Search

Introduction: Dysmenorrhea is one of the most common gynecologic disorders that affects women’s quality of life and social activities. Lifestyle, eating behaviors, and general health are essential to the management of menstrual symptoms. This study was conducted to examine the relationship between lifestyle and primary dysmenorrhea in students at Sari University of Medical Sciences in 2015 in order to facilitate the performance of lifestyle-improving interventions among young women. Methods: This study was conducted on 250 students with and without primary dysmenorrhea at Sari University of Medical Sciences in 2015. Data were collected using personal-social and lifestyle questionnaires (addressing nutrition, physical activity, stress, social relationships, improper health behaviors, and self-care). The data were analyzed by SPSS software, version 18, using the independent-samples t-test, the chi-squared test, and logistic regression analysis. Results: Given the scores obtained on the lifestyle questionnaire, significant differences were observed between the groups with and without dysmenorrhea in terms of eating behavior (p=0.008), physical activity (p=0.011), stress (p=0.041), and social relationships (p=0.000). No differences were observed in terms of self-care (p=0.115) and smoking, drinking, and drug use (p=0.355). According to the logistic regression analysis, age (OR=1.208, p=0.014), physical activity (OR=1.008, p=0.040) and social relationship (OR=0.952, p=0.002) were different in the two groups, but there was no statistical differences in their eating behavior, self-care, and stress. Conclusion: To prevent and reduce the incidence of primary dysmenorrhea, knowledge and awareness should be raised in young women through proper lifestyle education and health promotion measures.

Oral contraceptives are one of the most popular contraceptive methods worldwide. They offer many benefits other than contraceptive efficacy; women also choose the pill for medical or personal reasons. While the pill is extremely safe, there are still concerns about side effects and complications, difficulties with cycle control and compliance. Several approaches have been developed to improve overall experience with oral contraceptives, including lowering doses of estrogen to diminish side effects, though that can create more bleeding irregularities and possibly reduce efficacy. Modifications of pill scheduling by proposing extended or continuous cycle have shown good results decreasing symptoms related to menses. Contraceptive pills can effectively decrease certain premenstrual and menstrual symptoms. Finally, the use of new technologies to try to increase adherence is being explored, though without convincing results so far.

Menstrual symptoms may have a significant impact on women's lives. Many women experience menses-related health problems, such as menstrual pain, heavy menstrual bleeding, and premenstrual syndrome, during their reproductively fertile years. Circadian misalignment in shift workers has been reported to contribute to menstrual cycle irregularity and/or painful menstruation. However, the relationship between social jetlag (SJL) and menstrual symptoms/menstrual cycle has not been elucidated. In this study, we aimed to elucidate this relationship among female university students. One-hundred and fifty female university students (mean [SD]: 18.8 [0.71]-years old) completed self-reported questionnaires consisting of menstrual symptoms and menstrual cycle, sleep quality and sleep habits, quality of life, and demographic variables. The average menstrual cycle was 32.0 [5.4] days. The percentage of students who showed menstrual cycle irregularity, having less than 25 days or more than 39 days of menstrual cycle during the previous four menstrual cycles, was 60.6%. SJL, the difference between mid-sleep time on free days and mid-sleep time on school days, was categorized into small (absolute SJL 1 h) or large (≥1 h). Overall, 78.0% of participants had SJL ≥ 1 h. Among the menstrual symptoms, pain, behavioral change, and water retention subscale scores were significantly higher in the SJL ≥ 1 h group than in the SJL 1 h group. However, no significant differences were found in concentration, autonomic reaction, or negative affect subscale scores between the two groups. The menstrual cycle was 31.2 [5.5] days in the SJL 1 h group and 32.2 [5.4] days in the SJL ≥ 1 h group, without significant difference. Logistic regression analysis showed that more than 1 h of SJL was a significant associated factor with severe menstrual symptom, independently of sleep duration and late chronotype. This study indicated that SJL was a significant factor associated with severe menstrual symptoms, suggesting the possibilities of association between circadian system and reproductive function among humans.

Background: Dysmenorrhoea is a common health problem among females in their reproductive years. Available information on dysmenorrhoea in university student in abah, Saudi Arabia is limited. The objective of the study was to assess the prevalence of dysmenorrhea and associated menstrual symptoms and their self-management techniques among female university students of King Khalid University (KKU). Methods: This cross-sectional study was conducted at College of health science in KKU, Saudi Arabia. Sample: A total of 197 students aged between 18 and 23 years. A Self-administrated questionnaire was used to collect data. Results: Dysmenorrhea was reported by more than two-thirds of the girls (70.6%). In the 139 girls, who reported dysmenorrhea, its related information on severity of pain, medication use, and care-seeking behavior is detailed in the table. Severe pain was reported by (35.2%) respondents. Two-third of the respondents (66%) reported using medications for pain relief and use of herbal medicine was also found to be quite prevalent (69.1%). The gastrointestinal problems were the most common symptoms experienced by the students and were significantly high among the dysmenorrheal students. Less than one in four respondents (23%) reported consulting a doctor for their dysmenorrheal while most of them consulted with friends and family. Conclusion: Dysmenorrhea is a very common problem among the university students. A number of symptoms were related with dysmenorrhea. Even though it is common, and may not have a pathological cause, few students seek medical advice. Increasing the awareness can help in relieving the burden of this common health problem.

