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Many women are familiar with the experience of spasmodic dysmenorrhoea, one of the commonest gynaecological conditions that affects the quality of life of many in their reproductive years. This condition manifested as painful menstruation, is the most frequently encountered gynaecological complaint and it can be included under Udavartha yonivyapat, caused by Apanavata vaigunya described in Ayurvedic classics. This situation not only has a significant effect on quality of life and personal health but also resulting in loss of work hours and depression. Scholastic backwardness and work absenteeism as a result of dysmenorrhoea is common nowadays. Most of the medical therapies for painful periods like analgesics, antispasmodics, NSAID, and anti-prostaglandins are having many side effects. Hormonal and surgical therapies are also not advisable to all type of patients, especially teenagers as it may harm their future reproductive capacity. Here comes the importance of Yoga, which provides good approach to treat primary dysmenorrhea. Yoga asanas helps in stretching muscles of pelvic cavity and increases the blood circulation to the pelvic organs and also helps to neutralize Apana vayu, which help in normal menstrual flow. The practice of Asanas has a beneficial impact on the whole body systems and helps in relaxation of both body and mind. This study is undertaken to find out the Yogasanas having pain relieving capacity in spasmodic dysmenorrhoea as it doesn’t cause any side effects but improve the quality of life. A thorough literary survey was done in Yogic classics especially Asanas for women’s health, Asanas for reproductive health and tried to compile the Asanas together having the pain relieving capacity in primary dysmenorrhoea.
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Background: Dysmenorrhoea is a common problem during menses in adolescent girls which affects their quality of life, academic activities, cannot attend social functions and use over the counter medicines which may lead to dangerous adverse effects and infertility. Objectives: 1. To study the prevalence of dysmenorrhea in adolescent girls studying in government municipal high schools of Tirupati. 2.To determine the significant factors related to menstrual distress in adolescent girls. Methodology: A cross-sectional study conducted among 320 adolescent girls studying in the selected government high schools of Tirupati, India. The study investigated symptoms, related factors and consequences of menstrual distress in adolescent girls with dysmenorrhea. Four instruments were used to collect data: Questionnaires on Demographic Data, Menstrual Distress Questionnaire, A Questionnaire related to Menstrual characters and A Short Form McGill Pin Questionnaire. Results: Prevalence of dysmenorrhoea among adolescent girls was found 67.7%. Regression analysis indicated that the best subset for predicting menstrual distress in adolescent girls included MPQ-SF, menstrual cycle in days, socioeconomic status and education. Conclusions: Majority (67.7%) of the adolescent girls were suffering with dysmenorrhoea. Menstrual distress is significantly correlated with impact on daily activities, absence from class, and analgesic usage.
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Background:The study aims to prove the efficacy of Homoeopathic Medicines in Dysmenorrhoea was conducted for 1½ year in the age of 14-45 years. Dysmenorrhoea is commonest complaint in females affecting half of females in the age of 11-45 years. It is one of the leading causes of periodic absentee in colleges and school. It incapacitates women in her day to day life1. It is defined as painful menstruation of uterine origin and is divided in two categories Primary and secondary. Primary begins typically during adolescences and there is no pelvic cause while secondary is uncommon during adolescences and results from pelvic origin. This article focuses on classification, pathology, clinical type and efficacy of homoeopathic medicines. The aim is to give a pain free menstruation to female thus improving quality of life in women. Material And Methods:A total of 20 patient were selected who complained of moderate to severe dysmenorrhoea for 1½ year with holistic approach according to model case proforma. Result:The study shows that in majority of cases there was no major cause for dysmenorrhoea 90% of cases responded well with Homoeopathic medicines where majority cases required PULSATILLA as a constitutional medicine, Mag Phosphoricum as an acute and Tuberculinum as intercurrent remedy. Among these,constitutional medicine acts more effectively.Conclusion:Thus it can be concluded that Homoeopathic medicines prove effective along with change in lifestyle, food habits and distress. Acute exacerbation can be controlled with acute medicines and anti miasmatic are required in stands still conditions. Potency can be 30 or 200 depending on susceptibility.
