Management Of Dysmenorrhea Research Articles

Meta-Analysis the Effect of Acupressure in Lowering Pain of Dysmenorrhea

Background: Dysmenorrhea is the most common cause of lower abdominal pain and has a negative impact on women's quality of life resulting in activity limitations. Non-pharmacological management can be used as an intervention in the management of dysmenorrhea. Acupressure is a therapy that is given by massaging or pressing certain points. The purpose of this study was to analyze the effect of acupressure therapy on reducing dysmenorrhea pain. Subject and Method : This study was a meta-analysis with the following PICO, population: Women aged 16-30 years old with primary dysmenorrhea. Intervention: administration of Acupressure Therapy. Comparison: Acupressure therapy was not performed. Results: Decreased pain in primary dysmenorrhea. The articles used in this study were obtained from three databases, namely Google Scholar, Pubmed, and Science Direct. Keywords to search for articles “Acupressure” OR “Acu­pressure Therapy” AND “Sanyinjiao Point (SP6)” AND “Hequ Point (LI4)” AND “Dysmenorrhea” OR “Primary Dysmenorrhea” OR “Menstrual Pain” AND “Randomized Controlled Trial”. The articles included are full-text English with a Randomized Control Trial study design from 2007 to 2022. The articles were selected using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application. Results : Meta-analysis of 9 randomized controlled trial articles from Asia and Europe concluded that acupressure therapy can reduce pain in primary dysmenorrhea (SMD= -0.66; 95% CI = -0.96 to -0.36; p < 0.001). Conclusion: Acupressure therapy can affect pain reduction in women with complaints of primary dysmenorrhea. Keywords: Acupressure, pain relief, primary dysmenorrhea Correspondence: Anisya Fajar Rahmawati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Mobile: +6285715840985. Email: anisyafajar25­@gmail.com. Indonesian Journal of Medicine (2022), 07(01): 51-60 https://doi.org/10.26911/theijmed.2022.07.01.06

Androgens, Endometriosis and Pain.

The intriguing relationship between androgens, endometriosis and chronic pain continues to unfold. Determining this relationship is of crucial importance to gynecologists managing people with these conditions, as common treatments dramatically alter her hormonal profiles, with both intended and unintended consequences. Although they may be present in the same individual, there is a recognized disconnect between pain or pain-related symptoms, and the presence or extent of endometriosis lesions. Reduced androgen levels provide a potential mechanism to link the development of endometriosis lesions and the presence of chronic pain. This research paper expands the presentation of our research at the World Endometriosis Congress in 2021, subsequently published in the Journal of Pain Research which demonstrated a strong inverse relationship between androgen levels and days per month of pelvic and period pain. Here we extend and further explore the evidence for a role for androgens in the etiology and management of dysmenorrhea and pelvic pain in women, both with and without endometriosis. We explore the potential for inflammation to induce low androgen levels and consider ways in which clinicians can optimize levels of androgens when treating women with these conditions. This article prompts the question: Is it estrogens that predispose people to a life of pain, or androgens that are protective?

A Cross Sectional Study to Assess the Knowledge, Attitude and Health Care Seeking Behaviour towards Dysmenorrhea among Female Students in a Medical College, Kancheepuram, Tamil Nadu

Background: Menstruation is a normal physiological process that occurs throughout the reproductive years of every woman[1]. Most of the women experience mild pain and discomfort during menstruation. Dysmenorrhea is defined as cramping pain in the lower abdomen accompanying menstruation.
 Objectives: The objective of this study was to assess the knowledge, attitude, and healthcare-seeking behavior towards dysmenorrhea among female students in a medical college, Kancheepuram, Tamil Nadu.
 Materials and Methods: A cross-sectional study was conducted among 292 female students in Saveetha Medical College and Hospital, Chennai. A pre-tested and structured questionnaire was used and data collected were analyzed using Statistical Package for Social Sciences (SPSS) 16.0 and were presented in tables reporting frequency counts and percentages. Statistical significant tests were conducted using chi-square.
 Results: The dysmenorrhea was reported in 243 (83.2%) of them. Out of which 206 (70.54%) had primary dysmenorrhea and 37 (12.67%) had secondary dysmenorrhea which was categorized on the basis of onset of pain. A statistically significant relationship was seen between the type of menstrual cycle and dysmenorrhea (P=0.013).
 Conclusion: Many women consider dysmenorrhea to be a normal part of the menstrual cycle and thus fail to seek help. The consequences of untreated dysmenorrhea include poor concentration, highest incidence of absenteeism, resulting in loss of work hours and economic loss and social withdrawal. Therefore, interventions such as education programmes on effective management of dysmenorrhea can be planned with intention to improve the quality of life among the female students.

