Moos Menstrual Distress Questionnaire Scores Research Articles

Comparing Pilates and Gym Ball Exercises for Primary Dysmenorrhea Management: An Empirical Study.

Primary dysmenorrhea, commonly known as menstrual cramps, is a prevalent gynecological issue that impacts many women in their childbearing age. It manifests as reoccurring, cramp-like lower abdominal pain, usually commencing right prior to or during the menstrual period. These painful sensations can be severe, extending to the lower back and upper thighs can greatly disrupt a woman's daily life and overall well-being. The optimal exercise approach is needed for individuals seeking relief from primary dysmenorrhea, allowing healthcare providers and women themselves to make informed decisions regarding their treatment options. Though many forms of exercise interventions exist in the treatment of primary dysmenorrhea,this study aimsto compare two forms of intervention namely pilates and gym ball exercises on pain and menstrual distress among women with Primary Dysmenorrhea. This experimental comparative study was carried out with 30 young female participants over a 12-week period. Participant recruitment was done through a simple random sampling method. The criteria of inclusion encompassed young females aged 17-25 years, those in good health, and those experiencing primary dysmenorrhea. Exclusion criteria included secondary dysmenorrhea, medication use, polycystic ovarian syndrome, bleeding disorders, positive pregnancy tests, breastfeeding, and other medical conditions. Group A received Pilates exercises, while Group B underwent Gym ball exercises. The assessment of both groups' menstrual distress levels was conducted using the Moos Menstrual Distress Questionnaire (MDQ) and pain scores using the Visual Analog Scale (VAS). In the statistical analysis, Group A (Pilates Exercises) showed a significantly lower mean value (2.60) on the VAS compared to Group B (Swiss Ball Exercises) (5.46), with both groups experiencing a notable reduction in post-test scores (p ≤ 0.001). Additionally, on the MOOS MDQ score, Group A (Pilates Exercises) achieved a lower mean value (79.33) compared to Group B (Swiss Ball Exercises) (103.26), with both groups demonstrating a significant decrease in post-test scores (p ≤ 0.001). In conclusion, this study underscores the significance of exercise therapy, particularly Pilates exercises, as a holistic approach to addressing primary dysmenorrhea, improving physical well-being, and enhancing the overall quality of life.

Correlation of menstrual distress to severity of gastrointestinal symptoms in inflammatory bowel disease patients.

Inflammatory bowel diseases (IBD), namely, Crohn's disease (CD) and ulcerative colitis (UC) are idiopathic chronic, relapsing, inflammatory diseases of the gastrointestinal(GI) tract. Triggers for disease flares include medications, infection, acute stress, and the menstrual cycle. Varying ovarian hormone levels i.e. prostaglandins and progesterone may exaggerate GI symptoms in IBD. We aimed to determine the relationship between quality of life, endoscopic and clinical disease activity and the menstrual cycle among females with IBD through a questionnaire based cross-sectional study. The first 75 women of child-bearing age seen at IBD clinic completed a questionnaire incorporating the short IBD questionnaire (SIBDQ). Menstrual symptoms were evaluated using the validated Moos Menstrual Distress Questionnaire (MDQ) to measure cyclical peri-menstrual symptoms. Endoscopic disease severity was assessed using the Rutgeert's score (post ileo-cecal resection patients) or Simple Endoscopic Score for CD and the Mayo score for UC. There was a statistically negative correlation between MDQ and SIBDQ scores (p<0.001); i.e. patients with lower menstrual distress scores had betterquality of life. We found no correlation between the SIBDQ, MDQ and endoscopic scores (p = 0.094, 0.626 respectively). Previous studies suggest that the severity of menstrual symptoms correlate with a poorer quality of life among women with IBD. However, this may not be reflective of the endoscopic disease severity. Larger studies are necessary to evaluate adjusting medication closer to menstrual period and adding supportive therapy peri-menstrually in anticipation of symptoms.

