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Aim: To examine the prevalence of dysmenorrhea in the predominantly female nursing profession and investigate the role of occupational characteristics in dysmenorrhea. Background: Studies on working women have mostly examined the effects of dysmenorrhea symptoms on work performance, as opposed to shedding light on the association between work‐related characteristics and dysmenorrhea. Methods: In this cross‐sectional study, we used data obtained from survey 9 of the Korea Nurses' Health Study. The participants were female nurses of childbearing age. Statistical analysis included descriptive statistics and multivariable logistic regression. Results: Data from 6697 participants were analyzed. Of the total sample, 47.3% had dysmenorrhea. After adjusting for confounders to examine the relationship between occupational characteristics and dysmenorrhea, the odds for dysmenorrhea were 1.230 times higher among women who lifted heavy objects at least six times a day compared to those who did not engage in heavy lifting (95% confidence interval: 1.028–1.473) and 1.042 times higher among women with higher physical fatigue (odds ratio: 1.042, 95% confidence interval: 1.023–1.061). Conclusion: The findings clarify the potential for reducing dysmenorrhea through the improvement of work environment factors. Thus, this study may prove useful for developing educational programs and policies that aim to alleviate dysmenorrhea among working women, including nurses. Implications for Nursing Management: Nursing managers and health policymakers need to understand the factors influencing dysmenorrhea and minimize female nurses' physical burden by implementing appropriate nurse–patient ratios and improving their work environment. [ABSTRACT FROM AUTHOR]

This study aimed to assess the relationship between menstruation‐related attributes and mental distress in adolescent girls. A cross‐sectional study was conducted in Rangeli Municipality, Nepal, among 270 adolescent girls. Data were collected using a self‐administered questionnaire. Unadjusted and adjusted odds ratios (aOR) were calculated at a 5% level of significance to identify factors associated with depression, anxiety and stress. Of 270 adolescent girls, 28.9% (95% CI: 23.5%–35.2%) experienced anxiety, 14.4% (95% CI: 10.0%–18.5%) experienced stress and 32.2% (95% CI: 26.6%–37.4%) experienced depression. Low perceived family support during menstruation (aOR: 2.87, 95% CI: 1.03–7.97), low perceived support from friends during menstruation (aOR: 4.09, 95% CI: 1.66–10.07) and experiencing moderate/severe dysmenorrhea (aOR: 2.31, 95% CI: 1.105–5.08) were associated with anxiety. Those with moderate/severe dysmenorrhoea had higher odds (aOR: 5.60, 95% CI: 1.56–20.05) of experiencing stress. Low perceived family support (aOR: 3.07, 95% CI: 1.08–8.67), low perceived support from friends (aOR: 2.77, 95% CI: 1.11–6.89) and experiencing moderate to severe dysmenorrhoea (aOR: 3.56, 95% CI: 1.63–7.79) were associated with depression. The findings underscore the importance of proper management of dysmenorrhoea and need for social support from both family and friends during menstruation as these factors are associated with psychological distress among adolescent girls. [ABSTRACT FROM AUTHOR]

Background: Chamomile and flaxseed are traditionally used medicinal plants to treat painful menstruation. Therefore, this study aimed to investigate the effects of chamomile and flaxseed on pelvic pain, dyspareunia, and dysmenorrhea in endometriosis patients. Materials and Methods: A controlled randomized clinical trial was conducted on 102 endometriosis patients referred to Reyhane Infertility Center of Qom University of Medical Sciences, Iran, from July 2021 to March 2022. Patients were divided into three groups: chamomile, flaxseed, and placebo, using the block randomization method. Patients used 1000 mg capsules (three times a day) for 8 weeks. A Visual Analog Scale (VAS) was used to measure the severity of pain. Pelvic pain, dyspareunia, and dysmenorrhea were assessed on three occasions Data were analyzed using the Chi-square, repeated measures ANCOVA, and ANOVA. All statistical analysis was performed using SPSS version 20. Results: Before the intervention, there was no significant difference between the three groups regarding dysmenorrhea, pelvic pain, or dyspareunia (p > 0.05). The mean score of pelvic pain (on one and two-month follow-ups) in the chamomile and flaxseed groups (F = 383.07, p < 0.001) was lower than that in the placebo group. The mean score of dyspareunia (on one and two-month follow-ups) in the chamomile and flaxseed groups was significantly lower than that in the placebo group (F2 = 479.34, p < 0.001). The mean score of dysmenorrhea on one and two-month follow-ups (F2 = 385.67, p < 0.001) in the chamomile and flaxseed groups was lower than that in the placebo group. Conclusions: Chamomile and flaxseed may reduce pelvic pain, dyspareunia, and dysmenorrhea associated with endometriosis. [ABSTRACT FROM AUTHOR]

Background: Primary dysmenorrhea is a common gynecological disorder that affects many women of reproductive age. Ginger, a widely used spice with anti-inflammatory properties, has been suggested as a potential treatment for the painful cramps associated with this condition. Objective: The aim of this systematic review and meta-analysis was to evaluate the efficacy of ginger for pain management in primary dysmenorrhea. Methods: Our systematic review was registered in Prospero (CRD42023418001). Six English (PubMed, Scopus, Web of Science, PsycINFO, CINAHL complete, and Cochrane) and one Persian electric database (SID) was searched up to May 2023 for English or Persian studies that measure the effect of ginger on pain in dysmenorrhea. The Cochrane tool was used to assess the risk of bias of the included studies. Random effects meta-analyses were performed to obtain standardized mean differences (SMD) and 95% confidence intervals (CI). Results: Out of the 804 articles initially identified from the search, 24 were included for qualitative analysis and 12 for quantitative analysis after a full-text evaluation. The combined results of the studies indicate that ginger is notably more effective than placebo in reducing both the intensity (SMD = −1.13; 95% CI = −1.59 to −0.68, I2 = 81.05%) and duration of pain (SMD = −0.29; 95% CI = −0.46 to −0.12). There were no differences between ginger and nonsteroidal anti-inflammatory drugs (NSAIDs) (SMD = 0.01; 95% CI = −0.24 to 0.25), or exercise (SMD = 0.06; 95% CI = −0.66 to 0.78) for pain intensity. Safety-related data were infrequently reported. Conclusions: The results of this meta-analysis suggest that ginger can effectively reduce pain associated with dysmenorrhea. The findings are limited due to risk of bias in the included studies and the unclear risk-benefit ratio. [ABSTRACT FROM AUTHOR]

Adenomyosis is a chronic, hormone-related disease characterized by the presence of the endometrial glands and stroma within the myometrium. This condition can manifest in various features, focal or diffuse adenomyosis or as an adenomyoma, and it may involve different uterine walls (posterior, anterior, and/or lateral walls). The disease can also be classified into different degrees, as mild, moderate and severe, which can be associated with more intense symptoms, although this correlation is not always directly proportional. In fact, adenomyosis can be asymptomatic in about a third of cases or it can significantly impact patients' quality of life through painful symptoms, such as dysmenorrhea and dyspareunia, abnormal uterine bleeding—particularly heavy menstrual bleeding—and potential effects on fertility. Historically, adenomyosis has been considered a disease primarily affecting premenopausal women over the age of 40, often multiparous, because the diagnosis was traditionally based on surgical reports from hysterectomies performed after the completion of reproductive desire. Data on the presence of adenomyosis in adolescent patients remain limited. However, in recent years, advancements in noninvasive diagnostic tools and increased awareness of this pathology have enabled earlier diagnoses. The disease appears to have an early onset during adolescence, with a tendency to progress in terms of extent and severity over time. Adenomyosis often coexists with endometriosis, which also has an early onset. Therefore, it is important, when diagnosing adenomyosis, to also screen for concomitant endometriosis, especially deep endometriosis in the posterior compartment. The aim of this narrative review is to investigate the prevalence of different types and degrees of adenomyosis in younger patients, assess the associated symptoms, and describe the most appropriate diagnostic procedures for effective therapeutic management and follow-up, with the goal of improving the quality of life for these young women. [ABSTRACT FROM AUTHOR]

Pain catastrophizing is a prominent psychological factor that is strongly correlated with pain. Although the complex properties of pain catastrophizing vary across different pain phases, the contribution of chronic pain to its progression from a general trait to a higher state remains unclear. This study aimed to examine the neural mechanisms and degree to which pain catastrophizing is reinforced in the context of primary dysmenorrhea (PDM), one of the most prevalent gynaecological complaints experienced by women of reproductive age. Altogether, 29 women with moderate‐to‐severe PDM were included in this study. Arterial spin labelling was used to quantify the cerebral blood flow (CBF) in each participant in both the pain‐free and painful phases. The pain catastrophizing scale (PCS) was completed in two phases, and the Short‐Form McGill Pain Questionnaire was completed in the painful phase. Compared with pain catastrophizing in the pain‐free phase (PCSpf), pain catastrophizing in the painful phase (PCSp) is higher and positively correlated with the composite factor of menstrual pain. CBF analysis indicated that the PCSp is positively associated with CBF in the frontal cortex, hippocampus and amygdala. The reinforcement of pain catastrophizing correlates with CBF in the prefrontal cortex. Specifically, the medial prefrontal cortex, which correlates with pain state, plays a crucial role in mediating the reinforcing effect of pain in the PCSp. These results promote the mechanical comprehension of pain catastrophizing management in individuals with chronic pain. [ABSTRACT FROM AUTHOR]