Prevalence and Predictors of Dysmenorrhea, its Effects and Coping Mechanism among Adolescent

Background and Aim: Dysmenorrhea is one of the most common gynecological disorders in the world. The current study aims to know the prevalence of dysmenorrhea and its management practices among adolescent girls. The study also aim to assess predictors of dysmenorrhea treatment options. Materials and Methods: This institutional-based cross-sectional study was carried out at Obstetrics & Gynaecology department of Mardan Women Hospital, Sheikh Maltoon Town Mardan and Jinnah International Hospital, Abbottabad from June 2020 to November 2020. Pretested self-administrated and a semi-structured questionnaire was used for data collection from volunteer adolescent girls to take part in this study. The outcome and exposure variables association was evaluated through a multi regression model and chi-square test. Dysmenorrhea risk was reported by taking the odds ratio at a confidence interval of 95%. SPSS version 20 was used for data analysis and statistical significance was considered at p<0.05. Results: Of the total 680 questionnaires, 601 (88.4%) were completed. The response rate and dysmenorrhea prevalence were 88.4% and 53.3% respectively. The mean age of the adolescents was 16.3 ± 1.92. While mean age for Menarche was 12.41 ± 1.62. A significant difference (t= 5.78, p< 0.001) between dysmenorrhea and non-dysmenorrhea age girls was (16.81 ±1.98) and (12.56 ± 1.65) respectively. The common symptom of waist pain among participants was (345, 57.4%). The prevalence of participants taking Over-the-counter (OTC) drugs for menstrual symptoms was 191 (31.8%). Dysmenorrhea’s severity and age were the two significant predictors for the prospect of taking a dysmenorrhea pharmacological agent. Conclusion: Our study concluded that a higher prevalence of dysmenorrhea was observed among adolescents compared to Menarche which adversely affects the routine major activities. A significant association between self-reported dysmenorrhea and the abnormal menstrual cycle was found. Adolescents must be educated early on about the safety and efficacy of various dysmenorrhea management options. Keywords: Dysmenorrhea, Adolescence, Menarche

Innovation in management of dysmenorrhea: A nursing approach

Dysmenorrhea is abdominal pain caused by uterine cramps that occur during menstruation. The pain is caused by the onset of menstruation and lasts several hours to several days until it reaches the peak of pain. However, many people still do not know about the management of dysmenorrhea. This causes an increase in abdominal pain which often interferes with daily activities. Therefore, this review is structured to describe the various treatments for dysmenorrhea. The results of this review can be used as part of the education of patients who complain of dysmenorrhea and also as an innovation development in the field of reproductive health.

Manajemen Nyeri : Senam Dysmenorrhea Dan Abdominal Stretching Dengan Masalah Keperawatan Nyeri Akut Pada Remaja Menstruasi Di Desa Telukan