P080 DYSMENORRHEA IN WOMEN WITH ULCERATIVE COLITIS

Dysmenorrhea and ulcerative colitis (UC) are conditions that commonly affect women of reproductive age. Despite their similar symptoms, the relationship between the two is poorly understood. The aims of this study were to explore the relationships between dysmenorrhea, UC disease activity, and health-related quality of life (HRQoL) as well as determine the impact of dysmenorrhea on pain severity and pain medication use in women with UC. This was a case-control study comparing menstruating women with UC (cases) to healthy, age-matched controls. All subjects completed a series of questionnaires to assess the prevalence of dysmenorrhea, menstrual cycle characteristics, and the experience of menstrual distress as measured by the Moos Menstrual Distress Questionnaire (MDQ). In addition, menstrual pain severity, pain medication use, UC disease activity, and HRQoL were analyzed and compared among cases and controls with dysmenorrhea and between cases with and without dysmenorrhea. Logistic regression models were performed to assess relationships Fifty women with UC and 65 healthy controls were studied, and the prevalence of dysmenorrhea was somewhat higher in women with UC compared to controls (62%, 46% respectively, p=0.091). We found no difference in MDQ scores during the premenstrual or menstrual phases between cases and controls with dysmenorrhea. However, cases with dysmenorrhea had lower menstrual distress scores during the intermenstrual phase compared to controls with dysmenorrhea (p=0.042). Cases with dysmenorrhea had lower HRQoL compared to controls with dysmenorrhea according to some measures. No differences were found in HRQoL or UC disease activity scores between cases with and without dysmenorrhea. No significant difference was found between menstrual pain scores in cases and controls with dysmenorrhea; however, pain medication use significantly differed with controls reporting higher levels of non-steroidal anti-inflammatory drug (NSAID) use (p<0.0001). Cases with dysmenorrhea reported higher pain scores compared to cases without (p<0.0001). Dysmenorrhea is common among women with and without UC resulting in higher pain scores in comparison to individuals without dysmenorrhea. When comparing cases and controls with dysmenorrhea, no difference in menstrual distress was found during the premenstrual and menstrual phases of the menstrual cycle suggesting that women with dysmenorrhea experience menstrual distress similarly regardless of UC status. Despite women with UC and dysmenorrhea having similar pain scores to their healthy counterparts with dysmenorrhea, pain medication use was lower among cases. This suggests that women with UC may be undertreating their menstrual pain by avoiding use of NSAIDs due to the conventional advice to avoid these agents in the setting of IBD.

P080 DYSMENORRHEA IN WOMEN WITH ULCERATIVE COLITIS

Dysmenorrhea and ulcerative colitis (UC) are conditions that commonly affect women of reproductive age. Despite their similar symptoms, the relationship between the two is poorly understood. The aims of this study were to explore the relationships between dysmenorrhea, UC disease activity, and health-related quality of life (HRQoL) as well as determine the impact of dysmenorrhea on pain severity and pain medication use in women with UC. This was a case-control study comparing menstruating women with UC (cases) to healthy, age-matched controls. All subjects completed a series of questionnaires to assess the prevalence of dysmenorrhea, menstrual cycle characteristics, and the experience of menstrual distress as measured by the Moos Menstrual Distress Questionnaire (MDQ). In addition, menstrual pain severity, pain medication use, UC disease activity, and HRQoL were analyzed and compared among cases and controls with dysmenorrhea and between cases with and without dysmenorrhea. Logistic regression models were performed to assess relationships. Fifty women with UC and 65 healthy controls were studied, and the prevalence of dysmenorrhea was somewhat higher in women with UC compared to controls (62%, 46% respectively, p=0.091). We found no difference in MDQ scores during the premenstrual or menstrual phases between cases and controls with dysmenorrhea. However, cases with dysmenorrhea had lower menstrual distress scores during the intermenstrual phase compared to controls with dysmenorrhea (p=0.042). Cases with dysmenorrhea had lower HRQoL compared to controls with dysmenorrhea according to some measures. No differences were found in HRQoL or UC disease activity scores between cases with and without dysmenorrhea. No significant difference was found between menstrual pain scores in cases and controls with dysmenorrhea; however, pain medication use significantly differed with controls reporting higher levels of non-steroidal anti-inflammatory drug (NSAID) use (p<0.0001). Cases with dysmenorrhea reported higher pain scores compared to cases without (p<0.0001). Dysmenorrhea is common among women with and without UC resulting in higher pain scores in comparison to individuals without dysmenorrhea. When comparing cases and controls with dysmenorrhea, no difference in menstrual distress was found during the premenstrual and menstrual phases of the menstrual cycle suggesting that women with dysmenorrhea experience menstrual distress similarly regardless of UC status. Despite women with UC and dysmenorrhea having similar pain scores to their healthy counterparts with dysmenorrhea, pain medication use was lower among cases. This suggests that women with UC may be undertreating their menstrual pain by avoiding use of NSAIDs due to the conventional advice to avoid these agents in the setting of IBD.

