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

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

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

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]

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

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

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

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

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

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

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

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

Background: Dysmenorrhoea, or period pain, is a prevalent gynaecological condition that can result in functional interference during menstruation. Despite the significant disruption dysmenorrhoea can have on functioning and well-being, medical help-seeking rates are low. Little is known about what factors may predict help-seeking for dysmenorrhoea. Objectives: The current study aimed to test the predictive validity of the Behavioural Model of Health Services Use (BMHSU) for help-seeking behaviour in dysmenorrhoea, whereby help-seeking behaviour was operationalised as having attended to a healthcare professional for dysmenorrhoea-related care. Design: A cross-sectional observational design was used. Methods: Participants (N = 439) completed an online survey, which measured the following eight predictor variables: menstrual pain characteristics, health beliefs, self-efficacy, social support utilisation and satisfaction, perceived healthcare availability, and pain intensity and interference. Participants were also asked to report whether they had ever attended to a healthcare professional for their menstrual pain. Results: The BMHSU accounted for 8% of the variance in help-seeking behaviour. Pain interference and appointment availability were significant predictors of the variance in past help-seeking behaviour, such that those who experienced greater pain interference, and those who perceived greater availability of healthcare appointments were less likely to have visited a healthcare professional for their menstrual pain. The BMHSU had an overall 69% classification accuracy in predicting help-seeking behaviour. Conclusion: Although the BMHSU demonstrated reasonably good model fit, it does not appear to be a particularly robust model for predicting help-seeking behaviour for dysmenorrhoea. Future research should explore whether a refined BMHSU or an alternative theoretical model can provide more useful insight into this behaviour. Better understanding of the determinants of help-seeking behaviour will enable the development of interventions to promote appropriate help-seeking and improve health outcomes for individuals with menstrual pain. Plain language summary: What makes people with period pain seek help? Many people experience common period pain, which can be severe and debilitating. Even though it can make daily life difficult, not many people seek medical help for period pain. The purpose of this study was to find out why people with period pain might or might not go to a doctor for help. We used a theoretical framework called the Behavioural Model of Health Services Use to try to understand this. This framework tells us that predisposing factors like age or health beliefs, enabling factors like family support and access to healthcare, and need factors like severe symptoms, can predict whether someone will go to the doctor. We wanted to test if this way of thinking could accurately predict if someone with period pain had been to see a doctor. We asked people with period pain to fill in an online survey. We asked about things like how painful their periods were, what they believed about their menstrual health, how confident they felt in managing their pain, whether they got support from others, if they thought healthcare was available, and how much the pain affected their lives. We also asked if they had ever gone to a doctor for help with their period pain. We found that these factors were not very accurate in predicting whether people sought help for period pain. The most important predictors were how much the pain affected their lives and whether they believed that healthcare appointments were available to them. If the pain was very disruptive, and if they felt there were free appointments, people were less likely to have gone to see a doctor. This study was the first to use this way of thinking to understand help-seeking for people with period pain. In the future, researchers should test different models to see if they work better for understanding help-seeking behaviour for period pain. It is important to find ways to understand this behaviour to help people seek help for their pain when they need it. [ABSTRACT FROM AUTHOR]

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

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

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

Introduction: Dysmenorrhoea affects many adolescents with significant impacts on education and well-being. In the UK, most of the adolescents who seek care (and many never do), will do so through general practice (primary care). Knowing how best to care for adolescents reporting menstrual pain is an area where UK general practitioners would like better guidance and resources. Methods: This mixed-methods narrative synthesis collates community and specialist evidence from 320 papers about adolescent dysmenorrhoea, with a UK general practice community health perspective. Results: We report a narrative summary of symptoms, cause, consequences and treatments for adolescent dysmenorrhoea. We highlight areas of tension or conflicted evidence relevant to primary care alongside areas of uncertainty and research gaps identified through this synthesis with input from lived experience advisers. Discussion: There is little evidence about primary care management of adolescent dysmenorrhoea or specific resources to support shared-decision making in general practice, although there are evidence-based treatments to offer. Primary care encounters also represent potential opportunities to consider whether the possibility of underlying or associated health conditions contributing to symptoms of dysmenorrhoea, but there is little epidemiological evidence about prevalence from within community health settings to inform this. The areas where there is little or uncertain evidence along the care journey for adolescent dysmenorrhoea, including at the interface between experience and expression of symptoms and potential underlying contributory causes warrant further exploration. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