Background: Pain is a common, severe symptom related to endometriosis. Despite this prominent feature, there is limited literature regarding its description and use of integrative treatment methods. Objective: We aimed to describe endometriosis-related pain characteristics, severity, and association with an integrative approach encompassing pharmacological and non-pharmacological methods. Methods: A cross-sectional descriptive correlational study was conducted using convenience sampling of adult women with endometriosis-related pain. Three questionnaires were utilized: a demographic and general health questionnaire, a visual analog pain scale (VAS), and the short-form McGill pain questionnaire (SF-MPQ). Results: Participants included 93 women with a mean general pain level of 6.2/10 (SD = 2.7) on the VAS. The total mean pain score on the SF-MPQ was 26.25/45 (SD = 10.1). Sixty-four women (68.8%) reported experiencing pain at the time of completion of the questionnaire (mean: 1.6/4, SD = 1.3). All participants utilized analgesia; those who used opioids reported a higher overall mean pain score of 2.3 (SD = 1.3) than patients who did not use opioids reported a mean of 1.4 (SD = 1.2; z = 9.59; P <.001). Present pain intensity was significantly higher for women using opioids than those not using opioids. In all, 77 women (82.8%) used integrative methods to alleviate the pain symptoms. Women who utilized nutritional therapy as part of the non-pharmacological method experienced lower mean (SD) overall pain (4.4 [2.5]) compared with patients who did not utilize nutritional therapy (6.75 [2.5]; P <.01). Conclusions: More studies are needed to find evidence-based treatment options for women for integrative pain relief for endometriosis-related pain. [ABSTRACT FROM AUTHOR]

Women with endometriosis were deemed more prone to COVID-19 infection in some reports. Considering that endometriosis-related aberrant immune response, understanding how COVID-19 vaccination influences its clinical status is crucial. The aim of this meta-analysis was the evaluate the susceptibility to COVID-19 infection and modifications of symptoms following COVID-19 vaccination in women with endometriosis. Electronic searches on EMBASE, MEDLINE, Scopus, Cochrane at CENTRAL, Scielo.br, LILACS and other databases were searched from inception to March 2024. Studies were eligible if they analyzed the incidence of infection in endometriosis women or the changes in symptoms after two doses of COVID-19 vaccine and had a control group. Four studies (2249 women) were included. No increased susceptibility to COVID-19 infection due to presence or absence of endometriosis was retrievable (risk ratio (RR) 1.42 [95% CI 0.88 to 2.27]; I2 = 33%). Patients with endometriosis did not experience an overall worsening of symptomatology relative to controls (RR 1.58 [95% CI 0.67 to 3.75]; I2 = 94%). An increase in the risk of dysmenorrhea worsening was noted (RR 1.88 [95% CI 1.11 to 3.17]; I2 = 63%). No other differences regarding menstrual flow (RR 1.25 [95% CI 0.70 to 2.23]; I2 = 78%), intermenstrual bleeding (RR 1.14 [95% CI 0.83 to 1.56]; I2 = 39%) and pelvic pain (RR 2.55 [95% CI 0.65 to 10.05]; I2 = 80%) compared to controls was retrievable. Therefore, mRNA vaccines do not seem to lead to worsening of symptomatology in endometriotic women. However, a slight temporary increase in dysmenorrhea may be present. Moreover, endometriosis does not seem to increase the risk of contracting COVID-19. [ABSTRACT FROM AUTHOR]

Cavernous hemangioma within the female genital tract is an extremely rare pathology, characterized by irregular vascular spaces containing blood or thrombus. We present a unique case of a 42-year-old primiparous woman who presented with typical endometriosis symptoms such as dysmenorrhea, dyspareunia, and heavy menstrual bleeding. The patient also experienced complex postpartum symptoms, which were misdiagnosed as cholecystitis and retained placental products. Imaging studies suggested deep infiltrative endometriosis with extraovarian endometriotic lesions. Surgical exploration revealed a hemangioma within the right anterior broad ligament alongside peritoneal endometriosis lesions. The hemangioma itself expresses estrogen and progesterone receptors in stromal cells. The presence of steroid hormone receptors strongly suggests symptom alleviation during the menstrual cycle and the postpartum period. The coexistence of cavernous hemangioma and endometriosis in the broad ligament, previously unreported, and symptomatic overlap between the two conditions complicates diagnosis and management, emphasizing the need for comprehensive evaluation integrating clinical symptoms and imaging findings. [ABSTRACT FROM AUTHOR]

Objectives: Using magnetic resonance imaging (MRI), we analysed the clinical manifestations of granulomatous lobular mastitis (GLM) before and after treatment with traditional Chinese medicine (TCM). Methods: This was a retrospective study. Clinical manifestations and imaging features of patients with biopsy-proven GLM before and after treatment were retrospectively analysed from April 2021 to April 2023 at Xiyuan Hospital, China Academy of Chinese Medical Sciences. Results: Among 29 women of childbearing age (mean age, 34.3±3.6 years), Compared to pre-therapy, the number of patients with lumps, ruptures, pain, and menstrual irregularities was significantly reduced (P < 0.05). The Chinese medicine staging demonstrated a transition from bulk to ulcerated (P=0.041). Pre- and post-treatment MRI changes included lesion number, distribution, maximal diameter, time-signal intensity curves (TIC), apparent diffusion coefficients (ADC), and BI-RADS categories 3 and 4a (all P<0.05). Furthermore, substantial changes were seen in chest wall invasion, nipple discharge, increased feeding arteries, and skin edema (all P<0.05). Conclusion: Combining internal and external Traditional Chinese Medicine (TCM) therapy proved successful for GLM. A reliable assessment of therapy efficacy is provided by MRI examination of lesion changes before and after treatment. [ABSTRACT FROM AUTHOR]

This essay details the author's personal process of being diagnosed with endometriosis, including her experience of medical gaslighting and societal attitudes toward "period pain." Many people who experience excessive menstrual pain report dismissive attitudes and/or trivialization of their symptoms, from both the public and health professionals. The author recalls conversations from throughout her diagnostic journey, which evidence the ingrained beliefs and attitudes of gendered observations of pain. Ultimately, the author contends that the "burden of proof" is with the patient, being forced to continually fight for their right to be heard in an archaic medical system. The people experiencing this condition are experts-by-experience, who are continually providing knowledge about endometriosis, and self-advocating to rewrite the societal narratives concerning menstrual pain. The goal of this essay is not to blame or cause discomfort, but rather to raise awareness and encourage everyone to talk more openly about menstrual related issues. The following prose is written as a first-person account of my experience with this condition, drawing on appropriate support from academic literature. [ABSTRACT FROM AUTHOR]

Background: Dysmenorrhea, or menstrual pain, is a subjective experience, and can only be assessed by patient‐reported outcomes. These instruments should be reliable, valid and responsive. Aim: To identify and critically appraise the available evidence for the measurement properties of specific patient‐reported outcome measures used for dysmenorrhea. Methods: The PRISMA statement was used to report this systematic review. Databases searched were PubMed, SCOPUS, CINAHL, Web of Science, ScienceDirect and Google Scholar (April 2021; updated on February 2023). Original studies with primary data collection, with no restriction on language and publication date that reported psychometric properties of one or more dysmenorrhea‐related patient‐reported outcome measure. The literature searches, selection of studies, data extraction and assessment of the risk of bias were performed independently by two reviewers and followed the COSMIN guidelines. Results: Thirty studies were analysed in this review, and 19 patient‐reported outcome measures were evaluated. The instruments varied in relation to the measured construct and measurement properties (validity, reliability and responsiveness). The methodological quality of the studies and the quality of evidence of the patient‐reported outcome measures were variable. Among the 13 studies that reported the development of patient‐reported outcome measures, most had inadequate methodological quality, and the overall rating was insufficient or inconsistent. Conclusions: The Dysmenorrhea Symptom Interference (DSI) scale was the only identified patient‐reported outcome measure that has the potential to be recommended because of its sufficient rating combined with moderate quality of evidence for content validity. Future studies should further evaluate the measurement properties of the existing patient‐reported outcome measures, or develop new patient‐reported outcome measures following the COSMIN methodology. Patient or public contribution: Not applicable as this is a systematic review. Trial registration: PROSPERO protocol: CRD42021244410. Registration on April 22, 2021. [ABSTRACT FROM AUTHOR]

Aim: To examine the effect of listening to music and drawing on coping with dysmenorrhea complaints of nursing students. Methods: The study was a double-blind, three parallel-group randomized controlled trial conducted between August 2023 and May 2024 at Bartın University, Faculty of Health Sciences, Department of Nursing. Ninety-six dysmenorrheic nursing students with regular menstrual cycles were included in the study and randomly assigned to three groups as drawing, music and control groups. Visual Analog Scale (100mmVAS of pain), Perceived Stress Scale (PSS) and Menstrual Symptoms Scale (MSS) were applied to the students at baseline, 1st and 2nd months. The interventions were as follows: the music group listened to a 29-minute and 32-second song three days before menstruation and on the first day of menstruation in the third month composed by Juan Sebastian Martin-Saavedra, while the drawing group created art for the same duration. The pain scores, perceived stress, and menstrual symptoms were measured in all groups after the interventions. Results: Pretest, 1st and 2nd months 100mmVAS of pain score averages were 7.16 ± 1.99, 7.16 ± 1.99 and 7.50 ± 1.98 for the control group, 7.22 ± 1.64, 4.84 ± 1.80 and 2.13 ± 1.45 for the music group and 6.69 ± 1.80, 5.09 ± 1.55 and 2.91 ± 1.33 for the drawing group, respectively. Pretest, 1st and 2nd months PSS score averages were 28.75 ± 3.71, 29.09 ± 3.87 and 30.03 ± 4.16 for the control group, 29.91 ± 3.98, 14.06 ± 4.06 and 3.59 ± 3.82 for the music group and 27.38 ± 3.63, 18.13 ± 5.60 and 8.34 ± 5.46 for the drawing group, respectively. Pretest, 1st and 2nd months MSS score averages were 79.25 ± 15.41, 88.00 ± 20.08 and 90.66 ± 19.13 for the control group, 85.41 ± 10.77, 62.41 ± 15.23 and 34.00 ± 12.62 for the music group and 80.69 ± 11.07, 65.53 ± 15.37 and 47.31 ± 15.11 for the drawing group, respectively. Mean menstrual pain intensity, mean perceived stress level, and mean menstrual symptoms level in the art and music group decreased significantly at 1st and 2nd months post-intervention (p <.001). A significant increase in score levels was observed in the control group. Conclusions: Both art and music practices are effective in significantly reducing menstrual pain, perceived stress, and menstrual symptoms in nursing students with dysmenorrhea. It is important to include listening to music and drawing on women's health and disease nursing practices to control menstrual pain, perceived stress, and menstrual symptoms in dysmenorrhea. Clinical trials registration number: https://clinicaltrials.gov identifier NCT06027489; registered August 30, 2023. [ABSTRACT FROM AUTHOR]