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Symplastic leiomyoma is an unusual variant of leiomyoma. Malignant transformation accounts for 0.2% of all cases of leiomyoma. Atypical and bizarre leiomyoma synonymous with symplastic leiomyoma are rare smooth muscle tumors that contain cells with moderate to severe cytological atypia, still cell necrosis is absent and mitotic index is fewer than 10/10 HPF. A 42-year P1L1A3 with no comorbidities came with complaints of lower abdominal pain for one year and heavy menstrual bleeding for eight months, LMP- 15/2/19, regular cycles, changes 4-5 pads/day, clots (+) (+), dysmenorrhoea (+). Parity score of P1L1A3, LCB-24 years, not sterilized. On examination - moderately built and nourished, pallor (+). Per abdomen examination - uterus - 22 weeks size, irregular mass, arising from pelvis - no tenderness, lower border not made out. Per speculum examination - cervix and vagina healthy. Per vagina examination - cervix firm, posterior, left fornix: mass felt, non-tender. The patient underwent Abdominal hysterectomy and B/L salpingo-oophorectomy under CSEA. Intraoperative findings - uterus - 20 weeks size, enlarged, a posterior wall subserosal fibroid with degeneration of 6×8 cm. Microscopic appearance - uterus - myometrium shows changes in adenomyosis. Sections of smaller mass reveal structure of leiomyoma. Nuclei are large, hyperchromatic, and show coarse chromatin clumps. Many giant-sized cells with multiple large nuclei were seen. It showed large chromatin clumps. Stroma showed myxoid change. Diagnosis - symplastic leiomyoma, adenomyosis. Symplastic leiomyoma is an unusual variant of leiomyoma. Malignant transformation accounts for 0.2% of all cases of leiomyoma. The regularity of the tumor margins, low mitotic activity, and absence of nuclear atypia or necrosis should be made for the exclusion of malignancy.
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Background: Medical students are at high risk for developing menstrual irregularities due to their lifestyle, food pattern and exercise habits. Also, majority of the menstrual disorders are preventable by changing better lifestyle, early diagnosis and treatment. Hence this study was conducted with the objective of addressing the menstrual disorders and associated problems among the medical students.Methods: The cross-sectional study was conducted by the department of obstetrics and gynaecology, at Sri Muthukumaran Medical College Hospital and Research Institute, among the first, second- and third-year female students who are doing their MBBS course in the same institute, during the month of December 2019. A total of hundred students were included in the study. Data was collected using a proforma and analysis was done using Statistical Package for Social Sciences (SPSS) version 17.Results: Menstrual cycle periodicity was irregular among 17% of participants. Dysmenorrhoea, mid cycle pain, heavy menstrual bleeding was noted among 27%, 19% and 11% respectively. Also 10% of students reported sickness absenteeism due to menstrual disorders.Conclusions: Adolescent students should be educated on the importance of physical and mental health in terms of healthy food habits and regular physical exercise to overcome the menstrual disorders and to enjoy healthy reproductive period.
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Robert uterus is a rare Mullerian development anomaly with very few cases reports available. It presents with triad of morphologic features of - Blind hemi cavity with or without unilateral hematometra, contralateral unicornuate uterine cavity and normal uterine fundus with or without small external indentation. The major difficulty lies in making the diagnosis of Robert’s uterus. All the reported cases of Robert’s uterus have been managed differently according to patient’s complaints. A 25-year-old married female, resident of Agra presented to gynecology OPD of Dr RML Hospital and associated PGIMER in June 2013, with primary infertility and cyclical left sided dysmenorrhoea since menarche. Patient was consulting at her hometown Agra for 2 years and had an USG and MRI pelvis report of Feb. 2013 with her showing unicornuate uterus with rudimentary horn. Infertility investigations were done in our hospital. HSG report was of localized spill on right with left tubal block. Patient was posted for diagnostic hystero-laproscopy which was further followed by laprotomy, after which we could reach to a diagnosis of Robert uterus with non-communicating left cavity and with severe endometriosis. Patient needed a second hysteroscopy for lysis of septum and subsequently conceived with IVF. She delivered a healthy male baby of 2.65 kg by elective LSCS at 37 weeks with associated breech presentation with gestational hypertension with severe IHCP on 20 June 2019. Paediatric surgeons and gynecologists should be aware of this rare atypical obstructive Mullerian malformation and its management to avoid inappropriate management delays in these patients. A timely diagnosis and definite treatment have a great impact on future reproductive and endocrine function.
