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This short paper outlines a potential solution to the ENDO Challenge posed by the US National Institutes of Health to spur development of painless, noninvasive diagnostic tools for early diagnosis in women suffering needlessly from endometriosis. Endometriosis is a common condition caused by regurgitation of menses backwards through the Fallopian tubes from the uterine cavity into the abdominal cavity during menstruation. A few still viable endometrial cells then implant widely and unpredictably throughout the abdominal cavity and become established on the surfaces of internal organs and the abdominal wall. There they live and remain responsive to cyclic hormones. The resulting patches of endometrial tissue bleed into the abdominal cavity with successive menstrual periods, causing pain. Because the endometrial implants can be scattered widely throughout the peritoneal cavity and can also spread to new locations therein, endoscopic or even open surgical methods rarely discover and eliminate all of them. The more that endometriosis spreads, the more difficult it is to diagnose and treat. Sadly, diagnosis may be delayed many years, with continued spread, due to normalization of intense menstrual pain by patients and their healthcare providers. Simple, noninvasive, low-cost screening methods, applicable to large numbers of women worldwide, are needed. The present proposed solution is a smart phone application that prompts the patient to track and record symptoms day-by-day, and later to compare the detailed patient record both with data for known populations of healthy women versus data for women with recently diagnosed endometriosis. The foundational principle for success is asking the best questions, based upon understanding of the abnormal physiology and anatomy of the endometriosis and published studies. Day to day tracking should reveal more abundant, accurate, and precise data than one-time history taking in a provider’s office. Use of artificial intelligence and

Menstrual pain or dysmenorrhea refers to abdominal cramping or pain before and during menstruation, causing a spectrum of discomfort among people who menstruate. Menstrual pain is often regarded as 'female trouble', as a nuisance that gets dismissed or as a symptom requiring medical intervention. While there are FemTech products that explicitly attend to menstrual pain, they predominantly seek to hide it without accounting for the lived experience of this pain. In this paper we use feminist disability studies (FDS) as a critical analytical lens to reframe the understanding of menstrual pain. Using this lens, we conduct an interaction critique of FemTech market exemplars for alleviating menstrual pain. We then ofer three design provocations to better design menstrual pain technology and call for designers to attend to menstrual pain as a cyclical, chronic lived experience with the potential of spurring leaky contagious coalitions., Part of ISBN: 9798400703300QC 20240613

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 < 0.001). Conclusions Menstrual pain is a prevalent problem among women of reproductive age and can affect their everyday life and professional environment, requiring work leaves on some occasions.

The experience of menstruation is often associated with negative connotations and gender stereotypes, which results in making it invisible. This research aimed to explore the perceptions, beliefs, and knowledge of young Spanish women regarding the menstrual cycle and menstruation and their impact on their lives. The study delves into their understanding, menstrual management practices, the types of menstrual products employed, and their experiences related to menstrual health. Qualitative methodology was used with discussion groups as a data collection technique. The participants comprised 45 young Spanish women, aged between 18 and 23, hailing from both rural and urban areas. The majority were university students, with some engaged in part-time work, and one participant working full-time. While many experienced menstrual pain ranging from mild to debilitating, a normalization of this pain often led them to forego seeking specialist assistance. Disposable menstrual products (DMPs) are the most used by participants, despite limited awareness of their absorption capacity. Regarding reusable menstrual products (RMPs), menstrual cup users emphasized comfort but expressed a need for proper training. Negative menstruation experiences could evoke fear and difficulties, underscoring the importance of providing comprehensive menstrual health education encompassing both theoretical and practical components.

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 gi

The experience of menstruation is often associated with negative connotations and gender stereotypes, which results in making it invisible. This research aimed to explore the perceptions, beliefs, and knowledge of young Spanish women regarding the menstrual cycle and menstruation and their impact on their lives. The study delves into their understanding, menstrual management practices, the types of menstrual products employed, and their experiences related to menstrual health. Qualitative methodology was used with discussion groups as a data collection technique. The participants comprised 45 young Spanish women, aged between 18 and 23, hailing from both rural and urban areas. The majority were university students, with some engaged in part-time work, and one participant working full-time. While many experienced menstrual pain ranging from mild to debilitating, a normalization of this pain often led them to forego seeking specialist assistance. Disposable menstrual products (DMPs) are the most used by participants, despite limited awareness of their absorption capacity. Regarding reusable menstrual products (RMPs), menstrual cup users emphasized comfort but expressed a need for proper training. Negative menstruation experiences could evoke fear and difficulties, underscoring the importance of providing comprehensive menstrual health education encompassing both theoretical and practical components.

This report described three cases with long-term severe dysmenorrhea, and these cases were referred to our department for medical help. The diagnosis of accessory cavitated uterine malformation (ACUM) was considered based on symptoms and ultrasound/MRI findings. Moreover, a combined approach involving hysteroscopic surgery and laparoscopic surgery was undertaken, and no complications occurred during surgery and in the post-operative period. It is important to consider ACUM in patients with severe dysmenorrhea that does not respond to medical management. Surgery is the most effective treatment for this anomaly.

Introduction: Bank workers who provide services to customers are required to have an optimal performance. They are vulnerable to stress that can interfere with their performance. Stress causes an increase in sebaceous glands, resulting in seborrheic dermatitis and an increase in hormones. This can cause contraction of the uterine muscles which can lead to dysmenorrhea. This study aims to determine the relationship between occupational stress and dysmenorrhea and seborrheic dermatitis among female bank workers. Methods: This research followed an analytic observational cross-sectional design using primary data from female workers at SumSel Babel Bank A. Rivai Branch. The sample consisted of 75 female bank workers, who met the inclusion and exclusion criteria and were selected using consecutive sampling. The independent variable in this study was occupational stress, while the dependent variables were dysmenorrhea and seborrheic dermatitis. Data were collected from primary data, the workplace stress scale questionnaire for occupational stress, the WaLIDD score for dysmenorrhea, and seborrheic dermatitis examination by a dermatologist. After obtaining the data, bivariate analysis was performed using the Chi-square test. Results: Sixty respondents (80%) had occupational stress, 47 respondents (62.7%) experienced dysmenorrhea, and 69 respondents (92%) did not experience seborrheic dermatitis. The results of statistical tests showed that there was a relationship between occupational stress and dysmenorrhea in female bank workers with a p-value 0.000 and no significant relationship between stress and the incidence of seborrheic dermatitis with p-value 0.202. Conclusion: Occupational stress can cause health problems including dysmenorrhea in female workers.

Uterine disorders are common and can be debilitating, but they are poorly understood. Endometriosis is the most common cause of secondary dysmenorrhea, yet existing treatments have substantial side effects and are not able to fully resolve pain for most patients. Many studies have shown that endometrial tissue from individuals with endometriosis has differential gene expression and DNA methylation patterns compared to endometrial tissue from controls. Data sharing efforts have made large amounts of genetic and epigenetic data available to researchers. However, it is technically challenging to compare datasets from different platforms and study designs, and these resources are underutilized. In this dissertation, I explore methods of combining DNA methylation and gene expression data to gain additional insights into endometrial disorders. First, I demonstrate that DNA methylation age can be used to understand ectopic endometriosis lesions. Then, I correlate DNA methylation age changes caused by hormonal treatment with differential gene expression in endometriosis. Given a candidate pathway, I then use datasets of infertility to determine whether these expression changes could provide insight into clinical phenotypes. Finally, I explore whether clinical phenotypes of menstrual pain resistant to non-steroidal anti-inflammatory drugs (NSAIDs) can predict altered signaling of related pathways in menstrual-derived tissues. This work explores methods of utilizing the vast amounts of genetic and epigenetic data that have already been generated, while taking into consideration both the unique dynamic properties of uterine tissue and the aspects of uterine dysfunction that are most disruptive to quality of life.

