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1.
Eur Rev Med Pharmacol Sci ; 27(1): 172-178, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36647866

RESUMO

OBJECTIVE: Dysmenorrhea is a global public health issue that affects around three-quarters of young women and is categorized into primary and secondary. Primary dysmenorrhea is characterized by painful menstrual cramps and it is not linked to any underlying uterine pathology. The global prevalence of primary dysmenorrhea has been estimated to range from 45-95% of women of reproductive age. Dysmenorrhea negatively impacts the quality of life of young women and commonly contributes to absences from work and school. This study was conducted to examine the self-management practices for primary dysmenorrhea among female undergraduate students in the Asir region. SUBJECTS AND METHODS: The study has followed a cross-sectional design using a web-based self-administered questionnaire. A total of 391 students agreed to participate in the study and completed the questionnaire. RESULTS: Around 82% (n=322) of the participants reported experiencing menstrual pain in the last three menstruations (dysmenorrhea). Just below two-thirds (62.1%) were current users of analgesics for managing menstrual pain. Paracetamol (70.4%) was the most commonly used analgesic, followed by Ibuprofen (45.7%). However, about 67% of the respondents were current users of complementary and alternative therapies (CATs) for managing dysmenorrhea. The participants indicated that their reasons for using CATs included reducing the need for analgesics (82%), safety (53.3%), efficacy (46%), availability (35.6%), recommendation from others (19.9%) and cost (7.3%). Just above half of the study participants indicated that CATs are less effective than analgesics. Around 74% of the respondents agreed or strongly agreed that CATs are safer than analgesics in relieving menstrual pain. CONCLUSIONS: Community pharmacists are one of the most accessible healthcare practitioners that offer a wide range of health services and consultations. Collaboration between educational institutions and community pharmacies could play a role in promoting self-care practices among young women.


Assuntos
Dismenorreia , Qualidade de Vida , Humanos , Feminino , Dismenorreia/epidemiologia , Dismenorreia/terapia , Estudos Transversais , Autocuidado , Arábia Saudita/epidemiologia , Analgésicos/uso terapêutico
2.
Expert Rev Pharmacoecon Outcomes Res ; 23(1): 111-121, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36625547

RESUMO

BACKGROUND: Physicians' preferences for attributes of medical treatments for endometriosis-associated pain have not previously been quantified. METHODS: US obstetrician-gynecologists completed an online discrete-choice experiment survey. In a series of questions, physicians chose a medical treatment for a hypothetical patient with endometriosis experiencing severe, persistent dysmenorrhea, nonmenstrual pelvic pain, and/or dyspareunia. Each question presented two hypothetical medical treatments for endometriosis-associated pain, defined by seven attributes with varying levels. Preferences weights and conditional relative importance (CRI) were calculated using a random-parameters logit model. RESULTS: Respondents (N = 250) had an average age of 53 years; 36% were female. The most important attribute, conditional on the attributes and levels evaluated, was risk of moderate-to-severe hot flashes (CRI, 3.34). In descending order of importance, the CRIs of the other attributes were 2.13 for improvement in nonmenstrual pelvic pain, 2.04 for improvement in dyspareunia, 1.88 for improvement in dysmenorrhea, 1.16 for risk of pregnancy-related complications if pregnancy occurs during treatment, 0.62 for increased risk of bone fracture later in life, and 0.48 for mode of administration. CONCLUSIONS: In addition to valuing pain reduction, respondents prioritized avoiding moderate-to-severe hot flashes, followed by less common and less immediate risks of pregnancy-related complications and bone fracture.


Assuntos
Dispareunia , Endometriose , Fraturas Ósseas , Médicos , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Endometriose/complicações , Endometriose/tratamento farmacológico , Dismenorreia/tratamento farmacológico , Dismenorreia/etiologia , Dispareunia/tratamento farmacológico , Dispareunia/etiologia , Fogachos , Dor Pélvica/tratamento farmacológico , Dor Pélvica/etiologia
3.
BMC Womens Health ; 23(1): 37, 2023 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-36703173

