Menstrual Distress Questionnaire Scores Research Articles

Changes in menstrual symptoms and work productivity after checklist-based education for premenstrual syndrome: an 8-month follow-up of a single-arm study in Japan.

Premenstrual syndrome (PMS) is prevalent among women of reproductive age, but most do not seek medical advice. We hypothesized that building PMS awareness could promote medical help-seeking for PMS and thus reduce menstrual symptoms and improve work productivity. In January 2020, women aged between 25 and 44years, having paid work, and not currently consulting with an obstetrics and gynecology doctor (n = 3090) responded to the Menstrual Distress Questionnaire (MDQ), the Premenstrual Symptoms screening tool, and the World Health Organisation Health and Work Performance Questionnaire. In addition, they received checklist-based online education for PMS. Of 3090 participants, 2487 (80.5%) participated in a follow-up survey in September 2020. We conducted multiple logistic regression analyses and text analyses to explore factors that encouraged and discouraged medical help-seeking. We also evaluated changes in menstrual symptoms and work productivity, using generalized estimating equations with interactions between the severity of PMS, help-seeking, and time. During the follow-up period, 4.9% of the participants (121/2487) sought medical help. Those having high annual income (adjusted odds ratio [aOR] = 2.07, 95% confidence interval [CI]: 1.21-3.53) and moderate-to-severe PMS (aOR = 2.27, 95% CI: 1.49-3.46) were more likely to have sought medical help. Those who did not seek medical help despite their moderate-to-severe PMS reported normalization of their symptoms (36%), time constraints (33%), and other reasons for not seeking medical help. Participants with moderate-to-severe PMS who had sought medical help showed a significant improvement of - 8.44 points (95% CI: - 14.73 to - 2.15 points) in intermenstrual MDQ scores during the follow-up period. However, there were no significant improvements in premenstrual and menstrual MDQ scores or absolute presenteeism. Medical help-seeking alleviated intermenstrual symptoms in women with moderate-to-severe PMS, but only a small proportion of them sought medical help after PMS education. Further research should be conducted to benefit the majority of women who are reluctant to seek medical help, including the provision of self-care information. UMIN Clinical Trials Registry number: UMIN000038917.

The Changes in Menstrual and Menstrual-Related Symptoms among Japanese Female University Students: A Prospective Cohort Study from Three Months to Nine Months after Admission.

Menstrual and menstrual-related symptoms can significantly impact an individual's physical and psychological health. Understanding how these symptoms evolve over time is crucial to provide appropriate support and healthcare services to young women. This study aimed to investigate changes in menstrual and menstrual-related symptoms among first-year female university students. A prospective longitudinal design was used to compare the symptom profiles between two time points (three and nine months after admission). Out of 100 female university students, 30 responses were analyzed. Data on menstrual and menstrual-related symptoms were collected using standardized questionnaires focusing on menstrual status and the Menstrual Distress Questionnaire (MDQ); no notable changes occurred between the time points. Approximately half reported having irregular menstruation during the three time periods. Among the sub-scales, premenstrual "impaired concentration" showed a tendency to be lower, whereas menstrual "water retention" tended to be higher in timepoint 2 compared to timepoint 1. "Distractible" was found to be significantly lower in timepoint 2 compared to timepoint 1. There was a significant association between a sleep duration of <7 h and worsened MDQ scores. These findings may underscore the importance of providing comprehensive lifestyle and menstrual education to new university students, along with access to appropriate medical care.

The menstrual distress questionnaire (MEDI-Q): reliability and validity of the English version

Background Menstrual cycle has a significant impact on women’s health from different perspectives, both physically and psychologically. The assessment of menstrual-related distress is of pivotal clinical interest, especially in women with chronic exposure to abnormal bleeding or pain. The Menstrual Distress Questionnaire (MEDI-Q) is a new tool originally developed in Italian that comprehensively evaluates menstrual-related distress. Objective To validate the English version of the MEDI-Q in an English-speaking population. Methods The study consisted of two phases: an initial translation phase of the original Italian version of the MEDI-Q, and a data collection phase to validate the new English version among 288 native English-speaking women. Results The English version of MEDI-Q showed excellent psychometric properties, with high internal consistency (Cronbach’s alpha = 0.84) and test-retest reliability (intraclass correlation coefficient = 0.95). Construct validity was supported by significant correlations between MEDI-Q scores and scores on measures of psychological distress and premenstrual symptoms. Conclusions The English version of the MEDI-Q is a valid and reliable instrument for the assessment of menstrual distress and its impact on psychological well-being. This tool can be utilized in research and clinical settings to comprehensively investigate the impact of menstruation on various populations, identify and monitor menstruation-related disorders promptly and effectively, and to evaluate the effectiveness of targeted treatments for menstrual distress.

