Severe Dysmenorrhea Research Articles

MENSTRUAL IRREGULARITIES IN FEMALE HEALTHCARE WORKERS FOLLOWING COVID VACCINATION: A CROSS SECTIONAL OBSERVATIONAL STUDY.

Aim Of The Study: To study the menstrual irregularities in female healthcare workers in the age group of 18-45 years following COVID vaccination. A self-reporting questionnaire, was designed and after being validated, Method: was administered via email and telephonic interviews to female healthcare workers in the age group of 18-45 years as they were amongst the rst to receive the COVID vaccine. From AprilNovember 2021,132 respondents, mainly from Mumbai, some from Pune, Nashik & Aurangabad completed the questionnaire The questionnaire pertained to and gathered details of two consecutive menstrual cycles following the rst dose and the booster dose of the COVID vaccine. Result: Following the rst dose of the COVID vaccine, it was found that around 26% experienced delayed menses,14% reported menorrhagia and around 12% of the women experienced severe dysmenorrhoea. Following the booster dose, 31% reported delayed menses, 16 %reported menorrhagia and 11% experienced severe dysmenorrhea. Menstrual irregularities following the COVID va Conclusion: ccination (rst & booster dose) predominantly included delayed menses, menorrhagia, severe dysmenorrhoea than experienced otherwise, followed by early menses and scanty bleeding.

Investigation of the 12-month efficacy and safety of low-dose mifepristone in the treatment of painful adenomyosis

Objective: To study the 12-month effects and possible mechanisms of low-dose mifepristone in the treatment of adenomyosis. Methods: Patients included in this retrospective study had painful adenomyosis and previously received 5 mg mifepristone daily (group A, n = 45) or 5 mg mifepristone daily with a poor-effect levonorgestrel-releasing intrauterine device (group B, n = 13) for 12 months. Uterine size, serum CA125 levels, estradiol levels, Visual Analogue Scale (VAS) score, endometrial thickness, and hemoglobin levels were compared before and after treatment and investigated again at 3 to 6 months after drug withdrawal. Another 8 patients with adenomyosis (group C, n = 8) who underwent surgery for severe dysmenorrhea during the same period were only used as a control group for immunohistochemical research. Endometrial biopsy results and expression of nerve growth factor (NGF), cyclooxygenase-2 (COX-2), and nuclear-associated antigen Ki-67 (Ki-67) in endometrial tissues and adenomyotic lesions were also analyzed. Results: The VAS scores in both experimental groups at all time points during treatment and follow-up were significantly lower (P <0.001) than those before treatment. The uterine size was significantly reduced, and endometrial thickness was distinctly thicker after 12 months of treatment than that before treatment in group A receiving 5 mg/d mifepristone. The immunohistochemical expression of NGF and COX-2 decreased in both eutopic and ectopic endometrium after treatment, whereas that of Ki-67 slightly increased in eutopic endometrium after treatment and rapidly recovered to the baseline value after stopping mifepristone. There were no signs of hyperplasia, atypical hyperplasia, or malignancy in the endometrial biopsies. Conclusions: The results suggested that a daily dose of 5 mg mifepristone for 12 months down-regulated the expression of NGF and COX-2 and was effective in treating painful adenomyosis with few side effects.

Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA): Case report

Background: Hemivaginal obstruction syndrome and ipsilateral renal anomalies are known as Herlyn-Werner-Wunderlich syndrome (HWWs) or better known by the acronym OHVIRA (Obstructed Hemivagina and Ipsilasteral Renal Anomaly). It occurs as a result of complete failure of the Müllerian ducts to fuse and accounts for about 5% of Müllerian duct anomalies. Initial manifestations usually appear as a result of secretions accumulating within the hemivaginal obstruction. Patients with HWWs can come with complaints of lower abdominal pain, severe dysmenorrhea, pelvic or vaginal mass, abnormal vaginal discharge, acute urinary retention, fever or vomiting. Therefore, careful diagnosis and appropriate management of this condition is desirable. The objective of the study was to report on the management of the obstruction due to HWWs. Case Report: A 12-year-old patient was admitted to the gynecology ward of Dr. M. Djamil Central General Hospital from polyclinic with abdominal pain since 4 months before being admitted to the hospital. The pain gets worse every day before menstruation and decreases when given painkillers. Bleeding from the vagina often recurs with blackish color, a little smelly since the 1 month ago. Conclusion: OHVIRA syndrome is a triad characterized by hemivaginal obstruction and agenesis of the ipsilateral kidney (OHVIRA) and uterus in the delphys. Clinical symptoms in general are cyclic dysmenorrhea, palpable mass due to accumulation of menstrual flow, and severe pelvic pain which can later develop into a persistent form as a result of prolonged retention of menstrual secretions, obstructed hemivagina. Management options are surgical resection of the obstructed vaginal septum and drainage.

