Menstruation-related Symptoms Research Articles

Association between Menstruation-Related Symptoms and the Type of Stress in Japanese Female University Students: A Prospective Cohort Study from Admission to the Second Year

Association between Menstruation-Related Symptoms and the Type of Stress in Japanese Female University Students: A Prospective Cohort Study from Admission to the Second Year

Fluctuation of fine motor skills throughout the menstrual cycle in women

The effect of the menstrual cycle on fine motor skills is unclear. This study determined whether the menstrual cycle affected fine motor skills and related neural activities. Nineteen women with regular menstrual cycles were tested for fine motor skills using two types of tasks: grooved pegboard task (GPT), which evaluates motor control with high freedom of movements, and force modulation task (FMT), which evaluates more complex and fine motor control with low freedom of movements. We also assessed primary motor cortex intracortical circuits and sensorimotor integration using paired-pulse transcranial magnetic stimulation to reveal why the menstrual cycle affects fine motor skills. The present study indicated that fine motor skills assessed by FMT varied throughout the menstrual cycle while those measured by GPT did not. These results suggest that fine motor skills requiring more complex and fine control may be affected by the menstrual cycle. Additionally, changes in fine motor skills throughout the menstrual cycle may be associated with the severity of menstruation-related symptoms.

Menstruation-Related Symptoms and Associated Factors among Female University Students in Vietnam

Menstruation and menstrual-related symptoms, stress, and lifestyle factors can significantly affect the health and academic lives of university students. This study aimed to explore menstruation-related symptoms and associated factors among female university students in Vietnam. This study used a cross-sectional design. Data from 349 students were analyzed for menstrual and menstrual-related symptoms using the Menstrual Distress Questionnaire (MDQ). We found that 92.0% and 98.9% of the students had menstrual-related symptoms in the pre- and intra-menstrual phases, respectively. The most common symptoms in each phase were backache (71.1%) in the pre-menstrual phase and fatigue (90.3%) in the intra-menstrual phase. Menstruation-related symptoms were associated with stress. These results contribute significantly to our understanding of menstrual health among Vietnamese university students. These findings imply the need to strengthen support systems for university students, especially by providing proper information about menstruation and managing stress.

Menstruation-related symptoms are associated with physical activity and midpoint of sleep: a pilot study.

Menstruation-related symptoms (MRSs) significantly impact women's health and contribute to economic burdens worldwide. Current interventions, primarily pharmacological ones, have limitations and side effects that underscore the need for alternative management strategies. This study explores the association between MRSs and lifestyle factors, specifically physical activity and sleep timing across menstrual cycle phases, to inform non-pharmacological intervention development. Fourteen female students from Ritsumeikan University, Japan, with regular menstrual cycles (25-38 days), not on hormonal treatment or engaged in shift work, participated in this observational study. Using a Fitbit Inspire 2, total daily energy expenditure (TDEE) and sleep timing were monitored over a complete cycle. Menstrual cycle phases were defined based on ovulation day, predicted using home luteinizing hormone tests. Participants completed daily electronic questionnaires rating MRSs using a modified menstrual distress questionnaire. Data were analyzed using a generalized linear mixed model with a gamma distribution and logarithmic link function, examining the relationship of TDEE and the midpoint of sleep time (MS time) with MRS severity. The following observations were noted: first, MRS severity, except for behavioral change symptoms, significantly increased during the menstrual and luteal phases compared to the follicular phase. Second, delayed MS time was associated with reduced pain, concentration symptoms, water retention, and negative affect during the menstrual phase and reduced negative affect during the luteal phase. Finally, an increase in TDEE was associated with reduced concentration symptoms, autonomic reaction symptoms, and negative affect during the menstrual and luteal phases and reduced water retention only during the luteal phase. This study provides insights into the relationship between MRSs and TDEE/MS time, suggesting potential non-therapeutic approaches for symptom management, though further research is needed to substantiate these findings for practical applications.