Quality of Life in Japanese Patients with Dysmenorrhea or Endometriosis-Associated Pelvic Pain Treated with Extended Regimen Ethinylestradiol/Drospirenone in a Real-World Setting: A Prospective Observational Study.

IntroductionDysmenorrhea and endometriosis are common gynecologic disorders among women of reproductive age that significantly impact health-related quality of life (HRQL) as well as productivity. Although there are treatment options listed in Japanese guidelines, a gap remains in unmet medical needs for maximizing treatment outcome. The extended regimen of ethinylestradiol and drospirenone (EE/DRSP) (taken daily for up to 120 consecutive days) has been available in Japan for treating dysmenorrhea and/or endometriosis-associated pain since 2016. Yet, the effectiveness of its usage on HRQL has not been investigated elsewhere to date. Therefore, in this study, we aim to observe changes in HRQL of Japanese women treated with an extended regimen of EE/DRSP for dysmenorrhea and/or endometriosis-associated pain.MethodsAs part of a 2-year post-marketing surveillance study, women with dysmenorrhea or endometriosis-associated pelvic pain were prescribed extended EE/DRSP during routine clinical practice. Data were collected 1 month before and 3 and 6 months after initiating treatment. Primary outcomes were the Menstrual Distress Questionnaire (MDQ) (before, during, and after menstruation) in patients with dysmenorrhea, and the Endometriosis Impact Scale (EIS) and European Quality of Life 5-dimensions 5-level instrument (EQ-5D-5L) in patients with endometriosis.ResultsThe study cohort included 315 patients (mean age 28.9 years) with dysmenorrhea and 262 patients (mean age 31.3 years) with endometriosis. Mean MDQ total scores before and during menstruation decreased significantly after 6 months with extended EE/DRSP; there was no improvement in after-menstruation MDQ score. Mean EIS domain scores improved significantly by 6 months, with improvement in most EIS individual item scores. Mean EQ-5D-5L scores increased slightly during 6 months of treatment.ConclusionsExtended EE/DRSP treatment improved HRQL outcomes in Japanese women with dysmenorrhea or endometriosis-associated pelvic pain.Trial RegistrationRegistered at ClinicalTrials.gov (NCT03126747) on June 2017.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-022-02301-3.

The Relationship Between Menstruation-related Symptoms And Oxidative Stress In Young Women

The symptoms associated with menstruation affect the daily lives of many premenopausal women. These symptoms are classified into two categories: premenstrual symptoms which occur during the luteal phase, and menstrual symptoms which occur during the menstrual period. Recently, oxidative stress has been shown to be associated with various gynecological diseases, but the relationship between oxidative stress and menstrual symptoms is unclear. PURPOSE: To examine the relationship between menstruation-related symptoms and oxidative stress levels in young women. METHODS: Sixteen female college students completed a menstrual distress questionnaire (MDQ)for a menstrual cycle. A blood sample was taken at four points during one menstrual cycle: menstrual period (day 2.4 ± 1.0), follicular phase (day 9.2 ± 1.0), early luteal phase (day 16.2 ± 0.9) and late luteal phase (day 22.8 ± 0.8). All participants have a regular menstrual cycle and have never taken oral contraceptives. We measured plasma reactive oxygen metabolites (Reactive Oxygen Metabolites-derived compounds: d-ROMs) and antioxidant capacity (Biological Antioxidant Potential: BAP). RESULTS: MDQ scores were highest during the menstrual period, decreased during the follicular and early luteal phases, and increased slightly during the late luteal phase (menstrual period: 31.1 ± 20.1 vs. early luteal phase: 16.4 ± 15.7, p < 0.05). The highest d-ROMs levels were observed during the menstrual period, followed by a gradual decrease during the follicular, early luteal, and late luteal phases (menstrual period: 322.2 ± 49.2 U.CARR vs. early luteal phase: 300.3 ± 32.5 U.CARR p < 0.05). The BAP level did not change during the menstrual cycle. The pain score in the MDQ was significantly higher in the menstrual period than in the early luteal phase, and its rate of change showed a weak positive association with the rate of change in d-ROMs (r = 0.30, NS). CONCLUSIONS: Pain of menstruation-related symptoms was observed to be possibly related to changes in oxidative stress in individuals. In healthy female college students, oxidative stress was the highest during the menstrual period, but the degree of oxidative stress was mild. Further studies are needed in women with severe menstruation-related symptoms, irregular menstrual cycles, and high oxidative stress status.

