dysmenorrhea

This study aimed to assess the therapeutic effect of a dopamine agonist (bromocriptine) together with medroxyprogesterone for three months on ovarian endometrioma size.

In this double-blind randomized clinical trial, 60 women with clinical or ultrasonographic evidence of residual ovarian endometriomas were randomly assigned into two groups (n=30/each): the Bromo group received medroxyprogesterone (20 mg) and bromocriptine (1.25 mg) twice a day orally for three months and the placebo group received medroxyprogesterone (20 mg) and placebo twice a day orally for three months. Demographic characteristics, pre- and post-treatment endometrioma size, pelvic pain, dysmenorrhea, and dyspareunia were compared in both groups.

Mean endometrioma size was significantly different in both groups compared with the pre-treatment stage (P < 0.0001). Endometriosis symptoms of dysmenorrhea, dyspareunia, and pelvic pain improved after the treatment in Bromo group compared with placebo group (P < 0.01).

We found that medroxyprogesterone with placebo is effective in reducing the ovarian endometrioma size and also improves dysmenorrhea, dyspareunia, and pelvic pain, but the combination of medroxyprogesterone and bromocriptine has a stronger effect than using medroxyprogesterone alone.

Chamomile and flaxseed are traditionally used medicinal plants to treat painful menstruation. Therefore, this study aimed to investigate the effects of chamomile and flaxseed on pelvic pain, dyspareunia, and dysmenorrhea in endometriosis patients.

A controlled randomized clinical trial was conducted on 102 endometriosis patients referred to Reyhane Infertility Center of Qom University of Medical Sciences, Iran, from July 2021 to March 2022. Patients were divided into three groups: chamomile, flaxseed, and placebo, using the block randomization method. Patients used 1000 mg capsules (three times a day) for 8 weeks. A Visual Analog Scale (VAS) was used to measure the severity of pain. Pelvic pain, dyspareunia, and dysmenorrhea were assessed on three occasions Data were analyzed using the Chi‑square, repeated measures ANCOVA, and ANOVA. All statistical analysis was performed using SPSS version 20.

Before the intervention, there was no significant difference between the three groups regarding dysmenorrhea, pelvic pain, or dyspareunia (p > 0.05). The mean score of pelvic pain (on one and two‑month follow‑ups) in the chamomile and flaxseed groups (F = 383.07, p < 0.001) was lower than that in the placebo group. The mean score of dyspareunia (on one and two‑month follow‑ups) in the chamomile and flaxseed groups was significantly lower than that in the placebo group (F2 = 479.34, p < 0.001). The mean score of dysmenorrhea on one and two‑month follow‑ups (F2 = 385.67, p < 0.001) in the chamomile and flaxseed groups was lower than that in the placebo group.

Chamomile and flaxseed may reduce pelvic pain, dyspareunia, and dysmenorrhea associated with endometriosis.

Endometriosis is a common and complex gynecological condition. (Cymbopogon citratus (DC.) Stapf (lemongrass) has been mentioned in Iranian traditional medicine references for uterus disorders. This study aimed to assess the effects of a lemongrass oil vaginal cream on pain levels, mass size, and overall health profiles in endometriosis patients.

In this single-arm, before-and-after clinical trial, participants with endometrial cysts larger than 2 cm and experiencing dysmenorrhea were treated with lemongrass oil vaginal cream for two months. Their pain and health status were assessed using the Visual Analogue Scale (VAS) and the Endometriosis Health Profile Questionnaire (EHP-30) before and after the treatment. Transvaginal ultrasounds were also performed to measure the size of the cysts before and after the intervention.

The intervention led to a significant reduction in pain scores (p<0.001). Additionally, 8 out of 11 domains of the EHP-30 questionnaire showed significant improvement. The average size of endometriomas decreased from 39.9 mm to 31.3 mm (p<0.001).

This study indicated that lemongrass oil vaginal cream could alleviate pain in endometriosis patients, enhance their overall health and reduce the size of endometrioma. However, rigorous clinical trials with randomized designs and control groups are necessary to validate these results.

Primary dysmenorrhea is associated with problems in women’s life and hormonal disorders. This research aims to investigate the effect of resistance training and melatonin supplementation on luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prostaglandin F2α (PGF2a) in females with primary dysmenorrhea.

