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At least 19 recordsLinked to original sources
PubMed1988

Nonsteroidal anti-inflammatory drugs and changing attitudes toward dysmenorrhea.

Dysmenorrhea, which may be primary or secondary, is the occurrence of painful uterine cramps during menstruation. Until a decade ago, medical and social attitudes toward dysmenorrhea were shrouded with folklore, psychoanalytical profiles, or psychosomatic bases. In secondary dysmenorrhea, there is a visible pelvic lesion to account for the pain, whereas only a biochemical abnormality is responsible for primary dysmenorrhea. Recent advances in the biochemistry of prostaglandins and their role in the pathophysiology of primary dysmenorrhea and intrauterine device (IUD)-induced dysmenorrhea have now firmly established a rational basis for the disorder. In primary dysmenorrhea, menstrual prostaglandin release is significantly increased but can be readily suppressed to normal levels when nonsteroidal anti-inflammatory drugs (NSAIDs) capable of inhibiting cyclo-oxygenase are given during menstruation. Many clinical trials (controlled and uncontrolled) have demonstrated the efficacy of NSAIDs such as the fenamates, indole-acetic acid derivatives, and arylpropionic acid derivatives in relieving primary dysmenorrhea as well as IUD-induced dysmenorrhea that is also due to elevated prostaglandin levels. With a few of these NSAIDs, it has been shown that the relief of pain is associated with a significant decrease in menstrual fluid prostaglandin levels. Cumulative data of clinical trials indicate that with the effective NSAIDs, 80 percent of patients with significant primary dysmenorrhea can be adequately relieved. Ongoing studies suggest that in some women, endometrial leukotriene, but not PGF2a production, is increased. With the official approval and availability of several effective NSAIDs for the specific treatment of primary dysmenorrhea in the United States, women who have primary dysmenorrhea have been greatly relieved and their productivity increased. Primary dysmenorrhea affects 50 percent of postpubescent women and absenteeism among the severe dysmenorrheics has been estimated to cause about 600 million lost working hours or 2 billion dollars annually. Thus, an effective, simple, and safe treatment of primary dysmenorrhea for two to three days during menstruation will not only have a positive economic impact but will also enhance the quality of life. The availability of effective dysmenorrhea therapy with NSAIDs has induced greater expectations of relief by the patient, as well as greater willingness to seek medical help, a more rational approach to patient management by physicians, changes in attitude toward women with primary dysmenorrhea, and the debunking of myths about dysmenorrhea that often have been perpetuated as fact.(ABSTRACT TRUNCATED AT 400 WORDS)

Absenteeism↗
PubMed2000

Prevalence and impact of dysmenorrhea on Hispanic female adolescents.

BACKGROUND: 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. OBJECTIVE: 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. PARTICIPANTS AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

Absenteeism↗
PubMed1990

The experience of dysmenorrhea and its relationship to personality variables.

The aims of this study were: to relate women's subjective experience of primary dysmenorrhea to psychogenic needs assessed longitudinally at the age of 15 and at the age of 25 in a nonclinical sample; to compare the psychogenic needs of women with severe primary dysmenorrhea with those of other women who never have experienced dysmenorrhea; and to examine whether women with severe dysmenorrhea were less conventionally feminine than women who never have experienced dysmenorrhea. At 25 years, 42% of the women experienced dysmenorrhea and 15% experienced pain that limited their daily activity. Differences in psychogenic needs according to the Cesarec Marke Personality Schedule and in psychological masculinity and femininity according to the Attitude Interest Schedule were found in women with severe primary dysmenorrhea compared with women who never experienced dysmenorrhea. The results indicate that women with severe dysmenorrhea have less self-esteem at 15 years, but compensate for this at 25 years by being more achievement-oriented and aggressive than women who never experienced dysmenorrhea. Further, women with severe dysmenorrhea are more conventionally feminine than women who never have experienced dysmenorrhea.

Adaptation, Psychological↗
PubMed2001

Primary dysmenorrhea in adolescent girls and treatment with oral contraceptives.

This review examines the prevalence, associated morbidity, and treatment of primary dysmenorrhea in adolescent girls. Relevant literature was examined by systematic, evidence-based review using MEDLINE and Cochrane Collaboration databases. Dysmenorrhea is highly prevalent during adolescence. Despite differences in measurement methods, 20%-90% of adolescent girls report dysmenorrhea and about 15% of adolescents describe their dysmenorrhea as severe. During adolescence, dysmenorrhea leads to high rates of school absence and activity nonparticipation. Most adolescents with dysmenorrhea self-medicate with over-the-counter preparations; few consult healthcare providers. Combined oral contraceptives (COC) are an accepted treatment for dysmenorrhea in nonadolescent women. However, data supporting the efficacy of COC is limited. Very small studies show decreased prostaglandin in menstrual fluid associated with high-dose COC use. Larger studies are limited to cross-sectional comparisons showing lower prevalence of dysmenorrhea in low-dose COC users compared to non-COC users. One small, randomized controlled trial including some adolescents demonstrated an improvement in dysmenorrhea with high-dose COC treatment compared to placebo. The efficacy of low-dose COC in the treatment of adolescent dysmenorrhea has yet to be determined. If effective, well-established safety and noncontraceptive health benefits may make COC an ideal treatment for dysmenorrhea in adolescent girls.