Quality of Life of Japanese Dysmenorrhea/Heavy Menstrual Bleeding Patients Treated with Levonorgestrel Intrauterine Delivery System in a Real-World Setting.

IntroductionThe present study collected 1-year follow-up patient-reported outcome data from Japanese women with dysmenorrhea and/or heavy menstrual bleeding (HMB) who underwent insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) 52 mg. We aimed to evaluate the quality of life (QOL) of Japanese women over the course of the investigational period.MethodsThis was a multicenter, non-interventional, prospective, single-cohort, post-marketing surveillance study (J-MIRAI). The primary outcome was the median change in the Menstrual Distress Questionnaire (MDQ) and Menorrhagia Multi-Attribute Scale (MMAS) scores from baseline to 3 and 12 months after LNG-IUS insertion, with decreasing and increasing scores, respectively, indicating improvement. The secondary outcomes were the statistical relationships between the MDQ and menstrual pain (measured by a visual analog scale, VAS), and between the MMAS and pictorial blood loss assessment chart (PBAC) scores by regression analysis.ResultsIn total, 593 patients were evaluated; 376, 467, and 250 patients were diagnosed with dysmenorrhea, HMB, or both, respectively. The median MDQ score decreased significantly at 3 and 12 months after LNG-IUS insertion in both the premenstrual and menstrual periods (both p < 0.001 vs baseline), and the median MMAS score showed a similar improvement during the menstrual period. Changes in median MDQ and MMAS scores were observed regardless of patient background. Correlations between MDQ and menstrual pain (VAS) and between MMAS and PBAC scores were found (estimated regression coefficients 0.29 and − 0.15, respectively).ConclusionThe LNG-IUS contributed to improvements in the QOL of patients with dysmenorrhea, HMB, and both, regardless of patient background characteristics.Trial RegistrationRegistered at ClinicalTrials.gov (NCT02475356) on 18 June 2015.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-022-02205-2.

Weight Class and Menstrual Symptoms in Female Judo Athletes

Background: Menstrual cycle and menstrual symptoms can affect the physical, mental and exercise performance of female athletes. Objectives: This study aimed to determine the associated symptoms of premenstrual, menstrual, and postmenstrual periods in female judo athletes by weight class. Methods: The participants were 169 female judo athletes aged between 18 and 21 years (age 19.5 ± 1.1 years, height 1.6 ± 0.1 m, body mass 64.8 ± 12.1 kg). Weight class and physical characteristics were measured using a questionnaire. Associated menstrual symptoms were measured using the Menstrual Distress Questionnaire (MDQ). For the purposes of this study, athletes of &lt; 48 kg, &lt; 52 kg, and &lt; 57 kg weight were defined as “lightweight,” athletes of &lt; 63 kg and &lt; 70 kg as “medium weight,” and athletes of &lt; 78 kg and &gt; 78 kg as “heavyweight.” Results: In the postmenstrual MDQ score, the scores for “lack of autonomic nervous system coordination” (P = 0.037), “poor concentration” (P = 0.046) and “water conservation” (P = 0.030) were higher in the lightweight ranks than in the medium and heavyweight ranks (P &lt; 0.05). Scores for negative postmenstrual effects tended to be higher in the lightweight ranks than in the medium and heavy weight ranks (P = 0.053). For other items, there were no significant differences between the medium and heavy weight ranks and the lightweight ranks before, during, or after menstruation. Conclusions: This study shows that the degree of postmenstrual symptoms in female judo athletes varies with weight class. These results will contribute to support the condition of female judo athletes based on their menstrual cycle by weight class.