Bakgrund: Primär och sekundär dysmenorré hos barn är vanligt och bidrar till lidande och frånvaro från både skola och fritidsaktiviteter. Endometrios, som är den vanligaste orsaken till sekundär dysmenorré, innebär lidande och problematik som kan leda till kronisk smärta och infertilitet om det inte upptäcks och behandlas i tid. Skolsköterskan har en viktig funktion när det handlar om att identifiera, stötta och hjälpa barn med dysmenorré, varför det krävs kunskap om dysmenorré och endometrios hos skolsköterskan. Det är i nuläget oklart hur den kunskapen och erfarenheten ser ut. Syfte:Syftet med studien var att undersöka skolsköterskors kunskap och erfarenheter av dysmenorré hos barn och vilka samband som finns mellan kunskap och erfarenhet. Metod: En studie med kvantitativ design av tvärsnittstyp genomfördes genom en webbenkät som 113 skolsköterskor i Skåne besvarade anonymt. Materialet bearbetades sedan för att mynna ut i beskrivande och analytisk statistik. Resultat: Resultatet visade att råden skolsköterskor generellt ger till barn med dysmenorré går i linje med rådande forskning. Det visade även att skolsköterskor, oavsett kunskapsnivå, är i behov av mer utbildning gällande dysmenorré. Slutsats: För att fler skolsköterskor ska kunna hjälpa barn med dysmenorré på bästa sätt bör de få mer utbildning inom området. Vidare forskning bör göras kring barnens upplevelse av skolsköterskans stöd i förhållande till dysmenorré., Background: Primary and secondary dysmenorrhea are common problems in children and contributes to both suffering and absence from school and daily activities. Endometriosis, which is the most common cause of secondary dysmenorrhea, involves suffering and problems that can lead to chronic pain and infertility if not detected and treated in time. The school nurse has an important function when it comes to identifying, supporting, and helping children with dysmenorrhea, which is why knowledge of dysmenorrhea and endometriosis is required for the school nurse. It is currently unclear what the knowledge and experience look like. Purpose: The purpose of the study was to investigate school nurses' knowledge and experiences of dysmenorrhea in children and what connections exist between knowledge and experience. Method: A study with quantitative design of a cross-sectional type was conducted through a web survey that 113 school nurses in Skåne answered anonymously. The material was then processed to result in descriptive and analytical statistics. Results: The results showed that the advice school nurses generally give to children with dysmenorrhea is accurate according to current research. It also showed that school nurses, regardless of their level of knowledge, are in need of more education regarding dysmenorrhea. Conclusion: For more school nurses to be able to help children with dysmenorrhea in the best way, they should receive more education in the field. Further research is needed about how children experience the school nurse's support in relation to dysmenorrhea.

Adenomyosis corresponds to a benign gynecological pathology, which frequently occurs in female patients, where an invasion of the myometrium by the endometrium occurs causing microscopic and macroscopic changes in the uterus. The incidence and prevalence are difficult to estimate, however, it affects approximately 35% of women, this in relation to risk factors. There are multiple theories of why this pathology occurs, among the relevant ones are embryonic intussusception, presence of metalloproteinases, alteration in the modulation of estrogen and progestin receptors and others. The predominant signs and symptoms are dysmenorrhea and abnormal uterine bleeding. To have an accurate diagnosis, a biopsy is performed after hysterectomy; however, in nowdays the ultrasound (US) and nuclear magnetic resonance (MRI) are useful tools for diagnosis. Currently the treatment of choice corresponds to hysterectomy, on the other hand there are alternatives in case the patient wants to continue with the desire to reproduce. The prognosis is individualized and uncertain according to each patient., La adenomiosis corresponde a una patología ginecológica benigna, la cual se presenta frecuentemente en pacientes femeninas, en donde ocurre una invasión hacia el miometrio por parte del endometrio, provocando cambios microscópicos y macroscópicos en el útero. La incidencia y la prevalencia son difíciles de estimar; sin embargo, afecta aproximadamente a 35% de las mujeres, esto en relación con los factores de riesgo. Existen múltiples teorías acerca de por qué ocurre esta patología, dentro de las relevantes se encuentran la invaginación embrionaria, la presencia de metaloproteinasas, la alteración en la modulación de receptores estrogénicos y progestágenos, entre otras. Los signos y síntomas predominantes son la dismenorrea y el sangrado uterino anormal. Para tener un diagnóstico certero se realiza una biopsia posterior a la histerectomía; sin embargo, hoy en día el ultrasonido (US) y la resonancia magnética nuclear (RMN) son herramientas útiles para el diagnóstico. Actualmente, el tratamiento de elección corresponde a la histerectomía; por otra parte, existen alternativas en caso de que continúe con el deseo de reproducción. El pronóstico es individualizado e incierto según cada paciente.

Endometriosis is a clinical condition characterized by the presence of stroma and extrauterine endometrial glands, that is to say, they are abnormally located outside the uterine cavity, usually found in the pelvis; uterosacral ligaments, ovaries and Douglas bag, however they can also be located in various places such as the intestine, pleural cavity and diaphragm. It is a benign, estrogen-dependent inflammatory process that causes discomfort that can interfere with a woman's quality of life, with a wide range of symptoms that vary from dysmenorrhea, dyspareunia to infertility and chronic pain that can be severely debilitating and incapacitating, it can generate damages in diverses stages: premenarchal, reproductive and in some postmenopausal occasions; It also affects various spheres: social, mental and physical. Over the years its possible pathogenesis has been investigated, some of the main hypotheses are retrograde menstruation, the induction theory, lymphatic or vascular dissemination and metaplasia of the germinal epithelium. The decisive diagnosis of endometriosis is surgical and among its treatments we have available hormonal, non-hormonal and surgical medications. It is a frequent disease that produces great disagreement in the life of the patient, so as health professionals we must manage this pathology in the best way with individualized, timely and effective treatment, either pharmacologically or surgically, depending on the case., La endometriosis es una condición clínica que se caracteriza por presencia de estroma y glándulas endometriales extrauterinas, es decir, que se ubican anormalmente fuera de la cavidad uterina. Por lo general, se encuentran en la pelvis, ligamentos uterosacros, ovarios y saco de Douglas; sin embargo, también se pueden localizar en diversos sitios como lo es el intestino, la cavidad pleural y el diafragma. La endometriosis es un proceso inflamatorio de carácter benigno dependiente de estrógenos, que causa malestar y puede llegar a interferir en la calidad de vida de la mujer, con una amplia gama de síntomas que varían desde dismenorrea, dispareunia hasta infertilidad y dolor crónico, que puede ser severamente debilitante e incapacitante, puede generar perjudicaciones en etapas: premenárquica, reproductiva y en ocasiones postmenopáusica; además, afecta diversas esferas: social, mental y física. Durante años se ha investigado su posible patogénesis, algunas de las principales hipótesis son la menstruación retrograda, la teoría de la inducción, la diseminación linfática o vascular y la metaplasia del epitelio germinal. El diagnóstico determinante de la endometriosis es quirúrgico, y entre sus tratamientos se tiene a disponibilidad de medicamentos hormonales, no hormonales y quirúrgicos. Es una enfermedad frecuente que produce gran disconformidad en la vida de la paciente, por lo que como profesionales de la salud es necesario manejar esta patología de la mejor manera, con un tratamiento individualizado, oportuno y eficaz, ya sea de manera farmacológica o quirúrgica, según sea el caso.

Dysmenorrhea is a gynecological disease that affects a large number of women of childbearing age, characterized by the presence of chronic pelvic pain during the menstrual period, becoming disabling enough to negatively affect the daily activity of the woman, limiting their actions in the social, personal and professional sphere. Through the study of comparative regulations of countries in Asia, Europe and Latin America, where leave for painful menstruation has already been approved or discussed, the feasibility of increasing paid leave for three days a month for women who provide labor services in Ecuador, who medically demonstrate suffering from dysmenorrhea. In such a way that the Ecuadorian State guarantees the full exercise of rights, ensuring the well-being of women, reconciling their right to health and work, since it offers the possibility of justified absence without any repercussion of their labor rights., La dismenorrea es una enfermedad ginecológica, que afecta a una gran cantidad de mujeres en edad fértil, se caracteriza por la presencia de dolor pélvico crónico durante el periodo menstrual, llegando a ser lo suficientemente incapacitante como para afectar de forma negativa la actividad cotidiana de la mujer, limitando su accionar en el ámbito social, personal y profesional. Mediante el estudio de normativa comparada de países de Asia, Europa y Latinoamérica, donde ya se ha aprobado o discutido la licencia por menstruaciones dolorosas, se analizará la viabilidad de incrementar una licencia remunerada por tres días al mes para las mujeres que prestan servicios laborales en Ecuador, que demuestren médicamente padecer dismenorrea. De tal manera que el Estado Ecuatoriano garantice el pleno ejercicio de los derechos, asegurando el bienestar de la mujer, conciliando su derecho a la salud y al trabajo, ya que brinda la posibilidad de ausentarse de manera justificada sin ninguna repercusión de sus derechos laborales.

