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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
World Appl. Sci. J., 17 (10): 1246-1252, 2012
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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... The majority of the sample was has normal body mass index according to WHO classification of BMI. This finding is in line with (Noorbakhsh et al., 2012). ...
... The highest percent of the sample has regular menses. This finding is in line with (Noorbakhsh et al., 2012). The entire sample of current study was complaining from dysmenorrhea. ...
... The entire sample of current study was complaining from dysmenorrhea. This finding is in line with (Noorbakhsh et al., 2012) who investigated the effect of physical activity on primary dysmenorrhea of female university students and stated that there were no significant differences in the demographic characteristics between subjects of the experimental and control groups. This minimized the effects of group differences that could affect outcome measures. ...
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Primary dysmenorrhoea is considered the most common gynaecologic disorder among young females. Primary dysmenorrhea is defined as painful and difficult menstrual flow in the absence of any pelvic disorders. The study was carried out to examine the effect of heat application on relieving pain of primary dysmenorrea, examine the effect of stretching and core strengthening exercises on relieving pain of primary dysmenorrhea, compare between heat application and stretching and core strengthening exercises on relieving pain of primary dysmenorrhea among young females. Quasi experimental design (randomized controlled trial design) was used to conduct this study. The subjects included in the study were between 18-25 years with primary dysmenorrhea selected from female girls at faculty of Nursing, Menoufia University. Three tools were used in this study; tool one: interviewing questionnaire which include; socio-demographic data, menstrual history. Tool two; assessment of dysmenorrheal symptoms. Tool three; the numeric pain rating scale (NRS) assessing pain of dysmenorrhea before and after intervention. Simple random sample was used to select the participants of this study, total sample was 150 females. There was no statistical significance difference between the three studied groups regarding pain scores before intervention but there was a highly statistical significance difference between them after intervention (after use in the same menstrual cycle, second cycle and after third cycle (p=<0.001**, <0.001** and<0.001**) respectively. Stretching and core strengthening exercises (Group B) was more effective in reducing pain of dysmenorrhea as compared with heat application (Group A). Heat application and stretching and core strengthening exercises help in decreasing the intensity of pain of dysmenorrhea in group A and B than group C (control group). Stretching and core strengthening exercises was more effective in reducing pain of dysmenorrhea than heat application. Health education of young female girls about the importance of the use of heat application and physical exercises to relieve pain of primary dysmenorrheal is recommended.
... With severe pain suffers may be absent from school or work for one to two days and it could have negative impact on academic, social and sports activities of adolescent girls. 3 Since this pain is very severe it interferes with day to day activities of the girl. Health of an adolescent girl is an important part of the entire population. ...
... Primary dysmenorrhea reportedly stops spontaneously after 13 years; however, sometimes it is possible to continue until childbirth. 3 To deal with menstrual pain many therapies, including medication and thermotherapy, which are types of conservative therapy, and other self treatment methods have been prescribed to alleviate symptoms. For example, several medical therapies, herbal remedies and acupuncture have been reported to relieve menstrual pain. ...
... 5 Dysmenorrhea can cause gynecological problem worldwide. 3 Primary psychological problems in some of the females resulting dysmenorrhea begins when adolescent girls first experience in their loneliness and inactive participation in different social activities.3In many countries, primary dysmenorrhea is the leading cause of recurrent shortterm school and work absenteeism in adolescent girls. ...
... During the current study, it was found that after practicing the stretching exercises along eight weeks, pain duration and amount of consumed analgesic medications decreased significantly (P1= .000) in the study group as compared to the control group. Also, pain duration during menstrual days reduced significantly from the pretest to the posttest .These results were similar to a study conducted in by Mahvash et al, (2012) to see the effect of physical activity on primary dysmenorrhea among female students at Azad University-Karaj Branch in Iran and concluded that length of menstruation pain was reduced significantly in experimental group after 8 weeks of practicing exercise. Mahvash suggested that mechanism for reducing the length of menstruation pain in post-exercise group is physical activity may help a faster transfer of vast products and prostaglandins as a root of menstruation pain from uterine muscle. ...
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Primary dysmenorrhea is a difficult menstrual flow in the absence of any pelvic pathology where pain is spasmodic in character and felt mainly in the lower abdomen .It can influence females' daily-life activities. Stretching exercises has been advocated to reduce the pain of primary dysmenorrhea. Methods: A quasi-experimental design was utilized. Sample: Purposive sample of 164 adolescence girl. Setting: The study was carried out at two secondary schools at Menouf city (Martyr Pilot Ezzat secondary school and co-secondary developed school. Instrument: Adolescent girls structured interviewing questionnaire, a menstruation assessment questionnaire, and a Numerical Rating Scale (NRS) and a home based stretching exercises checklist. Result: there is a highly statistically significant difference and reduction on menstrual pain score, duration of pain and use of painkiller to relive this pain between the study and the control group. Conclusion: Stretching exercises are effective in reducing pain in young females with primary dysmenorrhea. Recommendations: Secondary school curricula should contain items about menstruation, dysmenorrhea, and methods of management including stretching exercise.
