Dysmenorrhea Patients Research Articles

Use of Continuous Oral Drospirenone for Menstrual Suppression in Adolescents

PurposeTo describe experiences of adolescents taking continuous drospirenone (DRSP-C) oral contraceptives, without placebo, for menstrual suppression, including breakthrough bleeding and other side-effects. MethodsThis was a retrospective chart review of adolescents prescribed DRSP-C for menstrual suppression. Demographics and indications for DRSP-C were collected on the visit where DRSP-C was prescribed. Data through the final follow-up visit during the study period included documented effects and side-effects of DRSP-C and continuation of therapy. Statistical analyses were primarily descriptive. ResultsPatients prescribed DRSP-C were included (n = 136). Dysmenorrhea was the most common indication for DRSP-C (58.8%, n = 80/136) followed by endometriosis (44.8%, n = 61/136). The median time on DRSP-C for the 116 patients who were able to initiate treatment was 12.3 months (interquartile range [IQR] 6.8, 17.4). Patients trialed, on average, 2 other forms of menstrual management before starting DRSP-C (IQR 1, 3). Pelvic pain or dysmenorrhea resolution or improvement was reported in 84.6% (44/52) of dysmenorrhea patients, and 77.8% (28/36) of pelvic pain patients. Almost half of patients reported breakthrough bleeding on DRSP-C (41.3%, n = 48/116); however, only 11 patients (42%, 11/26) discontinued DRSP-C because of it. Within the study period, 22.4% (n = 26/116) of patients discontinued DRSP-C, with a median treatment duration of 101 days (IQR 71, 157). Among patients who discontinued DRSP-C, the most common reason was breakthrough bleeding (42%, n = 11/26). DiscussionDRSP-C for menstrual suppression was well tolerated in adolescents, with most patients reporting resolution or improvement of their indication for taking DRSP-C. Findings demonstrate DRSP-C is a viable option for menstrual suppression in adolescents.

Effectiveness and safety of Chinese herbal footbaths as an adjuvant therapy for dysmenorrhea: a systematic review and meta-analysis.

To evaluate the effectiveness and safety of Chinese herbal footbaths (CHF) as an adjunctive therapy in managing dysmenorrhea. 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. 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). 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. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=188256, identifier registration number.

Abnormal Topological Organization of Human Brain Connectome in Primary Dysmenorrhea Patients Using Graph Theoretical Analysis.

Accumulating studies have revealed altered brain function and structure in regions linked to sensory, pain and emotion in individuals with primary dysmenorrhea (PD). However, the changes in the topological properties of the brain's functional connectome in patients with PD experiencing chronic pain remain poorly understood. Our study aimed to explore the mechanism of functional brain network impairment in individuals withPD through a graph-theoretic analysis. This study was a randomized controlled trial that included individuals with PD and healthy controls (HC) from June 2021 to June 2022. The experiment took place in the magnetic resonance imaging facility at Jiangxi Provincial People's Hospital. Static MRI scans were conducted on 23 female patients with PD and 23 healthy female controls. A two-sample t-test was conducted to compare the global and nodal indices between the two groups, while the Network-Based Statistics (NBS) method was utilized to explore the functional connectivity alterations between the groups. In the global index, The PD group exhibited decreased Sigma (p = 0.0432) and Gamma (p = 0.0470) compared to the HC group among the small-world network properties.(p<0.05) In the nodal index, the PD group displayed reduced betweenness centrality and increased degree centrality in the default mode network (DMN), along with decreased nodal efficiency and increased degree centrality in the visual network (VN). (P < 0.05, Bonferroni-corrected) Furthermore, in the connection analysis, PD patients showed altered functional connectivity in the basal ganglia network (BGN), VN, and DMN.(NBS corrected). Our results indicate that individuals with PD showed abnormal brain network efficiency and abnormal connection within DMN, VN and BGN related to pain matrix. These findings have important references for understanding the neural mechanism of pain in PD.

