Verbal Multidimensional Scoring System Research Articles

Exploring the Efficacy of Homeopathic Medicines in Treating Uterine Fibroids: A Comprehensive Review

Abstract: Introduction: Uterine fibroids are a common gynaecological condition affecting women worldwide, often leading to significant morbidity and impacting quality of life. While conventional treatment options exist, there is growing interest in alternative therapies such as homeopathy. Objective: The objective of this review paper is to assess the effectiveness of homeopathic medicines in treating uterine fibroids through the analysis of recent clinical trials and observational studies, aiming to provide insights into the potential role of homeopathy as a complementary or alternative therapy for uterine fibroids. Methodology: A thorough search of databases such as PubMed, Google Scholar, Scopus, and pertinent medical journals was undertaken to locate recent studies on the efficacy of homeopathic medicines for uterine fibroids. Only studies meeting predefined inclusion criteria, including randomized controlled trials, prospective observational studies, and systematic reviews, were included in the review process. Result: Recent studies investigating the efficacy of homeopathic medicines in treating uterine fibroids consistently demonstrated positive outcomes, including symptom alleviation, reduction in fibroid size, and improved quality of life. Various remedies showed effectiveness across various potencies. Symptom severity scales, including the Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), and Verbal Multidimensional Scoring System (VMSS), were utilized to assess pelvic pain, menstrual bleeding, and discomfort. Quality of life measures like the WHOQOL-BREF scale provided insights into overall well-being. Conclusion: In conclusion, homeopathic medicines show promise as a safe and effective treatment option for uterine fibroids, offering personalized care and improving quality of life. However, more research, including larger trials and long-term studies, is needed to confirm these findings and understand the underlying mechanisms better.

Evaluation of Electromagnetic Therapy in the Treatment of Severe Dysmenorrhea in Young Women of Basrah.

Primary dysmenorrhea (PD) is a public disease of young female worldwide, it affects their daily performances. Severe recurrent uterine cramps are the main complaints in 90% of adolescents and 50% of reproductive-age females. This study aimed to evaluate the use of magnetic field therapy in the treatment of severe dysmenorrhea grade 3 and provide an encouraging goal to continue daily work without pain. Two hundred and fifty female patients were recruited in this study from gynecological clinics in Basrah, southern Iraq. All had severe dysmenorrhea, patients were subjected to a questionnaire form, Visual Analog Scale, and verbal multidimensional scoring system to determine the pain intensity and grade of dysmenorrhea. Only 38 young females had severe dysmenorrhea grade 3 with ages ranging from 16 to 28 years with a mean age of 22.04 ± 1.43 years and body mass index 23.81 ± 1.94, patients subjected to electromagnetic field therapy (EMFT), two sessions per week for 20 min each for 6 weeks. Three categories were assessed, working ability, associated symptoms, and drugs used. Data were collected and statistically analyzed using SPSS version 22. The present study showed statistically significant progress (P < 0.05) in reducing pain, rare physical and mental complaints, and improved working ability with no need for drugs in majority of patients. EMFT has better results than other methods in relieving pain and symptoms of dysmenorrhea with a settled lifestyle.

Efficacy of Homoeopathic Ultra High Dilutions in management of Dysmenorrhoea: A Review

Introduction: Dysmenorrhea, or painful menstruation, affects a substantial portion of women worldwide, with prevalence rates reaching up to 67 to 90% among young women. This condition, characterized by intense lower abdominal cramps and associated symptoms, has a significant impact on women's quality of life. Conventional treatments like non-steroidal anti-inflammatory drugs (NSAIDs) have limitations, leading many to explore alternative therapies such as homeopathy. Objective: This article reviews the effects of homeopathic treatments on dysmenorrhea patients and examines seven studies conducted in this context. Methods: Studies which meet the specific required criteria; involving dysmenorrhea and Homoeopathy and being published in peer-reviewed English-language scientific journals were only included. Various parameters, such as disease intensity scales, the Menstrual Distress Questionnaire (MDQ), Pain Rating Scale (PRS), Visual Analogue Scale (VAS), and quality of life (QoL) using the World Health Organization Quality of Life: Brief Version (WHOQOL-BREF) scale, numerical rating scale (NRS), and verbal multidimensional scoring system (VMSS), were evaluated. The results before and after treatment with homoeopathic high dilutions have been compared and summarized. Results: Clinical analysis and statistical data of reviewed studies reveal homeopathic high dilutions as effective for Primary Dysmenorrhea, reducing pain (VAS), improving quality of life (WHOQOL), and demonstrating safety, emphasizing their holistic potential.&#x0D;