RESUMO

BACKGROUND: Extrapelvic endometriosis occurring at skeletal muscle and joint sites is not rare and is prone to delayed diagnosis and inappropriate treatment. Herein, endometriosis of the skeletal muscular system (ESMS) is systematically reviewed to facilitate early diagnosis and treatment. METHODS: Literature on ESMS published before March 2022 was retrieved from the Ovid Medline and Web of Science databases, and the major clinical data were extracted for descriptive analysis. RESULTS: A total of 62 studies (78 ESMS cases) met these requirements. The ESMS included the abdominal muscles (50.7%), pelvic floor muscles (11.6%), lower limb muscles (11.6%), hip muscles (8.7%), lumbar muscles (7.2%), joints (5.8%), upper limb muscles (2.9%), and shoulder-neck muscles (1.4%). The age was 34.0 ± 7.2 years (range 17-49 years). Approximately 63.8% of patients had at least one previous pelvic surgery, and 76.8% of local symptoms were related to the menstrual cycle. The course of disease was 29.6 ± 25.4 months (range 0.5-96 months). Only 30.3% of the patients sought initial medical advice from gynecologists, while 69.7% sought initial medical advice from a nongynecological physician. Twenty-seven patients underwent fine-needle aspiration (FNA) under ultrasound or CT monitoring, and only 44.4% (12/27) were confirmed to have endometriosis by FNA tissue pathology. Approximately 47.4% (37/78) of the patients had a normal pelvic cavity appearance. Surgical resection was performed in 92.3% (72/78) of the patients, of whom 88.9% (64/72) underwent complete resection of the lesion (negative surgical margin) and 20.8% (15/72) received postoperative hormone therapy. At 16.7 months of follow-up, 83.3%, 13.8%, 2.9%, and four patients had complete response, partial response, recurrence, and permanent function impairment, respectively. CONCLUSION: Endometriosis can occur at almost any site in the musculoskeletal system. For women of reproductive age with catamenial pain or a mass in the musculoskeletal system, endometriosis should be suspected. Fine-needle aspiration can easily lead to missed diagnoses. Surgical resection for negative margins is the main treatment, and permanent impairment of function may occur in a few patients due to delayed diagnosis. Vascular lymphatic metastasis is the most likely mechanism of pathogenesis.


Assuntos
Endometriose , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Endometriose/diagnóstico , Endometriose/cirurgia , Endometriose/patologia , Dismenorreia , Ciclo Menstrual , Músculo Esquelético , Ultrassonografia
4.
Influenza Other Respir Viruses ; 17(1): e13088, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36578138

RESUMO

BACKGROUND: There have been varying reports on the potential occurrence and severity of changes to menstruation including the median cycle length, days of bleeding, bleeding heaviness, and menstrual pain, following receipt of COVID-19 vaccinations. We aimed to assess potential postvaccination menstrual changes in women residing in the Middle East. METHODS: We implemented a cross-sectional online survey-based study. Data about the participants' demographic characteristics, menstruation experience, and vaccination status were collected and analyzed among six Arab countries. RESULTS: Among 4942 menstruating females included in this study, females who had received one or more doses of COVID-19 vaccination reported a higher frequency of back pain, nausea, tiredness, pelvic pain with periods, unprescribed analgesics use, and passage of loose stools. They also reported higher scores describing average and worst menstrual pain. Fully vaccinated females reported heavier flow and more days of bleeding. CONCLUSION: Our findings indicate that COVID-19 vaccine may have an effect on menstruation in terms of menstrual pain and bleeding heaviness. The evidence needs to be further investigated in longitudinal studies.


Assuntos
COVID-19 , Menstruação , Feminino , Humanos , Estudos Transversais , Vacinas contra COVID-19 , Dismenorreia , Árabes , COVID-19/epidemiologia , COVID-19/prevenção & controle
5.
Women Health ; 63(2): 73-82, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36581403

RESUMO

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


Assuntos
Dispareunia , Endometriose , Humanos , Feminino , Adulto , Citocinas , Interleucina-10 , Interleucina-2 , Interleucina-4 , Dismenorreia , Células Th1 , Células Th2
6.
Int J Hyperthermia ; 40(1): 2161641, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36586419

RESUMO

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


Assuntos
Adenomiose , Ablação por Ultrassom Focalizado de Alta Intensidade , Feminino , Criança , Humanos , Levanogestrel/uso terapêutico , Adenomiose/tratamento farmacológico , Adenomiose/cirurgia , Mifepristona/farmacologia , Mifepristona/uso terapêutico , Dismenorreia/induzido quimicamente , Dismenorreia/tratamento farmacológico
7.
Zhonghua Fu Chan Ke Za Zhi ; 57(11): 856-863, 2022 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-36456483