The impact of dysmenorrhea on quality of life among health care nursing staff in Abha maternity and children hospital in the year 2022

Background: Dysmenorrhea is a common health problem among women of childbearing age. It is given low priority in most parts of the world, including Saudi Arabia. Therefore, attention is needed for better prevention and management practices, and thus to improve the quality of life. This study aims to explore the impact of dysmenorrhea on the quality of life among nursing staff in Abha Maternity and Children Hospital. Methods: Cross-sectional study that included 209 nurses who are in childbearing age. The questionnaire contained information about sociodemographic factors, menstrual characteristics, presence or absence of dysmenorrhea, presence or absence of other menstruation- related symptoms, and questions to assess the impact of dysmenorrhea on their quality of life. Results: 79.9% of the participants reported having moderate to severe dysmenorrhea. Regarding the other menstruation-related symptoms, more than 90% of the participants reported having abdominal pain or discomfort (95.2%), fluctuation of mood (95.2%), anger (93.3%), back pain (91.9%), and fatigue (90.9%). In addition, significant associations were found between dysmenorrhea and the following quality of life variables: wanting to cry and to be alone during menstruation; menstrual problems that affects relationship with friends, performance at work, and daily activities. Conclusions: The prevalence of dysmenorrhea is high among the nursing staff in Abha Maternity and Children Hospital. Its impact on quality of life is pronounced especially on the attendance and performance at work. Adverse health problems of menstrual disturbances represent a significant occupational health challenge among the nursing profession in Saudi Arabia.

Volatile organic compounds from human skin as biomarkers of menstruation phase and severity of premenstrual syndrome: An exploratory pilot study

Background and aimNumerous women of reproductive age experience physical or mental discomfort during their natural menstrual cycle due to paramenstrual symptoms, such as premenstrual syndrome (PMS). To date, there is no established biomarker for the diagnosis of PMS. This study investigated the relationship between skin gas composition and menstruation cycles, and evaluated the possibility of skin gas composition as a biomarker of paramenstrual symptoms. MethodsWe conducted an exploratory pilot study. Healthy Japanese women (aged 20–29 years) underwent blood and skin gas analyses on 1 day corresponding to menstruation, preovulatory, middle luteal, and late luteal phases. Skin gas was collected from the cubital fossa and armpit using a Passive Flux Sampler; samples were analyzed for 65 volatile organic compounds (VOCs) by gas chromatography-mass spectrometry (GC-MS). Non-parametric statistical analysis was performed to identify VOCs related to the menstrual cycle, levels of female hormones, and severity of PMS. ResultsFourteen women participated; of those, 12 completed the study. Regarding the relationship with the menstrual cycles, seven and four VOCs were significantly and marginally changed, respectively, at the cubital fossa during menstruation. Of those 11 compounds, 10 were also correlated with the levels of serum female hormones. At the armpit, five and three compounds were significantly and marginally changed, respectively, during menstruation. Of those eight compounds, five were also correlated with the levels of serum female hormones. In the study of PMS severity, analysis of the changes in VOCs suggested that ketones and fatty acids are increased during menstruation in the severe PMS group versus the mild PMS group. ConclusionsThe results of this study suggest that certain VOCs emitted in skin gas related to the menstrual cycle, levels of female hormones, and severity of PMS. These findings may advance the metabolic understanding and development of diagnostic biomarkers for menstruation-related symptoms.

The Impact of Menorrhagia/Dysmenorrhea on Work Performance

Excessive menstrual bleeding (menorrhagia) and painful menstrual periods (dysmenorrhea) affect a substantial proportion of reproductive-aged women and impact their quality of life and work performance due to missed work or limitations in daily activities. This systematic literature review evaluated the impacts of menorrhagia/dysmenorrhea on work performance and identified potential health disparities related to socioeconomic status on the severity of consequences. PubMed, Embase, CINAHL Plus, and PsychINFO databases were searched for relevant articles published between the years 2001 and 2021. The authors synthesized data from studies which described associations between menstrual disorders and work performance, addressed menorrhagia or dysmenorrhea specifically, and contained study samples of employed adult women. The search strategy identified a total of 915 unique titles; 31 articles satisfied the eligibility criteria for full-text review. Twenty-one articles were ultimately included in the data synthesis. For women with menorrhagia/dysmenorrhea, the most common contributors to decreased work performance were absenteeism and decreased work productivity. Unemployment and loss of income were common work-related impacts of these menstrual symptoms. Few studies reported comprehensive demographic or socioeconomic data, and fewer than half of the studies collected any information from participants related to employment. The present literature on the impact of menstrual disorders on work performance is limited. Further investigations are needed to evaluate the disparities of menstruation-related symptoms on work performance based on socioeconomic status and occupational, demographic, and contextual variables.

A 12-Year-Old Girl with Juvenile Granulosa Cell Tumor of the Ovary, Presenting with Adolescent Hyperprolactinemia, Galactorrhea, and Amenorrhea.

