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Purpose Internal cervical os (ICO) stiffness is related to menstrual pain, a key symptom of endometriosis. The study evaluated whether women with endometriosis have a stiffer ICO than unaffected women. Methods A retrospective cross-sectional analysis was conducted using prospectively collected data from women with and without endometriosis, spanning from June 2020 to September 2022. Endometriosis was diagnosed through clinical and ultrasound evaluations, with histological confirmation in a subset of participants. Strain elastography (SE) was employed to measure tissue elasticity in four cervical regions of interest: the ICO and the anterior, posterior, and middle cervical compartments (ACC, PCC, and MCC, respectively). Tissue elasticity was quantified using a color-based scoring system ranging from 0.1 (blue, indicating less elasticity) to 3.0 (red, indicating greater elasticity). Results Overall, 287 women were included, with 157 diagnosed with endometriosis and 130 controls. On SE, women with endometriosis exhibited a lower color score (mean±standard deviation), indicating lower elasticity, for the ICO (0.56±0.28 vs. 0.70±0.26, P=0.001) and PCC (0.69±0.30 vs. 0.80±0.27, P=0.002). Additionally, they had a lower ICO/MCC ratio (0.45±0.28 vs. 0.60±0.32, P=0.001) and ICO/ACC ratio (0.68±0.42 vs. 0.85±0.39, P=0.001). Multiple logistic regression analysis revealed that endometriosis was associated with the ICO color score (odds ratio, 0.053; 95% confidence interval, 0.014 to 0.202; R2=0.358; P=0.001), even after adjusting for confounding factors like the presence of myomas (P=0.040) and the use of hormonal therapy (P=0.001). The results were corroborated in women with histologically confirmed endometriosis (n=71). Conclusion The findings suggest a potential relationship between a stiffer ICO and endometriosis.

Endometriosis is one of the most significant disorders affecting women of all ages, including adolescents. Its prevalence is estimated at an average of 15 %, but data in adolescents is lac­king and the real data may be significantly higher. Endometriosis in adolescents is a global medical, social and economic problem, as the associated symptoms worsen the quality of life, reduce the level of socialization, have negative impact on health indicators and quality of life, affect future reproductive capabilities and increase economic costs. For a long time, endometriosis was considered as a disease of women of reproductive age; however, now it is known that it affects women of all ages. In adolescent girls, endometriosis is understudied, sometimes ignored, or unrecognized that leads to delays in diagnosis and, consequently, in treatment. The aim of this review was to analyze clinical manifestations of endometriosis in adolescents, factors associated with the risk of development and progression of the disease, and the peculiarities of diagnosis and treatment in adolescence. Understanding the features of this disease, its symptoms, diagnosis, and treatment in adolescents will significantly improve the quality of life, control the disease, and enhance future reproductive capabilities.

Abstract 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

Abstract 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

Objective To investigate the expression levels of nerve injury-induced protein 1 (Ninjl), interleukin-1β(IL-1β), and protein gene product 9.5 (PGP-9.5) in the ectopic endometrial tissues of patients with endometriosis (EMT) and their relationship with dysmenorrhea. Methods Ectopic endometrial tissues from 40 patients with ovarian EMT diagnosed by post-ope-rative gynecological pathological examination in our hospital from April 2020 to April 2021 were selected as group A. In situ endo-metrial tissues from 20 of these patients were obtained as group B. Normal endometrial tissues from 20 patients with uterine fi-broids in the same period were collected as group C. Group A was divided into a dysmenorrhoea subgroup and a non-dysmenorrhoea subgroup according to the presence or absence of dysmenorrhoea, with 20 patients per subgroup. The expression levels of Ninj1, IL-1β, and PGP-9.5 in the endometrial tissues of groups A, B, and C were measured by immunohistochemistry, and their correlation was analyzed. The expression level of IL-1β in the peripheral blood of patiens in groups A and C was measured by enzyme-linked immunosorbent assay. Results The expression level of IL-1β in the peripheral blood of patients in group A was signifi-cantly higher than that in group C (t=-4.184,P

Background : Constant chronic dysmenorrhea pain, should be screened with a single morning serum cortisol concentration. Uncontrolled pain (acute and chronic) initially indicates high serum cortisol concentrations. Then, one of the factors that can influence pain during menstruation is stress. Objectives : This study aims to assess non-pharmacological interventions for facial acupressure (BL-2, Yin Tang, GV 23, GB 15, Tai Yang, GB 14, Ex Hn4, TE 23, Sang Ming , LI-20, Ex Hn 8, ST-3, Si 18, Du 26, REN 24, JiaCenjiang, SJ21, SJ17, GB-2) combined with Mozart classical music in reducing cortisol levels, depression and stress in dysmenorrhea primary. Methods: This is quantitative research with a quasi-experimental design. The research approach used is pre-post test design. In November 2021-January 2022 at Megarezky University Makassar. There were 42 Adolescents with Primary Dysmenorrhea for respondents to this research. The sample in this study was divided into three groups, namely an intervention group (combination of facial acupressure with classical music) and 2 control groups which were only given classical music and facial acupressure treatment. Data collected included depression and stress. In addition, cortisol levels were checked using an ELISA Kit. Then the data was analyzed using the Paired T-test, while to see the differences if it was normally distributed using the One Way Anova test and if it was not normally distributed using Kruskal-Wallis. Results: The results of the study found that there was a decrease in cortisol levels, depression and stress when given facial acupressure and classical music, but the reduction was more effective if a combination of facial acupressure and classical music.Conclusions: Among the variables of cortisol levels, depression and stress, the combination of facial acupressure and classical music was significantly more effective in improving stress than just giving facial acupressure and classical music.

Objective: The objective of this study is to determine the prevalence of dysmenorrhea and to assess the predictors of pain intensity during dysmenorrhea among female medical students at Rawalpindi Medical University. Study Design: Descriptive Cross-sectional study Place and Duration of Study: The study was conducted from May 2023 to October 2023 at Rawalpindi Medical University. Materials and Methods: A validated, self-structured and self-administered 24 items questionnaire regarding dysmenorrhea was used to assess the prevalence and pain intensity of dysmenorrhea focused on 277 undergraduate medical students, excluding those with any pre-existing pelvic pathology. Participants were selected through convenience sampling and data was analyzed using SPSS version 26. Results: The study involved 277 female medical students, showing an 83.2% dysmenorrhea prevalence. Based on visual analog scale, most of the research participants experienced moderate to severe pain (49.6%), along with symptoms like depressed mood (50.7%) and mood swings (51.4%). Common outcomes were limited daily activities (57.5%) and emotional instability (55%). Heavy bleeding (p=0.041, OR=3.56) and stress (p=0.041, OR=2.108) were significant predictors. BMI and caffeine consumption showed no significant improvement, but the pain's duration during periods significantly affected pain scale scores, with the "more than 3 days" group reporting the most severe pain. Conclusion: Dysmenorrhea is widespread among female medical students, causing substantial disruptions in their daily routines. This condition is closely linked to heavy bleeding and stress, highlighting the importance of addressing these factors. Understanding the timing and duration of pain during the menstrual cycle is crucial for developing effective treatment strategies.

Patrick Sami Bou Haidar,1,* Desiree N Alam,1,* Sahar Obeid,2 Diana Malaeb,3 Mariam Dabbous,4 Fouad Sakr,4 Sami El Khatib,5,6 Rabih Hallit,1,7,8,* Feten Fekih-Romdhane,9,10,* Souheil Hallit1,11,12,* 1School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon; 2School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon; 3College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates; 4School of Pharmacy, Lebanese International University, Beirut, Lebanon; 5Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon; 6Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology (GUST), Hawally, Kuwait; 7Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon; 8Department of Infectious Disease, Notre Dame des Secours, University Hospital Center, Byblos, Lebanon; 9The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, Manouba, 2010, Tunisia; 10Faculty of Medicine of Tunis, Tunis El Manar University Tunis, Tunis, Tunisia; 11Department of Psychology, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia; 12Applied Science Research Center, Applied Science Private University, Amman, Jordan*These authors contributed equally to this workCorrespondence: Souheil Hallit, School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon, Email souheilhallit@usek.edu.lbBackground: 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.Keywords: dysmenorrhea, psychometric, scale, Arabic

Abstract 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.

