Severity Of Dysmenorrhea Research Articles

Cervical Anatomical Characteristics in Women with Endometriosis: A Diagnostic Approach

Background: Endometriosis is a gynecologic disorder which causes dysmenorrhea and infertility. Early diagnosis of endometriosis can help prevent the necessity for invasive diagnostic procedures. Medical imaging has been widely utilized to diagnose various diseases without the need for invasive procedures. The purpose of this study was to investigate the cervical length in women with endometriosis. Methods: In this case-control study, the case group consisted of nulliparous women with endometriosis, while the control group comprised nulliparous women without endometriosis. A total of 42 individuals were included in each group. Cervical length was measured using transvaginal ultrasound from the external os to the internal os. The patients in the case group underwent laparoscopy to confirm the diagnosis. Pearson chi-square test and Fisher’s exact test were employed to compare categorical variables with a p<0.05 considered statistically significant. Results: In both groups, there were no notable variations in any of the demographic characteristics. However, the severity of dysmenorrhea was significantly different between the two groups (p=0.01). The average diameter of the mediolateral cervix (29.48±6.2 and 27.14±3.8) was statistically significant between the patient group and control group, respectively (p=0.04). The mediolateral width may have a positive predictive effect on the presence of endometriosis, while cervical length appears to have a protective effect against endometriosis. Conclusion: Demographic data do not predict endometriosis. This study suggests that mediolateral width in transvaginal sonography can serve as a minimally invasive diagnostic tool for endometriosis, showing correlation with endometriosis symptoms like dysmenorrhea and dyspareunia.

Associations between menstrual pain and sexual function: the role of visceral hypersensitivity on developing sexual pain.

Dyspareunia, defined as pain before, during or after intercourse, is a subset of female sexual dysfunction with overlapping gynecologic, urologic and psychosocial etiologies. This study aimed to evaluate the impact of menstrual pain and visceral hypersensitivity on sexual function and to identify risk factors for sexual pain in healthy reproductive-age females. In this prospective cohort study, we evaluated gynecologic and psychologic self-reported histories, validated sexual function questionnaires, and conducted a standardized gynecologic examination enhanced by quantitative sensory testing in reproductive-aged females with menstrual pain versus pain-free controls. Correlation analysis was conducted between the Female Sexual Function Index (FSFI) pain subdomain score and a priori hypothesized risk factors for dyspareunia: menstrual pain severity, experimentally provoked bladder sensitivity, anxiety, depression, pain catastrophizing, and vaginal pressure-pain sensitivity. The primary outcome was severity of sexual pain as measured by the FSFI, comparing participants with moderate-to-severe dysmenorrhea (n = 99), dysmenorrhea with bladder hypersensitivity (n = 49) identified on non-invasive oral water challenge, and pain-free controls (n = 37). In our young (median age 22 [IQR 19, 29]), nulliparous, predominantly heterosexual cohort (78.3%, 144/185), 64.3% (119/185) engaged in sexual intercourse within the four-week recall period. The median total FSFI score was 27.2 (22.0, 30.2). Across groups, only the dysmenorrhea with bladder hypersensitivity phenotype met the threshold for sexual dysfunction as measured by total FSFI score (24.6 [20.0, 28.1], p= 0.008). Dysfunction was driven by difficulties with lubrication and higher pain levels during and after intercourse. On physical examination, those with and without dyspareunia were largely indistinguishable, with little to no tenderness of the pelvic floor, bladder, uterus and uterosacral ligaments. Amongst the six hypothesized risk factors for sexual pain, only experimentally provoked bladder pain was significantly associated with the severity of dyspareunia (r = 0.41, corrected p< 0.001). Young, otherwise healthy individuals with dysmenorrhea and occult visceral hypersensitivity exhibit signs of sexual dysfunction and significantly higher rates of dyspareunia in the absence of reliable clinical examination findings. Strengths include the use of a nonclinical sample of almost exclusively nulliparous females with no co-morbid pelvic pain diagnoses and prospective diary confirmation of dysmenorrhea severity. The study is limited by the narrow heteronormative, cisnormative sexual experience of penile-vaginal intercourse captured by the FSFI. Sexual pain is more prevalent in those with dysmenorrhea with bladder hypersensitivity than isolated dysmenorrhea, suggesting visceral hypersensitivity may be a non-structural mechanistic driver for dyspareunia.