BACKGROUND Juvenile-type granulosa cell tumors (JGCTs) are a rare subtype of sex cord stromal tumor with a characteristic histology that is commonly found in the first 3 decades of life. It most commonly presents with symptoms of hyperestrogenism, which may present as precocious pseudopuberty or as menstruation-related symptoms, allowing for early detection of the tumor. CASE REPORT We present the case of a 12-year-old girl who presented to her primary care provider (PCP) with secondary amenorrhea with intermittent abdominal pain, who underwent an ultrasound for further evaluation, which revealed a large incidental pelvic mass. She was admitted to the Emergency Department (ED) and had findings of galactorrhea and hyperprolactinemia on examination. Imaging studies demonstrated a large ovarian mass measuring 15.0×9.0×18.8 cm that was resected, and subsequent pathology results showed JGCT stage 1A. CONCLUSIONS Prognosis of granulosa cell tumors (GCT) largely depends on its initial size, stage at diagnosis, residual tumors after surgery, and the subtype of GCT. If the patient is of reproductive age, fertility-sparing surgical options must be considered and patients must be regularly monitored for recurrence. JGCTs can present with minimal to no symptoms of precocious puberty in young girls but may present with amenorrhea, which may be considered normal for their developmental age. Although JGCTs are rare, they are important to include in differential diagnoses of younger female patients with abdominal pain, especially if accompanied by hormonal irregularities.

Oral Administration of Artemisia argyi Polysaccharide Increases Estrogen Level and Maintains Blood Lipid Homeostasis in Ovariectomized Rats

Introduction: Artemisia argyi polysaccharide (AAP) has a beneficial effect on menstruation-related symptoms and the potential regulation of lipid metabolism. It is expected to be a safe and effective ingredient for estrogen deficiency and lipid metabolic disorders. Here, we investigate the effect of AAP on body weight gain, estrogen level, and blood lipid changes in ovariectomized (OVX) rats. Methods: Thirty-six female Wistar rats were randomly divided into six treatment groups, including a sham-operated (Sham) group, OVX group, estrogen replacement (OVX + E2) group, and AAP treatment (OVX + 125, 250, 500 mg/kg AAP) group. The body weight and feed intake were recorded every week. The level of estrogen and blood lipid was determined. The gene expressions and protein expressions of estrogen receptors (ERs), fatty acid synthetase (FAS), acetyl CoA carboxylase 2 (ACC2), and 3-hydroxy-3-methyl glutaryl coenzyme A reductase (HMGR) were determined. Results: AAP treatment significantly decreased the body weight gain and average daily food intake of rats in the OVX group. Treatment with AAP significantly increased the relative weight of the uterus, plasma estrogen level, and the gene expression and protein expression of ER-α in the uterus. For blood lipids, plasma levels of triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly reduced by AAP treatment in OVX rats. AAP treatment decreased the expression of FAS and HMGR in the liver of OVX rats. Furthermore, AAP treatment significantly increased the gene expression of ACC2, the protein expression of P-ACC2, and the ratio of P-ACC2/ACC2. Conclusion: In summary, AAP treatment exerts beneficial effects on body weight gain and lipid metabolism disorder induced by ovariectomy through increasing estrogen levels, inhibiting FAS, and promoting fatty acid oxidation.

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.

Associations of psychological status in the early postpartum period with resumption of menstruation and degree of menstruation-related symptoms

The aim of this prospective study was to clarify the associations of psychological status in the early postpartum period with resumption of menstruation and degree of menstruation-related symptoms. This study was conducted from February in 2017 to July in 2018 in Japan. We conducted self-administered questionnaire surveys for 229 postpartum women at 3 days postpartum, 2 weeks postpartum, one month postpartum, 3 months postpartum and 6 months postpartum. The proportion of women who resumed menstruation in the period up to 6 months postpartum was 38.8%. The Edinburgh Postnatal Depression Scale (EPDS) score at 6 months postpartum in women who resumed menstruation in the period up to 6 months postpartum was significantly higher than that in women who did not resume menstruation. EPDS scores during the postpartum period in women in whom menstruation-related symptoms became worse than those before pregnancy were significantly higher than those in women in whom menstruation-related symptoms did not change compared to those before pregnancy. In multiple regression analysis, there was no significant difference between EPDS score at 6 months postpartum and degree of menstruation-related symptoms. Additional research is needed to clarify the association of psychological condition during the postpartum period with resumption of menstruation. Impact Statement What is already known on this subject? Postpartum psychological symptoms such as depression and anxiety during the postpartum period may affect degrees of menstruation-related symptoms after resumption of menstruation, and there also may be a bidirectional relationship between psychological symptoms and menstrual pain. What do the results of this study add? Resumption of menstruation occurred in 38.8% of 121 women within 6 months postpartum, and poor psychological condition during the postpartum period was associated with early resumption of menstruation. The psychological condition in women with earlier resumption of menstruation might affect menstruation-related symptoms. What are the implications of these findings for clinical practice and/or further research? Management of a stable psychological status during the early postpartum period should be implemented for women's health care in the future.