The prevalence of menstrual disorders and premenstrual syndrome among adolescent girls living in North Borneo, Malaysia: a questionnaire-based study

BackgroundThis study aimed to determine menstrual characteristics and related morbidities among adolescent girls living in Sabah, North Borneo, a less-developed state in Malaysia.MethodsData were obtained from a quantitative survey conducted in three government high schools located in Ranau, Sabah. The participants were adolescent girls who had attained menarche between the ages of 14 and 19.ResultsBased on the analysis of questionnaires completed by 757 adolescent girls, the mean age at the time of the survey was 17 ± 1.4 years, and the mean menarche age was 12.2 ± 1.1 years. Our data demonstrated that 85.7% of the participants experienced dysmenorrhoea, of which at least 42.1% (mean pain score ± SD: 4.81 ± 0.76, 95% confidence interval (CI) 4.72, 4.90) experienced moderate dysmenorrhoea, and 11.2% (mean pain score ± SD: 7.86 ± 0.94, 95% CI 7.64, 8.08) experienced severe dysmenorrhoea. Over 70% of these girls complained of tiredness, headache, and appetite changes during menses.ConclusionsThe prevalence of menstrual disorders and related morbidities was high among the girls residing in Sabah. Reproductive health issues in rural and socioeconomically deprived areas remains poorly addressed. The main consequence of neglecting menstrual disorders and their related morbidities is impaired future sexual reproductive health in adults. Thus, addressing adolescent reproductive health issues is crucial, especially for girls living in areas where access to healthcare is difficult. The information gathered from this study can be used to strategize effective interventions to improve adolescents' reproductive health status in rural areas.

Therapeutic journey of adolescents and young adults with severe dysmenorrhea and endometriosis

Introduction: We aimed to appreciate the diagnostic and therapeutic journey of young women with endometriosis including disease presentation, obstacles to diagnosis and management, and impact on their life. Methods: We employed a mixed-method design, including chart review, 94-item questionnaire assembled from components of the EPHect EPQ-S and semi-structured interviews. The study setting was Kingston Health Sciences Centre in Kingston, Ontario. Participants were women under 28 years with severe dysmenorrhea. Questionnaire data was analyzed using descriptive statistics. Interviews were coded using the constant comparative analysis method by two analyzers and inter-rater reliability was calculated, then data were compared using a cross-sectional method. Results: Twenty-four participants were identified through chart review, 10 completed the questionnaire, and 5 participated in the interviews. Questionnaire participants, mean age 24.5 years ± 2.3, reported initial pelvic pain at a mean age of 13.9 years (SD 1.9). Fifty percent of participants have an endometriosis diagnosis, at a mean age of 19.2 years (SD 2.6). Three major themes emerged from our analysis. The journey with disease and therapy begins long before diagnosis and creates a culture of self-directed care. Lack of knowledge about endometriosis and women’s health by health care professionals and the public delays diagnosis and therapy. Endometriosis broadly impacts every aspect of an individual’s life. Conclusion: We found that young adults with severe dysmenorrhea and/or endometriosis present with symptoms at a young age. They encounter multiple obstacles in reaching a diagnosis and obtaining therapy. They often self-manage their pelvic pain and experience reduced quality of life.

Trends in pelvic pain symptoms over 2 years of follow-up among adolescents and young adults with and without endometriosis.