RESUMO

Objective: To investigate the efficacy and safety of dienogest (DNG) alone and gonadotropin-releasing hormone agonist (GnRH-a) combined with DNG sequential treatment to adenomyosis. Methods: The clinical data of 110 patients with adenomyosis attending the First Affiliated Hospital of Nanjing Medical University from December 2019 to March 2022 were retrospectively analyzed, including 40 patients treated with DNG (2 mg/day) alone (DNG group) and 70 patients treated with sequential DNG (2 mg/day) after 3-6 injections of GnRH-a (GnRH-a+DNG group). The clinical data before and after treatment were compared between the two groups. Results: (1) The dysmenorrhea visual analogue scale (VAS) scores, cancer antigen 125 (CA125) and cancer antigen 19-9 (CA19-9) levels at different time periods after treatment were significantly lower than before treatment in both groups (median before treatment: DNG group 70.0 mm, 68.55 kU/L, 22.45 kU/L respectively, GnRH-a+DNG group 80.0 mm, 151.50 kU/L, 20.44 kU/L respectively; all P<0.001). (2) The hemoglobin (Hb) levels of patients in both groups at different time periods after treatment were significantly higher than those before treatment (median: DNG group 102.00 g/L, GnRH-a+DNG group 94.00 g/L; all P<0.001). (3) Treatment with DNG alone did not have a significant effect on uterine volume in patients of DNG group (P>0.05), and uterine volume decreased significantly in the 15th-24th months of GnRH-a+DNG group compared with that before treatment (median: 167.76 vs 227.77 cm3; P<0.05). (4) There were no significant differences in hepatic and renal function and coagulation indexes between the two groups before and after treatment (all P>0.05), and no significant abnormal lesions were observed in breast tissue during the follow-up period. (5) The incidence of amenorrhea of GnRH-a+DNG group was higher than that of DNG group, and the incidences of irregular spotting bleeding and breakthrough hemorrhage were lower than those in DNG group. Conclusions: Whether DNG is used alone or in combination with GnRH-a in sequence, it could significantly relieve dysmenorrhea symptoms, improve the level of Hb, reduce the levels of CA125 and CA19-9 in patients with adenomyosis, with no adverse effects on coagulation and hepatic or renal function. GnRH-a sequential DNG therapy is superior to DNG alone in improving uterine bleeding patterns and controlling the growth of uterine volume in patients with adenomyosis.


Assuntos
Adenomiose , Feminino , Humanos , Adenomiose/tratamento farmacológico , Dismenorreia , Estudos Retrospectivos , Antígeno Ca-125 , Hormônio Liberador de Gonadotropina
8.
Reprod Biol Endocrinol ; 20(1): 176, 2022 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-36578019

RESUMO

BACKGROUND: There is a growing body of human, animal and in vitro studies on vitamin D (vit D) substitution in endometriosis. The aim of this systematic review is to critically appraise and qualitatively synthesize the results of the available studies that examine the supplementation of vit D for endometriosis treatment. METHODS: A systematic search of the literature was conducted in four electronic databases (Medline, Cochrane, Scopus, Embase) and grey literature for original research articles on humans, animals and in vitro models published in any language. RESULTS: Four human studies, four animal studies and four in vitro studies were included. Quantitative synthesis of human studies showed no significant effect of vit D intake for dysmenorrhea (2 studies, 44 vit D vs 44 placebo, mean -0.71, 95% CI -1.94, 0.51) and non-cyclic pelvic pain (2 studies, 42 vit D vs 38 placebo, mean 0.34, 95% CI -0.02, 0.71). Regarding reproductive outcomes in women with endometriosis after in vitro fertilization, the only available study showed no differences between women taking vit D and women taking placebo. Three of the four included animal studies showed regression of endometriotic implants when treated with vit D. The in vitro studies demonstrated that vit D decreases invasion and proliferation of endometriotic lesions without affecting apoptosis. CONCLUSIONS: Although in vitro and animal studies suggest regression of the endometriotic implants and decrease of invasion and proliferation after vit D supplementation, this was not reflected in the results of the meta-analysis, which showed no benefit of vit D supplementation in patients with endometriosis and dysmenorrhea or non-cyclic pelvic pain as well as on the outcome of IVF treatment. However, given the heterogeneity and the diversity of the available studies, more research is required to shed light on the role of vit D supplementation in women with endometriosis.