This is a randomized controlled clinical trial with a pre-test/post-test design. Sixty girls with primary dysmenorrhea recruited from a women’s sports club in Mashhad, Iran, were randomly divided into four groups: Training+melatonin, training+placebo, melatonin, and control group. For supplementation, 10 mg of melatonin was taken daily using two 5 mg capsules, and the placebo was 10 mg of carbohydrates using two 5 mg capsules. Resistance training consisted of 50-60 minutes of weight training daily, three days a week, for eight weeks. Collected data were analyzed using repeated measures analysis of variance, followed by a post hoc test.

The results showed a significant increase of FSH and LH levels in the training+melatonin group compared to other groups and in the training+placebo and melatonin groups compared to the control group. Moreover, there was a significant decrease in PGF2a in the melatonin group compared to other groups and in the training+placebo and training+melatonin groups compared to the control group.

The resistance training protocol used in this study is effective for women with primary dysmenorrhea. Melatonin, by affecting gonadotropin hormones as well as prostaglandin, overcomes the hormonal disorders caused by dysmenorrhea and can eliminate its symptoms.

Young women, especially those with disabilities suffering from primary dysmenorrhea (PD), should be a cause for concern, as it negatively affects both their physical and mental health, as well as their future productivity. This study aimed to evaluate the effect of implementing audio-educational measures on the severity of PD among blind female students.

This quasi-experimental study was conducted at 2 schools for blind females in Egypt in 2022. The sample consisted of 40 blind female students who were selected randomly. The WaLIDD (working ability, location, intensity, days of pain, dysmenorrhea) scale was used to assess the degree of dysmenorrhea, while the 12-Item Short Form Health Survey (SF-12) was used to evaluate their physical and mental well-being. The intervention program involved audio education sessions designed to improve their health, education, and skills, as well as reduce the severity of dysmenorrhea. These audio education sessions took place twice a week, with each session lasting 45 minutes for a duration of 3 months. Data analysis was performed using chi-square and paired sample t tests at a significance level of α = 0.05.

The average age of the participants was 15.5 ± 1.91 years. The findings showed that the implementation of the audio-educational intervention led to a significant reduction in the severity of dysmenorrhea symptoms, significant increase in general knowledge, and significant improvements in the physical and mental health of the participants (P < 0.001). Listening training was a positive and significant predictor for the health status of blind female students (ß = 0.614; P = 0.028), while the severity of dysmenorrhea was a significant negative predictor for their health status (ß = -0.046; P = 0.05).

The use of audio-educational measures is an effective strategy for increasing knowledge, practice, and health status while reducing the severity of dysmenorrhea among blind female students. Therefore, it is recommended that nurses educate blind teenage girls about menstruation and standard menstrual care to reduce dysmenorrhea and enhance their overall health. Additionally, dysmenorrhea and its management strategies should be included in school curricula for females.

Dysmenorrhea is one of the main factors affecting the quality of life.  This study aimed to determine the impact of rosemary and mefenamic acid capsules on the quality of life of students with primary dysmenorrhea.

This double-blind clinical trial study was performed on 82 students with primary dysmenorrhea from June to september 2018 at the Faculty of Medicine of the Islamic Azad University of Mashhad. Students with moderate dysmenorrhea, after controlling two menstrual cycles by the convenience sampling method and using PASS software, were randomly assigned to the rosemary and mefenamic acid groups using double blocks. They consumed rosemary and mefenamic acid capsules every 8 hours for the first 3 days of intervention cycles. The SF-36 questionnaire was used to assess quality of life before and after the intervention at the end of menstrual bleeding.  The data were analyzed using SPSS 24 and descriptive and interpretive statistical tests.

The mean score of physical health in the first cycle after the intervention increased by 300.07±62.43 and 306.00±66.11and in the second cycle after the intervention increased by 306.54±63.90and 308.63±64.14 (P=0.94). The mean score of mental health in the first cycle after the intervention increased by283.90±58.48 and 282.98±65.63 and in the second cycle after the intervention increased by 261.13 ±80.61and 258.94± 86.67 (P=0.90).