We described trends in pelvic pain characteristics over 2 years of follow-up among adolescents and adults with and without endometriosis participating in the longitudinal observational cohort of the Women's Health Study: From Adolescence to Adulthood, using data reported at baseline and at years 1 and 2 of follow-up. Participants completed a questionnaire at baseline (between November 2012 and May 2019) and annually thereafter that included validated measures of severity, frequency, and life interference of dysmenorrhea, acyclic pelvic pain, and dyspareunia. Our study population included 620 participants with surgically confirmed endometriosis (rASRM stage I/II = 95%) and 671 community-based and hospital-based controls, with median age = 19 and 24 years, respectively. The proportion reporting hormone use varied across the 3 years ranging from 88% to 92% for cases and 56% to 58% for controls. At baseline, endometriosis cases were more likely to report severe, frequent, and life-interfering dysmenorrhea, acyclic pelvic pain, and dyspareunia compared with controls. Among cases, frequency and severity of dysmenorrhea and dyspareunia were relatively static across 2 years. However, acyclic pelvic pain improved. Severe acyclic pain decreased from 69% at baseline to 46% at year 2. Daily pain decreased from 28% to 14%, and life interference from 68% to 38%. Trends among controls remained fairly stable across 2 years. Among endometriosis cases who completed the questionnaire at all 3 time points, 18% reported persistent, severe acyclic pelvic pain at all 3 time points. Over time, different trends were observed by pelvic pain type among endometriosis cases and controls, supporting the importance of assessing multidimensional features of pelvic pain.

A case of didelphys uterus: tackling the double trouble adenomyosis and infertility

To present a case of didelphys uterus with severe pelvic pain and primary infertility with focal adenomyosis of outer myometrium (FOAM) of the left hemiuterus and tips and tricks for hemihysterectomy as a fertility preserving surgery. Descriptive step-by-step video demonstration of a case of didelphys uterus with adenomyosis of the hemiuterus. Local institutional review board approval for publication was obtained. Endometriosis Centre, Apollo Hospitals, Hyderabad, India. Women with uterus didelphys with FOAM of the left hemiuterus with severe pelvic pain and infertility. A 30-year-old woman presented with chronic pelvic pain and severe progressive dysmenorrhea with primary infertility for 3 years. She was diagnosed with uterus didelphys and longitudinal vaginal septum 3 years back and underwent hysteroscopy for septal resection and diagnostic laparoscopy for pain in an outside setting; however, no laparoscopic intervention was performed. The patient was diagnosed with FOAM of the left hemiuterus involving 75% of the hemiuterus. After detailed discussion and counseling regarding different options, laparoscopic hemihysterectomy was performed as pelvic pain relief was a major expected outcome along with fertility preservation. Pain relief with improved quality of life and fertility preservation. The postoperative period was uneventful. The patient was discharged on the second postoperative day with no complaints. Her chronic pelvic pain and dysmenorrhea resolved. She was not prescribed any medication after the surgery. During the routine follow-up, she had a regular menstrual cycle with a visual analogue score of 0/10. The safe removal of a hemiuterus in case of a didelphys uterus with pathology of hemiuterus through a minimally invasive technique is possible, which cures the pain caused by adenomyosis and enables quick recovery while preserving future fertility.

Surgical techniques for excision of juvenile cystic adenomyoma

To review causes of pelvic pain among adolescents and discuss surgical techniques for safe and effective resection of juvenile cystic adenomyomas. Case report. Academic medical center. We present a 16-year-old patient with chronic pelvic pain and ultrasound evidence of a 2.4 cm adenomyoma. The lesion was thought specifically to represent a juvenile cystic adenomyoma, defined as a cystic lesion >1 cm occurring in women younger than 30 years with severe dysmenorrhea that is distinct from the uterine cavity and surrounded by hypertrophic myometrium. Given minimal relief from medical therapy and high suspicion for coexistent endometriosis, our patient elected to undergo laparoscopic resection of adenomyoma and excision of pelvic lesions. Preoperative considerations discussed in this video include imaging to identify the location of the lesion and adjacent structures, such as the uterine vessels, discontinuation of gonadotropin-releasing hormone agonist for adequate intraoperative visualization, and the high likelihood of encountering endometriosis at operation. We review the following surgical techniques: maximize visualization with the use of a uterine manipulator and temporary oophoropexy, optimize hemostasis via temporary uterine artery ligation and control of collateral blood vessels, complete ureterolysis, meticulous enucleation of adenomyoma, and excision of coexistent endometriotic lesions. Surgical findings demonstrated a 2 cm lesion along the left lower uterine segment and red-brown lesions along bilateral ovarian fossa, pathologically confirmed as adenomyoma and superficial endometriosis, respectively. This video presents strategies for safe and effective adenomyoma resection and treatment of refractory chronic pelvic pain in an adolescent.