Assuntos
Endometriose , Animais , Humanos , Feminino , Endometriose/tratamento farmacológico , Dismenorreia/tratamento farmacológico , Vitamina D/uso terapêutico , Vitaminas , Dor Pélvica/tratamento farmacológico , Suplementos Nutricionais
9.
Clin Nutr ESPEN ; 52: 50-59, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36513486

RESUMO

BACKGROUND & AIMS: Primary dysmenorrhea (PD) refers to the presence of painful menstrual cramps due to increased synthesis of prostaglandins. Vitamin E inhibits the release of arachidonic acid and its conversion to prostaglandins through its antioxidant properties. This study sought to examine the effects of oral vitamin E supplementation on PD intensity (primary outcome) and its side effects (secondary outcomes). METHODS: In this systematic review and meta-analysis, databases in English and Persian, including PubMed, Cochrane Library, Google Scholar, Scopus, Web of Science, SID, and Magiran, were systematically searched until August 30, 2021. The study included all randomized, controlled clinical trials comparing oral vitamin E to placebo in healthy women with PD and measuring PD severity as a primary or secondary outcome. The quality of the included articles was assessed using the Cochrane Handbook, and the meta-analysis was performed using RevMan software. Given the continuous nature of the data and the utilization of different tools in the extracted articles, the meta-analysis results were reported using standardized mean difference (SDM) and 95% confidence interval (95% CI). A subgroup analysis was performed in low-dose (100 units), moderate-dose (200 units), and high-dose (400 units) categories. The quality of evidence was examined according to the GRADE approach. RESULTS: Eight articles with a sample size of 1002 people were entered into this systematic review. The results of meta-analysis revealed that vitamin E consumption significantly reduced PD mean intensity in the first month (n = 7 records; SDM = -1.16; 95%CI: -2.16 to -0.17; I2 = 31.9%; P = 0.02) and the second month (n = 8 records; SDM = -1.83; 95%CI: -2.90 to -0.77; I2 = 76.3.9%; P < 0.0001) compared with placebo. Serious side effects were not reported in vitamin E recipients. CONCLUSION: Vitamin E could be an adjunctive treatment for women with PD. However, higher-quality clinical trials with larger sample sizes are recommended for a more definite conclusion. PROSPERO ID: CRD42021276609.


Assuntos
Dismenorreia , Vitamina E , Feminino , Humanos , Dismenorreia/tratamento farmacológico , Vitamina E/uso terapêutico , Prostaglandinas , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
J Sports Sci Med ; 21(4): 595-607, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36523895

RESUMO

Dysmenorrhea with high prevalence has been categorized as primary dysmenorrhea (PD) and secondary dysmenorrhea due to differences in pathogenesis. A significant number of reproductive females suffering from monthly menstruation have to deal with negative impacts on their quality of life, work/study productivity, activities, and social relationships. In addition to medical treatment, exercise has been recognized as a complementary and alternative strategy for disease prevention, alleviation, and rehabilitation. This study aimed to investigate the potential effects of exercise on the severity of primary dysmenorrhea, physiological modulation, and physical fitness. Participants consisted of university students who were enrolled in the study and divided into a non-PD (Control) and a PD group based on recruiting criteria, the latter being randomly assigned to either an untreated dysmenorrhea group or a dysmenorrhea group that underwent 10 weeks of high intensity interval training (HIIT) exercise (Dysmen and DysmenHIIT, respectively). The DysmenHIIT group used spinning bikes and the training intensity was validated by heart rate monitors and BORG rating of perceived exertion. Forms containing participant information (premenstrual symptoms, menstrual distress, and a Short Form McGill Pain Questionnaire) as well as physical fitness, biochemical variables, hormone and prostaglandin (PGE2 and PGF2α) levels were assessed before and after the exercise intervention. After intervention, premenstrual symptoms (anger, anxiety, depression, activity level, fatigue, etc.), menstrual distress symptoms (cramps, aches, swelling, etc.), and pain severity were shown to be significantly mitigated, possibly through hormone (estradiol, prolactin, progesterone, and cortisol) modulation. Furthermore, high-sensitivity C-reactive protein (HsCRP), PGE2 and PGF2α levels were also down-regulated, resulting in the amelioration of uterine contraction and inflammation. Participants' physical fitness, including cardiovascular endurance and explosive force, was significantly improved after HIIT. The 10-week HIIT spinning bike exercise used in this study could be employed as a potential and complementary treatment for PD symptoms alleviation and considered as part of an educational health plan for promoting women's health. However, the effects of HIIT utilizing different exercise methods and accounting for different age populations and secondary PD warrant further investigation.