Background: There is growing global concern about poor mental health among adolescents in sub-Saharan Africa. In particular, adolescent girls face multiple challenges in managing menstruation which can impact both their health and wellbeing. In this study we address an evidence gap on the association of a broad range of menstrual-related factors with mental health problems amongst secondary school female adolescents in Uganda. Methods: We used baseline data from a cluster-randomised menstrual health intervention trial conducted in 60 secondary schools in two districts in Uganda. Baseline data were collected between March and July 2022, including socio-demographic characteristics, menstrual knowledge and attitudes, menstrual practices and self-efficacy, and mental health problems measured using the Strengths and Difficulties Questionnaire Total Difficulties score (SDQ-25). We used random-effects linear regression to estimate the adjusted mean difference (aMD) for the association between mental health problems (SDQ Total Difficulties Score) and menstrual-related factors, including the Menstrual Practice Needs Scale (MPNS) and the Self-Efficacy in Addressing Menstrual Needs scale (SAMNS)), accounting for school-level clustering and adjusting for prior confounders. Results: Among the 3841 female participants, there was strong and consistent evidence of associations between mental health problems and menstrual-related factors. Mental health problems were associated with poor knowledge about menstruation (aMD = 1.17, 95%CI 0.50, 1.84 <0.001), using disposable and reusable menstrual products compared to using just disposable products (aMD = 1.42, 95%CI 0.92, 1.92, p <0.001), and experiencing menstrual pain even when using an effective management method at last menstrual period (LMP) compared to those experiencing no pain (aMD = 1.60, 95%CI 1.19, 2.01, p <0.001). Mental health problems were also associated with greater unmet menstrual needs according to the MPNS (aMD = 4.40 95%CI 3.96, 4.84, p <0.001), and with lower menstrual self-efficacy measured by the SAMNS (aMD = 0.94 95% CI 0.51, 1.37, p <0.001). Conclusion: This study shows strong evidence that mental health problems reported by adolescent girls in Uganda are associated with poor menstrual health. The association between menstrual health and mental health provides evidence as to why menstrual health should be a public health priority. Trial registration: Trial registration: ISRCTN 45461276. Registered on 16 September 2021. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the safety and efficacy of suture fixation of the levonorgestrel-releasing intrauterine device (LNG-IUD) by hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion, to provide a viable treatment option for these patients. Methods: Twenty-one patients with large symptomatic adenomyosis were sewed and fixed with the LNG-IUD in the uterus by hysteroscopy to prevent the device expulsion. Results: In this prospective case series, all 21 patients were successfully sewed and fixed with the LNG-IUD in the uterus by hysteroscopy. The amount of menstruation was significantly decreased and dysmenorrhea was significantly relieved in 3, 6, and 12 months after surgery compared with before surgery. Only one patient underwent a laparoscopic hysterectomy due to dysmenorrhea which was not alleviated one month later. Serious IUD complications including expulsion and perforation were not observed. There was no development of new side effects than LNG-IUD insertion. Conclusion: Our findings indicate that suture fixation of the LNG-IUD by hysteroscope is a safe, effective, and minimally invasive surgical procedure to prevent the device expulsion. It is a good solution for the treatment of large symptomatic adenomyosis and has shown to be effective in managing symptoms related to adenomyosis. [ABSTRACT FROM AUTHOR]

Background: Menstrual pain, or dysmenorrhea, can cause physical discomfort and mood swings, potentially impacting the attitudes of female nursing students toward marriage. Effective emotion regulation strategies are essential for managing stress and shaping their perspectives on marriage. This study sought to investigate the relationship between dysmenorrhea, emotional regulation skills, and attitudes toward marriage among female nursing students. Methods: A cross-sectional survey was conducted using a stratified sample of 504 female nursing students from four academic years. The study used a combination of the Working Ability, Location, Intensity, Days of Pain, Dysmenorrhea (WaLIDD) Questionnaire, the Marital Attitude Scale, and the Emotion Regulation Questionnaire to assess various factors among the participants. The Pearson correlation coefficient was utilized to examine the relationships among the three primary variables. Additionally, linear regression analysis was employed to forecast attitudes toward marriage based on factors such as dysmenorrhea, residence, family type, regularity of the menstrual cycle, and age at menarche. Results: The findings of the study are significant, revealing a negative correlation between dysmenorrhea and marital attitudes (r = -0.105, p = 0.019). Dysmenorrhea exhibited minimal and non-significant correlations with emotion regulation strategies, including cognitive reappraisal (r = -0.006, p = 0.898) and expressive suppression (r = 0.013, p = 0.774). In contrast, marital attitudes significantly influenced emotion regulation (β = -0.169, p < 0.001). Moderation analyses indicated significant effects of various factors on marital attitudes, including residence (β = -0.5136, p = 0.0478), family type (β = 5.9923, p = 0.0060), regularity of the menstrual cycle (β = 6.1262, p = 0.0014), and age at menarche (β = 1.5521, p = 0.0491). Conclusion: A significant negative correlation between dysmenorrhea and certain attitudes, specifically optimistic and realistic marital attitudes, was found. This indicates that higher levels of dysmenorrhea are associated with less favorable perspectives in these domains. Additionally, the study demonstrates that negative marital attitudes were linked to poorer emotional regulation. This suggests that individuals with more pessimistic views about marriage may face challenges in effectively managing their emotions. These results underscore the intricate connections between physical health, attitudes, and emotional well-being. They highlight the need to address dysmenorrhea within nursing education and practice, considering its broader psychological impact. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study was to compare the effectiveness of combined exercise training during different menstrual phases on pain, quality of life and menstrual symptoms. Methods: A total of 72 participants for the study were randomly assigned into three groups: Group 1 (N = 24), Group 2 (N = 24) and Group 3 (N = 24) which had undergone combined exercise training during the follicular, luteal and bleeding phases of their menstrual cycle, respectively. The treatment programme included combined exercise training involving deep breathing exercises, Kegel exercises, core strengthening exercises and stretching exercises. Exercises were repeated 5 times with hold duration of 15 s with total of 30–40 min session with 5–10 min of warm‐up and cooldown sessions. Demographic data and outcome measures (Visual Analogue Scale [VAS], Menstrual Symptom Questionnaire [MSQ], and Working ability, Location, Intensity, Days, Duration [WaLIDD]) were assessed at baseline and assessed again during the first menstrual cycle after the completion of the treatment programme. One‐way ANOVA was used for between‐group comparisons of the normally distributed data. Results: Within‐group comparison of the outcome variables except VAS in group 3 showed a statistically significant difference in all groups. Comparison of post‐intervention results of the outcome measures of all the groups revealed a statistically significant difference for the VAS, while there was no statistically significant difference for in between the comparison of the WaLIDD and MSQ scoring. Conclusion: Combined exercise training is effective in reducing pain only when performed during follicular and luteal phases and significantly improve quality of life and menstrual symptoms in all phases of the menstrual cycle. [ABSTRACT FROM AUTHOR]

Menstrual disorders are very common in women, with rates as high as 75%, and dysmenorrhea is the most commonly reported menstruation-related disorder. Dysmenorrhea is defined as a painful, cramping sensation in the lower abdomen, often accompanied by headache, nausea, vomiting and sweating. Studies on primary dysmenorrhea and its severity have investigated the effects of various demographic, physical, lifestyle and psychosocial factors. However, there is a need for a study that examines these factors together and comprehensively, especially in the Turkish population. This study aimed to determine the factors associated with primary dysmenorrhea in Turkish women. The study was a cross-sectional study conducted between May 2021 and December 2021. The study included 760 literate, reproductive-age women over 18 years of age. Personal Information Form and Beck Anxiety Scale were used to collect data. When the socio-demographic and lifestyle characteristics of the participants were compared, it was found that family history of menstrual pain (p=<.001) and alcohol use (p=.027) were associated with increased menstrual pain. Duration of menstruation (p=.026), duration of pain during menstruation (p=.005) and giving birth (p=.024) were associated with pain intensity. As the duration of menstruation increased, the severity of pain increased in those who stated that they experienced pain during menstruation and in those who did not give birth. When the severity of menstrual pain and anxiety levels of the participants were compared, it was determined that the severity of menstrual pain increased as the anxiety level increased (p=.026). Family history, alcohol use, duration of menstruation, giving birth and anxiety level were determined as risk factors for pain intensity in primary dysmenorrhea. [ABSTRACT FROM AUTHOR]