A COMPARATIVE STUDY TO ASSESS THE EFFECTIVENESS OF PELVIC ROCKING EXERCISE AND GINGER ON DYSMENORRHEA AMONG NURSING STUDENTS IN A SELECTED NURSING COLLEGE, BANGALORE

A spectrum of pharmacologic and non-pharmacologic measures is used for managing dysmenorrhea. A quasi- experimental comparative pre-test post-test design was adopted to nd effectiveness of pelvic rocking exercise and ginger on dysmenorrhea and the data collection instruments used were structured baseline questionnaire and Verbal multidimensional scoring system (VMDS) and VAS for assessing the severity of dysmenorrhea. Study was carried out among 70 nursing students with 35 students each in exercise and ginger group, selected by simple random sampling technique for 2 menstrual cycles. Among the 70 subjects 17.15%, 62.85% and 20% subjects had severe, moderate and mild dysmenorrhea The nding of the study revealed that there is a signicant more or less similar reduction in dysmenorrhea among nursing students practicing pelvic rocking exercise and consumption of ginger powder. Therefore, such simple remedial measures can be used in day – to day basis in reducing dysmenorrhea.

Prevalence and Severity of Dysmenorrhoea Among some Adolescent Girls in a Secondary School in Accra, Ghana

Background: Dysmenorrhoea is a common problem among the adolescent but it is unclear the extent to which adolescent girls in Ghana are incapacitated each month due to the severity of dysmenorrhoea.Objective: The objective of this study was to determine the prevalence and severity of dysmenorrhoea in adolescent girls and its effect on class attendance.Setting: St Mary’s Senior Secondary School, AccraMethodology: Cross-sectional descriptive study using selfadministered questionnaireResults: The prevalence of dysmenorrhoea in 453 adolescent girls in this study was 74.4% (CI 95%, 72.5%-76.3%). Primary dysmenorrhoea is usually the type of dysmenorrhoea suffered by adolescent girls, a characteristic age group 14-19 years of respondents in the study. The percentage distribution for the various degrees of severity of dysmenorrhoea in 453 adolescent girls was 18.1%, 37.5%, and 18.8% for mild, moderate and severe dysmenorrhoea respectively. About 9.5% of respondents with dysmenorrhoea had absented themselves from class at some time. Among those who had severe dysmenorrhoea, 35.3% had absented themselves from class at some time (p<0.0001).Conclusions: This study shows that dysmenorrhoea is common among girls of this Senior Secondary School in Accra, Ghana. The correct approach to management of adolescent girls with dysmenorrhoea can reduce the adverse impact of severe dysmenorrhoea on academic activities in the form of class absenteeism.

Reproductive health practices and use of health services among immigrant Indonesian women working in Malaysia.

ABSTRACTOBJECTIVE To describe the reproductive health practices of immigrant Indonesian women working in Malaysia and their accessibility to health services.METHODS A cross-sectional study using a validated self-administered questionnaire was conducted with 593 immigrant Indonesian workers who stayed in Malaysia for at least six months and within the reproductive age group.RESULTS About 13.5% of the respondents have used health facilities for reproductive health-related problems. Less than half of the respondents preferred to use public health facilities. Only 15% used treatment available in health facilities related to irregular menstrual cycles (34.6%), severe dysmenorrhea (58.7%) and nonspecific symptoms related to menstruation (31.7%). Family planning services were the most required health service. However, only 31.5% met the needs for family planning services. One-third of the respondents had sexual reproductive health problems and required treatment, but only 9.9% sought reproductive health services when needed.CONCLUSIONS Strategies to improve the accessibility to sexual reproductive health services requires a collaboration between the Indonesian government representatives in Malaysia and non-governmental organizations to address the reproductive health issues among immigrant Indonesian women in Malaysia. Health policy related to immigrant workers is needed in order to enhance the accessibility to women’s health needs for universal health coverage.

