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Prevalence and severity of dysmenorrhoea, and management options reported by young Australian women


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Background Little is known about the severity of dysmenorrhoea and attitudes towards its management in young females. Objective/s The aim of this study was to evaluate the prevalence and severity of dysmenorrhoea in women aged 16−25 years. Methods Participants were recruited via targeted Facebook advertising and asked to complete an online questionnaire covering medications, menstruation and lifestyle-related themes. A follow-up questionnaire on dysmenorrhoea was also administered. Results The prevalence of dysmenorrhoea was 88% (n = 247, mean age 21.5 years, SD 2.6). Only 34% of participants reported consulting a healthcare provider about their pain, whereas 86% consulted other sources. Pain medication was used by 58% of the participants. Dysmenorrhoea was associated with interference with daily activities (P <0.001). Discussion Dysmenorrhoea is highly prevalent among these women, with most indicating moderate to severe pain and a significant adverse impact on daily activities. Most women did not obtain information about dysmenorrhoea from healthcare providers, indicating the need for general practitioners to provide accurate information about dysmenorrhoea to young females.
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AFP VOL.45, NO.11, NOVEMBER 2016© The Royal Australian College of General Practitioners 2016
Prevalence and severity of
dysmenorrhoea, and management
options reported by young
Australian women
Asvini K Subasinghe, Lina Happo, Yasmin L Jayasinghe, Suzanne M Garland, Alexandra Gorelik, John D Wark
ysmenorrhoea, or painful menstruation, is a common
symptom of menses.
Dysmenorrhoea is defined as a painful,
cramping sensation in the lower abdomen or back associated
with menstrual periods
and is classified into primary and secondary
types. Primary dysmenorrhoea is painful menstrual periods, not due
to other diseases, and often occurs soon after menarche. Secondary
dysmenorrhoea is due to an underlying pelvic abnormality, such
as endometriosis, and can be either new-onset or a change in the
nature of the dysmenorrhoea (intensity, duration) over time.
Dysmenorrhoea has been examined in Australian women in
only a small number of studies, mostly involving adolescent girls
recruited from secondary schools.
The national prevalence of
dysmenorrhoea is 70–90%,
which is comparable to that reported
worldwide. Although dysmenorrhoea is a common problem faced by
women, many are reluctant to consult their doctor about it.
We evaluated the prevalence and severity of dysmenorrhoea using
online questionnaires at two time points in a cohort of women aged
16–29 years. We assessed the impact of menstrual pain and its
severity on relationships, productivity, health and wellbeing. We also
sought to determine the level of concern in young women regarding
dysmenorrhoea, and their use of available treatments.
Study design
The Young Female Health Initiative (YFHI)
and Safe-D studies
the first comprehensive prospective studies in which clinical and
self-reported data are collected relating to sexual and mental health,
lifestyle and wellbeing in young Australian women.
The YFHI study was approved by the Human Research and Ethics
Committee (HREC) at the Royal Women’s Hospital (approval number
Little is known about the severity of dysmenorrhoea and
attitudes towards its management in young females.
The aim of this study was to evaluate the prevalence and
severity of dysmenorrhoea in women aged 16−25 years.
Participants were recruited via targeted Facebook advertising
and asked to complete an online questionnaire covering
medications, menstruation and lifestyle-related themes.
A follow-up questionnaire on dysmenorrhoea was also
The prevalence of dysmenorrhoea was 88% (n = 247, mean age
21.5 years, SD 2.6). Only 34% of participants reported consulting
a healthcare provider about their pain, whereas 86% consulted
other sources. Pain medication was used by 58% of the
participants. Dysmenorrhoea was associated with interference
with daily activities (
Dysmenorrhoea is highly prevalent among these women, with
most indicating moderate to severe pain and a significant
adverse impact on daily activities. Most women did not obtain
information about dysmenorrhoea from healthcare providers,
indicating the need for general practitioners to provide accurate
information about dysmenorrhoea to young females.
AFP VOL.45, NO.11, NOVEMBER 2016 © The Royal Australian College of General Practitioners 2016
11/14), and the Safe-D study by Melbourne
Health HREC (approval number 2013.007).
Procedures followed were in accordance
with the Helsinki Declaration of 2000 as
revised in 2002.
Recruitment and inclusion criteria
Eligible participants were females
aged 16−25 years and living in Victoria,
7, 8
Advertisements were posted
on Facebook to recruit women into two
general health studies called YFHI and
Clicking on the advertisement directed
respondents to secure websites containing
more information and where expressions
of interest were registered. Prospective
participants were then contacted by
investigators and consented into the study.
Participation included the completion
of a web-based questionnaire, using
SurveyMonkey (
or Limesurvey (,
covering demographics, mental health,
lifestyle and reproductive health. Existing
participants from YFHI and the Safe-D study
who had consented to be contacted for
future studies were invited to fill in a follow-
up dysmenorrhoea questionnaire.
Collection of dysmenorrhoea data
Dysmenorrhoea was defined as ‘period
pain’ of any severity in the six months
preceding questionnaire completion.
The nature of the dysmenorrhoea was
ascertained according to time of onset
in relation to menarche (‘primary onset’
at menarche, versus ‘secondary onset’
some years after menarche). This is not a
reflection of whether the dysmenorrhoea
itself was primary or secondary, as
information on underlying disease was not
ascertained for all participants.
The severity of pain and level of
interference with daily activities were
measured on a Likert scale (1 [little] to 10
[severe]). This rating was used to categorise
participants according to the Numerical
Rating Scale (NRS) for pain, which is useful
in the assessment of dysmenorrhoea.
rating of 1–3 was considered mild pain, 4–6
as moderate pain and 7–10 as severe pain.
Statistical analyses
Statistical analyses were performed
using Stata version 11.1 (StatCorp LP,
College Station, TX, USA). Analyses for
associations between dysmenorrhoea
and categorical variables were performed
using Fisher’s exact test. Ordered logistic
regression was performed to determine
the risk of interference on aspects of daily
living. A two-sided P <0.05 was defined as
statistically significant.
It is important to note that there were
missing data from participants for various
questions (4−10%). Therefore, we present
prevalence estimates using different
denominators for a number of questions.
Baseline questionnaire data were available
from 250 YFHI respondents and 228 Safe-D
participants. Follow-up questionnaires
were completed by 247 participants
(YFHI n = 141, Safe-D n = 106; Figure 1).