Consumption of rosemary and mefenamic acid capsules improves the quality of life by increasing the scores of physical and mental health.

 This study systematically reviewed the clinical trials to assesse Achillea millefolium's impact on primary dysmenorrhea and menstrual bleeding

In this systematic review, the databases of Science Direct, PubMed, ProQuest, Cochrane library, Scopus, Web of Science were searched using the keywords of "Dysmenorrhea", "Pain"," Menorrhagia" and "Achilles" until Aug 2022. The study population included women with moderate to severe dysmenorrhea or menorrhagia with a score of 100 on Pictorial menstrual bleeding Assessment Chart (PBLAC). Intervention included oral administration of Achillea millefoliums with other modern dosage forms. The Cochran's Risk of Bias tool was applied to evaluate the quality of articles.

Among 80 initial articles, six studies were systematically reviewed. Among six reviewed studies, three studies examined the impact of Achillea millefolium on primary dysmenorrhea, two studies evaluated the effect of Achillea millefolium on menorrhagia and one study assessed the impact of Achillea millefolium on both primary dysmenorrhea and menorrhagia. The results showed the effect of Achillea millefolium in pain relief of  dysmenorrhea and reduction of menstrual bleeding.

Achillea millefolium is an effective and safe herbal remedy for primary dysmenorrhea and reduction of menstrual bleeding.

Positive and negative emotions have recently revealed a link with primary dysmenorrhea in adults. Among them, roles of stress and self-esteem have been less studied specially in adolescents and the direction of causality has not been clearly established. Therefore, this study investigated whether stress and selfesteem independently affect primary dysmenorrhea after adjustment for the known risk factors in adolescents. Additionally, indirect effects of stress and self-esteem were determined using mediation analyses.

This survey was conducted in adolescent girls aged 15-18 yr in metropolitan regions in South Korea in 2021. The survey included general, menstrual, and lifestyle characteristics, menstrual pain and symptom, perceived stress, self-esteem, depression, and state-trait anxiety.

Stress, depression, and anxiety were associated positively with menstrual pain and symptom (all P<0.001) in adolescent girls (n=519). Self-esteem was also associated inversely with negative emotions and dysmenorrhea (all P<0.001). Additionally, stress independently affected frequency and severity of menstrual symptom (both P<0.05), but not pain intensity after adjustment for covariates. Stress also had indirect effect through depression and anxiety on menstrual pain and symptom. Effect of self-esteem vanished after adjustment for covariates, but indirectly reduced menstrual pain and symptom through mediations of stress, depression, and anxiety.

Mental health such as stress and self-esteem are important for managing menstrual pain and symptom in adolescents. It should be considered in managing dysmenorrhea.

Dysmenorrhea has a negative impact on women's daily activities and quality of life. The purpose of this study was to investigate the effect of topically applied chamomile oil along with dry cupping on dysmenorrhea. A total of 12 patients with dysmenorrhea were included in this consecutive case series study and treated for three consecutive cycle periods. One ml of chamomile oil was gently massaged on the skin of the suprapubic area for 10 minutes once every night. After the massage, dry cupping was done. During the study, patients were visited on the third day of menstruation for three consecutive cycles, and mean pain was evaluated and recorded based on the visual analog scale (VAS). The mean ± SD of pain intensity in three cycles before the study was 7.5 ± 0.43 and in three cycles after the interventions was 1.44 ± 0.33 (P = 0.002). Indeed, the pain score was decreased as 86.72 ± 1.12% due to the interventions. All the patients discontinued using the analgesic during the study. Topical application of chamomile oil and dry cupping significantly reduced the severity of pain during menstruation and it could be considered as a low-cost modality without side effects for dysmenorrhea. Further studies with larger sample size and longer follow-up are recommended.

Dysmenorrhoea is one of the leading causes of school absenteeism among adolescent girls. Many women have menstrual cramps before and during their menstrual periods. For some women, the discomfort is merely annoying. Methods used to relieve dysmenorrhea include; exercise, a healthy diet, and yoga.

This study aims to evaluate the effect of a gym ball exercise program on dysmenorrhea in nursing students from a selected college in Mangaluru, India.