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Background: This study was conducted to detect various presenting clinical features, type and severity of pelvic endometriosis according to revised American fertility society classification. Objective of this study was to assess outcome of endometriosis after medical and surgical treatment in form of pregnancy, reduction of symptoms like dysmenorrhoea, dyspareunia and others.Methods: This prospective study conducted at one of tertiary care teaching institutes for period of 3 years from January 2011 to December 2013. A total number of 100 patients of pelvic endometriosis were examined and divided according to Revised American Fertility Society Classification on bases of severity, type and clinical features and laparoscopic findings. After 1 year of follow up, outcome assessed after completion of medical and surgical treatment in form of pregnancy, reduction of dysmenorrhoea and dyspareunia and other symptoms.Results: This study showed most affected patients (46%) belongs to 26-30 years of age group, dysmenorrhoea was the most common presenting symptoms in 76% patients. Most common site affected (52%) was ovaries. Laparoscopy was done in 86% patients. Most patients (44%) were benefited with fulguration of endometriotic nodules. 62% of patients were given oral contraceptive pills or progesterone pills after definitive surgery as freely available in Governmental setup and fewer side effects as compared to Danazol and GnRH analogues. 40 patients became pregnant after medical and surgical treatment, where 60 patients had reduced dysmenorrhoea and 20 patients had reduced dyspareunia.Conclusions: Laparoscopy is gold standard diagnostic as well as therapeutic tool in pelvic endometriosis as it can rule out other causes of infertility without interfering normal anatomy.
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Endometrial osseous metaplasia is an uncommon pathology with varied clinical symptoms. Its pathogenesis is not exactly known and has a benign course. Here we present a case of a 42-year-old female with abnormal uterine bleeding who did not respond to medical management. On ultrasonography, suspected endometrial calcification was seen. Patient opted for hysterectomy and the biopsy report showed endometrial osseous metaplasia. Thus, in this case of menometrorrhagia and dysmenorrhoea, the cause was found to be osseous metaplasia.
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Background: Dysmenorrhoeais a debilitating menstrual problem and may be related to body mass index (BMI). This study was done to explore the various gynecological problems in girls in their late adolescence that is pursuing professional courses in medicine, dental and nursing.Methods: This was a prospective, questionnaire based study conducted between January and February 2019 in a medical college in Visakhapatnam, India. The survey included female undergraduate students of the Medical, Dental and Nursing colleges to find out their menstrual history and reproductive awareness with the help of a self-structured questionnaire. Participants were categorized based on BMI. Data was reported as number and percentage.Results: Of the 190 participants, 154 participants (age range; 16-19 years) were included in the study. Fifty percent of the total participants reported to have dysmenorrhoea, of which 21% reported severe dysmenorrhoea. A very high % of participants in the obese category (77.8%) reported severe dysmenorrhoea, followed by 27.3% in the underweight category. A U-shaped relationship between percentage of participants with severe dysmenorrhoea and increasing BMI was observed. A fair percentage of obese participants reported for infrequent periods beyond 35-45 days and androgenic features like excess hair, acne and dark pigmentation around neck, suggestive of polycystic ovarian syndrome (PCOS). The participants possessed a high level of awareness and reported in the range of 87.1 to 96.8% related to reproductive health.Conclusions: Despite high level of awareness among the participants we observed a considerably high prevalence of dysmenorrhoea which was even more prevalent, in the obese category.
