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

This research wasdesigned to provide a visual analysis of the current status, hotspots, and trends of global acupuncture for dysmenorrhea over the past 2 decades. The literature about acupuncture for dysmenorrhea from the Web of Science Core Collection database. Cite Space (5.6.R3) was used to analyze the volume of publications, journals, authors, cited journals, cited authors, countries, cited references, institutions, and keywords by using standard bibliometric measures. The most productive countries and institutions in this area were China (79) and BeijingUniversity of Chinese Medicine (24). The Evidence-Based Complementary and Alternative Medicine was the most published journal (29) and also had the highest number of citations (80). The article by Woo HL (2018) (number of citations: 13) and the article by (centrality: 0.38) were the most representative references. JiangZhu (17) was the most productive author and Dawood MY (47) was the top cited author. The number one keyword in terms of frequency and centrality was 'primary dysmenorrhea", and the leading hotspot from 2002 to 2022 was "Functional connectivity". The three forefront topics were "prevalence", "impact"and "point'. This research is thefirst bibliometric analysis of the current situation and new trends about acupuncture for dysmenorrhea in the past 20 years using CiteSpace. It offered some information on acupuncture for dysmenorrhea and valuable information for researchers to identify prospective collaborators, partner institutions, popular topics, and research frontiers. [ABSTRACT FROM AUTHOR]

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

Objective: Lynch syndrome (LS) is a hereditary condition associated with an increased risk of colorectal and endometrial cancer. This study aimed to assess the knowledge, attitudes, and beliefs of women with LS regarding combined hormonal contraceptive (CHC) use compared to a control group of healthy women. Methods: Pre-menopausal women with LS (n=43) and an age-matched control group of healthy women (n=128) participated in this prospective, cross-sectional study (NCT05909410). Participants completed an electronic questionnaire evaluating perceptions of CHC use and its impact on various cancers, medical conditions, and symptoms. Statistical analysis compared responses between the two groups, with reported p-values. Results: Women with LS were less likely to use CHCs compared to the control group (p=0.03) and had a more negative perception of CHCs' impact on colorectal cancer (p=0.023) and endometrial cancer (p=0.028). Limited knowledge was observed in both groups regarding the protective effects of CHCs against colorectal and ovarian cancer. Perceptions of CHC use and its impact on symptoms and chronic diseases did not significantly differ between the groups (p>0.05). CHC use was not associated with greater awareness of the protective effect against colorectal (p=0.89) and endometrial cancer (p=0.47), but it was associated with a desire for contraception (OR 21.25; 95% CI 1.16 to 388.21; p=0.039). Conclusion: This study highlights contrasting perceptions of CHCs and their implications in oncology between women with LS and healthy women. Tailored counselling and support strategies are crucial for empowering women with LS to make informed decisions about their gynaecologic health. [ABSTRACT FROM AUTHOR]

The Mediterranean fever (MEFV) gene codes for protein pyrin, which is among the modulators of inflammasome activity in innate immune cells. It was suggested that there is a relation between MEFV variations and inflammatory diseases. The aim of this study was to investigate MEFV gene variations in the patients with primary dysmenorrhea. The prevalence of common MEFV gene variations (M694V, M680I, V726A, E148Q and R202Q) was investigated in 145 young women with primary dysmenorrhea and 135 unrelated healthy controls. MEFV gene variations were genotyped using PCR-based RFLP assay. Number of childbirth and marriage were significantly lower in the study group than the controls, respectvely (p < 0.001, p = 0.001). Family history was statistically higher in the patient group (p < 0.001). In total, MEFV genotype and allele frequencies were significantly higher in patients than controls, respectively (p = 0.008 and p = 0.005, respectively). It was found that MEFV gene E148Q allele was more common in patient group (p = 0.039). MEFV R202Q A allele was higher in the patients than the controls (p = 0.045). A significant association was observed when the patients were compared with the controls according to R202Q variant AA versus GG+GA genotypes (p=0.020). Our findings suggest that MEFV variations may be a risk factor for patients with dysmenorrhea in a Turkish cohort. There are very few studies in the literature regarding the relationship between pathological variants of MEFV and dysmenorrhea disease. The common MEFV mutations/variants were evaluated in primary dysmenorrhea patients. Family history was statistically higher in the patient group (p <.001). MEFV gene variations were found 52 (35.9%) in patients and 29 (21.5%2) in controls. MEFV gene allele frequency was significantly higher in-patient group than control (p =.005). [ABSTRACT FROM AUTHOR]

Dysmenorrhea, characterized by pain and related symptoms, significantly impacts women's quality of life in work and education, prompting a comprehensive evaluation of associated factors. The objective of this study was to utilize structural equation modeling (SEM) to analyze and assess the biopsychosocial factors influencing dysmenorrhea among university students. Three hundred and thirty-nine university students were included in this cross-sectional descriptive study. Data were collected using the Participant Information Form, the Beck Anxiety Scale (BAS), the Beck Depression Scale (BDS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Adverse Childhood Experiences Scale (ACES), the Pain Catastrophizing Scale (PCS) and the Visual Analogue Scale (VAS). It was determined that the variables of pain onset (t = 3.24, p <.05) and age at menarche (t = -2.16, p <.05) showed a significant relationship with the model. The variables of the PCS (t = 16.87, p <.001), BDS (t = 3.06, p <.05), and BAS (t = 5.13, p <.001) showed a significant relationship with the model. Social factors in the model were examined, and a family history of dysmenorrhea and the ACES variables did not contribute significantly to the model (p >.05). The study indicates primary dysmenorrhea influenced by biological and psychological factors. Nurses should conduct holistic assessments and provide comprehensive care for affected women. [ABSTRACT FROM AUTHOR]

Studies have examined the effect of stress on dysmenorrhea and premenstrual syndrome. For this reason in this study, it was aimed to determine the impact of stress on menstrual symptoms (adverse effects, abdominal pain, and coping methods). This descriptive and correlational study was conducted with 351 university students in Turkey by sharing the link to the questionnaire on online social media platforms. It was determined that those whose income was equal to their expenses had lower menstrual symptoms, having a chronic disease and smoking increased menstrual symptoms (F = 3.19/p =.04; t = 2.33/p =.02; t = 3.96/p =.00). The study identified that there was a positive low-level correlation (r: 0.25, p <.01) between the Perceived Stress Scale-14 and the Menstruation Symptom Questionnaire, and the 6.5 percent change in menstrual symptoms was explained by perceived stress. In the study, it is thought that stress affects the experience of menstrual symptoms. Therefore, it is believed that by providing training on stress and effective coping methods by midwives and nurses, menstrual symptoms can be reduced, contributing to women's health. For future studies, it is recommended to examine the effects of stress coping methods training on stress and menstrual complaints. [ABSTRACT FROM AUTHOR]

Endometriosis is a common gynecological disorder that occurs in women of reproductive age, and negatively affects women's quality of life. We tested 'Attachment-Diathesis Model of Chronic Pain' in a sample of Turkish women with endometriosis by analyzing the paths among attachment styles, pain catastrophizing, coping strategies, and health-related quality of life (HRQoL). Attachment anxiety was related to using less problem-focused coping and seeking more social support, while attachment avoidance was associated with seeking less social support as a coping strategy. Moreover, attachment anxiety and higher pain catastrophizing were related to a worse HRQoL. Finally, problem-focused coping strategy mediated the relation between attachment anxiety and HRQoL, meaning that by employing less problem-focused coping strategies, anxiously attached women experienced a poorer HRQoL. In light of our findings, psychologists may develop intervention techniques that question attachment patterns, pain perception, and coping strategies in clients diagnosed with endometriosis. [ABSTRACT FROM AUTHOR]