This is a quasi-experimental study on 52 eligible nursing students (26 in the exercise group and 26 in the control group). A pre-test assessment was done in both groups to assess the level of dysmenorrhea by using the numerical pain rating scale. The gym ball exercise was performed in the exercise group for 3 weeks prior to their predicted menstrual date, three times a week, each for 45 minutes. The post-test assessment was done on the first day of their menstruation and followed up one month later to assess the sustainability of the effect of the exercise. To analyze the data, inferential statistics, including chi-square test, Fisher’s exact test, Wilcoxon signed rank test, and Mann-Whitney U test were used.

The participants had moderate to severe pain. They had regular menstrual cycles lasting for 28-30 days, with a menstrual duration of 3-6 days, and moderate bleeding. The level of dysmenorrhea in the exercise group was lower (2.69±1.15) than in the control group (4.77±1.75) in the post-test phase. The mean level of dysmenorrhoea in the follow-up phase was 3.08±1.74 and 4.35±1.79 in the exercise and control groups, respectively. A significant difference was found between pre-test and follow-up pain scores (P=0.001) and between post-test and follow-up pain scores (P=0.001). Mann-Whitney U test results showed a significant difference between the two groups in the post-test (P=0.001) and follow-up phases (P=0.001).

The four-week gym ball exercise program is effective in reducing the intensity of dysmenorrhea in nursing students.

Dysmenorrhea is a common gynecological issue among young females. However, no studies in Zambia have examined the prevalence and associated factors of primary dysmenorrhea among adolescent girls. This study aimed to determine the prevalence and associated factors of primary dysmenorrhea among adolescents in selected schools in the Lusaka District.

A cross-sectional study was conducted in eight randomly selected schools in Lusaka, including 400 post-menarche girls aged 10–19 years. Participants were selected via random sampling, and data were collected using a researcher-designed questionnaire informed by literature. The tool included closed-ended and Likert scale questions, piloted for reliability (Cronbach's alpha: 0.8–0.9). Analysis was performed using STATA version 14.2, with variables having p < 0.05 in multivariate logistic regression considered statistically significant.

All 400 participants responded (response rate: 100%). The prevalence of primary dysmenorrhea was 78% (312/400; 95% CI: 73.6%–82.0%). Major risk factors included a positive family history (p < 0.001) and symptoms like breast tenderness (p = 0.008), diarrhea (p < 0.001), headache (p = 0.002), and nausea (p = 0.015). Menstrual cycles lasting 31–35 days (p = 0.034) and moderate menstrual flow (p = 0.011) were also significant.

Primary dysmenorrhea is highly prevalent among adolescents in Lusaka. Determinants included family history, long cycles, moderate flow intensity, and menstrual discomfort.

The current study aims to investigate the relationship between dysmenorrhea and menstrual disorders with the type and severity of blood pressure disorders in pregnancy in Bandar Abbas hospitals in 2024.

This research is a cross-sectional study of the descriptive-analytic type. 404 pregnant women in the third trimester of pregnancy who were hospitalized in Bandar Abbas hospitals due to high blood pressure were included in this study. After receiving the consent form, the demographic-social and medical information form was recorded by a researcher from patients' files. The blood pressure of pregnant women was measured during hospitalization. The dysmenorrhea multidimensional scoring system questionnaire and checklist on other menstrual cycle disorders such as menorrhagia and menstrual irregularity were completed by the participants. After collecting the data, SPSS version 26 software was used to analyze the data.

According to the results of the present study, it has been shown that the average age of the patients was 30.43 ± 5.82. There is a significant positive correlation between primary dysmenorrhea and gestational hypertension, preeclampsia, eclampsia, and superimposed (p < 0.05). There is a significant positive correlation between secondary dysmenorrhea and gestational hypertension, preeclampsia, and superimposed (p < 0.05). There is a significant positive correlation between menstrual disorders and gestational hypertension, preeclampsia, eclampsia, and superimposed (p < 0.05). There is a significant positive correlation between hypermenorrhea and gestational hypertension and superimposed (p < 0.05).        

The results of the study showed that there is a significant relationship between menstrual disorders and hypertension in pregnancy.