12559 Objective Versus Subjective Measures Of Reproductive Development And Psychological Well-Being In Peri-Menarcheal Adolescents: A Pilot Study

Abstract Disclosure: K.C. McCormick: None. M.E. Lujan: None. J. Chang: None. L. Ipp: None. A. Alladeen: None. H. Lamar: None. J. Mendle: None. H. Vanden Brink: None. Introduction: Risk of psychopathology emerges during the pubertal and peri-menarcheal years; however objective physiological measures of maturation often differ from adolescents’ own reports of their development. Understanding how psychological symptoms emerge in relation to both objective and subjective evaluations of reproductive development can provide critical insights into mental health risk and variability in psychological symptom severity during the pre-menarcheal and early post-menarcheal years. Methods: 52 females 9-15 years old (n=16 pre-menarcheal, n=36 &amp;lt;2 years post-menarche) underwent a non-fasting blood draw for reproductive hormones (estradiol, anti-mullerian hormone (AMH), luteinizing hormone (LH), follicle stimulating hormone (FSH)), anthropometry, detailed reproductive and menstrual history, and a series of surveys to evaluate depression (CES-DC), anxiety (MASC), perceptions of pubertal-related change (POPS), and transdiagnostic psychological processes (rumination, emotional clarity) which can contribute to, and are risk factors for, psychopathology. Whether psychological symptoms are associated with objective measures (menarche, gynecological age, reproductive hormone concentrations) versus subjective measures (self-reported tanner stage, severity of dysmenorrhea) were contrasted using t-tests and Pearson Correlation Coefficient analyses (JMP Pro (v17)). Results: The majority of participants (26/36 post-menarcheal and 11/16 pre-menarcheal) exceeded the standard cut-off of 15 for depressive symptoms, consistent with research on mental health symptomatology in this cohort of youth. POPS scores were higher (39±10.9) in post-menarcheal versus pre-menarcheal (31±12.6) adolescents indicating post-menarcheal adolescents reported more puberty-linked change in their lives (Pttest=0.04). Lower emotional clarity was associated with higher AMH concentrations (r= -0.27, p=0.0944). Depressive symptoms tended to be greater (27+14.8) in those with moderate dysmenorrhea versus mild/no dysmenorrhea (19±11.1, Pttest=0.08). Depression (r=0.30, p=0.032) and anxiety symptoms (r=0.32, p=0.027), and rumination (r=0.30, p=0.033) were associated with higher self-reported Tanner scores; POPS was trending (r=0.25, p=0.0776). Neither estradiol nor FSH were associated with any measures of psychological well-being. Conclusion: Both objective measures of reproductive development and adolescent self-reports may help providers assess individual vulnerability to internalizing psychopathology, such as depression and anxiety. Additionally, given population level increases in depressive symptoms in adolescents, researchers should avoid utilizing simple cutoffs for depression and anxiety, which lack specificity and overlook critical variability which can further elucidate mental and physical health dynamics. Presentation: 6/2/2024

Prevalence and risk factors of primary dysmenorrhoea among medical students: a cross-sectional survey in Indonesia.

This study aimed to assess the prevalence and associated risk factors of primary dysmenorrhoea among medical students in Indonesia. A web-based survey was conducted among 630 medical students across Indonesia, selected based on specific inclusion criteria. Dysmenorrhoea prevalence, severity and associated risk factors were assessed using a self-reported questionnaire. To analyse the data, univariate and multiple binary logistic regression analyses were performed. A significance level of 5% (p<0.05) was used for both types of analyses to determine the statistical significance of the observed associations. Indonesia (2021: n=630 female medical students). The primary outcome is primary dysmenorrhoea, defined as painful menses without previous diagnosis of pelvic pathology. The severity of dysmenorrhoea was measured using the Verbal Multidimensional Scoring System. Independent variables include socio-demographic characteristics, menstrual history and other identified associated risk factors. Of the 630 Indonesian medical students surveyed, a large proportion (91.27%) reported experiencing dysmenorrhoea, with 52.35% experiencing moderate-to-severe pain. Family history of dysmenorrhoea emerged as a significant predictor for both occurrence (OR 3.76; 95% CI 1.89 to 7.45) and severity (OR 1.47; 95% CI 1.04 to 2.06). Dysmenorrhoea severity was positively associated with cycle length (OR 1.57; 95% CI 1.01 to 2.43), whereas higher body mass index (BMI) (OR 0.94; 95% CI 0.90 to 0.98) and being Indonesian of foreign descent (OR 0.46; 95% CI 0.27 to 0.84) were negatively associated with moderate-to-severe dysmenorrhoea. Dysmenorrhoea is prevalent among Indonesian medical students, with family history, BMI, cycle length and race significantly associated with its occurrence or severity. These findings underscore the need for further research on more diverse populations to enhance awareness and address this prevalent gynaecological concern effectively.