Background: Limited research has delved into the effects of work characteristics on premenstrual symptoms (PMS) in women, which can influence work performance and overlook potential hazards for women in their work environments. This study aimed to investigate the impact of shift work and working in a clean room on premenstrual symptoms, menstrual status, and menstrual pain among employed females in an electronics manufacturer. Methods: A retrospective cohort study was conducted on menstruating female employees between August and December 2014, aged 18–55, who received regular employee health checks. Questionnaires were designed to collect information on demographics, personal lifestyle, menstrual status, menstrual pain scores, and self-reported premenstrual symptoms. Results: Among 7,193 participants, 18.6% reported moderate to severe menstrual pain affecting their work. Female workers who reported shift work showed an increased prevalence of moderate to severe premenstrual symptoms, including fatigue (RR = 1.20), somatic discomforts (RR = 1.04), diarrhea (RR = 1.04), and tension (RR = 1.05). Additionally, shift work was associated with an elevated risk of experiencing a moderate or significant impact of menstrual pain on work (RR = 1.03), menstrual irregularity (RR = 1.30), and high menstrual pain (RR = 1.23). Working in a clean room was associated with an increased risk of high menstrual pain (RR = 1.13). Subjects working shifts in a clean room had the highest pain scores compared to the other groups. Conclusion: This study underscores the association of work-related factors on PMS in female employees. Our findings contribute to a better understanding of premenstrual symptoms in female workers with different work characteristics, emphasizing the potential hazards of work-related factors on female employees.

Introduction: The physiological disorder experienced by most women in Indonesia every month is primary dysmenorrhea (60-70%). The incidence of primary dysmenorrhea was experienced by female students at SMAN 4 Kediri City, as many as (90.8%) of all female students. One factor is stress. Objective: Determine the relationship between stress and the incidence of primary dysmenorrhea at SMAN 4 Kediri City. Methods: This research used the Analytical research design correlation with a cross-sectional approach, a population of 258 students, and a simple random sampling with a sample of 39 female students. The instrument used was questionnaires, with Spearman rank correlation analysis. Result: The results of this study were moderate stress 28.2% and moderate pain dysmenorrhea 53.8%. Statistical tests showed the correlation coefficient of Spearman rank sig value was 0.030; there was a significant relationship with a reasonably strong relationship strength of 0.347. Stress is the cause of dysmenorrhea to prevent dysmenorrhea can be minimized by preventing stress. Conclusion: the higher the stress, the higher the risk of dysmenorrhea in female students at SMAN 4 Kediri City. The higher the stress level experienced by female students, the greater their risk of experiencing dysmenorrhea (menstrual pain). This suggests that psychological factors such as stress can affect physical health conditions, particularly related to menstrual disorders in adolescent girls. To reduce the risk of dysmenorrhea, it is important to pay attention to stress management in students.

Introduction: Dysmenorrhea is a common condition in women during menstruation, characterized by severe pain that can interfere with daily activities. The administration of medical therapy is often used to treat these symptoms, but natural approaches such as giving young coconut water are also starting to be considered. Objective: This study aims to analyze the effectiveness of giving young coconut water in reducing pain intensity in dysmenorrhea patients and provide an overview of the application of natural therapy-based obstetric care in patients with menstrual complaints. Methods: This study uses a case study design with a qualitative approach. The subject of the study was an adult woman who experienced primary dysmenorrhea. Data were collected through in-depth interviews, direct observation, and assessment of pain intensity using the VAS (Visual Analog Scale) scale before and after administering young coconut water. Result: The study showed a significant decrease in the intensity of dysmenorrhea pain after administering young coconut water. Before the administration of therapy, patients reported pain intensity at level 8 (scale 0-10), and after three days of administration of young coconut water, pain intensity decreased to level 3. Patients also reported feeling more comfortable and being able to continue their daily activities better. No significant side effects were found related to the consumption of young coconut water. I am injuring kei three mestiuia such does not feel jealous, the nature of the blood of meirah can bioactivity deingan good to know the absence of the current suidah in the absence of good. Conclusion: Giving young coconut water can be effective in reducing the symptoms of dysmenorrhea in patients who experience it. This therapy can be a safe and natural alternative to help relieve menstrual pain. It can be applied in obstetrics as part of a comprehensive approach to reproductive health care. Further research with larger samples is needed to reinforce these findings and explore the mechanism of action of young coconut water in dysmenorrhea

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.

Background: Menstrual hygiene is an important risk factor for reproductive tract infections among adolescent girls. Unhygienic practices during menstruation have a significant impact on health. Fear of blood leaking, fatigue, dysmenorrhea, and lack of cleanliness in schools during menstruation contribute to absenteeism. Frequent episodes of absenteeism result in poor school performance. Objectives: The objectives of the study were to assess menstrual hygiene practices among the study population and estimate the proportion of school absenteeism among girls during menstruation and evaluate the associated factors. Materials and Methods: A cross-sectional study was conducted among 231 high schools (8th, 9th, and 10th standards) girls in Narayanguda, Hyderabad. A semi-structured questionnaire was used to interview the subjects after taking permission from the principal, and confidentiality was ensured for the students. Adolescent girls who have attained menarche and who were present on the day of the survey were included in the study. Adolescent girls who have not attained menarche were excluded from the study. Results: The mean age of menarche was 12.19 ± 1.17 years. The majority (93%) were using sanitary pads. Disposal of material used for menstruation was majorly (95.6%) by throwing in dustbins. Almost 92.2% of them were following good hygienic practices. The proportion of school absenteeism during menstruation was 53%, and the reasons were dysmenorrhea and fear of leaking menstrual blood while transiting. Conclusions: The majority of the girls were following good hygienic practices and used sanitary pads. About half of them remained absent from school during menstruation.

Elayna Kirsch,1 Sadiq Rahman,2 Katrina Kerolus,2 Rabale Hasan,1 Dorota B Kowalska,1 Amruta Desai,2 Sergio D Bergese2 1Department of Obstetrics and Gynecology, Stony Brook University Hospital, Stony Brook, NY, USA; 2Department of Anesthesiology, Stony Brook University Hospital, Stony Brook, NY, USACorrespondence: Sergio D Bergese, School of Medicine, Stony Brook University, Health Science Center, Level 4, Room 060, Stony Brook, NY, 11794, USA, Tel +631444-2979, Fax +631444-2907, Email sergio.bergese@stonybrookmedicine.eduAbstract: Dysmenorrhea is the most common pathology women of childbearing age face. It is defined as painful uterine cramping associated with menstruation. Primary dysmenorrhea occurs in the absence of an organic cause, whereas secondary dysmenorrhea is pelvic pain associated with an underlying pelvic pathology. The purpose of this review is to discuss the pathophysiology of dysmenorrhea and provide a discussion of pharmacologic and non-pharmacologic treatment options. Prostaglandins play a large role in the pathophysiology of dysmenorrhea by causing myometrial contraction and vasoconstriction. The first-line treatment for dysmenorrhea is with nonsteroidal anti-inflammatory drugs due to the inhibition of cyclooxygenase enzymes, thereby blocking prostaglandin formation, as well as hormonal contraception. Other pharmacologic treatment options include Paracetamol, as well as Gonadotrophic Release Hormone Analogs, which are typically used in the treatment for endometriosis. Non-pharmacologic treatments with strong evidence include heat therapy and physical exercise. There are less evidence-based data behind other modalities for treating dysmenorrhea, such as dietary supplements, acupuncture, and transcutaneous nerve stimulation, and these methods should be used in conjunction with first-line therapy after a discussion of risks and benefits. Lastly, for women who fail medical management, surgical options include endometrial ablation, presacral neurectomy, and laparoscopic uterosacral nerve ablation. Further research is needed to measure the socioeconomic burden of dysmenorrhea on the healthcare system and to evaluate the efficacy of treatment combinations, as a multi-modal approach likely provides the most benefit for women who suffer from this condition.Keywords: dysmenorrhea, prostaglandin, NSAIDs, hormonal contraception, pelvic pain, pharmacologic management, behavioral interventions, surgical intervention

Abstract 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.