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

This article discusses the prevalence of female genital schistosomiasis (FGS) among long-term sub-Saharan African migrants in Europe. FGS is a condition characterized by gynecological signs and symptoms, such as menstrual disturbances and vulvovaginal discomfort, that can occur in women with urinary Schistosoma haematobium infection. The study found that African migrant women with a positive Schistosoma serology often experienced gynecological and urinary complaints, despite living in non-endemic European countries for many years. The findings suggest that chronic genitourinary schistosomiasis may be an underestimated condition in non-endemic countries, with significant implications for the sexual and reproductive health of migrant women. Further research is needed to develop a gold standard diagnostic and determine the appropriate treatment for chronic FGS. [Extracted from the article]

Decidual cast is a little-known entity characterized by sloughing of the endometrium in several large pieces or in one cylindrical or membranous piece retaining the shape of the uterine cavity. Accounts of the diagnosis are sporadic and have not previously appeared in the pediatric imaging literature. We describe a case of a post-menarchal adolescent girl presenting with abnormal uterine bleeding, severe dysmenorrhea, and imaging features of genital tract obstruction, the cause of which was found to be a large decidual cast during examination under anesthesia. While rare, awareness of this phenomenon should be useful to pediatric imagers as the combination of bleeding and obstructive symptoms produces a confusing picture that may lead to a protracted clinical and imaging course. [ABSTRACT FROM AUTHOR]

Introduction: There is a gap in knowledge regarding development of endometriosis and adenomyosis lesions visible at transvaginal ultrasound. The objectives were to evaluate if women with symptoms suggestive of endometriosis or adenomyosis but normal ultrasound examination develop endometriosis or adenomyosis lesions visible at ultrasound over time and if alterations of symptoms over time are associated with ultrasound findings at follow‐up. Material and Methods: This was a prospective cohort study of 100 symptomatic women with normal initial ultrasound examination during 2014–2017 who underwent follow‐up ultrasound examination in 2022. Symptoms suggestive of endometriosis were assessed using visual analog scale at both examinations and minimal clinically important difference of 10 mm was considered as a significant alteration. An examiner with expertise in advanced ultrasound examination of endometriosis performed transvaginal ultrasound examinations in accordance with the consensus protocol by the International Deep Endometriosis Analysis group. Results: At follow‐up ultrasound examination of 100 women, 13 (13% [95% CI 7.1–21.2]) had visible endometriosis or adenomyosis lesions, 8 (8% [95% CI 3.5–15.2]) had endometriosis lesions, and 6 (6% [95% CI 2.2–12.6]) had adenomyosis. At follow‐up, women with endometriosis or adenomyosis lesions reported lower intensity of dysmenorrhea and chronic pelvic pain compared to women without lesions (48 mm [IQR 16–79] vs. 73 mm [IQR 46–85] and 45 mm [IQR 26–57] vs. 57 mm [IQR 36–75], p = 0.087 and p = 0.026, respectively). None of the women with endometriosis or adenomyosis lesions reported increased intensity of dysmenorrhea at follow‐up, compared to 32/86 women (37%) without lesions (p = 0.008). Increased intensity of chronic pelvic pain tended to be less common in women with lesions compared to those without (3/13 [23%] vs. 35/86 [41%], p = 0.223). Conclusions: Our findings suggest that in symptomatic women, endometriosis and adenomyosis lesions visible at ultrasound may develop over time. However, majority of women remain having normal ultrasound examinations despite symptoms. Exacerbation of dysmenorrhea or chronic pelvic pain during follow‐up was not associated with the development of endometriosis or adenomyosis lesions visible at ultrasound, suggesting that even women with less severe symptoms might benefit from a follow‐up ultrasound when indicated. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Do adolescents and young adult women (YAW) with histologically proven endometriosis present a specific clinical history? SUMMARY ANSWER Questionnaire screening of adolescents and YAW can identify clinical markers associated with histologically proven endometriosis. WHAT IS KNOWN ALREADY Some validated questionaries can contribute to an earlier endometriosis diagnosis in adults. None of these scores, however, have been validated for adolescents or YAW. STUDY DESIGN, SIZE, DURATION This was an observational cross-sectional study using prospectively recorded data performed between January 2005 and January 2020 in a single university tertiary referral centre for endometriosis diagnosis and management. After a thorough surgical examination of the abdomino-pelvic cavity, women with histologically proven endometriosis were allocated to the endometriosis group, and symptomatic women without evidence of endometriosis were allocated to the endometriosis-free control group. The endometriotic patients were allocated into two sub-groups according to their age: adolescent (≤20 years) and YAW (21–24 years). PARTICIPANTS/MATERIALS, SETTING, METHODS Adolescents and YAW ≤24 years of age were operated for a symptomatic benign gynaecological condition with signed informed consent. A standardized questionnaire was prospectively completed in the month before the surgery and included epidemiological data, pelvic pain scores, family history of endometriosis, and symptoms experienced during adolescence. The study searched for correlations by univariate analysis to determine clinical markers of endometriosis in adolescents and YAW compared with endometriosis-free control patients. MAIN RESULTS AND THE ROLE OF CHANCE Of the 262 study participants, 77 women were adolescents (≤20 years of age) and 185 patients (70.6%) were YAW. The endometriosis group included 118 patients (45.0%) and 144 (55.0%) were assigned to the control group. A family history of endometriosis, absenteeism from school during menstruation, history of fainting spells during menstruation, and prescription of oral contraceptive pills for intense dysmenorrhea were significantly more frequently observed in the endometriotic patients. The prevalence and mean pain scores for dysmenorrhea, deep dyspareunia, non-cyclic chronic pelvic pain and gastrointestinal and lower urinary tract symptoms were significantly greater in the endometriosis group, as was experienced rectal bleeding. LIMITATIONS, REASONS FOR CAUTION The study was performed in a single referral centre that treats patients with potentially more severe disease. This questionnaire was evaluated on a population of patients with an indication for endometriosis surgery, which can also select patients with more severe disease. Women with asymptomatic endometriosis were not considered in this study. These factors can affect the external validity of this study. WIDER IMPLICATIONS OF THE FINDINGS Patient interviews are relevant to the diagnosis of endometriosis in adolescents and YAW. Combined with imaging and clinical examination, this approach will enable earlier diagnosis and treatment, while remaining non-invasive and rapid. STUDY FUNDING/COMPETING INTEREST(S) The study received no funding from external sources. There are no conflicts of interest. TRIAL REGISTRATION NUMBER N/A [ABSTRACT FROM AUTHOR]