Menstruation is periodic vaginal bleeding due to the detachment of the uterine endometrial lining. Based on a preliminary study conducted, 16 of 22 adolescent girls in Telukan village with an age range of 13-20 years experienced moderate to severe menstrual pain. Dysmenorrhea can be overcome with dysmenorrhea exercise and abdominal stretching. The purpose of the study: to describe the management of dysmenorrhea and abdominal stretching exercises with menstrual pain in adolescent girls. The research design is a qualitative research, using a case study with a nursing process approach. The population of this research is adolescent girls who are menstruating in Telukan Village. The sampling technique is non-probability sampling with a purposive sampling approach. Inclusion criteria: adolescent girls aged 13-20 years, menstruating, experiencing menstrual pain on a scale of 4-6, never bleeding between menstruation after getting regular menstrual cycles. The results of the assessment of menstrual pain; holding pain, closing eyes while grimacing, holding stomach, duration of menstrual pain is approximately 15-20 minutes. Blood pressure were 110/70-120/80 mmHg, RR: 19-21 breaths per minute, N: 78-93 times per minute, S: 36.6-36.8°C. The nursing diagnosis is acute pain related to biological injury agents (menstruation). Nursing actions for dysmenorrhea and abdominal stretching were carried out for 3 times. General evaluation of dysmenorrhea and abdominal stretching exercises can reduce pain levels from a scale of 5-6 to 2-3. The results of the research on dysmenorrhea and abdominal stretching can reduce the scale of menstrual pain.

Prospective Association between Dysmenorrhea and Chronic Pain Development in Community-Dwelling Women

Despite emerging evidence of associations between dysmenorrhea, enhanced pain sensitivity, and functional neuroimaging patterns consistent with chronic pain, it is unknown whether dysmenorrhea is prospectively associated with chronic pain development. Gaining a better understanding of this relationship could inform efforts in prevention of chronic pain. Using data from the national Midlife in the United States cohort, we examined the prospective association between dysmenorrhea and chronic pain development during a 10-year follow-up (starting 10 years after dysmenorrhea was measured) among 874 community-dwelling women aged 25-74 at baseline (when dysmenorrhea was measured). We fit modified Poisson regression models adjusting for sociodemographic, lifestyle and psychosocial factors. Among women who were menstruating at baseline, self-reported dysmenorrhea was associated with a 41% greater (95% confidence interval [CI] = 6%-88%) risk of developing chronic pain. Women with dysmenorrhea also developed chronic pain in more body regions (≥3 regions vs 1-2 regions vs none, odds ratio [OR] = 1.77, 95% CI = 1.18-2.64) and experienced greater pain interference (high-interference vs low-interference vs none, OR = 1.73, 95% CI = 1.15-2.59). Among women who had stopped menstruation at baseline, we did not find evidence of an association between their history of dysmenorrhea and subsequent risk of chronic pain development. Results suggest dysmenorrhea may be a general risk factor for chronic pain development among menstruating women. PerspectiveThis study supports the temporality of dysmenorrhea and chronic pain development in a national female sample. Dysmenorrhea was also associated with developing more widespread and disabling pain among women who were still menstruating. Early management of dysmenorrhea may reduce the development and severity of chronic pain in women, although further research is required to determine whether dysmenorrhea is a causal risk factor or a risk marker of chronic pain.

Prevalence of dysmenorrhea, its association with overall academic engagement, and management among nursing undergraduates at Peradeniya University, Sri Lanka: A cross-sectional study

Background: Dysmenorrhea or painful menstrual periods is one of the common health issues the female university students experience which intervenes with academic activities and quality of life. Objectives: We aimed to find the prevalence, intensity, extent of impairment in academic engagement, and efficacy of the management of dysmenorrhea among nursing students at Peradeniya University, Sri Lanka. Methodology: This cross sectional study comprised 86 female nursing students who represented all four academic years. A self-administered questionnaire was used. The intensity and level of dysmenorrhea were assessed. Association of the extent of working impairment with the level of pain determined by Pearson correlation. Duration of dysmenorrhea persisted before and after management was compared using paired sample t-test. The effectiveness of management was analyzed using Wilcoxon signed-rank test. Results: The prevalence of dysmenorrhea was 97.7%. The majority (54.7%) suffered moderate pain. Mean age of the participants was 24.02 (±1.503). During the period of dysmenorrhea, 32.6%, 33.7%, and 17.4% students experienced slight, moderate, and heavy impairment of overall academic engagement. A positive correlation was observed between level of pain and extent of academic impairment ( p < 0.05). The majority practiced pharmacological and non-pharmacological pain relieving methods together. Wilcoxon signed-rank test value revealed more negative ranks and statistically significant reduction in intensity in post-management period ( z = −7.793, p = 0). Post-management dysmenorrhea duration was significantly reduced than pre-management ( t76 = 8.984, p = 0). Conclusion: A substantial percent of undergraduates suffer from dysmenorrhea. It is associated impairment of overall academic engagement. The nursing students were able to manage dysmenorrhea successfully.