Dysmenorrhea is defined as “painful menstruation”. Two types of dysmenorrhea are known: primary, which occurs in the absence of any gynecological disease, and secondary, which is associated with an underlying pathology. Primary dysmenorrhea typically occurs approximately 6 months after menarche. Approximately 16% to 81% of women of childbearing age experience primary dysmenorrhea, with 2% to 29% reporting moderate to severe intensity. The treatment of primary dysmenorrhea focuses on pain relief. However, supplements such as Vitamin D3 and Zinc should be considered. Vitamin D3 inhibits prostaglandin synthesis, while zinc also inhibits its synthesis, thereby improving uterine microcirculation and reducing the intensity of uterine contractions. It is important to note that not only pharmacological treatment should be considered, but also lifestyle changes that promote maximum physical and emotional well-being to reduce the consumption of analgesics and achieve control or remission of the underlying pathology.

Abstract Background Nutrition is important to the management and relief of the symptoms in menstrual disorders. This study aims to investigate the relationship between menstrual disorders and specific foods and nutrient intake in women. Methods Five-hundred-nine menstruating women participated in the study. The questionnaire form was created by the researchers via Google Forms and distributed in online applications (WhatsApp, Instagram etc.). The questionnaire consists of 5 sections, including demographic data, declared anthropometric measurements (height (m or cm), weight (g or kg)), questions about eating habits, menstruation status, and 24-hour food consumption. Statistical analysis was made with SPSS 23; nutrient analysis of food consumption was made using BeBiS 9.0. Results It was found that the body mass index (BMI) of healthy participants was higher than women with menstrual disorders. Women with menstrual disorders have lower intake of protein, vitamin K, vitamin B3, vitamin B5 and sodium compared with healthy women. All participants have a higher intake of vitamin B3, sodium, phosphorus, and manganese, and have a lower intake of other nutrients compared with the national adequate intake. Conclusion Our findings showed that women with menstrual disorders consume more high-sugar food/beverages and have inadequate nutrients intake.

Introduction: : Premenstrual syndrome (PMS) is a group of physical and psychological symptoms that occur during the luteal phase of the menstrual cycle. Objective: To determine the proportion of adolescent girls suffering Premenstrual Syndrome using ACOG criteria, to describe the clinical presentations of PMS and to identify the factors associated with PMS among them. Method: A cross-sectional study included adolescent girls in XI and XII standards from selected Higher Secondary Schools in Goa. A sample size of 210 was calculated with a 95% confidence interval, p=0.73, and an absolute error of 0.06. A pre-tested questionnaire covering socio-demographic details, menstrual history, PMS symptoms, and lifestyle factors was distributed before a health talk to girls who had attained menarche, experienced at least three menstrual cycles, and were willing to participate. BMI was calculated and classified per Asian Pacific guidelines. Regular menstruation was defined as cycles averaging 28 ± 7 days and 3–5 days of bleeding. PMS was assessed using ACOG criteria. Data were analyzed using Jamovi Software version 2.3.28, employing descriptive statistics and the Chi-square test to study associations between variables and PMS. Results: In a cross-sectional study among 228 adolescent girls, more than half (59.2%) of the girls reported to have PMS. The mean BMI of the participants was 20.1 ± 4.31 kg/m . Irritability was reported to be the most frequent symptom in as high as 41.7% girls.Nearly two-thirds of the adolescent girls (64%) reported to have heavy low, while the majority of the girls (91.7%) suffered from dysmenorrhea. PMS was found to be associated with age at menarche, amount of blood low during menstruation and presence of dysmenorrhea (p < 0.05). Conclusion: This study revealed that 59.2% of adolescent girls reported to have PMS. Schools should foster an environment where students feel comfortable discussing PMS and other women's health issues.

Objective: To evaluate the efficacy and safety of 2 doses of vilaprisan vs. placebo in participants with symptomatic endometriosis. Design: Multicenter, randomized, double-blind, placebo-controlled, parallel-group phase 2b trial (NCT03573336). The initially planned sample size was 315 patients. Recruitment was paused to assess long-term toxicity findings in rodents; although the findings were assessed as likely to be of limited clinical relevance in humans, the study was closed by the sponsor. During the pause, enrolled patients completed 3 or 6 months of treatment per their assigned regimen. Setting: University hospitals, a regional hospital, and a private clinic. Patients: Premenopausal adults with confirmed endometriosis and moderate-to-severe pelvic pain (≥4/10 on a numerical rating scale) were enrolled. Inclusion required protocol adherence, including ≥24 diary entries, and an average pain score of ≥3.5. Intervention: Participants were randomly assigned 1:1:1 to receive vilaprisan (2 mg), vilaprisan (4 mg), or placebo. Main Outcome Measures: The primary outcome was a change in the 7-day mean “worst pain” (per the endometriosis symptom diary item 1) from baseline to month 3. All analyses were descriptive only. Results: Eight participants were randomly assigned to treatment before the study pause: 6 received vilaprisan (4 mg, n = 4 and 2 mg, n = 2), and 2 received placebo. The 6 vilaprisan recipients experienced an improvement in endometriosis-associated pelvic pain, whereas the 2 placebo recipients experienced no change or increased pain; all 8 participants had decreased use of pain medication. Bleeding intensity decreased from baseline in the vilaprisan group. Conclusion: The study findings suggest that vilaprisan may improve outcomes in patients with endometriosis. Further studies in larger populations would be needed to accurately assess treatment effects. Clinical Trial Registration Number: NCT03573336

IntroductionPartnership is an important resource in dealing with endometriosis related chronic pain. Hence, our objective was to assess partnership in the context of endometriosis and its symptoms, considering the perspectives of both individuals involved.MethodsThe study was designed as a multi-center matched case–control study in Switzerland, Germany and Austria. Altogether 381 women with surgically/histologically confirmed endometriosis and 381 control women, 250 male partners of endometriosis-affected women and 229 of control women were evaluated. Partnership quality, partnership happiness, separation thoughts, and areas of conflict were evaluated through the Partnership Questionnaire and a validated list of conflict areas.ResultsQuality of partnership was rated as high by 60.1% of the women with endometriosis and 66.7% of the control women, as well as by 45.8 and 50.2% of their respective partners. Women with endometriosis mentioned separation thoughts, mostly related to sexual satisfaction, more often (34.9%/28.3%) and experienced more partnership-related conflicts than control women. Chronic pain, dyspareunia, dissatisfaction with sexuality, fatigue, and infertility were significantly associated with partnership conflicts. Fatigue and infertility but not pain experiences were related to lower partnership quality. Male partners in both groups reported separation thoughts equally often. In men, a high intensity of pain experienced by their partner was associated with reduced partnership happiness.ConclusionGiven the significance of partnership in dealing with chronic diseases and the connection between symptoms of endometriosis and a decrease in partnership quality, it is essential to incorporate strategies that alleviate the negative impacts on relationships for both partners into medical support.Clinical trial registrationidentifier NCT 02511626.