Introduction: Dysmenorrhea is a prevalent gynecological disorder that is characterized by the presence of unpleasant menstrual cramps. This condition has been found to have significant medical, psychological, and social implications for individuals who experience it. Although commonly seen as an inherent characteristic of a properly functioning reproductive system, it can potentially operate as a diagnostic tool for underlying illnesses. Regrettably, dialogues pertaining to dysmenorrhea are sometimes prohibited, particularly among males, within diverse cultural contexts. Objective: The primary objective of this study is to evaluate the level of knowledge and attitudes among allied health professions students enrolled at various universities of West Bengal (WB), India with regard to dysmenorrhea. This study aims to examine the impact of cultural variables on the knowledge and communication surrounding dysmenorrhea, specifically within conservative Indian districts. Methods: The study sample consisted of 494 students enrolled in allied health professions faculties at different universities of WB. Data collection took place from September 2021 to February 2023. A meticulously designed survey was employed to gather data pertaining to the various sources of knowledge, levels of awareness, attitudes toward discussing dysmenorrhea, and willingness to engage in conversations about menstruation with prospective females. Data interpretation involved the utilization of statistical analysis techniques, such as descriptive statistics and correlation analysis. Results: In terms of demographic composition, the study consisted of 86% female participants and 14% male participants. The mean knowledge scores of females (14.41 ± 3.14) were found to be considerably higher compared to males (13.75 ± 4.56). The primary sources of information were the internet (58.3%), maternity figures (48.8%), and educational institutions (46.2%). An observed positive connection (r = 0.244) was found bet

Tato práce se zabývá bolestivou menstruací (dysmenorea). Práce je rozdělena do dvou částí, teoretické a praktické. V teoretické části je popsána anatomie vnitřních pohlavních orgánů ženy, fyziologie menstruačního cyklu a také jeho řízení. Dále je zde podrobněji popsána celková problematika dysmenorey a kvalita života právě s bolestivou menstruací. Druhá část bakalářské práce pojednává přímo o tématu bolestivé menstruace - dysmenorey. V praktické části bylo použito kvantitativního průzkumu pomocí dotazníkového šetření. Hlavním cílem průzkumu bylo zjistit, jak respondentky tlumí bolest při menstruaci a zda bolestivou menstruaci mají také matky respondentek. Vedlejším cílem práce bylo zjistit, jakými konkrétními příznaky se dysmenorea u respondentek projevuje a zda respondentky znají i nefarmakologické metody tlumení bolesti. Shrnutí výsledků, které přinesl průzkumný dotazník, je popsáno v textu a znázorněno v grafech., This bachelor thesis deals with "painful menstruation (dysmenorrhea) ". The work is divided into two parts - theoretic and exploratory part. The theoretical part describes the anatomy of the women´s internal genital organs, physiology of the menstrual cycle and it's managment. Futhermore, the overal issue of dysmenorrhoea and the quality of life with menstrual pain are described in more details. The second part of this bachelor's thesis deals directly with the topic of painful menstruation - dysmenorrhea. In the exploratory part the quantitative survey with questionnaire was used. The main goal of the survey was to find out how the respondents supress the pain during menstruation and whether the mothers of respondents also have painful periods. A secondary goal of this thesis was to find out how the specific symptoms of dysmennorrhea are shown and if the respondents also know non-pharmacological methods of pain relief. The summary of the results produced by the survey questionnaire are described in the text and shown in graphs., Fakulta zdravotnických studií, Student/ka úspěšně obhájil/a bakalářskou práci, odpověděl/a na doplňující otázky oponenta., Dokončená práce s úspěšnou obhajobou

Background: Adolescence is when there is a sex change, both primary and secondary. In adolescent girls, the primary sex change is marked by the arrival of menstruation. Dysmenorrhea is pain that is felt during the menstrual process. Several types of non-medical therapy can be used to treat dysmenorrhea, including herbal drink products. Objectives: This research analyzed the relationship between knowledge and herbal drink product consumption patterns with dysmenorrhea of female adolescents in Pondok Pesantren Subulussalam Surabaya. Methods: This research was an analytical observational study with the cross-sectional method. This study's population was young women living in Pondok Pesantren Subulussalam Surabaya, Indonesia. The research sample was taken using the census sampling method where the population was sampled, namely 49 students. Data were collected by interview using a knowledge questionnaire of herbal drink products, the SQ – FFQ questionnaire, and the Numeric Rating Scale questionnaire. Results: From the research that has been done, the results showed that the average age of the research respondents was 14 years six months, and as many as 85.7% of respondents have normal menarche age, as many as 26.5% of respondents have long menstrual periods, as many as 30.6% of respondents know it is classified as lacking, and 75.5% of respondents have a consumption pattern of herbal beverage products with a seldom category. Conclusions: There was a relationship between knowledge of herbal drink products and the incidence of dysmenorrhea, but there was no relationship between consumption patterns of herbal drink products and the incidence of dysmenorrhea., ABSTRAK Latar Belakang: Usia remaja merupakan usia dimana terdapat pertumbuhan seksual, baik primer maupun sekunder. Pada remaja putri, perubahan kelamin primer ditandai dengan datangnya menstruasi. Dismenore merupakan sebuah rasa sakit yang dirasakan selama proses menstruasi. Terdapat beberapa jenis terapi non medis yang dapat digunakan untuk mengatasi dismenore, salah satunya adalah menggunakan produk minuman herbal yang dapat digunakan untuk mengatasi dismenore, salah satunya adalah menggunakan produk minuman herbal. Tujuan: Tujuan dari penelitian ini adalah untuk menganalisis hubungan pengetahuan dan pola konsumsi produk minuman herbal dengan kejadian dismenore pada remaja putri di Pondok Pesantren Subulussalam Surabaya, Indonesia. Metode: Penelitian ini merupakan penelitian yang termasuk dalam penelitian observasional analitik dengan metode potong lintang. Populasi pada penelitian ini adalah remaja putri yang tinggal di Pondok Pesantren Subulussalam Surabaya, Indonesia. Pengambilan sampel penelitian menggunakan metode sampling sensus dimana semua populasi dijadikan sampel yaitu sebanyak 49 siswi. Pengambilan data dilakukan dengan cara wawancara menggunakan kuesioner pengetahuan produk minuman herbal dan kuesioner SQ – FFQ, serta kuesioner Numeratic Rating Scale. Hasil: Dari penelitian yang telah dilakukan didapatkan hasil bahwa rata – rata usia responden penelitian adalah 14 tahun 6 bulan, dan sebanyak 85,7% responden memiliki usia menarche normal, sebanyak 26,5% responden memiliki lama menstruasi panjang, sebanyak 30,6% responden memiliki pengetahuan tergolong kurang dan 75,5% responden memiliki pola konsumsi produk minuman herbal dengan kategori jarang. Kesimpulan: Terdapat hubungan antara pengetahuan produk minuman herbal dengan kejadian dismenore, namun tidak terdapat hubungan antara pola konsumsi produk minuman herbal dengan kejadian dismenore.

55 p. -- Bibliogr.: p. 27-30, Marko kontzeptuala eta justifikazioa: Dismenorrea hilekoan ematen den minaren izen teknikoa da, zeina patologia batekin erlazionatuta egon daitekeen edo ez, hots bigarren mailako dismenorrea edo lehen mailako dismenorrea, hurrenez urren. Bi mota hauetatik prebalentzia altuena duena lehen mailako dismenorrea da, zeinak 17 eta 24 urte artean piko gorena duen. Dismenorreak adin tarte honetako emakumeei egunerokotasunean eragin diezaiekeen mugapena nabarmena dela ikusita, terapia alternatiboetara jo da mina murrizteko helburuarekin. Helburua: Ariketa fisikoaren eraginkortasuna zehaztu adin emankorrean dauden emakumeen hilekoarekin erlazionatutako minaren murrizketan. Metodologia: Berrikuspen honetan lehen mailako dismenorrea diagnostikatuta duten emakumeak kontuan izan dituzten ikerketak aztertu dira, zeinetan intentsitate gutxiko zein handiko ariketa fisikoen eraginkortasuna zehaztu den hilekoarekin erlazionatutako minarekiko. Bilaketak Medline OVID, Cochrane, Psycinfo, Cinahl eta Lilacs datu baseetan eta RNAO eta NICE erakundeetan burutu dira. Guztira, hamabost artikulu erabili dira emaitzak osatzeko. Artikuluak 2012. eta 2022.urteetan argitaratutakoak dira. Emaitzak: Ikerketa hauetan ariketa fisikoak, hala nola, intentsitate gutxikoak (erlaxazioa, yoga, ariketa isometrikoak, luzaketak, pilatesa eta Kegel ariketak) eta intentsitate handikoak (dantza, korrika, spinning-a eta HIIT), dismenorrea murrizten dutela zehaztu da. Ondorioak: Nahiz eta ariketa fisikoarekin dismenorrearen murrizketa eman, ebidentzia maila esanguratsua duten azterketa gehiagoren beharra azpimarratzen da, lortutako emaitzen baliagarritasuna zehazteko eta emaitza hauek emakumeen artean orokortuak izateko.