This study explored the extent of menstrual manipulation and its associated impact on period-related symptoms and training disruptions in Australian Female Cyclists. 205 female cyclists, from recreational to elite level, participated in an online "Female Cyclist Questionnaire (FCQ)". The FCQ utilised a series of validated questionnaires to obtain demographic information and menstrual function of the respondents, and to investigate their menstrual manipulation habits and perceptions on how their period-related symptoms affected their well-being, mood, energy and training tolerance. More than 80% of the cyclists reported that their period-related symptoms impacted upon training and 41% made training adjustments based on these symptoms. Two-thirds of respondents thought their training should be phase-controlled yet only half discussed their hormonal cycles with their coaches. Menstrual manipulation was predicted by reduced "workout tolerance" in these cyclists (odds ratio = 0.632). Half of the respondents reported compromised ability to tolerate high-intensity interval training with period-related symptoms. Period pain, increased irritability, lower energy levels and more sugar cravings were commonly reported but did not predict menstrual manipulation. The data indicated that period-related symptoms are present in Australian female cyclists across all levels of participation. However, the perceived impact to training and subsequent behavioural changes varied among individuals. [ABSTRACT FROM AUTHOR]

Up to 92 percent of Chinese women of reproductive age have pre-menstrual syndrome (PMS). The severe form of PMS (i.e. pre-menstrual dysphoric disorder [PMDD]) negatively affects women's everyday functioning and reproductive health. This study examined the relationships between menstrual, psychosocial characteristics and the risk of PMDD among young Chinese women. A cross-sectional online survey was conducted among Chinese university students in Hong Kong. Logistic regression was used to compute adjusted odds ratio (aOR) for the association of high-risk PMDD with menstrual and psychosocial characteristics. A total of 541 Chinese university students were recruited. Approximately 53 percent of female students were at high risk of developing PMDD. The high-risk PMDD group was significantly associated with a heavy volume of menstrual flow (aOR = 2.17, 95 percent CI 1.06–4.45), irregular menstrual cycle (1.72, 1.17–2.52), high dysmenorrhea (2.80, 1.95–4.04) and older ages of menarche (0.67, 0.45–0.98) in the menstrual characteristics. In the psychosocial characteristics, high-risk PMDD was significantly associated with symptoms of anxiety (2.19, 1.48–3.32) and depression (2.22, 1.48–3.32), high loneliness (1.94, 1.34–2.79) and low resilience (2.21, 1.52–3.23) levels. Additionally, resilience had a potential moderating effect on the associations between the high risk of PMDD and anxiety, depression and loneliness. The development and delivery of interventions that can enhance resilience and manage psychological distress would be beneficial for young Chinese women's reproductive health. [ABSTRACT FROM AUTHOR]

Excessive menstrual bleeding (menorrhagia) and painful menstrual periods (dysmenorrhea) affect a substantial proportion of reproductive-aged women and impact their quality of life and work performance due to missed work or limitations in daily activities. This systematic literature review evaluated the impacts of menorrhagia/dysmenorrhea on work performance and identified potential health disparities related to socioeconomic status on the severity of consequences. PubMed, Embase, CINAHL Plus, and PsychINFO databases were searched for relevant articles published between the years 2001 and 2021. The authors synthesized data from studies which described associations between menstrual disorders and work performance, addressed menorrhagia or dysmenorrhea specifically, and contained study samples of employed adult women. The search strategy identified a total of 915 unique titles; 31 articles satisfied the eligibility criteria for full-text review. Twenty-one articles were ultimately included in the data synthesis. For women with menorrhagia/dysmenorrhea, the most common contributors to decreased work performance were absenteeism and decreased work productivity. Unemployment and loss of income were common work-related impacts of these menstrual symptoms. Few studies reported comprehensive demographic or socioeconomic data, and fewer than half of the studies collected any information from participants related to employment. The present literature on the impact of menstrual disorders on work performance is limited. Further investigations are needed to evaluate the disparities of menstruation-related symptoms on work performance based on socioeconomic status and occupational, demographic, and contextual variables. [ABSTRACT FROM AUTHOR]

Menstruation is a natural phenomenon considered an important indicator of women's health, reflecting their endocrine function. Women in low middle income countries face substantial menstrual hygiene management challenges. Data on the knowledge of dysmenorrhea and health-related practices among Malaysian women are scarce. The present study aimed to investigate the prevalence of dysmenorrhea among Malaysian women in Kuala Lumpur and its association with socio-demographic factors, knowledge level, and general practices. A cross-sectional study was carried out among Malaysian women in Kuala Lumpur. A total of 362 unmarried women, nulliparous and aged between 18 and 25 years old, were included in this study. Participants were conveniently recruited through online platforms as well as face to face using a self-administered questionnaire with five sections consisting of demographics, menstrual characteristics, Working ability, Location, Intensity, Days of pain, Dysmenorrhea (WaLIDD) score for diagnosing and assessing the severity of dysmenorrhea as well as an evaluation of respondents' general knowledge and practices towards dysmenorrhea. The collected data were analysed using the SPSS tool, a descriptive statistic was used to report demographic characteristics. Inferential statistics was used to report the differentiation, association, and correlations of the variables. The prevalence of primary dysmenorrhea was 73.2%. It was found that the majority of the respondents had poor knowledge (60%) and poor practices (61.88%) of dysmenorrhea. The most common preventive practices among the respondents were using dietary supplements, and herbs, taking a rest and exercising. The findings also indicated that dysmenorrhea among the respondents was significantly associated with family history of dysmenorrhea (p = 0.002), monthly income (p = 0.001), and knowledge level (p = 0.001). Dysmenorrhea has a high prevalence among women in Malaysia in Kula Lumpur driven by low knowledge and lack of evidence-based practices among these women. Thus, it is critical for Government and healthcare authorities to promote education related to women health among Malaysian women. [ABSTRACT FROM AUTHOR]

A recent group cognitive behavioral therapy (gCBT) intervention for dysmenorrhea conducted by our team demonstrated feasibility, acceptability, and preliminary efficacy at reducing menstrual pain. This study aimed to use qualitative analyses to explore participants' reflections about the intervention's group dynamic. Participants included 20 young women ages 18–24 years with average menstrual pain of 8.0 (SD = 1.1) on a 0–10 (0 = none, 10 = worst pain possible) numeric rating scale. Semi-structured individual and group interviews were conducted after the intervention. Researchers then conducted deductive, iterative thematic analysis using a template analysis approach. Two themes were generated: benefit and logistics. The benefit theme included two sub-themes: (1) camaraderie (an emotional, psychological, or social connection between participants); and (2) sharing (information, advice, or experiences). The logistics theme highlighted how the structure of the group influenced the dynamic and was divided into two sub-themes according to the time frame being described: (1) reactions (participants' experiences with how the group dynamic was facilitated); and (2) future (how the group structure could be improved). Results of this study contribute to the growing body of literature related to gCBT for pain conditions. Future research is needed to optimize the group dynamic and evaluate its specific therapeutic role in the treatment. [ABSTRACT FROM AUTHOR]