Effects of a Bovine Lactoferrin Formulation from Cow's Milk on Menstrual Distress in Volunteers: A Randomized, Crossover Study.

Dysmenorrhea is a highly prevalent complaint and highly undiagnosed gynecologic condition. Dairy products have a potential in the management of menstrual distress, and bovine lactoferrin can help the subjective dysphoria associated with dysmenorrhea. In the present study, we aimed to investigate the effects of a lactoferrin formulation isolated from cow’s milk on menstrual symptoms in volunteers. A double-blind, randomized, placebo-controlled, crossover study of the iron-lactoferrin complex (FeLf) was performed in thirty-five healthy Japanese women. Participants received the 150 mg FeLf (per day) or placebo from day ten of the luteal phase to day four of the follicular phase. The Moos Menstrual Distress Questionnaire (MDQ) was measured for menstrual distress, and heart rate variability was measured as an index of autonomic nerve balance during menses. A visual analog scale for menstrual pain, and a verbal rating scale for quality of life during the first three days of menstruation were measured. The MDQ score for the automatic nervous system subscale was lower and the parasympathetic nervous system activity was greater in FeLf than in placebo for intention-to-treat or per-protocol populations. The other variables were not different between the groups. No treatment-related side effects were observed during the study. The results indicate that FeLf can provide a beneficial effect on the psychological symptoms in women affected by menstrual distress.

Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: II. Clinical effects

ObjectivesCombined oral contraceptives (COCs) decrease androgen levels, including testosterone (T), which may be associated with sexual dysfunction and mood complaints in some women. We have shown that ‘co-administration' of dehydroepiandrosterone (DHEA) to a drospirenone (DRSP)-containing COC restored total T levels to baseline and free T levels by 47%. Here we describe the effects on sexual function, mood and quality of life of such an intervention. Study designThis was a randomized, double-blind, placebo-controlled study in 99 healthy COC starters. A COC containing 30mcg ethinylestradiol (EE) and 3mg DRSP was used for three cycles, followed by six cycles of the same COC combined with 50mg/day DHEA or placebo. Subjects completed the Moos Menstrual Distress Questionnaire (MDQ), the McCoy Female Sexuality Questionnaire and the short form of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Safety and tolerability, including effects on skin, were evaluated. ResultsThe addition of DHEA induced small but significant improvements compared to placebo in the MDQ score for autonomic reactions during the menstrual (−2.0 vs. 0.71; p=0.05) and the premenstrual phase (−3.1 vs. 2.9; p=0.01) and for behavior during the intermenstrual phase (−1.4 vs. 3.6; p=0.02). A significant difference was found in the MDQ score for arousal during the premenstrual phase in favor of placebo (−5.0 vs. 1.0; p=0.01). There were no statistically significant differences between groups for the MSFQ and Q-LES-Q scores. DHEA ‘co-administration' resulted in an acceptable safety profile. DHEA negated the beneficial effect of the COC on acne according to the subjects’ self-assessment. Conclusions‘Co-administration' with DHEA did not result in consistent improvements in sexual function, mood and quality of life indicators in women taking EE/DRSP. Retrospectively, the 50 mg dose of DHEA may be too low for this COC. ImplicationsA well-balanced judgment of the clinical consequences of normalizing androgens during COC use may require complete normalization of free T.