This represented a 69% response rate
A difference in age was found between
YFHI and Safe-D participants who
completed the follow-up questionnaire
(Figure 1). However, after adjustment for
a delay in the inclusion of participants
aged 16–17 years in the YFHI study, no
differences in age were obser ved. Thus,
the two data sets were collated and the
results of pooled data are presented in this
Descriptive statistics
Dysmenorrhoea was reported by 88%
(n = 207/236) of respondents who
completed the follow-up dysmenorrhoea
questionnaire and had had a period
in the past 12 months. This was
comparable to the prevalence found in the
respondents who completed the baseline
questionnaires (86%, n = 369/431).
Those who reported dysmenorrhoea at
baseline did not differ, with respect to
age, marital status or education level,
from those not reporting dysmenorrhoea.
However, a greater proportion of those
who experienced dysmenorrhoea reported
depression (32% versus 19%, P = 0.04)
and had experienced a pregnancy (24%
versus 4%, P = 0.02; Table 1).
At follow-up, 19% reported mild
dysmenorrhoea, 49% moderate and 32%
severe. Dysmenorrhoea commenced
at menarche for 70% (n = 144/207)
of respondents (‘primary onset’
dysmenorrhoea), while for 30% (n =
63/207) dysmenorrhoea commenced
some years after menarche (‘secondary
onset’ dysmenorrhoea).
Primary versus secondary onset
No significant differences were obser ved
between those who reported primary
onset of dysmenorrhoea and secondary
onset of dysmenorrhoea with regards
to age (21.8 ± 2.5 versus 21.4 ± 2.6;
P = 0.02), current use of hormonal
contraceptives (60% versus 51%; P = 0.2)
and severity of dysmenorrhoea (P = 0.7).
Reported management options
for dysmenorrhoea
At follow-up, use of pain medication
was reported by 58% (n = 120/206) of
respondents with dysmenorrhoea. Pain
medication included paracetamol, aspirin,
mefenamic acid and ibuprofen. Those with
severe dysmenorrhoea were more likely to
use pain medication when compared with
those who experienced moderate or mild
period pain (73% versus 56% and 30%,
respectively; P = 0.001).
Hormonal contraception was used by
57% (n = 140/247) of women, with 74%
using the combined oral contraceptive pill
(COCP), 13% etonogestrel implant, 9%
levonorgestrel intrauterine device, 2%
progestogen-only oral contraceptive pill,
and 2% medroxyprogesterone acetate
injection. Period pain was the reason for
using hormonal contraception in 36%
(n = 45/117). There was no significant
difference in hormonal contraceptive use
between respondents who experienced
dysmenorrhoea and respondents who did
not (P = 0.6).
Most respondents with dysmenorrhoea
(92%; n = 190/207) indicated using non-
pharmacological measures, either alone
AFP VOL.45, NO.11, NOVEMBER 2016© The Royal Australian College of General Practitioners 2016
or in conjunction with analgesics, to relieve
period pain. The use of heat packs was
most popular, with 54% (n = 112) reporting
their use, followed by hot baths (37%; n =
77), meditation (7%; n = 15) and exercise
(2%; n = 3).
Association between
dysmenorrhoea and consultations
Only 34% (n = 71/207) of those with
dysmenorrhoea had ever consulted a
healthcare provider about period pain.
Participants with severe dysmenorrhoea
(53%; n = 34/64) were more likely to
consult their healthcare provider than
those with mild (13%; n = 5/39) or
moderate (31%; n = 30/98) dysmenorrhoea
(P <0.001). Approximately 86% (n =
176/206) who experienced dysmenorrhoea
had sought information about period pain
from other sources (eg internet, social
media, friends, magazines), including 34%
(n = 69/206) who obtained information from
family members.
Impact of dysmenorrhoea on
quality of life
More severe dysmenorrhoea was
associated with greater risk of interference
in numerous aspects of daily living (work/
study attendance and productivity;
relationships with family, friends and
partners; exercise; sexual activity [P <0.001;
Table 2]). Among respondents experiencing
dysmenorrhoea, 24% (n = 50/207) required
time off work or study in the preceding six
months because of the pain. Taking time off
because of period pain was associated with
the severity of dysmenorrhoea (52% [n =
33/64] in severe dysmenorrhoea, 15% [n
= 15/98] in moderate and 3% [n = 1/39] in
mild; P <0.001).
The very high prevalence of dysmenorrhoea
among the study participants falls within
the range reported in a systematic
review conducted by the World Health
A greater proportion of
those who experienced dysmenorrhoea
also reported depression, compared with
those who did not. This finding is supported
by that reported in a case-control study
comprising 424 adolescents,
and is
intuitive as dysmenorrhoea may have a
negative impact on quality of life.
While a large proportion of
women reported moderate to severe
dysmenorrhoea, approximately 60% of
these used pain medication for relief. By
contrast, 82% of women with moderate
or severe dysmenorrhoea reported using
non-pharmacological measures, such
as heat therapy, despite the limited and
inconsistent evidence for their efficacy
in dysmenorrhoea.
The discrepancy
between the use of pharmacological
and non-pharmacological measures may
suggest inherent resistance in young
women towards the use of pharmacological
analgesics. Alternatively, there may be
a lack of knowledge of pharmacological
treatments for dysmenorrhoea. Further
research may shed more light on these
It is surprising that there was no
relationship between COCPs and
Figure 1. Sample derivation for follow-up dysmenorrhoea questionnaire from Young Female Health
Initiative (YFHI) and Safe-D participants
YFHI eligibility
• Female
• Lives in Vic,
• 16–25 years old
Completed initial YFHI
n = 250
Completed initial Safe-D
n = 228
Data analysis
YFHI participants who
consented to further studies
n = 212
SAFE-D participants who
consented to further studies
n = 147
Completed follow-up
dysmenorrhoea questionnaire
n = 141 (66.5%)
Completed follow-up
dysmenorrhoea questionnaire
n = 106 (72.2%)
• Uncontactable (n = 2)
• Withdrew interest (n = 2)
• No response (n = 36)
• Incomplete
questionnaire (n = 1)
• Uncontactable (n = 3)
• Withdrew interest (n = 1)
• No response (n = 35)
• Incomplete
questionnaire (n = 5)
Subsequent analysis performed separately on data
obtained from YFHI and SAFE-D participants revealed
results of no signicant difference
Characteristic YFHI participants
n = 141*
SAFE-D participants
n = 106*
P value
Age (years), n (%)
21 (15.2)
117 (74.8)
45 (42.9)
60 (57.1) <0.001
Educational level, n (%)
<Year 12
<Year 12
9 (6.6)
128 (93.4)
28 (26.7)
77 (73.3) <0.001
Socio-economic index
, n (%)
Not lowest quartile
Lowest quartile
111 (86.1)
18 (14.0)
90 (85.7)
15 (14.3) 0.942
Median (min–max) 13.0 (10–20) 12.8 (8–16) 0.688
Days of menstrual bleeding, n (%)
<4 days
4–6 days
>6 days
12 (8.5)
102 (72.3)
27 (19.2)
9 (8.5)
67 (63.2)
30 (28.3) 0.236
Hormonal contraception, n (%)
Currently using
81 (57.1) 59 (55.7) 0.0796
*Numbers may not add up to total due to missing data.