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Background: Adolescence is the period of rapid physical growth, psychological and social changes. This period is marked by the onset of menarche in the girls. Menstruation is a natural biological process experienced by all adolescent girls and women in reproductive age. The menstrual cycle is characterized by variability in volume, pattern and regularity. Conversely, variability in menstrual cycle characteristics and menstrual disorders are common among adolescent girls. The objectives of the study were to determine patterns of menstruation, prevalence of menstrual disorders and hygienic practices during menstruation in the adolescent school girls.Methods: A cross-sectional study was conducted among 210 adolescent school girls of Delhi.Results: The mean age at menarche in the study subjects was 13.47±0.87 years. Average menstrual interval was days. Dysmenorrhea was reported by 76.1% of the girls, body ache was experienced by 64 (30.4%). Majority of girls 174 (82.8%) used sanitary pads as absorbent during cycle.Conclusions: Menstrual problems are frequent among adolescent girls. Dysmenorrhoea was the commonest problem among the adolescents. Adolescent girls withstand their pain and think it as a normal phenomenon. Educating students about menstrual health by health professionals and teachers can help in reducing their psychological and physical stress.
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Background: The aim of the study was to evaluate average age of menarche, the pattern and types of menstrual disorders and their relation with BMI, dietary habits, physical exercise and stress.Methods: A cross sectional prospective study was conducted on female medical students during the academic year 2018-2019 at Mallareddy medical college for women, Suraram, Hyderabad, India. The various life style factors including BMI, junk food consumption and physical exercise were factored. Prevalence of each different menstrual abnormality were identified and analyzed by Chi-squire test and p value <0.005 was considered as statistically significant.Results: Study included 255 medical students who had attained menarche without known medical problems. Mean age of menarche was 12.81years. The most frequent menstrual disorders were premenstrual syndrome 192 (75 %), dysmenorrhoea 146 (57 %), and irregular cycle 97(38%). Statistically significant association of Body mass index (BMI) related to premenstrual syndrome (PMS) and dysmenorrhoea was reported (both p<0.05). Similarly, statistically significant association of lack of physical activity had greater risk of premenstrual syndrome and dysmenorrhoea (both p<0.0001). Unhealthy dietary patterns had statistically significant higher risk for dysmenorrhoea (p<0.0001).Conclusions: In conclusion premenstrual symptoms, dysmenorrhoea and menstrual irregularities were more prevalent. Majority of symptoms were stress, pain abdomen, irritability, mood swings. Comprehensive education programs on lifestyle modifications like regular physical activities, promoting healthy eating habits should be emphasised to prevent menstrual abnormalities of young students as early as at school level.
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Endometriosis is common cause of infertility. We report a case of 28 year old female presenting with left iliac fossa lump diagnosed as endometriosis of fallopian tube on histopathological examination.
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Adolescence is the rapid growing period when mainly the physical changes are important. 95% girls attain menarche at the age group of 10 to 16 yrs, the peak being 13yrs. Among them, not less than 50% of female are said to experience some discomfort or pain in relation to menstruation. Kashtartava is a symptom mentioned in various Yoni vyapads, Vata being the main causative factor for this condition, which is commonly compared with dysmenorrhoea by cotemporary science. Conventional treatment of primary dysmenorrhoea consists of non-steroidal and anti-inflammatory drugs, hormonal therapy which causes unwanted side effects. Hence Rutukari Vati which is mentioned in Bheshaja Samhita for Kashtartava having the properties like, Vedanashamaka, Arthavajanana have been selected for the planned study. Design of Study: A Single blind comparative clinical study of two groups, trial and control, consisting of 15 subjects in each with pre-test and post-test design. Group A was given Rutukarivati and Group B was given Kumaryasava 25ml twice daily after food. Result: Rutukarivati contains most of the drugs with Tiktha and Katu rasa, Usnaveerya property and Vatakaphahara property; it is effective in controlling pain and regularizing the cycle. On comparison of overall effect of both groups has more significant result but percentage wise group A is more effective than group B. Mild increase in amount of bleeding was noted in patients in group A. It may be because of most of the ingredients in Rutukarivati are Artavajanana and Apanavatashaman.