Effect of pilates exercise versus yoga on primary dysmenorrhea in adolescent girls

The aim of this study was to investigate the effect of Pilates exercise versus yoga on primary dysmenorrhea in adolescent girls. The study was designed as a randomized controlled trial and was conducted with adolescent girls at an experimental school in Cairo. Sixty adolescent girls, aged 12 to 16 years, who were all diagnosed with primary dysmenorrhea, participated in this study. They were randomly assigned to one of two groups: Group (A) (Pilates exercise) with 30 participants, and Group (B) (Yoga exercise) with 30 participants. Participants were assessed before and after the treatment period. Group (A) performed Pilates exercises for 30 minutes, three days per week, for three months, while Group (B) engaged in yoga exercises for 30 minutes, three days per week, for three months. The Visual Analog Scale (VAS) was used to rate the intensity of pain, and the Verbal Multidimensional Scoring System (VMS) was used to assess the severity of menstrual symptoms. Data analysis was conducted using the Statistical Package for the Social Sciences (SPSS). The study revealed a statistically significant improvement in VAS and VMS measures following Pilates exercise in Group A (p &lt; 0.05). Similarly, a statistically significant improvement in VAS and VMS measures was observed following yoga exercise in Group B (p &lt; 0.05). Both Pilates and yoga exercises demonstrated a significant impact on managing primary dysmenorrhea. The findings indicate that these mind-body interventions are effective in alleviating the severity of menstrual pain and related symptoms.

Prevalence of dysmenorrhea and associated factors and its effect on daily academic activities among female undergraduate students of Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia.

Dysmenorrhea is pain during menstrual flow and is the most common gynecologic complaint in reproductive-age girls. The severity of dysmenorrhea ranges from mild to severe pain during menstruation, which affects their academic activities. To assess the prevalence and associated risk factors of dysmenorrhea and its effects on academic activities among Hawassa University students from April 1-30/2021. A cross-sectional study was conducted and a systematic random sampling technique was used to select 348 study participants. Standardized self-administered questionnaires were used to obtain relevant data. The severity of pain was assessed using a verbal multidimensional scoring system and Numerical Pain Rating Scale (NPRS) methods. The collected data was entered into Epi info version 7 and exported to SPSS version 21 for analysis and then descriptive statistics and logistic regression analysis were performed. The prevalence of dysmenorrhea was 80% (277). Of those affected by dysmenorrhea, using the verbal multidimensional scoring system, 47.6% (132) were found to have mild pain, 39.7% (110) had moderate pain, and 12.6% (35) had severe pain. However, using the Numeric Pain Rating Scale (NPRS), 21.7% (60) were found to have mild pain, 33.2% (92) had moderate pain, 37.5% (104) had severe pain, and 7.6% (21) had very severe pain. It was found to have a negative effect on academic activity, such as loss of concentration in class (p = 0.00), disruption of study time (p = 0.00), sleep disturbances (p = 0.00), issues in personal relationships (p = 0.00), and absenteeism (p = 0.00). Associated factors included being sexually active, having a family history of dysmenorrhea, and the presence of depression. Dysmenorrhea is prevalent in this study and has a significant impact on academic activities. Family history of dysmenorrhea, being sexually active, and the presence of depression are associated factors.