PENGARUH KOMPRES HANGAT TERHADAP NYERI DISMENORE PADA REMAJA: LITERATURE REVIEW

Dysmenorrhea is pain in the lower abdomen before and during menstruation. Dysmenorrhea is not dangerous, but can interfere with physical activities and if left untreated can be annoying and cause discomfort. According to WHO (World Health Organization), dysmenorrhea was found in 1,769,425 (90%) women, of which 10-15% suffered from severe dysmenorrhea. Dysmenorrhea pain can be treated non-pharmacologically, one way is by using warm compresses. The aim of this literature review is to determine the effect of giving warm compresses to adolescents on the intensity of dysmenorrhea pain. The design used is a literature review. Literature search through several international and national literature search databases including Google Scholar, Mendeley, and Garuda. The study sources used from 2017-2022 used PRISMA. After selecting 6 journals that met the criteria and showed how applying warm compresses helped dysmenorrhea patients feel better, a review was carried out. Based on the articles collected, the results showed that warm compresses can reduce dysmenorrhea pain.

Efficacy of Homoeopathic Ultra High Dilutions in management of Dysmenorrhoea: A Review

Introduction: Dysmenorrhea, or painful menstruation, affects a substantial portion of women worldwide, with prevalence rates reaching up to 67 to 90% among young women. This condition, characterized by intense lower abdominal cramps and associated symptoms, has a significant impact on women's quality of life. Conventional treatments like non-steroidal anti-inflammatory drugs (NSAIDs) have limitations, leading many to explore alternative therapies such as homeopathy. Objective: This article reviews the effects of homeopathic treatments on dysmenorrhea patients and examines seven studies conducted in this context. Methods: Studies which meet the specific required criteria; involving dysmenorrhea and Homoeopathy and being published in peer-reviewed English-language scientific journals were only included. Various parameters, such as disease intensity scales, the Menstrual Distress Questionnaire (MDQ), Pain Rating Scale (PRS), Visual Analogue Scale (VAS), and quality of life (QoL) using the World Health Organization Quality of Life: Brief Version (WHOQOL-BREF) scale, numerical rating scale (NRS), and verbal multidimensional scoring system (VMSS), were evaluated. The results before and after treatment with homoeopathic high dilutions have been compared and summarized. Results: Clinical analysis and statistical data of reviewed studies reveal homeopathic high dilutions as effective for Primary Dysmenorrhea, reducing pain (VAS), improving quality of life (WHOQOL), and demonstrating safety, emphasizing their holistic potential.&#x0D;

Use of Vitex agnus-castus in patients with menstrual cycle disorders: a single-center retrospective longitudinal cohort study

PurposeTo evaluate clinical characteristics, quality of life (QoL) and effectiveness in patients with menstrual cycle disorders (MCDs) including abnormal uterine bleeding, dysmenorrhea and mastodynia/mastalgia related to premenstrual syndrome taking the Vitex agnus-castus (VAC) products Cyclodynon® or Mastodynon® in a real-world setting.MethodsA single-center retrospective longitudinal cohort study (3 ± 1 months), using data obtained from healthcare data archive and telephone interviews. The main study variables were changes in bleeding, menstrual pain, breast tenderness and patients’ QoL.ResultsData from 1700 women with a mean age of 30.2 years (± 6.3) were analyzed. The most common MCDs were dysmenorrhea (43.8%) and mastodynia/mastalgia (21.1%). Three-month treatment with VAC extract substantially decreased the percentage of patients with irregular cycle (from 9.1% to 0.1%) and breast tenderness (from 39.9% to 0.8%). Improvement in bleeding intensity, frequency and menstrual pain was experienced by 83.4%, 79.2%, and 85.2% of the patients, respectively. When analyzed by disease category, these parameters improved in almost all dysmenorrhea patients, while they improved to a lesser extent in mastodynia/mastalgia patients. QoL improved in all aspects, but was reported by a higher proportion of dysmenorrhea patients compared to mastodynia/mastalgia patients. Treatment was overall well tolerated with a favorable safety profile.ConclusionThese real-world data demonstrate the effectiveness of the VAC-containing products Cyclodynon® and Mastodynon® in the three-month treatment of MCDs, with a pronounced improvement in key disease symptoms and QoL. Intriguingly, while QoL was generally greatly improved, the response to VAC therapy varied depending on the type of underlying MCD.