... Regular exercise also plays an essential role in controlling stress and helps improve blood circulation and increases endorphins and nerve transducers. The mechanism of inhibition of stress is one of the causes of the relationship between exercise and menstruation 20,21,22 . In a recent narrative review by Dash SS 23,24 where it was also discussed that though menstrual pain is common in India still, women do not seek treatment or take proper treatment for addressing this health issue which affects their efficiency and productivity to a larger extent. ...
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Background: Menstrual cycle is a physiological process in women of reproductive age but when this cyclical shedding of endometrium is painful, it is known as dysmenorrhea. As per previous studies the incidence of menstrual pain among college going girls is 84.2%. The most likely cause for the menstrual pain being the increase in uterine ischemia (uterine angina). Dysmenorrhoea remarkably affects women's health and performance. There have been incidences of increased absenteeism, decreased involvement in academic activity among college students. And overall decrease in quality of life. This menstrual pain also affects women in working age group, post education. Moreover, the incidences of menstrual pain among young working women, it's report to health care facilities, treatment for menstrual pain is not well noted. Due to multiple sociocultural factors women do not seek help or proper treatment to manage menstrual pain and suffer. Methods: A survey was conducted with the help of online / mail format which was distributed randomly to young women in the age group of 18-35 years to assess their awareness levels of menstrual pain, how it affects their functioning and performance. The survey also aimed to assess the awareness levels of women of urban Bangalore to various methods of treatment available for managing menstrual pain. Results: From the survey conducted it was learnt that Menstrual pain was prevalent among 89% of young women participant, 80% of these women complained of pain, 65% experienced tiredness, 75% had mood swings and irritability and 20% of them felt depressed. Most of these women had pain commonly in abdomen and low back pain. Professional commitments of these 63% of them was affected because of menstrual pain. Around 61% of the women were interested in an exercise protocol which will help in managing Menstrual pain. Conclusions: Studies need to be conducted to find out the incidences of menstrual pain among young working women in urban Bangalore. Studies also need to be done to understand the awareness of young women regarding various non-pharmacological treatment options to manage menstrual pain.
... The first day of agony is the worst, and the next day's discomfort is rarely worse. 2 In about 10% of teenagers and young adults with dysmenorrhea, painful menstruation linked to pelvic abnormalities is referred to as secondary dysmenorrhea. The likelihood of secondary dysmenorrhea being accompanied by dyspareunia, metrorrhagia, midcycle pain, and persistent pelvic pain is higher. ...
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Introduction: Primary dysmenorrhea (PD) is defined as recurrent, cramp-like pain occurring with normal ovulatory menses in the absence of any pelvic pathology. Isometric exercise is a subgroup of exercises, during which the muscle length and joint remain constant during contraction. To date, the effectiveness of isometric exercise in reducing the intensity and duration of PD is not yet established. Objective: The aim of the study is to investigate the effect of isometric exercise on the intensity and duration of PD among physically inactive young females. Methods: In this randomised controlled trial, twenty-four young females with PD were randomly assigned to either exercise or control groups, with twelve participants in each group. While participants in the control group continued with their physically inactive lifestyle, participants in the exercise group were required to perform isometric exercises for eight weeks, five days per week, two sessions per day, and ten minutes per session. Pain intensity and duration of all the participants were measured during menses at pre, mid and post-test. The intensity of pain was measured by using the Visual Analogue Pain Scale (VAPS) and the duration of pain was recorded in hours. The data was analysed by Mixed ANOVA, SPSS version 26.0. Results: After eight weeks of isometric exercise intervention, the mean score of pain intensity was significantly reduced in the exercise group (6.08 to 1.92) (p = 0.002), while it remained constant in the control group (6.25 to 6.58) (p = 0.126). The mean duration of pain (hours) was also significantly reduced in the exercise group (10.00 to 2.00 hours) (p = 0.000) but remained constant in the control group (9.25 to 9.42 hours) (p = 0.691). Conclusion: The mean intensity and duration of menstrual pain were significantly reduced after eight weeks of isometric exercise intervention. It appears that isometric exercise is an effective non-pharmacological method to induce a positive reduction in intensity and duration of pain for primary dysmenorrhea.
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Background and Aims: Dysmenorrhea poses a significant health challenge, affecting not only the daily lives and quality of life of female students but also presenting implications for healthcare providers. This research aimed to assess the prevalence of dysmenorrhea and explore how female students manage its symptoms, focusing particularly on their self-initiated strategies to alleviate discomfort. Methods: Employing a descriptive cross-sectional methodology, this investigation was carried out at Alghad International College for females. A sample of 107 students was selected through convenience sampling. Data collection methods included structured interviews and open-ended questionnaires for every student, with the first part gathering baseline characteristics of the participants. The subsequent parts evaluated the menstrual cycle, dysmenorrhea history and experiences, its impact on physical and psychological well-being, and the self-management techniques employed. Results: Findings indicated that a significant portion of the participants, 59.8%, experienced moderate pain due to dysmenorrhea, with many reporting that heat did not alleviate their symptoms. Moreover, a large majority of respondents—74.8%, 76.6%, and 72% of school custodians concurred on the lack of exercise as a method for managing dysmenorrhea. Conclusions: The study concluded that extended menstrual periods and the presence of blood clots are potent predictors of dysmenorrhea among female students, who generally demonstrated inadequate self-management skills for dealing with dysmenorrhea. Recommendations: The study advocates for enhanced educational and awareness efforts regarding dysmenorrhea. It emphasizes the importance of encouraging students suffering from dysmenorrhea to seek further consultation and assistance from healthcare professionals.