Background: Dysmenorrhea and its associated pain disable adolescents in their daily activities and also affect the social and mental behavior. The vehement practice of self-medication alarms health-care professionals for conducting periodic awareness programs. Aims and Objectives: We aimed to assess the knowledge about dysmenorrhea and to compare the level of understanding and practices among medical students. Materials and Methods: It was a prospective, observational, cross-sectional, and questionnaire-based study conducted among medical students in a tertiary care hospital. Results: There was no difference in distribution regarding knowledge and attitude of the study population toward dysmenorrhea among the three groups regarding treatment of dysmenorrhea and health education. In contrast, response about contraindications and adverse effects of medications used was observed in only half of the 1st-year students. Half of the study participants, daily activities were affected and led to absenteeism. The negative emotions such as depression, anger, anxiety, and irritability are most noted and the majority of the students felt like distancing themselves during menstruation. Conclusion: The present study concludes that dysmenorrhea, a major problem among adolescents, had an impact on the quality of life including psychological disturbances. Thus, the awareness patterns and practices need to be analyzed periodically among adolescents for better improvement and management of dysmenorrhea. [ABSTRACT FROM AUTHOR]

Copyright of Mediterranean Nursing & Midwifery is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Menstrual function is an integral component of the overall health and well-being of cyclically menstruating athletes, impacted by and affecting their participation in sport and athletic training. This review used the coach–athlete relationship to examine the sport environment for factors that facilitate or hinder healthy sport participation for cyclically menstruating athletes with respect to their menstrual cycles. Four databases were searched until June 30, 2023, for studies that explored the experiences, perceptions and knowledge related to the menstrual cycle among athletes training under a coach and coaches of cyclically menstruating athletes. The search produced 2511 studies, which, following screening for relevance and eligibility, resulted in 34 studies of moderate-to-high quality. Thematic synthesis and integration of qualitative and quantitative data from 7558 athletes and coaches from elite to amateur level uncovered 4 main themes pertaining to the coach–athlete relationship and the menstrual cycle that constituted barriers (menstruation taboo, lack of knowledge and awareness, and lack of communication among stakeholders) and facilitators (presence of female coaches, positive experiences of communicating about the menstrual cycle, and trust) to healthy sport participation. A final theme summarised the needs of athletes and coaches related to the menstrual cycle. Greater education, representation of females in sporting roles, and improved collaboration among the various stakeholders emerged as the primary factors for driving a culture-shift in the sporting environment, in order to abolish the taboo against menstruation and promote healthy sport participation for cyclically menstruating athletes. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the impact of antibiotic treatment for chronic endometritis (CE) on the pregnancy outcome of frozen-thawed embryo transfer (FET) cycles and the relevant clinical risk factors associated with CE. Methods: A retrospective cohort analysis was conducted on 1352 patients who underwent hysteroscopy and diagnostic curettage at Nanjing Maternal and Child Health Hospital from July 2020 to December 2021. All patients underwent CD138 immunohistochemical (IHC) testing to diagnose CE, and a subset of them underwent FET after hysteroscopy. Patient histories were collected, and reproductive prognosis was followed up. Results: Out of 1088 patients, 443 (40.7%) were diagnosed with CE. Univariate and multivariate binary logistic regression analyses revealed that parity ≥ 2, a history of ectopic pregnancy, moderate-to-severe dysmenorrhea, hydrosalpinx, endometrial polyps, a history of ≥ 2 uterine operations, and RIF were significantly associated with an elevated risk of CE (P < 0.05). Analysis of the effect of CE on pregnancy outcomes in FET cycles after antibiotic treatment indicated that treated CE patients exhibited a significantly lower miscarriage rate (8.7%) and early miscarriage rate (2.9%) than untreated non-CE patients (20.2%, 16.8%). Moreover, the singleton live