48 p.: il.-- Bibliogr.: p. 26-27, Marku eta justifikazioa: Dismenorrea primarioa (PD) hilerokoaren aurreko egunetan edo hilerokoan zehar ematen den eta ageriko arazorik ez duen umetokiko min bezala definitzen da. PDa gaixotasun ginekologiko ohikoena da menstruatzen duten emakumeen artean. Historikoki, hilekoa zikin, lizun, toxiko eta gaiztotzat jo izan da eta oraindik ere gai tabua da, mitoz eta sinesmenez blai jarraitzen duena. Azken urte hauetan, feminismoaren gorakada izan dela medio, emakume askok hilekoaren alterazioen, hilekoa bizitzeko modu berrien eta hilekoaren osasunaren garrantzia aldarrikatzen hasi dira. Hala eta guztiz ere, emakumeen ehuneko handi batek ez du osasun-arretarik bilatzen PDarekin erlazionatutako zeinu eta sintomak (z/s) dituztenean eta, orokorrean, automedikazioara jotzen dute. Helburu orokorra: Dismenorrea primarioak bizi-kalitatean duen eragina eta horrekin lotutako erizaintzako interbentzioak aztertzea. Metodologia: Literatura zientifikoaren berrikusketa kritikoa gauzatu da Medline, Cochrane, PsycInfo, Embase, Cuide eta Cinahl datu-baseetan zein Enfermería Clínica, American Journal of Obstetrics and Gynecology eta BMC aldizkarietan bilaketak eginez. Azkenean, Gradu Amaierako lan honetan 2011 urtetik aurrera, ingelesez zein gazteleraz argitaratutako 15 artikulu erabili dira: 7 ikerketa kuantitatibo transbertsalak, ikerketa kualitatibo bat, 5 entsegu kliniko eta 2 errebisio bibliografikoak. Erantzunak eta eztabaida: Emaitzak bi kategorietan banatu ziren; alde batetik PDak bizi- kalitatean dituen eraginak eta bestetik PDarekin erlazionatutako erizaintzako interbentzioak. PDak eragin biopsikosoziala dauka patologia hau pairatzen duten emakumeengan. Erizaintzako interbentzioei dagokionez bost dira aztertutakoak: osasunerako hezkuntza eta kirola izan dira onurarik handiena erakutsi duten esku-hartzeak; bestalde, nutrizio-ohiturek, bero-terapiak eta akupresioak onbide moderatuagoa erakutsi dute. Ondorioak eta limitazioak: Literaturaren berrikusketa honetan berretsi egin da

Background primary dysmenorrhea (PD) is considered to be a cyclic chronic pelvic pain, with its onset in menstrual periods, often accompanied by the presence of myofascial trigger points (MTP). Most MTPs in subjects with chronic pelvic pain are in the inferior part of the abdomen, in the rectus abdominis (RA) area. Central sensitization is closely related to chronic pain processes. Previous studies in women with chronic pelvic pain reported central sensitization signs in their subjects, such as lower pain pressure threshold (PPT). Several authors agree that PPT in the tibialis anterior (TA) muscle, seems to be a reliable reference for signs of central sensitization. Amongst the factors that seem to accompany central sensitization, the presence of anxiety needs to be considered. The aim of the present study was to analyze the existence of hyperalgesic MTPs in RA, central sensitization signs and anxiety in women with PD, in comparison with a control group (CG). Methods: This study was designed following an observational, cross-sectional, case-control model. A total sample of 80 subjects was recruited trough social webs and advertising (PD n = 39) (CG n = 41). PPT in RA and AT was assessed bilaterally through algometry, and anxiety was evaluated through the State–Trait Anxiety Inventory. Results: Statistically significant differences (p < 0.001) were shown for NRS average and maximum increase, as well as lower bilaterally RA and TA PPT in favor of PD group compared to CG. State or trait STAI did not show any statistically significant differences (p > 0.05) between groups. Conclusions: In this study, women with PD reported symptoms of myofascial pain syndrome and central sensitization, when compared with healthy controls, without any sign of anxiety acting as a confounder for pain sensitivity., Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería), Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Despite being one of the most common gynecological issues faced by women of reproductive age, dysmenorrhea largely remains an ignored, underdiagnosed and untreated condition. It continues to be a public health issue and has a significant impact on the quality of life of the affected women in terms of inability to lead routine activities, absenteeism from academic activities or work and reduced social activities. Currently, existing evidence correlates and implicates the excessive synthesis of prostaglandins with the menstrual pain. Hence, treatment approaches that can inhibit prostaglandins' production or already formed prostaglandins can provide relief in dysmenorrhea. In this review, the impact of dysmenorrhea on the quality of life of women, the role of prostaglandins in the pathogenesis of dysmenorrhea, and how nonsteroidal anti-inflammatory drugs (NSAIDs) like mefenamic acid can be safe and effective in managing dysmenorrhea are discussed.

Penelitian ini bertujuan untuk mengetahui hubungan dari dukungan keluarga sebagai mekanisme koping remaja dengan dismenorea. Desain penelitian yang digunakan ialah observasional dengan pendekatan cross-sectional. Sampel penelitian adalah remaja putri di Sekolah Menengah Atas Negeri di Kota Kendari yang berjumlah 81 responden. Teknik pengambilan sampel dengan total sampling. Instrumen pengumpulan data yang digunakan adalah kuesioner dukungan keluarga, dan kuesioner perilaku remaja. Data dianalisis dengan uji statistik Chi-square. Hasil penelitian menunjukkan 42 responden dari kategori dukungan keluarga baik sebanyak 36 (62,06%) dengan perilaku positif dan 6 (26,08%) dengan perilaku negatif, 22 responden dari kategori dukungan cukup sebanyak 14 (24,13%) dengan perilaku positif dan 8 (34,78%) dengan perilaku negatif, 17 responden dari kategori dukungan kurang sebanyak 8(13,79%) dengan perilaku positif dan 9 (39,13%) dengan perilaku negatif. Berdasarkan hasil uji statistik menggunakan chi-square menunjukkan bahwa nilai p <0,05. Secara statistik ada hubungan antara dukungan keluarga dengan perilaku remaja putri dalam mengatasi dismenorea., This study aims to determine the relationship of family support as a coping mechanism for adolescents with dysmenorrhea. The research design used was observational with a cross-sectional approach. The research sample was young women at State Senior High Schools in Kendari City, totaling 81 respondents. Sampling technique with total sampling. The data collection instruments used were family support questionnaires and adolescent behavior questionnaires. Data were analyzed by Chi-square statistical test. The results showed that 42 respondents from the good family support category were 36 (62.06%) with positive behavior and 6 (26.08%) with negative behavior, 22 respondents from the sufficient support category as many as 14 (24.13%) with positive behavior and 8 (34.78%) with negative behavior, 17 respondents from the less support category as many as 8 (13.79%) with positive behavior and 9 (39.13%) with negative behavior. Based on the results of statistical tests using chi-square showed that the value of p <0.05. Statistically, there is a relationship between family support and young women's behavior in overcoming dysmenorrhea.

The prevalence of dysmenorrhea in Indonesia is 55% and 15%. Dysmenorrhea causes painful cramping in the lower abdomen, affecting adolescents' absenteeism from work and school activities by about 13-51%. It's perhaps influenced by age, menarche, body mass index (BMI), pain level, anemia, knowledge, weight, and height are associated with the incidence of dysmenorrhea. The purpose of this study was to determine the difference in age, menarche, mass index (BMI), pain level, HB levels, knowledge, weight, and height of students who experienced dysmenorrhea and non-dysmenorrhea and their relationship with dysmenorrhea in high school girls students of Aziziah boarding school Palembang. This research is a cross-sectional study. We collected 110 students who had met the inclusion criteria. The independent variables included knowledge, HB levels, levels, body mass index, height, and weight. The dependent variable was Primary Dysmenorrhea. Data were collected through interviews and observations. Statistical analysis using SPSS and tested by a non-parametric test method. The body mass index, pain level, and body weight of students in the primary dysmenorrhea group were significantly different compared to the primary dysmenorrhea group (p < 0.05). There is a significant relationship between body mass index, level, and weight of SMA Pondok Aziziah Palembang high school students with the incidence of primary dysmenorrhea, each with p = 0.01, p = 0.00, and p = 0.025. The body mass index (BMI), pain levels, and weight of girls students with dysmenorrhea were significant difference from non-dysmenorrhea, as well as a significant relationship with the incidence of dysmenorrhea in students at the Aziziah Boarding High School Palembang.

The period of transition from childhood to adulthood is called adolescence. Adolescent girls experience physical changes, namely, starting to menstruate. Complaints that often arise during menstruation are menstrual pain (dysmenorrhea), which can be reduced by doing abdominal stretching exercises that will stimulate the production of endorphins and give a feeling of calm and resistance to painful feelings, especially menstrual pain (dysmenorrhea). This study aimed to determine the effect of abdominal stretching exercise on the intensity of dysmenorrhea in adolescent girls in Ma Nurut Taqwa Besuki-Situbondo. The research design used was pre-experimental with a one-group pre-posttest approach. The population in this study was 83 respondents, with a sample of 37 respondents using purposive sampling, collecting data by questionnaires, and then processing the data using SPSS using the paired t-test. Wilcoxon test analysis results get a sig value Of 0.000 < 0.05. This proves that giving abdominal stretching exercises affects the intensity of dysmenorrhea in adolescent girls in Ma Nurut taqwa besuki-Situbondo.

Background: Pain during the menstrual period is called dysmenorrhea. This pain is felt in the lower side of the abdomen or Michaelis. The pain can be felt before, during, or after menstruation and can be colic or continuous. Students said that they experienced pain during menstruation. A warm compress can relieve the pain because its function is to improve blood circulation. Objective: The effect of health education on knowledge levels of first years students of the nursing study program about giving warm compress to deal with dysmenorrhea in STIKes Eka Harap Palangka Raya. Methods: This research used a pre-experimental method with one group pretest-posttest design. The sample was chosen using total sampling, which consisted of 52 respondents with students with IA and IB degrees. The data were collected using a questionnaire and analyzed using non-parametric statistics Wilcoxon signed ranks test. Results: Based on the statistical test of Wilcoxon signed ranks test with p-value was 0.05, because the sig asymp value=0.000, then ho was rejected which means that there is an effect of health education on knowledge levels. Conclusion: It was concluded that there is an increased level of knowledge after being given health education. Expected further research can develop research on various menstrual disorders in female students.