As determined by Socio-Economic Indexes for Areas (SEIFA) 2011 developed by the Australian Bureau of
Statistics. Ranks areas in Australia according to relative socioeconomic advantage and disadvantage based
on ve-yearly census data.
Invited to complete follow-up dysmenorrhoea questionnaire
Ongoing recruitment
AFP VOL.45, NO.11, NOVEMBER 2016 © The Royal Australian College of General Practitioners 2016
dysmenorrhoea, given the high prevalence
of dysmenorrhoea in our cohort and that
COCPs are widely used for the treatment
of dysmenorrhoea in both sexually active
and non–sexually active women.
unexpected finding may reflect the
wide variety of indications for the use of
hormonal contraception in young women,
regardless of whether they experienced
dysmenorrhoea. Indeed, approximately
one-third of women using hormonal
contraception stated that dysmenorrhoea
was the reason for use of these agents.
We did not assess the level of alleviation
women with dysmenorrhoea achieved with
the use of hormonal contraception. Data
pertaining to their use and effectiveness
was not obtained in this study and
represents an avenue for further research in
this group of women.
Although severe pain was more likely to
prompt a consultation than milder pain, the
majority of women with moderate to severe
dysmenorrhoea had never sought medical
attention for dysmenorrhoea. The low
frequency with which women seek medical
attention for dysmenorrhoea has been
previously described.
This is particularly
relevant in young women who perceive
dysmenorrhoea to be a common menstrual
complaint that needs to be tolerated, and
thus find difficulty determining if and when
to seek medical attention.
By contrast, 86%
of women with dysmenorrhoea had sought
information about period pain from other
sources such as the internet and family
members. These sources may be perceived
as ‘more accessible’ to young women than
a healthcare practitioner, but represent a
greater potential for misinformation. These
findings highlight the need for accessible,
reliable and helpful information with which
young women are comfortable.
A three-pronged approach could be
taken to better inform young women of
dysmenorrhoea and associated support
services. First, informative leaflets could
be handed out to girls in schools by the
school nurse so that adolescent females
are familiar with the symptoms for
dysmenorrhoea, which they can obser ve,
and for which they can contact their GP if
they require prescription pain medication.
Second, health professionals could be
more proactive in asking about this
sensitive topic so that if young women
have dysmenorrhoea they may be more
likely to discuss their pain. Third, given the
information-seeking behaviours reported
in this sample, health professionals and
schools could promote the use of reliable
websites on which accurate information on
dysmenorrhoea is published.
Dysmenorrhoea significantly affects the
quality of life of females in our sample.
Approximately 50% of women with
Table 1. Characteristics of respondents who experienced dysmenorrhoea versus
those who did not at baseline
n = 369
n = 62
Age (years) mean ± SD 21.5 ± 2.7 21.4 ± 2.4 0.8
Marital status
Never married 315 (87.3) 53 (85.5) 0.7
Married/de facto 44 (12.7) 9 (14.5)
Level of education
No tertiary qualication 105 (28.8) 18 (29.0) 0.7
Undergraduate (or equivalent) 231 (63.3) 41 (66.1)
Postgraduate (or equivalent) 29 (8.0) 3 (4.8)
No paid employment 103 (28.2)
37 (10.1)
22 (35.5)
5 (8.1)
Labourer or related work 81 (22.2)
144 (39.5)
7 (11.3)
28 (45.2)
Managerial or professional occupation
Clerical or related work
SEIFA quartiles
Not lowest quartile 309 (84.7) 47 (77.1) 0.1
Lowest quartile 56 (15.3) 14 (23.0)
Current smoker 40 (11.3) 8 (13.3) 0.6
Alcohol consumption in the last 12 months
≤Once a month 91 (32.2) 19 (39.6) 0.5
2–3 days a month 70 (24.7) 11 (22.3)
1–2 days a week 92 (32.5) 16 (33.3)
≥3 days a week 30 (10.6) 2 (4.2)
Depression 117 (32.1) 12 (19.4) 0.04
Experienced a pregnancy 24 (8.8) 4 (8.5) 0.02
Current hormonal contraception use 134 (36.4) 24 (38.7) 0.7
SEIFA, Socio-Economic Indices for Areas.*n (%) unless specied otherwise; As determined by Socio-Eco-
nomic Indexes for Areas (SEIFA) 2011 developed by the Australian Bureau of Statistics. Ranks areas in
Australia according to relative socioeconomic advantage and disadvantage based on ve-yearly census data.
There were missing data for information regarding the prevalence of dysmenorrhoea for 47 participants.
Numbers may not add up to 100% due to missing values.
AFP VOL.45, NO.11, NOVEMBER 2016© The Royal Australian College of General Practitioners 2016
Table 2. Relationship between severity of dysmenorrhoea and impact on normal daily activities
Interference Mild n (%) Moderate n (%) Severe n (%) P value OR (95% CI)
Daily activities
None 8 (20.5) 7 (7.2) 0 (0)
Mild 31 (79.5) 70 (72.2) 26 (41.9) <0.001 7.1
Moderate 0 (0) 19 (19.6) 12 (19.4)
Major (0) 1 (1.0) 24 (38.7)
Work/study attendance
None 3 (37.5) 9 (19.2) 3 (6.0)
Mild 5 (62.5) 26 (55.3) 15 (30.0) <0.001 3.1
Moderate 0 (0) 10 (21.3) 15 (40.0)
Major 0 (0) 2 (4.3) 12 (24.0)
Work/study productivity
None 6 (46.2) 9 (14.8) 4 (7.7)
Mild 6 (46.2) 34 (55.7) 20 (38.5) <0.001 3.7
Moderate 1 (7.7) 16 (26.2) 11 (21.2)
Major 0 (0) 2 (3.3) 17 (32.7)
None 3 (60.0) 14 (26.4) 6 (14.3)
Mild 2 (40.0) 28 (52.8) 14 (33.3) 0.002 3.9
Moderate 0 (0) 11 (20.8) 15 (35.7)
Major 0 (0) 0 (0) 7 (16.7)
Family relationships
None 6 (66.7) 13 (24.1) 5 (12.2)
Mild 3 (33.3) 30 (55.6) 14 (34.2) <0.001 4.7
Moderate 0 (0) 11 (20.4) 15 (36.6)
Major 0 (0) 0 (0) 7 (17.1)
Relationship with partner
None 3 (30.0) 9 (16.1) 3 (8.1)
Mild 7 (70.0) 26 (46.4) 12 (32.4) 0.004 3.2
Moderate 0 (0) 18 (32.1) 12 (32.4)
Major 0 (0) 3 (5.4) 10 (27.0)
Sexual activity
None 1 (5.6) 3 (4.3) 1 (2.2)
Mild 9 (50.0) 23 (32.9) 7 (15.6) 0.005 2.7
Moderate 4 (22.2) 18 (25.7) 6 (13.3)
Major 4 (22.2) 26 (37.1) 31 (68.9)
None 7 (26.9) 5 (5.8) 2 (3.6)
Mild 16 (61.5) 37 (43.0) 12 (21.4) <0.001 4.9
Moderate 3 (11.5) 30 (34.9) 12 (21.4)
Major 0 (0) 14 (16.3) 30 (53.6)
CI, condence interval; OR, odds ratio
Odds ratio, as determined by ordinal logistic regression analyses
95% condence interval
AFP VOL.45, NO.11, NOVEMBER 2016 © The Royal Australian College of General Practitioners 2016
severe dysmenorrhoea reported time
off, compared with only 2.6% with mild
dysmenorrhoea. Given that 80% of
women in our study reported moderate to
severe dysmenorrhoea, this represents a
significant recurrent burden not only for
the women themselves, but also for the
workforce and economy.