birth rate (45.5%) was significantly higher in treated CE patients than in untreated non-CE patients (32.7%). Survival analysis revealed a statistically significant difference in the first clinical pregnancy time between treated CE and untreated non-CE patients after hysteroscopy (P = 0.0019). Stratified analysis based on the presence of recurrent implantation failure (RIF) demonstrated that in the RIF group, treated CE patients were more likely to achieve clinical pregnancy than untreated non-CE patients (P = 0.0021). Among hysteroscopy-positive patients, no significant difference was noted in pregnancy outcomes between the treatment and control groups (P > 0.05). Conclusion: Infertile patients with a history of parity ≥ 2, hydrosalpinx, a history of ectopic pregnancy, moderate-to-severe dysmenorrhea, endometrial polyps, a history of ≥ 2 uterine operations, and RIF are at an increased risk of CE; these patients should be recommended to undergo hysteroscopy combined with CD138 examination before embryo transfer. Antibiotic treatment can improve the reproductive outcomes of FET in patients with CE, especially those with RIF. [ABSTRACT FROM AUTHOR]

Background: Abdominal pain due to menses (primary dysmenorrhea) is an extremely pervasive and debilitating symptom affecting up to 90% of menstruating individuals. Objective: The objective of this randomized control trial was to investigate the effect of a commercial transcutaneous electrical nerve stimulation unit, Therabody PowerDot® (Therabody Inc., Los Angeles) on dysmenorrhea compared with non-steroidal anti-inflammatory drug use. Design: This was a randomized cross-over study. Methods: A total of 47 participants agreed to participate in the study, with 34 completing it. Participants completed treatments across three consecutive menstrual cycles in randomized order: single-unit transcutaneous electrical nerve stimulation (Uno), dual unit transcutaneous electrical nerve stimulation (Duo), and non-steroidal anti-inflammatory drug use (Control). Upon onset of dysmenorrhea, participants applied transcutaneous electrical nerve stimulation to their abdomen for a minimum of 30 min. Control participants were instructed to take non-steroidal anti-inflammatory drugs as needed. Surveys were used to record pain before and after treatment. We hypothesized that the PowerDot would decrease self-reported pain scores, and decrease non-steroidal anti-inflammatory drug consumption during menses. Results: Participants experienced a statistically and clinically significant reduction in pain during the Control (−3.52 ± 1.9), Uno (−2.10 ± 1.6), and Duo (−2.19 ± 1.7) cycles (p < 0.001). The doses of non-steroidal anti-inflammatory drugs consumed during the Control cycle (3.5 ± 2.6), was significantly different as compared with that of Uno (1.5 ± 3.0), or Duo (1.1 ± 2.6) (p = 0.004). Conclusions: Use of a commercial transcutaneous electrical nerve stimulation unit results in significant decrease in pain. Although not as robust as the relief in pain induced by non-steroidal anti-inflammatory drugs, the adverse events of transcutaneous electrical nerve stimulation are minimal in comparison. Therefore, transcutaneous electrical nerve stimulation appears to be a viable alternative to pain relief from dysmenorrhea. Clinical Trial Registration: NCT05178589 Plain Language Summary: The role of electrical signals for period pain relief Menstruation, also known as the period, is a cyclicly occurring event in people who are assigned female at birth. Often, the period is associated with abdominal pain that can be debilitating for many. This abdominal pain is typically treated using over-the-counter medications, such as ibuprofen; however, there several noted side effects that can arise from use of such medication. As such, this study aimed to understand if a device (Therabody PowerDot®; Therabody Inc., Los Angeles) that sends an electrical current to pads placed over the abdomen, much like a heating pad, could be used to decrease pain during the period to a similar level as medication. The research team studied three consecutive periods with differing setups: a single, elongated pad, placed on the lower abdomen (Uno), two circular pads placed on the lower abdomen (Duo), or no use of the device, only medication (Control). The researchers analyzed data from 34 individuals. It was found that all three cycles experienced a significant decrease in pain, with the control cycle having a greater decrease in pain than both the Uno and Duo. This study suggests that the electrical stimulation used here can greatly decrease pain during the period, though not as substantial as medication. [ABSTRACT FROM AUTHOR]