The effect of vitamin D on the severity of dysmenorrhea and menstrual blood loss: a randomized clinical trial

BackgroundPrimary dysmenorrhea is considered as one of the women’s main problems during reproductive age. The present study aimed to investigate the effect of vitamin D on the severity of dysmenorrhea and menstrual blood loss.MethodsThis double-blind, randomized, placebo-controlled trial, was performed on 84 single female college students between 18 and 25 years old who living in dormitories. Students with primary dysmenorrhea and vitamin D deficiency were divided into experimental (n = 42) and control (n = 42) groups. Five days before the putative beginning of their next menstrual cycle, the experimental group received 300,000 IU vitamin D (50,000 IU, two tablets every 8 h), and the control group received a placebo (oral paraffin). The effects of the supplement on the severity of dysmenorrhea and menstrual blood loss were evaluated one cycle before and during two successive cycles. Using the visual analog scale (VAS), verbal multidimensional scoring system (VMS), and pictorial blood assessment chart (PBLAC) questionnaires. Fisher’s exact, Chi-square, independent sample t-test and repeated measurements were used.ResultsIn total, 78 of the 84 students completed the study (39 students per group). The intervention resulted in a significant reduction in the mean scores of both the VAS and VMS in the experimental group, in the first and second menstrual cycles (p < 0.001, p < 0.001, respectively), but not in the means score of PBLAC. Mefenamic acid consumption at the first and second menstruation period, in the experimental group was lower than the control group (p = 0.009, p < 0.001, respectively).ConclusionsThe results indicate that vitamin D supplementation could decrease the severity of primary dysmenorrhea and the need to consume pain-relief medications. Contrariwise vitamin D supplementation had no significant effect on menstrual blood loss.Trial registrationThis trial was registered in the Iranian Registry of Clinical Trials with code IRCT201305212324N on 18/1/2014. URL of registry: https://en.irct.ir/trial/1964.

Effect of an Instructional Guideline regarding Physical Measures on Primary Dysmenorrhea among Nursing Students

Bakeground: Physical measures are from one primary goal of alternative medicines and commonly cited as a probable remedy for primary dysmenorrhea. Aim: of the present work was to assess instructional guideline influence regarding physical measures on primary dysmenorrhea among nursing students. Design: A quasi experimental design pre/post-test one group was employed. Setting: This research was carried out at Benha University Hospital, technical nursing institution. Sample: 218 nursing students were involved as a purposive study sample. Tools: Data gathering was performed using 4 tools: An interviewing questionnaire to collect data related to sample and menstrual characteristics, Verbal multidimensional scoring system, Visual Analogue scale and Likert scale. Results: the present work assumed that a highly substantially critical change was found between symptoms of primary dysmenorrhea at pre and post- intervention and a highly substantially critical change was present among studied sample satisfaction and pain intensity of dysmenorrhea at post intervention phase (Р-value ≤ 0.05). Conclusion: Dysmenorrheal symptoms and pain were alleviated after implementation of an instructional guideline regarding physical measures than before implementation. Also there was a highly statistically critical association among studied sample satisfaction and pain intensity of dysmenorrhea at post intervention phase (Р-value ≤ 0.05).Consequently, the study hypothesis was confirmed. Recommendation: Physical measures as dysmenorrheal treatment are needed to develop and dissemination of illustrated guideline to control and relief of dysmenorrheal syndrome among nursing students and women in other ages.

Menstrual Cycle Length and Dysmenorrhea in Female Adolescents Aged 9-18 Years

Abstract&#x0D; Objective: To determine the relationship between menstrual cycle length and dysmenorrhea in female adolescents aged 9-18 years in Sang Timur Tomang School West Jakarta.&#x0D; Methods: This study used a cross-sectional study approach to conduct observational analytic research. The study samples were female students aged 9-18 years in Sang Timur Tomang School. Study data were obtained through the Verbal Multidimensional Scoring System (VMSS) questionnaire in Indonesian. The Chi-square test of independence was used to determine the relationship between menstrual cycle length and dysmenorrhea.&#x0D; Results: From a total of 137 respondents, 38% have abnormal menstrual cycle length. Eighty-two-point-seven percent of respondents who have abnormal menstrual cycle length experienced dysmenorrhea, and 17,3% of participants who have abnormal menstrual cycle length did not experience dysmenorrhea. Chi-square test results showed a significant relationship between menstrual cycle length and dysmenorrhea in female adolescents aged 9-18 years in Sang Timur Tomang School West Jakarta (p = 0,005).&#x0D; Conclusion: There is a significant relationship between menstrual cycle length and dysmenorrhea in female adolescents aged 9-18 years in Sang Timur Tomang School West Jakarta.&#x0D; Keywords: female adolescents, dysmenorrhea, menstrual cycle, menstrual cycle length