Background: Endometriosis is a chronic gynecologic disease that is dependent on estrogen and is associated with the existence of endometrial glands and stroma outside the uterus. It has been demonstrated that dienogest significantly and fairly effectively alleviates endometriosis-related symptoms such as dysmenorrhea and irregular menstruation. Material and Methods: This was a randomized, prospective, comparative, open-label study. For 12 weeks, Group A (n=30) received Dienogest 2 mg OD while Group B (n=30) received Medroxyprogesterone acetate (MPA) 10 mg BD. The patients were assessed at 4, 8, and 12 weeks to observe the VAS Score for dysmenorrhea, number of patients having dysmenorrhea, number of patients having irregular menstrual cycles. Adverse drug reactions (ADRs) were recorded for safety assessment. Results: After 12 weeks, VAS score & number of patients experiencing dysmenorrhea decreased in both groups significantly. Dienogest depicted better response than MPA in the reduction of VAS score (95.99% versus 84.91%; p-value=0.048) & reduction in the number of patients having dysmenorrhea after 12 weeks (6.67% versus 26.67%; p-value=0.038) and the difference was statistically significant. MPA group had a greater number of ADRs. Conclusion: Dienogest is significantly more effective than MPA, especially for dysmenorrhea. Dienogest shows better tolerability than MPA.

IntroductionThis study aimed to investigate the causal relationship between phosphatidylcholine (PC) levels and dysmenorrhea using Mendelian randomization (MR) analysis.MethodsWe conducted a two-sample MR analysis using GWAS data on PC levels and dysmenorrhea. Single nucleotide polymorphisms (SNPs) associated with PC levels were used as instrumental variables. MR-Egger regression and inverse variance weighting (IVW) were used to estimate the causal effect of PC levels on dysmenorrhea. Sensitivity analyses were performed to assess the robustness of the results.ResultsThe IVW analysis revealed a significant positive association between higher PC levels and dysmenorrhea (OR: 1.533, 95% CI: 1.039–2.262, P = 0.031). The MR-Egger regression did not detect pleiotropy. Sensitivity analyses confirmed the robustness of the results.ConclusionThis study provides evidence suggesting a causal link between increased PC levels and dysmenorrhea. Further research is needed to understand the biological mechanisms underlying this relationship and to explore potential therapeutic implications.

Background: Hemoglobin (HGB) was the most important factors which could cause dysmenorrhea in women. Metals exposure and hemoglobin level in dysmenorrhea female was unclear. We aimed to explore the associations of multi-metal exposure and HGB level in female college students with dysmenorrhea. Methods: 253 female students who had dysmenorrhea was included in our study. The Last Absolute Shrinkage and Selection Operator (LASSO) regression, generalized linear model (GLM), and Bayesian Kernel Machine Regression (BKMR) models were used to explore the associations of multi-metal exposure and HGB levels in female college students with dysmenorrhea. Results: GLM results showed that plasma Fe, Ni and Rb was positively associated with HGB and plasma Co was negatively associated with HGB. In menarche age ≤13 years old group, plasma Co and Rb only was negatively and positively associated with HGB level, respectively, and plasma Ni had positive association with HGB level in menarche age >13 years old group. BKMR results showed the reverse U-shaped relationship between the five metals mixture (Co, Fe, Ni, Cu and Rb) and HGB levels in overall and menarche age ≤13 years old group. However, there were positive association between the five metals mixture and HGB levels in menarche age >13 years old group. Conclusion: Our present study revealed that metals (Fe, Ni, Co, Rb, Cu) mixture exposure could effect HGB levels in female college students with dysmenorrhea. And the relationships were different during different menarche age in female college students.

Magnesium is an important cofactor for metabolic reactions involving more than 300 enzymes, regulating a series of fundamental processes, such as myocardial contraction and blood pressure control, glucose regulation, participation in neuromuscular transmission. The prevalence of magnesium deficiency in various cohorts of fertile age women comprises up to 73.8 %. In clinical studies it was demonstrated that magnesium deficiency is associated with diseases and states such as dysmenorrhea, premenstrual syndrome (PMS), polycystic ovary syndrome (POS), climacteric syndrome, osteoporosis, use of combined oral contraceptives (COCs) and menopausal hormone therapy (MHT). Magnesium supplementation in combination with basic therapy can positively affect course and outcome of such pathologies. Magnesium organic salts could be used for countering magnesium deficiency. Among such agents, magnesium citrate has some advantage used in combination with pyridoxine (vitamin B6) providing additional effects. Health care professionals should be guided by the criteria for Mg-containing preparation selection, defined by the Russian Society of Obstetricians and Gynecologists (RSOG).

Objective: To examine the effects of Jacobson's Progressive Muscle Relaxation Technique (JPMRT) on menstrual pain and symptoms, anxiety, quality of life (QoL), social activity, and work/school performance in primary dysmenorrhea (PD). Materials and methods: Women with PD were randomly divided into two groups as relaxation and control groups. JPMRT was applied three times a week from the estimated date of ovulation to the onset of the next menstruation. No treatment was performed in the control group. Pain intensity, menstrual symptoms, anxiety, impacts on QoL, social activity, and work/school performance were assessed before and after the interventions. Results: After the interventions, there was a further decrease in menstrual pain intensity, menstrual symptoms, anxiety level, the impact of QoL, and the work/school performance scores in the relaxation group than in the control group (p

ObjectiveTo explore the ultrasound characteristics of accessory cavitated uterine malformation (ACUM) and the causes of misdiagnosis, in order to better understand the disease and improve the diagnostic ability of radiologists.MethodsWe retrospectively collected clinical, pathological and imaging data of ACUM patients who were diagnosed after surgery at Peking Union Medical College Hospital from December2013 to December 2023. Besides, we analyzed ultrasound features of ACUM and the cause of misdiagnosis.ResultsA total of 11 patients were included, with a mean age of diagnosis of (27.1±7.4)years. There was a mean interval of (6.1±5.5)years between menarche and onset of dysmenorrhea. Preoperative ultrasound showed that ACUM appeared as solitary lesions located under the insertion of the round ligament, with a mean maximum diameter of (3.0±1.0)cm. Lesions were round or oval (90.9%, 10/11) and not connected to the uterine cavity (100%, 11/11) with clear boundaries (72.7%, 8/11), presenting as regular thick-walled cystic-solid structures. Cystic areas were observed within the mass (100%, 11/11) with a ground-glass-like appearance (90.9%, 10/11) and hyperechoic endometrial lining (90.9%, 10/11). The surrounding of the mass showed hypoechoic or isoechoic areas resembling the muscular layer and circular or semi-circular vascularity was detected around the mass. No adenomyosis or other uterine lesions were found. Analysis of misdiagnosis: Among the 11 ACUM cases, 6 were correctly diagnosed by the initial ultrasound examination, and 5 cases by MRI. Two patients were misdiagnosed as residual horn uterus by MRI, despite ultrasound suggesting ACUM with visible bilateral uterine horns.ConclusionsACUM exhibits distinct ultrasound characteristics. When young women present with progressive dysmenorrhea and ultrasound reveals a regular cystic-solid mass with thick wall located under the round ligament insertion, ACUM should be considered.