The relationship between the severity of perimenstrual symptoms and a regular exercise habit in Japanese young women: a cross-sectional online survey

BackgroundExperiencing perimenstrual symptoms is a major health concern for young women. Women in the reproductive age experience menstruation about once a month, and many experience perimenstrual symptoms. Drug therapies such as painkillers (commonly used) and hormonal medications help to achieve symptomatic relief from perimenstrual symptoms. However, many women are concerned about tolerance and compliance of the drugs used to treat perimenstrual symptoms and lack awareness on how to cope with perimenstrual symptoms. If the association between exercise habits and the severity of symptoms is emphasized in young women, methods for coping with perimenstrual symptoms can be established, not relying only on pharmaceuticals. The objective of this study was to determine the differences in the severity of perimenstrual symptoms in young Japanese women with and without a regular exercise habit.MethodsA cross-sectional study using an online survey was sent among 500 Japanese women aged 18–25 years. The severity of perimenstrual symptoms was assessed using the Menstrual Distress Questionnaire (MDQ). The differences in MDQ scores between those with and without exercise habits (exercise for more than 30 min for 2 days a week) were compared using the chi-square test and Mann–Whitney U test. The logistic regression analysis detected subscales of the premenstrual and menstrual symptoms affected by an exercise habit.Results282 (56.4%) young Japanese women were answered this survey. Respondents were divided into the exercise group (n = 157) and the non-exercise group (n = 125). The exercise group had significantly low premenstrual and menstrual MDQ scores. The results of the logistic regression analysis stated that the subscale related to negative emotion before menstruation was associated with an exercise habit. In the analysis performed during menstruation, a statistically significant association was detected between an exercise habit and a behavioral change such as avoiding interaction with others.ConclusionsThis study suggested that exercise habits may reduce the severity of perimenstrual symptoms and could help to develop a non-pharmacological coping strategy. In addition, this study provides useful information for young women who want to prevent perimenstrual symptoms but do not have an exercise habit. Further, it may encourage young women to start exercising.

Comparison of Menstruation-Related Symptoms Before and During Menstruation of University Students in Japan, a Year after the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic affected the daily lifestyle of people, including many aspects affecting young women. Subsequent to the COVID-19 pandemic stress and anxiety have been reported related to menstrual disorders (Takmaz, Gundogmus, Okten, &amp;amp; Gunduz, 2021). The purpose of this study was to investigate the intensity and to compare menstruation-related symptoms before and during menstruation among university students in Japan. We conducted an online cross-sectional study from May to July 2021 using a menstrual distress questionnaire (MDQ) to assess symptoms experienced before and during menstruation. Our results showed that of 141 students, five students (3.5%) did not report any symptoms before menstruation and one student (0.7%) had no symptoms during menstruation. We found that the most frequently experienced symptoms before menstruation were skin blemishes or disorder, mood swings, irritability, swelling, cramps, fatigue, take naps, stay in bed, feeling sad or blue, weight gain and difficulty concentrating. The most frequently experienced symptoms during menstruation were cramps, fatigue, irritability, mood swings, take naps, stay in bed, feeling sad or blue, backache, swelling, skin blemish or disorder, and poor school/work performance. The total MDQ score was significantly higher during menstruation than before menstruation. Among the MDQ eight scales, the scores of five scales including pain, autonomic reaction, impaired concentration, behavior change, and control were significantly higher during menstruation than before menstruation. The prevalence of increased appetite and craving for sweets were higher than MDQ symptoms before menstruation. The prolonged exposure to pandemic may have more effect on psychological symptoms than on physical symptoms.

EFFECT OF KARATE EXERCISES ON IRREGULAR MENSTRUAL CYCLES IN COLLEGE GOING GIRLS- A PRE AND POST EXPERIMENTAL STUDY

Studies which are done worldwide, have stated that 74% of adult women suffer from irregular menstrual cycles and other associated symptoms. They have also found that there is association between quality of life and irregular menstrual cycles and distress related to menstrual irregularities. This study was a pre and post experimental study, where 45 college going girls were screened for irregular menstrual cycles, followed by that, demographic details were taken and pre intervention BMI was calculated and menstrual distress questionnaire scores were analyzed. The Karate exercises included, 15 minutes of Running, 15 minutes of 100 punches, 100 kicks for 15 minutes, 15 minutes of Karate techniques and 10 minutes of Katas and 5 minutes of cool down exercises and breathing exercises. The results of pre and post interventions showed that the Karate exercises were effective on irregular menstrual cycles along with decrease in BMI levels and menstrual distress questionnaire scores including domains. Based on the results, the study can be concluded that, the Karate exercises are effective on irregular menstrual cycles along with reduction in BMI levels and menstrual distress questionnaire scores. In addition it showed the improvement in pain, negative thoughts, concentration related to menstrual irregularities. The study found that the karate exercises are mostly effective on menstrual distress than BMI levels.