Primary Dysmenorrhea Associated with Psychological Distress in Medical Sciences Students in The North of Iran: A Cross-Sectional Study.

Primary dysmenorrhea is the usual medical status in medical students that are defined as pain<br />during the menstrual period. This study was done to evaluate the psychological problems associated with dysmenorrhea.<br />Materials and Methods: Three hundred forty students aged 18 to 20 years participated in this cross‑sectional<br />study (194 with dysmenorrhea and 150 without dysmenorrhea). In this cross‑sectional study, data were collected<br />through the sociodemographic checklist, the verbal multidimensional scoring system (VMS), and the revised<br />version of the Symptom Checklist-90 (SCL-90-R) questionnaire using the convenience sampling method. This<br />questionnaire includes 9 Subscale and a GSI index. We considered psychological distress to be equivalent to<br />the Global Severity İndex (GSI), which is obtained by dividing 90 questions by 90. The significance level of the<br />tests was considered 0.05.<br />Results: The GSI of the SCL-90 score in the 194 students with dysmenorrhea and 150 students without dysmenorrhea<br />was 1.02 ± 0.42 and 0.34 ± 0.15 respectively (P<0.001). In the group with dysmenorrhea, the severity<br />of dysmenorrhea was significantly associated with a family history of dysmenorrhea and mother's education<br />(P=0.012 and P=0.037, respectively). The strongest predictors of GSI>1 were a family history of dysmenorrhea<br />and mother's education [odds ratio (OR)=2.33, 95% confidence interval (CI), 1.43-4.15 and OR=0.45, 95% CI,<br />0.24-0.87, respectively].<br />Conclusion: According to the result, dysmenorrhea is associated with psychological distress. Psychological interventions<br />and counseling in addition to drug treatment are suggested for treatment of primary dysmenorrhea.<br />Therefore, it is necessary to formulate strategies and health policies to recover psychological issues of menstrual<br />health.

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.

Relationships between Gender Roles and Attitudes Towards Menstruation and Perception of Menstrual Pain in Iranian Women

Background: Menstruation is a prominent mark of womanhood. It is necessary to explore what factors may develop female attitudes towards this natural phenomenon in different populations. Objective: This study aimed to explore the relationships between gender roles and attitudes towards menstruation and perception of menstrual pain among Iranian women. Methods: This cross-sectional study was conducted on 164 women of reproductive age in Torbat-e Heydariyeh in the east of Iran between September and December 2019. The participants completed the Bem Sex-Role Inventory (BSRI), Menstrual Attitude Questionnaire (MAQ), and Verbal Multidimensional Scoring System (VMSS). Data analysis was then performed in SPSS 16.0. Results: According to the results, menstruation was perceived as a natural phenomenon more significantly by the androgynous group than by the undifferentiated and masculine groups (p&lt;0.05). It was also perceived as a predictable phenomenon more significantly by the feminine women than by the other gender role groups (p&lt;0.05). Furthermore, the gender role groups had no significant differences in the prevalence and severity of menstrual pain (p&gt;0.05). Conclusion: Androgynous women considered menstruation a natural phenomenon more often. Psychological interventions should focus on the correction of attitudes towards menstruation, especially in women with femininity, masculinity, and undifferentiated gender roles.