The Role of NK and T Cells in Endometriosis.

Endometriosis, a debilitating condition, affects one in ten women of reproductive age. Its pathophysiology remains unclear, though deficiencies in immune surveillance are thought to create an environment conducive to the evasion of ectopic endometrial cells from the immune system. Our research explores the immunological impact of endometriosis both locally and systemically, emphasizing natural killer (NK) and T cell subpopulations. We incorporated 62 female patients who underwent laparoscopic surgery; of those, 47 had endometriosis, and 15 were controls. We collected peritoneal fluid (PF) and peripheral blood (PB) samples which were tagged with monoclonal antibodies and subsequently scrutinized using flow cytometry. Our findings revealed significant differences in immunological profiles based on demographic factors and symptomatology. In the endometriosis cohort, there was an increase in PB CD56HiCD16dim and PF CD8+ CD56dimCD16Hi NK cells. CD16+ CD4 T cell levels were significantly lower in the PB of endometriosis patients who smoke. Individuals with more severe disease displayed significantly higher levels of PB CD16+ CD8 T cells, which also increased in those with non-menstrual pelvic pain. Dysmenorrhea severity correlated with a progressive increase in PF CD8+ CD56dimCD16Hi NK cells. These variations in specific lymphocyte subsets, namely, within NK and T cells, suggest potential immunological mechanisms in the evolution and clinical presentation of endometriosis.

Lesion size and location in deep infiltrating bowel endometriosis: Correlation with gastrointestinal dysfunction and pain.

Presence of deep infiltrating bowel endometriosis (DE) is associated with occurrence of dyschezia and gastrointestinal symptoms. The degree of the disease, the lesion length, and the location, that is, lesion-to-anal-verge distance (LAVD) of DE, as well as the severity of the symptoms appear to be correlated. Nevertheless, it is not yet known to what extent the size and LAVD of bowel DE influence the severity of gastrointestinal symptoms. The present study aims to evaluate a possible correlation of lesion location (LAVD) and size (according to the #Enzian classification) with preoperative symptoms. In this prospective study, premenopausal patients with histologically confirmed DE undergoing modified limited nerve-vessel sparing rectal segmental bowel resection or full-thickness discoid resection were evaluated. Extent of endometriosis was defined according to the #Enzian classification during surgery. The primary outcome measure was the correlation between lesion size and location with the GI function impairment reflected by presurgical lower anterior resection syndrome (LARS) scores; the secondary outcome was differences in presurgical numeric rating scale pain scores of dyschezia, dyspareunia, and dysmenorrhea as well as the impact of concomitant DE of other locations on symptom intensity. Of 162 consecutive patients, 151 were included in the final analysis. No significant correlation was observed between lesion size (#Enzian compartments C1/C2/C3) or LAVD and GI dysfunction reflected by LARS-like symptoms (p = 0.314 and p = 0.185, respectively) or pain symptoms (dyschezia, p = 0.440; dyspareunia, p = 0.136; and dysmenorrhea p = 0.221). Furthermore, no significant correlation was observed between lesion size and GI dysfunction when merging two severity grades (#Enzian compartments C1 plus C2 vs. C3; p = 0.611). In addition, LAVD did not affect the degree of dyschezia (p = 0.892), dyspareunia (p = 0.395), or dysmenorrhea (p = 0.705). Finally, the presence of concomitant DE lesions infiltrating the vagina/rectovaginal space (#Enzian compartment A) and/or sacrouterine ligaments/parametrium (#Enzian compartment B) did not alter the severity of preoperative dyschezia (p = 0.493) or dysmenorrhea (p = 0.128) but showed a trend toward affecting gastrointestinal function (p = 0.078) and was significantly associated with dyspareunia (p = 0.035). In present study, we could not find a correlation between colorectal DE lesion size and location (LAVD) and gastrointestinal function impairment or intensity of dyschezia and dysmenorrhea. Additional involvement of vagina/rectovaginal space (#Enzian compartment A) and/or sacrouterine ligaments/parametrium (#Enzian compartment B) exerts a significant impact on the degree of dyspareunia in women with colorectal DE.