106 Accessory cavitated uterine mass (ACUM): A rare uterine obstructive anomaly diagnosed in menstruating girls and young women with severe dysmenorrhea (case series)

Introduction: Uterine obstructive anomalies, that should be considered as a cause of severe dysmenorrhea in girls and young women, involve: obstructed uterine horn, unilateral cervical aplasia and Robert’s uterus. In contrast to these anomalies, the accessory cavitated uterine mass (ACUM) is diagnosed in patients with a normal shape of the uterine cavity.

Large uterine juvenile cystic adenomyoma in an adolescent

Juvenile cystic adenomyoma (JCA) is a rare uterine pathology with <40 cases reported in the current literature since 1996 when Tamura described it. We report a 13-year-old girl with a history of chronic pelvic pain and dysmenorrhea for 12 months. After diagnostic evaluation and identification of the cystic structure (∼6 cm) within the myometrium, fertility-sparing surgery was successfully performed. Histopathological examination of the uterine cyst was consistent with the diagnosis of JCA. The postoperative course was uneventful, and the patient was disease-free three years after surgery. JCA is a rare condition but should be considered in the differential diagnosis in adolescents with moderate to severe dysmenorrhea. Despite diagnostic advances, the awareness of the disorder remains low. Thus, our case report aims to increase awareness of this rare pathology with unclear etiology. • Juvenile cystic adenomyoma (JCA) is a rare uterine pathology with <40 reported cases. • We report a 13-year-old girl with a 12-months history of dysmenorrhea. • Surgery revealed a 6 cm mass, histopathologically confirmed as a JCA. • JCA is a rare condition but should be considered in the differential diagnosis in adolescents with dysmenorrhea.

Partners matter: The psychosocial well-being of couples when dealing with endometriosis

BackgroundEndometriosis is often associated with severe dysmenorrhea, pelvic pain and dyspareunia and has a high impact on daily life as well as sexuality. Quality of partnership positively influences the course of various diseases and ability to cope with emotional and physical distress. However, studies focusing on the male partners of endometriosis patients are rare, and even less is known about the reciprocal relationship in these couples. Therefore, this study aims to explore the interrelations in couples with endometriosis in matters of psychological distress, sexual and partnership satisfaction and social support.MethodsThe cross-sectional study was conducted in two university-affiliated fertility centres in Germany and Austria with n = 104 female/male couples affected by endometriosis. Participants completed a questionnaire regarding endometriosis, partnership, sexuality, stress, anxiety, depression and social support. Both women and men were asked about the impact of women’s endometriosis-related pain (IEP) on their everyday life (e.g. leisure time). Data were analysed using the Actor-Partner-Interdependence Model.ResultsSignificant partner effects were evident: High depression, anxiety and stress scores in women were associated with a higher IEP in men (all p ≤ 0.01), reciprocally high stress and depression scores in men were correlated with a higher IEP in women (all p ≤ 0.05). Less sexual satisfaction in women was associated with a higher IEP in men (p = 0.040). There was a significant reciprocal association between the perceived lack of understanding from the social environment and a higher IEP, for both women (p = 0.022) and men (p = 0.027).ConclusionsThe male partner should be taken into account when counselling or treating women with endometriosis. Our study shows a high interdependence and reciprocal influence from both partners—positively and negatively—concerning psychological distress and sexual satisfaction. Furthermore, there ought to be more awareness for the psychosocial impact of endometriosis, especially in regard to social support and understanding. Talking about and improving sexual satisfaction as well as enhancing stress reducing techniques may hold great benefits for dealing with endometriosis.Registration number The study is registered with the German Clinical Trials Register (DRKS), number DRKS00014362.