A major strength of this study is that
we were able to gain an insight into
the experience of young women with
dysmenorrhoea in a representative general
population of young females. When
compared with national data for this age
group, a greater proportion of participants
in our study had attained tertiary
education. However, no other significant
differences were obser ved. Therefore,
our findings should be generalisable to a
general population of young females.
There were a number of potential
limitations. The sample size only allowed
an estimation of dysmenorrhoea
prevalence. Additionally, the definitions
of primary onset and secondary onset
dysmenorrhoea were from self-report
rather than proven pathology.
The prevalence of dysmenorrhoea is
critically high in this sample of young
females, with many indicating that pain
had a significant adverse impact on
numerous daily activities. However, a large
proportion did not use pain medication and
obtained information about dysmenorrhoea
from sources other than health
professionals, which poses a large risk of
misinformation and a potential barrier to
seeking early medical advice. Therefore,
educational materials, information on
reliable websites and guidance about
dysmenorrhoea and treatment options
should be made readily available to young
women in schools as well as by health
Implications for general practice
Dissemination of accurate information
about treatment options for
dysmenorrhoea in Victoria may improve
the quality of life of young females.
Asvini K Subasinghe PhD, Research Fellow,
Department of Microbiology and Infectious
Diseases, Royal Women’s Hospital, Parkville,
Vic; Infection and Immunity, Murdoch Childrens
Research Institute, Parkville, Vic. asvini.
Lina Happo PhD, medical student, Department of
Medicine, University of Melbourne, Parkville, Vic
Yasmin L Jayasinghe MBBS, FRANZCOG,
PhD, Paediatric and Adolescent Gynaecologist,
Department of Obstetrics and Gynaecology,
University of Melbourne, Royal Women’s Hospital,
Parkville, Vic; Department of Gynaecology, Royal
Children’s Hospital, Parkville, Vic
Suzanne M Garland MBBS, MD, FRCPA,
FAChSHM, FRANZCOG, Professor, Director of
Microbiology and Infectious Diseases, Department
of Microbiology and Infectious Diseases, Royal
Women’s Hospital, Parkville, Vic; Infection and
Immunity, Murdoch Childrens Research Institute,
Parkville, Vic; Department of Obstetrics and
Gynaecology, University of Melbourne, Royal
Women’s Hospital, Parkville, Vic
Alexandra Gorelik MSc, Biostatistician, Department
of Medicine, University of Melbourne, Parkville, Vic;
Melbourne EpiCentre, Royal Melbourne Hospital,
Parkville, Vic
John D Wark MBBS, FRACP, PhD, Professor,
Endocrinologist, University of Melbourne
Department of Medicine and Bone & Mineral
Medicine, Royal Melbourne Hospital, Parkville, Vic
Competing interests: Dr Garland reports
grants from Merck, GSK, CSL, Commonwealth
Department of Health, and non-financial support
from Merck, outside the submitted work; and has
delivered lectures and received speaking fees from
MSD and SPMSD for work performed in personal
Provenance and peer review: Not commissioned,
externally peer reviewed.
We thank the YFHI and Safe-D research teams and
participants for their time. YFHI was supported by
an Australian NHMRC program grant (568971) and
Safe-D study by a NHMRC project grant (1049065).
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... A Likert scale (0-3) was used to estimate the perceived infuence of dysmenorrhoea on academic performance. Dysmenorrhoea was defned as painful menstruation at least once in the preceding six months [16,17]. Te menstrual bleeding pattern was estimated by the number of pads or tampons used during one menstruation. ...
... Te prevalence of primary dysmenorrhoea was 90.1%, which is slightly more than other studies conducted among women in the same age group. Te prevalence of menstrual pain according to these studies is 88.0% in Australia [16], 76.7% in Ethiopia [20], 84.1% in Italy [21], 89.1% in Malesia [22], 64.9% in Poland [23], 80.0% in Saudi Arabia [24], 84.8% in Serbia [25], 76.5% in Spain [8], and 55.5-88.0% in Turkey [7,[26][27][28]. Diferences arise due to the use of diferent methods of data collection such as self-reported physical or online questionnaires, but also through a conversation with research participants (interview) conducted live or by phone. ...
... Te most important factor contributing to the diferences in established prevalence is the lack of a unifed defnition of primary dysmenorrhoea. In some studies [16], dysmenorrhoea was defned as painful menstruation regardless of intensity, while others [21] consider dysmenorrhoea only menstrual pain associated with the need to take medication and a signifcant limitation of normal activities, or pain so strong that women have to stay at home or in bed. Te high prevalence of dysmenorrhoea in our study could be the result of a selection bias because female students who have painful menstruation could be more motivated to respond to such a questionnaire. ...
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Background: Dysmenorrhoea is one of the most common gynaecological problems. Therefore, it is important to investigate its impact during the COVID-19 pandemic which has a great impact on the lives of menstruating people all over the world. Aim: To determine the prevalence and impact of primary dysmenorrhoea on academic performance among students during the pandemic. Materials and methods: This cross-sectional study was conducted in April 2021. All data were collected by an anonymous self-assessed web-based questionnaire. Due to voluntary participation in the study, 1210 responses were received, but 956 were left for analysis after exclusion criteria were applied. Descriptive quantitative analysis was performed and Kendall rank correlation coefficient was used. Results: The prevalence of primary dysmenorrhoea was 90.1%. Menstrual pain was mild in 7.4% of cases, moderate in 28.8%, and severe in 63.8%. The study found that primary dysmenorrhoea has a great perceived impact on all included aspects of academic performance. Most affected were concentration in class in 810 (94.1%) and doing homework and learning in 809 (94.0%) female students. There is also a correlation between menstrual pain intensity and its impact on academic performance (p < 0.001). Conclusions: Our study found that the prevalence of primary dysmenorrhoea among students at the University of Zagreb is high. Painful menstruation greatly impacts academic performance and therefore it is important to do more research on this topic.