Given that primary dysmenorrhea can affect individuals’ course of life and social activities, it is necessary to consider the role of related variables in its incidence and conduct more studies to take effective measures to reduce this pain.

This study aims to model the structural equations of the relationship between metacognitive beliefs and body image concerns with the mediating role of pain self-efficacy on the severity of primary dysmenorrhea.

This study adopted a cross-sectional, descriptive correlational research design. A structural equation modeling method was conducted on 724 students studying in the first semester of 2021 - 2022. Questionnaires assessed menstrual pain severity, body image concern, pain self-efficacy, and metacognitive beliefs. Data were analyzed using structural equation modeling, SPSS.25, and AMOS 24.

According to data analysis, all indices of fit were appropriate after modifications, and the model had a very good fit at the significance level (χ 2 /df = 3.619, CFI = 0.931, TLI = 0.910, NFI = 0.907, RMSEA = 0.060, 90%CI [0.053, 0.068], SRMR = 0.077). In examining direct pathways, metacognitive beliefs showed a direct effect on and a negative correlation with the severity of dysmenorrhea. The investigation of indirect pathways also confirmed the effect of metacognitive beliefs on the severity of primary dysmenorrhea with the mediating role of pain self-efficacy. The effect of the direct pathway of body image concern on the severity of primary dysmenorrhea was not significant and was removed from the model. On the other hand, as the examination of the indirect path showed, the effect of body image concerns on the severity of primary dysmenorrhea was mediated by pain self-efficacy.

According to the findings, the promotion of mental health was effective in controlling primary dysmenorrhea. Hence, more attention to psychological issues is required through effective practical protocols to provide an introduction to menstrual health and the grounds for performance improvement in girls.

 Primary dysmenorrhea is a prevalent condition characterized by menstrual pain in the absence of pelvic pathology, which can affect quality of life (QOL).

 This study aimed to assess the QOL in medical students with dysmenorrhea in Iran.

 This cross-sectional study included 298 female students between December 2021 and August 2022. The EQ-5D-3L questionnaire was used to assess the QOL of subjects. Also, age, weight, height, sleep hours per day, and exercise hours per week were evaluated. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 22. The chi-squared test and Fisher’s exact test were used for data analysis.

 The mean age of students was 20.32 ± 3.19 years, and the prevalence of dysmenorrhea was 83.6% (n = 249). There was a significant difference in daily activity (P < 0.05) and exercise hours per week (P < 0.05) between the two groups. Pain and discomfort were remarkably higher in group with dysmenorrhea (P < 0.01). In addition, personal care was significantly reduced among subjects with dysmenorrhea (P < 0.05). Sleep hours per day, body mass index (BMI), age, mobility, and anxiety were similar between the two groups.

 According to our results, dysmenorrhea was significantly related to impaired QOL, considering some aspects such as daily activity.

Primary dysmenorrhea is one of the most common complaints in women. This study compared the effect of ginger-lavender, ginger and mefenamic acid capsules on the severity of primary dysmenorrhea among female university students.

This randomized, triple-blind clinical trial was performed in 2020 on 90 female students with primary dysmenorrhea, who lived in dormitories of Shahid Beheshti University of Medical Sciences, Tehran, Iran and randomly assigned to three groups. During the first three days of menstruation, the students received ginger-lavender (250 mg ginger and 50 mg lavender extract), ginger (250 mg), and mefenamic acid (250 mg) in two consecutive cycles, which were prescribed four times daily for three days from the onset of menstruation. A menstrual status questionnaire, verbal multidimensional scoring system, and visual analog scale were used to measure pain duration and intensity before and two cycles after intervention. Data were analyzed using two-way (intragroup) and one-way (intergroup) repeated measures ANOVA.

 Ginger- lavender, ginger and mefenamic acid significantly reduced the severity and duration of primary dysmenorrhea (P 0.05). This decrease was greater in the ginger-lavender group than in the other two groups. Also, the mean score of pain in the ginger-lavender group was 1.04 and 1.53 units lower than the ginger and mefenamic acid groups, respectively. The mean pain score in the ginger group was 0.49 units lower than that the mefenamic acid group.

Ginger-lavender significantly reduced the duration and severity of menstrual pain and was more effective than only ginger and mefenamic acid.