Relationship Between Nutritional Status, Exercise Level and Recreational Level with Dysmenorrhea in Nursing Students at Airlangga University

Introduction: Dysmenorrhea is a pain that occurs when a woman experiences menstruation with characteristics of pain that is felt before or during menstruation in a short time. It caused by a poor physiological condition. This study aims to analyzed the relationship between nutritional status, exercise level and recreation level with dysmenorrhea. Methods: This research was an analytic survey with cross sectional design. The number of samples taken were 116 students who fit the inclusion criterias, they were students of regular nursing faculty in the 2019 class, 18 and 19 years old and not yet married. Exclusion criteria included being pregnant and undergoing hormonal therapy. Instrument for dysmenorrhea using the Numeric Rating Scale (NRS) and questionnaire. Measurement nutritional status using the Mid Upper Arm Circumference (MUAC). Exercise and recreation also use a questionnaire as an instrument. Data were analyzed using Spearman Rho test with a significant α=0.05. This study was conducted at one of the public universities in Surabaya East Java. Results: The result of the analysis of nutritional status, exercise level and recreation level were showed a significant relationship, nutritional status (r=0.206, p=0.026), exercise level (r=-0.224, p=0.015) and recreation level (r=-0.272, p=0.003). Conculusion: Dysmenorrhea. Poor nutritional levels were tended to increase dysmenorrhea, less exercise levels were tended to cause severe dysmenorrhea and less recreational levels were also tended to cause severe dysmenorrhea. Health education about fulfilling nutrition, maintaining health by continuing to exercise and making time for recreation will reduce the risk of dysmenorrhea.

Unicornuate Uterus with Noncommunicating Rudimentary Horn (Class U4aC0V0/ESHRE/ESGE Classification) and a Communicating Bladder Endometriotic Nodule

To describe the diagnostic workup and laparoscopic management of a noncommunicating left uterine rudimentary horn (class U4aC0V0 European Society of Human Reproduction and Embryology/European Society of Gastrointestinal Endoscopy Classification) with communicating endometriotic bladder nodule. Step-by-step description of the surgical treatment. A 33-year-old woman with unicornuate uterus and a left-side noncommunicating rudimentary horn affected by primary infertility, mild dysmenorrhea (visual analog scale score 6), severe catamenial dysuria (visual analog scale score 10), and catamenial hematuria. Noncommunicating rudimentary horns are rare Müllerian anomalies present in 20% to 25% of women with a unicornuate uterus. It is associated with severe dysmenorrhea, pelvic pain, subfertility, and poor obstetric outcomes and usually presents with cyclic pelvic pain that starts early after the menarche. Endometriotic bladder nodules are present in 1% to 2% of patients with endometriosis. In the literature, there are no reported cases of noncommunicating rudimentary horn with communicating endometriotic bladder nodules. Surgical excision of the rudimentary horn is the treatment of choice. In our case, the 2-dimensional/3-dimensional ultrasound revealed a right unicornuate uterus with a left noncommunicating rudimentary horn with hematometra. The uterine fundus presented «gamma sign» vascularization. In addition, a bladder endometriotic nodule (16×15 mm) communicating with hematometra was displayed. Magnetic resonance imaging demonstrated no additional malformations. Diagnostic hysteroscopy revealed a single cervix without vaginal malformation and small right uterine cavity with single tubal ostium. At laparoscopy, using hysteroscopic transillumination, a clear plane of dissection was identified between the rudimentary horn and the uterus confirming the presence of a noncommunicating horn. Evaluation of the abdominal cavity showed bilateral normal adnexa with normal ovaries. Chromopertubation showed a patent right Fallopian tube and obstructed left tube. A left salpingectomy using bipolar and the ultrasonic energy was performed. The utero-ovarian ligament was transected, and the left ovary was preserved. The left ovary was suspended at the pelvic wall, the retroperitoneum was opened, the ureter was identified, and the left uterine artery was temporary occluded. The left round ligament was transected and the left paravesical space was developed. With a lateromedial approach, we opened the vesicouterine septum to dissect the bladder from the rudimentary horn. The endometriotic bladder nodule was gently detached from the uterine horn with a lateromedial approach. The left uterine artery was coagulated and dissected at level of the cervix. A solution of vasopressin was injected between the uterine horn and the uterus. Resection of the rudimentary horn was performed. The peritoneum was closed. The temporary occlusion of the uterine artery was removed. The specimen was placed in a bag and removed using an extracorporeal tissue extraction technique. The late clinical presentation of our patient with only mild dysmenorrhea could be explained by the drainage of the hematometra from the noncommunicating horn into the endometriotic bladder nodule. The bladder symptoms in patients with Müllerian anomalies should be carefully investigated. The laparoscopic removal of rudimentary horn with mobilization of communicating bladder nodule when present is a safe and feasible method to improve symptomatology.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN NYERI HAID (DYSMENORRHEA) PADA REMAJA PUTRI DI WILAYAH KERJA PUSKESMAS MEKAR SARI KABUPATEN BANYUASIN