Assessment of Pattern, Determinants and Treatment Practices of Menstrual Disorders Among Medical Undergraduate Students

Background: Menstruation-related symptoms (MRSs) have been observed to result in absenteeism from either work or education, more commonly among women below 21 years than women of any other age group. Despite its high prevalence and associated ill effects, it is generally ignored even by medical students. Objectives: This study was conducted to assess the pattern, determinants, and treatment practices of menstrual disorders among undergraduate medical students. Methods: This was a cross-sectional study conducted among 215 female medical students from first to final year. Data were collected by using a self-administered questionnaire. The height and weight of participants were measured using standard procedures. Results: The most common menstrual disorders reported by participants over the past six months were dysmenorrhoea (191(88.8%)) followed by irregular cycles (43(20.0%)). In multivariable analysis, the presence of polycystic ovarian syndrome (PCOS) and excessive consumption of coffee was associated with irregular menstrual cycles; the presence of anaemia was associated with menorrhagia, the presence of fibroids and age of participants were associated with polymenorrhoea, excessive chocolate consumption was related to intermenstrual bleeding, excessive chocolate consumption, presence of anaemia, and low body mass index (BMI) were associated with premenstrual syndrome. Self-medication was reported by 15 (42.9%) out of the 35 participants on treatment. Conclusion: Dysmenorrhoea and menstrual irregularities were common among participants. They need to limit potential risk factors like excessive consumption of coffee and chocolates. Additionally, screening for anaemia, PCOS, fibroids and low BMI needs to be done. Self-medication practices need to be also dissuaded in the setting.

Development of an endometriosis self-assessment tool for patient.

ObjectiveThis study aimed to develop and verify an endometriosis self-assessment tool (ESAT).MethodsA non-experimental, descriptive, correlational study design was used. Candidate items were developed based on a conceptual framework constructed using the results of in-depth interviews and an integrative literature review. The construct validity of the developed tool was also examined. One-hundred and forty-two participants (117 patients with endometriosis and 25 patients without endometriosis) were included in the validity and reliability tests. The data were collected between August and December 2018. Nomological validity was verified based on significant correlations between the ESAT and the quality-of-life scores.ResultsA 21-item ESAT was developed, and its construct validity was supported. Exploratory factor analysis indicated that the tool consisted of four components (gastrointestinal symptoms, dysmenorrhea, usual symptoms, and the amount and characteristics of menstrual bleeding) with a variance of 61.6%. The variance in quality-of-life scores, as explained by the ESAT scores, was relatively high. Receiver operator characteristics curve analysis indicated that ESAT scores significantly differentiated endometriosis from non-endometriosis with fair discriminatory power at a cut-off score of 50 (sensitivity, 0.76; specificity, 0.72; area under the curve, >0.75; P<0.001). This means that patients with ESAT scores >50 points were more likely to have endometriosis. Thus, the reliability of the ESAT was confirmed.ConclusionThe devised tool appears valid and reliable. This tool may allow women to determine their risk of endometriosis by distinguishing between normal and pathological menstruation-related symptoms.

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.

Differences in Menstruation-Related Symptoms of University Students Depending on Their Living Status in Japan.

Mothers and family members of young female students play important roles for guiding their self-care strategies for menstruation-related symptoms; which often affect their daily life and academic life. The aim of this study is to clarify the differences in menstruation-related symptoms before and during menstruation in university students living alone and university students living with their family in Japan. We conducted a cross-sectional online survey to assess menstruation-related symptoms before and during menstruation using the menstrual distress questionnaire (MDQ). Among 135 students; the proportion of students living alone was 60.7% and the proportion of students living with their family was 39.3%. Before menstruation; the MDQ total score and the scores for negative affect and behavior change were significantly higher in students living alone than in students living with their family. During menstruation; scores for negative affect and impaired concentration were also significantly higher in students living alone. In addition; before menstruation; scores for an increase in appetite and craving for sweets were significantly higher in students living alone. Thus; living alone affected the psychological aspects of menstruation-related symptoms in young women. The results suggest that university students who live alone should be aware of the importance of talking about their menstruation problems with family members and seeking their advice

The relationship between psychological distress in menstruation-related symptoms and well-being

The relationship between psychological distress in menstruation-related symptoms and well-being

Nifedipine for primary dysmenorrhoea.