Assuntos
Ciclismo , Dismenorreia , Humanos , Feminino , Dismenorreia/terapia , Qualidade de Vida , Dinoprosta , Dinoprostona , Aptidão Física , Hormônios , Inflamação
11.
Int J Mol Sci ; 23(24)2022 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-36555842

RESUMO

Dysmenorrhoea effects up to 90% of women of reproductive age, with medical management options including over-the-counter analgesia or hormonal contraception. There has been a recent surge in medicinal cannabis research and its analgesic properties. This paper aims to critically investigate the current research of medicinal cannabis for pain relief and to discuss its potential application to treat dysmenorrhoea. Relevant keywords, including medicinal cannabis, pain, cannabinoids, tetrahydrocannabinol, dysmenorrhoea, and clinical trial, have been searched in the PubMed, EMBASE, MEDLINE, Google Scholar, Cochrane Library (Wiley) databases and a clinical trial website (clinicaltrials.gov). To identify the relevant studies for this paper, 84 papers were reviewed and 20 were discarded as irrelevant. This review critically evaluated cannabis-based medicines and their mechanism and properties in relation to pain relief. It also tabulated all clinical trials carried out investigating medicinal cannabis for pain relief and highlighted the side effects. In addition, the safety and toxicology of medicinal cannabis and barriers to use are highlighted. Two-thirds of the clinical trials summarised confirmed positive analgesic outcomes, with major side effects reported as nausea, drowsiness, and dry mouth. In conclusion, medicinal cannabis has promising applications in the management of dysmenorrhoea. The global medical cannabis market size was valued at USD 11.0 billion in 2021 and is expected to expand at a compound annual growth rate (CAGR) of 21.06% from 2022 to 2030. This will encourage academic as well as the pharmaceutical and medical device industries to study the application of medical cannabis in unmet clinical disorders.


Assuntos
Canabinoides , Cannabis , Maconha Medicinal , Feminino , Humanos , Dismenorreia/tratamento farmacológico , Maconha Medicinal/efeitos adversos , Canabinoides/uso terapêutico , Dronabinol/uso terapêutico , Analgésicos/uso terapêutico
12.
Cell Mol Biol (Noisy-le-grand) ; 68(7): 9-13, 2022 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-36495526

RESUMO

This experiment was carried out to analyze the placement and fixation of Mirena in the treatment of adenomyosis (AM) and its influence on the level of serum inflammatory factors in patients. For this purpose, the subjects of this study were 100 AM patients hospitalized in our hospital from June 2019 to June 2021. They were divided into two groups according to the lottery method (n=50 for each group). The control group was treated with intramuscular triptorelin after the operation, and the observation group was treated with Mirena during the operation. Sex hormone indexes, VAS score, uterine volume, serum inflammatory indexes, the total incidence of adverse reactions, WHOQOL-BREF score and recurrence rate were compared between the two groups. Results showed that in the observation group after treatment E2VAS score and uterine volume were lower, serum IL-8 and TNF-A were lower, the whoqOL-BREf score was higher, and the recurrence rate (0) was lower than that in the control group (12.00%). The total incidence of adr in the observation group (4.00%) was lower than in the control group (8.00%). Then intraoperative placement of Mirena can effectively regulate sex hormone indexes of AM patients, reduce uterine volume, relieve dysmenorrhea symptoms, reduce the inflammatory response, improve quality of life, and reduce recurrence rate, without obvious adverse reactions.


Assuntos
Adenomiose , Levanogestrel , Feminino , Humanos , Qualidade de Vida , Adenomiose/tratamento farmacológico , Adenomiose/cirurgia , Adenomiose/complicações , Dismenorreia/etiologia , Útero/cirurgia
13.
BMC Womens Health ; 22(1): 451, 2022 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-36384588

RESUMO

BACKGROUND: Placement of a levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective treatment for adenomyosis, especially for patients who have severe dysmenorrhea symptoms but a strong desire to preserve fertility. Nonetheless, for patients with adenomyosis accompanied by an enlarged uterus, expulsion of the ring is a troublesome problem. In this study, we sewed and fixed the LNG-IUS in the uterus, which provides a good solution to this problem. METHODS: In this prospective case series approved by the Ethics Committee of Hangzhou Women's Hospital, 12 patients with adenomyosis were successfully enrolled after providing informed consent, and all patients underwent long-term postoperative follow-up. RESULTS: Twelve patients with adenomyosis underwent suture fixation with an LNG-IUS, and during the long-term postoperative follow-up, every patient experienced complete remission of their symptoms: a significant decrease in menstrual flow, relief of dysmenorrhea, and improvement in quality of life. Only one person reported expulsion a year later. CONCLUSION: In patients with adenomyosis suffering from dysmenorrhea or excessive menstrual blood loss, suture fixation of an LNG-IUS using the hysteroscopic cold knife surgery system is a minimally invasive and effective alternative treatment for adenomyosis and decreases the risk of LNG-IUS expulsion.