Effect of Knee Chest Position in Primary Dysmenorrhea- A Randomized Controlled Trial

Background and objectives: Dysmenorrhea is a painful symptom that accompanies the menstrual cycles. Although exercise is generally thought to alleviate the symptoms of menstrual pain the scientific literature displays mixed evidence. The main objective of this research was to determine the effect of knee chest position on primary dysmenorrhea. Materials and method: 30 female participants were recruited from KLE's Institute of Physiotherapy, Belgaum and randomly allocated to control and experimental group after obtaining an informed consent and clearance from the institutional ethical committee. Visual analogue scale (VAS) and Moos menstrual distress questionnaire (MMDQ) were used as primary and secondary outcome measures. Control group received hot moist pack for 10 mins and the experimental group received hot moist pack (HMP) for 10 mins and knee chest position for 10 repetitions with 20 seconds hold. The intervention was carried out for 2 days beginning from the first day of menses. Outcome measures were documented using VAS on both the days pre intervention and post intervention and MMDQ on 1st day pre intervention and 2nd day post intervention respectively. Results: The results showed statistically significant reduction in VAS and MMDQ scores in the experimental group when compared to the control group with p Conclusion: Intervention with Knee chest position can be used in conjunction with HMP for reducing pain and menstrual distress in primary dysmenorrhea.

Premenstrual and menstrual symptomatology in young adult Japanese females who smoke tobacco

The present study examines the correlation between premenstrual and menstrual symptomatology and smoking status in young adult Japanese females. A cross-sectional study was conducted to assess premenstrual and menstrual symptomatology using the Moos Menstrual Distress Questionnaire (MDQ). Findings were compared between smokers and nonsmokers. The correlation between symptomatology and smoking status assessed by the Fagerström Test for Nicotine Dependency (FTND) and the Reasons for Smoking Scale (RSS), which identifies smoker's motives, was determined. Data were obtained from 785 participants, including 71 smokers, 29 quitters and 685 nonsmokers. All smokers consumed 20 or fewer cigarettes per day with the exception of one heavy smoker. Smoking status affected the cycle of menstruation, but did not affect the duration. Smokers demonstrated more severe symptomatology than nonsmokers during the menstrual and premenstrual phases. Among smokers, premenstrual symptomatology was significantly more severe than menstrual symptomatology. Five premenstrual symptom groups (pain, concentration, water retention, behavior change and negative affect) were significantly higher in smokers than in nonsmokers. Overall MDQ scores and those of three subcategories (concentration, behavior change, and negative affect) during the premenstrual phase were significantly correlated with nicotine dependency and smoking motives. Smoking motives were also correlated with the severity of autonomic reaction. Our findings suggest that young adult Japanese females with a light smoking habit have severe premenstrual symptomatology, which was correlated with nicotine dependency and smoking motives.

Dietary glycemic index is associated with decreased premenstrual symptoms in young Japanese women

ObjectivesHigh glycemic index (GI) carbohydrates may increase brain serotonin, which in turn acts to alleviate premenstrual symptoms, because, although the main determinant of brain serotonin concentration is a high plasma ratio of tryptophan to other large neutral amino acids, a high-GI diet has been shown to increase this ratio. In this observational cross-sectional study, we investigated associations between dietary GI and other dietary carbohydrates and premenstrual symptoms. MethodsSubjects were 640 female Japanese dietetic students 18–22 y of age. Dietary carbohydrates were assessed using a validated, self-administered, comprehensive diet history questionnaire. Menstrual cycle symptoms were assessed using the retrospective version of the Moos Menstrual Distress Questionnaire (MDQ). Independent associations of dietary GI and glycemic load and intake of available carbohydrate and dietary fiber with the MDQ total score and subscale scores (pain, concentration, behavioral change, autonomic reactions, water retention, and negative affect) in the premenstrual phase (expressed as percentages relative to those in the intermenstrual phase) were examined. ResultsDietary GI was independently inversely associated with total MDQ score in the premenstrual phase (P for trend = 0.02). Dietary GI also showed independent and inverse associations with several MDQ subscale scores in the premenstrual phase, including concentration, autonomic reactions, and water retention (P for trend < 0.05). Conversely, dietary glycemic load and intake of available carbohydrate and dietary fiber were not associated with any of the MDQ scores in the premenstrual phase. ConclusionDietary GI was independently associated with decreased premenstrual symptoms in a group of young Japanese women.

