Prevalence, impact, and management perception of dysmenorrhea among university students: A cross-sectional study

Abstract Dysmenorrhea is a common condition among females that is characterized by painful cramps before or during menstruation. It is considered as a common gynecological complaint that affects the quality of women's life. The study evaluated prevalence of dysmenorrhea, its impact, associated risk factors, and the management strategies adopted by female university students in Taif city, Saudi Arabia. A cross-sectional study was conducted among 562 female students aged 18-30 years at the university level. The results showed a high prevalence rate of dysmenorrhea (79.4%) among the students. The most common risk factors were family history (87.4%) and length of menstruation (79%). Half (50.2%) of the respondents were absent at the university at least 1 day every month. The most widely used medications by the respondents were ibuprofen (42%) and paracetamol (40%), whereas only 3% used mefenamic acid, despite that they experienced complete pain relief with mefenamic acid. High prevalence rate of dysmenorrhea associated with risk factors such as family history and length of menstruation, was found among university students. However, pain and associated symptoms affect the quality of life.

Dexketoprofen más pamabrom versus acetaminofen en dismenorrea primaria: estudio controlado, randomizado, doble ciego, multicéntrico / Dexketoprofen plus pamabrom versus acetaminophen in primary dysmenorrhea: a controlled, randomized, double-blind, multicenter study

RESUMEN Introducción: se sabe que las concentraciones plasmáticas de hormona antidiurética o vasopresina son más altas en las mujeres con dismenorrea primaria (DiPr) y podría ser causa de retención de agua con signos y síntomas concomitantes que agravan su cuadro clínico. La monoterapia con AINEs en ocasiones alcanza solo un alivio parcial porque no incide sobre la vasopresina. Objetivo: evaluar la eficacia y tolerabilidad del dexketoprofeno + pamabrom en la DiPr tomando como referencia el acetaminofén. Materiales y métodos: estudio doble ciego, controlado, randomizado, en pacientes con DiPr asignados al azar. Fueron aleatorizadas 172 pacientes, 86 en cada grupo 1) Grupo casos (DP): dexketoprofeno + pamabrom o 2) Grupo control (AC): acetaminofén. Se evaluó la evolución de la intensidad del dolor, el alivio del dolor, la gravedad de otros síntomas presentes y la satisfacción global del médico y paciente. Se registró las reacciones adversas. Resultados: la disminución de la intensidad del dolor, de los síntomas acompañantes y el alivio del dolor evaluados por la EVA, la PID, la SPID, el PAR y el TOTPAR respectivamente es mayor y más rápida de modo significativo en todos los tiempos para la combinación DP. Las reacciones adversas fueron mínimas. La satisfacción global de pacientes y médicos respecto al tratamiento es significativa a favor de la combinación DP. Conclusiones: dexketoprofeno + pamabrom es significativamente más eficaz y rápido en el control del dolor y otros síntomas presentes en la dismenorrea primaria que acetaminofén demostrando la validez de añadir un diurético suave a un AINE para incrementar su eficacia. El tratamiento DP es bien tolerado (AU).

ABSTRACT Background: It is known that plasma concentrations of antidiuretic hormone or vasopressin are higher in women with primary dysmenorrhea (DiPr) and could cause water retention with concomitant signs and symptoms that aggravate the illness. Monotherapy with NSAIDs sometimes achieves only partial relief because it does not affect vasopressin. Objective: The aim was to evaluate the efficacy and tolerability of dexketoprofen + pamabrom in DiPr taking as reference acetaminophen. Materials and methods: Double-blind, controlled, randomized study in patients with DiPr random to 1) Case group (PD): dexketoprofen + pamabrom or 2) Control group (CA): acetaminophen. The evolution of pain intensity, pain relief, severity of other present symptoms and overall satisfaction of the doctor and patient were evaluated. Adverse reactions were recorded. Results: 172 patients were randomized, 86 in each group. The decrease in pain intensity, accompanying symptoms and pain relief evaluated by VAS, PID, SPID, PAR and TOTPAR respectively is significantly greater and faster at all times for the combination DP. Adverse reactions were minimal. The overall satisfaction of patients and doctors regarding treatment is significant in favor of the DP combination. Conclusions: Dexketoprofen + pamabrom is significantly more effective and faster in the control of pain and other symptoms present in primary dysmenorrhea than acetaminophen demonstrating the validity of adding a mild diuretic to an NSAID to increase its effectiveness. DP treatment is well tolerated (AU).