Assuntos
Adenomiose , Dispositivos Intrauterinos Medicados , Humanos , Feminino , Adenomiose/complicações , Adenomiose/tratamento farmacológico , Adenomiose/cirurgia , Levanogestrel/uso terapêutico , Dismenorreia/etiologia , Dismenorreia/complicações , Qualidade de Vida , Suturas
14.
Sex Reprod Healthc ; 34: 100795, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36413880

RESUMO

BACKGROUND: Menstrual pain is relatively common among young girls. Many girls turn to youth clinics when seeking care for menstrual problems. OBJECTIVE: The objective of the study was to describe midwives' experiences of supporting girls with menstrual pain. METHODS: This is a qualitative study with an inductive approach. Semi-structured interviews were conducted with 15 midwives working at Swedish youth clinics. Interviews were held inSeptember 2021. The recordings were transcribed and analyzed using thematic analysis. RESULTS: Two main themes, consisting of three subthemes each, emerged: Guiding and educating young women about menstrual pain and Striving toward pain relief. It was important to the midwives to increase young women's knowledge of menstrual pain and coping strategies, and to guide them in finding a method for menstrual pain relief. Hormonal contraceptives were often a natural choice and an effective method for pain relief, although the midwives occasionally faced resistance from young women or their mothers when recommending this. The midwives also referred to a gynecologist if needed. CONCLUSION: The results highlight that midwives working at youth clinics have an important role in the care of young women with menstrual pain. The midwives found it important to increase young women's knowledge about menstrual pain and coping strategies, since they had noticed knowledge gaps in these areas. The results suggest a need to improve education about menstrual pain and coping strategies for young women, preferably in school and in cooperation with healthcare professionals.


Assuntos
Dismenorreia , Tocologia , Adolescente , Feminino , Humanos , Gravidez , Adaptação Psicológica , Manejo da Dor , Escolaridade
15.
Obstet Gynecol ; 140(6): 1017-1030, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36357958

RESUMO

OBJECTIVE: To explore to what extent intrauterine device (IUD) expulsion is associated with demographic and clinical risk factors. METHODS: The APEX-IUD (Association of Perforation and Expulsion of IntraUterine Devices) study was a U.S. cohort study using electronic health records from three integrated health care systems (Kaiser Permanente Northern California, Southern California, and Washington) and a health care information exchange (Regenstrief Institute). These analyses included individuals aged 50 years or younger with IUD insertions from 2001 to 2018. Intrauterine device expulsion cumulative incidence and incidence rates were estimated. Using Cox regression models, hazard ratios with 95% CIs were estimated before and after adjustment for risk factors of interest (age, race and ethnicity, parity, body mass index [BMI], heavy menstrual bleeding, and dysmenorrhea) and potential confounders. RESULTS: In total, 228,834 individuals with IUD insertion and no delivery in the previous 52 weeks were identified (184,733 [80.7%] with levonorgestrel-releasing intrauterine system). Diagnosis of heavy menstrual bleeding-particularly a diagnosis in both recent and past periods-was the strongest risk factor for IUD expulsion. Categories with the highest risk of IUD expulsion within each risk factor included individuals diagnosed with overweight, obesity, and morbid obesity; those in younger age groups, especially among those aged 24 years or younger; and in those with parity of four or more. Non-Hispanic White individuals had the lowest incidence and risk, and after adjustment, Asian or Pacific Islander individuals had the highest risk. Dysmenorrhea was not independently associated with expulsion risk when adjusting for heavy menstrual bleeding. CONCLUSION: Most risk factors for expulsion identified in this study appear consistent with known physiologic factors that affect uterine anatomy and physiology (age, BMI, heavy menstrual bleeding, parity). The increased risk of IUD expulsion among individuals of color warrants further investigation. Intrauterine devices are an effective long-term contraceptive; expulsion is uncommon, but patients should be counseled accordingly. FUNDING SOURCE: Bayer AG. CLINICAL TRIAL REGISTRATION: EU PAS register, EUPAS33461.