Round ligament endometriosis is a rare phenomenon reported in approximately 0.3% to 0.6% of endometriosis cases. Presurgical diagnosis is carried out for about 50% of the cases. The association of the right-sided inguinal hernia, nonspecific pain in the organs, and no history of surgery or labor make the diagnosis intricate. We report a case of endometriosis of the round ligament in a 39-year-old woman who complained of intense pain in the right groin during the menstrual period for about 4 years, with no complaints of bulging or change in the size of the mentioned area. The clinical suspicion of inguinal endometriosis, supported by sonography and magnetic resonance imaging, was confirmed by histological examination of the surgical specimen after laparoscopic surgery, which included the mass and the extraperitoneal segment of the round ligament. After surgery, the patient's pain disappeared completely. The round ligament endometriosis or endometriosis of the inguinal region could be considered an important differential diagnosis in women of reproductive age without a history of surgery who presented with inguinal region pain during menstruation but no clear mass was palpable in the physical exam. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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

Background: Chronic pelvic pain is a common disease that affects approximately 4% of women of reproductive age in developed countries. This number is estimated to be higher in developing countries, with a significant negative personal and socioeconomic impact on women. The lack of data on this condition in several countries, particularly those in development and in socially and biologically vulnerable populations such as the indigenous, makes it difficult to guide public policies. Objectives: To evaluate the prevalence of chronic pelvic pain (dysmenorrhea, dyspareunia, non-cyclical pain) and identify which variables are independently associated with the presence of the condition in indigenous women from Otavalo-Ecuador. Design: A cross-sectional study was carried out including a sample of 2429 women of reproductive age between 14 and 49 years old, obtained from April 2022 to March 2023. A directed questionnaire was used, collected by bilingual interviewers (Kichwa and Spanish) belonging to the community itself; the number of patients was selected by random sampling proportional to the number of women estimated by sample calculation. Data are presented as case prevalence, odds ratio, and 95% confidence interval, with p < 0.05. Results: The prevalence of primary dysmenorrhea, non-cyclic pelvic pain, and dyspareunia was, respectively, 26.6%, 8.9%, and 3.9%.all forms of chronic pain were independently associated with each other. Additionally, dysmenorrhoea was independently associated with hypertension, intestinal symptoms, miscegenation, long cycles, previous pregnancy, use of contraceptives and pear body shape. Pain in other sites, late menarche, exercise, and pear body shape were associated with non-cyclic pelvic pain. And, urinary symptoms, previous pregnancy loss, miscegenation, and pear body shape were associated with dyspareunia. Conclusion: The prevalence of primary dysmenorrhea and non-cyclical chronic pelvic pain was notably high, in contrast with the frequency of reported dyspareunia. Briefly, our results suggest an association between dysmenorrhoea and conditions related to inflammatory and/or systemic metabolic disorders, including a potential causal relationship with other manifestations of pelvic pain, and between non-cyclical pelvic pain and signs/symptoms suggesting central sensitization. The report of dyspareunia may be influenced by local cultural values and beliefs. [ABSTRACT FROM AUTHOR]

This study aimed to identify the prevalence of menstrual disorders and unusual symptoms among teenagers. A questionnaire survey was conducted amongst girls aged 15-19 years attending government secondary schools in Taif. Respondents were asked basic demographic information and questions about their menstrual cycles. They were also asked whether their cycles interfered with their activities of daily living. An independent sample t-test and chi-squared test were used to assess the difference between students' frequency of school absenteeism and demographic and puberty characteristics. Of the 450 students who were invited to fill in the questionnaire, 400 (88.9%) completed the survey. Approximately 59.5% of the girls had missed school due to menstruation-related symptoms, and about 79.9% reported general body pain as the primary symptom associated with school absenteeism. Teenagers whose periods were irregular were 2.72 times more likely to miss school than those who had regular periods (p = 0.002). Most respondents (83.5%) reported that menstrual symptoms impacted their general activities of daily living. Overall, menstrual disorders are common among secondary school girls in Taif. Menstrual disorders such as menorrhagia, dysmenorrhea, and metrorrhagia affected the academic and social lives of some students. [ABSTRACT FROM AUTHOR]