Premenstrual syndrome (PMS) is a collection of symptoms caused by hormonal changes that last about two weeks before menstruation until the start. In addition to hormonal changes (an increased estrogen hormone), several other contributing factors include vitamin and mineral deficiencies such as vitamin B, calcium, magnesium, lack of physical activity, and stress. This study aimed to find out more clearly the effect of consuming red spinach pudding on complaints of dysmenorrhea and symptoms of premenstrual syndrome in adolescent girls. This study used a Quasy Experiment with a two-group pretest-posttest design with a total sample of 60 people. Based on the linear regression analysis results after controlling for the confounding variables BMI and HB levels, the mean reduction in PMS scores in the intervention group was 2.44 and in the control group was 0.54. The mean difference between groups was 2.98, with a p-value = 0.009. The results showed a decrease in the mean premenstrual syndrome score in the group of young women who consumed red spinach pudding.

This paper presents a study to assess “Effectiveness of muscle stretching exercises and dry ginger versus muscle stretching exercises on primary dysmenorrhea among nursing students: An extensive comparative evaluation.

Background: Type 1 diabetes (T1D) is associated with reproductive dysfunction, particularly in the setting of poor metabolic control. Improvements in contemporary management ameliorate these problems, albeit at the cost of increased exogenous insulin and rising obesity, with emerging reproductive implications. Objective(s): To evaluate changes in body mass index (BMI) and the relationship between obesity, menstrual irregularity and polycystic ovary syndrome (PCOS) in young women with T1D, compared with controls. Method(s): Longitudinal observational study using data from the Australian Longitudinal Study in Women's Health of the cohort born in 1989-95, from 2013 to 2015. Three questionnaires administered at baseline and yearly intervals were used to evaluate self-reported menstrual irregularity, PCOS and BMI. Result(s): Overall, 15 926 women were included at baseline (T1D, n = 115; controls, n = 15 811). 61 women with T1D and 8332 controls remained at Year 2. Median BMI was higher in women with type 1 diabetes (25.5 vs 22.9 kg/m2, P <.001), where over half were overweight or obese (54.4% vs 32.9%, P <.001). Median BMI increased by 1.11 and 0.45 kg/m2, in the T1D and control groups, respectively. T1D was independently associated with an increased risk of menstrual irregularity (RR 1.22, 95% CI 1.02-1.46) and PCOS (RR 2.41, 95% CI 1.70-3.42). Obesity conferred a 4-fold increased risk of PCOS, compared to those with normal BMI (RR 3.93, 95% CI 3.51-4.42). Conclusion(s): Obesity is prevalent amongst women with T1D and may be a key contributor to the higher risk of menstrual irregularity and PCOS in this cohort, representing an important opportunity for prevention and intervention.Copyright © 2020 John Wiley & Sons Ltd

The present study was conducted to investigate and analyze the recent and relevant studies about primary dysmenorrhea and its pathophysiology. Literature searches were performed electronically in PubMed, Medline, ISI, DOAJ, Springer, Embase. Web of Knowledge, DOAJ, Google Scholar and the Cochrane Library for original articles written in English and in Scielo, Lantidex, Imbiomed-L, Redalycand Google Scholar for original articles written in Spanish. The searches included the key words (Mesh): menstruation, menstrual period, menstrual cycle, dysmenorrhea, primary ysmenorrhea, inflammatory substance and inflammatory markers. Publications from January 1980 to February 2021 were reviewed. Dysmenorrhea is the most common gynecologic condition experienced by menstruating women. It is characterized by crampy lower abdominal pain that can range widely in severity, and associated to others symptoms. Its overall impact often has significant medical and psychosocial implications. The hallmark of primary dysmenorrhea is painful menses in the absence of any associated macroscopic pathologic process, and it occurs in up to 50% of menstruating females and causes significant disruption in quality of life and absenteeism. An excessive or imbalanced amount of prostanoids and possibly eicosanoids released from the endometrium during menstruation have been mentioned as the main cause of primary dysmenorrhea. The uterus is induced to contract frequently and dysrhythmically, with increased basal tone and increased active pressure. Uterine hypercontractility, reduced uterine blood flow and increased peripheral nerve hypersensitivity induce pain. Diagnosis rests on a good history with negative pelvic evaluation findings. This narrative review investigated and analyzed the pathophysiology of primary dysmenorrhea and the implications of other chemical substances., La presente revisión fue realizada con el objeto de investigar y analizar los estudios más recientes y elevantes sobre la dismenorrea primaria y su fisiopatología. La literatura revisada fue realizada electrónicamente en PubMed, Medline, ISI, DOAJ, Springer, Embase. Web of Knowledge, DOAJ, Google Scholar y la Librería Cochrane para los artículos escritos en inglés. Scielo, Lantidex, Imbiomed-L, Redalyc y Google Scholar fueron revisados en búsqueda de artículos escritos en español. La búsqueda incluyó las palabras claves (Mesh): menstruación, periodo menstrual, ciclo menstrual, dismenorrea, dismenorrea primaria, substancias inflamatorias y marcadores inflamatorios. Se revisaron publicaciones desde enero 1980 a febrero 2021. La dismenorrea es la condición ginecológica más común presente en la mujer menstruante. Se caracteriza por dolor en el abdomen bajo tipo cólico, su severidad es variable y está asociada con otros síntomas. Su impacto general tiene implicaciones médicas y psicosociales significativas. La característica de la dismenorrea primaria son las menstruaciones dolorosas en ausencia de un proceso patológico macroscópico, ocurre hasta en un 50% de las mujeres menstruantes y causa alteración de la calidad de vida y ausentismo. Un exceso o desbalance de la cantidad de prostanoides y posiblemente liberación de eicosanoides por el endometriodurante la menstruación han sido mencionados como la principal causa de la dismenorrea  primaria. El útero es inducido a contraerse frecuente y disritmicamente con aumento del tono basal e incremento de presión activa. La hipercontractibilidad del útero reduce el flujo sanguíneo e incrementa la hipersensibilidad periférica lo cual induce dolor. Esta revisión narrativa investigó y analizó la patofisiología de la dismenorrea primaria y las implicaciones de otras sustancias químicas.

Abstract Objective Primary dysmenorrhea and secondary dysmenorrhea due to endometriosis share overlapping symptoms and likely demonstrate aspects of central sensitization. The present study aimed to identify distinct phenotypes of women who have dysmenorrhea with and without endometriosis to shed light on the unique mechanisms contributing to the pathogenesis of each condition. Methods An online survey was used to investigate the relationship between ratings of menstrual pain severity, menstrual symptoms (abdominal cramps, abdominal discomfort, low back pain, headache, body aches, bloating, nausea, diarrhea, increased bowel movements), widespread pain, and functional pain disability in a community sample of 1,354 women (aged 18–50) with menstrual pain in Australia. Results Compared with women without endometriosis, those with endometriosis had statistically significant higher menstrual pain severity (P<0.01), symptom severity and fatigue (all symptoms P<0.001, although only cramps and bloating were clinically significant), widespread pain sites (P<0.001), and functional pain disability (P<0.001, although this difference was not clinically significant). When examining symptoms by pain severity, women with severe menstrual pain were more likely to experience symptoms than women with less severe pain, regardless of the presence of endometriosis. Similar predictors of functional pain disability emerged for women with and without endometriosis, such as body aches, nausea, fatigue, and widespread pain, respectively, suggesting the presence of central sensitization in both groups. Logistic regression revealed that after accounting for menstrual pain severity (odds ratio [OR], 1.61) and duration (OR, 1.04), symptoms of bloating (OR, 1.12), nausea (OR

Uterine adenomyosis is a commonly encountered estrogen-dependent disease in reproductive-age women, causing heavy menstrual bleeding, intense pelvic pain, and infertility. Although adenomyosis was previously considered a disease of multiparous women, it is becoming increasingly evident that it also affects younger nulliparous women and may compromise their fertility potential. It is clear that hysterectomy, the standard approach to definitively manage the disease, is not an option for patients wishing to preserve their fertility, so there is an urgent need to develop novel conservative strategies. We searched the current literature for available methods for conservative management of adenomyosis, including both pharmacological and surgical approaches. There is no existing drug that can cure adenomyosis at present, but some off-label treatment options may be used to tackle disease symptoms and improve fertility outcomes. Adenomyosis in patients wishing to conceive can be 'treated' by conservative surgery, though these procedures require highly experienced surgeons and pose a considerable risk of uterine rupture during subsequent pregnancies. While currently available options for conservative management of adenomyosis do have some capacity for alleviating symptoms and enhancing patient fertility perspectives, more effective new options are needed, with gonadotropin-releasing hormone antagonists showing encouraging results in preliminary studies.