Menstrual symptoms are the commonest gynecologic complaints presenting to health professionals in most cultures, yet it is only very recently that the FIGO Menstrual Disorders Committee developed a pair of systems focusing on more logical and consistent terminologies, definitions and underlying causes relating to menstrual symptoms, signs, and pathologies. These initiatives have resulted in several ill-defined terminologies such as menorrhagia and dysfunctional uterine bleeding (DUB) becoming obsolete. In addition to intermenstrual spotting or bleeding, symptoms of abnormal uterine bleeding (AUB) are now primarily defined by regularity, frequency, duration and volume, and underlying causes are classified by the PALM-COEIN System. Heavy menstrual bleeding (HMB) is the commonest of these “bleeding symptoms” and has the greatest social and physical impacts on women and society, especially through iron deficiency and anemia.

Aim of the study was to assess the attitude of female adolescents towards menstruation. The sample for the study consisted of 32 adolescent's girls in the age group of 14 to 18 years studying in class 9 th to 12 th currently enrolled at Government Middle, High and Higher Secondary schools of Kargil block, J&K state. Random sampling technique was used to select the sample females from Purig tribe, a predominant Muslim tribe of the area. A standardized scale on Adolescent Menstrual Attitude Questionnaire (AMAQ) developed by Morse et al. (1993) was used to assess the required attitude. The results revealed that on an average girl held more negative attitude towards menstruation then being positive attitudes towards it. The samples adolescent had accommodated living with menstruation and were open towards it however they had lesser acceptance of menarche. Most of the girls had faced menstrual symptoms but continued to visualize it with negativity.

Menstrual symptoms are associated with various health problems in women and may also significantly impact their lives. This study aims to assess the current burden of menstrual symptoms in Japanese women.Two online surveys were conducted among women aged 15-49 years, where sampling was designed to approximate the age and geographic distribution in Japan. The first survey collected data on menstrual symptom severity based on a modified, 35-item, Japanese version of the Menstrual Distress Questionnaire (mMDQ), current treatments, and impact on work productivity. The second survey collected costs of outpatient treatment within the previous 3 months. Additional outcomes of the second survey will be presented in a separate paper.In this study, 19,254 women had menses, with 74% suffering from menstrual symptoms. A total of 50% reported pain and 19% reported heavy bleeding. Increasing severity of menstrual symptoms and self-reported heavy bleeding were related to more outpatient visits and greater work productivity loss. Among subjects with heavy bleeding, increasing severity of symptoms was related to greater interference with daily life. The estimated annual economic burden extrapolated to the Japanese female population was 683 billion Japanese Yen (JPY) or ~8.6 billion United States Dollars (USD).The study population may be biased due to the online survey method.To the authors' knowledge, this is the first large-scale research assessing outcomes by severity categories for all menstrual symptoms and women's perception of bleeding. A large proportion of women suffer from menstrual symptoms, and symptom severity impacts women's lives. Menstrual symptoms lead to significant economic burden, mainly due to work productivity loss. However, the majority of women do not visit a gynecologist, even when their menstrual symptoms are severe. Thus, increasing public awareness on the recently available medical treatments has the potential to improve the overall burden of menstrual problems.

抄録 健康センター利用者のうち,月経症状の有無により 2 群に分け,同時にライフスタイル調査と身体計 測値も加味して,月経症状を訴える学生の背景因子や特徴を分析し,学生の生活指導に生かすことを目 的とした. 有症状としては,月経痛 67.0%,月経不順 29.8%,月経量異常 6.3%,無月経 5.2%,不正出血 5.2%の 順に出現し,10%に月経痛と月経不順の重複がみられた. 有症状群では無症状群に比して,痩せており,昼食または夕食の欠食が多く,肉類の摂取が少なく, 食事は栄養バランスより食べたい物を優先していた.また,睡眠時間が短く,手足の冷えやだるさの身 体症状を伴っていた.有症状群内の症状別の特徴は,月経痛,月経不順のある学生で欠食が多く,特に 月経不順のある学生は,牛乳,卵などの蛋白質および野菜の摂取が少なく,眠れないとの睡眠障害が認 められた.月経痛のある学生では頭痛,だるさを,月経不順のある学生ではだるさなどの身体症状が認 められた.無月経の学生では血圧が低いことがわかった.

PURPOSE: Hormonal variation throughout the menstrual cycle is posited to impact various physical and mental health symptoms; however, this is not observed in all women and mechanisms are not well understood. Difficulty in emotion regulation may elucidate differences women experience in physical and mental health functioning between menstrual phases. We examined the moderating role of difficulty in emotion regulation in the relation between menstrual phase and menstrual symptom severity and perceived control over anxiety-related events in healthy, regularly menstruating women. METHOD: The participants were 37 women (M(age) = 26.5, SD = 9.6). A series of regression analyses were used to examine whether individual differences in emotion regulation difficulties moderate the relation between menstrual phase and our outcomes, severity of menstrual symptoms and perceived control over anxiety related events, using a within-subjects design. RESULTS: The analyses revealed that difficulty in emotion regulation significantly moderated the relation between menstrual phase and perceived control over anxiety-related events (B = −0.42, p < .05), but not menstrual symptom severity. CONCLUSION: Women who reported higher emotion regulation difficulty experienced greater differences in perceived control over anxiety-related events between menstrual phases. Specifically, women lower in difficulty in emotion regulation report greater increase in control over anxiety during the late luteal phase compared to women with higher emotion regulation difficulty. Difficulty in emotion regulation may play an important role in understanding differences in menstrual phase-associated impairments, thereby informing the development of targeted interventions for vulnerable women.