... Erősebb menstruációs fájdalomról számoltak be a krónikus fájdalommal, a szabálytalan ciklussal, erős vérzéssel rendelkező nők, illetve azok, akik egyetértenek azzal, hogy a menstruáció gyengítő, és akik szerint megjósolható esemény [32][33][34][35]. Arról is olvashatunk, hogy bár a panaszok jelentősen rontják az életminőséget, a nők ritkán fordulnak vele orvoshoz, vagy ha elmennek is, ritkán beszélnek orvosuknak a tünetekről [36][37][38], nehézségeiket még egymással sem vagy csak krízishelyzetben osztják meg [34]. Ennek kapcsán érdekesek a menstruációs fájdalom mértékét befolyásoló tényezők közül a személyiségjellemzők, melyek közül vizsgálták már a neuroticismust, a szorongásérzékenységet, a magasabb fájdalomküszöböt és a fájdalomkatasztrofizálás jelenségét [39][40][41][42][43][44]. ...
... A megkérdezetteknek csupán a 0,07%-a (!) válaszolta, hogy soha nincs menstruációs fájdalma. Adataink hasonlók a korábbi kutatásokban találtakhoz [13,15,20,21,25,38]. A fájdalom mindennapi tevékenységet korlátozó voltára vonatkozó kérdésre a megkérdezettek 38%-a válaszolta, hogy erőteljesen, 45%-a, hogy kissé befolyásolja a menstruáció a mindennapi tevékenységüket, és 20% válaszolta, hogy a menstruációja nincs ilyen hatással. ...
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Bevezetés: A menstruációs fájdalom kutatása az érintettek számának, a szenvedéssel töltött idő mértékének és a következményeknek az ismeretében hiányzik a szakirodalomból. Célkitűzés: A fájdalomkatasztrofizálás szerepét vizsgáltuk a menstruációs fájdalom szubjektív mértékének, gyakoriságának, mindennapi tevékenységet korlátozó voltának megélésében. Módszer: Vizsgálatunkban személyes tesztfelvétel során gyűjtöttünk adatokat mintegy 1000 már és még menstruáló, egészséges, túlnyomórészt felső-és középfokú végzettséggel rendelkező, túlnyomórészt nagyvárosban, többségében párkapcsolatban élő, saját megélése szerint kitűnő vagy jó egészségi állapotnak örvendő, többségében hormonális fogamzásgátló eszközzel nem élő, túlnyomórészt rendszeres menstruációs ciklussal rendelkező, 18 és 51 év közötti nőtől, 2016 és 2018 között. A menstruációs fájdalom mértékének, gyakoriságának és mindennapi tevékenységet befolyásoló voltának mérésére egy-egy nyitott kérdést, a fájdalomkatasztrofizálás mérésére a Sullivan és mtsai által kidolgozott Fájdalomkatasztrofizálási Kérdőívet használtuk. Eredmények: Saját mintánkon azt találtuk, hogy minél inkább "hajlamos" a vizsgálati személy a fájdalomkatasztrofizálásra, annál erősebb menstruációs fájdalomról számol be, annál gyakrabban él meg menstruációs fájdalmat, és mondja azt, hogy a fájdalom korlátozza mindennapi tevékenységét. Következtetés: Az eredmények rámutattak, hogy érdemes a menstruációs fájdalom mértékét befolyásoló tényezők közül a személyiségjellemzőket is vizsgálat tárgyává tenni, az eredmények beépíthetők a diagnosztikai és terápiás munkába. Introduction: Research on menstrual pain is lacking in the literature in terms of the number of people affected, the amount of time spent suffering, and the consequences. Objective: We examined the role of pain catastrophizing in experiencing the subjective extent and frequency of menstrual pain and its perception as a limitation to daily activities. Method: In our study, during personal tests between 2015 and 2018, we collected data from around 1000 healthy women aged 18 to 51 years, predominantly with secondary and higher education, already and still menstruating, mostly living in a large city, mainly in a relationship, perceiving themselves to be in excellent or good health, predominantly not using hormonal contraceptives, mostly having a regular menstrual cycle. We used an open-ended question to measure the extent, frequency, and impact on daily activities of menstrual pain, and used the Pain Cata-strophizing Questionnaire. Results: In our own sample, we found that the more the subject "tends" to report pain catastrophizing, the stronger is the menstrual pain she reports, the more often she experiences menstrual pain and says that the pain limits her daily activities. Conclusion: The results showed that it is worth examining the personality characteristics among the factors influencing the extent of menstrual pain; the results can be incorporated into diagnostic and therapeutic work.
... Of this, approximately 1.94 billion are of reproductive age (15-49 years) [1]. Menstrual health and gynecological disorders are common across the reproductive lifespan but especially prevalent among young adolescents occurring in 70-91% of teenagers [2][3][4][5], and can include primary and secondary dysmenorrhea (period pain), emotional changes, premenstrual syndrome (PMS), heavy menstrual bleeding, polycystic ovarian syndrome (PCOS), endometriosis, fibroids, or vulvodynia [6][7][8]. These menstrual health and gynecological disorders can impact all aspects of a person's life, increase absenteeism and presenteeism (where people come in unwell and work less productively than normal) from work or school, and negatively impact a person's quality of life, social engagement, relationships, and sports [7][8][9][10]. ...
... Our review found that despite residing in HICs, where sexual health education is widely available in schools [10,60,61] and where discussion of menstruation is expected to be less taboo [21], there was little to no representation in the literature for Indigenous peoples and their experiences of menstrual and gynecological health. The paucity of research evidence is disproportionate to the scale of the issues associated with menstrual health, education, and gynecological disorders and their management [3]-and small in comparison to the volume of evidence for the non-Indigenous community [5,61]. This may be reflective of the lack of funding and engagement and the challenges that may surround research in these groups. ...