Dysmenorrhoea (period pain) is a common condition with a substantial impact on the well-being and productivity of women. Primary dysmenorrhoea is defined as recurrent, cramping pelvic pain that occurs with periods, in the presence of a normal uterus, ovaries and fallopian tubes. It is thought to be caused by uterine contractions (cramps) associated with a high level of production of local chemicals such as prostaglandins. The muscle of the uterus (the myometrium) responds to these high levels of prostaglandins by contracting forcefully, causing low oxygen levels and consequently pain. Nifedipine is a calcium channel blocker in widespread clinical use for preterm labour due to its ability to inhibit uterine contractions in that setting. This review addresses whether this effect of nifedipine also helps with relief of the uterine contractions during menstruation OBJECTIVES: To assess the effectiveness and safety of nifedipine for primary dysmenorrhoea. We searched for all published and unpublished randomised controlled trials (RCTs) of nifedipine for dysmenorrhoea, without language restriction and in consultation with the Cochrane Gynaecology and Fertility Group (CGF) Information Specialist. The following databases were searched to 25 November 2021: the Cochrane Gynaecology and Fertility Group (CGF) Specialised Register of Controlled Trials, CENTRAL, MEDLINE, Embase, PsycINFO, and CINAHL. Also searched were the international trial registers: ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal, the Web of Science, OpenGrey, LILACS database, PubMed and Google Scholar. We checked the reference lists of relevant articles. We included RCTs comparing nifedipine with placebo for the treatment of primary dysmenorrhoea. The primary outcomes to be assessed were pain, and health-related quality of life. Secondary outcomes were adverse effects, satisfaction, and need for additional medication. The two review authors independently assessed the included trials. There were insufficient data to allow meaningful meta-analysis. The evidence assessed was of very low quality overall. We examined three small RCTs, with a total of 106 participants. Data for analysis could be extracted from only two of these trials (with a total of 66 participants); two trials were published in the 1980s, and the third in 1993. Nifedipine may be effective for "any pain relief" compared to placebo in women with primary dysmenorrhoea (odds ratio (OR) 9.04, 95% confidence interval (CI) 2.61 to 31.31; 2 studies, 66 participants; very low-quality evidence). The evidence suggests that if the rate of pain relief using placebo is 40%, the rate using nifedipine would be between 64% and 95%. For the outcome of "good" or "excellent" pain relief, nifedipine may be more effective than placebo; the confidence interval was very wide (OR 43.78, 95% CI 5.34 to 259.01; 2 studies, 66 participants; very low-quality evidence). We are uncertain if the use of nifedipine was associated with less requirement for additional analgesia use than placebo (OR 0.54, 95% CI 0.07 to 4.20, 1 study, 42 participants; very low-quality evidence). Participants indicated that they would choose to use nifedipine over their previous analgesic if the option was available. There were similar levels of adverseeffects and menstruation-related symptoms in the placebo and intervention groups (OR 0.94, 95% CI 0.08 to 10.90; 1 study, 24 participants; very low-quality evidence); if the chance of adverseeffects with placebo is 80%, the rate using nifedipine would be between 24% and 98%. There were no results regarding formal assessment of health-related quality of life. The evidence is insufficient to confirm whether nifedipine is a possible medical treatment for primary dysmenorrhoea. The trials included in this review had very low numbers and were of low quality. Notably, there was a large imbalance in numbers randomised between placebo and treatment groups in one of the two trials with data available for analysis. While there was no evidence of a difference noted in adverse effects between groups, more data from larger participant numbers are needed for this outcome. Larger, more well-conducted trials are required to elucidate the potential role of nifedipine in the treatment of this common condition, as it could be a useful addition to the therapeutic options available if shown to be well tolerated and effective. The safety of nifedipine in women of reproductive age is well established from trials of its use in preterm labour, and clinicians are accustomed to off-label use for this indication. The drug is inexpensive and readily available. Other options for relief of primary dysmenorrhoea are not suitable for all women; NSAIDs and the oral contraceptive pill (OCP) are contraindicated for some women, and the OCP is not suitable for women who are trying to conceive. In addition, the trials examined suggest there may be a participant preference for nifedipine.