Introduction: Premenstrual Syndrome (PMS) is a common disorder in childbearing age. Based on different definitions, it is accompanied with specific annoying symptoms that clearly emerge after ovulation and decrease or end with the onset of menstruation. Methods: The present study aimed to determine common premenstrual symptoms & their severity (pain) with relation to VAS in 200 female medical students of GMC, Kannauj in the academic year 2016. Two Hundred female students studying in medical college were randomly selected. The subjects completed two questionnaires of Demographic Information and Symptom Assessment based on the criteria of ACOG and DSM-IV. The pain severity was assessed by using Visual Analogue Scale(VAS).Results: According to the mentioned criteria, among medical students, the most common mood symptom (emotional) was mood variability(“35%”) and somatic symptom (physical) was Abdominal Pain(“38%”)& pain felt by students was mild(“45%”).Conclusion: Given the high prevalence of PMS and its effect on various aspects of life, we highly recommend informing young individuals through books, workshops and media in order to identify the symptoms, provide information about methods of control and treatment of this syndrome, and apply non-interventional treatments and methods to reduce the symptoms.

Background The recurrence of menstrual symptoms markedly interferes with the daily life, social functioning, work disability and quality of life of women. Patient perception of healthcare services is underexplored but crucial for understanding how to efficiently develop healthcare practices. Aims To identify and describe the different patterns of treatment expectation and physician–patient relationships perceived by women receiving traditional Chinese medicine treatment for menstrual symptoms. Methods A two-stage data collection design was used. In the first stage, in-depth interviews with 40 participants were conducted; the interview data were used for content analysis. Q statements were developed on the basis of the content analysis results. In the second stage, a series of Q sorts was performed by 60 other participants to subjectively rank the Q statements. Results The results of factor analysis revealed that four factors retained in the final model accounted for 56% of total variance. Women associated with Factor 1 had experienced few negative physician–patient interactions; these women were relatively young (31.6 years) and had mild perimenstrual mood discomfort (6.4). Women who loaded on Factor 2 preferred physician guidance and encountered few barriers to adherence; these participants were older (38.6 years) and had the most severe perimenstrual mood discomfort (9.5) among the four groups. The women in agreement with Factor 3 tended to patiently wait for treatment effects; these participants had the highest scores for both cyclic pelvic pain (4.9) and perimenstrual physical discomfort (8.8). The women associated with Factor 4 demanded effective treatment and had the lowest scores for both cyclic pelvic pain (3.8) and perimenstrual physical discomfort (6.8). Conclusions The exploration of clustering patients according to their perspectives could influence healthcare providers to acknowledge patient expectations and enable effective communication between physicians and patients.

Objective To obtain estimates of the rate of spontaneous resolution of heavy menstrual bleeding and to explore any association with specific menstrual symptoms. Design Two-year prospective cohort study. Setting Seven general practices, with 67 100 registered patients. Population All women aged 40–54 years on the practices age–sex registers. Methods Baseline postal questionnaire, with follow-up questionnaires sent to naturally menstruating respondents at 6, 12, 18 and 24 months. Main outcome measures Rate of spontaneous resolution of heavy menstrual bleeding in naturally menstruating women. Results A total of 7121 baseline questionnaires were sent out, with an initial response rate of 63%. We recruited 2051 naturally menstruating women for the prospective cohort study. The spontaneous rate of resolution of heavy menstrual bleeding varied from 8.1% (95% CI 5.3–12%) in women aged 45–49 years, who had resolution without recurrence for 24 months, to 35% (95% CI 30–41%) in women aged 50–54 years, who had resolution without recurrence for 6 months. Rates were lower in those who reported interference with life from heavy menstrual bleeding. There was a strong association between the spontaneous resolution of heavy menstrual bleeding and skipped periods in women aged over 45 years. The association with ‘cycle too variable to say’ was significant, but weaker. Conclusion There is a high prevalence, incidence and significant spontaneous rate of resolution of heavy menstrual bleeding in naturally menstruating women during the perimenopausal years. The rates have potential use for individual women, clinical decisions, devising and implementing interventions and planning the care of populations. Please cite this paper as: Shapley M, Blagojevic M, Jordan K, Croft P. The spontaneous resolution of heavy menstrual bleeding in the perimenopausal years. BJOG 2012;119:545–553.

Background: Menstruation is a phenomenon unique to females and nearly universal experience in women's lives and is poorly understood. This study has been done to assess menstrual pattern and associated factors. Materials and Methods: A total of 194 girl students aged 18 to 27 years were selected and asked to complete a questionnaire anonymously. Data regarding demographic features, menarche age, menstrual pattern, severity of dysmenorrhea and associated symptoms, and impact of menstrual pain on working ability were obtained. Source for information about menarche and menstruation the participants depend was also elicited. Results: Mean age of the subjects at menarche was 13.36 ± 1.25 years with a range being 10 to 17 years. Mean duration of menstrual flow was 4.77 ± 1.06 days. The most prevalent menstrual symptoms were tiredness (47.9%), backache (38.3%), and anger (34.5%). Prevalence of menstrual irregularity and dysmenorrhea was 11.9 and 78.2%. 6.7% of the participants had severe dysmenorrhea. 76.6% of the dysmenorrheic girls reported that their working ability was affected. 60.4% of the girls were aware of menstruation prior to menarche. Mothers and friends were the main sources of information (47.8%). Conclusion: In conclusion, it can be mentioned that prevalence of dysmenorrhea and menstrual irregularity among young females is high. Working ability is reported to be affected by menstrual pain. It could be possible to improve menstrual discomforts management by including awareness programs.

This study examined the factor structure of the Menstrual Symptom Questionnaire (MSQ) in a sample of 210 adolescent girls (11—17 years). Such an examination has not been carried out with an adolescent sample. In addition, the definitions of menstrual disorders have evolved since the creation of the MSQ. Exploratory factor analysis supported a three factor structure indicating abdominal pain, negative affect/somatic complaints, and back pain. Partial correlations indicated all three MSQ factors were correlated with depressive symptoms, but only the negative affect factor was correlated with trait anxiety. Future research should explore potential associations in multiple areas of functioning as menstrual symptoms may alter healthy developmental processes during adolescence.