Correlation of Menstrual Distress to the Severity of Gastrointestinal Symptoms in Inflammatory Bowel Disease Patients

Introduction: The pathogenesis of inflammatory bowel disease (IBD) remains unclear to date. Although numerous risk factors have been identified, the disease is thought to be multifactorial in origin. It is suggested that varying ovarian hormone levels, estrogen and progesterone withdrawal may contribute to the exaggerated gastrointestinal (GI) symptoms in IBD. Furthermore, women with IBD on hormonal contraception (HC) were also observed to have improvement in cyclical menstrual-related IBD symptoms. Aim: To determine the relationship between GI symptoms and the menstrual cycle among females with IBD in a questionnaire based cross-sectional study. Methods: 60 women of child-bearing age (18-45 years) seen at our IBD clinic completed a questionnaire incorporating the Harvey Bradshaw index (HBI) for Crohn's disease (CD) or ulcerative colitis activity index (UCAI) for ulcerative colitis (UC), and the short IBD questionnaire (SIBDQ) with Menstrual Distress Questionnaire (MDQ). Higher HBI, UCAI and MDQ scores are reflective of greater symptom severity. Higher SIBDQ scores correlate with better quality of life. Scores were evaluated for linear associations using the Pearson correlation coefficients. Women on HC, status post hysterectomy/oophorectomy, and pregnant women were excluded.Figure: Correlation between MDQ scores and SIBDQ scores in the sample population.Results: Of the 60 patients, 48 had CD and 12 had UC with mean age of 29±7 years standard deviation (SD); 36(60%) were on anti-TNF therapy. There was a negative correlation between MDQ scores and SIBDQ scores (r = -0.46). We noted a weak positive relationship between MDQ and the Harvey Bradshaw Index score (r = +0.15). There was a higher negative correlation of MDQ scores and SIBDQ scores among patients under 35 years of age (r= -0.46) in comparison to those older than 35 (r= -0.39). Furthermore, patients on anti tumor necrosis factor (TNF) therapies had lower correlation of MDQ scores with higher SIBDQ scores compared to those on other therapies (r = -0.42 vs -0.52) suggesting improved disease control. All p values were less than 0.0001. Conclusion: Severity of GI symptoms in women with IBD are correlated to severity of menstrual symptoms. Understanding changes in GI symptomatology during the menstrual cycle may help determine appropriate management strategies. Further studies are necessary to evaluate adjusting medication doses closer to menses (i.e timing medications during this time to provide higher drug levels or adding symptomatic therapy such as anti-diarrheals in anticipation of symptoms).Figure: Correlation between MDQ scores & SIBDQ scores in patients on anti TNF therapy Vs patients on other therapy.

Effects of Stretching and Sling Exercise on Pelvic Correction and Dysmenorrhea in University Students

Background/Objectives: The purpose of this study was to investigate the effects of stretching and sling exercises on pelvic correction and dysmenorrhea in university students. Methods/Statistical Analysis: The subjects were divided into three groups: sling exercise group, stretching group, and control group. All groups performed each exercise for 40 minutes three times a week for 4 weeks. The control group received thermotherapy. All groups were measured for pelvic alignment, Visual Analog Scale(VAS) and Menstrual Distress Questionnaire(MDQ). Repeated measures ANOVA were used to verify differences between groups and assessment times with respect to pelvic alignment, VAS and MDQ. Findings: Comparisons of all three groups before and after the intervention revealed significant differences in the VAS and MDQ scores. The post-intervention decreases in the VAS scores of the stretching group were more significant than those of the control group. Comparisons of pelvic alignment before and after the intervention in each group indicated that sling exercise significantly decreased sagittal imbalance, coronal imbalance, pelvic inclination, and pelvic torsion. In addition, stretching significantly decreased sagittal imbalance, coronal imbalance, pelvic inclination, pelvic torsion, and pelvic obliquity. The control group, however, did not demonstrate decreases in any of the variables, with the exception of coronal imbalance. In the stretching group, in particular, post-intervention pelvic inclination was more significantly decreased than that of the control group. Improvements/Applications: Sling and stretching exercises improve pelvic alignment, painful menstruation and dysmenorrhea. These exercises can be used as the data for various directions of interventions to alleviate or prevent dysmenorrhea.