MEFV gene pathogenic variants: a risk factor for dysmenorrhea in the Turkish population

Background/Aim The Mediterranean fever (MEFV) gene codes for protein pyrin, which is among the modulators of inflammasome activity in innate immune cells. It was suggested that there is a relation between MEFV variations and inflammatory diseases. The aim of this study was to investigate MEFV gene variations in the patients with primary dysmenorrhea. Methods The prevalence of common MEFV gene variations (M694V, M680I, V726A, E148Q and R202Q) was investigated in 145 young women with primary dysmenorrhea and 135 unrelated healthy controls. MEFV gene variations were genotyped using PCR-based RFLP assay. Results Number of childbirth and marriage were significantly lower in the study group than the controls, respectvely (p < 0.001, p = 0.001). Family history was statistically higher in the patient group (p < 0.001). In total, MEFV genotype and allele frequencies were significantly higher in patients than controls, respectively (p = 0.008 and p = 0.005, respectively). It was found that MEFV gene E148Q allele was more common in patient group (p = 0.039). MEFV R202Q A allele was higher in the patients than the controls (p = 0.045). A significant association was observed when the patients were compared with the controls according to R202Q variant AA versus GG+GA genotypes (p=0.020). Conclusion Our findings suggest that MEFV variations may be a risk factor for patients with dysmenorrhea in a Turkish cohort. Highlights There are very few studies in the literature regarding the relationship between pathological variants of MEFV and dysmenorrhea disease. The common MEFV mutations/variants were evaluated in primary dysmenorrhea patients. Family history was statistically higher in the patient group (p <.001). MEFV gene variations were found 52 (35.9%) in patients and 29 (21.5%2) in controls. MEFV gene allele frequency was significantly higher in-patient group than control (p =.005).

The Effect of Exercise on Pulsatility Index of Uterine Arteries and Pain in Primary Dysmenorrhea.

Primary dysmenorrhea (PD) is one of the most common diseases in women of reproductive age. Our aim was to examine whether a twice-weekly thirty-minute exercise intervention could result in a difference in the pulsatility index (PI) of the uterine arteries (UAs) and level of menstrual pain in patients with PD. In our prospective observational trial, the observation period included one spontaneous menstrual cycle and the consecutive time of the next menstruation of all participants, aged 18-44, with no extensive sports experience. In total, 73 volunteers were enrolled: 38 persons in the intervention group (IG) and 35 in the control group (CG). The intervention program was accompanied by music, performed in groups under the supervision of a qualified instructor in Hungary. The primary outcome was the difference between the IG and CG regarding the PI values of UAs at the 1st and the 2nd ultrasound (US) Doppler flowmetry. The secondary outcome was the difference between the IG and CG regarding the PI of UAs and menstrual pain measured by using the Numeric Rating Scale and adherence to the intervention. Statistical tests such as an independent-samples t-test, chi-square test, Mann-Whitney test and analysis of covariance (ANCOVA) were used during the analyses. Examining the mean of the PI of UAs in the IG and the CG at the 1st and the 2nd US measurement, a significant difference was found in the change in the measured value (Z = -2.545; p = 0.011). The IG showed a significantly higher increase in the mean of the PI of UAs (Median = 0.825) than the CG (Median = 0.130). The difference in the PI of the UAs of the IG and the CG is not related to the level of pain in any group (p = 0.336) and not related to the whole sample (p = 0.354); furthermore, the level of pain did not significantly differ between the two groups. Our study is the first to document the significant effects of mild-to-moderate exercise training on the change in the PI of the UAs in individuals with PD. The IG had a reduced blood flow due to circulatory redistribution after exercise. The level of menstrual pain of primary dysmenorrhea patients is independent of the level of blood circulation regarding the PI of the UAs. Randomized controlled studies with more participants and a longer research period are needed to confirm our findings regarding the association between regular exercise and the PI of UAs. The study was registered at clinicaltrials.gov: NCT04618172.