Background/Objectives: Adenomyosis is a debilitating gynecologic condition that affects both multiparous older women and nulliparous younger women, inducing a variety of symptoms such as dysmenorrhea, menorrhagia, and infertility. Thermal ablation techniques are new procedures that have been proposed for the treatment of adenomyosis. They include high-intensity focused ultrasound (HIFU), percutaneous microwave ablation (PMWA), and radiofrequency ablation (RFA). Because thermal ablation techniques are minimally invasive or noninvasive, fertility is not impaired while symptoms improve. In addition, hospital stays and financial costs are generally reduced, increasing the interest in these alternative management options. Methods: In this narrative review, we conducted a thorough literature search of PubMed/Medline from the database inception to September 2022. In our search, we focused on noninvasive treatment methods such as HIFU ablation, RFA ablation, and PMWA as well as adenomyosis-specific terms and noninvasive techniques (ultrasonography, ultrasound, or magnetic resonance imaging). The queries were a combination of MeSH terms and keywords. The search was limited to the English language. Abstracts were screened according to their content, and relevant articles were selected. Results: Overall, the results showed that the above-mentioned ablation techniques are effective and safe in providing adenomyosis treatment. Lesion size and uterus volume are reduced, leading to considerable symptom alleviation with all three methods. Positive results concerning safety and fertility preservation have been described as well. Conclusions: Nonetheless, more research is required in this field to compare the efficacy and safety of different ablation techniques with traditional therapies. Such research will help improve these procedures and their associated decision-making processes. [ABSTRACT FROM AUTHOR]

Background: Dysmenorrhea is a common condition that may have negative effects on social life, couples' relationships and professional activities. The objectives of this study were to evaluate the prevalence, risk factors and characteristics of dysmenorrhea and its impact on patients' quality of life using a specific self-questionnaire named "DysmenQoL questionnaire". We also checked the validity and reliability of this questionnaire in our population. Methods: We conducted a cross-sectional study that included 504 participants of reproductive age between 18 and 45 years of age. The data were collected with an original form divided into three sections. The last section (DysmenQoL questionnaire) included 20 statements scored from 1 ("never") to 5 ("every time") that evaluates the effects of menstrual pain on health and feelings, daily activities, relationships and professional activity. We calculated the sum of the scores for each statement and we called it the "DysmenQoL score". Results: The prevalence of dysmenorrhea was 83.7%. The presence of dysmenorrhea was statistically significant associated with the degree of menstrual bleeding (p = 0.017), the presence of infertility (p = 0.034) and dyspareunia (p = 0.002), but also with the presence of premenstrual syndrome and a family history of dysmenorrhea (p < 0.001). Among the participants with dysmenorrhea, 73.9% considered that this symptom affected their quality of life, and this was correlated with pain intensity and the DysmenQoL score (p < 0.001). A significant difference regarding the DysmenQoL score depending on the pain intensity, frequency and duration of dysmenorrhea and the methods used to reduce the pain was observed. Conclusions: Dysmenorrhea had a high prevalence among the participants included in the study, and its presence was associated with a series of risk factors. Most women considered that dysmenorrhea affected their quality of life. The DysmenQoL questionnaire proved to be a reliable and valid method for evaluating the impact of dysmenorrhea on quality of life. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What is the distribution of endometriosis phenotypes according to age in adult women undergoing surgery? SUMMARY ANSWER The phenotype of endometriosis did not significantly vary after 24 years old. WHAT IS KNOWN ALREADY The phenotypic evolution of endometriosis over time remains unclear. While adolescents can exhibit any type of endometriosis lesions, ovarian endometriosis (OMA) and/or deep-infiltrating endometriosis (DIE) tend to increase with age in young adults. In adulthood, understanding the evolution of lesions is crucial for disease management, but the literature on this subject is limited. This study aims to examine the distribution of endometriosis phenotypes in relation to age among adult patients requiring surgical treatment. STUDY DESIGN, SIZE, DURATION This observational cohort study included patients aged between ≥18 and ≤42 years, who underwent surgery for benign gynecological conditions at our institution between January 2004 and December 2022. A standardized questionnaire was completed for each patient during a face-to-face interview conducted by the surgeon in the month preceding surgery. Women with histologically proven endometriosis were included. PARTICIPANTS/MATERIALS, SETTING, METHODS The distribution of endometriosis phenotypes (isolated superficial (SUP) endometriosis, OMA ± SUP, DIE ± SUP/OMA) was compared between young adults (≤24 years) and adults (>24 years) and among adults (25–28 years, 29–33 years, 34–38 years, 39 to ≤42 years) using univariate and multivariate analysis. The distribution of different subtypes of DIE (uterosacral ligament(s), vagina, bladder, intestine, and ureter), OMA size, and intensity of pain symptoms were also examined. MAIN RESULTS AND THE ROLE OF CHANCE A total of 1311 adult women with histologically proven endometriosis were included. In women aged 24 years or younger (n = 116), the distribution of endometriosis phenotypes differed significantly from women older than 24 years (n = 1195): The frequency of the DIE ± SUP/OMA phenotype was lower (41.4% versus 56.1%, respectively), while the rate of isolated superficial lesions was higher (from 32.0% versus 25.9%) (P  = 0.001). In the group of women aged >24 years, a significantly higher proportion of vaginal DIE lesions (P  = 0.012) and a lower proportion of uterosacral ligament DIE lesions (P  = 0.004) were found compared to women aged ≤24 years. No significant differences were observed in terms of endometrioma size. Between the ages of 25 and 42 years, there were no significant changes in the distribution of endometriosis phenotypes after univariate and multivariate analysis. The distribution of subtype of DIE lesions did not significantly change with age between 25 and 42 years. Concerning pain symptom scores, there was a significant decrease with age for dysmenorrhea and dyspareunia. LIMITATIONS, REASONS FOR CAUTION Inclusion of only surgical patients may have introduced a selection bias. Women referred to our center may have suffered from particularly severe clinical forms of endometriosis. WIDER IMPLICATIONS OF THE FINDINGS This study highlights that endometriosis presentation did not change with age in adult women. Further research on endometriosis phenotype evolution is necessary to assist practitioners in clinical decisions and treatment strategies. STUDY FUNDING/COMPETING INTERESTS None declared. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

To evaluate the effect of relugolix combination therapy (relugolix CT; 40 mg relugolix, 1 mg estradiol, and 0.5 mg norethisterone acetate) for up to 2 years in the SPIRIT long-term extension study on functioning and health-related quality of life (QoL), using the Endometriosis Health Profile (EHP)-30 questionnaire, and assess how changes in QoL domains correlated with improvements in dysmenorrhea as well as nonmenstrual pelvic pain (NMPP). Long-term extension study of the SPIRIT phase 3 trials. Clinics and University Hospitals. Premenopausal women with moderate-to-severe endometriosis pain who previously completed the randomized SPIRIT trials were eligible to enroll in an 80-week long-term extension where all women received relugolix CT. Relugolix CT (relugolix 40 mg, estradiol 1 mg, and norethindrone acetate 0.5 mg). Least squares (LS) mean changes in the EHP-30 domain and total scores from baseline (pivotal) were analyzed using a mixed-effects model. Results up to 104 weeks are reported by a pivotal trial treatment group with a focus on the relugolix CT group (i.e., relugolix CT or placebo for 24 weeks, or delayed relugolix CT [relugolix 40 mg monotherapy for 12 weeks, followed by relugolix CT for 12 weeks]). In addition, the relationships between changes in dysmenorrhea and NMPP as well as changes in EHP-30 scores were assessed. In the 277 women treated with relugolix CT, LS mean EHP-30 pain domain scores improved by 57.8% (LS mean change: −32.8; 95% CI: −35.5, −30.1), 66.4% (LS mean change: −37.7; 95% CI: −40.3, −35.0), and 72.2% (LS mean change: −41.3; 95% CI: −43.9, −38.7) at weeks 24, 52, and 104, respectively. The proportions of women with clinically meaningful improvement in the EHP-30 pain domain were 75.9%, 83.6%, and 88.6% at weeks 24, 52, and 104, respectively. Non-pain EHP-30 domain and total scores likewise improved. A positive correlation between changes in dysmenorrhea/NMPP and all EHP-30 domain scores was observed. Results were similar for the delayed relugolix CT and placebo → relugolix CT groups. Sustained reduction of endometriosis-associated pain with relugolix CT observed up to 104 weeks was accompanied by improvements in functioning and health-related QoL. These findings complement the results of the pivotal SPIRIT trials, which showed that relugolix combination therapy significantly reduced dysmenorrhea, NMPP, and dyspareunia vs. placebo in premenopausal women with endometriosis-associated pain. Registration/clinicaltrials.gov identifier: SPIRIT Extension Study (NCT03654274). [ABSTRACT FROM AUTHOR]

Background: Heavy menstrual bleeding (HMB) and dysmenorrhea (DM) are common gynecological problems. Objective: To systematically review the needs, quality of life (QOL), and effectiveness of self‐management strategies among young women (12–25 years) with DM or HMB. Search Strategy: Relevant terms were searched through PubMed, EBSCO, Google Scholar, ProQuest, and Ovid between 2010 and 2022. Selection Criteria: Qualitative and quantitative studies published in peer‐reviewed journals, females aged 12–25, exploring DM or HMB, reporting supportive care needs, quality of life, self‐treatment strategies, and/or treatment‐seeking behavior. Data Collection and Analysis: Abstracts were reviewed for eligibility by two researchers. Included studies were extracted and assessed for quality independently by two authors, with discrepancies resolved through consensus or the involvement of a third researcher. Data extracted included study details, menstrual history, symptoms, self‐care strategies, and quality of life. The Joanna Briggs Institute checklists were used for quality assessment. Main Results: The search returned 285 190 studies, of which 55 were eligible for inclusion. Prevalence rates of HMB and DM were in the ranges 4%–63% and 42%–94%, respectively. Over 80% of young women with DM and HMB experienced physical and psychological problems, including pelvic pain, sleep issues, mood disturbance, diarrhea, and nausea. Academic performance and daily activities were severely affected. Most (>62%) named their mothers as their primary source of information, and friends as the secondary source (10%–65%). Few studies explored needs, but they could be inferred and fell under school‐related and social needs. QOL was poorer in those who had DM than those who did not. Pain was the most common issue that drove young women to find treatment. More than 70% used medication to reduce pain. More than half chose home remedies (e.g., heat therapy, massages, herbal tea, hot drinks). No studies provided information about the efficacy and dosage of medication and herbal remedies. Conclusions: HMB and DM have a large impact on daily living, with large areas of unmet need. Limited access to information impairs the management of symptoms and consequent QOL. Synopsis: Heavy menstrual bleeding and dysmenorrhea significantly affect daily life, leaving numerous unmet needs. Insufficient information hinders symptom management, leading to compromised quality of life. [ABSTRACT FROM AUTHOR]