It’s Not About Sex

In my early years as a women’s health nurse practitioner, the health maintenance organization director informed me that a member had filed a complaint about a routine visit that I had completed for a young woman who requested oral contraceptives for the management of dysmenorrhea. The patient’s mother was upset because the visit included a gynecologic examination. This was the late 1970s, and the standard of care for prescribing oral contraceptives included several blood tests, sexually transmitted infection (STI) screening, and a Pap test.

DYSMENORRHEA MANAGEMENT BY NON-MEDICAL FACULTIES STUDENTS OF UNIVERSITAS MUHAMMADIYAH SURAKARTA IN 2019

Objective: The aim of this study was to investigate the dysmenorrhea management by non-medical Faculties Students of Universitas MuhammadiyahSurakarta through self-medication.Methods: An observational study with cross-sectional design was conducted across 394 respondents at non-medical Faculties of UniversitasMuhammadiyah Surakarta. Respondents were selected by purposive sampling method. Data were obtained using questionnaire that filled out byrespondents.Results: Among the 394 respondents, 100% managed dysmenorrhea by non-pharmacological treatment (88.78%, 53.83%, and 42.35% weresleeping and taking a rest, eating nutritrious food, and compressing with warm water), whereas 160 (40.82%) respondents managed dysmenorrheaby taking medicines (70.62%, 16.88%, 11.25% and 1.25% were unidentified, over the counter, mandatory drug pharmacy [Obat Wajib Apotek], andprescription only medicine).Conclusion: Dysmenorrhea management among non-medical Faculties Students of Universitas Muhammadiyah frequently appropriate. The role ofpharmacists in providing information about medicine used by community was very important because many respondents do not know the names orbrands.

A Drug Release Mechanism Controlled by Hydrophobic/Hydrophilic Balance of the Matrix. Theoretical and Experimental Perspectives

Controlled drug release is a promising pathway of biomedicine, meant to suppress side effects with the aim of increasing patient s comfort. A route to achieve this goal represents the encapsulation of drugs into matrixes, capable to develop physical forces, which further can control the drugs release. To this purpose, mathematical modeling is an important tool, which offers the possibility to understand the drug release mechanisms and to further design new performant systems. In this paper, a theoretical model for drug release from an amphiphilic matrix is presented. This is achieved using a conservation multifractal law of probability density followed by validation of the model. Moreover, because non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac, are widely used in endometriosis as painkillers for dysmenorrhea management or Asherman syndrome for reducing the endometrial inflammation, some implications of our model for drug delivery systems applied in the field of gynecology have been discussed.

Assessment of the Effectiveness of Trigonella Foenum-Graecum (Fenugreek seeds) On Management of Dysmenorrhea among Late Adolescent Girls at Selected Villages, Tamil Nadu, Indi

Assessment of the Effectiveness of Trigonella Foenum-Graecum (Fenugreek seeds) On Management of Dysmenorrhea among Late Adolescent Girls at Selected Villages, Tamil Nadu, Indi

Conventional and Alternative Management of Dysmenorrhea – A Narrative Review

Introduction: Dysmenorrhea also known as painful menstruation is a public health problem with high prevalence among adolescents. It is defined as a severe, painful, cramping sensation within the lower abdomen occurring just before, during or few days after menstruation starts. Dysmenorrhea can negatively affect a woman's quality of life and interfere with daily activities. The two categories of dysmenorrhea are primary and secondary. Dysmenorrhea occurring in the absence of any pathological condition of the pelvis is known as primary dysmenorrhea while dysmenorrhea occurring in the presence of pathological condition of the pelvis is called secondary dysmenorrhea. Aim of review: The purpose of this review is to present a general overview of the types, epidemiology, diagnosis and available treatment options of both primary and secondary dysmenorrhea. Methods: PubMed, Google Scholar and Medline search engines (2000 to 2021) were used to conduct searches of relevant articles on dysmenorrhea. Citation lists of publications, including studies for randomized controlled trials (RCTs) and review articles were searched. Conclusion: Although prevalence is difficult to determine, dysmenorrhea may affect as high as 90% of menstruating women. Risk factors for dysmenorrhea may include smoking, early menarche, nulliparity, and family history. Analgesics and oral contraceptives are the mainstay of treatment for primary dysmenorrhea. Complementary and alternative treatments options such as herbal medicines, exercise and diet are also available. Addressing the underlying pathology of secondary dysmenorrhea is the main stay for its management.