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In today’s lifestyle woman’s status is expected to reach new horizons both socially and physically but some of the physiological things trouble the lady to make her slow down the race, by disturbing the normal menstruation, which is the function of Apana vayu. One of such problem is ‘Kashtartava’ (Dysmenorrhoea) i.e. painful menstruation. In Ayurvedic texts, though various conditions are described in which menstruation occurs with pain but Kashtartava is not mentioned specifically. It is a symptom of various Yonivyapadas specially Udavarta, Vatala, Sannipatika etc. The genital tract of women does not get affected without Vata, Hence one should pacify it first and then treat the other Doshas. For Vata dosha basti chikitsa is very important. Matrabasti is used by someone who emaciated by overwork or too much exercise, too much heavy lifting, walking too long of a distance, too much sexual activity or someone with Vata disorders. One of the effects of Matrabasti is “Vatarognut”, Hence Matrabasti may be effective on Kashtartava (Dysmenorrhoea). From above study, it can be concluded that due to Basti chikitsa vitiated Vata dosha gets mitigated and hence all the symptoms diminish and it has been observed that Til taila Matra Basti is very effective in subjects of Kashtartava (Primary Dysmenorrhoea).
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Background: Chronic Pelvic Pain (CPP) is one of the commonest symptomatology in gynaecologist’s outpatient clinics. CPP has a profound impact on a woman's health and quality of life, including an economic impact through loss of working hours. Treatment for chronic pelvic pain is often unsatisfactory. Present study compares Laparoscopic Uterosacral Nerve Ablation (LUNA) with laparoscopy without pelvic denervation in patients presenting with chronic pelvic pain to our outpatient clinic.Methods: It was a Randomised Controlled Trial Study. After considering inclusion and exclusion criteria, 120 patients were selected, out of which 60 (Group I) had undergone diagnostic laparoscopy and 60 (Group II) had undergone diagnostic laparoscopy with LUNA.Results: The overall success rate for group I and group II were 80%, 78.3% and 66.6% versus 85%, 81.6%, and 83.3% at 3, 6, and 12 months, respectively. However, on subgroup analysis it was found that in patients suffering from Congestive Dysmenorrhoea, there was a significant difference in success rate of both the groups.Conclusions: It was found in present study that there was a benefit for patients with dysmenorrheal, further research in this area is desirable to reach towards a discrete conclusion regarding the benefits of LUNA in patients of CPP.
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Objective To assess the efficacy of Tiaojing Huoxue CapsuleS for the primary dysmenorrhoea (PD). Methods A total of 300 women with PD were enrolled and randomly divided into the control and treatment group, which were administrated with placebo and Tiaojing Huoxue Capsules for three menstrual cycles, respectively. The efficacy of Tiaojing Huoxue Capsule was evaluated by visual analogue scale (VAS) and traditional Chinese medicine (TCM) syndrome scores. Results The effective rate of VAS was 62.43% in the experiment group with statistical significance when compared with the control group (P < 0.01). Similarly, the total effective rate in the treatment group was 76.30% while that in the control group was 36.67% after treatment of three menstrual cycles. Conclusion Tiaojing Huoxue Capsules can relieve the alleviating pain for women with PD.
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Objetivo: Descrever o perfil epidemiológico e clínico de pacientes inférteis com endometriose. Métodos: Estudo transversal que avaliou 450 prontuários de mulheres que procuraram tratamentos de reprodução assistida entre outubro de 2006 e maio de 2012. Analisaram-se sintomas como dismenorreia, intensidade da dor, alterações intestinais e doenças associadas. O software estatístico usado foi o Stata 11.0.Resultados: A mediana de idade foi 34 anos. A dismenorreia acometeu 84,2% das pacientes, de intensidade grave em 40,4%. Alterações intestinais presentes em 54,4%. Dentre as doenças ginecológicas associadas, destaca-se mioma em 23,3%. Em relação às doenças em tratamento, destaca-se a metabólica (8,4%). Discussão: Sabe-se que a dismenorreia é o sintoma mais prevalente nas mulheres com endometriose, assim como alterações intestinais, presente em 6% a 30% das mulheres com a endometriose profunda. Justifica-se a relação com outras doenc¸as também estrogênio-dependentes, como miomas e pólipos, devido ao endométrio dessas mulheres ter aromatases p450 e cyp19, que gerariam ambiente hiperestrogênico. No grupo estudado de mulheres brasileiras, o perfil de idade compreende a quarta década de vida, com infertilidade predominantemente primária, significativa prevalência de dismenorreia grave e associação com pólipos e mioma.