Regularity of meridian-acupoint reactions of foot three yin meridians in primary dysmenorrhea and secondary dysmenorrhea patients

To observe the meridian-acupoint reactions of foot three yin meridians in primary dysmenorrhea(PD) and secondary dysmenorrhea(SD) patients, so as to summarize the rules of meridian-acupoint reaction and acupoints selection. Thirty-five patients with PD (PD group), 34 patients with SD (SD group) and 35 healthy subjects (healthy group) were recruited. The compression method was used to examine the lower leg segment of the foot three yin meridians. Positive reactions(palpable skin changes, including cords, nodules, depressions) and tenderness of meridians and acupoints were recorded. The visual analogue scale (VAS) was used to evaluate the tenderness severity of acupoints. Compared with the healthy group, the probability of positive reactions and tenderness in foot three yin meridians were higher in PD and SD groups (P<0.01,P<0.05). Compared with the PD group, the probability of positive reactions in Spleen and Liver Meridians were higher in the SD group, with higher probability of tenderness in Liver Meridian(P<0.05). The probability of positive reactions and tenderness in the Spleen Meridian of PD and SD groups was significantly higher than that in the Kidney Meridian (P<0.01), while the probability of tenderness in the Spleen Meridian of the PD group was significantly higher than that in the Liver Meridian (P<0.05). Positive reactions and tenderness were concentrated at Yinlingquan (SP9), Diji (SP8) and Sanyinjiao (SP6) of Spleen Meridian and Xiguan (LR7) and Ligou (LR5) in Liver Meridian of PD and SD groups. In comparison with the PD group, the probability of positive reactions, tenderness and VAS score of SP8 and LR5 of the SD group were higher (P<0.05, P<0.01). The positive reaction occurs most frequently in the Spleen Meridian, followed by the Liver Meridian, and least frequently in the Kidney Meridian. The acupoints with positive reaction are different between PD and SD, which suggests that the Spleen Meridian acupoints should be the main acupoints when treating the two kinds of dysmenorrhea, and acupoints should also be selected according to the meridian and acupoint examination results.

Investigation of familial tendency of endometriosis

Objective: To investigate the familial heritability of endometriosis and to compare the clinical characteristics of patients with or without a family history of endometriosis. Methods: From January 2020 to June 2022, 850 patients with endometriosis confirmed by laparotomy or laparoscopy in Peking University Third Hospital were included in this study. Clinical data were collected, family history was followed up, and the differences of clinical indicators between patients with and without family history of endometriosis were compared. Results: A total of 850 patients were enrolled, with an average age of (33.8±7.0) years old, 315 (37.1%, 315/850) patients in stage Ⅲ and 496 (58.4%, 496/850) patients in stage Ⅳ. There were 100 patients with family history of endometriosis, accounting for 11.8% (100/850). Most of the 113 relatives involved were mothers, daughters and sisters (76.1%, 86/113), 81.5% (22/27) of the second and third degree relatives were maternal relatives. The median ages of patients with and without family history of endometriosis were 30 and 33 years old respectively at the time of diagnosis. The unmarried rate of patients with family history was higher [42.0% (42/100) vs 26.3% (197/750)]. The percentage of dysmenorrhea patients with family history was higher [89.0% (89/100) vs 55.5% (416/750)]. The medians of dysmenorrhea score in patients with and without family history were 6 and 2, and the median durations of dysmenorrhea were 10 and 1 years. There were significant differences in age, marital status, percentage of dysmenorrhea, dysmenorrhea score and duration (all P<0.001). The median levels of serum cancer antigen (CA) 125 in patients with family history and patients without family history at the time of diagnosis were 57.5 and 46.9 kU/L respectively, with a statistically significant difference (P<0.05). However, there were no significant differences between the two groups in nationality, bady mass index, menarche age, menstrual cycle, menstrual period, menstrual volume, serum CA19-9 level, cyst location and size, stage, history of adverse pregnancy and childbirth, infertility, adenomyosis and deep infiltrating endometriosis (all P>0.05). By comparing the specific conditions of dysmenorrhea patients with and without family history of endometriosis, there were no significant differences between the two groups in terms of the age of onset of dysmenorrhea, duration of dysmenorrhea, primary and secondary dysmenorrhea, and progressive aggravation of dysmenorrhea (all P>0.05). The difference in the degree of dysmenorrhea in dysmenorrhea patients with family history of endometriosis was significant (P<0.001). Conclusions: The incidence of endometriosis has a familial tendency, and most of the involved relatives are the first degree relatives. Compared with patients without family history of endometriosis, endometriosis patients with family history are diagnosed at an earlier age, with higher percentage of dysmenorrhea, had more severe dysmenorrhea and higher serum CA125 level.