The aim of this questionnaire study is to investigate the impact of life-time experiences of violence on the course and severity of endometriosis at a University Endometriosis Center. It also explores women's attitudes toward medical screening for violence. The questionnaire covered demographic data, medical data, information involving possible experiences of psychological, physical, sexual, and intimate partner violence as well as violence screening in medical care. Questionnaires of 118 participants were analyzed. 41/118 women reported some form of violence (34.8%). These women had a significantly higher risk for severe dysmenorrhea, use of analgesics, and comorbidities in comparison to women without life-time experiences of violence. Statistically significant differences were also found for employment status and impaired working ability. More than 60% of women considered the aspect of violence as important for health. However, only 17.1% of women with experiences of violence recalled being asked about violence by a medical professional. The study results suggest that experiences of violence have a significant impact on the course and severity of endometriosis. The findings highlight the importance of healthcare providers to be aware of the potential impact of violence on women's health, and routine screening for violence in medical care, especially in women with endometriosis. [ABSTRACT FROM AUTHOR]

Although menstrual pain (dysmenorrhea) is common and can have detrimental effects on work and social functioning, little is known about how people manage it in their professional life. Existing evidence indicates that people with dysmenorrhea often engage in presenteeism, meaning they work despite experiencing symptoms and report perceptions of social stigma around menstruation. In this study, we investigated individual health-related factors, psychosocial factors, and work factors associated with period pain presenteeism in a cross-sectional survey study including N = 668 employed people with experiences of dysmenorrhea. Our results show that symptom severity, disclosure of menstrual pain to the leader, and remote work are directly associated with period pain presenteeism. We further found that the presence of medical diagnosis moderates the association between symptom severity and presenteeism. Disclosure to the leader was associated with leader gender, leader-member exchange (LMX), and the absence of a medical diagnosis, indicating a potential mediating effect. We did not, however, find the perceptions of public beliefs regarding the concealment of menstruation to be related to presenteeism or disclosure. Our findings have important implications for research on menstrual health and occupational health management practice. [ABSTRACT FROM AUTHOR]

This prospective cohort study aimed to compare the clinical efficacy and safety of goserelin 10.8 mg administered trimonthly with goserelin 3.6 mg administered monthly in premenopausal females with symptomatic adenomyosis. We recruited 139 premenopausal females with adenomyosis who complained of dysmenorrhea and/or menorrhagia. The first group (n = 70) received a single subcutaneous injection of goserelin 10.8 mg, and the second group (n = 69) received monthly subcutaneous goserelin 3.6 mg administered for 3 months. Follow-up was performed at the outpatient department after 12 weeks. Ultimately, 130 patients completed the study, including 68 and 62 patients in the goserelin 10.8 mg (n = 70) and 3.6 mg (n = 69) groups, respectively. We observed a significant decrease in the dysmenorrhea (NRS) score, uterine volume, and cancer antigen 125 (CA125) levels, and a significant increase in hemoglobin (HGB) levels in both treatment groups. There was no significant difference between the two groups. The sum of the adverse event scores was slightly higher in the goserelin 3.6 mg than in the 10.8 mg group. The clinical efficacy of trimonthly administration of goserelin 10.8 mg was equivalent to monthly 3.6 mg dosing and was non-inferior regarding safety and tolerability. Hence, it can be a more cost-effective and convenient alternative treatment option in premenopausal females with symptomatic adenomyosis. ChiCTR2200059548 [ABSTRACT FROM AUTHOR]

Objectives: to evaluate menstruation characteristics, perceptions, and health-seeking behaviours in women. Methods: We conducted this cross-sectional study with 394 women between February 2021 and October 2021. according to the self-perception of women, menstruation characteristics were divided into two groups, including 'normal' and 'abnormal'. the data were collected using the Personal information Form, assessment Form of the Menstrual cycle characteristics, and health-seeking Behaviour scale. Results: among all women, 49.7% perceived their menstruation characteristics as 'normal', and 50.3% perceived them as 'abnormal'. the menstruation characteristics negatively affected the daily life of 57.6% of women in the normal group and 68.7% of women in the abnormal group. Online health-seeking behaviour was the most common behaviour of seeking remedy; however, professional health-seeking behaviour was inadequate. among women who perceived their menstruation characteristics as 'normal', excessive menstrual bleeding, extreme pain, and adverse effects on daily life increased health-seeking behaviour. among women who perceived their menstruation characteristics as 'abnormal', irregular cycles, frequent bleeding, low levels of bleeding, the use of too many pads, extreme pain, and adverse effects on daily life increased health-seeking behaviour. Conclusion: the participants in this study exhibited insufficient health-seeking behaviour for abnormal menstruation characteristics. Women should be directed by health professionals to reliable online sources to seek help, and they should be encouraged to display professional health-seeking behaviour. Short condensation: the knowledge and perception of menstruation characteristics among women is inadequate. the results of this study suggested that many gynecological symptoms that can affect women in their later stages of life may be unintentionally ignored. [ABSTRACT FROM AUTHOR]

Primary dysmenorrhea (PD) has a significant impact on women's lives, especially among young women who miss school and work due to painful periods. Experiences and how women manage PD have been explored to some extent, but the evidence has not been systematically collated and reviewed to allow health professionals to better understand women's experiences of and perceptions about PD. Hence, we aim to synthesize the qualitative evidence related to women's experiences of PD and associated symptoms. For this purpose, seven databases (Ovid MEDLINE®, PubMed, Embase, APA PsycINFO, Web of Science, CINAHL and OpenGrey) were searched for relevant papers published in English, Spanish, Greek and Chinese between January 1997 and May 2021. All studies investigating women's experiences with PD were included; besides, The Critical Appraisal Skills Programme (CASP) tool for qualitative studies was used to critically appraise the papers. A data extraction form was developed using JBI template and findings from the papers were analyzed and synthesized using meta-aggregation. Sixteen articles were included and during the analysis five themes were identified: Experiencing pain and associated symptoms, the psychological dimension of PD, knowledge and support, day-to-day living with PD, and coping strategies. We concluded taboos and deeply rooted beliefs around menstruation can potentially lead to gender inequalities; hence, women's common concerns and their experiences with PD need to be considered. Training and treatment protocols for health practitioners are needed. Future research should focus on development and testing of protocols for diagnosis, pharmacological and non-pharmacological management and men's perceptions of menstruation of their lovers. [ABSTRACT FROM AUTHOR]

Endometriosis is an oestrogen dependent, benign, chronic inflammatory disease characterised by ectopic endometrial implants. Current medical practices for the treatment of the disease are associated with several side effects over long periods, making the effect of diet on endometriosis an important aspect. To alleviate this need, we review related literature to identify the association between nutrients and endometriosis and to find the probable therapeutic effects of the nutrients and foods on endometriosis. Despite variations among the findings, several of the prior studies point to an inverse relationship between endometriosis and the consumption of fruits, vegetables, dairy products, and omega-3 fatty acids. Another common finding among the studies is the increased risk of endometriosis with higher consumption of trans-unsaturated fatty acids and red meat. Due to the limited size of the samples in existing literature, however, significance of the association between diet and endometriosis is not conclusive. Further research is needed to better identify the role of diet on endometriosis. [ABSTRACT FROM AUTHOR]

