Development of a functional and emotional measure of dysmenorrhea (FEMD) in Chinese university women.

Primary dysmenorrhea, or cramps, causes pain, limits activity, and increases emotional tension in young women, but its measurement has not received enough research attention. We have developed a functional and emotional measure of dysmenorrhea (FEMD, 14 items), and trialed it with a sample of 833 Chinese university women. Two factors (scales) were extracted by principal component analysis (PCA) and subsequently approved by a confirmatory factor analysis (CFA). The two scales were intercorrelated and were correlated with experienced pain severity and, to a lesser degree, with the depressive tendency. We have demonstrated that FEMD has stable components that might help measure dysmenorrhea-related dysfunctions.

Premenstrual syndrome and dysmenorrhea: urban-rural and multiethnic differences in perception, impacts, and treatment seeking.

BACKGROUND: Attitudes toward menarche and menstruation are largely influenced by sociological, cultural, and family environmental factors. Recognizing the influential effects that these factors might have on shaping adolescents' attitudes is crucial in designing a more effective means of transmitting health information. AIMS: This study aimed to gather an in-depth understanding of perceptions, impacts, and treatment seeking on menstruation-related issues from an ethnically mixed group of rural and urban girls. METHODOLOGY: In total, 27 focus group discussions (172 participants) were conducted between November 2008 and April 2009. Participants were adolescent girls aged 13-19 years, recruited from 7 public secondary schools in the Federal Territory of Kuala Lumpur and 4 public secondary schools from the rural districts of Kelantan, in Malaysia. RESULTS: Many participants revealed that they were not given or had not received detailed information about the mechanism or physiology of menstruation prior to its onset. Thus, many described the onset of menarche as shocking, an event for which they were unprepared, and which has had a tremendous impact on their emotions. More positive acceptance of menarche was reported in the urban than with the rural groups. Despite the high prevalence of premenstrual syndrome and dysmenorrhea, participants across urban-rural and ethnic groups perceived the problems as completely normal, hence they relied on self-care methods and did not want to seek professional treatment. More rural girls compared to urban girls were embarrassed to talk to their mothers or consult their physicians regarding menstruation-related problems. CONCLUSION: Menstruation-related education would have a positive impact in improving adolescent girls' knowledge and in nurturing a positive attitude toward menstruation-related matters at home, at school, and in the community.

Menstrual and oral contraceptive use patterns among deployed military women by race and ethnicity.

Menstrual cycle patterns and concerns and oral contraceptive use in the combat environment were examined in Caucasian, Asian, Hispanic, and African American women to guide the development of educational resources for women soldiers. An anonymous, questionnaire was completed by 455 U.S. Army women-Caucasian (CA: n = 141); Asian (AS: n = 67); Hispanic (HIS: n = 67); and African American (AA: n = 184) to compare menstrual patterns and concerns, dysmenorrhea, and oral contraceptive patterns. Total menstrual concerns were significantly lower among African Americans relative to Caucasians, Asians, or Hispanics; Asians and Hispanics reported the greatest concern. Overall, secondary amenorrhea was noted by 14.9% of women. Severe dysmenorrhea rates were significantly lower in African American (6.1%) compared to Caucasian (11.6%), Asian (20.9%) and Hispanic (19.7%) women. Asian women reported missing less work-only 9.3% with moderate to severe dysmenorrhea missed work compared to 25.1% of all other women. Only 9.2% of women with mild, compared to 25.8% with moderate to severe (OR = 3.44; p ≤ 0.0001) dysmenorrhea sought health care. Less than 50% of women took oral contraceptive, and less than half of those women took oral contraceptive continuously. African Americans seemed to experience menstruation as less bothersome than others, despite no difference in the proportion with menstrual irregularities, mean duration of menses, and/or mean time between cycles.

The prevalence of menstrual pain and associated risk factors among Iranian women.

AIM: To estimate the prevalence of dysmenorrhea in Iranian women and investigate associated risk factors. MATERIAL & METHODS: In a cross-sectional study in Tehran, Iran in 2007, 381 women (81% response rate, age 16-56 years) were selected through a stratified random sample of 22 different districts and completed a questionnaire about dysmenorrhea. Descriptive statistics, spearman rank correlation statistic, and ordinal logistic regression models were used. Confounding and effect-modification were explored for each association. RESULTS: The prevalence of no, mild, moderate, and severe menstrual pain was 10%, 41%, 28%, and 22%, respectively. Older age and high intake of fruits and vegetables were protective factors for menstrual pain while women with family history of dysmenorrhea, higher stress and depression tended to have more severe pain. Body mass index, parity, smoking, and physical activity were not significantly associated with dysmenorrhea after controlling for potential confounding factors and effect modifiers. CONCLUSION: Menstrual pain is a common complaint in Iranian women. The inverse association between fruit and vegetable intake and dysmenorrhea, and reduction of stress and depression need to be further explored and considered in terms of recommendation to reduce dysmenorrhea.