Association of menstrual phase with smoking behavior, mood and menstrual phase-associated symptoms among young Japanese women smokers

BackgroundPrevious studies of the relationship between the menstrual phases and smoking behavior have been problematic, so the association of menstrual phases with smoking behavior and correlations among smoking, psychological and physical conditions in each phase of the menstrual cycle are unclear.MethodsTo accurately examine the association between menstrual phases and the amount of smoking (number of cigarettes smoked and breath CO concentration), craving of smoking on visual analogue scale (VAS), depression in the Center for Epidemiologic Studies Depression (CES-D) Scale, and menstrual phase-associated symptoms in the Menstrual Distress Questionnaire (MDQ), we improved various methodological issues, specifically, 1) Ovulation was confirmed by measuring the basal body temperature and identifying a urinary luteinizing hormone (LH) surge in two cycles; 2) The menstrual, follicular, and luteal phases were clearly defined for subjects with different menstrual cycles; 3) The breath CO concentration was measured every day. A notice was posted on public bulletin boards to recruit research subjects and twenty-nine young Japanese women smokers aged 19 to 25 years old were analyzed.ResultsThe number of cigarettes smoked was greater and the CO concentration was higher in the luteal phase than in the follicular phase. The levels of craving for smoking (VAS), depressiveness (CES-D), and menstrual phase-associated symptoms (MDQ) in the menstrual and luteal phases were higher than those in the follicular phase. The mean score for CES-D was 16 points (the cut-off value in screening for depression) or higher in the menstrual (16.9 ± 8.2) and luteal phases (17.2 ± 8.4).The number of cigarettes smoked and CO concentration were significantly correlated with the levels of craving for smoking, depressiveness, and menstrual phase-associated symptoms in all phases except for MDQ scores in follicular phase. The amount of smoking in the luteal phase was most strongly correlated with these symptoms.ConclusionsIn the menstrual and luteal phases, young Japanese women smokers increased their amount of smoking and suffered from greater craving for smoking, depressiveness and menstrual phase-associated symptoms. The amount of smoking was correlated with these symptoms, but their cause-effect relationship has not been determined yet.

Effect of Heated Red Bean Pillow Application for College Women with Dysmenorrhea.

Dysmenorrhea is a menstrual condition characterized by severe and frequent cramps and pain. Effective treatment methods for dysmenorrhea are not yet fully understood. This research compares the effects of pain killers and heated red bean pillows. Data were got on demographic data, menstrual cycle status, and activities of daily living (ADLs) limitations, dysmenorrhea severity and menstrual pain scores. Following a 10% drop-out rate, 44 young women satisfied the inclusion criteria. To prevent any bias, the experimental and control groups were selected from different campuses. We used two sizes of red bean pillows: 15x18 cm, weighing 400g; and 13x11.5 cm, weighing 220g. For analysis, we used IBM SPSS statistics 19.0. Ninety-nine point seven percentage of total subjects reported moderate to severe dysmenorrhea and 63.6% reported as moderate to severe daily activities limitations. The mean pain score with visual analogue scale was 80.2+/-9.42 of 100 and 86.4% used pain killers to alleviate menstrual discomfort in all the subjects. In both groups, all three variables showed significant improvement and the Moos's Menstrual Distress Questionnaire (MDQ) scores changed significantly between menstrual and post-menstrual time point at within groups and not significantly different at premenstrual and menstrual time point at between groups. However, the MDQ score was significantly higher in experimental group than control group at post-menstruation time point and the degree of satisfaction was higher in the control group. This research shows that red-bean pillows on the abdomen are effective in assisting the ADL and diminishing pain severity. With regard to its safety the study indicates it can be a convenient and safe option for female students with menstrual discomfort in schoolas a non-pharmacological self-help.

Auricular acupressure combined with an internet-based intervention or alone for primary dysmenorrhea: a control study.