Skin Temperature of Acupoints in Health and Primary Dysmenorrhea Patients: A Systematic Review and Meta-Analysis.

Dysmenorrhea is a common clinical condition and some studies shown that the skin temperature of some acupoints changes in primary dysmenorrhea (PD) patients. This study aimed to evaluate the changes in skin temperature at specific acupoints in PD patients and healthy subjects. The literature for assessing skin temperature at acupoints in PD patients and healthy subjects was searched in eight databases. The literatures obtained from the search was independently screened by two authors, and the quality of the included articles was evaluated using the consensus checklist of the Thermographic Imaging in Sports and Exercise Medicine (TISEM) and the Newcastle-Ottawa Scale (NOS) scale. The skin temperature of the relevant acupoints or the difference between the left and right acupoints of the same name was used as the outcome during any period of menstruation. Finally, the meta-analysis was performed using RevMan 5.4.1 software to evaluate the changes in skin temperature in the related acupoints. Seven eligible studies were included, which included 328 patients with PD and 279 healthy subjects. The results of the meta-analysis revealed a significant difference in skin temperature around the Sanyinjiao (SP6)(MD: 0.04, 95% CI: 0.00, 0.08), Xuehai (SP 10)(MD: -0.07, 95% CI:-0.11, -0.02) and Taixi (KI 3)(MD: 0.06, 95% CI:0.01, 0.11) acupoints between PD and healthy subjects. PD patients also showed a difference in skin temperature at the Taixi (KI 3)(MD: 0.14, 95% CI:0.04, 0.24), Shuiquan (KI 5)(MD: 0.11, 95% CI: 0.03,0.19), Taichong (LR 3)(MD: -0.10, 95% CI: -0.19,-0.01), Diji (SP 8)(MD: -0.09, 95% CI: -0.16, -0.01), and Xuehai (SP 10)(MD: -0.14, 95% CI: -0.23, -0.06) acupoint areas at different times of menstruation compared to that of healthy subjects, as revealed by the subgroup analysis. Primary dysmenorrhea patients showed some differences in the skin temperature of the special acupoints are as Sanyinjiao (SP6), Diji (SP 8), Xuehai (SP 10), Shuiquan (KI 5), Taichong (LR 3), and Taixi (KI 3) compared with healthy subjects. CRD42022381387.

Primer Dismenorede D Vitaminin Rolü

Primary dysmenorrhea is uterine cramping that occurs during or before menstruation without pelvic disease and causes suprapubic pain. In researching the causes of dysmenorrhea, several studies have highlighted the role of lacking vitamin D (vit D). Vit D acts by suppressing the synthesis of prostaglandins that cause pain. Our study aims to investigate whether vit D level affects primary dysmenorrhea. For this purpose, vit D 3 level will be studied in patients with primary dysmenorrhea and a control group without dysmenorrhea. This retrospective, randomized, case-controlled study was conducted between January 2020 and August 2021 at two different centers. It was approved by the ethics committee. Information was obtained by interviewing eligible subjects for the study, and informed consent was obtained. 750 women presented to the gynecology departments of the participating centers involved in the study. Ages between 16-35 are included in the study. Under 18 patients were referred from pediatric clinics with similar symptoms. 325 women were assigned to the dysmenorrhea group. All patients had a regular menstrual cycle and pain that began the day before menstruation. 325 patients unrelated to dysmenorrhea were selected randomly as a control group. The participants in our study were randomly selected into the dysmenorrhea group and the control group, and their clinical characteristics were compared in Tables 1 and 2. Significance was remarkable comparing the dysmenorrhea patients with the healthy control groups. That dysmenorrhea patients with 25-hydroxyvitamin D3 deficiency had significantly less consumption of dairy products. VAS values were higher, and undereducation and unemployment were also significantly more common. Low serum vit D levels and dysmenorrhea are strongly related. It is obvious that there is a significant relationship between vit D levels, VAS score, and primary dysmenorrhea. More studies at larger scales are needed to underline the efficiency of vit D in primary dysmenorrhea.