Dysmenorrhea is pain during menstruation. Dysmenorrhea consists of a complex of symptoms in the form of lower abdominal cramps that radiate to the back. (Marmi, 2015). Based on data from the World Health Organization (WHO) in 2015 there were 1,769,425 people (90%) of women who experienced dysmenorrhea with 10-15% experiencing severe dysmenorrhea. The purpose of this study was to determine the relationship between anxiety, physical activity and nutritional status simultaneously with the incidence of dysmenorrhea in adolescent girls in the working area of ​​the Mekarsari Health Center, Banyuasin Regency. This study used an analytical survey method with a cross sectional design, the variables studied were the independent variables (the relationship between anxiety, physical activity, and nutritional status) and the dependent variable (dysmenorrhea) were measured and collected together. This research was conducted in the working area of ​​the Mekarsari Health Center, Banyuasin Regency with a sample of 60 people. This analysis was conducted to determine the relationship between the independent variables (anxiety, physical activity, and nutritional status) and the dependent variable (dysmenorrhea). value 0.860, physical activity variable p value 0.003 and nutritional status variable p value 0.000, which means that there is a significant relationship between nutritional status and the incidence of dysmenorrhea. There is no relationship between anxiety, physical activity and nutritional status simultaneously with dysmenorrhea in the working area of ​​the Mekarsari Health Center, Banyuasin Regency  Keywords            : Anxiety, Physical Activity, Nutritional Status and Dysmenorrhea

The Influence of Lifestyle Variables on Primary Dysmenorrhea: A Cross-Sectional Study.

BackgroundPrimary dysmenorrhea is a common and often debilitating, gynaecological condition.ObjectiveTo investigate the effects of specific lifestyle variables on the prevalence and severity of primary dysmenorrhea.Materials and MethodsA cross-sectional study of Jordanian women aged between 18–25 years old utilized a questionnaire as the main instrument of the study.ResultsPrimary dysmenorrhea was reported by 660 women out of 1988. It was found that approximately two thirds of them were students. Overall, 54.5% of the participants reported severe dysmenorrhea. A statistically significant correlation was found between severe dysmenorrhea and smoking at p value ˂0.001, sleeping less than 7 hours per 24 hours at p = 0.005, holding a university degree at p = 0.032, non-alcohol consumption at p = 0.044, frequent energy, fizzy, tea, coffee drinks and sugar intake. Interestingly, we found that severe dysmenorrhea was statistically significantly associated with women who never eat meat at p ˂0.001, cereals and fish consumers and with those who take less than 3 servings of fruit or none at all per week at p = 0.006. In addition to the previous variables, water intake of less than 1.0 litre a day, irregular cycles, non-OCP use and positive family history were found significantly associated with severe dysmenorrhea. Severe dysmenorrhea was significantly related to working less hours per week, higher stress level and longer bleeding duration at p = 0.021, 0.017 and 0.008, respectively. On the other hand, there was no statistically significant difference found between severe dysmenorrhea and the following variables: age, body mass index (BMI), weekly studying hours and age of menarche.ConclusionPrimary dysmenorrhea is prevalent in the Jordanian population. To overcome severe dysmenorrhea, women should increase their intake of fish and fresh fruits, drinking water and use of oral contraceptive pills. The study concluded that smoking, frequent sugar intake, fizzy drinks, coffee, tea and energy drinks were associated with severe dysmenorrhea. It is also worth mentioning that alcohol consumption had a positive impact on dysmenorrhea.Trial RegistrationRegistered in Clinicaltrial.gov (ID: NCT04583943).