Expected research in the workplace among Japanese female workers: A cross-sectional online survey based on the framework of patient and public involvement

This study aimed to investigate the work-related health and social problems among Japanese female workers and the expected research in the workplace. A cross-sectional study using an Internet survey was conducted on female workers in Japan. Using an original questionnaire, we obtained data on "a system that can be used by female workers," "female workers' problems (physical symptoms, mental symptoms, menstrual problems, pregnancy/childbirth problems, work-life balance, etc.)," and "expected research in the workplace." The last two were compared using the chi-square test and considering demographic characteristics (age, marital status, having children, having preschool children, employment status, occupation). We conducted the chi-square test to examine the relationship between the presence of symptoms and four expected studies. The survey was carried out in July 2019 by using a patient and public involvement (PPI) framework in medical research. We obtained 416 responses that highlighted that those who have work-related problems also have physical symptoms (89%), menstrual problems (65%), psychiatric symptoms (49%), and work-life balance problems (39%), followed by career as well as pregnancy and childbirth concerns (38%). Regarding the system, the respondents' usage rate was an infertility treatment communication card (0%), flextime and telework (1 to 3%), menstrual leave (4%), and short-time work system (8%). Expected workplace studies included "Research to ease stiff shoulders and back pain" (45%), "Research to improve women's mental health" (41%), "Research on menstruation and work performance" (35%), and "Research to improve work-life balance" (34%). Expectations for research on "mental health" and "menstruation" were high among subjects in their 20s and 30s, with no spouse or children, and working full-time. Among those who lived with preschoolers, expectations for research on "mental support after childbirth," "physical support after childbirth," and "prevention of postpartum depression" were significantly higher, but research related to work-life balance was not remarkably different. There was a significant association between having menstrual problems, work-life balance challenges, and study expectations. However, the percentage of those experiencing certain symptoms who expected workplace studies was about 48%. Menstruation-related symptoms are frequently observed to make work difficult and it is expected that health issues, such as mental and physical conditions related to gynecology, will be the subject of future research regarding female workers. However, discrepancies between having difficulties and whether or not they wish to accept research in the workplace should be carefully considered in each context.

Associations between Sensitivity to Cold, Menstruation-Related Symptoms and Handgrip Strength in Female University Students in Japan

Sensitivity to cold, which is a popular symptom in Japanese women, is associated with various symptoms such as shoulder stiffness and general fatigue. However, an association of sensitivity to cold with muscle strength has not been reported. The aim of the study was to clarify the associations of sensitivity to cold with handgrip strength and with menstruation-related symptoms in female university students in Japan. We recruited 278 female university students in Japan. Sensitivity to cold and menstruation-related symptoms including physical and psychological symptoms were assessed by using a self-administered questionnaire that we designed. Handgrip strength was measured by using a handgrip strength dynamometer. We received responses from 269 students. The prevalence rate of sensitivity to cold in the subjects was 54.3%. The students who had sensitivity to cold had a lower handgrip strength level (25.5 ± 3.8 kg) than did the students who did not have sensitivity to cold (26.7 ± 3.9 kg) (p = 0.017). Sensitivity to cold was associated with low body mass index. In addition, the students who had sensitivity to cold tended to have low back pain and constipation during menstruation. In conclusion, sensitivity to cold is an important symptom associated with muscle strength as well as menstruation-related symptoms for young women.

Advancement in female sports medicine and preventive medicine.

Sport plays a major role in maintaining and improving physical function and health of women from adolescence to sexual maturity, through to menopause and old age, and it also plays a key role in social productivity and medicine from the perspective of preventive medicine. However, in routine clinical practice, there are many gynecological problems that affect the condition and performance of female athletes due to a lack of appropriate medical intervention, such as neglect of amenorrhea and menstruation-related symptoms. In addition, the number of athletes aiming to return to competition post-partum has been increasing in recent years, but there is little medical data on the well-being of female athletes during pregnancy and the post-partum period. I previously conducted clinical research on three separate topics, with the aim of clarifying the current issues unique to female athletes, mainly in terms of conditioning and injury prevention. The goal was that clinical research was to examine the situation of athletes with and without disabilities and provide feedback from the survey results to athletes and coaches. This paper divides the clinical studies conducted to date into three topics that will be explored herein: (i) research on the female athlete triad (Triad); (ii) research on oral contraceptives/low-dose estrogen-progestin; and (iii) research on pregnancy and post-partum period.