Dismenorreia membranosa: uma doença esquecida / Membranous dysmenorrhea: a forgotten disease

OBJETIVO: apresentar uma série de casos de dismenorreia membranosa. MÉTODOS: todas as pacientes foram selecionadas a partir da suspeição diagnóstica, após atendimento clínico em consultório privado por relato de dismenorreia dolorosa associada à eliminação espontânea de material elástico com formato semelhante a útero. Apenas fatos relevantes foram descritos do quadro álgico, história médica atual e pregressa e hábitos de vida. O material eliminado foi encaminhado para laboratório de patologia no qual ocorreu a análise macro e microscópica. Os casos em que não se pode provar a eliminação de material com característica membranácea não foram selecionados. Após a confirmação diagnóstica, realizou-se uma revisão da literatura até o ano de 2008 utilizando o método MeSH com o termo "membranous dysmenorrhea". RESULTADOS: três casos clínicos de dismenorreia foram transcritos. Todos os casos, além do quadro característico de dor e eliminação vaginal de material elástico, foram associados ao uso de métodos anticoncepcionais hormonais. CONCLUSÕES: embora haja apenas escassos relatos de caso de dismenorreia membranosa na literatura científica, sua etiologia deve ser suspeita em casos de dor associada a sangramento vaginal com eliminação de material elástico ou firme. O diagnóstico final é dependente do exame anatomopatológico que nunca deve ser dispensado. Observamos necessidade de mais discussões sobre esta patologia com o objetivo de manter o profissional atualizado para exercer diagnóstico e terapêutica adequados.

PURPOSE: to present a series of cases of membranous dysmenorrhea. METHODS: all the patients selected were under diagnostic suspicion, after being clinically attended in a private medical office due to the report of painful dysmenorrhea associated with spontaneous elimination of elastic material with uterine shape. Only relevant facts about the pain condition have been described, together with the present and previous medical history and life habits. The material eliminated was forwarded to the pathology laboratory, where the macro and microscopic analyses were done. Cases with no confirmation of membranous material elimination were not selected. After the diagnostic confirmation, literature up to 2008 was carried out using the MeSH method, with the words "membranous dysmenorrheal". RESULTS: three cases of dysmenorrhea were transcribed. Besides the characteristic picture of pain and vaginal elimination of elastic material, all the cases were associated with the use of hormonal contraceptive methods. CONCLUSIONS: despite the fact that there are only sporadic reports of cases of membranous dysmenorrhea in the scientific literature, this etiology must be considered in cases of pain associated with vaginal bleeding plus elimination of elastic or solid material. The final diagnosis depends on anatomopathological exam, which should not be dismissed. We highlight the need for more discussion about this pathology, to keep the professionals updated with the aim of exerting adequate diagnosis and therapeutics.

Características epidemiológicas de pacientes atendidas en la consulta de endometriosis de un hospital universitario / Epidemiological characteristics of patients attended at the outpatient clinic of endometriosis in universitary hospital

Establecer las características epidemiológicas de pacientes con endometriosis. Es un trabajo descriptivo y transversal. La población fue de 54 pacientes. La recolección de la información mediante la revisión documental en una ficha. Consulta de endometriosis del Hospital Universitario Dr. Angel Larralde de Valencia. Edad promedio 30 ± 5,8 años. Motivos de consulta: dismenorrea (70,7 por ciento), dolor pélvico (58,5 por ciento) y dispareunia (36,6 por ciento). Edad promedio de menarquía 12 años. El 29 por ciento reportó algún tipo de trastorno menstrual, el más frecuente la metrorragia (17 por ciento). El 41,5 por ciento refirió uso previo de anticonceptivos orales. El 34 por ciento de las pacientes no habían estado embarazadas, 26,88 por ciento primigesta. Entre los antecedentes quirúrgicos gineco-obstétricos, 39 por ciento reportó cesáreas, 26,88 por ciento ooforectomía y 19,55 por ciento legrado uterino. Las endometriosis más frecuentes fueron la ovárica (56,09 por ciento) y en cicatriz abdominal postcesárea (24,39 por ciento). La endometriosis es una patología típica de la mujer en edad reproductiva, que puede darse inclusive en la adolescencia.

Endometriosis del íleon como causa de obstrucción intestinal: Report of two cases / Ileal endometriosis as a cause of intestinal obstruction. Report of two cases

Endometriosis is a common, chronic, benign, estrogen dependent gynecological disorder associated to pelvic pain and infertility. Its main characteristic is the presence of endometrial tissue outside the uterus. The prevalence of pelvic endometriosis ranges between 6% and 10% women during their reproductive years. Clinical symptoms of pelvic endometriosis are pelvic pain, dysmenorrhea, dispareunia and infertility. Distal ileum endometriosis is an uncommon cause of intestinal obstruction with a frequency of 7% to 23% of all cases with intestinal involvement. We report two patients, 30 and 34 years old, with terminal ileum endometriosis and intestinal obstruction that required surgery and intestinal resection. Both patients are well one year after the operation.

Dismenorréia / Dysmenorrhea

Os autores inicialmente estabelecem o conceito de dismenorréia edados demográficos gerais, bem como a classificaçäo do transtorno. A seguir mencionam as bases etiopatogênicas da doença e o desenvolvimento das prostaglandinas E2 e F2-alfa e o quadro clínico que possibilita o diagnóstico clínico e laboratorial (ultra-ssonografia e CA 125). O tratamento é apresentado em detalhes, salientando que os medicamentos antiinflamatórios que atuam específicamente sobre a COX-2 possibilitam resultados satisfatórios e menor quantidade de efeitos colaterais; adicionalmente salientam os benefícios do uso dos contraceptivos hormonais e da piridoxina (vitamina B6). Finalmente, mencionam os aspectos profiláticos da dismenorréia.(au)