Considerable recent interest has focused on new methods of delivery of oral contraceptives that reduce or eliminate the hormone-free interval in order to improve convenience and acceptability, but maintain contraceptive efficacy, minimize side effects and reduce or eliminate the frequency of withdrawal bleeding episodes. Studies in several countries, including the US, have documented that many women would prefer to have no episodes of withdrawal bleeding when using oral contraceptives. This review focuses on a unique oral contraceptive formulation containing levonogestrel 90 microg and ethinyl estradiol 20 microg, approved for use in a continuous dosing regimen designed to eliminate withdrawal bleeding throughout the entire year.

This study was undertaken to assess the knowledge and beliefs of Saudi female nursing students towards menstruation. A cross sectional survey was conducted on a sample of 400 students, the data was collected using a self-administered questionnaire. The results revealed that a considerable percentage lacked the knowledge and correct beliefs regarding menstruation. Furthermore a significant relationship was found between the marital status, academic year and the score of knowledge and beliefs but not with age. Although the source of information among the majority of the participants was derived from their mother, those who had good knowledge were the participants who belonged to the above 3rd academic year. In conclusion, it is essential to emphasize the importance of compulsory reproductive health education from an early age to help adolescent girls manage menstrual symptoms and increase their awareness; this could be achieved by adding a course of reproductive health course beginning at the intermediate school level.

To compare premenstrual and menstrual symptoms in healthy women using nomegestrol acetate/17β-estradiol (NOMAC/E2) and drospirenone/ethinylestradiol (DRSP/EE) via the Moos Menstrual Distress Questionnaire Form C (MDQ-C).Women completed the MDQ-C at baseline and after completion of cycles 1, 3, 6 and 13, for the premenstrual (four days before most recent flow) and menstrual (most recent flow) phases in two randomized controlled trials. Treatment effects of NOMAC/E2 and DRSP/EE on the t-scores of eight MDQ-C symptom domains from 3522 women were examined, and the effects of both treatments on the score for cramps from 1779 women with moderate to severe cramps at baseline. Longitudinal data analysis methods were applied in both analyses.NOMAC/E2 users experienced a significant improvement in Pain, Water Retention, Negative Affect, Impaired Concentration and Behaviour Change domain scores in the menstrual phase compared with DRSP/EE users (p < 0.001 for all comparisons). However, Arousal (emotional and mental) scores worsened with NOMAC/E2 but not with DRSP/EE. Women with moderate to severe cramps experienced an improvement in the cramps score with NOMAC/E2 and DRSP/EE.NOMAC/E2 was effective in reducing most premenstrual and menstrual symptoms, and was associated with significantly greater improvements in many MDQ-C domain scores compared with DRSP/EE. ( ClinicalTrials.gov: NCT00413062 and NCT00511199).

The prevalence of hypertension is increasing among younger women, and new strategies are needed to identify high-risk women who should be targets for early intervention. Several mechanisms underlying hypertension might also contribute to premenstrual syndrome (PMS), but whether women with PMS have a higher risk of subsequently developing hypertension has not been assessed. We prospectively evaluated this possibility in a substudy of the Nurses' Health Study II. Participants were 1,257 women with clinically significant PMS (1991-2005) and 2,463 age-matched comparison women with few menstrual symptoms. Participants were followed for incident hypertension until 2011. Over 6-20 years, hypertension was reported by 342 women with PMS and 541 women without. After adjustment for age, smoking, body mass index, and other risk factors for hypertension, women with PMS had a hazard ratio for hypertension of 1.4 (95% confidence interval: 1.2, 1.6) compared with women without PMS. Risk was highest for hypertension that occurred before 40 years of age (hazard ratio = 3.3; 95% confidence interval: 1.7, 6.5; P for interaction = 0.0002). The risk associated with PMS was not modified by use of oral contraceptives or antidepressants but was attenuated among women with high intakes of thiamine and riboflavin (P < 0.05). These results suggest that PMS might be associated with future development of hypertension and that this risk may be modifiable.

The Women's Health Questionnaire (WHQ) includes 36 items assessing nine domains of physical and emotional experiences of mid-aged women. The primary aim of the current research was to examine the psychometric properties of the WHQ across linguistic versions in view of the increased need for reliable health-related quality of life (HRQL) measures in multinational studies.In this paper, we examine the hypothesized structure of the questionnaire in a UK sample, to develop and verify a revised model to be used in multicenter, international studies.Content analysis and evaluation of missing data led to exclusion of 'Menstrual symptoms' and 'Sexual behavior' domains, retaining these as optional modules of the core questionnaire. Additionally, item 13 was excluded because it does not investigate the same concepts as other domains and the deletion of five additional items appeared to improve the questionnaire's factor structure. The revised WHQ comprises 23 items, investigating six domains. The cross-sectional psychometric properties of the 23-item WHQ were good and better than those of the 36-item version. The 23-item WHQ was assessed with multinational data, to evaluate cross-cultural equivalence of linguistically adapted versions. In addition, its reproducibility and responsiveness need to be documented.