The purpose of the current study is to examine the effect of a core exercise program on pain and quality of life, to reduce PD pain in young women. Young women aged 19–24 years primary dysmenorrhea were included in the study and followed for eight weeks. The primary outcome was the difference in visual analog scales core (VAS) and quality of life (Qol) scores between pre-exercise, week four, and week eight. Non-randomized controlled trial was performed at Necmettin Erbakan University. In the study, with in the group measurements, it was observed that the VAS value in the experiment group decreased significantly in the first 72 hours compared to the previous cycle, while there was no change in the control group. It was determined that the mean scores of physical function, physical role, vitality, socialfunction, which are sub-dimensions of Qol, increased in the experimental group after the exercise program (P < 0.05) An eight-week core exercise program, a non-pharmacological intervention, significantly reduced the severity of dysmenorrhea and menstrual symptoms in young women with primary dysmenorrhea, while also resulting in significantly improved SF36 quality of life in physical function, pain, vitality and so functions. [ABSTRACT FROM AUTHOR]

Aim: To investigate the clinical characteristics, diagnosis, and clinical treatment of submucosal cystic adenomyosis. Methods: The clinical data of five cases of patients with submucosal cystic adenomyosis in our hospital from January 2020 to June 2023 were retrospectively analyzed. Results: The average age of the patients was 37.8 ± 4.5 years old, three of them experienced prolonged menstruation and heavy menstrual bleeding. All patients had a history of abnormal uterine bleeding and mild to moderate dysmenorrhea, with a VAS score of 2.8 ± 1.6. The average Carbohydrate antigen 125 (CA125) value was 29.9 ± 23.6U/ml. Two out of the five patients (40%) had CA125 values above the upper limit of normal. The nodules had a diameter of 3.2 ± 1.3 cm and a cavity size of 1.3 ± 0.7 cm. Color ultrasound revealed hypo or iso or anechoic echoic cysts, and blood flow signals were detected. The magnetic resonance imaging (MRI) findings varied among each patient. All the patients underwent hysteroscopy and resection of uterine cavity-occupying lesions, and no recurrence was observed. Conclusions: The clinical features of submucosal cystic adenomyosis include abnormal uterine bleeding and menstrual changes, and the degree of dysmenorrhea is generally not severe. The diagnostic utility of CA125 in submucosal cystic adenomyosis may be limited. The three-dimensional ultrasound and MRI are valuable preoperative examination methods currently. Hysteroscopy can not only diagnose submucosal cystic adenomyosis, but also treat it, and preserve the fertility function of the patient. [ABSTRACT FROM AUTHOR]

Introduction: Fennel or Foeniculum vulgare is one of the herbal medicines that has a wide and different use in women's health. Considering the need to know about the application of this plant in women's health, this study was conducted with aim to consolidate the existing knowledge and to determine the applications of fennel in women's health. Methods: In this systematic review, clinical trial studies with fennel intervention on women were searched from databases among all articles, both Persian and English, without time limitation. The quality of the found clinical trials was reviewed by Jadad system and analyzed by using qualitatively analysis. Results: In this study, 38 clinical trial studies with fennel intervention in women's health were investigated. Of these 38 articles, 4 articles were found on the treatment of premenstrual syndrome, 14 articles on dysmenorrhea, 1 article on the prevention of postpartum dyspareunia, 2 articles on breastfeeding, 3 articles on polycystic ovary syndrome, 12 articles on menopause and 2 articles related to women's bone health. Fennel has been used in various forms of gel, powder, extract, capsule, oil, and vaginal cream. Since the methodology of the studies was heterogeneous in terms of quality, it was not possible to conduct a meta-analysis. Conclusion: Fennel has been used in women's health and treatment of premenstrual syndrome, dysmenorrhea, postpartum dyspareunia, breastfeeding, polycystic ovary syndrome, menopausal symptoms and bone health. On the other hand, due to the possibility of side effects such as the growth of breast tumors with the consumption of fennel and that these plants can be one of the important sources of heavy metals transfer to the human body and endanger human health, it is suggested to avoid excessive consumption of fennel. [ABSTRACT FROM AUTHOR]

Background: Dysmenorrhea is a menstrual pain that is often experienced by young women, with a global prevalence of 16.8-81%. In Indonesia, the prevalence reaches 54.89%, with adolescent girls being the largest group. Treatment generally uses analgesics, but it has side effects. Yoga as a non-pharmacological therapy can reduce pain through muscle relaxation. Purpose: Analyzing the effect of yoga therapy on the intensity of the degree of dysmenorrhea in female students of the Class of 2018 Undergraduate Medical Education Study Program, Faculty of Medicine, Andalas University. Methods: This research uses a pure experimental design with a pre-test, post-test, and only group design, with a sample size of 32 people. The research instrument used in the study was a pre-test and post-test questionnaire, which contained VAS scores and guidelines regarding yoga movements. The questionnaire contains a Visual Analog Scale (VAS), which consists of a vertical scale from 0 to 10 cm. Results: The results showed there were no differences related to age. As many as 18% of respondents usually took analgesics, while 81.3% did not take analgesics to treat dysmenorrhea before yoga therapy. Meanwhile, after yoga therapy, 5 out of 6 respondents who usually consumed analgesics in previous menstrual cycles no longer consumed analgesics, and one respondent still consumed analgesics. Bivariate analysis showed a value of p=0.00 (p<0.05), which means there is a relationship between the provision of yoga therapy and the degree of dysmenorrhea. Where providing yoga therapy can reduce the intensity of pain in respondents who experience dysmenorrhea. Conclusion: This research concludes that there is a significant relationship between the provision of yoga therapy and the degree of dysmenorrhea. [ABSTRACT FROM AUTHOR]

Background: Dysmenorrhea, characterized by painful menstrual cramps, significantly impacts the well-being of women globally. Despite its prevalence and adverse effects, dysmenorrhea is often underdiagnosed and inadequately treated. This study aims to validate the Arabic version of the Working ability, Location, Intensity, Days of pain, and Dysmenorrhea (WaLIDD) scale among Lebanese female university students aged 18– 45. Methods: This cross-sectional study, involving 729 participants, utilized a translated WaLIDD scale and the Depression, Anxiety, and Stress Scales (DASS-8). Results: Confirmatory Factor Analysis (CFA) confirmed the one-factor structure of the WaLIDD scale, demonstrating excellent fit indices, with good internal reliability. Concurrent validity analysis revealed significant associations between higher WaLIDD scores and elevated levels of depression, anxiety, and stress. The prevalence of dysmenorrhea in the study was estimated at 7.3%. Conclusion: The study underscores the importance of the WaLIDD scale as a reliable and valid tool for assessing dysmenorrhea among Arabic-speaking populations. The successful validation of the Arabic version facilitates its application in Lebanon and potentially other Arab regions, providing a universal tool to predict and assess dysmenorrhea and its impact. Further research is encouraged to explore the scale's applicability in clinical settings and tailor interventions for improved women's well-being. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the menstrual symptoms and dysmenorrhea in university students who underwent Female genital mutilation/cutting (FGM/C), in Mogadishu, Somalia, and students who did not undergo FGM/C in Ankara, Türkiye. Methods: A comparative cross-sectional study design was used. Results: Among the participants with FGM/C, 88.5% were Type 1 and the age at FGM/C was 8 years. The pain severity was 6.20± 2.54 in women with FGM/C and was higher than that of those without FGM/C (5.97± 2.32), but no significant difference was found. Among those who had FGM/C, 66% had a menstrual duration of 3– 5 days, while 52.0.% of those who did not have FGM/C had a menstrual duration of 6– 8 days (p< 0.05). While 85.1% of those without FGM/C had a menstrual cycle of 21– 35 days, 35% of those with FGM/C had a menstrual cycle of less than 20 days (p< 0.05). It was found that 95% of those who have undergone female circumcision and 90.2% of those who have not had dysmenorrhea (p< 0.05). Painkillers were always used by 28% of women with FGM/C and 26.3% of women without FGM/C (p< 0.05). The total MSS score of those who have not had FGM/C was 3.34± 0.72 and the score of those who have had FGM/C was 2.91± 0.74 (p< 0.05). The negative effects sub-dimension score was found to be higher in the non-FGM/C group with 3.20± 0.75, while the coping methods sub-dimension score was higher in the FGM/C group with 2.91± 1.13 (p< 0.05). Conclusion: FGM/C is still common in Somalia. Our study results showed that having FGM/C may cause differences in dysmenorrhea and menstrual symptoms. Efforts to increase students' effective coping with menstrual symptoms and dysmenorrhea are thought to be useful. [ABSTRACT FROM AUTHOR]

Dysmenorrhea treatment with 0.5 mg dienogest tablets twice daily (1 mg/day) has proven useful, but its effect on premenstrual disorders has not yet been evaluated. This study aimed to evaluate the efficacy of 0.5 mg dienogest tablets in relieving premenstrual syndrome (PMS)-like symptoms during the treatment of dysmenorrhea in comparison with that of continuous low-dose estrogen–progestin (LEP/COC) drospirenone/ethinylestradiol combination, which is considered effective in treating premenstrual dysphoric disorder. During the standard course of dysmenorrhea treatment with dienogest or LEP/COC, PMS-like symptoms were scored based on patients' reports, and the treatment effects were compared. As a result, the dienogest group experienced a significant improvement in PMS-like symptoms compared with the LEP/COC group over the 6-month study period (p < 0.01). Furthermore, dienogest was more effective in providing relief from PMS-like symptoms, with 89.7% of patients reporting a complete resolution of PMS-like symptoms at 6 months, compared with 47.1% in the LEP/COC group (p < 0.01). These results indicate that dienogest is effective in relieving PMS-like symptoms, similar to LEP/COC. Further studies are needed to determine whether 0.5 mg dienogest tablets, which are only available in Japan, are effective in treating premenstrual disorders diagnosed via standard methods. [ABSTRACT FROM AUTHOR]