Impact of Obesity on Dysmenorrhea and Lower Urinary Tract Symptoms in Adenomyosis Patients

Obesity poses a substantial health challenge globally, affecting various aspects of reproductive health, including adenomyosis. Adenomyosis, characterized by the presence of endometrial tissue within the myometrium, commonly affects women during their reproductive years, leading to symptoms such as dysmenorrhea and lower urinary tract symptoms (LUTS). This study aimed to investigate the influence of obesity on dysmenorrhea and LUTS severity in adenomyosis patients, considering demographic factors such as age and educational levels as potential moderators. Forty-four adenomyosis patients participated in a cross-sectional study at Dr. Moewardi General Hospital in Surakarta City of Indonesia, between April and September 2023. Diagnosis was confirmed using 2D Transvaginal Ultrasound (2D-TVUS). Obesity was defined using Body Mass Index (BMI) categories, and dysmenorrhea and LUTS were assessed using the Numerical Rating Scale (NRS) and modified International Prostate Symptom Score (IPSS) questionnaire, respectively. Statistical analyses included Pearson correlation. Results indicated a significant positive correlation between obesity and dysmenorrhea (rho = 0.256, P = 0.049) and LUTS (rho = 0.292, P = 0.029). Age and educational level did not significantly moderate these relationships, emphasizing the independent influence of obesity on symptom severity. In conclusion, obesity significantly impacts the severity of dysmenorrhea and LUTS in adenomyosis patients, highlighting the need for tailored management strategies that address both hormonal and inflammatory pathways.

Pengaruh Pemberian Ekstrak Jahe terhadap Penurunan Intensitas Dismenore pada Remaja

Background: Dysmenorrhea occurs when the hormone prostaglandin increases excessively during menstruation. Dismenorrhea complaints in adolescents, when untreated, can cause discomfort that interferes with daily activities and school activities. Dysmenorrhea experienced by teenagers can be overcome by consuming ginger extract. Objective: To find out the impact of giving ginger extract on decreasing the intensity of dysmenorrheic pain in adolescents at ‘Aisyiyah Surakarta University. Research methods: This study uses a pre-experimental design with a one-group pretest-posttest approach with samples of 23 respondents. The measurement used the NRS (Numeric Rating Scale) and analyzed data using the Wilcoxon Sign Rank test. Result: It was found that of the 23 respondents before giving ginger extract the majority experienced severe pain (60.86%), and after being given ginger extract, the majority experienced mild pain (56.52%). In light of the Wilcoxon signed rank test p value &lt;0,001 smaller than 0,05. Conclusion: at ‘Aisyiyah Surakarta University, we found that administering ginger extract reduced the severity of dysmenorrhea in adolescents.

Efficacy of postsurgical medical therapy for infertile patients with deep endometriosis.

Though laparoscopic surgery is effective for the treatment of deep endometriosis (DE), postoperative management remains controversial. Dienogest therapy after surgery may improve spontaneous pregnancy rates and decrease the severity of dysmenorrhea in infertile patients with DE. To determine the efficacy of postsurgical therapy with dienogest for improving fertility and reducing the intensity of dysmenorrhea in infertile patients with DE. This open label, randomized controlled trial was conducted involving 88 women aged 21-38 years with infertility who underwent surgery for DE. Three patients were lost to follow-up. After surgery, eligible patients were randomly divided into two groups. Forty-four patients who received dienogest for three months following surgery were enrolled in group 1. The remaining 41 patients comprised group 2 and did not receive any postsurgical treatment over the same period. The primary outcome measure was the pregnancy rate calculated nine months after surgery, while the mean intensity of dysmenorrhea was measured before and nine months after surgery. The pregnancy rate in group 1 was significantly higher than in group 2 (47.7% vs 22%, p = 0.013) nine months following surgical intervention. Patients in group 1 exhibited a more statistically significant reduction in the mean score of dysmenorrhea intensity compared to group 2, from 8.7 to 2.8 vs 8.76 to 5.63, respectively (p < 0.001). The use of dienogest as an add-on therapy for treating DE may show significantly higher effectiveness compared to surgical intervention alone for improving fertility and reducing the severity of dysmenorrhea.