GPs should look out for a specific pattern of symptoms to enable endometriosis to be diagnosed much earlier, says research in the British Journal of General Practice .1 Endometriosis can be difficult to diagnose clinically as its symptoms are common and non-specific. As a result, often a long time elapses between the first primary care consultation and diagnosis. Distinct episodes of gynaecological pain and combinations of gynaecological pain with menstrual symptoms …

OBJECTIVE This study examined the association between depressive and menstrual symptoms in adolescent girls in a 3-year longitudinal study. It was hypothesized that menstrual symptoms would increase in early adolescence and decrease in later adolescence, that girls with greater depressive symptoms would report greater menstrual symptoms, and that effects would persist after adjusting for general somatic complaints. METHODS A community sample of girls (n = 262) enrolled in an observational study by age cohort (11, 13, 15, 17 years) completed three annual visits. At each time point, girls completed the Menstrual Symptom Questionnaire, Children's Depression Inventory, and the Youth Self Report to assess general somatic complaints. RESULTS Menstrual symptoms increased significantly across adolescence (p = .006) and began to plateau in later adolescence (p = .020). Depressive symptoms at study entry were significantly associated with menstrual symptoms (p < .001). When general somatic complaints were included in the models, the effect of depressive symptoms on menstrual symptoms remained significant for the sum score (p = .015) and the menstrual somatic symptoms subscale (p = .001). After adjusting for somatic complaints, initial report of depressive symptoms predicted change in menstrual symptoms only for girls with the lowest menstrual symptoms sum score (p = .025). Initial report of somatic complaints predicted change in menstrual symptoms (p = .020). CONCLUSIONS Girls with higher depressive symptoms and higher somatic complaints are at greater risk for experiencing menstrual symptoms and increasing symptoms across adolescence, with a heightened vulnerability for girls with lower baseline menstrual symptoms.

A case of infertility with no success after several IVF trials. She also had MS, the symptoms of which were strongly suppressed by cortisone. Only some mental and local symptoms were left. Taking the totality of the symptomatology along her life the same remedy came up in both the neurological and the menstrual symptoms. After repertorisation, the simillimum appeared, with the expected clinical success.

OBJECTIVES We aimed to explore how menstrual symptoms affect women, women's health care needs, and their expectations and experiences when seeking care; to identify ways to assist women in having their needs met. METHODS Qualitative research using focus group methodology was carried out. Identification of women experiencing menstrual symptoms through a random community survey of 200 women aged 30-50 years in the Hunter region of New South Wales. Focus group discussions were recorded and transcripts were analysed. RESULTS All women attending focus groups had sought medical advice for their menstrual problems. Having one doctor with whom they felt comfortable was important. Women expressed difficulties asking questions and were concerned that symptoms may not be taken seriously or may be dismissed as psychological. There was widespread acceptance of alternative 'natural' therapies. CONCLUSIONS Interactions between doctors (particularly GPs) and women with menstrual symptoms are central to how women perceive the care they receive. There is a need for doctors to demonstrate empathy. For many women, what they needed most from their doctors was to be understood and 'to know they weren't alone'.

When I first began researching how women with learning disabilities experience menstruation, it was suggested that I was taking an unwarranted interest in matters that should remain private. However, the small body of work on menstruation that includes women’s own perspectives shows how important menstruation is, with profound private impacts and consequences that should be of public concern. Ditchfield and Burns’ paper situates the issues in the context of women’s more general mental and physical health and well-being. Menstrual symptoms can affect women’s well-being very directly. Barnard et al’s (2003) work in the United States found that women who report one or more menstrual symptom had significantly lower scores for all but one domain of a health status measurement (the SF-36).These associations remained after controlling for coexisting illness and for sociodemographic and psychosocial factors.

Adenomyosis is a benign gynaecological condition associated with menstrual symptoms and pelvic pain in premenopausal women, it has also been linked to subfertility. Improvement in ultrasound and MRI imaging has allowed accurate diagnosis of this condition prior to histological confirmation. Patients opting for surgical management need to be counselled regarding the surgical options available. This review summarizes the surgical management of adenomyosis and reviews the recent surgical developments.For patients who wish to preserve their fertility, cytoreductive surgery is an option in centres with surgical expertise. Recently, modified surgical procedures to remove extensive adenomyosis known as an adenomyomectomy have been described. These operations may enhance subsequent fertility.Access to accurate imaging modalities such as MRI and transvaginal ultrasound allows for adequate patient counselling preoperatively. Depending on the fertility requirements and the extent of adenomyosis, patients can be offered various surgical treatment options including laparoscopic hysterectomy or adenomyomectomy.

Objective: To evaluate endometrial cryoablation (ECA) as a treatment for menorrhagia. Method: Prospective study of 67 women. ECA uses the Joule Thompson principle of expanding gases. The ECA probe has a channel to inject saline solution into the uterine cavity. The probe is introduced into the uterine cavity, which is distended with 5 ml saline solution. The device is activated for two freeze-thaw cycles. The saline solution forms an ice mold of the uterine cavity which can be observed by ultrasound scan. Results: No surgical or long-term complications were observed. Two-thirds of patients followed up for > 3 months were completely satisfied. Conclusions: ECA is technically very easy, can be learned quickly, is free of complications and led to improvement of menstrual symptoms in 63% of patients followed up for 3–18 months. The device is virtually maintenance-free and requires only a small initial investment, while running costs are negligible.

To study the predictive value of the history of genital pain, psychiatric complaints and menstrual symptoms on a woman's sexual life before and after subtotal hysterectomy.One hundred and four premenopausal women were interviewed one month before and one year after surgery. A latent variable for pre- and postoperative sexuality was constructed from the intercorrelation between the measured parameters of frequency of desire for sex, coital frequency, cyclicity of desire and existence of multiple orgasm, and other variables for genital pain, psychiatric morbidity and menstrual symptoms were compared to the latent factors for sexuality.No difference was seen in postoperative sexuality in women with and without a history of psychiatric complaints. The regular use of analgetics, a need to stay home from work because of menstruation, and the occurrence of dyspareunia were positively correlated to the latent factors for sexuality before and after the operation. A history of the need to use psychopharmaceuticals, such as sedatives or antidepressants, had a negative influence on preoperative, but not on postoperative sexuality. Dysmenorrhea had a positive influence on postoperative, but not on preoperative, sexuality.Among variables studied, dysmenorrhea was the best predictor for postoperative sexuality. That is: women with dysmenorrhea do not only invariably experience relief from the pain, but also have a chance to improve their sexual lives after removal of their malfunctioning uterus. Presence of psychiatric problems had, in general, little influence on sexuality.