Intake of dietary soy isoflavones in relation to perimenstrual symptoms of Korean women living in the USA

This study was conducted to identify the potential relationship between the dietary intake level of soy isoflavones and perimenstrual symptomatology. The research design was a cross-sectional study. The sample was made up of 84 Korean women living in the USA, aged 28-40 years. The Moos Menstrual Distress Questionnaire (MDQ) and the Food Frequency Questionnaire were used as measurement tools. The soy isoflavone intake was significantly correlated with MDQ scores in the menstrual phase. In conclusion, the beneficial effect of dietary soy isoflavones on certain menstrual symptoms was established, suggesting that soy isoflavones could be one of the dietary factors related to the complexity of premenstrual syndrome (PMS). The positive effect of soy isoflavones on PMS warrants further study.

Prospective, open-label, noncomparative study to assess cycle control, safety and acceptability of a new oral contraceptive containing gestodene 60 μg and ethinylestradiol 15 μg (Minesse®)

Objective A prospective, open-label, noncomparative, multicenter study was carried out in 163 women aged 18–39 (mean 25±5 years), who used an ultra-low-dose oral contraceptive pill (OCP) containing gestodene (GTD) 60 μg/ethinylestradiol (EE) 15 μg for 6 months. The objective of the study was to evaluate the acceptability, safety, bleeding patterns and premenstrual symptomatology in these women. Methods Patients used the OCP from Days 1–24, followed by a 4-day pill-free interval from Days 25–28 of the menstrual cycle. Physical and gynecological examinations were carried out at baseline and after 3 and 6 months, at which time blood pressure, weight, hemoglobin, hematocrit, SGOT, SGPT and urinalysis were also assessed. The Moos Menstrual Distress Questionnaire (MDQ) was completed on three consecutive days (Days 25–27 of the cycle) at baseline and at the end of the third and sixth cycles. Patients kept a menstrual diary throughout the study. Results A total of 146 women completed the study. Ten women discontinued because of adverse events and one undesired pregnancy occurred during treatment. No adverse metabolic effects were observed. The adverse event most frequently reported was breakthrough bleeding, which diminished, however, as the time of OC use increased. Cycle length and duration of bleeding decreased significantly with OC use (p<.01 and p<.05, respectively, after 6 months). Intensity of menstrual bleeding tended to decrease with OC use, but this difference was not statistically significant. Systolic and diastolic blood pressure were significantly lower after 6 months of OC use compared to baseline (p<.02). No alterations were recorded in body weight or laboratory evaluations. Statistically significant changes were found both in the total MDQ score and in several of the factors evaluated, and patients showed a statistically significant improvement in well-being with respect to premenstrual complaints and symptoms. Conclusion This OC regimen is safe, well-accepted and well-tolerated, affects menstrual patterns beneficially by reducing both the intensity and duration of bleeding, provides good cycle control and improves premenstrual symptomatology.

Soy, fat and other dietary factors in relation to premenstrual symptoms in Japanese women.

To evaluate the relations of intakes of soy, fat and other dietary components to premenstrual symptoms. Cross sectional study. Three colleges and two nursing schools. One hundred and eighty-nine Japanese women aged 19 to 34 years. Intakes of nutrients and foods, including soy products and isoflavones, were estimated by a semiquantitative food frequency questionnaire. Change in menstrual cycle symptoms were assessed by the Moos Menstrual Distress Questionnaire (MDQ). Spearman rank correlation of soy and other dietary factors with changes in MDQ scores between the follicular and the premenstrual phases after controlling for age, marital status, exercise, smoking status, age at menarche and number of days of bleeding. Neither soy product nor isoflavone intake was significantly associated with change in MDQ score in the premenstrual phase. Intakes of total, saturated and monounsaturated fats were significantly correlated with change in scores for total MDQ and subscale 'pain' in the premenstrual phase after controlling for the covariates. Intake of cereals/potatoes/starches was significantly inversely correlated with a change in total MDQ score in the premenstrual phase. High intake of fats and low intake of foods with high concentration of carbohydrate may be associated with premenstrual symptoms.