Assuntos
Dispositivos Intrauterinos de Cobre , Dispositivos Intrauterinos Medicados , Dispositivos Intrauterinos , Menorragia , Feminino , Humanos , Gravidez , Estudos de Coortes , Demografia , Dismenorreia/etiologia , Expulsão de Dispositivo Intrauterino , Dispositivos Intrauterinos/efeitos adversos , Dispositivos Intrauterinos de Cobre/efeitos adversos , Dispositivos Intrauterinos Medicados/efeitos adversos , Levanogestrel/efeitos adversos , Menorragia/etiologia , Fatores de Risco
16.
Lakartidningen ; 1192022 11 01.
Artigo em Sueco | MEDLINE | ID: mdl-36321300

RESUMO

Membranous dysmenorrhoea is present when the decidualized endometrium sheds in one piece, a decidual cast, which remains the shape of the uterine cavity. It has often been associated with initiation or cessation of hormonal treatments. Cases with extrauterine pregnancy, miscarriage, abortion, pregnancy in uterus didelphys/bicornis, and following post partum haemorrhage, as well as a few spontaneous cases, have also been described. We report a case of a 24-year old woman who started oral contraceptive pills three months previously. She presented with abdominal pain and vaginal bleeding. During examination membranous tissue was found, a pregnancy test was negative, and histology revealed decidualized endometrium. Further, we discuss clinical management and possible etiologic pathways suggesting that matrix-metalloproteinases or their regulators are involved.


Assuntos
Dismenorreia , Endométrio , Gravidez , Feminino , Humanos , Adulto Jovem , Adulto , Dismenorreia/diagnóstico , Útero , Anticoncepcionais Orais
17.
Trials ; 23(1): 964, 2022 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-36443858

RESUMO

BACKGROUND: Acupuncture or moxibustion has been proven to be effective for patients with primary dysmenorrhea (PDM). However, the respective advantages and potential central mechanism of acupuncture and moxibustion are worthy of investigating to promote their further application. METHODS: In this randomized controlled neuroimaging trial, 72 patients with PDM will be randomly assigned to three groups: acupuncture treatment group, moxibustion treatment group, and waiting list group. The acupuncture treatment group and moxibustion treatment group will receive acupuncture or moxibustion, respectively, for a total of 3 sessions over 3 consecutive menstrual cycles, and the waiting list group will not take acupuncture or moxibustion during these 3 menstrual cycles. The COX Menstrual Symptom Scale (CMSS), visual analog scale (VAS), and Pain Catastrophizing Scale (PCS) will be used to evaluate the clinical efficacy. The Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and 36-Item Short Form Health Survey (SF-36) will be used to assess the mental state and quality of life at baseline and at the end of treatment. Functional magnetic resonance imaging (fMRI) will be performed for detecting the cerebral activity changes at baseline and at the end of the treatment. The clinical data and imaging data will be analyzed among the groups. Correlation analysis will be conducted to investigate the relationship between brain functional changes and symptom improvement. DISCUSSION: The application of the randomized controlled neuroimaging trial will provide objective and valid evidence about how acupuncture and moxibustion treatment relieve menstrual pain. The results of this study would be useful to confirm the potential similarities and differences between acupuncture and moxibustion in clinical efficacy and central mechanism for patients with PDM. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100043732 . Registered on 27 February 2021.


Assuntos
Terapia por Acupuntura , Moxibustão , Feminino , Humanos , Moxibustão/efeitos adversos , Dismenorreia/diagnóstico , Dismenorreia/terapia , Qualidade de Vida , Terapia por Acupuntura/efeitos adversos , Neuroimagem , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Artigo em Inglês | MEDLINE | ID: mdl-36430040

RESUMO

The aim of this study was to develop a Korean medicine (KM) core outcome set (COS) for primary dysmenorrhea to evaluate the effectiveness of herbal medicine (HM) in treating primary dysmenorrhea in patients visiting KM primary clinics. Previously reported outcomes were identified through a literature review to define outcomes and effect modifiers (EMs) for the questionnaire. Experts were invited to conduct modified Delphi consensus exercises, and primary care clinicians were invited to conduct Delphi consensus exercises to evaluate suitability and feasibility. Finally, an additional round of a modified Delphi exercise was conducted with experts to obtain a final agreement on the COS. Seventeen outcomes and 15 EMs were included from a literature review, and one effect modifier was suggested by the experts (Phase 1). In Phase 2, after the modified Delphi consensus exercises by experts, 10 outcomes and 11 EMs were included in the COS. The clinicians all agreed on the feasibility of COS (Phase 3). Finally, 10 outcomes and 6 EMs were included in the COS-PD-KM after the final modified Delphi consensus exercise (Phase 4). The effectiveness of HM used in primary clinics could be evaluated with this COS in patients with primary dysmenorrhea. Further studies that involve more relevant stakeholder groups, such as patient representatives and gynecological experts, are needed.