An Analysis of the Current Status of dysmenorrhea patients visiting Korean Medicine Hospital

Objectives: This review aimed to present the characteristics of dysmenorrhea patients visiting a Korean Medicine hospital.Methods: One hundred thirteen dysmenorrhea patients visiting a Korean Medicine hospital from 2017 to 2021 were studied. We evaluated the general characteristics, type of dysmenorrhea, menstrual characteristics and overall therapies.Results: The average age of the 113 subjects was 29.4 years old, with 38.1% in their 20s and 25.7% in their 30s. The average pain intensity was NRS 7.5, and the menstrual pain severity of 79.6% of the subjects was grade 2 or 3. The types of dysmenorrhea were classified as primary dysmenorrhea in 62.0% and secondary dysmenorrhea in 38.1%. The average treatment period of the patients was 1–2 months in most cases (44.25%). The most common treatment method was herbal medicine.Conclusions: We figured out the status of dysmenorrhea patients and treatment in a Korean medicine hospital.

The relationship between spino-pelvic alignment and primary dysmenorrhea.

Most women of reproductive age suffered from the primary dysmenorrhea (PD). Up to date, most studies on the etiology of dysmenorrhea focused on endocrine factors while ignored the effect of spino-pelvic bony anatomy on uterus. In this study, we innovatively shed light on the relationship between primary dysmenorrhea and sagittal spino-pelvic alignment. 120 patients diagnosed with primary dysmenorrhea and a control group of 118 healthy volunteers were enrolled into this study. All subjects received the standing full-length posteroanterior plain radiography to evaluate the sagittal spino-pelvic parameters. The visual analog scale (VAS) was used to assess pain rating of primary dysmenorrhea patients. Analysis of variance (ANOVA) or Student's t test was performed to measure statistical significance between differences. There was a significant difference in pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL) and thoracic kyphosis (TK) between PD group and Normal group (P<0.05). Furthermore, in PD group, the PI and SS was significant different between mild pain group and moderate pain group (P<0.05) and there was a significant negative correlation between pain rating and SS. From the perspective of sagittal spinal alignment, the majority of PD patients were classified with Roussouly type 2, meanwhile most normal people were classified with Roussouly type 3. Sagittal spino-pelvic alignment was related to primary dysmenorrhea symptoms. Lower SS and PI angles may contribute to a worsen pain in PD patients.

Altered brain activities in mesocorticolimbic pathway in primary dysmenorrhea patients of long-term menstrual pain.

Patients with primary dysmenorrhea (PDM) often present with abnormalities other than dysmenorrhea including co-occurrence with other chronic pain conditions and central sensitization. Changes in brain activity in PDM have been demonstrated; however, the results are not consistent. Herein, this study probed into altered intraregional and interregional brain activity in patients with PDM and expounded more findings. A total of 33 patients with PDM and 36 healthy controls (HCs) were recruited and underwent a resting-state functional magnetic resonance imaging scan. Regional homogeneity (ReHo) and mean amplitude of low-frequency fluctuation (mALFF) analysis were applied to compare the difference in intraregional brain activity between the two groups, and the regions with ReHo and mALFF group differences were used as seeds for functional connectivity (FC) analysis to explore the difference of interregional activity. Pearson's correlation analysis was conducted between rs-fMRI data and clinical symptoms in patients with PDM. Compared with HCs, patients with PDM showed altered intraregional activity in a series of brain regions, including the hippocampus, the temporal pole superior temporal gyrus, the nucleus accumbens, the pregenual anterior cingulate cortex, the cerebellum_8, the middle temporal gyrus, the inferior temporal gyrus, the rolandic operculum, the postcentral gyrus and the middle frontal gyrus (MFG), and altered interregional FC mainly between regions of the mesocorticolimbic pathway and regions associated with sensation and movement. The anxiety symptoms are correlated with the intraregional activity of the right temporal pole superior temporal gyrus and FC between MFG and superior frontal gyrus. Our study showed a more comprehensive method to explore changes in brain activity in PDM. We found that the mesocorticolimbic pathway might play a key role in the chronic transformation of pain in PDM. We, therefore, speculate that the modulation of the mesocorticolimbic pathway may be a potential novel therapeutic mechanism for PDM.