Gestrinone (R-2323), or ethylnorgestrienone, is a synthetic steroid of the 19-nortestosterone group more commonly used as an oral, intravaginal, or subcutaneous implant for the treatment of endometriosis, contraception, and estrogen-dependent conditions such as hypermenorrhea, premenstrual dysphoria, and intense menstrual cramps. This review aims to reevaluate the routes, doses, and applicability proposed for using gestrinone, including its use in new conditions such as menopause, lipedema, and sarcopenia. Here, we present the possible application of gestrinone as a long-acting therapeutic possibility through hormonal implants and the benefits and potential risks. Available evidence on the safety of doses and routes is limited. Gestrinone appears to be effective compared to other progestins and may have some advantages in the treatment of estrogen-dependent pathologies. Future research must evaluate gestrinone's long-term safety and potential therapeutic indications. [ABSTRACT FROM AUTHOR]

Introduction: In 2021, the American Vein and Lymphatic Society convened a multi-disciplinary group to develop a valid and reliable discriminative instrument for the classification of patients suffering from pelvic venous disorders (PeVD) referred to as the Symptoms-Varices-Pathophysiology (SVP) system. Limited data exists regarding the utility of this instrument in the care of patients with PeVD. The goal of this investigation is to apply the SVP classification system to a group of patients treated for PeVDs. Methods: From January 2018 to January 2019, we retrospectively reviewed the records of 70 female patients treated for a PeVD at the Center for Vascular Medicine. Age, race, gender, medical/surgical histories, CEAP classification and intervention types were assessed and patients were categorized according to their SVP classification. The prevalence of each S and V class, their association with gonadal or iliac vein obstructive lesions and the prevalence of lower extremity varicosities was evaluated. Results: The average age of the entire cohort was 47.4 ± 13.4. The race distribution was as follows: African American (6), Hispanic (1), and Caucasian (63). Of the 140 limbs, 57% were C3 or greater with an average rVCSS score of 4.53. At the time of intervention, 54 patients (77%) demonstrated CEAP class 2 disease or greater with 25 patients (35%) demonstrating lower extremity varicosities. Medical co-morbidities included the following: Endometriosis (n = 1), Uterine Fibroids (n = 1), Ovarian cysts (n = 4), history of venous thrombosis (n = 2) and prior lower extremity venous procedures (n = 3). Overall, 47 patients (67.1%) demonstrated S2 disease secondary to dyspareunia, post-coital pain, or dysmenorrhea. S2 alone was observed in 17 patients (24.3%), S2,3a and S2,3a,3b in nine patients each (12.9%), and S2,3b was in 12 patients (17.1%). Thirteen patients presented with isolated extra-pelvic symptoms (19%); four (5.7%) were classified as S3a,3b, and nine (12.9%) were classified as S3b only. Finally, 10 patients (14%) had no pelvic symptoms and thus were classified as S0. V0 disease was observed in 17 patients (24.3%) secondary to a high incidence of iliac vein stenoses (IVS). V1 disease was observed in 1 patient (1.43%). V2 disease was observed in 53 patients (74.3%) secondary to iliac or ovarian vein reflux. Of these, 45 patients (64.3%) presented with reflux in the iliac veins. Sixteen patients had reflux in the common iliac veins, 17 patients exhibited reflux of the external iliac veins, and 41 patients demonstrated reflux of the internal iliac veins. Thirty-two patients (45.7%) presented with V2 disease secondary to reflux of the ovarian veins, 8 of whom presented with isolated ovarian vein reflux without IVS. Bilateral ovarian vein reflux was observed in 6 patients (9%) and unilaterally in 26 (37%) patients with concomitant ovarian vein reflux and IVS observed in 31 patients (44%). In patients with ovarian vein reflux, 89% had a concomitant iliac vein stenosis: (96.9% in the common iliac vein, 81.3% in the external iliac vein and 3.1% in the internal iliac vein). Conclusion: In our patient cohort, 70 women demonstrated 14 different SV classifications. The most common was S2V2, found in 10 patients. Chronic pelvic pain of venous origin, S2 disease, was the most common symptom, present in 47 patients (67.1%); followed by extra-pelvic symptoms as 22 patients demonstrated symptoms of the external genitalia (S3a), and 21 patients had symptoms secondary to the non-saphenous leg veins (S3b). Pelvic varicosities, V2, were also the most common variceal pattern seen in 53 patients, and 17 patients did not have any varices noted by venogram. Non-thrombotic IVS either alone or with ovarian vein reflux was the most common cause of PeVD in this cohort and may reflect referral patterns to our center. To determine the true incidence of these SVP patterns, larger cohort studies are necessary. [ABSTRACT FROM AUTHOR]

Purpose: Our study aimed to identify alterations in sleep, inflammatory mediators, fatigue and quality of life in women with dysmenorrhea and compare them to women without dysmenorrhea. Methods: The sample comprised 328 women from a Brazilian cross-sectional sleep study, EPISONO (2007), who had undergone 1-night polysomnography (PSG) type I and completed questionnaires related to sleep quality, daytime sleepiness, insomnia, fatigue, anxiety, depression, and quality of life. Blood samples were used to assess levels of interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein (CRP). The 2 groups were distributed based on the presence or absence of dysmenorrhea symptoms. Results: Sleep efficiency was significantly lower in the group of women with dysmenorrhea (82.5% ± 13.8) compared to the non-dysmenorrhea group (86.2% ± 10.9). Dysmenorrhea was associated with significantly higher scores of fatigue and worse scores in the physical quality of life. No statistical differences were detected in inflammatory markers between the 2 groups. Discussion: Fatigue and physical quality of life were presented in women with dysmenorrhea, as was reduced sleep efficiency, although no alteration on inflammatory markers were observed. Conclusion: These findings show that dysmenorrhea can have a deleterious effect on women's sleep, with repercussions on daily routines and quality of life. [ABSTRACT FROM AUTHOR]

A cross-sectional multinational collaborative study on women with endometriosis from Latin America and Spain uncovered high levels of painful symptomatology and high pain catastrophizing scores. Associations between pain perception/catastrophizing and race/ethnicity have been documented. This study was conducted to uncover factors moderating pelvic pain severity, including socioeconomic variables, self-identified race, and pain catastrophizing in women with endometriosis from Latin America and Spain, a population encompassing diverse racial and sociocultural contexts. Self-reported data on demographics, clinical history, Ob-Gyn history, pelvic pain intensity, and pain catastrophizing were collected with the Spanish World Endometriosis Research Foundation (WERF) Endometriosis Phenome Project (EPhect) Clinical Questionnaire (ECQ). Multiple logistic regression was conducted to analyze effects of self-identified race, demographic clusters (defined as countries with similar racial population distribution), socioeconomic factors, and pain catastrophizing on reporting severe vs moderate-mild levels of dysmenorrhea, dyspareunia, and pelvic pain. Self-identified race did not affect the likelihood of reporting severe pelvic pain; however, there were significant differences in reporting severe dysmenorrhea at worst among demographic clusters. Older age was associated with severe dyspareunia at worst and recent pelvic pain. Pain catastrophizing score was highly predictive of reporting most types of severe pelvic pain, regardless of race and demographic cluster. These results negate a role of racial categories as moderator of pain in women from Latin America and Spain and support integration of pain catastrophizing assessments and psychological interventions into the pain management plan to enhance therapeutic outcomes and QoL for patients with endometriosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether an early need of hormonal contraceptive (HC), or a failure to find a suitable method, are warning signs for endometriosis. Design: A retrospective cohort study. Setting: Sweden. Population: The cohort consisted of 720 805 women aged 12–27 years during the period 2005–2017. All women, regardless of whether they received a diagnosis of endometriosis or not (reference group), were included. Methods: We used data from Swedish national registers. Risks are expressed as crude and adjusted hazard ratios (HRs and aHRs, respectively) with 95% confidence intervals (95% CIs), adjusted for age, education level, civil status, parity, country of birth, and diagnoses of infertility, dysmenorrhea or depression. Main outcome measures: A diagnosis of endometriosis between 12 and 27 years of age. Results: During this period, 3268 women were diagnosed with endometriosis (0.45%). Women who started HC at the ages of 12–14 years had a higher risk of receiving the diagnosis (aHR 2.53, 95% CI 2.21–2.90) than those who began at age 17 years or older. Having tried more types of HCs was associated with a twofold increased risk of endometriosis (more that three types of HC, aHR 2.31, 95% CI 1.71–3.12). Using HC for more than 1 year was associated with a decreased risk of endometriosis (>1 year, aHR 0.53, 95% CI 0.48–0.59). Women with endometriosis more commonly had dysmenorrhea, depression or infertility. Conclusions: The use of HCs at an early age and a failure to find a suitable HC were identified as warning signs of later receiving an endometriosis diagnosis. A longer duration of HC usage reduced the risk of receiving the diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Clinical characteristics of patients with endometrioma without dysmenorrhea have not been well delineated; our goal was to remedy this issue by performing a retrospective cohort study. Methods: A total of 379 patients who underwent laparoscopic surgery for endometrioma ≥4 cm at a tertiary hospital were included in this retrospective study. Patients were divided into two groups based on the presence of dysmenorrhea at the time of hospital visit; with dysmenorrhea group and without dysmenorrhea group. Results: Patients without dysmenorrhea comprised 9.5% of all surgically confirmed endometriomas. Significant differences were found in the revised American Society for Reproductive Medicine (rASRM) stage, age at surgery, and bilaterality. Patients with rASRM stage IV were more likely to have dysmenorrhea than were subjects with rASRM stage III (odds ratio (OR), 10.58; 95% confidence interval (CI), 4.63–24.21; P < 0.001). Older patients were less likely to have dysmenorrhea (OR, 0.94; 95% CI, 0.88–1.00; P = 0.045), as were patients with bilateral rather than unilateral endometrioma (OR, 0.36; 95% CI, 0.15–0.82; P = 0.015). No significant differences in cyst size, age at menarche, body mass index (BMI), parity, or history of previous ovarian surgery were found between the two groups. Conclusion: Patients without dysmenorrhea comprised 9.5% of endometrioma cases and had less advanced rASRM stage, were older at surgery, and had a higher probability of bilateral than unilateral endometrioma than patients with dysmenorrhea. Synopsis: Patients without dysmenorrhea had less advanced rASRM stage, were older at surgery, and had a higher probability of bilateral than unilateral endometrioma. [ABSTRACT FROM AUTHOR]