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There are a variety of cultural and religious beliefs and customs worldwide related to menstruation, and these often frame discussing periods and any gynecological issues as taboo. While there has been previous research on the impact of these beliefs on menstrual health literacy, this has almost entirely been confined to low- and middle-income countries, with very little information on high-income countries. This project used the Joanna Briggs Institute (JBI) scoping review methodology to systematically map the extent and range of evidence of health literacy of menstruation and gynecological disorders in Indigenous people in the colonized, higher-income countries of Australia, Canada, and New Zealand. PubMed, CINHAL, PsycInfo databases, and the grey literature were searched in March 2022. Five studies from Australia and New Zealand met the inclusion criteria. Only one of the five included studies focused exclusively on menstrual health literacy among the Indigenous population. Despite considerable research on menstrual health globally, studies focusing on understanding the menstrual health practices of the Indigenous populations of Australia, New Zealand, and Canada are severely lacking, and there is little to no information on how Indigenous beliefs of colonized people may differ from the broader society in which they live.
... Tis fnding is also similar to a study conducted in the southeastern part of Ghana 68.1% [24]. However, other studies conducted have reported a higher prevalence rate of dysmenorrhea such as 88% in Australia [30], 89.6% in Lebanon [31], 85.1% in Palestine [32], 84.2% in Lithuania [33], 84.1% in Italy [34], and 83.6% in northern Ghana [3]. ...
... Tis fnding is also similar to a study conducted in the southeastern part of Ghana 68.1% [24]. However, other studies conducted have reported a higher prevalence rate of dysmenorrhea such as 88% in Australia [30], 89.6% in Lebanon [31], 85.1% in Palestine [32], 84.2% in Lithuania [33], 84.1% in Italy [34], and 83.6% in northern Ghana [3]. ...
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Background: Dysmenorrhea is the most common gynecological problem affecting the majority of female students in the nursing profession today. They often experience severe pain that is not only incapacitating but also has a significant impact on their day-to-day college life, academic, and clinical performance. Aim: This study was conducted to assess the prevalence, management, and impact of dysmenorrhea on the lives of nurse and midwife trainees in northern Ghana. Methods: A descriptive cross-sectional design with a quantitative approach to data collection was employed to collect data from nurse and midwife trainees in three colleges of nursing and/or midwifery in the northern region of Ghana. A proportionate stratified random sampling technique was used to recruit 303 respondents for the study. After gaining permission from various institutions, data were collected by using a structured questionnaire from 13th September to 28th October, 2022. Stata (special edition) for Windows version 17.0 was used for the statistical analyses. Results: The study revealed a high prevalence of dysmenorrhea among female nursing students (66.7% and 95% CI: 0.611–0.720). More than half of the respondents (67.3%) experienced loss of appetite for food. The most common site of most intense pain was the pelvis and lower abdomen (98.0%). A greater proportion of students (65.8%) used antispastic drugs to reduce pain. The respondents’ concentration in the classroom was greatly affected (77.2%) as well as normal physical activities (58.4%). A multivariable logistic regression analysis revealed that the odds of dysmenorrhea are 2.67 times higher when the duration of menstruation is 4-5 days (AOR : 1.82, 95% CI : 1.13–6.28, and p = 0.024) than a duration of 1–3 days. Having urinary tract infections was associated with 3.56 times higher odds of dysmenorrhea (AOR : 3.56, 95% CI : 0.98–12.86, and p = 0.053). Again, the odds of dysmenorrhea were also four times higher among respondents with a family history of the same condition (AOR : 4.05, 95% CI : 2.16–7.61, and p = 0.001). Conclusion: The current study revealed a high prevalence of dysmenorrhea among nurse and midwife trainees in the northern part of Ghana. The majority of the respondent experienced loss of appetite and intense pain in the pelvis and lower abdomen, and their concentration during lectures was also significantly affected. The most predominant nonpharmacological method used for reducing the pain was sleep and the application of warm objects on the abdomen.
... Approximately three-quarters of the studied participants reported dysmenorrhea, which was in line with Zannoni et al. (2014), Suvitie et al. (2016), Kagia (2017), Alsaleem (2018), and Yousef et al. (2019), who mentioned that 70.6, 72.2, 67.6, 79.3, and 68% of the studied students experienced dysmenorrhea, respectively. In spite of that, different studies have stated a higher prevalence of dysmenorrhea (85.1, 89.6, 80.9, 95, and 88% in the studies by Kabbara et al., 2014;Subasinghe et al., 2016;Abu Helwa et al., 2018;Patel and Barot, 2020;Karout et al., 2021, respectively). Another study reported a lower prevalence (Ragab et al., 2015), which reported that half of the sample had dysmenorrhea. ...
Objectives Menstrual disorders are among the most prevalent health issues among young female students studying in health science faculties. This study aimed to provide insights into the menstrual patterns among medical faculty students and determine whether stress can be a risk factor for its various disorders. Methods This cross‐sectional study was conducted in the Faculties of Medicine, Dentistry, and Pharmacy at the Syrian Private University, Damascus, Syria, between October and November 2022. A total of 980 female students anonymously completed the identification of menstrual problems and the perceived stress scale (PSS) questionnaire. The data were analyzed using SPSS‐25. Results The mean age of students was 21.52 ± 2.06 years. The most common menstrual disorders in this study were dysmenorrhea (88%), and premenstrual syndrome (87%). A total of 82% had mild to moderate stress, 10% had high stress, and 8% had low stress. Moderate to high perceived stress was associated with an increased risk of PMS (OR = 1.79, P = 0.0037). Conclusion These findings stress the importance of universities, especially health science faculties, establishing protocols for early detection and intervention in students with stress and menstrual disorders. Implementing stress reduction education and timely counseling, along with preventive measures, is crucial for students' well‐being. Further research is needed to refine interventions for this group.
Aim This systematic literature review with meta‐analysis aimed to determine the effect of omega‐3 long chain polyunsaturated fatty acids on prostaglandin levels and pain severity in women with dysmenorrhoea and identify adverse side effects. Methods A literature search was conducted in Embase, Scopus, Web of Science, MEDLINE complete, CINAHL and AMED databases (PROSPERO CRD42022340371). Included studies provided omega‐3 long chain polyunsaturated fatty acids compared to a control in women with dysmenorrhoea and reported pain and/or prostaglandin levels. A random effects meta‐analysis with Cohen's d effect size (95% confidence interval) was performed in SPPS for studies that reported pain outcomes. Study quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Results Twelve studies ( n = 881 dysmenorrhoeal women) of predominantly neutral quality (83%) were included that provided daily supplementation of 300–1800 mg omega‐3 long chain polyunsaturated fatty acids over 2 or 3 months. Meta‐analysis ( n = 8 studies) showed a large effect of omega‐3 long chain polyunsaturated fatty acids ( d = −1.020, 95% confidence interval −1.53 to −0.51) at reducing dysmenorrhoea pain. No studies measured prostaglandin levels, 86% of studies measuring analgesic use showed a reduction with omega‐3 long chain polyunsaturated fatty acids and few studies reported mild adverse side effects in individual participants. Conclusions Findings suggest that daily supplementation of 300–1800 mg omega‐3 long chain polyunsaturated fatty acids over 2–3 months are generally well tolerated and reduces pain and analgesic use in women with dysmenorrhoea. However, the neutral quality of research is limited by methodological issues and the mechanism of action remains to be determined.