Perception and Healthcare seeking practices regarding dysmenorrhea among public secondary school students in Lagos, Nigeria

Objectives: Dysmenorrhea is an important health problem which may have a negative impact on female health, school activities and psychological status. This study assessed the prevalence, knowledge, perception and healthcare seeking practices of dysmenorrhea among secondary school students in Lagos State, Nigeria. The pattern of management of dysmenorrhea among respondents was also assessed. Methods: A cross-sectional descriptive survey was conducted among 420 adolescents in public secondary schools in Ikeja Local government area of Lagos State, Nigeria. Respondents were interviewed using a structured pretested questionnaire. Data was analyzed with SPSS Version 22.0. The level of statistical significance was set at p≤0.05. Results: Mean ± SD age at menarche was 12.3±1.3 years. The prevalence of dysmenorrhea among respondents was 75.2%. About one-quarter 106(25.2%) had good knowledge and 209(49.8%) had good perception of dysmenorrhea. Only 10% had ever sought health care for dysmenorrhea. A statistically significant association was found between the knowledge of respondents and healthcare-seeking behavior towards dysmenorrhea (p = 0.004). Conclusion: The prevalence of dysmenorrhea was high and majority of respondents had poor knowledge. Improving adolescents’ knowledge of dysmenorrhea through health education could positively influence their health care-seeking behavior.

Prevalence and treatment patterns of dysmenorrhea among female medical students: a questionnaire based study at KIMS, Koppal

Background: Dysmenorrhea is a common gynaecological condition which causes physical pain, affects mental well-being and quality of life. The aim of the present study was to evaluate the prevalence, severity and the treatment patterns of primary dysmenorrhea among female medical students.Methods: The present study was a prospective, questionnaire based study conducted during March-April 2020 at KIMS, Koppal. The willing participants were given a time period of 30 minutes to fill the questionnaire.Results: Among the total of 211 female medical students, 180 students were suffering from dysmenorrhea. Almost 78.3% of those suffering from dysmenorrhea belonged to the age group of 19-21 years. Most of the students suffering from dysmenorrhea achieved menarche at the age of 13-14 years. A majority (48.8%) of the dysmenorrhic females had dysmenorrhea of mild degree. 73.8% of dysmenorrhic females did not seek any medical advice for the management of the symptoms of dysmenorrhea. 76 (42.2%) of the dysmenorrhic participant females missed their classes due to the symptoms of dysmenorrhea. The most favoured drug for the management of the symptoms of dysmenorrhea was the combination of mefenamic acid and dicyclomine (56.8%). 56.6% of the subjects utilized pharmacological measures, while the rest 43.3% utilized non-pharmacological measures for the relief from the symptoms of dysmenorrhea.Conclusions: The present study recognized that dysmenorrhea is a common menstrual disorder among young females. There should be an effort at mass education of the young females regarding the management of dysmenorrhea.