Aim: Dysmenorrhea has a high prevalence among university students and affects important aspects of daily activity, psychological health, quality of life, and academic performance. This study aimed to evaluate the effect of mindfulness-based psychoeducation program on automatic thinking, pain beliefs and coping of nursing students with dysmenorrhea. Material and methods: This study was a quasi-experimental study using a nonrandomized control group pretest and posttest design. The study included 72 nursing students with primary dysmenorrhea. The experimental group received psychoeducation for 75 minutes per week for nine sessions. Data were collected using the Automatic Thoughts Questionnaire, Pain Beliefs Questionnaire, and Pain Coping Inventory. Results: The automatic thinking, organic pain beliefs, and passive pain coping total scores in the experimental group significantly decreased after program compared with those in the control group (p < 0.05). Moreover, there was a significant increase in psychological pain beliefs and active pain coping total scores in the experimental group (p < 0.05). Conclusions: These findings indicate that the program was effective in addressing automatic thinking, pain beliefs and coping of nursing students with dysmenorrhea. The mindfulness-based psychoeducation program can be easily applied to students suffering from dysmenorrhea.

HIGHLIGHTS • Complementary treatments have been shown to greatly reduce the intesity of dysminorrhea pain. • The use of medicinal plants, herbal concoctions, or compresses might reduce dysmenorrhea discomfort more effectively than taking medications like mefenamic acid, ibuprofen, piroxicam, etc. ABSTRACT Objective: The study's objective was to obtain latest data on alternative therapy for dysmenorrhea in adolescent females of reproductive age. Materials and Methods: A scoping review was conducted using the PRISMA ScR protocol. A search was conducted on PubMed, Science Direct, and Wiley, yielding 848 studies. Ten literature studies were identified that satisfied the criteria for population, exposure, and outcome. The studies also incorporated inclusion criteria, focusing on women of reproductive age who had dysmenorrhea. Results: Out of 848 articles, 32 were considered potentially relevant and met the inclusion criteria. The articles indicated that teenagers commonly used warm compresses and herbal drinks as supplementary therapies to alleviate dys-menorrhea due to their perceived effectiveness and comfort. Other complement-ary therapies for the condition included massage, relaxation, herbal products, self-care practices, acupuncture, and therapeutic methods. Conclusion: Herbal and warm water compress are the most commonly applied alternative therapies for treating dysmenorrhea.

Background: Dysmenorrhea or menstrual pain is a common health problem among reproduction women. The prevalence of dysmenorrhea was high in many countries including in Indonesia. Some previous studies showed that curcumin was effective reduced menstrual pain. Purpose: The aim of this study was to determine the effected of curcumin to dysmenorrhea. Method: This study used systematic review method with Randomize Control Trial (RCT) design. The data was collected by using electronic databases such as Google Scholar, Science Direct, Pubmed, Scopus, Web of Science, SpringerLink and EBSCOhost in last 10 years, or in 2013-2023. The keywords used curcumin, turmeric, curcuma longa, dysmenorrhea, menstrual pain. Results: There were 7 selected articles in this literature study. Curcumin reduced intensity and duration of dysmenorrhea; the increasing of vitamin D; the reducing of serum IgE, serum aspartate transaminase (AST) and direct bilirubin levels among women with dysmenorrhea. Conclusion: Curcumin was affected to reducing the severity and symptoms of dysmenorrhea.

Abstract Objective Considering the importance of endometriosis and its relatively high prevalence among women, this study sought to investigate clinical and Transrectal and transvaginal ultrasounds (TVS) findings of disease. Methods This descriptive-analytical study was performed based on medical records of 155 women with endometriosis admitted to Rasool-e Akram Hospital in Tehran for a TVS. All the sonography data and patients’ information were collected into checklists and analyzed in SPSS-25 software (IBM). Results The mean age of participants was 32.4 ± 6.1 years, ranging from 18 to 50 years. Endometrioma was prevalent in 129 patients (84.8%). Size of endometrioma (diameter) was more than 3 cm in 79.9% of patients, and 3 cm or fewer in 20.1% of cases. Bladder, intestinal, vaginal, and rectosigmoid involvements with endometriosis implants were observed in 4 (2.6%), 54 (35.5), 3 (0.2%), and 51 (33.5) of patients, respectively. A total of 64.5% of patients were diagnosed with incomplete stenosis of the Douglas pouch and 35.5% had complete stenosis. Deep infiltrating endometriosis (DIE) was less than 1 cm in 20.7%, 1 to 3 cm in 42.3%, and over 3 cm in 37% of patients. The most common manifestations of endometriosis Obliteration of the Douglas pouch, endometrioma, and DIE. In addition, imaging modalities have shown promising results, indicating the necessity to use transvaginal ultrasound as the first line of diagnosis in patients with clinically suspected endometriosis.

Background & aim:. This study systematically reviewed the clinical trials to assesse Achillea millefolium's impact on primary dysmenorrhea and menstrual bleedingMethods: In this systematic review, the databases of Science Direct, PubMed, ProQuest, Cochrane library, Scopus, Web of Science were searched using the keywords of "Dysmenorrhea", "Pain"," Menorrhagia" and "Achilles" until Aug 2022. The study population included women with moderate to severe dysmenorrhea or menorrhagia with a score of 100 on Pictorial menstrual bleeding Assessment Chart (PBLAC). Intervention included oral administration of Achillea millefoliums with other modern dosage forms. The Cochran's Risk of Bias tool was applied to evaluate the quality of articles.Results: Among 80 initial articles, six studies were systematically reviewed. Among six reviewed studies, three studies examined the impact of Achillea millefolium on primary dysmenorrhea, two studies evaluated the effect of Achillea millefolium on menorrhagia and one study assessed the impact of Achillea millefolium on both primary dysmenorrhea and menorrhagia. The results showed the effect of Achillea millefolium in pain relief of dysmenorrhea and reduction of menstrual bleeding.Conclusion: Achillea millefolium is an effective and safe herbal remedy for primary dysmenorrhea and reduction of menstrual bleeding.

Background & aim: Dysmenorrhea is one of the main factors affecting the quality of life. This study aimed to determine the impact of rosemary and mefenamic acid capsules on the quality of life of students with primary dysmenorrhea.Methods: This double-blind clinical trial study was performed on 82 students with primary dysmenorrhea from June to september 2018 at the Faculty of Medicine of the Islamic Azad University of Mashhad. Students with moderate dysmenorrhea, after controlling two menstrual cycles by the convenience sampling method and using PASS software, were randomly assigned to the rosemary and mefenamic acid groups using double blocks. They consumed rosemary and mefenamic acid capsules every 8 hours for the first 3 days of intervention cycles. The SF-36 questionnaire was used to assess quality of life before and after the intervention at the end of menstrual bleeding. The data were analyzed using SPSS 24 and descriptive and interpretive statistical tests.Results: The mean score of physical health in the first cycle after the intervention increased by 300.07±62.43 and 306.00±66.11and in the second cycle after the intervention increased by 306.54±63.90and 308.63±64.14 (P=0.94). The mean score of mental health in the first cycle after the intervention increased by283.90±58.48 and 282.98±65.63 and in the second cycle after the intervention increased by 261.13 ±80.61and 258.94± 86.67 (P=0.90).Conclusion: Consumption of rosemary and mefenamic acid capsules improves the quality of life by increasing the scores of physical and mental health.