Using local language improves the quality of healthcare and patient safety but little has been done to understand and use local language in naming and defining conditions such as dysmenorrhea. Many indigenous African women value their language especially when communicating about women's health. In this exploratory study, we wanted to understand the local language used to construct and conceptualize dysmenorrhea and highlight the importance of local language when healthcare practitioners engage with women experiencing dysmenorrhea guided by Africana Womanism Theory. Data were collected from 15 Black indigenous women using a Lekgotla discussion group and in-depth interviews. Data were thematically analyzed. Participants described how local language is important in naming and seeking healthcare. Drawing from their descriptions three themes emerged: (1) Self-naming and self-defining dysmenorrhea using a local language; (2) Types of local words, phrases, and terms used to name and define dysmenorrhea; (3) The importance of self-naming and self-defining dysmenorrhea in a local language. Communication between healthcare seekers and healthcare providers is at the heart of effective healthcare provision. Poor communication due to language barriers contributes to misunderstanding, misdiagnoses, poor or incomplete patient assessment, and delayed treatment. Therefore, communicating healthcare issues in a local language would promote culturally sensitive care. [ABSTRACT FROM AUTHOR]

Strength deficits are common following anterior cruciate ligament reconstruction (ACLR). Best practice guidelines recommend resistance training post-ACLR to target these strength deficits. Research has supported menstrual cycle (MC) phase-based resistance training for eumenorrheic women, however its applicability for women post-ACLR was unknown. This study aimed to establish whether there was a role for MC phase-based resistance training for women post-ACLR. Authors searched seven databases (MEDLINE, Scopus, CINAHL, SportDiscus, Web of Science, Cochrane Library, and Google Scholar) between 6/12/21 – 22/12/22. Primary studies or reviews describing MC phase-based resistance training at least one MC duration, published in academic journals, and written in English were included. Studies which investigated the effect of the oral contraceptive pill on training responses were excluded. The search yielded 1942 titles and abstracts, with 14 studies included in the final analysis (eight primary studies). No studies were found that investigated MC phase-based resistance training in women post anterior ligament reconstruction. Studies were limited by methodological issues. Six primary studies supported follicular phase-based training to enhance responses, including superior strength, power, lean mass gain, and reduced dysmenorrhea symptoms. One study reported no difference in strength gain between follicular and luteal phase-based resistance training, and another study reported that underweight participants obtained superior strength gain following luteal phase-based resistance training. The results suggest that MC phase-based training may influence responses pertinent to women post-ACLR. There is scope for future research to investigate follicular phase-based resistance training in women following ACLR. [ABSTRACT FROM AUTHOR]

The initial diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The pelvic examination should include a speculum examination and vaginal palpation. Mobility, fixation and/or tenderness of the uterus and site-specific tenderness in the pelvis should be evaluated. Transvaginal ultrasound and pelvic magnetic resonance imaging are recommended to evaluate the extent of the endometriosis and to determine whether any urinary tract or bowel procedures might also be required during surgical resection. Quality of life should be assessed by using the Endometriosis Health Profile-30, its short version EHP-5 or the generic quality of life questionnaire SF-36. Management of endometriosis is recommended when it has a functional impact (pain, infertility) or causes organ dysfunction. Many gynecological societies have published different guidelines for the evaluation and management of endometriosis. However, the complexity of this disease together with the different available treatments lead to significant discrepancies between the recommendations. Postmenopausal endometriosis should be considered when a patient has a history of symptoms before menopause including dysmenorrhea, dyspareunia, dyschezia, infertility and chronic pelvic pain. Malignant transformation of endometriosis is estimated to occur in about 0.7–1.6% of women affected by endometriosis. Endometriosis is associated with an increased risk of ovarian cancer, specifically clear cell, endometrioid and low-grade serous types. [ABSTRACT FROM AUTHOR]

Remote-living and Indigenous Australians can experience menstrual health and hygiene challenges. The topic is not often openly discussed as it is considered private 'women's business'. We were invited into a remote Indigenous town and community to discuss the lived experience of menstruation with female students as well as clinical, educational and community workers. Our yarning circles and interviews collated 16 barriers in four clusters: structural living situation; knowledge, culture and behavior; discomfort and public life; and finances. Targeted efforts by relevant organizations, including schools and government agencies, were identified by participants to better support menstrual health and hygiene without associated pain, ranging moods and a sense of shame. [ABSTRACT FROM AUTHOR]

In this study the researchers aimed to determine the effect of abdominal massage and stretching exercises on the severity of pain, dysmenorrhea symptoms and menstrual blood lost in university students. In this single-blind randomized controlled clinical trial 63 university students were included. Participants were randomly assigned into massage group, exercise and control groups. Our findings showed that the 2nd cycle scores related to abdominal-back pain and fatigue in the massage group and 2nd cycle scores related to mood change in the exercise group were significantly lower than those of the massage and control groups. However, there was no difference between groups in terms of the Visual Analogue Scale scores and blood lost. Our evidence indicates that massage was effective on abdominal-back pain and weakness, and exercise was effective on mood change. [ABSTRACT FROM AUTHOR]

The global value of the menstrual product market recently surpassed 40 billion dollars, yet little attention has been paid to how menstrual product advertising may impact women's perceptions of menstruation. We interviewed a diverse cohort of 18 adult women to understand how menstrual product advertising shapes women's interpretations of their bodies and the menstrual process. Three themes emerged, including gendered stigmatization, depictions of hyper-feminine women, and false narratives about periods. We concluded that dominant patriarchal images of women on their periods persist in female-targeted advertising and offer solutions for advertisers to eliminate stigmas and encompass inclusivity. [ABSTRACT FROM AUTHOR]

Primary dysmenorrhea (PD) is a leading cause of gynecological morbidity, but it is often accepted as a normal part of menstruation, and few women report PD or seek medical care. Using modified grounded theory, we examined the accounts of patients with PD via online narratives. Uncertainty and isolation emerged as extra-medical dimensions that worsened the experience of PD. Clinical encounters in which patients felt that their pain was dismissed or clinicians did not know much about PD may inadvertently exacerbate the experience of challenging menses. We found that people experiencing PD have an unmet need for social and emotional support and that clinicians have an opportunity to address the social dimensions of PD. [ABSTRACT FROM AUTHOR]

Endometriosis (EMS) is a challenging gynecological disorder prevalent in reproductive-aged women, and Th1/Th2 cytokines are implicated in EMS progression. This study probed the serum levels and clinical values of Th1/Th2 cytokines in EMS patients. Firstly, the clinic characteristics of EMS and control patients were recorded. The levels of interferon (IFN)-γ, interleukin (IL)-2, IL-4, and IL-10 in the serum of EMS and control patients were identified, respectively. The correlations between Th1 and Th2 cytokines and the diagnostic values of these cytokines in EMS were analyzed. We observed that EMS patients had obvious differences from the controls in dysmenorrhea, dyspareunia, pelvic pain, nulliparous, and CA125 levels. Serum IFN-γ and IL-2 were lower while IL-4 and IL-10 were higher in EMS patients. Serum IFN-γ, IL-4 were negatively correlated with serum IL-2, and IL-10 in EMS patients. Th1/Th2 cytokines may help the diagnosis of EMS. Serum IFN-γ and IL-2 were independent protective factors for EMS while dysmenorrhea, dyspareunia, nulliparous, and serum IL-4 and IL-10 were independent risk factors for EMS. Collectively, serum Th1/Th2 cytokine levels helped the diagnosis of EMS, with IFN-γ and IL-2 serving as independent protective factors whilst IL-4 and IL-10 serving as independent risk factors. [ABSTRACT FROM AUTHOR]