Background. Primary dysmenorrhea is prevalent in adolescents and young women. Menstrual pain and distress causes poor school performance and physiological damage. Auricular acupressure can be used to treat these symptoms, and Internet-based systems are a flexible way of communicating and delivering the relevant information. Objective. This study investigates the effects of auricular acupressure (AA) alone and combined with an interactive Internet-based (II) intervention for the management of menstrual pain and self-care of adolescents with primary dysmenorrhea. Design. This study adopts a pretest/posttest control research design with a convenience sample of 107 participants. Results. The outcomes were measured using the short-form McGill pain questionnaire (SF-MPQ), visual analogue scale (VAS), menstrual distress questionnaire (MDQ), and adolescent dysmenorrheic self-care scale (ADSCS). Significant differences were found in ADSCS scores between the groups, and in SF-MPQ, VAS, MDQ, and ADSCS scores for each group. Conclusion. Auricular acupressure alone and a combination of auricular acupressure and interactive Internet both reduced menstrual pain and distress for primary dysmenorrhea. Auricular acupressure combined with interactive Internet instruction is better than auricular acupuncture alone in improving self-care behaviors.

Altered autonomic nervous system activity evaluated by heart rate variability among women with severe premenstrual emotional distress

OBJECTIVE: Premenstrual syndrome (PMS) describes a range of physical, emotional, and behavioral symptoms occurring during the luteal phase. Although PMS is widely recognized, research has not yet clarified its etiopathogenesis. This study investigated whether autonomic nervous system (ANS) activity—a vital player in orchestrating human homeostasis—changed during the menstrual cycle of women with PMS. We also evaluated personality traits as possible agents affecting susceptibility to PMS.DESIGN: A within- and between-subjects study.MATERIALS AND METHODS: This study involved 71 women with regular menstrual cycles. We examined all subjects during the follicular and luteal phases and assessed resting ANS activity by heart rate variability (HRV) power spectral analysis. The Menstrual Distress Questionnaire (MDQ) evaluated subjects' menstrual cycle symptoms. We administered the Yatabe-Guilford Test and the Alexithymia Scale to assess subjects' personality traits and divided subjects into either Control or PMS group, depending on severity of symptoms.RESULTS: Total MDQ scores increased by 67.6% from the follicular to the luteal phase in the PMS group. Psychological factors (negative affection, behavioral change, and concentration) revealed the most remarkable changes between menstrual phases. Total power and high-frequency power—reflecting overall autonomic and parasympathetic nerve activity, respectively—markedly decreased regardless of menstrual cycle in the PMS group compared to the Control group. None of the subjects expressed the alexithymic trait; the PMS group showed other traits, such as cyclic tendency, lack of cooperativeness, and aggressiveness.CONCLUSIONS: This study suggests decreased ANS activity regardless of menstrual cycle in women with severe premenstrual emotional distress. The study also implies that specific psychosocial features may induce unfavorable mind-body interaction, especially premenstrually. OBJECTIVE: Premenstrual syndrome (PMS) describes a range of physical, emotional, and behavioral symptoms occurring during the luteal phase. Although PMS is widely recognized, research has not yet clarified its etiopathogenesis. This study investigated whether autonomic nervous system (ANS) activity—a vital player in orchestrating human homeostasis—changed during the menstrual cycle of women with PMS. We also evaluated personality traits as possible agents affecting susceptibility to PMS. DESIGN: A within- and between-subjects study. MATERIALS AND METHODS: This study involved 71 women with regular menstrual cycles. We examined all subjects during the follicular and luteal phases and assessed resting ANS activity by heart rate variability (HRV) power spectral analysis. The Menstrual Distress Questionnaire (MDQ) evaluated subjects' menstrual cycle symptoms. We administered the Yatabe-Guilford Test and the Alexithymia Scale to assess subjects' personality traits and divided subjects into either Control or PMS group, depending on severity of symptoms. RESULTS: Total MDQ scores increased by 67.6% from the follicular to the luteal phase in the PMS group. Psychological factors (negative affection, behavioral change, and concentration) revealed the most remarkable changes between menstrual phases. Total power and high-frequency power—reflecting overall autonomic and parasympathetic nerve activity, respectively—markedly decreased regardless of menstrual cycle in the PMS group compared to the Control group. None of the subjects expressed the alexithymic trait; the PMS group showed other traits, such as cyclic tendency, lack of cooperativeness, and aggressiveness. CONCLUSIONS: This study suggests decreased ANS activity regardless of menstrual cycle in women with severe premenstrual emotional distress. The study also implies that specific psychosocial features may induce unfavorable mind-body interaction, especially premenstrually.