Absenteeism↗
PubMed1985

Dysmenorrhea.

Dysmenorrhea affects over 50% of menstruating women and causes extensive personal and public health problems, a high degree of absenteeism and severe economic loss. In primary dysmenorrhea there is no macroscopically identifiable pelvic pathology, while in secondary dysmenorrhea gross pathology is present in the pelvic structures. With primary dysmenorrhea the pain is suprapubic and spasmodic, and associated symptoms may be present. Characteristically dysmenorrhea starts at or shortly after menarche. The pain lasts for 48-72 hours during the menstrual flow and is most severe during the first or second day of menstruation. It is now clear that in many women with primary dysmenorrhea the pathophysiology is due to increased and/or abnormal uterine activity because of the excessive production and release of uterine prostaglandins. Treatment with many of the prostaglandin synthetase inhibitors (nonsteroidal antiinflammatory drugs) will produce significant relief from dysmenorrhea and a concomitant decrease in menstrual fluid prostaglandins. For dysmenorrheic women who desire oral contraception, this agent will relieve the dysmenorrhea by suppressing endometrial growth, thus resulting in a decrease in the menstrual flow as well as in menstrual fluid prostaglandins. For those not requiring oral contraception the drug of choice for primary dysmenorrhea remains a prostaglandin inhibitor. Laparoscopy need be resorted to only if a pelvic abnormality is detected on examination or if treatment with prostaglandin inhibitors for up to six months is not significantly effective. In secondary dysmenorrhea, relief is obtained when the pelvic pathology--such as ovarian cysts, uterine fibroids, adhesions, cervical stenosis, congenital malformation of the uterus and endometriosis--is treated. In women using IUDs the dysmenorrhea is readily controlled with prostaglandin inhibitors since the underlying pathophysiology is excessive prostaglandin production and release.

Adult↗
PubMed1982

An epidemiologic study of young women with dysmenorrhea.

The prevalence of dysmenorrhea was studied in a random sample of 19-year-old women from an urban Swedish population. Dysmenorrhea was reported by 72% of the women. Fifteen percent suffered from dysmenorrhea which limited daily activity and was unimproved by analgesics. Dysmenorrhea occurred significantly (p less than 0.01) more often in women not using oral contraceptives. A significant correlation (p less than 0.01) was found between early menarche and an increased severity of dysmenorrhea. There was a significant correlation (p less than 0.01) between the severity of dysmenorrhea and the amount of menstrual flow. Parous women had significantly (p less than 0.01) less dysmenorrhea than women who had never been pregnant or women who had experienced a legal or spontaneous abortion. Smokers as compared to nonsmokers had significantly (p less than 0.01) less dysmenorrhea. The severity of dysmenorrhea was not affected by height, weight, or regularity of the menstrual cycle. Absenteeism as a result of dysmenorrhea was evaluated.

Absenteeism↗
PubMed2000

Prospective study of exposure to environmental tobacco smoke and dysmenorrhea.

Dysmenorrhea is a common gynecologic disorder in women of reproductive age. Previous studies have found an association between current cigarette smoking and prevalence of dysmenorrhea. This study investigated the association between exposure to environmental tobacco smoke (ETS) and the occurrence of dysmenorrhea among women without a history of this disorder. The study population consisted of 165 newly wed, nonsmoking Chinese women (in Shenyang, China), who intended to get pregnant and who had no past history of dysmenorrhea at the time of enrollment. These women completed a baseline questionnaire interview upon enrollment and were prospectively followed by daily diary. Dysmenorrhea was defined as a diary recording of abdominal pain or low back pain for at least 2 days during a menstrual period. A subject's ETS exposure was defined as the mean number of cigarettes smoked per day at home by household members over an entire menstrual cycle before the menstrual period. A logistic regression model was used to assess the effect of ETS on the risk of dysmenorrhea, with adjustment for age, body mass index, education, season, area of residence, occupation, shift work, perceived stress, passive smoking at work, and occupational exposure to chemical hazards, dust, and noise. Generalized estimating equations were used to account for autocorrelations as a result of multiple cycles per subject. This report is based on 625 prospectively followed menstrual cycles with complete baseline and diary data. ETS exposure was reported in 77% of cycles, within which average daily exposures throughout the cycle ranged from 0.02 to 10. 3 cigarettes. The incidence of dysmenorrhea was 9.7% and 13.3% among nonexposed and exposed cycles, respectively. Among ETS-exposed cycles, there was a positive dose-response relationship between the numbers of cigarettes smoked and the relative risk of dysmenorrhea. The adjusted odds ratios of dysmenorrhea associated with "low," "middle," and "high" tertiles of ETS exposure versus no exposure were 1.1 [95% confidence interval (CI), 0.5-2.6], 2.5 (CI, 0.9-6.7), and 3.1 (CI, 1.2-8.3), respectively. The findings were consistent with those of analyses limited to the first follow-up menstrual cycle from each woman. These data suggest a significant dose-response relationship between exposure to ETS and an increased incidence of dysmenorrhea in this cohort of young women.