On Zhihu, China's biggest social network platform for knowledge sharing, young male users are invited to put forward their experiences and suggestions on how to alleviate their partner's menstrual pain. By means of thematic analysis and critical discourse analysis, this present study concentrates on the (un)supportive discourses of male netizens on dysmenorrhea and their implying gender ideologies. It finds out that Chinese young men to a certain extent have broken the restraint of traditional gender norms by offering tangible, emotional, and informational support for their partners. However, this kind of idealized male tenderness is still embedded in the problematic gender relations, and is a form of gender performativity informed by consumerism, neoliberalism, and the Confucian tradition. Moreover, a few discourses featuring male levity and misogyny indicate the dual nature of knowledge-sharing social networks, which imbue hidden gender issues with visibilities on the one hand and reproduce gender inequity on the other. [ABSTRACT FROM AUTHOR]

Women face many sexist constraints globally, increasing the likelihood of psychological stress and related disorders. The present study explores general health constraints among urban Indian women with respect to stress. A cross-sectional study adhering to "strengthening the reporting of observational studies in epidemiology" (STROBE) guidelines was conducted in urban colonies in Delhi. A wide array of women above 18 years of age was recruited, which included students, working professional as well as housewives. General health issues and health behaviors among women were assessed through a questionnaire and stress was evaluated through Cohen's perceived stress scale (PSS)-10. Overall 532 women were contacted, among which 306 women (mean age = 28.8 ± 7.52) years participated. There was significant difference in mean PSS-10 scores, mean±standard error = −3.3 ± 0.6 and −3.1 ± 0.6; p <.0001 for irregular periods and dysmenorrhea, respectively. Likewise, there was significant difference (Mean± SE = −8.9 ± 0.7; p <.0001) in stress scores among women with chronic respiratory, gastrointestinal, and musculoskeletal pain symptoms. Changes in eating behavior during stress; prolong sitting/standing; and lack of exercise were categorized as 'negative health behaviors.' One-way ANOVA showed significant differences in PSS-10 scores (Mean ±SE = −11.3 ± 0.7; p <.0001) among participants exhibiting all "negative health behaviors." General health issues, not necessarily diagnosed medical condition can be psychological stressors among urban Indian women. Poor health behaviors adapted by urban Indian women like prolong sitting/standing, changes in eating habits during stress, and lack of exercise are associated with increased perception of stress. [ABSTRACT FROM AUTHOR]

This study assessed the improvement of symptoms and pregnancy outcomes in infertile patients with various types of adenomyosis who were treated with high-intensity focused ultrasound (HIFU). Between October 2017 and January 2022, 129 infertile patients with adenomyosis who wished to conceive were treated with HIFU. Based on the relationship between the adenomyotic lesion, the endometrium, and the subserosa of the uterus on magnetic resonance imaging, the adenomyotic lesions were divided into internal, external, intramural, and full-thickness types. Menstruation pain score, menstruation blood volume score, anti-Müllerian hormone (AMH) levels, reproductive results, pregnancy and delivery complications, and other clinical variables were compared among these four groups. Patients with external adenomyosis had the greatest menstrual distress, whereas patients with internal adenomyosis had the greatest menstrual blood volume. Dysmenorrhea and heavy menstruation were significantly improved after HIFU treatment in all groups. AMH levels were not significantly different before and six months after HIFU. Of the 129 patients, 50 (38.7%) became pregnant after HIFU, and patients with internal adenomyosis had the highest pregnancy rate. Patients with adenomyotic lesions located in the posterior wall of the uterus had a higher pregnancy rate than those with lesions located in the fundus of the uterus. The classification of adenomyosis is closely related to distinctions in clinical symptoms and pregnancy outcomes. Infertile patients with different types of adenomyosis could be effectively treated with HIFU. HIFU can be considered as an option for infertile patients with adenomyosis who want to maintain their fertility. [ABSTRACT FROM AUTHOR]

To compare the safety and efficacy of high-intensity focused ultrasound (HIFU) treatment for patients with internal or external adenomyosis based on magnetic resonance imaging (MRI) classification. A total of 238 patients with internal adenomyosis and 167 patients with external adenomyosis who received HIFU treatment were enrolled. HIFU treatment results and adverse effects between patients with internal and external adenomyosis were compared. The treatment time and sonication time for patients with external adenomyosis were significantly longer than that for patients with internal adenomyosis. The total energy used and EEF for patients with external adenomyosis were higher than that for patients with internal adenomyosis (p < 0.05). The pre-HIFU median dysmenorrhea score in patients with internal or external adenomyosis was 5 or 8 points, the median score decreased to 1 or 3 points in these two groups at 18-month post-HIFU (p < 0.05). The relief rate of dysmenorrhea was 79.5% in patients with internal adenomyosis, and it was 80.8% in patients with external adenomyosis. The pre-HIFU median menorrhagia score in patients with internal or external adenomyosis was 4 or 3 points, the median score decreased to 1 point in both groups at 18-month post-HIFU with a relief rate of 86.2% and 77.1%, respectively (p = 0.030). No serious complication occurred in any of these patients. HIFU is a safe and effective treatment either for patients with internal adenomyosis or external adenomyosis. It seemed that internal adenomyosis is easier to be treated with HIFU and with a higher relief rate of menorrhagia than external adenomyosis. [ABSTRACT FROM AUTHOR]

To evaluate the clinical efficacy of the combination of high-intensity focused ultrasound (HIFU), mifepristone, and levonorgestrel-releasing intrauterine system (LNG-IUS) in adenomyosis treatment. HIFU treatment was performed in 123 patients with symptomatic adenomyosis who had refused treatment with gonadotropin-releasing hormone agonist (GnRH-a) at Anyang Maternal and Child Health Care Hospital. In the control group, 34 patients were treated with HIFU alone, 29 patients with HIFU combined with mifepristone, 10 patients with HIFU combined with LNG-IUS. In the study group, 50 patients were treated with HIFU combined with mifepristone and LNG-IUS. Uterine volume, dysmenorrhea pain score, menstruation volume score, and serum CA125 level were significantly lower after treatment with HIFU combined with mifepristone and LNG-IUS than before treatment (p <.05). Moreover, hemoglobin level was significantly higher than that before treatment (p <.05). After 24 months, the efficacy of HIFU combined with mifepristone and LNG-IUS was significantly higher than that of HIFU alone, HIFU combined with mifepristone or HIFU with LNG-IUS (p <.05). Combination therapy of HIFU, mifepristone, and LNG-IUS is an effective, safe, and inexpensive treatment for patients with symptomatic adenomyosis. This combination therapy demonstrates superior efficacy to treatment with HIFU alone, HIFU combined with mifepristone, and HIFU combined with LNG-IUS. [ABSTRACT FROM AUTHOR]