Background: The first objective of this review was to present, based on recent literature, the most frequently applied medical options (oral contraceptive pills (OCPs) and progestogens) for the management of symptomatic endometriosis, and evaluate their effectiveness in treating premenopausal women with endometriosis-associated pelvic pain, dysmenorrhea, non-menstrual pelvic pain and dyspareunia. The second objective was to review the concept of progesterone resistance and newly available treatment options. Methods: We reviewed the most relevant papers (n = 73) on the efficacy of OCPs and progestogens as medical therapy for endometriosis, as well as those on progesterone resistance and new medical alternatives (oral gonadotropin-releasing hormone (GnRH) antagonist). Eleven papers, essentially reviews, were selected and scrutinized from among 94 papers discussing the concept of progesterone resistance. Results: Having reviewed the most significant papers, we can confirm that OCPs and progestogens are effective in two-thirds of women suffering from endometriosis, but that other options are required in case of failure (in one-third of women due to progesterone resistance) or intolerance to these compounds. It is clear that there is a need for effective long-term oral treatment capable of managing endometriosis symptoms, while mitigating the impact of side effects. Biochemical, histological and clinical evidence show that estrogens play a critical role in the pathogenesis of endometriosis, so lowering levels of circulating estrogens should be considered an effective medical approach. The efficacy of three oral GnRH antagonists is discussed on the basis of published studies. Conclusion: There is a place for GnRH antagonists in the management of symptomatic endometriosis and clinical trials should be conducted, taking into account the different phenotypes in order to propose novel algorithms.

To evaluate the effectiveness of a new class of medical drugs, namely oral gonadotropin-releasing hormone (GnRH) antagonists, in the management of premenopausal women with endometriosis-associated pelvic pain. We reviewed the most relevant papers ( = 27) on the efficacy of new medical alternatives (oral GnRH antagonists) as therapy for endometriosis. We first briefly summarized the concept of progesterone resistance and established that oral contraceptives and progestogens work well in two-thirds of women suffering from endometriosis. Since clinical evidence shows that estrogens play a critical role in the pathogenesis of the disease, lowering their levels with oral GnRH antagonists may well prove effective, especially in women who fail to respond to progestogens. There is a need for reliable long-term oral treatment capable of managing endometriosis symptoms, taking into consideration both the main symptoms and phenotype of the disease. Published studies reviewed and discussed here confirm the efficacy of GnRH antagonists. There is a place for GnRH antagonists in the management of symptomatic endometriosis. Novel algorithms that take into account the different phenotypes are proposed.

BackgroundWomen with endometriosis are commonly treated by their sole provider. In this single-provider model of care, women frequently report long diagnostic delays, unresolved pelvic pain, multiple laparoscopic surgeries, sequential consultations with numerous providers, and an overall dissatisfaction with care. The emergence of multidisciplinary endometriosis centers aims to reduce diagnostic delays, improve pain management, and promote patient satisfaction; however, baseline data at the time of presentation to a multidisciplinary center are lacking.MethodsA real-world, retrospective, single-site, cross-sectional study of women with surgically confirmed and/or clinically diagnosed endometriosis generated baseline data for a planned longitudinal assessment of multidisciplinary care of endometriosis. The primary objective was to determine the proportion of patients experiencing mild, moderate, or severe pain for dysmenorrhea, non-menstrual pelvic pain (NMPP), and dyspareunia at entry into a multidisciplinary endometriosis clinic. Also explored were relationships between pain scores and clinical endpoints obtained from electronic medical records.ResultsMore than half (59%) of the study participants (n = 638) reported experiencing pelvic pain for ≥ 5 years. Pain intensity was highest for patients reporting dysmenorrhea, followed by NMPP, and dyspareunia. Significant correlations were observed between total pelvic pain and patient age (r = -0.22, p < 0.001, n = 506) and number of previous healthcare providers (r = 0.16, p = 0.006, n = 292); number of previous providers and duration of pain (r = 0.21, p = < 0.0001, n = 279); and duration of pain and years since diagnosis (r = 0.60, p < 0.001, n = 302). Mean pain scores differed significantly by age group for dysmenorrhea (p < 0.001), NMPP (p = 0.005), and total pelvic pain (p < 0.001), but not for dyspareunia (p = 0.06), with the highest mean pain scores reported among those < 30 years of ag

ObjectiveIn this post hoc analysis, we evaluated the impact of elagolix on dysmenorrhea and nonmenstrual pelvic pain across menstrual period (bleeding days) and nonmenstrual (nonbleeding) days.MethodsData from two randomized, 6-month, placebo-controlled trials (Elaris Endometriosis (EM)-I and EM-II) of elagolix (150 mg once daily (QD) and 200 mg twice daily (BID)) in premenopausal women with moderate to severe endometriosis-associated pain (N = 1686) were pooled. Women recorded the presence of menstrual period and severity of dysmenorrhea or nonmenstrual pelvic pain in a daily electronic diary.ResultsAt baseline, women in the placebo group and both elagolix treatment groups reported moderate or severe dysmenorrhea, on average, 81% of their menstrual period days and moderate/severe nonmenstrual pelvic pain, on average, 56% of their nonmenstrual (nonbleeding) days. Compared with placebo at month 6, elagolix-treated women had a significantly lower mean (standard deviation (SD)) percentage of menstrual period days with moderate or severe dysmenorrhea (elagolix 150 mg QD = 52.4 (38.9), p = 0.002; elagolix 200 mg BID = 38.5 (43.6), p < 0.001, placebo = 61.3 (33.7)) and a significantly lower mean (SD) percentage of nonmenstrual (nonbleeding) days with moderate or severe nonmenstrual pelvic pain (elagolix 150 mg QD = 31.1 (35.8), p < 0.001; elagolix 200 mg BID = 19.7 (29.9), p < 0.001; placebo = 35.6 (33.9)).ConclusionFollowing 6 months of elagolix treatment, women who still menstruated had a lower proportion of menstrual period days with moderate or severe dysmenorrhea compared with placebo, demonstrating pain reduction despite continued menses. Additionally, pain did not shift from dysmenorrhea to nonmenstrual pelvic pain, as the percentage of days with moderate or severe nonmenstrual pelvic pain was also reduced for elagolix-treated women compared with placebo.Trial registrationThe Elaris EM-I study is registered with the US National Library of Medicine, www.Cli

Accessory and Cavitated Uterine Mass (ACUM) is a condition defined by the presence of a non-communicating uterine mass close to the insertion of the round ligament. ACUM is a rare M?llerian anomaly found in young women and is diagnosed by the presents of a central cavity in the uterus, lined by functional endometrium, and surrounded by a ring of smooth muscle. In most cases, surgical treatment is recommended due to severe dysmenorrhea. Herein, we present a case of a woman with severe dysmenorrhea since adolescence which was not relieved with any form of hormonal treatment. ACUM was suspected preoperatively based on MRI findings, and she was treated with total laparoscopic hysterectomy. A uterine mass was found at the insertion of the right round ligament during surgery. All her symptoms improved after resection.

Bakgrund Endometrios är en hormonberoende sjukdom vilken påverkar kvinnor i fertil ålder. Sjukdomen kan manifesteras genom symtom som tillexempel mensvärk, samlagssmärta. En av tio kvinnor i världen lever med endometrios vilket betyder att det finns stort behov av kunskap hos hälso- och sjukvården för att kunna erbjuda god vård till de berörda kvinnorna. För att ta reda på hur kvinnorna upplever bemötandet i vården vid endometrios har deras åsikter uppmärksammats för att presentera en samlad bild över hur fenomenet ser ut i verkligheten. Detta för att utifrån kvinnors erfarenheter och önskemål kunna förbättra bemötandet av hälso- och sjukvården. Syfte Syftet var att beskriva kvinnors upplevelser av bemötandet vid endometrios. Metod Icke-systematisk litteraturöversikt var vald metod för arbetet. Insamling av data skedde genom databaserna PubMed och CINAHL. Totalt 15 vetenskapliga artiklar inkluderades i resultatet. Artiklarna kvalitetsgranskades med Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering avseende studier med kvantitativ och kvalitativ metodansats. Både kvalitativa och kvantitativa studier inkluderades i litteraturöversikten. Resultat Resultatet sammanställdes till tre huvudkategorier: “Att bli bemött”, ”Bristande kommunikation” och “Förändrad självbild i samband med mötet”. Resultatet belyste att en bristande vårdmiljö samt avsaknaden av personcentrerad omvårdnad ledde till ökat vårdlidande för de berörda kvinnorna. Slutsats Trots att sjukdomen är vanlig upplevde kvinnorna otillfredsställande vård. Flertal kvinnor uppgav att deras symtom blivit normaliserade vilket hade resulterat i utebliven vård. Att befinna sig i en vårdsituation gällande endometrios innebar för många kvinnor en utsatthet då symtomen kunde vara nära kopplade integriteten och sexualiteten. Personcentrerad omvårdnad ansågs av många kvinnor vara viktigt för att uppleva ett respektfullt bemötande av vår, Background Endometriosis is a hormonal dependent disease which affects women of fertile age. Symptoms like dysmenorrhea and dyspareunia are often associated with the disease. Endometriosis affects one in ten women, thus there is a need for knowledge and understanding within the medical field. So that the affected women are offered good care. To examine the woman's perspective of the phenomenon, women's statements were heard and observed to conduct an overall view of the issue. Ideally, women's experiences and wishes can be taken into account to promote better health care encounters. Aim The aim was to describe women’s experiences of encounters regarding endometriosis. Method This non-systematic literature review was conducted of 15 research articles. Data was collected through the databases PubMed and CINAHL. The Quality assessment was based on Sophiahemmet Högskolas scientific classification of studies which include qualitative as well as quantitative studies. Both qualitative and quantitative studies were included. Results Results were gathered into three main categories: “To not be acknowledged”, “Deficient communication” and “Altered self-image as a result of the meeting". Results highlight the impact of unsatisfying care and lack of person-centred care regarding endometriosis. Conclusions Although endometriosis is common, women are experiencing unsatisfying care. Several women speak about how their symptoms have been normalized which has resulted in a lack of care. Endometriosis is a disease that can affect intimacy and integrity; thus, women explained how they may experience discomfort and exposure during interventions with healthcare. Women explained that greater person-centred care would provide women with better encounters to healthcare while consultations due to endometriosis. The women's statements showed a lack of quality and support given by healthcare professionals which is needed in order to fulfil good quality care.