Assuntos
Medicina Herbária , Plantas Medicinais , Feminino , Humanos , Técnica Delfos , Dismenorreia/tratamento farmacológico , Projetos de Pesquisa , Avaliação de Resultados em Cuidados de Saúde , República da Coreia
19.
Int J Mol Sci ; 23(21)2022 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-36361745

RESUMO

Endometriosis is defined as ectopic endometrial tissues dispersed outside the endometrium. This can cause disruption in hormonal and immunological processes, which may increase susceptibility to SARS-CoV-2 infection. Worsening of endometriosis symptoms may occur as a result of this infection. The aim of our review was to estimate the pooled prevalence of SARS-CoV-2 infection and the health impacts of the COVID-19 pandemic in endometriosis patients. We conducted a systematic review and meta-analysis. MEDLINE, Science Direct, Scopus, and Google Scholar databases were searched, using the keywords: (endometriosis) AND (COVID-19 OR SARS-CoV-2). Forest plots and pooled estimates were created using the Open Meta Analyst software. After screening 474 articles, 19 studies met the eligibility criteria for the systematic review, and 15 studies were included in the meta-analyses. A total of 17,799 patients were analyzed. The pooled prevalence of SARS-CoV-2 infection in endometriosis patients was 7.5%. Pooled estimates for the health impacts were 47.2% for decreased access to medical care, 49.3% increase in dysmenorrhea, 75% increase in anxiety, 59.4% increase in depression, and 68.9% increase in fatigue. Endometriosis patients were undeniably impacted by the COVID-19 pandemic, which caused the worsening of symptoms such as dysmenorrhea, pelvic pain, anxiety, depression, and fatigue.


Assuntos
COVID-19 , Endometriose , Feminino , Humanos , COVID-19/complicações , COVID-19/epidemiologia , Endometriose/complicações , Endometriose/epidemiologia , Endometriose/diagnóstico , SARS-CoV-2 , Pandemias , Dismenorreia , Prevalência , Fadiga
20.
BMC Pediatr ; 22(1): 574, 2022 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-36199045

RESUMO

OBJECTIVE: The present study investigated the relationship between a health-promoting lifestyle and menstrual pain intensity and distress among adolescent girls in Qazvin. METHODS: A cross-sectional survey study using a two-stage sampling method was conducted. The participants (n = 986) were female high school students aged 14-19 years living in Qazvin. Random cluster sampling was used to recruit participants from schools and classes from each grade. An online survey was provided to all participants to complete. Data were collected using a Demographic and Menstrual Characteristics Checklist, the Visual Analogue Scale (VAS) to assess dysmenorrhea intensity, the Andresh Milsom Scale (AMS) to assess dysmenorrhea severity, the Moos Menstrual Distress Questionnaire (MMDS) to assess menstrual distress, and the Health-Promoting Lifestyle Profile (HPLP) to assess a health promoting lifestyle. Data were analyzed using an univariable linear regression model at a significance level of 0.05. RESULTS: The findings indicated that 421 participants (42.7%) experienced dysmenorrhea with a mean duration of 2.24 days (SD = 1.57) and a mean pain intensity of 4.62 on the VAS (SD = 2.87). The mean score on the menstrual distress on the MDDS was 13.55 (SD = 8.88) and the mean score on the HPLP was 2.55 (SD = 0.50). Based on the results of univariable linear regression, nutrition (ß=-0.18, p < 0.001) and exercise (ß=-0.17, p < 0.001) had the most significant effect on the severity of dysmenorrhea pain. Also, self-actualization (ß=-0.29, p < 0.001), stress management (ß=-0.25, p < 0.001) and nutrition (ß=-0.25, p < 0.001) had the most significant effect on menstrual distress. CONCLUSION: Based on these findings, it is suggested that (i) improving nutrition and exercise might reduce the severity of dysmenorrhea pain and (ii) improving self-actualization, stress management and nutrition might reduce the severity of menstrual distress. Overall, it seems that improving health-promoting lifestyle behaviors can help improve the severity of dysmenorrhea pain and menstrual distress among adolescent girls.


Assuntos
Dismenorreia , Estilo de Vida , Adolescente , Estudos Transversais , Feminino , Promoção da Saúde , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Medição da Dor , Inquéritos e Questionários
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