Article
Background: Dysmenorrhea is one of the most common gynecologic complaints in young women who present to clinicians. It is a health burden for most women and key public health problem in the world. Dysmenorrhea affects the quality of life and daily activities of females in school. Despite the presence of different studies that assess its prevalence and associated factor among women in Ethiopia, there is sparse information in relation to medical students. This study tries to assess dysmenorrhea, its effects and associated factors among female medical students. Method: An institution-based cross-sectional study was employed to assess the prevalence of dysmenorrhea and its associated factors among female medical students of St Paul’s hospital millennium medical college. Using a single population formula with prevalence of 77.6%, 95% confidence level, ± 5% precision and 80% power for factors associated, sample size of 156 was calculated. With a simple random sampling data was collected with a pretested self-administered questioner. Data was entered and analyzed using SPSS version 23.0. Bivariate and Multivariable logistic regression was done and a P<0.05 was taken as statistically significant. Results: A total of 156 female medical students were included in the survey. The prevalence of dysmenorrhea was 79.5%. About one third (33.3%) of the participants reported that they have a family history of dysmenorrhea and experienced moderate type of pain (39.7%). Back pain (64.1%), Weakness (40.4%) and Loss of appetite (32.7%) are amongst the commonest symptoms associated with dysmenorrhea. More than half of the participants reported to be irritable (54.6%) and having decreased academic performance (50.6%). Students also reported having lack of concentration (42.9%) and poor appetite (41.7%). More than half of the respondents (58.3%) use home remedies as a primary management option. Heat (41%) and tea (41.7%) were the most used home remedies. More than half of the respondents (55.8%) reported to use over the counter drugs such as Ibuprofen and diclofenac. Alcohol consumption (AOR 95 % (CI) = 8.38 (1.078, 65.18), p=0.042) and longer menstrual cycle (AOR 95% (CI) =8.48 (1.087, 66.19), p=0.041) had statistically significant association with the occurrence of dysmenorrhea. Conclusion: The present study revealed that high proportion of female medical students experience dysmenorrhea. Decrease in academic performance was found to be the most common impact of dysmenorrhea. The majority of respondents used home remedies and over the counter medications for treatment. It is recommended to give due attention to female medical students and addressing their reproductive needs in relation to management of dysmenorrhea. Educating on effective management of dysmenorrhea with lifestyle modifications, seeking medical help and appropriate use of over the counter drugs is also recommended. Key words: Dysmenorrhea, menstrual cycle, over the counter drugs
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Background Studies have demonstrated that exercise can mitigate the intensity of menstrual pain in primary dysmenorrhea, but the most effective type of exercise remains unclear. The objective of this systematic review and network meta-analysis was to evaluate the effectiveness of different exercise regimens in reducing pain associated with primary dysmenorrhoea. Methods Randomized controlled trials investigating the relationship between menstrual pain and exercise were selected from major electronic databases until February 2, 2024. The primary outcome was the effect of exercise on pain intensity measured by the mean difference on a 10-cm visual analogue scale at 4 and 8 weeks after intervention. The secondary outcome was the difference in risk of dropout at 8 weeks. The study protocol was registered as INPLASY202330050. Results This systematic review and network meta-analysis included 29 randomized controlled trials, which involved 1808 participants with primary dysmenorrhea. Exercise interventions included relaxation exercise, strength training, aerobic activity, yoga, mixed exercise, and the Kegel maneuver. Relaxation exercise was the most effective in reducing menstrual pain in 4 weeks (− 3.56; 95% confidence interval: − 5.03 to − 2.08). All exercise interventions were effective in reducing menstrual pain at 8 weeks, with reductions ranging from − 3.87 (95% CI − 5.51 to − 2.22) for relaxation exercise to − 2.75 (95% CI − 4.00 to − 1.51) for yoga, compared to the control group. Relaxation exercises were found to have a significantly lower dropout risk (− 0.11; 95% CI − 0.20 to 0.02), while none of the exercise types was associated with a higher dropout risk than the control group. Conclusion All exercise interventions were effective in reducing menstrual pain in primary dysmenorrhea after 8 weeks of intervention. However, relaxation exercise was found to be the most effective intervention at 4 and 8 weeks and had the lowest risk of dropout. Graphical Abstract
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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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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.
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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.
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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.