Efficacy of active stretching exercises against symptoms of primary dysmenorrhoea in young adult females: a randomized controlled trial

IntroductionPrimary dysmenorrhea symptoms affect most women’s daily life activities. The aim of the current study was to assess the efficacy of active stretching exercises in reducing pain intensity and improving menstruation characteristics of young adult females.MethodsThirty-three females with primary dysmenorrhea, were randomly assigned into three equal groups; group A (&lt;i&gt;n&lt;/i&gt; = 11) practiced a supervised active stretching program three times a week for four weeks, group B (&lt;i&gt;n&lt;/i&gt; = 11) practiced a non-supervised active stretching three times a week for four weeks and a control group C (&lt;i&gt;n&lt;/i&gt; = 11). Pain intensity and menstruation characteristics were measured by Visual Analog Scale (VAS) and Verbal Multidimensional Scoring System (VMS) respectively, before and at the end of the study. Kruskal-Wallis test was used to test differences between groups; While Wilcoxon Signed-Ranks test was used to within-group comparison.ResultsA significant reduction in pain intensity was obtained in both intervention groups (A&amp;B) (&lt;i&gt;p&lt;/i&gt; = 0.003; 0.007 respectively), whereas post-treatment comparison between groups revealed a statistically significant reduction in pain intensity in favor of group A (&lt;i&gt;p&lt;/i&gt; ˂ 0.001). A significant improvement in menstruation characteristics was found in group A (&lt;i&gt;p&lt;/i&gt; = 0.007) with non-significant improvements in either group B or the control group C (&lt;i&gt;p&lt;/i&gt; = 0.07; 1.0 respectively).ConclusionsBoth supervised and non-supervised active stretching exercises could provide a safe non-pharmacological alternative for pain relief in primary dysmenorrhea.

HUBUNGAN DERAJAT DYSMENORRHEA DENGAN KONSISTENSI FECES PADA MAHASISWI KEDOKTERAN UNIVERSITAS UDAYANA

Gastrointestinal symptoms such as fecal consistency change commonly found in menstrual women. Women who have dysmenorrhea are likely to experience it than women without dysmenorrhea. This study aims to identify relationship between dysmenorrhea intensity with fecal consistency change among medical students of Udayana University. The hypothesis of this study is there is relationship between dysmenorrhea intensity with fecal consistency change among medical students of Udayana University. This study used analytic cross-sectional design. Questionnaires given to all medical students of Udayana University consists of questions about respondents’ identity, exclusion criteria, dysmenorrhea intensity in last menstruation based on Verbal Multi-dimensional Scoring System, and fecal consistency category based on Bristol Stool Scale. A total of 389 questionnaires collected and selected to rule out ineligible data. Eligible data were analyzed using descriptive test and Fisher Exact Test. Respondents involved in this study were female students aged 18-25 years. A number of 22.6% of respondents did not experience dysmenorrhea, while 59.1% had grade 1 dysmenorrhea, 16.5% grade 2, and 1.7% grade 3. A number of 14.8% of respondents had abnormal hard fecal consistency, 84.3 % normal, and 0.9% abnormal soft. There was no significant relationship between dysmenorrhea intensity and fecal consistency with P value equals to 0.238. This can caused by various factors such as diet, physical activity, sleep quality, stress, and different defecation habits of each respondents. Based on the results, it is concluded that there is no significant relationship between the dysmenorrhea intensity and the fecal consistency among medical students at Udayana University.

Reduced Activity and Quality of Life in Women Soldiers with Heavy Menstrual Bleeding and Dysmenorrhea.