PCR210 Quality of Life and Productivity Losses of Dysmenorrhea Patients in Korea

Dysmenorrhea is a common symptom in women. Dysmenorrhea impairs patients’ quality of life and causes productivity loss in patients. However, there is a limited study on the disease burden of dysmenorrhea. This study was conducted to measure health-related quality of life and productivity loss of dysmenorrhea patients in Korea.

Investigation of Laboratory and Clinical Features of Primary Dysmenorrhea: Comparison of Magnesium and Oral Contraceptives in Treatment.

Background The goal of this study was to identify the demographic, clinical, and laboratory characteristics of primary dysmenorrhea (PD) patients, as well as to compare the treatment options of 200 mg magnesium citrate (MgS) and combination oral contraceptive (COC) therapy. Methods This is a case-controlled prospective study consisting of 172 women with PD and a control group consisting of age-matched 172 without PD. The cases in the primary dysmenorrhea group were randomly divided into two groups, with 86 patients in the first group receiving 200 mg MgS, and 86 patients in the second group receiving COC treatment. The Visual Analogue Scale (VAS) was used to measure the severity of dysmenorrhea. VAS scoring was performed on the control group subjects included in the study at their first evaluation and the PD group subjects before treatment and at the third month of treatment (after three menstrual cycles). Results When compared to healthy controls, the PD patients had significantly more menstrual bleeding (p = 0.005), more historyof maternal dysmenorrhea (p < 0.001), lower serum calcium (p < 0.001), lower serum 25-hydroxyvitamin D3 (p < 0.001)and more 25-hydroxyvitamin D deficiency (p < 0.001). When compared to the MgS group, the patients in the COC group had significantly lower VAS scores and less need for painkillers following treatment (p < 0.001). The MgS treatment group had significantly lower post-treatment VAS values than pre-treatment VAS values. Conclusion Lower serum calcium and 25-hydroxyvitamin D levels were found in the presence of PD. In addition, it was observed that the administration of 200 mg MgS to PD patients significantly reduced pelvic pain in dysmenorrhea, although not as much as COC administration, and caused significant reductions in the need for painkillers.

The Effect of Magnesium Sulfate on Pain Intensity and Menstrual Blood Loss in Students With Primary Dysmenorrhea: A Randomized Controlled Trial

Background: No evidence exists for the lowest effective dose of magnesium on menstrual pain. Objective: To determine and compare the effects of two different doses of magnesium on pain intensity and menstrual blood loss in students with primary dysmenorrhea. Methods: Sixty dysmenorrhea patients were randomly assigned to one of two therapeutic groups and one placebo group (receiving one tablet a day of 300 or 150 mg magnesium sulphate or placebo from the 15th cycle day until no pain existed on the following cycle). Visual analogue scale (VAS) and Hjgham collected data for two cycles before and two cycles after the intervention. The data were analyzed using one-way ANOVA and ANCOVA tests. Findings: No significant difference was observed between the groups in terms of baseline characteristics. Both intervention groups outperformed the placebo group in terms of pain intensity (adjusted differences of -2.9, 95% confidence intervals of -3.3 to -2.4 and -1.9, -2.4 to -1.5, respectively) and menstrual bleeding (-20.0, -26.0 to -14.0, and -13.0, -19.0 to -7.0, respectively), as well as the secondary outcome, i.e. rest duration and ibuprofen consumption. In terms of pain alleviation and menstrual bleeding, participants in the 300 mg magnesium group outperformed those in the 150 mg magnesium group. No significant difference was observed between intervention groups regarding secondary outcomes. Conclusion: Both magnesium levels are useful in alleviating pain and reducing menstrual bleeding, although 300 mg of magnesium was more effective.

Label-free based quantitative proteomics analysis to explore the molecular mechanism of gynecological cold coagulation and blood stasis syndrome.