The purpose of this study is to analyze the potential benefits of aerobic exercises at different intensities in the management of pre menstrual syndrome.The study design is quasi-experimental; sixty-one female subjects were randomly allocated into three groups, Group A (mild intensity), Group B (moderate intensity) and Group C (severe intensity) and the intervention were given for 6 weeks. The study setting was general community settings. The outcome measures were menstrual symptom questionnaire, VO(2) max, forced vital capacity (FVC), maximum voluntary ventilation (MVV) and lipid profile (HDL, LDL, TGL).There is significant decrease in menstrual symptoms in both Groups B and C. However, Group C improved with increased rate of perceived exertion. LDL levels did not change significantly but HDL, TGL, VO(2) max, FVC, and MVV improved significantly in Groups B and C, but remains significantly unchanged in Group A.This study encourages the employment of regular, moderate intensity aerobic exercise as a potential intervention for pre menstrual syndrome.

Objective. To investigate the indication and limitations of uterine artery embolization (UAE), we retrospectively analyzed the case of patients with uterine leiomyomas who had undergone UAE. Methods. During the past 7 years, 25 patients with uterine leiomyomas had undergone UAE in our hospital. UAE was indicated in patients with menstrual disturbances such as hypermenorrhea or dysmenorrhea. The outcomes of this procedure for uterine leiomyomas were analyzed. Results. Improvement in the menstrual symptoms and/or reduction in the leiomyoma size after UAE were observed in 24 patients (96.0%). There was mean 67.9% reduction in the volume of leiomyomas at six months after UAE (𝑃l0.05). However, the symptoms recurred after UAE in 6 patients (24.0%), with multiple or intramural leiomyomas larger than 7 cm, which necessitated additional procedures. Conclusion. The indications and limitations of the UAE should be considered because of its noneffectiveness and/or recurrence in over 20% of patients with uterine leiomyomas.

Purpose: In this study the impact of pro-environmental behavior, well-being oriented behavior, and use of cloth menstrual pads on dysmenorrhea in Korean female adults was examined according to the theory of reasoned action. Methods: A cross-sectional study was conducted with 195 Korean female adults. Data were collected from June to August, 2010 using self-report questionnaires. Data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficients, multiple re gression, and logit regression with STATA 10.0. Results: Pro-environmental behavior explained 48% of well-being oriented behavior. Well-being oriented behavior explained 10% of cloth pad use. Use of cloth pad explained 4% of dysmenorrhea and 5% of menstrual pain. The path through well-being oriented behavior had a significant effect from pro-environmental behavior to cloth pad use. Conclusion: Use of cloth pad was significantly related with well-being oriented behavior, pro-environmental behavior, social influence, dysmenorrhea, and menstrual pain. The results of this study suggest that pro-environmental strate gies can help health care providers diminish clients’ menstrual symptoms. Nursing intervention can support pro-environmental behavioral strategies.

For the sake of improvement in therapeutic approaches for women with cyclical menstrual symptoms, the presentation of premenstrual mood disturbances per se deserves specific consideration. Treatments studies for premenstrual mood symptoms have included conservative, supportive, nutritional, psychotropic, hormonal, and anovulatory measures. An analysis of the literature on premenstrual mood symptoms suggests that a rational schemata for diagnosis can yield a hierarchy of selected individualized treatments based on minimizing the intervention necessary for effective relief.

Results obtained from administering the Adolescent Menstrual Attitude Questionnaire to 860 pre- and 1,013 postmenarcheal girls from 49 randomly selected schools in a large western Canadian city are reported. Scores obtained for both the pre- and the postmenarcheal versions of the total scale and the subscales are presented by age and by grade. In addition, for postmenarcheal girls, the self-report of menstrual symptoms gives insight into the prevalence of symptoms and the perception of symptom severity. Correlations between self-reported symptoms with the Menstrual Symptoms subscale score and the total scale score add validity to the scale. These data may be used by clinicians for comparison when administering the scale to individuals or to groups.

Recent experience with 3 cases of umbilical endometriosis which is a very rare type of cutaneous endometriosis is described, together with 42 cases seen in the Japanese literature. Three patients, 43-, 42-, and 37-year-old women, were seen at the hospital because of an umbilical tumor with a pain, swelling, and hemorrhage starting from immediately before menstruation and lasting during menstrual period. At the first visit all 3 patients were diagnosed as umbilical endometriosis. Enucleation of the tumor including normal parts was carried out. Histologically the diagnosis of umbilical endometriosis was confirmed in all cases. In the diagnosis of umbilical endometriosis, it is important to hear about menstrual symptoms in detail, entertaining a possible existence of this disease.