Endometriosis is a chronic inflammatory disease, which is considered to have a benign course and is dependent on estrogens. It is characterized by the presence of ectopic endometrial tissue (located outside the uterine cavity). The main theories on the genesis of this pathology include: retrograde menstruation, lymphatic or vascular spread, coelomic metaplasia, and induction theory. The most frequent lesions are in the pelvic area, such as: the ovaries, uterosacral ligaments, and Douglas sac, yet they can be found outside the latter. The disease generates varied clinical manifestations that involve dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. To procure a definitive diagnosis, this must be performed surgically. Medical treatment is only symptomatic and not curative; while the surgical approach, despite being curative, presents variable rates of recurrence., La endometriosis es una enfermedad inflamatoria crónica, de curso benigno y dependiente de estrógenos, la cual se caracteriza por la presencia de tejido endometrial ectópico, es decir, fuera de la cavidad uterina. Las principales teorías sobre la génesis de dicha patología, comprenden: menstruación retrógrada, diseminación linfática o vascular, metaplasia celómica y teoría de la inducción. Las lesiones con mayor frecuencia se ubican en la pelvis: en ovarios, ligamentos uterosacros y saco de Douglas; sin embargo, pueden encontrarse fuera de esta. La enfermedad genera manifestaciones clínicas variadas que involucra dismenorrea, dispareunia, dolor pélvico crónico e infertilidad. Su diagnóstico definitivo es quirúrgico. El tratamiento médico es solo sintomático y no curativo, mientras que el abordaje quirúrgico pese a ser curativo, presenta variables tasas de recurrencia.

Endometriosis refers to the presence of endometrial like tissue outside the uterine cavity. It affects approximately 10% of women of reproductive age worldwide and is related to the presence of dysmenorrhea, pelvic pain and infertility, although the clinical manifestations are very varied. Multiple theories explain its pathophysiology: retrograde menstruation, celomic metaplasia, impaired immune response, vascular lymphatic metastasis, and oxidative stress are the main theories currently available. There are numerous endometriosis classification systems, but none are universal. The diagnosis of endometriosis is complex and it usually takes several years from the onset of symptoms to a confirmed diagnosis. The gold standard is direct detection of lesions by laparoscopy with removal and histological confirmation. Treatment can be both medical and surgical, the latter being reserved for cases refractory to medical treatment. Medical treatment consists of hormonal therapy with combined oral contraceptives or with only progestogens. GnRH agonists and aromatase inhibitors have also been used in some cases. In ad endometriosis, dysmenorrhea, pelvic pain; analgesia with acetaminophen and NSAIDs is recommended, La endometriosis hace referencia a la presencia de tejido endometrial fuera de la cavidad uterina. Afecta a 1 de cada 10 mujeres en edad reproductiva a nivel mundial y se encuentra relacionada con la presencia de dismenorrea, dolor pélvico e infertilidad, aunque las manifestaciones clínicas son muy variadas. Múltiples teorías explican su fisiopatología, la menstruación retrógrada, la metaplasia celómica, la alteración de la respuesta inmune, la metástasis vasculolinfática y el estrés oxidativo son las principales con las que se cuenta actualmente. Existen diferentes sistemas de clasificación de endometriosis, pero ninguno es universal. El diagnóstico de endometriosis es complejo y usualmente pasan varios años desde el inicio de los síntomas hasta el diagnóstico. El “gold standard” es la visualización directa de las lesiones mediante laparoscopía con remoción y confirmación histológica. El tratamiento puede ser tanto médico como quirúrgico, reservándose este último para los casos refractarios al tratamiento médico. El tratamiento médico consiste en hormonoterapia con anticonceptivos orales combinados o con sólo progestágenos. También se han utilizado agonistas de GnRH e inhibidores de aromatasa en algunos casos. Además, se recomienda la analgesia con acetaminofén y AINES

This article reviews and updates the management of gynecological pathology in adolescent women and addresses contraception and the prevention of infectious and oncological diseases., En este artículo se revisa y actualiza el manejo de la patología ginecológica en la mujer adolescente y se aborda la anticoncepción y la prevención de enfermedades infecciosas y oncológicas.

Background: Yogic practices help decreasing the pain and disability caused by dysmenorrhea in menstruating  women.  Aim and Objective: This study aimed to assess the effects of 8 weeks of Asana (postures) with Pranayama  (control of Breath) and no yogic practices on menstrual pain and disability scores in menstruating women of  16-40 years of age. Subjects and Methods: A total of 60 participants (mean age: 24.35 years) were divided into a yoga (Y) group  and control (C) group. Participants attended a 45-min session every day for 8 weeks (2 menstrual cycles) before  meals in a community hall. Pain scores, WaLIDD scores, level of functioning, severity of the associated  symptoms assessed before and after the interventions in both the groups. Statistical Analysis: Changes in scores  were analyzed with the Wilcoxon signed rank test for each group. Pre-post results were compared for all the  measured values. P < 0.05 was considered statistically significant.  Results: Based on the % difference from the baseline scores, Intervention group (Y) showed significant  improvements in pain scores on VAS scale (81.5%), WaLIDD score (71.45%), sites of pain (73.3%) and total  duration of pain (66.69%) and overall improvement in the other systemic symptoms associated with  dysmenorrhea.  Conclusions: The 8-week yoga intervention for menstruating women improves the functioning of women  suffering from dysmenorrhea by decreasing the intensity, duration, sites and symptoms associated with  dysmenorrhea.&nbsp

Dysmenorrhoea is a menstrual disorder that causes chronic, cyclic pain or discomfort in the pelvic region.  It is the most common menstrual disorder among adolescent women. It is estimated that more than half of  all teenagers suffer from dysmenorrhea, which often affects their daily physical and emotional aspects. It  is the leading factor of short-term school absence and has a negative impact on academics and daily  activities From an Ayurvedic point of view, Kashtartava is a symptom mentioned in several Yonivyapads, with Vata being the main causative factor of this condition, commonly compared to dysmenorrhea by  modern science. All gynecological problems in Ayurvedic classics are described under the heading of  Yonivyapad. It is explained in classical text that due to Vegadharana (withholding natural urges), the  aggravated Vata moving in reverse directions fills the Yoni resulting in discharge of Artava with difficulty  with severe Shoola. The standard treatment for primary dysmenorrhoea consists of nonsteroidal and anti inflammatory drugs, as well as hormonal therapy, which has undesirable side effects. To effectively  alleviate dysmenorrhoea, Ayurveda recommends Ritucharya and Dinacharya, diet modification, and Yoga in the form of Asanas, Pranayam, and meditation on a regular basis. If necessary, Uttarbasti, Garbhashaya  balyaaushadhi, Anuvasan, or Matrabasti can also be administered. As a matter of fact, this study focuses  on the description of Kashtartava based on scattered classical references.&nbsp

