity of primary dysmenorrhea. A randomized controlled trial compared acupuncture with control acupuncture using a placebo needle. Eligible women were aged 14-25 years with a diagnosis of primary dysmenorrhea. Women received nine sessions of the study treatment over 3 months. The primary outcomes were menstrual pain intensity and duration, overall improvement in dysmenorrhea symptoms and reduced need for additional analgesia, measured at 3, 6 and 12 months from trial entry. A total of 92 women were randomly assigned to the intervention (acupuncture n = 46 and control n = 46). At 3 months although pain outcomes were lower for women in the acupuncture group compared with the control group, there was no significant difference between groups. Women receiving acupuncture reported a small reduction in mood changes compared with the control group, relative risk (RR) 0.72, 95% confidence interval (CI) 0.53-1.00, P = .05. Follow-up at 6 months found a significant reduction in the duration of menstrual pain in the acupuncture group compared with the control group, mean difference -9.6, 95% CI -18.9 to -0.3, P = .04, and the need for additional analgesia was significantly lower in the acupuncture group compared with the control group, RR 0.69, 95% CI 0.49-0.96, P = .03, but the follow-up at 12 months found lack of treatment effect. To conclude, although acupuncture improved menstrual mood symptoms in women with primary dysmenorrhea during the treatment phase, the trend in the improvement of symptoms during the active phase of treatment, and at 6 and 12 months was non-significant, indicating that a small treatment effect from acupuncture on dysmenorrhea may exist. In the study, acupuncture was acceptable and safe, but further appropriately powered trials are needed before recommendations for clinical practice can be made.
Article
Primary dysmenorrhoea (PD) is chronic, cyclic, pelvic, spasmodic pain associated with menstruation in the absence of identifiable pathology and is typically known as menstrual cramps or period pain. PD is the most common gynaecological disorder in menstruating women. Despite treatments being available for PD, relatively few women consult a clinician about their symptoms, preferring not to use treatment, or to self-treat using non-pharmacological or over-the-counter interventions. The notion that exercise is effective in preventing and treating symptoms has prevailed for many years and led to the promotion of anecdotal belief that exercise is beneficial. Behavioural interventions such as exercise may not only reduce dysmenorrhoea, but also eliminate or reduce the need for medication to control menstrual cramps and other associated symptoms. With emphasis on data from experimental studies, this report seeks to review the available evidence regarding the role of exercise in the management of PD and menstruation-related symptomatology. Using key search terms, online bibliographical databases were searched from the beginning of each database to 1 April 2007. Despite the widespread belief that exercise can reduce PD, empirical support is limited. Evidence from observational studies was mixed. Several observational studies reported that physical activity/exercise was associated with reduced prevalence of dysmenorrhoea, although numerous other studies found no significant association between outcomes. Evidence from controlled trials suggests that exercise can reduce PD and associated symptoms, but these have been small and of low methodological quality. There are, however, several plausible mechanisms by which exercise might be effective in the management of PD. A large randomized controlled trial is required before women and clinicians are advised that exercise is likely to be effective in reducing PD and related menstrual symptoms.
Article
To evaluate factors affecting the prevalence of dysmenorrhea in a group of Mexican students. A questionnaire was administered to 1152 high school students and the obtained data about severity, symptoms, and medications used were analyzed. Dysmenorrhea had a prevalence of 48.4% and was the cause of school absences for 24% of the affected students. It was mild in 32.9%, moderate in 49.7%, and severe in 17.4% of these students, of whom 28% consulted a physician and 60.9% self-medicated. The most common over-the-counter drugs used were a combination of paracetamol, pamabrom and pyrilamine maleate; metamizol (a nonsteroidal anti-inflammatory drug) plus butylhioscine; and naproxen. We found a significant correlation between the presence of dysmenorrhea and smoking, cycle pattern, cycle duration, flow duration, and amount of flow. The prevalence of dysmenorrhea was high in our sample. The condition caused short-term school absences and the students commonly addressed it by self-medicating.
Article
Please cite this paper as: Blakey H, Chisholm C, Dear F, Harris B, Hartwell R, Daley A, Jolly K. Is exercise associated with primary dysmenorrhoea in young women? BJOG 2010;117:222–224. Anecdotal beliefs that exercise is an effective treatment for primary dysmenorrhoea have prevailed for many years although evidence is contradictory. Previous studies have also contained a number of methodological inadequacies. A questionnaire that assessed menstrual pain and levels of exercise was administered to 654 university students. Attempts were made to blind the purpose of the study. A response rate of 91.3% (597/654) was obtained. Analyses showed no association between participation in exercise and primary dysmenorrhoea. Prospective studies would be useful in further research.
Article
Fourteen women with primary dysmenorrhea were administered four sessions of systematic desensitization (SD) by either a male or a female therapist. The following measures were taken during the flow periods before and after treatment and at a 6-month follow-up: menstrual symptom checklist, medication usage, invalid hours, and menstrual attitudes. At pretreatment, menstrually distressed women had significantly higher scores on all measures compared to a normative group and an explicitly nondistressed group. At posttreatment, treated women's scores on the dependent variables were significantly reduced. All indices were reduced to a "nondistressed level" at posttreatment and at 6-month follow-up. Type of dysmenorrhea (congestive vs. spasmodic), trait anxiety level, and therepist sex did not predict differential responsiveness to SD. SD did not affect frontailis EMG, peripheral blood flow, or pain threshold. A Retrospective Symptom Scale of menstrual distress was found to be highly reliable, valid, and sensitive.
Article
Dysmenorrhea is the most common of all gynecologic disorders in the female adolescent. Effective intervention for the patient requires medical knowledge of this condition and application of theory related to characteristics of early, middle, and late stages of adolescent growth and development. The pathogenesis, clinical features, differential diagnosis, and management of primary dysmenorrhea in the adolescent patient are presented.