The aim of the study was to examine the effect of heavy menstrual bleeding (HMB) and dysmenorrhea on daily activity and quality of life (QoL) in young women engaged in demanding activities. Cross-sectional study. A total of 422 Israeli women soldiers in combat and non-combat roles. Participants were asked to provide consent and to complete study questionnaires. A pictorial bleeding assessment chart (PBAC), visual analog scale (VAS), verbal multidimensional scoring system for assessment of dysmenorrhea, and approved Hebrew-translated age-appropriate Pediatric Quality of Life Inventory (PedsQL). HMB (PBAC >100) and severe HMB (PBAC >185) were demonstrated in 181 (50%) and 96 (26%) participants, respectively. A high PBAC score was recorded in 20% who answered "no" or "unknown" in the questionnaire on having HMB. Mild, moderate, and severe dysmenorrhea were demonstrated in 80 (21.5%), 115 (31%), and 142 (38%) participants, respectively. The prevalence of HMB and dysmenorrhea was similar in soldiers in combat and non-combat roles. Diagnosis of HMB was related to the lower fitness-for-service score, history of bleeding, and dysmenorrhea. Daily activity and QoL were both affected by the severity of HMB and dysmenorrhea. Underdiagnosis of HMB and dysmenorrhea results from a combination of unawareness from the women's side and inattention from the system. In an era of female empowerment, each woman should be at the optimal physiological and psychological level to start her career; thus, addressing the menstrual burden and providing effective treatment is needed in the military scenario and other settings with demanding activities.

The correlation between primary dysmenorrhea and oxidative stress markers in adolescents

Objectives: Primary dysmenorrhea is the most common gynecological complaint in adolescent girls. Among many factors, oxidative stress (OS) is thought to be a potential factor in the etiology of primary dysmenorrhea. In this study, it is thought that the use of IMA, thiol, and disulfide levels as a diagnostic marker in primary dysmenorrhea and antioxidant interventions may play a role in the treatment of primary dysmenorrhea and may benefit the pathophysiological and treatment process of the disease. Methods: Thirty adolescent girls (study group) with grade 2.3 primary dysmenorrhea who applied to outpatient clinic and 30 healthy young girls (control group) of similar age group were included in the study. Primary dysmenorrhea grade was analyzed with the help of the visual analog scale (VAS) and verbal multidimensional scoring system (VMS). Patient`s basal hormone levels in the early follicular phase, serum albumin, IMA, total thiol, native thiol, disulfide, C-reactive protein (CRP), and cancer antigen-125 (CA-125) were recorded as main parameters. Results: Oxidative stress markers were compared between the primary dysmenorrhea and control groups. Although albumin, IMA, and disulfide levels were higher on average in the group with dysmenorrhea, the difference was not statistically significant. Disulfide level was found to be significantly higher in the group with CA125 ≥ 35. Conclusions: In our study, we examined serum albumin, IMA, total thiol, native thiol and disulfide levels in two groups resuts were not statistically significant. In this study, we concluded that as the CA125 level increased, the disulfide level increased in parallel.

Primary Dysmenorrhea Associated with Psychological Distress in Medical Sciences Students in The North of Iran: A Cross-Sectional Study

Background:Primary dysmenorrhea is the usual medical status in medical students that are defined as pain during the menstrual period. This study was done to evaluate the psychological problems associated with dysmenorrhea.Materials and Methods:Three hundred forty students aged 18 to 20 years participated in this cross‑sectional study (194 with dysmenorrhea and 150 without dysmenorrhea). In this cross‑sectional study, data were collected through the sociodemographic checklist, the verbal multidimensional scoring system (VMS), and the revised version of the Symptom Checklist-90 (SCL-90-R) questionnaire using the convenience sampling method. This questionnaire includes 9 Subscale and a GSI index. We considered psychological distress to be equivalent to the Global Severity İndex (GSI), which is obtained by dividing 90 questions by 90. The significance level of the tests was considered 0.05.Results:The GSI of the SCL-90 score in the 194 students with dysmenorrhea and 150 students without dysmenorrhea was 1.02 ± 0.42 and 0.34 ± 0.15 respectively (P<0.001). In the group with dysmenorrhea, the severity of dysmenorrhea was significantly associated with a family history of dysmenorrhea and mother's education (P=0.012 and P=0.037, respectively). The strongest predictors of GSI>1 were a family history of dysmenorrhea and mother’s education [odds ratio (OR)=2.33, 95% confidence interval (CI), 1.43-4.15 and OR=0.45, 95% CI, 0.24-0.87, respectively].Conclusion:According to the result, dysmenorrhea is associated with psychological distress. Psychological interventions and counseling in addition to drug treatment are suggested for treatment of primary dysmenorrhea. Therefore, it is necessary to formulate strategies and health policies to recover psychological issues of menstrual health.