Background and Aim: Dysmenorrhea is influenced by hormonal imbalances and weight fluctuations. Physical activity plays a crucial role in managing dysmenorrhea. This study aimed to investigate the relationship between IGF1, IGFBP3, BMI, and dysmenorrhea following eight weeks of combined exercise (resistance and aerobic) in obese women. Methods: A quasi-experimental study was conducted on 24 inactive obese women aged 25 to 37 years, having a BMI of 30 to 35 kg/m2. Participants were randomly assigned to either a combined exercise group (resistance and aerobic) or a control group. The combined training regimen included resistance exercises at 67-80% of maximum strength and aerobic exercises at 60-85% of maximum heart rate, conducted three days a week for eight weeks. Blood samples were collected before and after the training period, and IGF1 and IGFBP3 levels were measured. Dysmenorrhea symptoms were assessed using the Menstrual Disorders Questionnaire (MDQ). Results: Pearson correlation analysis revealed no significant relationship between IGF1 and IGFBP3 levels in obese women (P≥0.73, r=0.05). There was no significant relationship between IGF-1 levels and dysmenorrhea (P≥0.61, r=0.07). A significant relationship was found between IGF-1 levels and BMI (P

This study aimed to review randomized controlled trials (RCTs) investigating the effects of dietary antioxidant supplements on the severity of endometriosis-related pain symptoms. The PubMed/Medline, Scopus, and Web of Science databases were searched until April 2022. Additionally, we manually searched the reference lists. Endpoints were summarized as standardized mean difference (SMD) with 95% confidence intervals (CIs) in a random-effects model. The I2 statistic was used to assess heterogeneity. Ten RCTs were included in this meta-analysis. Overall, 10 studies were related to dysmenorrhea, four to dyspareunia, and four to pelvic pain. Antioxidants significantly reduced dysmenorrhea (SMD, −0.48; 95% CI, −0.82 to −0.13; I2=75.14%). In a subgroup analysis, a significant reduction of dysmenorrhea was observed only in a subset of trials that administered vitamin D (SMD, −0.59; 95% CI, −1.13 to −0.06; I2=69.59%) and melatonin (SMD, −1.40; 95% CI, −2.47 to −0.32; I2=79.15%). Meta-analysis results also suggested that antioxidant supplementation significantly improved pelvic pain (SMD, −1.51; 95% CI, −2.74 to −0.29; I2=93.96%), although they seem not to have a significant beneficial impact on the severity of dyspareunia. Dietary antioxidant supplementation seems to beneficially impact the severity of endometriosis-related dysmenorrhea (with an emphasis on vitamin D and melatonin) and pelvic pain. However, due to the relatively small sample size and high heterogeneity, the findings should be interpreted cautiously, and the importance of further well-designed clinical studies cannot be overstated.

Abstract Background Dysmenorrhea (painful menstruation) is a condition that may have a profound effect on adolescent girls’ health status and well-being. It can impede their engagement in daily activities and hamper their regular school attendance. This study aims to explore the relationship between dysmenorrhea, well-being, and academic performance among adolescent girls living in Palestine refugee camps in the West Bank and Jordan. Methods We conducted a household survey between June and September 2019, with a total sample of 2737 adolescent girls 15 to 18 years old. Dysmenorrhea severity was assessed using the Working Ability, Location, Intensity, Duration of pain Dysmenorrhea scale (WaLIDD). The WHO-5 scale was used to evaluate the girls’ overall well-being. Menstrual academic disruption (MAD) was measured using a self-reported scale. Multiple linear regression models were employed to evaluate the association between dysmenorrhea, well-being, and academic performance. Directed Acyclic Graphs (DAGs) were employed to identify variables for control in regression models. Results The mean dysmenorrhea score was 6.6 ± 2.6, with 37.9% and 41.2% expressing moderate and severe symptoms, respectively. The mean WHO-5 score was 58.7 ± 25.1, and 34.9% reported a low well-being status. The mean MAD score was 3.1 ± 3.3. 26% reported missing school due to dysmenorrhea, 36% said dysmenorrhea impacted their ability to concentrate, and 39% were unable to study for tests, and complete homework. The first regression analysis showed a reduction of 1.45 units in WHO-5 score for each unit increase in dysmenorrhea. The second regression analysis showed a non-linear increase in MAD score for increasing dysmenorrhea. For each dysmenorrhea score less than 4 (mild) there was a modest increase in MAD scores (coefficient 0.08, p-value = 0.006), and for each dysmenorrhea score above 4 there was a stronger increase in MAD scores (coefficient 0.95, p

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare and complex congenital anomaly of the genitourinary system characterized by uterus didelphys, an obstructed hemivagina, and ipsilateral renal agenesis. It is the result of the maldevelopment of both the Mullerian and Wolffian ducts. Clinical manifestations of dysmenorrhea, dysuria, and urinary retention appear after menarche due to the accumulation of menstrual blood and distention of the obstructed hemivagina. Diagnosis of this anomaly is often delayed, and the obstructive nature of the condition is missed due to cyclic menstruation from the one canalized hemivagina. This case report represents a typical form of HWW syndrome to highlight the importance of considering this rare entity in an adolescent girl presenting with signs of dysmenorrhea and urinary complaints. A 13-year-old patient was presented at the obstetrics and gynecology clinic due to low abdominal pain and urinary retention on the fifth day of menstruation. For the last 6 months, the patient suffered progressive cyclic low abdominal pain associated with menstruation. Inspection of the external genitalia was unremarkable, and the hymenal membrane had a normal oval opening. An ultrasound examination revealed the sonographic features of the didelphys uterus and was suggestive of a right obstructed hemivagina with hematocolpos. Magnetic resonance imaging and computed tomography urography showed evidence of didelphys uterus, right blind obstructed hemivagina associated with huge hematocolpos, and ipsilateral renal agenesis. The diagnosis of HWW syndrome was established. Surgical resection of the vaginal septum was undertaken without delay, and the patient was discharged the following days.

Robert’s uterus was firstly reported in 1970, it’s a rare Müllerian duct anomaly with 2 intra-uterine cavities divided by asymmetrical septum. One of the cavities is completely obstructed to cervix by septum and menstruation fluid retents in this blind cavity, periodical pelvic pain during menstruation can lead attendance to hospital. We report a gravida of Robert’s uterus with missed abortion in the blind cavity, who had mild dysmenorrhoea since adolescent age, diagnosed and treated by minimally invasive surgical methods. To our knowledge, it’s a previously unreported case which gynaecologists terminated pregnancy in blind cavity of Robert’s uterus without resecting the septum while dysmenorrhoea relieved entirely and postoperative volume of menstruation stayed the same as preoperative.

Aim of the study The aim of this systematic review is to compare studies published since 2017 to evaluate whether yoga and other alternative methods should be recommended to patients with endometriosis and associated pain. As alternative methods, particularly yoga, have gained popularity in recent years, it is crucial for healthcare professionals to ensure that these approaches are scientifically valid. This systematic review examines the effects of practicing different types of yoga and possible advantages of other alternative methods that could be potentially beneficial on pain management for patients suffering form endometriosis. Methods This review synthesizes findings from twenty studies, including randomized controlled trials and observational studies. Conclusion The results consistently indicate significant improvements in the quality of life for patients with endometriosis. Yoga, as both a physical and mental practice, appears to be beneficial in managing pain. Although there are some limitations related to study design and variability, the evidence strongly supports the benefits of yoga in managing pelvic pain. Future research should focus on identifying which specific types of yoga practices offer the greatest benefits.

Introduction: The study will focus on presenting the effects of adequate intake or supplementation of omega-3 fatty acids on patients' perception of menstrual pain. Other known characteristics of these substances will also be presented. Aim of the study: The aim of the study was to demonstrate impact of omega-3 fatty acids supplementation or normal supply to dysmenorrhea among women through a literature review. State of Knowledge: Dysmenorrhea is a condition that limits normal functioning and affects up to 90% of women. Therefore, it is so important to study its pathogenesis and prevent its occurrence. It results in the use of painkillers and the absence of many women from daily activities. Omega-3 acids are polyunsaturated fatty acids that have a positive effect on numerous organs and functions of the human body. They are substances with anti-inflammatory properties, which have been used in research on the influence of omega-3 acids on reducing dysmenorrhea among women. Conclusion: Omega-3 acids reduce dysmenorrhea in women. It is very important to pay attention to the presence of acids in diet as well as supplementation among patients.