Adult↗
PubMed2002

A contemporary approach to dysmenorrhea in adolescents.

Dysmenorrhea is the most common gynecologic complaint among adolescent girls. Despite progress in understanding the physiology of dysmenorrhea and the availability of effective treatments, many adolescent girls do not seek medical advice or are undertreated. Dysmenorrhea in adolescents is usually primary (functional), and is associated with normal ovulatory cycles and no pelvic pathology. In approximately 10% of adolescents with severe dysmenorrhea, pelvic abnormalities such as endometriosis or uterine anomalies may be found. Potent prostaglandins from the second series and potent leukotrienes from the fourth series play an important role in generating dysmenorrhea symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common pharmacologic treatment for dysmenorrhea. A loading dose of NSAIDs (typically twice the regular dose) should be used as initial treatment for dysmenorrhea in adolescents followed by a regular dose until symptoms abate. Adolescents with symptoms that do not respond to treatment with NSAIDs for three menstrual periods should be offered combined estrogen/ progestin oral contraceptive pills for three menstrual cycles. Adolescents with dysmenorrhea who do not respond to this treatment should be evaluated for secondary causes of dysmenorrhea. Adolescent care providers have the important roles of educating adolescent girls about menstruation-associated symptoms, as well as evaluating and effectively treating patients with dysmenorrhea.

Adolescent↗
PubMed2006

Dysmenorrhea in adolescents and young adults: etiology and management.

Dysmenorrhea is the most common gynecologic complaint among adolescent and young adult females. Dysmenorrhea in adolescents and young adults is usually primary (functional), and is associated with normal ovulatory cycles and with no pelvic pathology. In approximately 10% of adolescents and young adults with severe dysmenorrhea symptoms, pelvic abnormalities such as endometriosis or uterine anomalies may be found. Potent prostaglandins and potent leukotrienes play an important role in generating dysmenorrhea symptoms. Nonsteroidal anti-inflammatory drugs (NSAID) are the most common pharmacologic treatment for dysmenorrhea. Adolescents and young adults with symptoms that do not respond to treatment with NSAIDs for 3 menstrual periods should be offered combined estrogen/progestin oral contraceptive pills for 3 menstrual cycles. Adolescents and young adults with dysmenorrhea who do not respond to this treatment should be evaluated for secondary causes of dysmenorrhea. The care provider's role is to explain about pathophysiology of dysmenorrhea to every adolescent and young adult female, address any concern that the patient has about her menstrual period, and review effective treatment options for dysmenorrhea with the patient.

Adolescent↗
PubMed2003

Effect of a low-dose oral contraceptive containing 20 microg ethinylestradiol and 150 microg desogestrel on dysmenorrhea.

This observational study evaluated the effect of a low-dose oral contraceptive (OC), containing 20 mug ethinylestradiol and 150 mug desogestrel (20EE/150DSG) on dysmenorrhea. Of the 346 women enrolled, 301 (87%) completed the three-cycle study. All participants (mean age: 22.6 years) wished to use oral contraception and had dysmenorrhea for at least 3 months. Dysmenorrhea was assessed using both the adapted verbal multidimensional scoring system (VMSS-A) and a visual analogue scale (VAS) to rate pain intensity. General dysmenorrhea symptoms and the use of analgesics were also assessed. The mean total combined scores on the VMSS-A scale decreased from 5.4 to 1.4 (p < 0.001), during the three cycles of OC use. The mean VAS pain-intensity score decreased from 6.8 to 1.8 (p < 0.001). During treatment there were substantial improvements in most individual parameters of dysmenorrhea. The percentage of women with dysmenorrhea lasting > or =2 days decreased from 81% at baseline to 14% at cycle 3. The percentage of women reporting generalized dysmenorrhea symptoms (e.g., lumbago, asthenia) decreased from 79% to 21% and the percentage needing analgesics dropped from 100% to 41%. The percentage of women for whom dysmenorrhea interfered with daily activities decreased from 73% to 10%. The results indicate that 20EE/150DSG can statistically and clinically significantly reduce the incidence and severity of dysmenorrhea, and its impact on daily activities.