Introduction: Presence of deep infiltrating bowel endometriosis (DE) is associated with occurrence of dyschezia and gastrointestinal symptoms. The degree of the disease, the lesion length, and the location, that is, lesion‐to‐anal‐verge distance (LAVD) of DE, as well as the severity of the symptoms appear to be correlated. Nevertheless, it is not yet known to what extent the size and LAVD of bowel DE influence the severity of gastrointestinal symptoms. The present study aims to evaluate a possible correlation of lesion location (LAVD) and size (according to the #Enzian classification) with preoperative symptoms. Material and Methods: In this prospective study, premenopausal patients with histologically confirmed DE undergoing modified limited nerve‐vessel sparing rectal segmental bowel resection or full‐thickness discoid resection were evaluated. Extent of endometriosis was defined according to the #Enzian classification during surgery. The primary outcome measure was the correlation between lesion size and location with the GI function impairment reflected by presurgical lower anterior resection syndrome (LARS) scores; the secondary outcome was differences in presurgical numeric rating scale pain scores of dyschezia, dyspareunia, and dysmenorrhea as well as the impact of concomitant DE of other locations on symptom intensity. Results: Of 162 consecutive patients, 151 were included in the final analysis. No significant correlation was observed between lesion size (#Enzian compartments C1/C2/C3) or LAVD and GI dysfunction reflected by LARS‐like symptoms (p = 0.314 and p = 0.185, respectively) or pain symptoms (dyschezia, p = 0.440; dyspareunia, p = 0.136; and dysmenorrhea p = 0.221). Furthermore, no significant correlation was observed between lesion size and GI dysfunction when merging two severity grades (#Enzian compartments C1 plus C2 vs. C3; p = 0.611). In addition, LAVD did not affect the degree of dyschezia (p = 0.892), dyspareunia (p = 0.395), or dysmenorrhea (p = 0.705). Finally, the presence of concomitant DE lesions infiltrating the vagina/rectovaginal space (#Enzian compartment A) and/or sacrouterine ligaments/parametrium (#Enzian compartment B) did not alter the severity of preoperative dyschezia (p = 0.493) or dysmenorrhea (p = 0.128) but showed a trend toward affecting gastrointestinal function (p = 0.078) and was significantly associated with dyspareunia (p = 0.035). Conclusions: In present study, we could not find a correlation between colorectal DE lesion size and location (LAVD) and gastrointestinal function impairment or intensity of dyschezia and dysmenorrhea. Additional involvement of vagina/rectovaginal space (#Enzian compartment A) and/or sacrouterine ligaments/parametrium (#Enzian compartment B) exerts a significant impact on the degree of dyspareunia in women with colorectal DE. [ABSTRACT FROM AUTHOR]

The article explores the relationship between contraception, specifically intrauterine systems (IUSs), and depression. It emphasizes the importance of reliable contraceptive methods for women's health and gender equality. The article presents mixed findings from studies on the potential effects of contraceptive preparations on mental health, with some evidence suggesting modest protective effects for women with previous mental disorders or dysphoric mood symptoms associated with menstrual cycle changes. It then focuses on a recent study that found a potential increased risk of depression within 12 months of using the levonorgestrel intrauterine system (LNG-IUS), with a higher risk associated with higher dosages. The article concludes by highlighting the need for healthcare professionals to be aware of potential mood symptoms and psychological changes associated with hormone preparations and to provide counseling on the risks and benefits of these methods. Further research is needed to determine if these symptoms are reversible after IUS removal. [Extracted from the article]

To assess the knowledge of ovulation and menstruation of adolescent females in Western Australia. A validated adolescent ovulatory menstrual health literacy questionnaire was used in a cross-sectional study, which included an open-response question inviting participants' reflections. Participants (n = 297) were from two single sex and seven coeducational schools of varied socio-educational advantage. Mean chronological age was 15 years and mean gynecological age was two years. The prevalence of dysmenorrhea was 69%. Primary sources of information included mothers (91%), friends (61%), and for postmenarchel participants (n = 274), mobile applications (52%). Most adolescents enjoyed finding out information about ovulatory menstrual health, and understood the information given to them. However, participants' knowledge of ovulation, menstruation and their occurrence in the cycle were low. Attendance at a single sex or Catholic school or use of mobile applications did not confer a knowledge advantage overall (P <.05), except for knowing the meaning of cervical mucus. Thematic content analysis of open-ended responses resulted in five themes, including normality, menstrual flow, charting, ovulation, and dysmenorrhea. Inadequate functional ovulatory menstrual health literacy hampers progression to acquiring complete health literacy. This has negative implications for progressing towards the interactive and critical ovulatory menstrual health literacy domains, which include providing an accurate menstrual history when engaging with healthcare providers. [ABSTRACT FROM AUTHOR]

Premenstrual syndrome (PMS), dysmenorrhea, and abnormal uterine bleeding are frequent gynecological problems in adolescent girls. Studies show that sleep disorders and menstrual cycle irregularities are common conditions and indicate that they may occur together. Studies on the relationship between sleep quality and menstruation are mostly available for late adolescents (17 years and older) and young adult age groups. Our study aims to evaluate this relationship in adolescents aged 12-18. A survey study was structured and consisted of 4 sections. The first section includes anthropometric measurements and medical history of the participants; the second section includes "menstruation and menstruation symptoms history"; the third section includes "The Sleep Quality Scale and Sleep Variable Questionnaire"; and the fourth section includes the "Premenstrual Syndrome Assessment Scale" (PMSAS). Our survey was applied to those who visited the adolescent medicine outpatient clinic. The Sleep Quality Scale score was significantly lower in those with high PMSAS scores (P <.001). The participants who had dysmenorrhea and experienced other symptoms during menstruation had significantly lower SQS scores and sleep efficiency (SE) (P <.001). There was no significant difference between heavy menstrual bleeding, defined as lasting more than 7 days, requiring more than 5-6 pads/tampons per day, and SE/quality (P >.05). According to our study, dysmenorrhea and the presence of PMS may negatively affect the sleep quality of adolescents. Health professionals dealing with young people should take into account the effects of menstrual problems on sleep quality and offer appropriate support/treatment options. [ABSTRACT FROM AUTHOR]

Background: This study examined the improvement of dysmenorrhoea and menorrhagia after uterine artery embolisation (UAE) in women with symptomatic adenomyosis and identified factors that could predict the improvement of dysmenorrhoea and menorrhagia. Methods: This retrospective study included women with adenomyosis who underwent bilateral UAE between December 2014 and December 2016. The percentage of the volume of the absence of contrast enhancement on T1-weighted images was evaluated 5-7 days after UAE. A receiver operating characteristic (ROC) analysis was used to determine a cut-off point and predict the improvement of dysmenorrhoea and menorrhagia. Results: Forty-eight patients were included. At 24 and 36 months after UAE, the improvement rates for dysmenorrhoea and menorrhagia were 60.4% (29/48) and 85.7% (30/35), and the recurrence rates were 19.4% (7/36) and 9.1% (3/33), respectively. Only the percentage of the volume of the absence of contrast enhancement on T1-weighted images was associated with the improvement of dysmenorrhoea (p = 0.001, OR = 1.051; 95% CI: 1.02-1.08) and menorrhagia (p = 0.006, OR = 1.077; 95% CI: 1.021-1.136). When the cut-off value of the ROC analysis was 73.1%, sensitivity, specificity, positive predictive value, and negative predictive value for the improvement of dysmenorrhoea were 58.6%, 94.7%, 94.4%, and 60%, while they were 58.9%, 80%, 100%, 100%, and 45.5% for the improvement of dysmenorrhoea. Conclusion: Bilateral UAE for symptomatic adenomyosis led to good improvement of dysmenorrhoea and menorrhagia. The percentage of the volume of the absence of contrast enhancement on T1-weighted images of the uterus in postoperative magnetic resonance imaging might be associated with the improvement of dysmenorrhoea and menorrhagia. [ABSTRACT FROM AUTHOR]

Headache and visceral pain are common clinical painful conditions, which often co-exist in the same patients. Numbers relative to their co-occurrence suggest possible common pathophysiological mechanisms. The aim of the present narrative review is to describe the most frequent headache and visceral pain associations and to discuss the possible underlying mechanisms of the associations and their diagnostic and therapeutic implications based on the most recent evidence from the international literature. The conditions addressed are as follows: visceral pain from the cardiovascular, gastrointestinal, and urogenital areas and primary headache conditions such as migraine and tension-type headache. The most frequent comorbidities involve the following: cardiac ischemic pain and migraine (possible shared mechanism of endothelial dysfunction, oxidative stress, and genetic and hormonal factors), functional gastrointestinal disorders, particularly IBS and both migraine and tension-type headache, primary or secondary dysmenorrhea and migraine, and painful bladder syndrome and headache (possible shared mechanisms of peripheral and central sensitization processes). The data also show that the various visceral pain–headache associations are characterized by more than a simple sum of symptoms from each condition but often involve complex interactions with the frequent enhancement of symptoms from both, which is crucial for diagnostic and treatment purposes. [ABSTRACT FROM AUTHOR]