Objective: Little is known about the association between maternal history of dysmenorrhea and perinatal outcomes. The aim of this study was to investigate the association between maternal history of dysmenorrhea and low birth weight (LBW). Methods: A total of 6754 pregnant women were recruited from the ongoing prospective cohort study in Guangxi, China, in 2015–2018. Information on the maternal history of dysmenorrhea was obtained by questionnaires including visual analog scale (VAS) questions during the first antenatal care visit. The association of maternal history of dysmenorrhea and LBW was evaluated using logistic regression analyses adjusted for confounding factors (infant sex, maternal age, parity, pre-pregnancy body mass index (BMI) (kg/m² ), gestational age, alcohol use during pregnancy, passive smoking, and occupational status). Results: Mothers with a history of dysmenorrhea were more likely to give birth to LBW infants (adjusted odds ratio (OR)=1.44; 95% confidence interval (CI): 1.12, 1.83). Among women with a history of dysmenorrhea, women 29 years old (adjusted OR 1.46; 95% CI 1.02, 2.10), multiparous (adjusted OR 1.59, 95% CI 1.12, 2.25), and women gave birth to female infant (adjusted OR = 1.53, 95% CI = 1.11, 2.11) had a higher risk of LBW. Conclusions: As the first cohort study to investigate the association between maternal history of dysmenorrhea and LBW, our study shows that dysmenorrhea may increase the risk of LBW. [ABSTRACT FROM AUTHOR]

Dysmenorrhea and mastodynia are the most common gynecologic pain causes in women of all ages and races during their reproductive life. The following study aimed to show the influence of two POP´s in the development of dysmenorrhea and mastodynia after nine months of use. A total of 858 women with 6691 drospirenone (DRSP) cycles and 332 women with 2487 desogestrel (DSG) cycles were analyzed. Women included in this study were all child-bearing potentials, at risk of pregnancy, agreeing to use only the study medication for contraception for the duration of the study medication treatment, aged 18 to 45. At screening, 168 (19.6%) of the 858 patients using DRSP and 64 (19,3%) of the DSG patients reported that they had suffered from dysmenorrhea within six cycles prior to the first visit before starting with the medication. 20,2% of the DRSP and 10,9% of the DSG group had a sever dysmenorrhea. After 9 cycles this was reduced to 0,6% and 3,1% respectively. In total, 96 women (11.2%) in the DRSP and 49 (14,8%) experienced mastodynia within six cycles before the screening. Of these 91.6% in the DRSP group and 91,8% in the DSG group had no or mild mastodynoa at follow-up. The progestins 4 mg and desogestrel 0,075 mg showed a marked effect in the non-contraceptive aspects of dysmenorrhea and mastodynia so that new possibilities are opened for these two benign gynecological diseases. Future studies must reaffirm these first data. [ABSTRACT FROM AUTHOR]

This article reported a rare case of severe ovarian hyperstimulation syndrome (OHSS) following oral clomiphene. The patient was instructed to take clomiphene on the 5th day of menstruation, 50 mg daily for 5 days, without any medical examination or laboratory tests before administration of clomiphene. The treatment outcome was ideal by conservative treatment. This reminded that full assessment and risk prediction should be performed before the prescription of clomiphene. And clomiphene should be used only when indicated. What's more, high risk factors of the particular patient should be taken into full consideration. [ABSTRACT FROM AUTHOR]

This was a randomised trial aimed to determine squatting exercises' effects on menstruation, pelvic mechanics, and uterine circulation in primary dysmenorrhoea. A total of 120 females with primary dysmenorrhoea were assigned into group (A), receiving yoga protocol, or groups (B, C & D), receiving yoga protocol added to modified wall squat, sumo squat, or deep squat, respectively. Menstrual pain and distress, pelvic inclination, and uterine circulation were measured before and after interventions using a pain scale, a questionnaire, palpation metre, and Doppler ultrasonography, respectively. There was a significant reduction in pain intensity in groups B & C (effect size = 3.97 & 5.89, respectively), compared to group A (effect size = 3.68), and in group C (effect size = 5.89) compared to group D (effect size = 3.94), pain subscale in the groups B, C & D (effect size = 1.69, 3.3 & 3.41, respectively), compared to group A (effect size= 2.47), water retention subscale in group D effect size 0.90 compared to group A (effect size =0.41) and in the questionnaire total scores in the groups C &D (effect size = 2.3 & 2.46, respectively) when compared to group A (effect size =1.94). Adding squatting exercises to yoga is more effective than yoga alone in reducing menstrual pain and distress. What is already known on this subject? Physical exercises positively affect primary dysmenorrhoea in terms of decreased pain and distress, possibly through altering faulty posture. Squatting exercises affect lumbopelvic mechanics. What do the results of this study add? This study explores the effect of squatting exercises on pelvic inclination, menstrual aspects, and circulation. What are the implications of these findings for clinical practice and/or further research? Squatting exercises can be utilised to affect pelvic mechanics leading to decreased menstrual pain and distress, because of decreased pelvic congestion. [ABSTRACT FROM AUTHOR]

Introduction: Menstrual cycle gets affected by various modifiable risk factors. To assess prevalence of various types of menstrual problems, lifestyle and mental health status, identification of variables as predictors for menstrual problems and level of polycystic ovary syndrome (PCOS) awareness among rural and urban population of Punjab, the present study has been carried out.Methods: The study was conducted from November 2019 to July 2020 in the Malwa region of Punjab, India, with 2673 participants (15-25 years). Epidemiological information was collected using predesigned questionnaire along with depression, anxiety and stress (DASS-21) score mental health assessment tool. MS-Excel (2019) and IBM SPSS 18.0 (SPSS Inc., Chicago, IL) was used for statistical analysis.Results: The overall prevalence of different menstrual problems was 60.61%, with dysmenorrhea (50.64%) being most common problem. Body mass index (BMI), menarche age, physical activity, and mental health status are significant (p < 0.05) predictors of menstrual problem both in rural and urban population. Overall, only 3.30% subjects were aware about PCOS.Conclusion: Dysmenorrhea is the most common menstrual problem, both in rural and urban population. BMI, sedentary lifestyle, electronic gadgets usage, and mental health are associated with menstrual problems. Low awareness on PCOS indicates need to create awareness as the condition can be easily managed with early intervention. [ABSTRACT FROM AUTHOR]

Purpose: Endometriosis is a chronic, inflammatory condition. The aim was to describe the self-reported disease characteristics and factors associated with the use of different treatment modalities among women with surgically diagnosed endometriosis.Method: A cross-sectional online survey featuring 58 fixed-response items measuring disease characteristics, self-efficacy, health service usage, and treatment approaches was conducted. Logistic regression was used to explore the factors associated with different treatment modalities.Results: Complete data were available from 620 respondents. Average delay to diagnosis was 6.4 years. Despite medical and surgical intervention, 65.8% reported dysmenorrhea and 61.1% reported dyspareunia, and 82.7% reported chronic pelvic pain in the last 3 months. Respondents had consulted an average of three different health practitioner specialties in the previous 12 months for their endometriosis.Discussion: A chronic disease management plan (CDMP) may be a useful mechanism to coordinate multidisciplinary care among women who experience ongoing symptoms. [ABSTRACT FROM AUTHOR]

This descriptive and cross-sectional study was conducted to investigate the prevalence of factors affecting dysmenorrhea and its effects on work life among nurses in Turkey. In total, 574 nurses were included. The prevalence of dysmenorrhea was 69.9%, and 86.0% of the nurses suffered from moderate and severe dysmenorrhea. According to the severity of dysmenorrhea, work satisfaction, work performance, quality of service, communication problems with teammates and patients/patient relatives, official leave of absence and requests for sick leave significantly differed. Therefore, prevalence and severity of dysmenorrhea are high in nurses, and problems experienced in the workplace differ according to its severity. [ABSTRACT FROM AUTHOR]