Background: Uterine adenomyosis is a chronic condition that is dependent on estrogen and affects approximately 20% of gynaecology patients. Dysmenorrhea, menorrhagia, and an enlarged uterus are commonly observed adenomyosis clinical symptoms. Objective: This study aimed to assess levonorgestrel-releasing intrauterine system (LNG-IUS) and gonadotropin-releasing hormone agonist (GnRH-a) effectiveness for adenomyosis symptoms improvement. Methods: This case-control study was carried out on 60 women with adenomyosis who had regular follow-up examinations. The patients were categorized into 2 equal groups: Case group (group 1 receiving GnRH-a as well as LNG-IUS) and control group (group 2 receiving GnRH-a only). The indices observed included: Serum CA125 level during, before and after the treatment, hemoglobin value before and 3 months after treatment, verbal rating scale (VRS), visual analogue scale (VAS), and uterine volume. Results: After treatment, the Hb level was significantly elevated in the case group compared to the control group (P=0.035), whereas CA125 was significantly lower in the case group compared to the control group (P=0.009). Regarding the clinical assessment, after treatment, the dysmenorrhea VRS score, and the dysmenorrhea VAS score were significantly reduced in the case group compared to the control group (P<0.05). Conclusions: Both LNG-IUS and GnRH-a combination treatment is efficient and safe in adenomyosis and caused a significant reduction in serum CA125 and dysmenorrhea. [ABSTRACT FROM AUTHOR]

Purpose: The current study aimed to examine the population of girls in two secure children's homes (SCHs) in the North East of England to consider the impact of menstruation on girls' physical, mental and emotional wellbeing within secure settings. Gender-responsive approaches and understanding gender differences are central to trauma-informed provision within the Children and Young People Secure Estate (CYPSE). Whilst trauma-informed approaches are central, it could be argued that basic gender differences, such as the menstrual cycle, are currently being overlooked within research and practice. Design/methodology/approach: A case file audit examined documentation of 24 girls who were admitted across both sites between January 2022 and January 2023. Findings: Of the sample (n = 24), 50% had information recorded regarding their menstrual cycle during admission assessments. Six girls (25%) disclosed experiencing irregular menstruation. Painful cramping was noted by two girls (8%). One girl (4%) disclosed heavy bleeding, and menorrhagia (abnormal heavy bleeding) was reported for one further girl (4%). One girl (4%) disclosed early onset menarche. Case formulations tended to focus less on girls' menstrual cycles or the potential impact of this on wellbeing. However, 100% of case formulations considered the potential impact of trauma and/or disrupted attachment on girls' presentations. Originality/value: The results indicate the impact of menstrual cycles on girls' physical, mental and emotional wellbeing may benefit from much further consideration. Implications are presented alongside directions for future research. [ABSTRACT FROM AUTHOR]

Background: Primary dysmenorrhea leads to significant gynecological consultations, school absenteeism, disrupted daily activities, and adversely affects overall quality of life (QOL). Purpose: This study compared the effects of aquatic exercise versus aerobic exercise on primary dysmenorrhea and QOL in adolescent females. Subjects and Methods: Sixty adolescent females suffering from primary dysmenorrhea with moderate to severe intensity were distributed randomly and equally into two groups was registered at ClinicalTrials.gov (NCT06129708) the Registration Date, November 13, 2023; group A was treated by aquatic exercise for 12 weeks, while group B was treated by aerobic exercise for 12 weeks. Assessment of both groups before and after treatment involved evaluating dysmenorrhea severity using the WaLIDD Score, measuring pain intensity with the numeric pain rating scale (NPRS), determining pressure pain threshold (PPT) with an algometry, and evaluating the QOL using EuroQol—5 Dimension—3 Level (EQ‐5D‐3L) and EuroQol‐visual analog scale (EQ‐VAS). Results: Both groups, A and B, experienced significant reductions in the WaLIDD score, NPRS, and all domains of EQ‐5D‐3L (p < 0.05), coupled with significant increases in PPT and EQ‐VAS (p < 0.05). Posttreatment comparisons between the groups showed insignificant differences in WaLIDD score, NPRS, and PPT (p > 0.05). However, there was a significant decrease in EQ‐5D‐3L and a significant increase in EQ‐VAS, favoring group A (p < 0.05). Conclusion: Both aquatic and aerobic exercises are effective methods in primary dysmenorrhea management and QOL improvement in adolescent females, with a better effect of aquatic exercise in enhancing QOL. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to investigate the association between post-cesarean sonographic uterine measures, dysmenorrhea, and bleeding disorders. Methods: This is a cross-sectional study where 500 women with a history of only one cesarean section (CS) were recruited. A transvaginal transducer, GE RIC6-12-D was used for the acquisition of volumetric datasets 18 ± 7 months postpartum. Uterine length (UL), cervical length (CL), niche length (L), niche depth (D), niche width (W), fibrosis length (FL), fibrosis depth (FD), residual myometrial thickness (RMT), endometrial thickness (EM), scar to internal os distance (SO), anterior myometrial thickness superior (sAMT) and inferior (iAMT) to the scar, and the posterior myometrial thickness opposite the scar (PMT), superior (sPMT), and inferior to it (iPMT) were measured. Logistic regression with odds ratios (OR), 95% confidence intervals (CI) and ROC curves were utilized. Results: The proportion of patients with incident post-cesarean bleeding disorders and dysmenorrhoea was 36% (CI 32%, 40%) and 17% (CI 14%, 21%) respectively. Univariate logistic regression showed that only UL was associated with bleeding disorders [OR 1.04 (CI 1.01,10.7) p value 0.005], whereas dysmenorrhea was associated with RMT [OR 0.82 (CI 0.71,0.95) p value 0.008], SO [OR 0.91 (CI 0.86,0.98) p value 0.01], and RMT ratio [OR 0.98 (CI 0.97,0.99) p value 0.03]. Multivariate logistic regression for dysmenorrhoea including SO and RMT remains statistically significant with p values <0.05 and area under the curve of 0.66. Conclusion: There is an association between sonographic appearance of CS scars and dysmenorrhoea. Nevertheless, the association is weak and other biological post-cesarean characteristics should be explored as potential causes. [ABSTRACT FROM AUTHOR]