Aims: To describe epidemiological and clinical aspects of infertile patients with endometriosis. Methods: Cross section study of 450 medical records of infertile patients with endometriosis from October, 2006 to May, 2012. Symptoms such as dysmenorrhea, pain intensity, intestinal disorders where analyzed, as well as, associated diseases and treatments. The statistical software used was Stata 11.0. Results: The median age was 34 years. 84.2% of patients presented dysmenorrhea and 40.4% had severe pain intensity. Intestinal disorders was found in 54.4%. From the associated gynecologic diseases, 23.3% had myoma. Metabolic disease was found in 8.4% among the diseases in treatment. Discussion: It is known that dysmenorrhea is the most prevalent symptom in women with endometriosis, as well as intestinal disorders, that can be found between 6% and 30% women with severe endometriosis. Other studies have demonstrated the relationship of estrogen-dependent disease and women with endometrial endometriosis with aromatase enzyme P450 CYP19 mutations; which generate a hyperestrogenic environment, contributing to the development of polyps and myomas. The profile of these patients was traced as being inthe fourth decade of life, with predominantly primary infertility with prevalent symptoms of severe dysmenorrhea and association with polyps and myomas.
Subject(s)
Humans , Female , Dysmenorrhea/diagnosis , Dysmenorrhea/epidemiology , Endometriosis/diagnosis , Endometriosis/epidemiology , Infertility, Female/diagnosis , Infertility, Female/epidemiology , Myoma/diagnosis , Myoma/epidemiologyABSTRACT
It has been accepted that food customs are closely associated with the quality of life in both men and women’s reproductive life. Food customs are speculated to not only influence the present lifestyle but also to induce gynaecological disorders such as dysmenorrhoea, spermatogenesis and irregular menstruation. though there is no consistent definition of regular or normal menstruation, epidemiologic evaluation of menstrual cycle has been becoming an important issue. In addition, latent development of organic diseases such as endometriosis, which are accompanied by dysmenorrhoea, is a concern under the current nutritional environment. Thus, it is an important issue to evaluate the present situation of eating habits in couples and estimate the influence of these habits on the quality of reproductive functions. A multi-faceted therapeutic approach to improving fertility involves identifying harmful environmental and occupational risk factors, while correcting underlying nutritional imbalances to encourage optimal reproduction and its function.
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Objectives : To estimate the prevalence of primary dysmenorrhoea among school girls and to compare the impact of exercise and hot water bottle on the occurrence and severity of primary dysmenorrhoea among the study population. Material and methods : A cross sectional study was done to estimate the prevalence of dysmenorrhoea in two schools of Chandigarh, India. For the Randomised Controlled Trial, group randomisation of the two schools was done into 2 intervention groups (exercise & hot water bottle groups). 53 girls in school 1 and 75 girls in school 2 participated in the intervention. Comparison of baseline Menstrual Distress Questionnaire (MDQ) scores & Visual Analogue Scale for Pain (VASP) scores were done with 1st, 2nd & 3rd month post intervention scores using mean, standard deviation, t-test. Results : Prevalence of dysmenorrhoea was 60.7%. Median age of the school girls was 14 years. The mean VASP score decreased from 5.75 to 2.96 (P<0.0001) and from 5.16 to 2.06 (P<0.0001) at 3 months, in the exercise and hot water bottle group respectively. The mean MDQ score decreased from 14.53 to 7.85 (P<0.0001) and from 14.92 to 8.16 (P<0.0001) at 3 months, in the exercise and hot water bottle group respectively. Conclusion : Both exercise & hot water bottle can be used in dysmenorrhoeic girls in home setting to provide relief from pain and menstrual distress.
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Objective To estimate the effects of occupational noise exposure to menstrual function of female cotton spinner. Methods 214 female workers of Anqing Textile Factory and urban community were investigated using questionnaire and the data of newly-married dairy by prospective cohort study from 1996 to 2000.The level of noise in their working place was measured. Results (1) The average level of occupational noise exposure of female workes of Anqing Textile Factory and urban community were 98.1 dB and 58.1 dB respectively. (2) Menstrual cycle of women in higher noise exposure group significantly shortened compared with those of the control group (P