Primary dysmenorrhea (PDM), which is the most prevalent problem related to the menstrual cycle in women of reproductive age, is due to sleep disorders and negative moods. Circadian rhythms, which are the immediate 24-h processes, enable an organism to adapt the suitable physiological responses to the environmental light-dark changes. Disturbed circadian rhythms are closely associated with several diseases, including sleep disorders. It has been reported that variable number tandem repeat (VNTR) variant in the coding region of circadian rhythm gene PERIOD 3 (PER3) affects sleep. Therefore, in the present study, we investigated the association between PDM and PER3 VNTR variant in Turkish females. A sample of 122 females with PDM and 150 healthy females were included in the study. Genoytyping of PER3 VNTR variant was performed on DNA by polymerase chain reaction (PCR) analysis using specific primers. We evaluated the relation between PER3 VNTR variant and PDM by calculating the odds ratios (ORs) and 95% confidence intervals (CIs). In our analyses of genotype data collected from total 272 subjects, we found that the PER3 VNTR variant was associated with development of PDM [codominant model (5/5 vs. 4/4 + 4/5): OR = 0.664; 95% CI, 0.39–1.10; p = 0.05). The three genotypes of the VNTR variant (4/4, 4/5, and 5/5) and their allelic frequencies showed nonsignificant differences between patients and control group (p > 0.05). In summary, PER3 VNTR variant may be associated with PDM in a Turkish female. However, further studies in different ethnic populations are needed to address the full role of this variant in PDM. [ABSTRACT FROM AUTHOR]

The article offers information on the equality of female athletes in the recent Olympic Games in Tokyo, with nearly 49% female athletes, reflecting the general population's participation. Topics include underrepresentation of female participants in sports medicine and exercise physiology research, ignorance of the menstrual cycle in scientific studies leading to exclusion of women, and the neglected and taboo nature of women's diseases, including the menstrual cycle.

Objective: To evaluate the efficacy and safety of dienogest (DNG) in women with symptomatic adenomyosis.Methods: Women with symptomatic adenomyosis were included in this retrospective observation study. Group 1 (maximum uterine dimension ≥ 100.0 mm) began DNG after 4 months of GnRH-a administration, Group 2 (maximum uterine dimension < 100.0 mm) received DNG with no prior GnRH-a treatment. All women were assessed for their pain symptoms, uterine size, adverse effects and laboratory hematology at baseline and every 6 months during the treatment.Results: 123 women were enrolled in this study, in Group 1 (71 women) with severe uterine enlargement, the median VAS score was 80 mm prior to GnRH-a administration and 10, 10, 10, 20, and 20 mm, respectively, after 0, 6,12,18, and 24 months of DNG treatment. The mean uterine volume decreased from 262.9 ml to 104.7 ml after GnRH-a therapy, and slowly increased from 104.7 ml to 139.5 ml after 24 month-treatment of DNG. Another 52 women with mild uterine enlargement received DNG without prior GnRH-a administration, median VAS score was 70 mm at baseline and decreased to 20, 20, 10, and 10 mm at 6,12,18, and 24 months. The mean uterine volume slightly decreased from 157.9 ml to 153.3 ml after 24 months of DNG treatment (p > 0.05). All laboratory parameters were in the normal range.Conclusions: DNG is effective and well tolerated as a long-term treatment for symptomatic adenomyosis, and it can be used as maintenance therapy after discontinuation of GnRH-a administration. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the numerical rating scale (NRS) measurement properties in women with dysmenorrhea. Methods: This was an online clinimetric study. Brazilian women aged over 18 years old with internet access to respond to online instruments were included in the study. We evaluated criterion validity (comparing women with and without dysmenorrhea), construct validity between the NRS and the bodily pain domain of the SF-36, test-retest reliability, and measurement errors (in women with dysmenorrhea). Results: Two hundred thirty-eight women with and 192 without dysmenorrhea participated in the study. For criterion validity, the area under the receiver operating characteristic curve was 0.902 (95%CI, 0.873–0.931), and a cutoff point of 3 was considered to have the best sensitivity (83%) and specificity (86%). For construct validity, the NRS showed a moderate negative correlation with the SF-36 bodily pain domain (r=-0.46; p < 0.001). For test-retest reliability and measurement errors, 105 women whose symptoms did not change between 7 and 10 days of retest, with intraclass correlation coefficient = 0.90, standard error of measurement = 0.97, and smallest detectable change = 2.76 points. Conclusions: The NRS can be considered a valid and reliable patient-reported outcome measure for assessing dysmenorrhea-related pain intensity. [ABSTRACT FROM AUTHOR]

To collect real-world safety and clinical outcome data on the levonorgestrel-releasing intrauterine system (LNG-IUS) for functional/organic heavy menstrual bleeding (HMB) and dysmenorrhoea in Japanese women (J-MIRAI). In this prospective, multicentre, single-cohort, open-label, post-authorisation study, we assessed menstrual blood loss after LNG-IUS insertion by changes from baseline in pictorial blood loss assessment chart (PBAC) scores. Scores for the menorrhagia multi-attribute scale (MMAS) were collected for 12 months to assess quality of life. We included 47 patients with complete PBAC score and patient diary data. The median PBAC score before LNG-IUS insertion was 159.0, which decreased significantly to 6.0 at 12 months post-insertion; for patients with adenomyosis (n = 20), PBAC score decreased from 174.5 pre-insertion to 19.5 at 12 months. The number of patient-reported bleeding days was correlated with PBAC score ≥5. The proportion of women with prolonged bleeding decreased from 85.7% to 34.6% by the study's end. Some women reported no bleeding after the first 90-day reference period. The mean MMAS overall score significantly increased from 50.50 before insertion to 88.67 at 12 months. Japanese women with functional/organic HMB experienced substantial reductions in bleeding symptoms and improvements in quality of life after 12-month use of the LNG-IUS. [ABSTRACT FROM AUTHOR]

The aim of this study was to understand the relationship between psychosocial factors, including mental health, pain cognitions and social support associated with menstrual pain severity in women with dysmenorrhea of no identified medical cause (primary dysmenorrhea; PD) and dysmenorrhea related to endometriosis. Participants included 1192 women aged 18–50 years with menstrual pain, recruited to an online cross-sectional survey in 2019. Questionnaires assessed self-reported menstrual pain severity, depression, anxiety, stress, pain catastrophizing, and social support. Women with endometriosis had significantly higher menstrual pain severity (p < 0.001) and pain catastrophizing (p < 0.001) than women with PD. Of the psychosocial factors, only pain catastrophizing (specifically, the helplessness sub-scale) predicted menstrual pain severity in each group. Overall, 36% of women with PD and 58% with endometriosis had clinically relevant levels of pain catastrophizing. Findings suggest a common psychological mechanism in women with menstrual pain, regardless of etiology. Interventions to reduce pain helplessness may be beneficial in supporting women with dysmenorrhea. [ABSTRACT FROM AUTHOR]