Prevalence of dysmenorrhea in adolescents in France: Results of a large cross-sectional study

BackgroundsDysmenorrhea is the most common gynecological complaint in young women but is overlooked by recent studies. Our objective was to evaluate the prevalence of dysmenorrhea in adolescents in France and its impact on daily living. MethodsIt was a cross-sectional study conducted between April–May 2019, in eight randomly selected high schools in France. Participants were randomly selected post-menarche girl pupils 15–19 years who completed a 50-item questionnaire. Dysmenorrhea severity was assessed with the Numerical Rating Scale (NRS) and Verbal Multidimensional Scoring System Scale (VMSS). ResultsQuestionnaires from 953 girls were analyzed (mean age: 16.9 years). The prevalence of dysmenorrhea was 92.9% with 8.9% describing their pain as severe. Impact on quality of life was significant: 43.3% reported school absences because of dysmenorrhea, 74.9% difficulties in attending classes and 77.2% difficulties in sports activities. Risk factors of severe dysmenorrhea in multivariate analysis were heavy menstrual bleeding (OR 2.02, 95%CI [1.12; 3.63] p = 0.0192), early menarche (OR 0.68, 95%CI [0.57; 0.81] p<0.0001), chronic pelvic pain (OR 2.60, 95%CI [1.10; 6.11] p = 0.0274), BMI (BMI<18, OR 1.94, 95%CI [1.03; 3.66] p = 0.0335). Of the 50.4% who had consulted a physician, 45.4% had seen a general practitioner. Among the girls who had not consulted, 55.1% reported that menstruation was a “woman's burden”. ConclusionsDysmenorrhea is highly prevalent in adolescents in France and has a real impact on daily living with social repercussions. As such, it should be treated as a public health problem with educational and information campaigns targeting the girls themselves, their families and healthcare professionals.

Comparison of effect of auriculotherapy and mefenamic acid on the severity and systemic symptoms of primary dysmenorrhea: a randomized clinical trial

BackgroundPrimary dysmenorrhea (PD) is the most common complaint in young women and adolescents. Side effects of non-steroidal anti-inflammatory drugs can limit their use. Therefore, non-pharmacological pain relief methods such as auriculotherapy may play an important role in PD management. This study was conducted to compare the effect of auriculotherapy and mefenamic acid on the severity and systemic symptoms of PD.MethodsIn a randomized clinical trial, 83 students were randomized into two groups. In the auriculotherapy group, electrical stimulation of the ear was conducted once a week for two menstrual cycles. In each cycle close to menstruation, ear seeds were inserted on pressure points to be pressed in times of pain. In the mefenamic acid group, subjects took mefenamic acid capsules upon seeing the initial symptoms of menstruation until the pain reduces. The primary outcomes were mean pain intensity and systemic symptoms associated with it. Pain intensity was measured through the visual analog scale (VAS) and the verbal multidimensional scoring system (VMS). Systemic symptoms were assessed using VMS, as well as the yes/no question form.ResultsMean pain intensity with the VAS was significantly lower in the auriculotherapy group than the mefenamic acid group in the first and second cycles of intervention. There was a significant difference in VMS grade between both groups during the second cycle of intervention. In terms of the systemic symptoms in the second cycle of intervention, no subjects had dysmenorrhea grade 3 (common systemic symptoms) in the auriculotherapy group. Whereas in the mefenamic acid group, 16.7% of the subjects still had dysmenorrhea grade 3. There was no significant difference between the two groups in the frequency of systemic symptoms of PD. There was a significant decrease in the frequency of fatigue and diarrhea in both groups. However, there was a significant reduction in the frequency of nausea, headache, and anger in the auriculotherapy group.ConclusionMean pain intensity with the VAS was lower with the auriculotherapy. Also, 65.9% of auriculotherapy group subjects were in the dysmenorrhea grades 0 and 1. Therefore, auriculotherapy is recommended because of its fewer complications and more effect on PD.Trial registrationClinicalTrials.gov IRCT20181207041873N1. Registered on February 24, 2019. https://en.irct.ir/user/trial/35967/view

Efficacy of individualized homeopathic medicines in primary dysmenorrhea: a double-blind, randomized, placebo-controlled, clinical trial.