Background Five to ten percent of women experience period pains that disrupt their lives yet 4 in 5 women believe that their claims for their dysmenorrhea are not taken seriously. Within the process of seeking support and understanding about their pain, they face various barriers that prevent them from finding the answers they deserve. Methods Semi-structured interviews were conducted with 8 women aged 20–28 to discuss their experiences with dysmenorrhea throughout their time since menarche. Results Using Scheper-Hughes and Lock understanding of the mindful body, this research explores women’s experiences of dysmenorrhea through their physical body (relationship with the body and needing control), the social body (cultural concepts and comparisons to others) and the body politic (medicalisation, the medical team and the transvaginal ultrasound). Conclusions The impact of these aspects of their mindful bodies developed arguments showing how different actors had an impact on preventing them obtaining the patient-centred care they required without resistance. More must be done to honour the experience of pain women have regarding their periods, especially by healthcare professionals. There must be consistency in the way women are approached for their dysmenorrhea to prevent discrepancies of support. This must be done with clearer guidance on what is offered to women with dysmenorrhea, especially in the primary care setting.
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Background: Dysmenorrhea refers to the pain and discomfort associated with the monthly menstrual period in women of child bearing age. It commonly presents as pain or cramps in the lower abdomen in addition to any of the following symptoms; bloating, diarrhea, nausea, waist pain etc. Dysmenorrhea is, reportedly, one of the commonest reasons for gynecological consultations in adolescents and young women. This study was aimed at determining the prevalence, impacts and coping mechanisms for dysmenorrhea. Methods: This was a descriptive cross-sectional study in which data on prevalence, impacts and coping variables were collected from 110 female clinical medical students at Chukwuemeka Odumegwu Ojukwu University Awka using self-administered questionnaires. Same was analyzed and data presented in frequency tables. Results: The prevalence of dysmenorrhea was 82.7%. Severe pain was reported by 53.8% of respondents with the pain majorly located in the lower abdomen (91.2%) and causing school absenteeism (69.2%). Combined pharmacologic and non-pharmacologic methods were adopted as coping mechanisms by 69.7% of respondents. Only 19.8% had ever consulted a doctor on account of dysmenorrhea. Family history of dysmenorrhea was significantly associated with prevalence of dysmenorrhea. Conclusions: Dysmenorrhea is very common among the medical students yet, very few of them seek professional medical assistance. Increased awareness to aid prompt diagnosis and proper management of dysmenorrhea is essential to reduce its impact.
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em>Background . Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study). Design and methods. Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. Expected impact. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life.
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Recruitment of young people for health research by traditional methods has become more expensive and challenging over recent decades. The Internet presents an opportunity for innovative recruitment modalities. To assess the feasibility of recruiting young females using targeted advertising on the social networking site Facebook. We placed an advertisement on Facebook from May to September 2010, inviting 16- to 25-year-old females from Victoria, Australia, to participate in a health study. Those who clicked on the advertisement were redirected to the study website and were able to express interest by submitting their contact details online. They were contacted by a researcher who assessed eligibility and invited them to complete a health-related survey, which they could do confidentially and securely either at the study site or remotely online. A total of 551 females responded to the advertisement, of whom 426 agreed to participate, with 278 completing the survey (139 at the study site and 139 remotely). Respondents' age distribution was representative of the target population, while 18- to 25-year-olds were more likely to be enrolled in the study and complete the survey than 16- to 17-year-olds (prevalence ratio=1.37, 95% confidence interval 1.05-1.78, P=.02). The broad geographic distribution (major city, inner regional, and outer regional/remote) and socioeconomic profile of participants matched the target population. Predictors of participation were older age, higher education level, and higher body mass index. Average cost in advertising fees per compliant participant was US $20, making this highly cost effective. Results demonstrate the potential of using modern information and communication technologies to engage young women in health research and penetrate into nonurban communities. The success of this method has implications for future medical and population research in this and other demographics.
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The aim of this study was to: (1) establish the typical experience of menstruation for senior high school girls and (2) determine how many experience considerable menstrual disturbance that could require further investigation and management of underlying pathology. Cross-sectional study. Senior High Schools in the Australian Capital Territory (ACT), Australia. A total of 1051 girls aged between 15 and 19 years. Data based on a quantitative survey. Self-reports of menstrual bleeding patterns, typical and atypical symptoms and morbidities. Typical menstruation in adolescence includes pain (93%), cramping (71%), premenstrual symptoms (96%) and mood disturbance (73%). Highly significant associations were found between increasing severity of menstrual pain, number of menstrual-related symptoms, interference with life activities and school absence. These associations indicate that approximately 25% of the sample had marked menstrual disturbance: 21% experienced severe pain; 26% school absence; 26% suffering five or more symptoms; > or =24% reporting moderate to high interference with four out of nine life activities. Approximately 10% reported atypical symptoms associated with menstruation. Diagnosis of menstrual pathology in the sample was low, even though 33% had seen a GP and 9% had been referred to a specialist. Menstrual pain and symptoms are common in teenagers. Girls indicating moderate to severe pain in association with a high number of menstrual symptoms, school absence and interference with life activities should be effectively managed to minimise menstrual morbidity. Those girls who do not respond to medical management should be considered for further investigation for possible underlying pathology, such as endometriosis.
BACKGROUND Numerous studies concerning endometriosis and pain have been reported. However, there is no consensus on the best method to evaluate pain in endometriosis and many scales have been used. Moreover, there are only a few descriptions of minimal clinically important differences after treatment (MCID) to evaluate variations in pain. In our study, we aim to identify pain scales used in endometriosis pain treatment, to address their strong and weak points and to define which would be the ideal scale to help clinicians and researchers to evaluate endometriosis-related pain.