Hubungan Gaya Hidup Dengan Kejadian Dismenore Primer Pada Mahasiswi Prodi S1 Keperawatan Di Stikes Abdi Nusantara

Background : According to the World Health Organization (WHO) in Sulistyorini's research (2017), the incidence of dysmenorrhea is quite high throughout the world. The average incidence of dysmenorrhea in young women is between 16.8-181%. On average in European countries dysmenorrhea occurs in 45-97% of women. with the lowest prevalence in Bulgaria (8.8%) and the highest at 94% in Finland. The highest prevalence of dysmenorrhea is often found in adolescent girls, which is estimated to be between 20-90%. About 15% of adolescents are reported to experience severe dysmenorrhea.&#x0D; Objective: To obtain or find out information about the relationship of lifestyle with the incidence of primary dysmenorrhea in Nursing Undergraduate Study Program students at Stikes Abdi Nusantara for the period of July 2020.&#x0D; Method: The research design used was analytical research with cross sectional approach, the samples in this study were all female students of Nursing Study Program at Stikes Abdi Nusantara Jakarta.&#x0D; Results : Respondents with primary dysmenorrhea were 91.5%, respondents who said stress were 27.1%. Respondents with high fast food consumption were 83.6%. Respondents with passive smoking were 47.5%. Statistical results between primary dysmenorrhea and incidence of stress (p = 0.73 and OR 0.6), fast food consumption (p = 0.027 and OR = 4.029), and passive smoking (p = 0.247 and OR = 1.904).&#x0D; Conclusions and suggestions: There is no relationship between stress and passive smoking with the incidence of primary dysmenorrhea. There is a relationship between fast food consumption and the incidence of primary dysmenorrhea in S1 nursing study program students at Stikes Abdi Nusantara Jakarta. It is recommended that nursing undergraduate students avoid unhealthy lifestyles such as reducing consumption of fast food in order to reduce the risk of primary dysmenorrhea.

Genome-wide association study of primary dysmenorrhea in the Taiwan Biobank validates associations near the NGF and IL1 gene loci.

Using the Taiwan Biobank, we aimed to identify traits and genetic variations that could predispose Han Chinese women to primary dysmenorrhea. Cases of primary dysmenorrhea included those who self-reported "frequent dysmenorrhea" in a dysmenorrhea-related Taiwan Biobank questionnaire, and those who have been diagnosed with severe dysmenorrhea by a physician. Controls were those without self-reported dysmenorrhea. Customized Axiom-Taiwan Biobank Array Plates were used to perform whole-genome genotyping, PLINK was used to perform association tests, and HaploReg was used to conduct functional annotations of SNPs and bioinformatic analyses. The GWAS analysis included 1186 cases and 24,020 controls. We identified 53 SNPs that achieved genome-wide significance (P < 5 × 10-8, which clustered in 2 regions. The first SNP cluster was on chromosome 1, and included 24 high LD (R2 > 0.88) variants around the NGF gene (lowest P value of 3.83 × 10-13 for rs2982742). Most SNPs occurred within NGF introns, and were predicted to alter regulatory binding motifs. The second SNP cluster was on chromosome 2, including 7 high LD (R2 > 0.94) variants around the IL1A and IL1B loci (lowest P value of 7.43 × 10-10 for rs11676014) and 22 SNPs that did not reach significance after conditional analysis. Most of these SNPs resided within IL1A and IL1B introns, while 2 SNPs may be in the promoter histone marks or promoter flanking regions of IL1B. To conclude, data from this study suggest that NGF, IL1A, and IL1B may be involved in the pathogenesis of primary dysmenorrhea in the Han Chinese in Taiwan.