Homeopathic treatment is claimed to be beneficial for primary dysmenorrhoea (PD); still, systematic research evidences remain compromised. This study was undertaken to examine the efficacy of individualized homeopathic medicines (IH) against placebo in the treatment of PD. A double-blind, randomized, placebo-controlled trial was conducted at the gynecology outpatient department of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, West Bengal, India. Patients wererandomized to receive either IH (n=64) or identical-looking placebo (n=64). Primary and secondary outcome measures were 0-10 numeric rating scales (NRS) measuring intensity of pain of dysmenorrhea and verbal multidimensional scoring system (VMSS) respectively; all measured at baseline, and every month, up to 3months. Group differences and effect sizes (Cohen's d) were calculated on intention-to-treat (ITT) sample. Groups were comparable at baseline (all p>0.05). Attrition rate was 10.9% (IH: 7, placebo: 7). Differences between groups in both pain NRS and VMSS favoured IH over placebo at all time points (all p<0.001, unpaired t-tests and two-ways repeated measures analysis of variance) with medium to large effect sizes. Natrum muriaticum and Pulsatilla nigricans (n=20 each; 15.6%) were the most frequently prescribed medicines. No harms, serious adverse events and intercurrent illnesses were recorded in either of the groups. Homeopathic medicines acted significantly better than placebo in the treatment of PD. Independent replication is warranted. Trial registration: CTRI/2018/10/016013.

Menstrual Cycle Pain Is Independent of Ovulation in Adolescents With Primary Dysmenorrhea.

This study aimed to evaluate the presence of anovulation in adolescents with primary dysmenorrhea (PD). Prospective cohort study. Hacettepe University Children's Hospital, Adolescent Medicine outpatient clinic between September 2018 and September 2019. Healthy female adolescents (between 11 and 18 years of age), with regular menstruation with a score of 1-3 according to the Numerical Rating Scale (NRS) and grade 0 (no limitation for daily activities, no analgesic need and systemic symptoms) according to the Verbal Multidimensional Scoring System (VBSS) were recruited as a control group. The participants who met the diagnostic criteria for PD with an NRS score ≥4, had analgesic need in at least the last 3 menstrual cycles, had defined moderate-to-severe PD according to VMSS (Grade 2-3), and had analgesic need every time were accepted as the PD group. For the determination of ovulation, suprapubic pelvic ultrasound and luteal SP levels were used. The first day of menstruation (DOM) was accepted as the first day of the menstrual cycle. The participants were called to the outpatient clinic for a total of 3 visits during 1 cycle; the first visit was for the suprapubic pelvic ultrasound imaging on the 12th-18th DOM, the second visit was for the first SP level measurement on the 21st-24th DOM, and the third visit was for the second SP level measurement on the 28th-31st DOM, if the next expected menstruation has not started yet. Participants' anthropometric measurements, menstrual history, family history of dysmenorrhea, and additional symptoms accompanying pain were recorded. Anovulatory cycle rates according to 2 different references for SP threshold values (3 and 5 ng/mL) were 31.7% and 36.6% in the PD group, and 44.4% and 55.6% in the control group, respectively (P = .250, P = .095). In the PD group, NRS scores were similar for the ovulatory and anovulatory cycles for both SP threshold values (P = .320, P = .205). When the reference value for SP threshold was accepted as ≥5 ng/mL, the NRS score was significantly higher in the ovulatory group (P = .0017). When the distribution percentages of SP levels were evaluated among all participants, the median value was 5.5 ng/mL. Contrary to classical information, anovulatory cycles are not rare in PD patients, and pain severity is at the same level in these cycles. The pathogenesis of PD in adolescents requires further study.