To examine the relationship between primary dysmenorrhea and symptoms of depression and anxiety among adolescent female students in Tbilisi, Georgia. A case-control study. Tbilisi, Georgia. Four hundred twenty-four postmenarcheal girls aged 14-20 years (a subset of a larger study involving 2561 girls). The data was gathered in 2011 by the use of a questionnaire prepared for the purpose of this study, completed anonymously. Menstrual pattern, depression and anxiety level were evaluated in both groups; continuous and categorical variables were compared by Pearson chi-square test. Depressive symptoms were determined by a self-reporting scale (Beck Depression Inventory); anxiety was determined using Taylor Manifest Anxiety Scale (TMAS) and Spielberger State-Trait Anxiety Inventory (STAI). Differences in mental health between two groups. Patients with primary dysmenorrhea (PD) had significantly higher scores of depression than the control subjects: moderate depression, 15.9% in PD patients vs 6.2% in control subjects and severe depression, 1.8% vs 0% (P < .003, LR 0.001). High anxiety (TMAS) was also more prevalent in adolescents with primary dysmenorrhea (44% vs 9.9%; P < .001, LR < 0.001). STAI scores were also significantly higher in these patients than in healthy women (68.9% vs 25.0%; P < .001, LR < 0.001). Primary dysmenorrhea is strongly linked with positive scores for depression and anxiety. Because of this association, attention should be given to effective mental health screening in these patients; psychological support may be necessary during their treatment and follow-up.
This review will empower the primary care provider (PCP) to evaluate, manage, and refer as needed adolescents with dysmenorrhea and/or chronic pelvic pain (CPP) who are suspected to have endometriosis. Endometriosis is a common cause of CPP in adolescents who do not respond to primary medical treatment. The presentation in adolescents is unique, causing high rates of misdiagnosis or delayed treatment. Endometriosis-related pain has a marked negative impact on social and mental health. Simple treatments that are available in the primary care setting can alleviate pain and improve quality of life for these young women if initiated in a timely fashion. Adolescents usually turn to their PCP for evaluation of dysmenorrhea and CPP. By maintaining a high index of suspicion, initiating treatment, and referring when needed, the PCP can have a tremendous effect on the patient's present and future quality of life.
To evaluate the efficacy and safety of low-dose oral contraceptives (IKH-01; 0.035 mg ethinyl estradiol and 1 mg norethisterone) for patients with primary dysmenorrhea. Placebo-controlled, double-blind, randomized trial. Clinical trial sites in Japan. One hundred fifteen patients with primary dysmenorrhea. Patients randomly assigned to receive IKH-01 or placebo for four cycles. Total dysmenorrhea score, verbal rating scale defining pain according to limited ability to work and need for analgesics, and visual analog scale (VAS). Reduction in total dysmenorrhea score and VAS before and after treatment was significantly higher in the IKH-01 group than in the placebo group. Total dysmenorrhea score and VAS in the IKH-01 group significantly decreased from cycles 2 to 5. Overall incidence of adverse events was significantly higher in the IKH-01 group. Incidence decreased over time in the IKH-01 group; it was invariable in the placebo group. No serious adverse events occurred. IKH-01 could be used as a single agent or in combination with analgesics for treatment of primary dysmenorrhea.
The data on the menstrual cycle as a health endpoint and as a risk factor for chronic disease are inadequate. Specifically the data on menstrual cycle length and blood loss do not have the detail on within-woman variability needed to allow women and clinicians to anticipate certain bleeding changes that tend to develop at different life stages to distinguish between potentially pathologic alterations from short-term aberrations and to recognize bleeding patterns that may be risk factors for the development of chronic disease. Lack of data on bleeding changes in premenopausal and menopausal women concerns many health professionals considering the many physician visits for abnormal bleeding and the prevalence of hysterectomy among women aged more than 35. Thus development of objective criteria on how much bleeding is too much is needed so women can determine whether their daily blood loss is or is not a concern. Women also need more information on what constitutes menstrual dysfunction. Some basic research needs include definition of population patterns of gynecologic disease identification of potentially modifiable risk factors the influence of recreational activity in gynecologically mature women influence of hard physical activity in the context of womens daily work life interaction of low weight and physical activity in developing countries effects of work stress effects of family interactions effects of violence environmental risk factors (e.g. pesticides) and physiologic variation across the menstrual cycle. Research on menstrual cycle-related risk factors for chronic disease could explain womens long term health status and identify preventive strategies for premenopausal women. Current womens health research tends to ignore hormonal influences. The limited available research on immune parameters suggests that follicular/luteal classification may not be able to detect meaningful variation. In conclusion a comprehensive research program would fill the many gaps in scientific knowledge about the menstrual cycle.
To explore the prevalence of dysmenorrhea among senior high school girls in Perth, Western Australia, its impact on school, sporting, and social activities, students' management strategies, and their knowledge of available treatment. A total of 388 female students in Grades 11 and 12 at three metropolitan secondary schools completed an anonymous questionnaire administered during class time. The following definition of dysmenorrhoea was used: any type of pain or discomfort associated with menstrual periods including cramps, nausea, and headaches. The reported prevalence of dysmenorrhea among these girls was 80%; 53% of those girls with dysmenorrhea reported that it limited their activities. In particular, 37% said that dysmenorrhea affected their school activities. The most common medication used by those reporting dysmenorrhea was simple analgesics (53%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs), used by 42%. More than a quarter of respondents (27%) were unaware that NSAIDs were a possible treatment option for dysmenorrhea. The prevalence and impact of dysmenorrhea on Grade 11 and 12 girls is high, and they lack knowledge of and experience with effective treatment. Health education measures are needed in this area to prevent unnecessary suffering and interruption to school routine.
Dysmenorrhea is the leading cause of short-term school absenteeism. It is associated with a negative impact on social, academic, and sports activities of many female adolescents. Dysmenorrhea has not previously been described among Hispanic adolescents, the fastest growing minority group in the United States. To determine the prevalence of dysmenorrhea among Hispanic female adolescents; its impact on academic performance, school attendance, and sports and social activities; and its management. A total of 706 Hispanic female adolescents, in grades 9 through 12, completed a 31-item questionnaire about the presence, duration, severity, treatment, and limitations of dysmenorrhea at a local urban high school. Among participants who had had a period in the previous 3 months, 85% reported dysmenorrhea. Of these, 38% reported missing school due to dysmenorrhea during the 3 months prior to the survey and 33% reported missing individual classes. Activities affected by dysmenorrhea included class concentration (59%), sports (51%), class participation (50%), socialization (46%), homework (35%), test-taking skills (36%), and grades (29%). Treatments taken for dysmenorrhea included rest (58%), medications (52%), heating pad (26%), tea (20%), exercise (15%), and herbs (7%). Fourteen percent consulted a physician and 49% saw a school nurse for help with their symptoms. Menstrual pain was significantly associated with school absenteeism and decreased academic performance, sports participation, and socialization with peers (P<.01). Dysmenorrhea is highly prevalent among Hispanic adolescents and is related to school absenteeism and limitations on social, academic, and sports activities. Given that most adolescents do not seek medical advice for dysmenorrhea, health care providers should screen routinely for dysmenorrhea and offer treatment. As dysmenorrhea reportedly affects school performance and attendance, school administrators may have a vested interest in providing health education on this topic to their students. Arch Pediatr Adolesc Med. 2000;154:1226-1229.