ObjectivesTo evaluate the effectiveness and safety of Chinese herbal footbaths (CHF) as an adjunctive therapy in managing dysmenorrhea.MethodsTen electronic databases were searched to identify eligible randomized clinical trials (RCTs) from inception until June 2023. Outcome measurements encompassed the total effective rate, visual analog scale (VAS) score of pain intensity, Cox menstrual symptom scale (CMSS) score, symptom score, Traditional Chinese Medicine (TCM) syndrome scale, and any reported adverse events. The methodological quality of the included studies was assessed with the Cochrane collaboration tool. Review Manager 5.3 software was employed for quantitative synthesis, and funnel plots were utilized to evaluate potential reporting bias.ResultsEighteen RCTs with 1,484 dysmenorrhea patients were included. The aggregated results suggested that the adjunctive CHF could significantly ameliorate dysmenorrhea, as evident from the improved total effective rate [risk ratio (RR) 1.18, 95% confidence interval (CI): 1.12 to 1.23, P < 0.00001], VAS (MD 0.88, 95% CI: 0.68 to 1.09, P < 0.00001), CMSS (MD 3.61, 95% CI: 2.73 to 4.49, P < 0.00001), symptom score (SMD 1.09, 95% CI: 0.64 to 1.53, P < 0.00001), and TCM syndrome scale (MD 3.76, 95% CI: 2.53 to 4.99, P < 0.0001). In addition, CHF presented fewer adverse events with a better long-term effect (RR 1.34, 95% CI: 1.11 to 1.63, P < 0.01) and diminished recurrence rate (RR 0.19, 95% CI: 0.09 to 0.39, P < 0.0001).ConclusionCurrent evidence implies that CHF may be an effective and safe adjunctive therapy for patients with dysmenorrhea. However, the methodological quality of the studies included was undesirable, necessitating further verification with more well-designed and high-quality multicenter RCTs.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=188256, identifier registration number.

IntroductionDysmenorrhea is associated with increased risk of chronic pain and hyperalgesia. Menstruating individuals with dysmenorrhea are more likely to have elevated pain reactivity when experiencing experimental pain, than those without. However, no study has examined intragroup differences in reactions to experimentally induced pain for individuals with dysmenorrhea. The main aim of this study was to examine the relative roles of dysmenorrhea severity and interference in the experience of experimentally-induced pain.MethodsParticipants were 120 menstruating individuals involved in a larger research study examining the influence of expectations on experimentally-induced pain. As part of the study, participants completed an online questionnaire regarding demographic and menstrual information and participated in a cold pressor task. Participants were randomized into four groups based on the manipulation of two independent variables: (1) high vs. low expectations about pain severity (pain-expectations); (2) and high vs. low expectations about one's pain tolerance (self-expectations). Participants verbally rated their pain severity throughout the cold pressor task using a 0–10 scale. Regression analyses were conducted examining the relationships between dysmenorrhea experience (i.e., average severity and interference) and cold pressor data [pain severity ratings and pain tolerance (i.e., total time in the cold pressor)], controlling for the manipulated expectations and age. Then, moderation analyses were conducted examining expectation group differences.ResultsWhen controlling for manipulated expectations and age, dysmenorrhea severity significantly predicted initial pain severity rating (p = 0.022) but did not predict final pain severity rating (p = 0.263) or pain tolerance (p = 0.120). Dysmenorrhea interference did not predict initial pain severity rating (p = 0.106), final pain severity rating (p = 0.134), or pain tolerance (p = 0.360). A moderation analysis indicated that the relationship between dysmenorrhea severity and initial pain severity rating was not moderated by pain-expectations, χ2(1) = 0.412, p = 0.521.DiscussionDuring an experimentally-induced pain task, dysmenorrhea severity but not interference predicted initial pain severity rating, such that higher levels of dysmenorrhea severity predicted greater initial pain severity rating. This suggests individuals with more severe dysmenorrhea pain may experience greater initial sensitivity to pain and be at risk for increased sensitivity to acute pain and potentially the development of chronic pain.

Background: Chronic pelvic pain (CPP) in women is a critical challenge. Due to the complex etiology and difficulties in diagnosis, it has a greatly negative impact on women's physical and mental health and the healthcare system. At present, there is still a lack of research on the related factors and predictive models of chronic pelvic pain in women. Our study aims to identify risk factors associated with chronic pelvic pain in women and develop a predictive nomogram specifically tailored to high-risk women with CPP. Materials and methods: From May to October 2022, trained interviewers conducted face-to-face questionnaire surveys and pelvic floor surface electromyography assessments on women from community hospitals in Nanjing. We constructed a multivariate logistic regression-based predictive model using CPP-related factors to assess the risk of chronic pelvic pain and create a predictive nomogram. Both internal and external validations were conducted, affirming the model's performance through assessments of discrimination, calibration, and practical applicability using area under the curve, calibration plots, and decision curve analysis. Results: 1108 women were recruited in total (survey response rate:1108/1200), with 169 (15.3 %) being diagnosed as chronic pelvic pain. Factors contributing to CPP included weight, dysmenorrhea, sexual dysfunction, urinary incontinence, a history of pelvic inflammatory disease, and the surface electromyography value of post-baseline rest. In both the training and validation sets, the nomogram exhibited strong discrimination abilities with areas under the curve of 0.85 (95 % CI: 0.81–0.88) and 0.85 (95 % CI: 0.79–0.92), respectively. The examination of the decision curve and calibration plot showed that this model fit well and would be useful in clinical settings. Conclusions: Weight, dysmenorrhea, sexual dysfunction, history of urinary incontinence and pelvic inflammatory disease, and surface electromyography value of post-baseline rest are independent predictors of chronic pelvic pain. The nomogram developed in this study serves as a valuable and straightforward tool for predicting chronic pelvic pain in women.

Pelvic pain in adolescents, especially during the menstrual period, is often underestimated as a health problem and significantly impacts quality of life. The objective was to evaluate the clinical and nutritional profile of adolescents with dysmenorrhea. 40 adolescents were selected, aged between 11 and 19 years old, treated at a teaching clinic in São Paulo, as well as using the snowball technique. Pelvic pain was assessed using a validated pain scale questionnaire and food consumption was assessed using a 24-hour dietary recall and Food Frequency Questionnaire. All participants had adequate height for their age and 72.5% were eutrophic. Thirty-five patients (87.5%) had moderate to severe pain, while five (12.5%) had mild or no pain. Practicing physical activity was less common among the group with moderate to severe pain (34.3%). There was no significant difference in the length of menstrual cycles between the groups. Lower calcium intake was observed in the group with more intense menstrual pain. Furthermore, there was a lower consumption of 'fresh' and "processed" foods in the group with moderate to severe pain during lunch and dinner meals, respectively. A negative correlation was identified between calcium and folate consumption and the duration of pain in days. The sample studied suggests that a balanced diet, rich in calcium, folate and natural foods, may be important in the management of dysmenorrhea. However, more research is needed to fully understand this relationship and develop effective interventions to treat this common condition among adolescents.