Objective: To compare the effects of Transcutaneous Electrical Nerve Stimulation (TENS) and cryotherapy in relieving painful symptoms in students with primary dysmenorrhea (PD). Methods: Cross-sectional and quantitative study, with 20 university women randomly divided into two groups: TENS Group (GT) whose participants were submitted to a 45 min TENS session with a frequency of 120 Hz and a pulse duration of 100 µs and Cryotherapy Group (CG), whose participants were submitted to a cryotherapy session for 20 min. Women with regular menstrual cycles, nulligravidas, without a report of pelvic disease, and with dysmenorrhea with pain levels between 4 and 10 during the first three days of menstruation were included. Those with contraindications to TENS or cryotherapy and who used drugs up to 24 h before the intervention were excluded. The participants' pain levels were recorded before and shortly after the intervention.Results: Women aged between 18 and 27 years (mean 22.8 ± 2.4 years) were evaluated. In addition to painful symptoms, all of them presented some other associated symptoms, the most common being diarrhea and fatigue (80%, each). The two-way ANOVA test of repeated measures considering group and evaluation factors revealed an effect only for the evaluation factor (p < 0.001) with no effect for the group/evaluation interaction (p = 0.09). Conclusion: TENS and cryotherapy are efficient resources for relieving pain symptoms in women with PD, with no superiority between the approaches., Objetivo: Comparar os efeitos da Estimulação Elétrica Nervosa Transcutânea (TENS) e da crioterapia no alívio da sintomatologia dolorosa de estudantes com dismenorreia primária (DP). Métodos: Estudo transversal e quantitativo, com 20 mulheres universitárias aleatoriamente divididas em dois grupos: Grupo TENS (GT) cujas participantes foram submetidas a uma sessão de 45 min de TENS com frequência de 120 Hz e duração de pulso de 100 µs e Grupo Crioterapia (GC) cujas participantes foram submetidas a sessão de crioterapia por 20 min. Foram incluídas mulheres com ciclos menstruais regulares, nuligestas, sem relato de doença pélvica e com dismenorreia com nível de dor entre 4 e 10 durante os três primeiros dias de menstruação. Foram excluídas aquelas com contraindicação ao uso da TENS e crioterapia ou que fizeram uso de medicamentos até 24 h antes da intervenção. Foi registrado o nível de dor das participantes antes e logo depois da intervenção. Resultados: Foram avaliadas mulheres com idade variando entre 18 e 27 anos (média 22,8 ± 2,4 anos). Todas apresentaram além dos sintomas dolorosos algum outro sintoma associado, sendo os mais comuns diarreia e fadiga (80%, cada). O teste ANOVA two-way de medidas repetidas considerando como fatores grupo e avaliação, revelou efeito apenas para o fator avaliação (p < 0,001), não apresentando efeito para a interação grupo/avaliação (p = 0,09). Conclusão: TENS e crioterapia são recursos eficientes para o alívio dos sintomas álgicos de mulheres com DP, não havendo superioridade entre as abordagens.

Study Objective: To show how the evaluation for endometriosis can be included in the routine pelvic ultrasound examination. Design(s): Stepwise narrated video demonstration of the sonographic evaluation for endometriosis in routine pelvic ultrasound following the recommended sonographic approach published in the 2016 consensus paper by the International Deep Endometriosis Analysis (IDEA) group [1]. Setting(s): Endometriosis is a common and often debilitating gynecological disorder that affects 5-10% of women [2]. The prevalence is even higher among women with symptoms of endometriosis [2], which include chronic pelvic pain, acquired dysmenorrhea, dyspareunia, dyschezia, menorrhagia, abnormal bleeding, and infertility. Approximately 80% of women who have endometriosis have superficial lesions, whereas 20% have deep infiltrating endometriosis (DIE; [3]). Laparoscopy is the gold standard for diagnosing endometriosis, because it allows the diagnosis of all forms of endometriosis and often immediate removal of superficial endometriosis. The removal of DIE is considerably more complicated and usually cannot be completed unless it was diagnosed preoperatively. The technique to diagnose DIE with transvaginal ultrasound (TVUS) was first described in detail in 2009 [4]. Since then, the accuracy of TVUS for the prediction of DIE has been well established in the literature [5-7]. TVUS is widely used as a first-line investigation for women with gynecological symptoms. The inclusion of an assessment for endometriosis in the routine pelvic ultrasound allows earlier diagnosis and better surgical outcomes for all women with DIE. Intervention(s): The evaluation for endometriosis in routine pelvic ultrasound based on the IDEA consensus promotes a 4-step dynamic ultrasound approach [1]: (1) routine evaluation of uterus and adnexa with particular attention for sonographic signs of adenomyosis and the presence or absence of endometriomas; (2) evaluation of transvaginal sonographic 'soft

This is a video of a total laparoscopic hysterectomy performed on a 46-year-old woman which presents multiple technical challenges. We aim to demonstrate several techniques employed to overcome these difficulties in order to complete the procedure laparoscopically. The patient was an obese woman who had previously had two caesarean sections. She presented with a history of worsening pelvic pain, menorrhagia and dysmenorrhea despite her ongstanding use of the combined oral contraceptive pill. On examination, there was a palpable 18-week-size mass arising from the pelvis to just below the level of the umbilicus. A pelvic ultrasound revealed this to be a large intramural fibroid with cavity compression. Intraoperatively, the bladder was adherent to the lower segment, requiring extensive adhesiolysis. Following ligation of the uterine vessels, a subtotal hysterectomy was performed to facilitate access to the vault. A McCartney tube was introduced to enable the colpotomy. Due to the large size and globular shape of the uterus, it could not be accommodated within the pelvis, hence rendering vaginal morcellation and retrieval impossible. Therefore, the specimen underwent power morcellation abdominally. Haemostasis was confirmed and routine closure was performed. At histopathological examination, the specimen weighed 490 g and the presence of uterine leiomyomata was confirmed. The case demonstrates the potential complexities that may emerge during procedures on large fibroid uteri. The awareness of a variety of surgical techniques and the availability of specialized equipment, together with judicious intraoperative problem-solving and decision-making, enabled this patient to undergo a safe and successful minimally invasive operation.

STUDY QUESTIONS: The objective of this study is to evaluate the effectiveness and cost-effectiveness of surgical treatment of women suffering from pain due to an ovarian endometrioma when compared to treatment with medication (analgesia and/or hormones). The primary outcome is defined as successful pain reduction (-30% reduction of pain) measured by the numeric rating scale (NRS) after 6 months. Secondary outcomes include successful pain reduction after 12 and 18 months, quality of life, affective symptoms, cost-effectiveness, recurrence rate, need of adjuvant medication after surgery, ovarian reserve, adjuvant surgery and budget impact. WHAT IS KNOWN ALREADY: Evidence suggests that both medication and surgical treatment of an ovarian endometrioma are effective in reducing pain and improving quality of life. However, there are no randomised studies that compare surgery to treatment with medication. STUDY DESIGN, SIZE, DURATION: This study will be performed in a research network of university and teaching hospitals in the Netherlands. A multicentre randomised controlled trial and parallel prospective cohort study in patients with an ovarian endometrioma, with the exclusion of patients with deep endometriosis, will be conducted. After obtaining informed consent, eligible patients will be randomly allocated to either treatment arm (medication or surgery) by using web-based block randomisation stratified per centre. A successful pain reduction is set at a 30% decrease on the NRS at 6 months after randomisation. Based on a power of 80% and an alpha of 5% and using a continuity correction, a sample size of 69 patients in each treatment arm is needed. Accounting for a drop-out rate of 25% (i.e. loss to follow up), we need to include 92 patients in each treatment arm, i.e. 184 in total. Simultaneously, a cohort study will be performed for eligible patients who are not willing to be randomised because of a distinct preference for one of the two treatment arms. We intend to i

Objective: High-anion gap metabolic acidosis (HAGMA) most commonly results from excess urea, lactate, ketones and exposure to toxins such as salicylate and toxic alcohols. Accumulation of pyroglutamic acid (PGA) is a rare cause of HAGMA. The exact incidence of HAGMA caused by PGA accumulation is unknown. A recent prospective study reported that high urine PGA concentrations were associated with 10% of patients with HAGMA. PGA is processed by the glutamate-glutathione cycle. The commonest cause of PGA accumulation is glutathione depletion. This causes the loss of negative feedback on gamma-glutamylcysteine (PGA precursor) production. Other causes include malnutrition, alcoholism, liver failure and sepsis. Though rare, deficiency of either glutathione synthetase causing gamma-glutamylcysteine (PGA precursor) accumulation or 5-oxoprolinase resulting in reduced PGA metabolism, also cause PGA accumulation. We describe a case of confirmed PGA accumulation after repeated supratherapeutic paracetamol use. Case report: A 32-year-old female presented with ongoing pain from shingles despite having taken 96 x 665 mg modified-release paracetamol caplets over the preceding two days. Two years prior, she suffered a gastric ulcer perforation following excessive ibuprofen use for dysmenorrhea. She subsequently ceased using NSAIDs and substituted these with regular use of four modifiedrelease paracetamol tablets every 3-4 hours. On presentation vital signs were normal except a respiratory rate of 24/min. Venous blood gas showed pH 7.04, bicarbonate 5.0mmol/L, pCO2 19 mmHg, lactate 1.4mmol/L, sodium 150mmol/L, chloride 117 mmol/L and anion gap 28, indicating a partially compensated HAGMA. Serum ketones were 2.8mmol/L, salicylate undetected and normal osmolar gap. Serum paracetamol was 312 mumol/L, 2.5 hours after the last dose. Liver function, INR and creatinine were normal. PGA accumulation from chronic paracetamol misuse and glutathione depletion was suspected. Acetylcysteine was in