The effect of dysmenorrhea severity and interference on reactions to experimentally-induced pain.

Dysmenorrhea is associated with increased risk of chronic pain and hyperalgesia. Menstruating individuals with dysmenorrhea are more likely to have elevated pain reactivity when experiencing experimental pain, than those without. However, no study has examined intragroup differences in reactions to experimentally induced pain for individuals with dysmenorrhea. The main aim of this study was to examine the relative roles of dysmenorrhea severity and interference in the experience of experimentally-induced pain. Participants were 120 menstruating individuals involved in a larger research study examining the influence of expectations on experimentally-induced pain. As part of the study, participants completed an online questionnaire regarding demographic and menstrual information and participated in a cold pressor task. Participants were randomized into four groups based on the manipulation of two independent variables: (1) high vs. low expectations about pain severity (pain-expectations); (2) and high vs. low expectations about one's pain tolerance (self-expectations). Participants verbally rated their pain severity throughout the cold pressor task using a 0-10 scale. Regression analyses were conducted examining the relationships between dysmenorrhea experience (i.e., average severity and interference) and cold pressor data [pain severity ratings and pain tolerance (i.e., total time in the cold pressor)], controlling for the manipulated expectations and age. Then, moderation analyses were conducted examining expectation group differences. When controlling for manipulated expectations and age, dysmenorrhea severity significantly predicted initial pain severity rating (p = 0.022) but did not predict final pain severity rating (p = 0.263) or pain tolerance (p = 0.120). Dysmenorrhea interference did not predict initial pain severity rating (p = 0.106), final pain severity rating (p = 0.134), or pain tolerance (p = 0.360). A moderation analysis indicated that the relationship between dysmenorrhea severity and initial pain severity rating was not moderated by pain-expectations, χ 2(1) = 0.412, p = 0.521. During an experimentally-induced pain task, dysmenorrhea severity but not interference predicted initial pain severity rating, such that higher levels of dysmenorrhea severity predicted greater initial pain severity rating. This suggests individuals with more severe dysmenorrhea pain may experience greater initial sensitivity to pain and be at risk for increased sensitivity to acute pain and potentially the development of chronic pain.

The Evaluation of Post-COVID-19 Effects on Ovarian Reserve and Menstruation in Reproductive-Aged Women in 2022: A Single-Centered Observational Study

Background: Despite the finite reproductive lifespan of women, the effect of Coronavirus disease 2019 (COVID-19) on female fertility is not widely evaluated, especially in the post-COVID recovery period. Objectives: The study aimed to detect COVID-19's long-term impact on ovarian reserve and menstruation in reproductive-aged women. Methods: One hundred and three reproductive-age women were recruited for this observational study from March to September 2022. Participants with a history of severe COVID-19 were included in the case group (n = 50), while those with non-severe or no infection were considered the control group (n = 53). The ovarian reserve was assessed using anti-Müllerian hormone (AMH) levels, and a structured questionnaire was used to evaluate menstrual cycle abnormalities. Results: We detected a significant decrease in the ovarian reserve indicator, AMH serum levels, in women with severe infection compared to controls (2.66 ± 1.95 vs. 3.38 ± 2.59 ng/L P = 0.03) in the post-COVID-19 recovery period. Characteristics related to menstrual cycle length and volume abnormalities, such as hypermenorrhea and hypomenorrhea, were similar in cases and controls (P = 0.79, P = 0.64), but the severity of dysmenorrhea was significantly higher in cases than controls (P = 0.02). Menstrual pain perception was not related to women’s marital status (r = 0.10, P = 0.27), employment (r = 0.16, P = 0.10), education (r = 0.11, P = 0.24), or AMH serum levels (r = 0.03, P = 0.74). Conclusions: This investigation sheds light on the potential long-term effects of severe COVID-19 on the ovarian reserve and menstrual cycle, which may lead to changes in female reproductive physiology. Longitudinal studies with larger sample sizes are needed to confirm the long-lasting fertility issues in women affected by severe COVID-19.

The Effect of Fenugreek on the Severity of Dysmenorrhea: A Systematic Review and Meta-analysis.