ASSESSMENT OF DYSMENORRHEA AND ITS ASSOCIATED FACTORS AMONG FEMALE MEDICAL STUDENTS OF ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA: AN INSTITUTION BASED CROSS SECTIONAL STUDY

ABSTRACT Background: Dysmenorrhea is one of the most common gynecologic complaints in young women who present to clinicians. It is a health burden for most women and key public health problem in the world. Dysmenorrhea affects the quality of life and daily activities of females in school. Despite the presence of different studies that assess its prevalence and associated factor among women in Ethiopia, there is sparse information in relation to medical students. This study tries to assess dysmenorrhea, its effects and associated factors among female medical students. Method: An institution-based cross-sectional study was employed to assess the prevalence of dysmenorrhea and its associated factors among female medical students of St Paul’s hospital millennium medical college. Using a single population formula with prevalence of 77.6%, 95% confidence level, ± 5% precision and 80% power for factors associated, sample size of 156 was calculated. With a simple random sampling data was collected with a pretested self-administered questioner. Data was entered and analyzed using SPSS version 23.0. Bivariate and Multivariable logistic regression was done and a P<0.05 was taken as statistically significant. Results: A total of 156 female medical students were included in the survey. The prevalence of dysmenorrhea was 79.5%. About one third (33.3%) of the participants reported that they have a family history of dysmenorrhea and experienced moderate type of pain (39.7%). Back pain (64.1%), Weakness (40.4%) and Loss of appetite (32.7%) are amongst the commonest symptoms associated with dysmenorrhea. More than half of the participants reported to be irritable (54.6%) and having decreased academic performance (50.6%). Students also reported having lack of concentration (42.9%) and poor appetite (41.7%). More than half of the respondents (58.3%) use home remedies as a primary management option. Heat (41%) and tea (41.7%) were the most used home remedies. More than half of the respondents (55.8%) reported to use over the counter drugs such as Ibuprofen and diclofenac. Alcohol consumption (AOR 95 % (CI) = 8.38 (1.078, 65.18), p=0.042) and longer menstrual cycle (AOR 95% (CI) =8.48 (1.087, 66.19), p=0.041) had statistically significant association with the occurrence of dysmenorrhea. Conclusion: The present study revealed that high proportion of female medical students experience dysmenorrhea. Decrease in academic performance was found to be the most common impact of dysmenorrhea. The majority of respondents used home remedies and over the counter medications for treatment. It is recommended to give due attention to female medical students and addressing their reproductive needs in relation to management of dysmenorrhea. Educating on effective management of dysmenorrhea with lifestyle modifications, seeking medical help and appropriate use of over the counter drugs is also recommended. Key words: Dysmenorrhea, menstrual cycle, over the counter drugs

Formulation and evaluation of capsules containing extracts of Cassia sieberiana for improved therapeutic outcome

In Ghana, the encapsulated blend of the powdered stem and root bark of Cassia sieberiana is prescribed and dispensed to patients at the Centre for Plant Medicine Research (CPMR), for the management of dysmenorrhea and gastric ulcer pain. This current formulation has significant challenges in manufacturing and optimization of therapeutic outcomes due to lack of standardization of actual quantities of the extracts obtained from ingestion of the product. The study sought to formulate and evaluate capsules of Cassia sieberiana using the stem and root bark. Extraction was undertaken with different solvents: absolute ethanol (F1) and 70% ethanol (F2). These 2 formulations were compared to the existing product (MP1) by CPMR. Granules for encapsulation were prepared by wet granulation and their flow properties compared with MP1. Drug-excipient compatibility was studied using FT-IR, TLC and UV. Quality control tests on MP1, F1 and F2 capsules were conducted using pharmacopoieal methods. From the results obtained, organoleptic and physicochemical properties of the extracts demonstrated its suitability for use in oral capsule formulation. MP1, F1 and F2 recorded a λmax of 278 nm, 278 nm and 276 nm, respectively. The extract per dose of capsules was found to be 27.84 ± 0.11 mg and 36.65 ± 0.03 mg for F1 and F2, respectively. Granules of F1 and F2 had good flow properties whereas MP1 demonstrated a fair flow property. FT-IR spectra showed possible interaction between extracts and excipients. However, TLC results indicated similar compounds present in the extracts and granules. The UV marker analysis also indicated no interaction since the percentage drug contents in F1 and F2 capsules were found to be 98.0% ± 1.40 and 98.90% ± 2.80 respectively. All 3 formulations passed the disintegration and uniformity of weight tests except MP1 which failed the latter. F1 capsules recorded the highest dissolution efficiency (99%) while MP1 recorded the lowest (22%). There was significant difference (p < 0.0001) in the release of Cassia sieberiana among the three formulations. This study has demonstrated the potential replacement of Cassia sieberiana capsules on the market with capsules developed from its extract with F1 capsules being the most desirable.