The aim of this study was to evaluate the effects of auricular acupressure on relieving menstrual symptoms and decreasing nitric oxide (NO) for women with primary dysmenorrhea.This was a randomized clinical trial comparing the effects of auricular acupressure by seed-pressure method and placebo adhesive patch.Settings included colleges in northern and central Taiwan.Serum CA-125 testing was used as a screening test for primary dysmenorrhea (35 mg/dL). The study included 36 college females randomized to acupressure group, 35 to control group.The acupressure group received auricular acupressure by seed-pressure method on liver (CO12), kidney (CO10), and endocrine (CO18) acupoints. The control group had a plain adhesive patch placed on the same acupoints with no seed attached. Acupressure protocol included massaging 15 times on each acupoint, 3 times a day, for a total of 20 days.Primary: Short-form Menstrual Distress Questionnaire (MDQs). Secondary: blood sample of NO. Assessments of MDQs and NO were performed at baseline and within the first 2 days of their next menses (after completion of 20 days of acupressure).In the acupressure group, the overall menstrual symptoms (95% confidence interval [CI] = -49.8 to -6.5, effect size [ES] = 0.43, p = 0.01) and two subscales, menstrual pain (95% CI = -16.4 -to -2.2, ES = 0.45, p = 0.01) and negative affects (95% CI = -11.9-2.0, ES = 0.38, p = 0.04), revealed that menstrual symptoms decreased significantly after auricular acupressure by the seed-pressure method. The ES for the MDQs were in favor of the auricular acupressure by seed-pressure method. NO level increased in the acupressure group, although this difference did not achieve statistical significance (p0.05).This study supports the effects of auricular acupressure by seed-pressure method in improving menstrual symptoms, and offers a noninvasive complementary therapy for women with primary dysmenorrhea.

The therapeutic effectiveness of evening primrose oil (Efamol, Vita-Glow) in the relief of 10 symptoms associated with premenstrual syndrome (PMS) as well as menstrual symptoms was studied in 38 women. The prospective trial was randomised, double-blind and placebo-controlled and was crossed-over after three cycles. Although the results showed an improvement in symptoms of PMS during the trial, no significant differences in the scoring between the active and placebo groups were found over six cycles. No "carry-over" effect of active medication was observed; the beneficial effect on all symptoms (psychological, fluid retention, breast) was rapid, the scores decreasing in the first cycle but increasing slightly at the change-over period after the third cycle, irrespective of whether the active or placebo medication was next given. These findings indicate that the improvement experienced by these women with moderate PMS was solely a placebo effect.

【Purpose: This study was conducted to explore the relationship between isoflavones intake from soy foods and perimenstrual symptoms among women. Methods: The research design was a cross sectional study. Subjects consisted of 245 women living in Korea, aged 19-49 years. The measurement tools were MDQ and FFQ. Results: Frequently consumed soy isoflavones foods were rice with soybeans, soybean paste stew, and soy paste with tofu. The amounts of soy isoflavones foods consumed in order from highest to lowest were rice with soybeans, soybean paste stew, seasoned soybean sprouts, and soy paste with tofu. Subjects were divided into three groups by isoflavones intake levels; the small intake group, moderate intake group, and large intake group. There were significant differences in some menstrual symptoms, and postmenstrual symptoms by isoflavones intake levels. In general, the moderate isoflavones intake group showed lower scores in some menstrual symptoms and postmenstrual periods compared to the small and large intake groups. Conclusions: These results suggest some positive health effects of isoflavones from soy foods on perimenstrual symptoms. More accurate, objective measurement needs to be applied and more investigation of soy isoflavones effects on many aspects of women's health need to be done in a future study.】

Extended cycle contraception is a safe and acceptable form of contraception and may be more efficacious than cyclic regimens, especially for users of oral contraceptive pills. Most extended cycle regimens result in fewer scheduled bleeding episodes, an outcome desired by many women. They may also result in more unscheduled bleeding and/or spotting episodes that decrease with time. Women who use extended cycle contraception experience fewer menstrual symptoms, particularly headache. Some women have medical conditions or menstrual symptoms that make extended cycle contraception a preferred method. Although we do not have enough data to recommend one particular extended cycle regimen over another, the use of these new regimens will provide women with more options, and almost certainly will improve the acceptability and efficacy of hormonal contraception. In this article, the authors focus on extended cycle combined hormonal contraceptive regimens and summarize their acceptability, efficacy, and safety. They also argue that extended cycle combined hormonal contraceptive may have increased efficacy compared with traditional cyclic combined hormonal contraceptive.

BACKGROUND: Dysmenorrhea is the most common gynecological problem among females and it is defined as cramping pain in the lower abdomen occurring just before or during menstruation. Menstrual symptoms are a broad collection of affective and somatic concerns that occur around the time of menses. The effect and importance of dysmenorrhea is very wide, therefore managing the problem is important.OBJECTIVE: To ascertain the prevalence, and impact of primary dysmenorrhea in student girls and their management behaviors.METHODS & MATERIALS: A Cross-sectional study was conducted on 1000 healthy females aged 11-28 years. Standardized Self-reporting questionnaires were used to obtain relevant data. Pain intensity was assessed by using the Numerical Pain Scale (NPS). Data was analyzed by SPSS version 16.RESULTS: Prevalence of dysmenorrhea was 70.2%. Majority of the subjects experienced pain for one or 1-2 days during menstruation. 23.2% of the dysmenorrheic girls experienced pain for 2-3 days. The most common symptom in both dysmenorrheic and non dysmenorrheic girls during the menstrual periods was tiredness and second most prevalent symptom was back pain.Females experiencing mild pain on an average absented for one and half day a month while 2.1±1.2 and 2.5±1.3 days for those who experienced moderate and severe forms of dysmenorrhea respectively. A small proportion of girls sought pharmacological management (25.5%) and 83.2% depended on non-pharmacological methods. Only 14.2% had sought medical advice.CONCLUSION: Sub optimal use of the medical advice and the barriers to seek medical attention by dysmenorrheic females need exploration. It is important that health education on puberty and menstruation is regarded as inadequate for many girls in India.