Activities of Daily Living↗
PubMed2004

[The relationship between dysmenorrhea and menstrual attitudes among female students in vocational nursing schools].

This research involved a cross-sectional investigation. An Essential background questionnaire and the Menstrual Attitude Questionnaire (MAQ) were used in the study. The purpose was to explore the relationship between dysmenorrhea and menstrual attitudes among female students in vocational nursing schools. Data collection was performed by questionnaire in school classes. Data were recorded using Microsoft Excel, and analyzed by JMP5.0. Essential background information was compared by t-test and Chi-square test, and menstrual attitudes by t-test. Eight hundred and five students answered the questionnaire, and 760 responses (94.4%) were valid. Among the valid sample, 557 respondents (73.3%) had experienced dysmenorrhea during the previous half year. This group was named the dysmenorrhea group. The other 203 students (26.7%) who had experienced no dysmenorrhea during the previous half year were called the non-dysmenorrhea group. Results of the study showed that the dysmenorrhea group agreed that "Menstruation is a debilitating event," and on the importance of "Anticipation and prediction of the onset of menstruation" more than the non-dysmenorrhea group. Markedly more of the non-dysmenorrhea group than of the dysmenorrhea group that agreed, "Menstruation has no effect". As to the propositions that "Menstruation is a bothersome event," and "Menstruation is a natural event," there were no significant differences between the two groups.

Adolescent↗
PubMed1992

Dysmenorrhea and use of oral contraceptives in adolescent women attending a family planning clinic.

OBJECTIVES: This study examined the prevalance of dysmenorrhea in female adolescents and the effect of experiencing a reduction in dysmenorrhea on oral contraceptive use. STUDY DESIGN: This was a prospective panel study in which 308 adolescent women at an inner-city family planning clinic were interviewed about their experiences with dysmenorrhea and their oral contraceptive use at three points in time over a 6-month period. A chi 2 test and multiple logistic regression analysis were done. RESULTS: The overall prevalence of dysmenorrhea in this population was 79.6%; 18.2% reported severe dysmenorrhea. Those who had severe dysmenorrhea and also experienced the reduction of dysmenorrhea as a result of oral contraceptives were eight times more likely to be consistent oral contraceptive users (p less than or equal to 0.02). CONCLUSIONS: It is important to screen female adolescents for dysmenorrhea, provide them with information about the beneficial side effects of oral contraceptives, and follow up these young women to make sure they are experiencing the alleviation of their symptoms.

Adolescent↗
PubMed2006

Effects of acupressure on dysmenorrhea and skin temperature changes in college students: a non-randomized controlled trial.

BACKGROUND: Complementary and alternative therapies may be adopted as nursing interventions to alleviate dysmenorrhea and improve productivity, creativity, work performance, and quality of life. OBJECTIVES: This study aimed to evaluate the efficacy of San Yin Jiao (SP6) acupressure as a non-pharmacologic nursing intervention for dysmenorrhea and identify its effects on temperature changes in two related acupoints as an explanatory mechanism of chi circulation. DESIGN: A non-equivalent control group pre and post-test design was employed to verify the effects of SP6 acupressure on skin temperature and dysmenorrhea. SETTING AND PARTICIPANTS: Young college women with primary dysmenorrhea were recruited from classrooms at two universities in Korea and 58 eligible participants were allotted to either a SP6 acupressure group or placebo group that received light touch on the SP6 acupoint. METHODS: The experimental group received acupressure treatment within the first 8h of menstruation, and severity of dysmenorrhea and skin temperature changes in the Zhongwan (CV2) and Qugu (CV12) acupoints were assessed prior to and 30 min, 1, 2, and 3h following treatment. RESULTS: There was a significant difference in severity of dysmenorrhea between the two groups immediately after (F=18.50, p=0.000) and for up to 2h (F=8.04, p=0.032) post treatment. Skin temperature was significantly elevated at 30 min after acupressure at the suprapubic CV2 acupoint in the experimental group compared to the control group. Temperature elevation was also noted at the epigastric CV12 acupoint post treatment but group differences were not significant, indicating that SP6 acupressure relieves dysmenorrhea primarily by temperature elevation in the CV2 pathway. CONCLUSIONS: Acupressure to the SP6 meridian can be an effective non-invasive nursing intervention for alleviation of primary dysmenorrhea, with effects lasting 2h post treatment.

Acupressure↗