Primary Dysmenorrhea: Diagnosis and Therapy.

Primary dysmenorrhea is defined as pain during the menstrual cycle in the absence of an identifiable cause. It is one of the most common causes of pelvic pain in women. Dysmenorrhea can negatively affect a woman's quality of life and interfere with daily activities. The pathophysiology of primary dysmenorrhea is likely a result of the cyclooxygenase pathway producing increased prostanoids, particularly prostaglandins (PGs). The increased PGs cause uterine contractions that restrict blood flow and lead to the production of anaerobic metabolites that stimulate pain receptors. Women with a history typical for primary dysmenorrhea can initiate empiric treatment without additional testing. Shared decision making is key to effective management of dysmenorrhea to maximize patient compliance and satisfaction. After a discussion of their risks and benefits, extremely effective empiric therapies are nonsteroidal antiinflammatory drugs and contraceptive hormonal therapy. Other treatments for primary dysmenorrhea can be employed solely or in combination with other modalities, but the literature supporting their use is not as convincing. The physician should initiate an evaluation for secondary dysmenorrhea if the patient does not report improved symptomatology after being compliant with their medical regimen.

Comparative Study between Different Acupressure Points on Relieving severity of Primary Dysmenorrhea

Background: Dysmenorrhea constitutes one of the most frequent disorders in women of a fertile age. The objective of this research was to Comparative Study between Different Acupressure Points on Relieving severity of primary dysmenorrhea. Research Design : Prospective experimental design was utilized, Setting: at Faculty of Nursing, Benha University Sampling: convenience sample 120 females aged 18–25 years old who met the study criteria. were randomly assigned to one of two groups and evaluated during three menstrual cycles. Tools: four tools were used for data collection, first tool, was An interview questionnaire (a) Socio-demographic data (b)Menstrual history Second tool, Pain responses sheet, (a) Physiological responses to pain, (b) Behavioral responses to pain, Third tool, a modified version of Johansson pain-o-meter ,Fourth tool, a follow up chart. Results: main results of this study revealed that the severity of dysmenorrhea pain diminished significantly following treatment with acupressure at the SP6 and SP8 points (P < 0.001). Furthermore, Significant differences was observed between usage the SP6 and SP8 regarding the effect on physical condition and regarding the effective words (pain severity) which was reduced significantly further with SP6 point compared to SP8 point (*p<0.05).at the first day and second day Conclusion: Acupressure on SP6 had statistically significant effect than SP8 in female in age of 18-25 years old, suffered from primary dysmenorrhea. Recommendation: acupressure management especially on SP6 for dysmenorrea should be considered an integral part of nursing care, Mass media should be utilized for dissemination of simple, correct and relevant information about Acupressure management of dysmenorrhea, Studies to find out and assess effectiveness of acupressure on SP6 with another acupressure point..

Development and Testing of the Dysmenorrhea Symptom Interference (DSI) Scale.

Dysmenorrhea affects most reproductive-age women and increases the risk of future pain. To evaluate dysmenorrhea interventions, validated outcome measures are needed. In this two-phase study, we developed and tested the dysmenorrhea symptom interference scale. During the scale-development phase (n = 30), we created a nine-item scale based on qualitative data from cognitive interviews. During the scale-testing phase (n = 686), we evaluated reliability, validity, and responsiveness to change. The scale measures how dysmenorrhea symptoms interfere with physical, mental, and social activities. Internal consistency was strong with Cronbach's α > 0.9. Test-retest reliability was acceptable (r = 0.8). The scale showed satisfactory content validity, construct validity (supported by confirmatory factor analysis), concurrent validity, and responsiveness to change. The minimally important difference was 0.3 points on a scale with a possible total score ranging from 1 to 5. This new psychometrically sound scale can be used in research and clinical practice to facilitate the measurement and management of dysmenorrhea.