Dysmenorrhea is the most common periodic pain, which affects more than 50% of women with regular menstruation. Fenugreek is one of the medicinal plants with analgesic properties. This study aimed to determine the effect of fenugreek application in the severity of dysmenorrhea and its side effects in women with dysmenorrhea. PICO: Population: women with dysmenorrhea; Intervention: fenugreek; Comparison: control groups; and Outcome: reduction in the severity of dysmenorrhea and its side effects. English database (PubMed, Cochrane Library, Scopus, and Web of Science) and Persian database [SID (Scientific Information Database) and Magiran] were used for research until February 11, 2023, using the keywords "Dysmenorrhea [Mesh]," "Foenum [Mesh]," "fenugreek [Mesh]," and "Trigonella [Mesh]." The reference list of the selected articles was also checked. The quality assessment was conducted through the Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0. The RevMan 5.3 software was used to analyze and report the data of the entered studies. Meta-analysis results were reported with the standardized mean difference (95% confidence interval). A subgroup analysis was performed based on the type of control groups. The quality of evidence was assessed using the GRADE approach. After removing duplicates and ineligible cases, four articles were included in the systematic review out of the 1526 records obtained. The results showed that the pain intensity caused by primary dysmenorrhea decreased with fenugreek compared to placebo (pooled result SMD: -2.21; 95% CI: -3.26 to -1.17; Z: 4.17; p <0.001). There was no significant difference between fenugreek with mefenamic acid (SMD: 0.05; 95% CI: -0.57 to 0.67; Z: 0.17; p = 0.86) and fenugreek with Chandrasura churna (SMD: 0.06; 95% CI: -0.56 to 0.68; Z: 0.19; p = 0.85). Bias, in terms of incomplete outcome data and selective reporting, was low risk in all studies, and the available evidence was low quality according to the GRADE approach. The results showed that the effect of fenugreek on pain intensity in dysmenorrhea is highly uncertain. The true effect is likely to be substantially different from the estimate of effect. Regarding the importance of the health and quality of life of women of reproductive age and the low quality of evidence of the studies, clinical trials with stronger methodology are suggested in this field.

Effect of aquatic exercise versus aerobic exercise on primary dysmenorrhea and quality of life in adolescent females: Arandomized controlled trial.

Primary dysmenorrhea leads to significant gynecological consultations, school absenteeism, disrupted daily activities, and adversely affects overall quality of life (QOL). This study compared the effects of aquatic exercise versus aerobic exercise on primary dysmenorrhea and QOL in adolescent females. Sixty adolescent females suffering from primary dysmenorrhea with moderate to severe intensity were distributed randomly and equally into two groups was registered at ClinicalTrials.gov (NCT06129708) the Registration Date, November 13, 2023; group A was treated by aquatic exercise for 12weeks, while group B was treated by aerobic exercise for 12weeks. Assessment of both groups before and after treatment involved evaluating dysmenorrhea severity using the WaLIDD Score, measuring pain intensity with the numeric pain rating scale (NPRS), determining pressure pain threshold (PPT) with an algometry, and evaluating the QOL using EuroQol-5 Dimension-3 Level (EQ-5D-3L) and EuroQol-visual analog scale (EQ-VAS). Both groups, A and B, experienced significant reductions in the WaLIDD score, NPRS, and all domains of EQ-5D-3L (p<0.05), coupled with significant increases in PPT and EQ-VAS (p<0.05). Posttreatment comparisons between the groups showed insignificant differences in WaLIDD score, NPRS, and PPT (p>0.05). However, there was a significant decrease in EQ-5D-3L and a significant increase in EQ-VAS, favoring group A (p<0.05). Both aquatic and aerobic exercises are effective methods in primary dysmenorrhea management and QOL improvement in adolescent females, with a better effect of aquatic exercise in enhancing QOL.