Purpose: To summarize evidence on levonorgestrel releasing intrauterine system (LNG–IUS) in the treatment of adenomyosis (AM) and to identify potential research gaps. Methods: Search was conducted in MEDLINE, The Cochrane Library, EMBASE, CBM, CNKI, and Wanfang. We included studies investigating patients with AM treated with LNG–IUS combined with conservative therapy. Results: Thirty-nine studies compared LNG–IUS with other conservative therapeutic drugs. The most common comparison was GnRH-a + LNG–IUS vs. LNG–IUS alone, followed by LNG–IUS vs. mifepristone, expected treatment, and GnRH-a. GnRH-a + LNG–IUS was more beneficial in reducing the intensity of dysmenorrhea than LNG–IUS alone at the 6-month follow-up in patients with an enlarged uterus and moderate to severe dysmenorrhea. Large and well-designed studies are needed to confirm the efficacy of LNG–IUS and GnRH-a on reducing uterine volume at 6-month follow-up. Thirty-two studies investigated LNG–IUS as the postoperative management. The most common comparison was surgical excision + LNG–IUS vs. surgical excision. Results showed VAS scores were lower in the surgical excision + LNG–IUS group than in the surgical excision group at the 1-year follow-up. Evidence on endometrial thickness, quality of life, adverse events and beneficial effect at 3 and 5 years are needed. Conclusions: Combined GnRH-a and LNG–IUS treatment was more efficacious than LNG–IUS alone for patients with an enlarged uterus and moderate to severe dysmenorrhea. Moreover, LNG–IUS seemed to show potential long-term benefits in postoperative therapy, warranting further meta-analysis for confirmation. [ABSTRACT FROM AUTHOR]

Aim: In April 2020, the Japanese government introduced a Specific Medical Fee for managing secondary dysmenorrhea (SD). This initiative provided financial incentives to medical facilities that provide appropriate management of SD with hormonal therapies. We aimed to assess how this policy affects the management processes and outcomes of patients with SD. Methods: Using a large Japanese administrative claims database, we identified outpatient visits of patients diagnosed with SD from April 2018 to March 2022. We used an interrupted time‐series analysis and defined before April 2020 as the pre‐introduction period and after April 2020 as the post‐introduction period. Outcomes were the monthly proportions of outpatient visits due to SD and hormonal therapy among women in the database and the proportions of outpatient visits for hormonal therapy and continuous outpatient visits among patients with SD. Results: We identified 815 477 outpatient visits of patients diagnosed with SD during the pre‐introduction period and 920 183 outpatient visits during the post‐introduction period. There were significant upward slope changes after the introduction of financial incentives in the outpatient visits due to SD (+0.29% yearly; 95% confidence interval, +0.20% to +0.38%) and hormonal therapies (+0.038% yearly; 95% confidence interval, +0.030% to +0.045%) among the women in the database. Similarly, a significant level change was observed after the introduction of continuous outpatient visits among patients with SD (+2.68% monthly; 95% confidence interval, +0.87% to +4.49%). Conclusions: Government‐issued financial incentives were associated with an increase in the number of patients diagnosed with SD, hormonal therapies, and continuous outpatient visits. [ABSTRACT FROM AUTHOR]