TREATMENT OF SEVERE PREMENSTRUAL SYNDROME WITH OESTRADIOL PATCHES AND CYCLICAL ORAL NORETHISTERONE

40 patients with premenstrual symptoms were randomly allocated to receive placebo patches or active treatment with transdermal oestradiol patches (2 x 100 μg) to suppress ovulation. Norethisterone 5 mg was given in each group from day 19-26 of the cycle to ensure a regular withdrawal bleed. Treatment was for 6 months with crossover at 3 months. Patients completed the Moos menstrual distress questionnaire (MDQ) and the premenstrual distress questionnaire (PDQ) daily throughout the study. 5 patients withdrew, 4 because of skin reactions and 1 because of considerable improvement with initial (active) treatment. After 3 months, both groups showed improvement in MDQ and PDQ scores. In general, between 3 and 6 months, patients who switched from active treatment to placebo had deteriorating scores while patients who switched from placebo to active treatment maintained or improved upon their initial gains. Significant improvements occurred after changing to active treatment in five of six negative MDQ symptom clusters and in six of ten PDQ symptoms.

Psychiatric screening in the premenstrual syndrome.

Prospective daily ratings of premenstrual symptomatology were obtained from 40 women for one full menstrual cycle. Nineteen of these women were complaining of suffering from a premenstrual syndrome. The General Health Questionnaire (GHQ) was administered in the mid-follicular and late luteal phases of the cycle. Women who were complaining of the premenstrual syndrome showed significant premenstrual increases in premenstrual symptoms, of a magnitude that was significantly greater than those of control subjects. The GHQ scores of the women who were complaining of premenstrual syndrome were significantly higher than those of the control subjects in both the follicular and luteal phases of the cycle. The mean GHQ score of the group with premenstrual syndrome was significantly elevated above the published normal value. Fifty-six per cent of those who complained of premenstrual syndrome had follicular GHQ scores which were higher than the recommended threshold for clinical psychiatric disturbance. Only 10.5% of the control group were above this threshold. General Health Questionnaire scores were stable across phases of the cycle and were correlated to the severity of symptoms of premenstrual syndrome. Premenstrual Moos Menstrual Distress Questionnaire (MDQ) scores were related strongly to follicular MDQ scores. A high proportion of women who complain of premenstrual syndrome show evidence of a more general psychiatric problem which should be evaluated before therapy.

The menstrual cycle and personal space

Sixty undergraduate women were individually tested for interpersonal distance preferences by either a male or female confederate who approached each subject from six different directions using a procedure reported by Kinzel (1970). Randomly, each participated during either the four days prior to menstrual flow (premenstrual), the four days beginning with the first day of flow (menstrual), or the four days midway between the onset of their last period and the estimated beginning of the next (midcycle). Unexpectedly, interpersonal distance preferences were greater for males than for female testers only during the midcycle phase. Moos Menstrual Distress Questionnaire scores were not reliably correlated with interpersonal distance preferences, nor were questionnaire items tapping extent of sexual experience, usage of birth-control pills, or concern about menstrual odor. Ratings of the attractiveness of the person doing the testing was inversely related to the preferred interpersonal distance with the exception of midcycle subjects. Both negative affect and sexual interest interpretations of the effects of menstrual cycle on personal space are discussed.

Marihuana use across the menstrual cycle

Thirty women completed marihuana use diaries and Form T of the Moos Menstrual Distress Questionnaire (MDQ) every day for three consecutive menstrual cycles. A 99.1% response rate was obtained: 2715 of a possible 2741 diaries were returned. Women reported smoking an average of 1.4 (± 2.0) marihuana cigarettes per day (range for individuals: 7.3 [± 3.8] to 0.2 [± 0.4]). There was no significant covariance between daily marihuana smoking and menstrual cycle phase. The psychological MDQ factors reflecting negative affect, difficulty in concentration, behavior change and arousal also did not vary with menstrual cycle phase. The physiological MDQ factors of pain, autonomic reactions and water retention were significantly increased during the premenstrual and/or menstrual phases of the cycle. MDQ scores during the premenstruum and menstruation were generally very low. These data indicate that in the absence of severe premenstrual dysphoria, changes in drug use are not systematically related to phase of the menstrual cycle.