Retracted Article: Analysis of Assisted Reproductive Technology Treatment of 126 Uterine Adenomyosis Patients Diagnosed via Ultrasonography

Background: Uterine Adenomyosis (Ut-Ad) is a condition in which the endometrial glands and stroma invade extensively into the uterine myometrium, causing the uterus to enlarge and leading to treatment-resistant infertility. In this study, we diagnosed Ut-Ad in the absence of concomitant ovarian endometriosis using ultrasound and conducted assisted reproductive technology (ART) on 126 patients desiring pregnancy. We report our clinical outcomes and discuss potential future treatments. Methods: Ut-Ad was diagnosed independently, without concurrent external endometriosis. We retrospectively analyzed the clinical pregnancy, live birth, and miscarriage rates of 126 patients with Ut-Ad who underwent ART at our clinic, comparing them with 2,472 non-Ut-Ad individuals as controls. Additionally, we examined CA-125 levels and assessed the severity of dysmenorrhea. Results: The Ut-Ad group exhibited significantly lower pregnancy and live birth rates, along with lower gestational age and birth weight, compared to the non-Ut-Ad group. However, embryonic development until embryo transfer was comparable between the Ut-Ad and non-Ut-Ad groups. Notably, the miscarriage rate in the Ut-Ad group was significantly higher than that in the control group. Conclusions: Historically, clinical outcomes for Ut-Ad have been suboptimal, even with the use of modern ART treatments, resulting in low pregnancy rates. While the exact cause of Ut-Ad remains elusive, recent ultrasound findings suggest that minor disruptions in the uterine endometrium may contribute to adenomyosis development in young women with symptoms. Continuous monitoring via transvaginal ultrasound could facilitate early diagnosis and treatment, potentially offering substantial benefits for Ut-Ad management in the future.

Experience of using drospirenone/ethinyl estradiol combination in women of reproductive age

Introduction. A woman’s unwillingness to enter pregnancy due to social and somatic factors is associated with a high risk of its termination and concomitant complications. A personalized selection of a method of contraception is necessary, which best meets the needs of a woman, including in achieving non-contraceptive effects.Aim. To evaluate the effectiveness, safety and compliance indicators when using a combined drug (3 mg of drospirenone + 20 mcg of ethinyl estradiol) in women in the early and mature reproductive period.Materials and methods. A study involving 68 women (polycystic ovary syndrome (PCOS), n = 31, adenomyosis, n = 20, uterine fibroids, n = 7, a combination of 2 or more diagnoses) was conducted on the basis of the Scientific polyclinic Department of the V.I. Kulakov National Research Medical Center of the Ministry of Health of the Russian Federation) of reproductive age (18–34 years) who took a combined contraceptive drug for 6 months or more. The control of the results was carried out on the basis of monitoring in the form of a survey.Results. The average time of use of the drug was 9 (Q₁–Q₃: 8–11) months. After 3 and 6 months, 77.8% (21/27) and 100% of the observed patients, respectively, noted a decrease in the severity of PMS symptoms. 91.7% (n = 11/12) of patients noted a subjective decrease in the severity of acne and/or hirsutism after 6 months. 91.3% (n = 21/23) of women with copious painful menstruation noted normalization of the bleeding profile (volume of menstrual blood loss). 95.6% (65 patients out of 68) noted 100% compliance in the use of the drug.Conclusions. The drug Dimia has a favorable profile of clinical and pharmacological safety and efficacy, along with the complete reversibility of contraceptive action when actualizing the issue of the realization of reproductive function. The advantages of the drug are to achieve well-studied non-contraceptive effects, in which patients with PCOS, internal endometriosis and uterine fibroids are interested, in the form of relieving manifestations of PMS and reducing the severity of dysmenorrhea, as well as cosmetic skin imperfections (acne-type rashes, hirsutism). Thus, the drug can be recommended to women of reproductive age as a reliable contraceptive, as well as to achieve non-contraceptive effects.

The relationship between physical activity level on the severity of dysmenorrhea

Dysmenorrhea is a disorder in which women experience pain or cramping in the abdominal region throughout the menstrual cycle. It has been noted that physical activity and psychological variables can exacerbate dysmenorrhea. The purpose of this study was to examine the association between physical activity level and the severity of dysmenorrhea in late adolescence. This cross-sectional study involved 126 late female adolescents aged 17 to 25 years experiencing dysmenorrhea. The independent variable was physical activity, which was measured using the International Physical Activity Questionnaires (IPAQ), categorized into high and low physical activity levels . The dependent variable was dysmenorrhea, measured using the working ability, location, intensity, days of pain, and dysmenorrhea (WaLIDD), which was categorized into severe and mild dysmenorrhea. The association between physical activity and dysmenorrhea was analysed using simple binary logistic regression analysis.The findings indicated that mild dysmenorrhea was 93.65% and severe dysmenorrhea was 6.35%. Adolescents who engage in high physical activity were more likely to experience severe dysmenorrhea than adolescents who engage in light physical activity (OR= 5.11; p= 0.032; 95% CI= 1,15 to 22,72). The probability of adolescents who participated in high physical activity in experiencing severe dysmenorrhea was 14.70%. It can be concluded that high physical activity level is correlated to higher risk of experiencing severe dysmenorrhea.