Chronic diseases have been associated with decrements in health status, as measured by the Medical Outcomes Study's Short Form-36 (SF-36). Menstrual symptoms (including irregular menses, menorrhagia, dysmenorrhea and premenstrual symptoms) are common, but little is known about their impact on health status. We sought to determine the prevalence of menstrual symptoms and the degree to which these symptoms affect health status.This was a mailed survey including questions about sociodemographic characteristics, military experiences, current physical symptoms and medical conditions, mental health, health status (SF-36), and life experiences. The participants were a nationally representative, randomly selected sample of women veterans who had made at least one ambulatory visit to a Veterans Affairs facility between July 1, 1994 and June 30, 1995. The main outcome measures were eight domains of the SF-36 health status questionnaire.Among 3632 respondents (58.4% response rate), 1744 were menstruating women and formed the analytical sample for this study. Among these women (mean age 35.8), 67% reported one or more menstrual symptoms. Women with menstrual symptoms had significantly lower scores for all domains of the SF-36 (p0.01), except energy and vitality (p0.05), both before and after adjusting for sociodemographic, psychosocial, and comorbidity variables.Women veterans who report one or more menstrual symptoms have significantly lower health status compared with those reporting none. Clinicians providing care for women should be attuned to the potential impact of menstrual symptoms on the lives of their patients.

In this paper, the skin blood flow for the stomach and forehead regions of 36 female patients with menstrual symptoms was studied using a moorLDI laser Doppler imager in which the results of 6 typical patients are included. The patterns obtained at the two sites are common to all women in the sample who have menstrual symptoms. Cold stress testing was also investigated to see if it was effective in bringing out any skin blood flow fluctuation at these regions caused by menstrual symptoms. Each patient attended two scanning sessions: one before and the other during menstruation. During each session, the patient was scanned three consecutive times, each on the stomach and the forehead skin regions. For each region, the first measurement was a bare scanning whereas for the second and the third, 85 % denatured ethanol (cold stress test) was applied onto the required scan areas. It was found that cold stress testing was able to bring out distinct differences in LDI perfusion images before and during menstruation. Results were best captured when perfusion images were taken approximately after 85% denatured ethanol had been applied in two layers for 30 s, allowed to evaporate over the next 5 min (approximately the time taken to obtain one image), reapplied for another 30 s and then finally over the next 30 s allowed to evaporate further. However, it was impossible to deduce conclusively any correlation regarding migraine and skin blood flow since all the patients for this work had menstrual cramps only.

The age at menarche and several menstrual symptoms were reported by 516 Portuguese school girls who took part in a cross-sectional anthropometric study in Coimbra, Portugal. The mean ages of menarche calculated using the recall method and also using probit analysis were 12.53 +/-1.27 and 12.03 +/- 1.26 years, respectively. Parents'educational level, place of residence and size of the family did not have any significant effect on the mean age at menarche in this sample of adolescents. The order of birth was the only variable that indicated a significative effect: the first borns reported a lower mean age at menarche (12.34 years) than the later borns (12.6 years). In this sample, 47% of the girls had a cycle length ofor = 29 days, 23.4% had irregular cycles, 59% reported that the duration of bleeding was 3-5 days and the majority, 49%, did not report any pain during the bleeding days. However, 14.3% and 24.45% reported severe and medium pain. The age at menarche has declined from 15.0 (girls born in 1880-1890) to 12.03 (girls born in 1970-1980) years in the Portuguese population. This decrease in age, and also the lack of influence of the family characteristics, appear as a result of the great improvements in the social and economic living conditions that occurred in Portugal, especially after the 1970s. These improvements are mainly related to better nutrition and better health care along with many other environmental factors.

The authors examined whether women with irregular cycles showed more symptoms of menstrual distress than women with regular cycles. One hundred fourteen college women prospectively recorded the dates of 6 to 8 menstrual cycles and replied to a menstrual-symptoms questionnaire. The researchers cross-classified regularity and irregularity, by the women's self-definitions (questionnaire data) and by objective criteria (based on the respondents' prospective recordings of their menstrual data). The results showed that women with irregular cycles experienced twice as many menstrual symptoms as women with regular cycles. The use of a more valid criterion for menstrual irregularity revealed that women with irregular cycles suffered more menstrual distress than did women with regular cycles.

The relationship between menstrual attitudes and menstrual symptoms among Taiwanese women Aim of the study. This study explored characteristics of the menstrual cycle including duration, prevalence and severity of symptoms and examined the relationship of these characteristics with attitudes toward menstruation. Background. Conceptualization of menstrual phenomena and attitudes toward menstruation may vary among cultures. While data about menstrual health among American women are widely available, there are little data concerning menstrual health in Taiwanese women. Design/Methods. A total of 30 healthy women with a mean age of 24·4 years participated in the study and made daily records of symptoms over a 90-day period with the Woods Daily Health Diary (WDHD). They then retrospectively completed the Moos Menstrual Distress Questionnaire (MMDQ) and the Menstrual Attitudes Questionnaire (MAQ). Results. The mean age of menarche of these women was 13 years, their mean cycle duration was 5·8 days and the cycle length was 31·1 days. The mean scores of five subscales for MAQ ranged from 2·19 to 3·28. Forty-six percent of the surveyed Taiwanese women agreed that the onset of menstruation can be predicted and anticipated, and 78% of these women agreed that menstruation was a natural event. Conclusions. Menstrual attitudes in Taiwanese women are multidimensional, and that significant cross-cultural differences are present. Attitudes toward menstruation in Taiwanese women are related to their physical, cognitive, behavioural and psychological changes in the premenstrual and menstrual phases.