THE EFFECTS OF MENSTRUAL CYCLE ON THE TASK PERFORMANCE USING A BODY WARMER FOR THE PALLIATION OF MENSTRUAL ASSOCIATED SYMPTOMS

The task performance and a questionnaire survey using the modified MDQ (Menstrual Distress Questionnaire) were examined for phases of the menstrual cycle. The lower abdomen was warmed using a body warmer to palliate menstrual associated symptoms. The effect of palliation using this folk remedy on the task performance was examined. The experimental tasks consisted of clicking on randomly displayed targets and a single tracking task. The task performance and MDQ score were measured as measurement indices. As the results, the precision of task during menstruation was lower than during the follicular phase. There were many complaints regarding menstrual associated symptoms during menstruation. The palliation treatment did not relieve the negative symptoms experienced by the subjects.

Primary dysmenorrhea treatment with a desogestrel-containing low-dose oral contraceptive

This randomized, double-blind, placebo-controlled exploratory study examined the efficacy and safety of a low-dose oral contraceptive (Mircette®), desogestrel/ethinyl estradiol [DSG/EE] and ethinyl estradiol [EE]) in relieving the symptoms of dysmenorrhea. Twenty-three clinics in the United States enrolled 77 women (age ≤32 years) with primary dysmenorrhea documented for at least four consecutive cycles. Forty participants received DSG/EE&EE and 37 received placebo for four consecutive 28-day cycles. The intensity of menstrual-related distress was measured with the Menstrual Distress Questionnaire (MDQ). Patient diaries were used to assess number of school/work days missed as well as the use of rescue medication. Participants receiving DSG/EE&EE recorded reduced menstrual pain severity, lower total MDQ scores, and significantly less menstrual cramping. No significant change in bloating, anxiety, loneliness, weight gain, or acne was reported. The DSG/EE&EE formulation shows promise for the treatment of primary dysmenorrhea and was well tolerated by the participants in this study.

Changes in nociceptive flexion reflex threshold across the menstrual cycle in healthy women.

We assessed the influence of changes in steroid hormones across the menstrual cycle on the spinal nociceptive reflex. We studied in 14 healthy women during the follicular and luteal phase the nociceptive flexion reflex (RIII reflex), an objective neurophysiological method that allows exploring possible abnormal functioning of the pain-control system. The basal body temperature (BBT) was used to evaluate the different phases of the ovarian cycle. The menstrual distress questionnaire (MDQ) was also applied for monitoring somatic and psychological symptoms during the cycle. During the luteal phase, the threshold of the RIII reflex (Tr) and the psychophysical threshold for pain (Tp) were both significantly reduced compared with the follicular phase. Moreover, the reflex threshold in the luteal phase was negatively correlated to the total MDQ score of the recording day. A higher sensitivity to pain stimuli was observed during the luteal phase of the menstrual cycle, which probably results from a reduction in the inhibitory descending control on spinal nociceptive flexion reflex. Complex neuromodulatory interactions of ovarian steroids with other systems of neurotransmission (especially serotonergic) may account for these observations.

Changes in Nociceptive Flexion Reflex Threshold Across the Menstrual Cycle in Healthy Women

Objective We assessed the influence of changes in steroid hormones across the menstrual cycle on the spinal nociceptive reflex. Method We studied in 14 healthy women during the follicular and luteal phase the nociceptive flexion reflex (RIII reflex), an objective neurophysiological method that allows exploring possible abnormal functioning of the pain-control system. The basal body temperature (BBT) was used to evaluate the different phases of the ovarian cycle. The menstrual distress questionnaire (MDQ) was also applied for monitoring somatic and psychological symptoms during the cycle. Results During the luteal phase, the threshold of the RIII reflex (Tr) and the psychophysical threshold for pain (Tp) were both significantly reduced compared with the follicular phase. Moreover, the reflex threshold in the luteal phase was negatively correlated to the total MDQ score of the recording day. Conclusions A higher sensitivity to pain stimuli was observed during the luteal phase of the menstrual cycle, which probably results from a reduction in the inhibitory descending control on spinal nociceptive flexion reflex. Complex neuromodulatory interactions of ovarian steroids with other systems of neurotransmission (especially serotonergic) may account for these observations.