The Effected of Curcuma to Dysmenorrhea: A Systematic Review

Background: Dysmenorrhea or menstrual pain is a common health problem among reproduction women. The prevalence of dysmenorrhea was high in many countries including in Indonesia. Some previous studies showed that curcumin was effective reduced menstrual pain. Purpose: The aim of this study was to determine the effected of curcumin to dysmenorrhea. Method: This study used systematic review method with Randomize Control Trial (RCT) design. The data was collected by using electronic databases such as Google Scholar, Science Direct, Pubmed, Scopus, Web of Science, SpringerLink and EBSCOhost in last 10 years, or in 2013-2023. The keywords used curcumin, turmeric, curcuma longa, dysmenorrhea, menstrual pain. Results: There were 7 selected articles in this literature study. Curcumin reduced intensity and duration of dysmenorrhea; the increasing of vitamin D; the reducing of serum IgE, serum aspartate transaminase (AST) and direct bilirubin levels among women with dysmenorrhea. Conclusion: Curcumin was affected to reducing the severity and symptoms of dysmenorrhea.

The effect of Citrus aurantium L. flower extract on the severity of primary dysmenorrhoea: a double-blind, randomised, controlled clinical trial

PurposeThis study aimed to assess the effect of Citrus aurantium L. flower on the distance between two cycles, physical activity, days of bleeding, and intensity of dysmenorrhoea (primary objectives), and complications of interventions or adverse effects (secondary purpose). MethodsThis double-blind, randomised controlled clinical trial was conducted on 105 girls (15–20 years old) with primary dysmenorrhoea. In the intervention cycles, from the first to the third day, participants received 250 mg C. aurantium flower hydro-alcoholic extract capsule, Mefenamic acid (MA) capsule, or placebo three times a day based on the study groups. ResultsThe results showed that the severity of dysmenorrhoea in the groups consuming C. aurantiumflower and MA was significantly lower than that before the intervention and compared to the placebo group (P< 0.001), which this reduction in the severity of pain in the C. aurantium flower group was also significantly higher than that of the MA group (P< 0.001) at the first and second days. ConclusionC. aurantium flower had higher efficacy and satisfaction rate and lower side effects in reducing the severity of primary dysmenorrhoea compared to MA.

Prevalence and severity of dysmenorrhea among adolescent Jordanian girls: a cross sectional study

Prevalence and severity of dysmenorrhea among adolescent Jordanian girls: a cross sectional study

Effects of intrauterine device use on attack frequency and severity ın woman of reproductive age with familial Mediterranean fever.

Familial Mediterranean fever (FMF) is the most common inherited autoinflammatory disease in the world. There are known triggers to initiate an FMF attack, yet potential effects of intrauterine devices (IUD) in women of reproductive age have not been evaluated before. Consecutive female patients with FMF who ever used IUD over the age of 18 were enrolled. Female patients with FMF were sub grouped according to the type of IUD they use. FMF attack frequency, severity, duration, presence of dysmenorrhea, severity of dysmenorrhea, having attacks during menstruation before and after IUD use were questioned. Demographic and clinical data were collected from hospital database. When all patients with IUD use were evaluated, it was found that the frequency of attacks increased after IUD insertion at 3rd and 12th months (median [min-max] attack frequency at 3rd month, 1 (0-3) vs 1 (0-6), p = 0.002, median [min-max] attack frequency at 12th month, 2 (0-12) vs 3.5 (0-18), p = 0.028). Attack severity measured by VAS pain was also significantly increased. Attack duration and menstrual pain was similar before and after IUD use. Attack frequency at 3rd and 12th months, attack severity and menstrual pain was all increased significantly in Cu-IUD users, whereas none of these parameters deteriorated in LNG-IUD group. IUD use, especially Cu-IUD, may increase the frequency and severity of attacks in female patients with FMF. Clinicians may benefit from considering LGN-IUD if IUDs are preferred as contraception in women of childbearing age with FMF.