Background: Dysmenorrhea often occurs in adolescent girls and disrupts their daily activities. Dysmenorrhea occurs 1-2 years after menarche, with an average age of 12.8 years. One way to reduce dysmenorrhea is to use plants, such as ginger and citronella oil. This research aimed to determine the effectiveness of ginger and citronella oil on dysmenorrhea in adolescent girls. Methods: This research was quasi-experimental with a one-group pretest-posttest design approach. The sample consisted of 68 adolescent girls from Junior High School 14 Tasikmalaya City who were experiencing dysmenorrhea with moderate pain intensity. Purposive Sampling was used. The results of this study were obtained using the Numeric Rating Scale (NRS) and then analyzed using the Wilcoxon signed-rank test. Results: The research results showed that the average dysmenorrhea score before being administered ginger and citronella oil to adolescent girls was 4.6, and after the intervention, it was 3.69 out of ten. The statistical test results showed that ginger and citronella oil were effective for dysmenorrhea in adolescent girls (p = 0.000). Conclusions: This study concluded that there is a difference in the average dysmenorrhea score before and after administering ginger and citronella oil to adolescent girls. Therefore, adolescent girls can use ginger and citronella oil to reduce dysmenorrhea. Implications for Nursing: Integrating complementary ginger and citronella oil therapy into nursing or midwifery services to reduce dysmenorrhea. This innovation can be a reference source to provide care and minimize chemical drug use.

Background: Dysmenorrhea is wide spread gynecological disorder among that affect the quality of life of women world wide. The current study aims to examine whether war displacement, mental health symptoms, and other clinical factors are associated with dysmenorrhea severity. Methods: This is a cross-sectional case-control study recruiting two groups: displaced Syrian women and un-displaced local Jordanian women. Demographics and clinical details were recorded. The severity of dysmenorrhea was assessed using WaLIDD scale, the PHQ-9 scale was emplyed to assess depressive symptoms, anxiety was assessed using the GAD-7 scale, and insomnia was assessed using the ISI-A scale. Predictors of severe dysmenorrhea in females using multivariate binary logistic regression. Results: Out of 808 of the total participants, 396 (49%) were Syrian displaced war refugees, 424 (42.5%) reported using paracetamol, 232 (23.2%) were using NSAIDs, and 257 (25.9%) using herbal remedies. Severe dysmenorrhea was associated with war displacement (OR = 2.14, 95% CI = 1.49–3.08, p < 0.001), not using NSAIDs (OR = 2.75, 95% CI = 1.91–3.95, p < 0.001), not using herbal remedies (OR = 2.01, 95% CI = 1.13–3.60, p = 0.01), depression (OR = 2.14, 95% CI = 1.40–3.29, p < 0.001), and insomnia (OR = 1.66, 95% CI = 1.14–2.42, p = 0.009). Conclusions: War displacement, type of analgesic, depression, and insomnia are risk factors for severe dysmenorrhea.

Aim: Dysmenorrhea is a condition characterized by pain during or before menstruation. This study aims to investigate how dysmenorrhea affects the quality of life of young women and explore effective treatment approaches. Methods: The research data in descriptive and cross-sectional types were collected using a personal information form containing students' socio-demographic characteristics and a Visual Analog Scale (VAS). A total of 336 students diagnosed with dysmenorrhea and willing to participate in the study were included. Results: The mean VAS scale score used to determine the severity of dysmenorrhea in the participants was 6.51±2.10. Among the participants who chose Complementary and Alternative Treatment (CAT), 81.8% preferred lying down for rest, and 72.9% opted for applying heat to the abdomen. A statistically significant difference was found in the use of analgesics and CAT methods for dysmenorrhea control based on a family history of dysmenorrhea and the impact of dysmenorrhea on daily life (p

Abstract Objective To examine the prevalence of menstrual pain among women of reproductive age and its impact on their daily lives and professional responsibilities. Methods A cross-sectional and descriptive study was conducted in July and August 2022. Phone interviews were carried out using a random system to select women aged between 15 and 49 years old. The questionnaire included sociodemographic variables, contraception method used, characteristics of the menstrual pattern (pain and bleeding amount), its influence on their working life, and if they would need to resort to sick leaves due to the impairments arising from the menstrual symptoms. Results A total of 1800 women representative of the Spanish population took part in this study. 72.6% of them report menstrual pain, with 45.9% requiring medication. 35.9% identify their menstrual bleeding as intense or very intense. 38.8% assert that menstrual discomforts affect their everyday life. 34.3% would have required not attending their work activities or having requested sick leave due to the discomforts, although only 17.3% of the women finally requested so, mainly because 58.4% considered that it might imply consequences in their professional environment, especially those with Higher Education. The women who report more discomfort are the youngest ones and those who resort to condoms as a contraceptive method (p

Abstract Background The sars-Cov-2 pandemic has determined psychological stress, particularly in the young population of medical students. We studied the impact of the pandemic on menstrual cycle alteration in relation to psychological stress, presence of depression, sleep disturbances and post-traumatic stress, on a population of medical students. Methods 293 female students at the Faculty of Medicine and Psychology of the Sapienza University of Rome (23.08 years old ± 3.8) were enrolled. In March 2021, one year after quarantine, a personal data sheet on menstrual cycle, examining the quality of the menstrual cycle during the pandemic, compared to the previous period. Concomitantly, the Beck Depression Inventory and the Impact of Event Scale have been administered. A Pearson chi-square test was assessed to evaluate the difference between the characteristics of the menstrual cycle and the scores obtained with the questionnaires. Results A statistically significant association between menstrual alterations and stress during pandemic had been found. The onset of depressive symptoms and sleep disturbances was observed in 57.1% and in 58.1% of young women with cycle’s alterations, respectively. Amenorrhea was three times more common in female students with depressive symptoms, premenstrual syndrome had a significant correlation with both depression and sleep disturbances. The pandemic has been related to menstrual alterations, with depressive symptoms and sleep disorders. Amenorrhea is connected to depression, as observed on the functional hypothalamic amenorrhea. Conclusions The pandemic affected the menstrual cycle as well as the depressive symptoms and sleep. Practical implications of the study lead to the development of strategies for psychological intervention during the pandemic experience, in order to help medical trainees, with specific attention to women’s needs. Future studies should analyze the impact of other types of social stress events, on sleep, depression and the menstrual cycle beside the pandemic.

Background: Dysmenorrhea is pain during menstruation. There are 2 types of dysmenorrhea, namely primary dysmenorrhoea and secondary dysmenorrhoea. Primary dysmenorrhea is dysmenorrhea without any abnormalities in the genital organs. Secondary dysmenorrhea is dysmenorrhea in the presence of abnormalities in the genital organs, such as tumors, inflammation, etc. Acupressure is a development of massage therapy pressing on acupuncture points which increases oxygen saturation and causes muscle relaxation effects. Objectives: This study aims to determine the effectiveness of acupressure therapy for dysmenorrhea pain that occurs in adolescent girls. Design: This research used a one group pretest-posttest design. Methods: This research was conducted in June-October 2020 using primary and secondary data at Patriot Peterongan High School, Jombang Regency. The population of this study was all 60 young women attending Patriot Peterongan High School, Jombang Regency. The sampling technique used in this research was purposive sampling, so that the total research sample was 42 respondents. Data was collected using a pain intensity questionnaire in the form of a numerical VAS (Visual Analog Scale) with an intensity scale (0-10). Acupressure therapy is carried out at the bilateral LI 4 (hegu) and ST 36 pressure points 30 times for 3 consecutive days during menstruation. Data analysis used the Wilcoxon test. Results: The results of the study showed a decrease in the quality of dysmenorrhea pain, namely before therapy, it was 2.67 and SD 0.687. Meanwhile, after acupressure therapy for 3 consecutive days, the average result of dysmenorrhea pain intensity was 1.19 and SD 0.552. The results of the Wilcoxon test showed a decrease in the average intensity of dysmenorrhea pain on day 1, namely 0.22, day 2, namely 0.43 and day 3, namely 0.83 with a P value = 0.00, which means acupressure therapy at point LI 4 ( Hegu) and bilateral ST 36 are effective in reducing dysmenorrhea in adolescent girls. Conclusion: Acupressure therapy at points LI4 and ST 36 is effective in reducing dysmenorrhea in adolescents. As for suggestions for future researchers, this research can be combined with other therapies so that it can be more effective in reducing pain.