B Speaker 1 b : Etienne Vachon-Presseau, PhD, McGill University, Montreal, Quebec, Canada, etienne.vachon-presseau@mcgill.ca B Speaker 1 Abstract Title b : Revisiting the biopsychosocial framework for chronic pain using large scale datasets B Speaker 1 Abstract b : Chronic pain conditions are highly prevalent, heterogeneous, and commonly overlapping with other pain conditions. In my talk, I will touch on few possible future research directions to further establish this assumption, including: 1) exploring the causality of dysbiosis in chronic pain; 2) screening patients with variety of chronic pain conditions to establish specific microbiome/pain trajectories; 3) exploring whether gut bacteria diversities and/or metabolomic changes could serve as diagnostic markers for specific pain conditions; 4) manipulating the composition of the gut microbiome as a potential therapeutic tool; 5) pre-emptively changing the microbiome to prevent the development of chronic pain. B Speaker 1 b : Manon Ranger, Ph.D., University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada, manon.ranger@ubc.ca @DrManonRanger B Speaker 1 Abstract Title b : Pain and sucrose induced neuroinflammation in neonatal mice as a mechanism explaining adverse effects on brain and memory B Speaker 1 Abstract b : Effective pain management in the neonatal intensive care unit (NICU) is crucial to help mitigate the known short/long-term negative consequences of early pain exposure in very preterm infants. In 2011, neuropathic pain was redefined by the International Association for the Study of Pain as 'pain that arises from damage or disease of the somatosensory nervous system', no longer encompassing pain from nervous system dysfunction (later termed nociplastic pain in 2016). [Extracted from the article]

To evaluate the different effects of a progestin-only contraceptive with desogestrel (DSG) vs combined oral contraceptives (COCs) for a first line long-term treatment of endometriosis-related pain among patients seeking hormonal contraception. An observational retrospective cohort study was conducted in collaboration with a local outpatient clinic for endometriosis among a group of nulliparous young women (n = 216) with endometriosis-related pain and seeking contraception. The cohort was subdivided into a group (n = 73) treated as first line by DSG and another group (n = 75) treated by a COC. During the study, clinical symptoms, side effects and possible changes in OC type use were recorded. No significant difference was found between the two groups in terms of clinical characteristics and pain scores before treatment. After 6 months both treatments were effective in reducing endometriosis-related pain, and those treated with DSG showed lower levels of dysmenorrhea, dyspareunia and nonmenstrual pelvic pain than COCs group (p <.01). After 12 months, in DSG Group some patients (15%) switched from DSG to a COC for breakthrough bleeding, whereas in COC Group 48% of patients switched to another type of COC for reduced efficacy on pain and/or for side effects. After 3 years of OC treatment, in DSG Group 79% of patients maintained the same therapy, whereas in COC Group only 14% continued the same COC type, 37% switched to another COC and 47% to DSG. A progestin-only contraceptive with DSG is a valid option for long term management of endometriosis-related pain in patients seeking hormonal contraception. [ABSTRACT FROM AUTHOR]

Endometriosis is a disease defined by the presence of benign lesions of endometrial-like glands and stroma outside the endometrial cavity. Affecting an estimated 11.4% of Australian women, symptoms include chronic pelvic pain, dysmenorrhea and infertility. The current gold standard of diagnosis requires an expensive and invasive laparoscopic surgery, resulting in delayed time to treatment. The identification of a non-invasive endometriosis biomarker – a measurable factor correlating with disease presence or activity – has therefore become a priority in endometriosis research, although no biomarker has yet been validated. As small molecule metabolites and lipids have emerged as a potential focus, this review with systematic approach, aims to summarize studies examining metabolomic biomarkers of endometriosis in order to guide future research. EMBASE, PubMed and Web of Science were searched using keywords: lipidomics OR metabolomics OR metabolome AND diagnostic tests OR biomarkers AND endometriosis, and only studies written in English from August 2000 to August 2020 were included. Twenty-nine studies met inclusion and exclusion criteria and were included. These studies identified potential biomarkers in serum, ectopic tissue, eutopic endometrium, peritoneal fluid, follicular fluid, urine, cervical swabs and endometrial fluid. Glycerophospholipids were identified as potential biomarkers in all specimens, except urine and cervical swab specimens. However, no individual molecule or metabolite combination has reached clinical diagnostic utility. Further research using large study populations with robust patient phenotype and specimen characterisation is required if we are to make progress in identifying and validating a non-invasive diagnostic test for endometriosis. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review is to evaluate the evidence for the use of progestin subdermal implants for the treatment of endometriosis-related pain symptoms and quality of life. A literature search of PubMed, Ovid (MEDLINE and EMBASE), and Web of Science was performed from inception to December 2020. In addition, a targeted search of cited references was also performed. Our search identified 330 articles of which 17 were deemed eligible for full-text review. Eligible studies included randomized control trials, observational studies, and case series with at least 5 cases, investigating the effect of progestin subdermal implants on endometriosis-related pain scores in women of reproductive age with a clinical, radiologic, or surgical diagnosis of endometriosis. Six articles were excluded after the full-text screen. Eleven articles describing a total of 335 patients were eligible for inclusion. Across all studies, etonogestrel- and segesterone-releasing progestin subdermal implants improved VAS pain scores for cyclic pelvic pain/dysmenorrhea (VAS at baseline ranged from 6.1 to 7.5 cm and after treatment from 1.7 to 4.9 cm, n = 121), non-cyclic pelvic pain (baseline VAS 7.2–7.6 cm and after treatment 2.0–3.7 cm, n = 96) and dyspareunia (baseline VAS 1.61–8.3 cm and after treatment 1.0–7.1 cm, n = 87). Symptom improvement with the progestin subdermal implant was equivalent to treatment with depot medroxyprogesterone acetate (DMPA; average baseline VAS 6.5 and after DMPA treatment 3.0, compared to 2.0 after treatment with the implant) or the 52 mg levonorgestrel-releasing intrauterine system (LNG-IUS; baseline cyclic and non-cyclic pain scores 7.3 and 7.4 respectively decreased to 1.9 and 1.9 after LNG-IUS treatment). Improvements were also demonstrated in quality-of-life scores (average improvement of 36% in all domains of the Endometriosis Health Profile-30 and significant improvements in social functioning, general health, bodily pain, vitality and mental health domains on the Short Form-36 questionnaire) and sexual function (total sexual function score improved from 24 to 25.35 and 26.25 at 6 and 12 months). Etonogestrel- and segesterone-releasing progestin subdermal implants appear to improve endometriosis-related pain symptoms and quality of life and may provide an additional component in the management of endometriosis. However, this systematic review is limited by the small sample size and heterogeneity in the data. As such, larger prospective randomized trials are needed to guide further management. CRD42021225665 [ABSTRACT FROM AUTHOR]

The risk of recurrence after surgery is a major problem in women who are suffering from endometriosis. The prescription oral contraceptives (OCs) in the treatment of endometriosis-related pain, in women who do not desire fertility, is still controversial. The aim of this prospective cohort study is to evaluate the time until the reduction in the mean intensity of dysmenorrhoea and deep dyspareunia takes effect, for patients who use combined OCs in the accepted cyclic manner, versus in the continuous fashion as after the laparoscopic excision of endometriosis. A total of 28 patients diagnosed with endometriosis who underwent surgical treatment were offered at least a 12 months course of oral contraceptives. The intensity of both symptoms was reduced at the end of observational period in both groups. The use of continuous OCs (11 patients) was associated with a more pronounced reduction in the mean intensity of dyspareunia and dysmenorrhoea at 9 (p = 0.004) and 6 (p = 0.003) months respectively as compared to the cyclic group (17 patients). [ABSTRACT FROM AUTHOR]