Purpose: To provide a method for the differential diagnosis of Robert's uterus with adenomyosis, a rare uterine malformation, and determine the best course of treatment. Methods: A patient who had Robert's uterus with adenomyosis was admitted to our hospital in December 2022. We analyzed and summarized her case. Results: Our patient complained of progressively worsening primary dysmenorrhea over the course of 3 years and lower abdominal pain lasting for 2 days. Her carbohydrate antigen 125 (CA125) level was 372.10 U/mL. Examinations conducted by several hospitals indicated that she had a single-horned uterus and a residual horned uterus, and our hospital's examination identified Robert's uterus. This malformation was corrected by open abdominal surgery. For the procedure, pelvic adhesions were first isolated, after which the closed uterine cavity and adenomyosis were resected. Subsequently, the left ovarian endometriosis cyst was resected and right tubal ligation was performed. After surgery, three injections of gonadotropin-releasing hormone A (GnRH-A) were administered, which lowered the patient's CA125 level to 14 U/mL and normalized her condition. Conclusion: We pioneered a new therapeutic approach for the treatment of Robert's uterus with adenomyosis. Some valuable references are provided for clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: One sign of maturity of the reproductive organs in young women is menstruation and it can be accompanied by dysmenorrhea. Studies show that the incidence of dysmenorrhea is high and it has a wide impact. Abdominal exercise is a non-pharmacological therapy that can be done easily. This study aimed to determine the effectiveness of abdominal exercise in reducing the intensity of dysmenorrhea in young women. Materials and methods: TSample in this study were 35 young women taken by simple random sampling technique. Dysmenorrhea intensity was measured with a numerical pain scale (1-10). Pretest on 2nd day of menstruation, 30 minutes abdominal exercise for 7 days before next cycle and posttest measured on the 2nd day of the next menstrual cycle. Data analysis used the Wilcoxon test. Results: Study showed that the intensity of dysmenorrhea before doing abdominal exercise was mostly on a scale of 7-9 (severe pain) and after doing abdominal exercise, most of it was on a scale of 4-6 (moderate pain). The intensity of dysmenorrhea was lower and significantly different after doing abdominal exercise (Z value=-4.64; p<0.001). Conclusion: It can be conclude that abdominal exercise reduces dysmenorrhea in female adolescents. [ABSTRACT FROM AUTHOR]

Objective • To investigate the clinical characteristics and prognostic factors in patients with endometriosisassociated ovarian cancer. Methods • In this study, we retrospectively analyzed the medical records of 135 ovarian cancer patients admitted to our hospital from January 2016 to January 2018. Based on the presence of concomitant endometriosis (EMs), the patients were divided into two groups: the Endometriosis- Associated Ovarian Cancer (EAOC) group (n=64) and the non-EAOC (NEAOC) group (n=71). We compared the clinical characteristics of the two groups. Additionally, in the EAOC group, we followed up with patients for 5 years, categorized them into the survival group (n=40) and the deceased group (n=24) based on their prognosis, and conducted univariate and multivariate logistic regression analyses to identify influencing factors. Results • In comparison to the NEAOC group, patients in the EAOC group exhibited higher rates of menopause occurrence, pathological stages I-II, vaginal bleeding, and history of cesarean section, with statistical significance (P < .05). They also had a lower incidence of dysmenorrhea, lymph node metastasis, and abdominal distension, as well as an earlier age of onset, all of which were statistically significant (P < .05). There were no statistically significant differences (P > .05) between the two groups in terms of parity, gravidity, tumor diameter, abdominal pain incidence, and body mass index. Based on prognosis, the patients were categorized into a survival group (n=40) and a deceased group (n=24). Comparison between the two groups showed statistically significant differences (P < .05) in terms of postoperative residue, epithelial-mesenchymal transition, and lymph node metastasis. In contrast, there were no statistically significant differences (P > .05) in terms of tumor laterality, histological type, tumor stage, differentiation degree, and vaginal bleeding. The variables with P < .05 were assigned as independent variables, with the prognosis of death as the dependent variable. Multivariate logistic regression analysis revealed that epithelial-mesenchymal transition and lymph node metastasis were independent risk factors for mortality in EAOC patients (P < .05). Conclusion • Clinical characteristics of EAOC patients show significant differences, with epithelial-mesenchymal transition and lymph node metastasis being identified as independent adverse prognostic factors associated with poor outcomes in EAOC patients. However, this study has limitations such as a relatively small sample size, and further research is therefore necessary. [ABSTRACT FROM AUTHOR]

Background • The use of plant medications in Unani medicine has been suggested to alleviate pain and related symptoms associated with primary dysmenorrhea, thus enhancing the overall quality of life. The purpose of the current study was to evaluate and compare the efficacy of Zarawand Mudaharaj (Aristolochia rotunda L.) and Qust (Saussurea lappa C.B. Clarke) in treating primary dysmenorrhea. Methods • This single-blind, randomized comparative study was conducted on patients with primary dysmenorrhea aged 18-35 years. The study participants were randomly allocated into Group A and Group B. Group A received Zarawand Mudaharaj 2 g twice daily with 5 mL honey while Group B received Qust 1.5 g twice daily with 5 mL honey from the 1st to the 5th day of their menstrual cycles for three consecutive cycles. The primary outcome measures were changes in pain severity measured on a 10 cm Visual Analog Scale (VAS) and changes in Verbal Multidimensional Scoring System (VMSS) grades. The secondary outcome measures included changes in Health-Related Quality of Life (HRQoL) measured on short form health survey-12 (SF-12) and changes in the symptoms such as pain during menstruation, lowbackache, nausea, vomiting, diarrhoea, giddiness, and headache. Results • Both groups showed a significant improvement in VMSS grade at all follow-ups compared to baseline (P < .0001). Group B showed better performance than Group A in changing the VMSS grade at the third cycle (P = .02) and the final follow-up (P = .002). Group B also had a more significant reduction in mean ± SD VAS score from baseline (6.43 ± 1.57) to the final follow-up (2.67 ± 1.69) (P < .0001) compared to Group A. Conclusion • The preliminary findings of the study support the use of Zarawand Mudaharaj and Qust in the treatment of primary dysmenorrhea, which is consistent with the traditional knowledge of Unani scholars. [ABSTRACT FROM AUTHOR]

This article is a review on the effects of commonly used analgesics on sleep architecture. It discusses the bidirectional relationship between sleep and pain, as well as the negative effects of insufficient sleep on bodily functions. The authors focus on the effects of analgesics on sleep in patients with persistent pain and in healthy volunteers, including drugs such as paracetamol, NSAIDs, opioids, tricyclic and dual-action antidepressants, and gabapentinoids. The article provides a table summarizing the effects of these drugs on sleep parameters and pain levels. It emphasizes the importance of further research in this field to identify optimal treatment strategies. Additionally, there are two documents that provide references to scientific studies exploring the relationship between sleep and pain, as well as the effects of medications on sleep quality and pain. These studies offer valuable insights for researchers and individuals interested in understanding and managing these conditions. [Extracted from the article]

Cardiovascular disease is a leading cause of death worldwide, affecting the quality of life of patients. The management of cardiovascular disease faces challenges in integrating clinical practice with updated diagnostic methods and treatment. Artificial intelligence shows promise as a diagnostic tool for cardiac disease, but it is limited without the support of clinicians. The article also discusses various diagnostic and treatment approaches for specific heart pathologies, such as noninvasive diagnostic methods and minimally invasive intervention techniques. The use of artificial intelligence and innovative prosthetic heart valve devices are also explored. The article concludes by emphasizing the importance of combining clinical examination, symptom identification, laboratory tests, and appropriate diagnostic examinations with the potential benefits of artificial intelligence in diagnosing severe heart disease. [Extracted from the article]

Cross-sectional studies indicate that menstrual problems are related to poorer mental health; however, longitudinal studies are limited. This longitudinal study aimed to determine whether baseline menstrual characteristics were risk factors for incident and persistent mental health problems. The study was conducted among Chinese adolescent girls. Menstrual characteristics including menarche, menstrual cycle and menstrual pain were assessed at baseline, whereas mental health problems including PTSD, depression, anxiety, ADHD, insomnia, psychotic-like experiences, non-suicidal self-injury, suicide ideation, suicide plan, and suicide attempt were assessed at baseline (n = 1039) and at the 1-year follow-up (n = 946) by self-administered, structured questionnaires. Multiple logistic regressions were performed to examine whether menstrual characteristics were associated with incident (e.g., PTSD at follow-up but not baseline) and persistent (e.g., PTSD at both time points) mental health problems. The results demonstrated that early menarche was related to persistence of psychotic-like experiences; irregular menstruation was associated with higher rates of incident anxiety and insomnia, and persistent depression, anxiety, ADHD, insomnia, non-suicidal self-injury, suicide ideation, and suicide plan; menstrual pain was associated with elevated rates of incident PTSD and depression, and persistent depression, insomnia, psychotic-like experiences, non-suicidal self-injury, suicidal ideation, suicide plan, and suicide attempt. In conclusion, irregular menstruation and menstrual pain specifically contributed to the development of emotional problems and insomnia, and were associated with maintenance of the most mental health problems in early adolescence. The long-term effects of menstrual problems on mental health need further study. [ABSTRACT FROM AUTHOR]