Are there any cross-ethnic differences in menstrual profiles? A pilot comparative study on Australian and Chinese women with primary dysmenorrhea.

AIM: To explore and compare the features of menstruation, perception and management of menstrual pain between two cohorts of Australian and Chinese women. METHODS: A pilot comparison study was carried out using modified valid menstrual questionnaires. The study included 120 Australian women and 122 Chinese women aged from 18 to 45 years with primary dysmenorrhea. RESULTS: Australian women rated menstrual pain as more intense than Chinese women (8.5 ± 1.5 on a 10-point pain scale vs 7.3 ± 1.8, P < 0.001), duration of pain was 36% longer (3.0 ± 2.5 vs 2.2 ± 0.9 days, P = 0.002) and menarche commenced earlier (12.7 ± 1.5 vs 14.2 ± 1.4 years, P < 0.001). The mean reported menstrual interval was also shorter (29.2 ± 5.3 vs 30.52 ± 3.7, P = 0.020) with heavier overall menstrual flow (P = 0.002) and fewer clots in menstrual blood (83% vs 95.8%, P = 0.001). There was no significant difference in duration of menstruation (5.2 ± 1.3 vs 5.4 ± 1.1 days; P = 0.180). Correlations were found between earlier menarche and increased intensity of menstrual pain (r = -0.16, P = 0.011), and between heavier menstrual flow and increased intensity of menstrual pain (r = 0.19, P = 0.003). CONCLUSION: Evidence from this pilot study suggested that the clinical menstrual presentations in the cohorts of Australian and Chinese women were different. Although the findings are preliminary, evaluating ethnic differences in menstruation and experimental menstrual pain models may not only provide some information about underlying mechanisms but may also predict or explain group differences.

Dysmenorrhea in a multiethnic population of adolescent Asian girls.

OBJECTIVE: To determine the prevalence of dysmenorrhea, its impact, and the treatment-seeking behavior of adolescent Asian girls. METHOD: A cross-sectional study with 1092 girls from 15 public secondary schools and 3 ethnic groups in the Federal Territory of Kuala Lumpur, Malaysia. RESULTS: Overall, 74.5% of the girls who had reached menarche had dysmenorrhea; 51.7% of these girls reported that it affected their concentration in class; 50.2% that it restricted their social activities; 21.5% that it caused them to miss school; and 12.0% that it caused poor school performance. Ethnicity and form at school were significantly associated with the poor concentration, absenteeism, and restriction of social and recreational activities attributed to dysmenorrhea. Only 12.0% had consulted a physician, and 53.3% did nothing about their conditions. There were ethnic differences in the prevalence, impact, and management of dysmenorrhea. CONCLUSION: There is a need for culture-specific education regarding menstruation-related conditions in the school curriculum.

Skipping breakfast adversely affects menstrual disorders in young college students.

In the present study we conducted a questionnaire survey to examine the relationship between dietary habits and menstrual disorders in young women. Subjects were recruited from 315 college students and were classified as: Group I, eating breakfast; Group II, skipping breakfast; Group III, not eating fast foods; Group IV, eating fast foods; Group V, not eating processed foods; and Group VI, eating processed foods. The intensity of dysmenorrhea was scored using three grades. All participants were further divided into groups based on having regular or irregular menstruation, having premenstrual symptoms or not, and self-perception of good or poor general health. General health was poor in Groups II and VI, and dysmenorrhea scores were high in Groups II, IV and VI. The incidence of irregular menses was also high in Group II. However, there was no apparent relation between premenstrual symptoms and dietary habits. These findings suggest that skipping breakfast adversely affects menstrual disorders in young college students.

Primary dysmenorrhoea: a comparative study on Australian and Chinese women.

OBJECTIVE: To explore the extent to which traditional Chinese medicine (TCM) diagnostic categories for primary dysmenorrhoea are useful in describing the clinical presentation of this condition in Australian women in comparison with Chinese women, and therefore the potential usefulness of these categories in guiding TCM treatment of Australian women. DESIGN AND SETTING: A comparative study of 120 Australian and 122 Chinese women aged from 18 to 45 years with primary dysmenorrhoea. MAIN OUTCOME MEASURES: Modified valid TCM diagnostic protocol. RESULTS: Difference in menstruation and menstrual pain profiles between the two groups of women found in the same study did not translate into differences in the underlying syndrome according to TCM diagnostic categories. The study found that Australian and Chinese women were represented in broadly similar proportions across the defined five diagnostic categories. CONCLUSION: Some evidence suggests that although the clinical presentation of symptoms in Australian and Chinese women is different, the distribution of women across the diagnostic categories in TCM is similar. Therefore, the TCM protocol used to diagnose primary dysmenorrhoea and guide treatment is unlikely to require adaptation for use with Australian women.