We aimed to qualitatively explore factors influencing contraceptive use in women living with sickle cell disease (SCD). We conducted a semi-structured qualitative study using data from interviews with reproductive-aged women with SCD. The Theory of Planned Behavior, which describes an individual's attitudes, subjective norms, and perceived behavioral control as drivers of a health behavior, served as a framework for data collection and thematic analysis. We analyzed interviews from 20 participants. Attitudes toward contraception showed skepticism regarding hormonal contraception and concern about adverse effects of contraception related to SCD. The role of subjective norms in contraceptive choice depended on whether participants possessed trusted sources of information, such as health care providers, family, and friends, or whether they relied on themselves alone in their contraceptive decision-making. The influence of health care providers was complicated by inconsistent and sometimes conflicting counseling. Finally, with regard to participants' perceived control in their contraceptive choices, some were motivated to alleviate menstrual pain or prevent SCD-related pregnancy risks, but many reported feeling disempowered in contraceptive decision-making settings because of ways that healthcare providers exerted pressure or responded to participants' demographic characteristics. Women living with SCD are influenced by many factors similar to those documented for other populations when making decisions about contraception. However, SCD amplifies both the importance and risks of contraception and may also complicate individuals' autonomy and contraceptive access. Hematology and reproductive health providers should recognize the risk of coercion, maximize patients' reproductive agency, and coordinate reproductive health counseling for patients with SCD. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What are the sonographic and clinical findings in women diagnosed with external and internal adenomyosis by ultrasound? SUMMARY ANSWER Patients with external and internal adenomyosis phenotypes, diagnosed by ultrasound, present differences in sonographic features of the disease and demographic characteristics including age, parity, and association with deep endometriosis (DE) and leiomyomas. WHAT IS KNOWN ALREADY Two different phenotypes of adenomyosis have been described based on the anatomical location of adenomyotic lesions in the myometrium, suggesting that adenomyosis affecting the inner myometrium and that affecting the external myometrial layer may have distinct origins. STUDY DESIGN, SIZE, DURATION A cross-sectional study including 505 patients with a sonographic diagnosis of adenomyosis was performed between January 2021 and December 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS Women sonographically diagnosed with adenomyosis in a tertiary referral hospital that serves as a national reference center for endometriosis were included over a 2-year period. Patients were divided into two groups (internal and external adenomyosis) according to the myometrial layer affected by adenomyosis. We compared sonographic and clinical outcomes including a multivariate analysis between the two groups. MAIN RESULTS AND THE ROLE OF CHANCE According to ultrasound findings, 353 (69.9%) patients presented with internal adenomyosis, while 152 (30.1%) presented with external adenomyosis. Women with internal adenomyosis were significantly older and less frequently nulliparous compared to those with external adenomyosis. Sonographically, internal adenomyosis appeared diffusely, it had a greater number of adenomyosis features, it presented a globular morphology of the uterus more frequently, and it coexisted with leiomyomas more frequently, compared to external adenomyosis. Conversely, the presence of translesional vascularity and associated DE were more common among the external adenomyosis group. No significant differences were found between internal and external adenomyosis groups regarding pain, heavy menstrual bleeding, spotting, or infertility. In the multivariate analysis, nulliparity, the presence of leiomyomas, and the presence of DE were independently associated with adenomyosis phenotypes (the presence of DE and nulliparity increased the risk of external adenomyosis, whereas the presence of leiomyomas was a risk factor for internal adenomyosis). Considering the impact of hormonal treatment, we found that the number of ultrasound adenomyosis criteria was significantly greater in patients without hormonal treatment. Non-treated patients more commonly presented dysmenorrhea or bleeding-associated pain and heavy menstrual bleeding than women on hormonal treatment, although there were no significant differences according to adenomyosis phenotypes. LIMITATIONS, REASONS FOR CAUTION As the population was selected from the Endometriosis Unit of a tertiary center, there may be patient selection bias, given the high prevalence of individuals with associated endometriosis, previous endometriosis-related surgery, and/or receiving hormonal treatment. WIDER IMPLICATIONS OF THE FINDINGS Transvaginal ultrasound is the most available and cost-effective tool for the diagnosis of adenomyosis. Adenomyosis phenotypes based on ultrasound findings may be key in achieving an accurate diagnosis and in decision-making regarding the most adequate therapeutic strategy for the management of patients with adenomyosis. Determination of the sonographic features associated with symptoms could help in the evaluation of treatment response. STUDY FUNDING/COMPETING INTEREST(S) No funding was obtained for this study and there are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]