Cold coagulation and blood stasis (CCBS) syndrome is one of the common traditional Chinese medicine (TCM) syndromes of gynecological diseases. However, the molecular mechanism of CCBS syndrome is still unclear. Thus, there is a need to reveal the occurrence and regulation mechanism of CCBS syndrome, in order to provide a theoretical basis for the treatment of CCBS syndrome in gynecological diseases. The plasma proteins in primary dysmenorrhea (PD) patients with CCBS syndrome, endometriosis (EMS) patients with CCBS syndrome, and healthy women were screened using Label-free quantitative proteomics. Based on the TCM theory of "same TCM syndrome in different diseases," the differentially expressed proteins (DEPs) identified in each group were subjected to intersection mapping to obtain common DEPs in CCBS syndrome. The DEPs of gynecological CCBS syndrome in the intersection part were again cross-mapped with the DEPs of gynecological CCBS syndrome obtained by the research group according to the TCM theory of "different TCM syndromes in same disease" theory in the early stage, so as to obtain the DEPs of gynecological CCBS syndrome that were shared by the two parts. The common DEPs were subjected to bioinformatics analysis, and were verified by enzyme-linked immunosorbent assay (ELISA). A total of 67 common DEPs were identified in CCBS syndrome, of which 33 DEPs were upregulated and 34 DEPs were downregulated. The functional classification of DEPs involved in metabolic process, energy production and conversion, immune system process, antioxidant activity, response to stimulus, and biological adhesion. The subcellular location mainly located in the cytoplasm, nucleus, and extracellular. Gene ontology (GO) enrichment analysis showed that the upregulated DEPs mainly concentrated in lipid transport, cell migration, and inflammatory reaction, and the downregulated DEPs mostly related to cell junction, metabolism, and energy response. Protein domain enrichment analysis and clustering analysis revealed that the DEPs mainly related to cell proliferation and differentiation, cell morphology, metabolism, and immunity. The Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis clustering analysis showed that the upregulated DEPs were involved in inflammation and oxidative damage, while the downregulated DEPs were involved in inflammation, cell adhesion, cell apoptosis, and metabolism. The results of ELISA showed significantly increased levels of Cell surface glycoprotein MUC18 (MCAM) and Apolipoprotein C1 (APOC1), and significantly decreased levels of Vasodilator-stimulated phosphoprotein (VASP), Fatty acid-binding protein 5 (FABP5), and Vinculin (VCL) in patients with CCBS syndrome compared with healthy women. We speculated that cold evil may affect the immune process, inflammatory response, metabolic process, energy production and conversion, oxidative damage, endothelial cell dysfunction, and other differential proteins expression to cause CCBS syndrome in gynecological diseases.

The Effect of Long-Term Menstrual Pain on Large-Scale Brain Network in Primary Dysmenorrhea Patients.

PurposePrimary dysmenorrhea (PD) is a common gynecological disease, characterized by crampy and suprapubic pain occurring with menses. Growing evidences demonstrated that PD patients were associated with abnormalities in brain function and structure. However, little is known regarding whether the large-scale brain network changes in PD patients. The purpose of this study was to investigate the effect of long-term menstrual pain on large-scale brain network in PD patients using independent component analysis (ICA) method.MethodsTwenty-eight PD patients (female, mean age, 24.25±1.00 years) and twenty-eight healthy controls (HCs) (mean age, 24.46±1.31 years), closely matched for age, sex, and education, underwent resting-state magnetic resonance imaging scans. ICA was applied to extract the resting-state networks (RSNs) in two groups. Then, two-sample t-tests were conducted to investigate different intranetwork FCs within RSNs and interactions among RSNs between two groups.ResultsCompared to the HC group, PD patients showed significant increased intra-network FCs within the auditory network (AN), sensorimotor network (SMN), right executive control network (RECN). However, PD patients showed significant decreased intra-network FCs within ventral default mode network (vDMN) and salience network (SN). Moreover, FNC analysis showed increased VN-AN and decreased VN-SMN functional connectivity between two groups.ConclusionOur study highlighted that PD patients had abnormal brain networks related to auditory, sensorimotor and higher cognitive network. Our results offer important insights into the altered large-scale brain network neural mechanisms of pain in PD patients.