Prevalence of primary dysmenorrhea and associated factors in adult women

SUMMARY OBJECTIVE: This study aimed to assess the prevalence and factors associated with primary dysmenorrhea in a sample of adult women. METHODS: A cross-sectional study was carried out with women aged between 19 and 49 years from a city of northeastern Brazil. Sociodemographic, gynecological, and obstetric variables were assessed by questionnaires and interviews. Dysmenorrhea was measured by self-report, and the Numerical Pain Rating Scale measured the intensity of pain. Statistical analyses included χ2 test, ANOVA, and logistic regression. RESULTS: The average age was 33.2±9.1 years and the prevalence of primary dysmenorrhea was 56% for the whole sample. The average duration of symptoms was 2.7±1.8 days and the mean intensity was 6.1±2.6. The previous cesarean section was associated with a higher rate of primary dysmenorrhea (PR=2.33; 95%CI 1.11-4.90) when considering the whole sample. Women who aged 25-39 years and are insufficiently active had higher rates of primary dysmenorrhea (PR=5.24; 95%CI 1.08-27.31). CONCLUSION: Primary dysmenorrhea has a high prevalence in young adults, adults, and middle-aged women. Cesarean section and being physically inactive was associated with increased rates of dysmenorrhea among adult women.

A dismenorreia e suas consequências em estudantes universitárias no Rio de Janeiro / Dysmenorrhea and its consequences in university students in Rio de Janeiro

Objetivo: Avaliar a prevalência da dismenorreia e suas consequências em uma população universitária. Métodos: Trata-se de um estudo descritivo, transversal, com 207 mulheres entre 18 e 46 anos de idade, universitárias. Os sujeitos da pesquisa responderam a um questionário desenvolvido para esse estudo. Resultados: A prevalência global de dismenorreia, entre as universitárias, foi de 84,1%; dessas, 58,6% classificaram a dor em intensidade leve a moderada e 41,4%, em intensa. O absenteísmo escolar e a dificuldade para se concentrar nos estudos durante o período menstrual foram significativamente influenciados pela dismenorreia intensa. Entre as estudantes, 60,9% deixaram de fazer atividades físicas ou de lazer e 41% tinham dificuldade para se concentrar e estudar devido à dismenorreia. Conclusão: A dismenorreia tem uma elevada prevalência na população universitária, contribuindo para um aumento do absenteísmo escolar e para um prejuízo social. A maioria utiliza a automedicação e poucas procuram atendimento médico eletivo com a finalidade de resolver esse problema.(AU)

Objective: Evaluate the prevalence of dysmenorrhea and its consequences in a university population. Methods: A cross-sectional descriptive study with 207 female university students between 18 and 46 years. Data collection was performed through a specific questionnaire developed for this study. Results: The overall prevalence of dysmenorrhea among university was 84.1%, of which 58.6% classified the pain intensity as mild to moderate and 41.4% as severe. School absenteeism and a difficulty to concentrate on studies during the menstrual period were significantly influenced by the presence of severe dysmenorrhea, with 60.9% of students interrupting some physical or leisure activity, and 41% reporting that they had difficulty concentrating and studying due to the dysmenorrhea. Conclusion: Dysmenorrhea has a high prevalence in the university population, contributing to a significant increase in school absenteeism and impairing social life. Most students use self-medication and few seek elective medical care to resolve this problem.(AU)

Primary dysmenorrhea: assessment and treatment / Dismenorreia primária: avaliação e tratamento

Abstract Primary dysmenorrhea is defined asmenstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain. It is the most common gynecological illness in women in their reproductive years and one of the most frequent causes of pelvic pain; however, it is underdiagnosed, undertreated, and even undervalued by women themselves, who accept it as part of themenstrual cycle. It hasmajor implications for quality of life, such as limitation of daily activities and psychological stress, being one of themain causes of school and work absenteeism. Its diagnosis is essentially clinical, based on the clinical history and normal physical examination. It is important to exclude secondary causes of dysmenorrhea. The treatment may have different approaches (pharmacological, nonpharmacological and surgical), but the first line of treatment is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and, in cases of women who want contraception, the use of hormonal contraceptives. Alternative treatments, such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure, may be an option in cases of conventional treatments' contraindication. Surgical treatment is only indicated in rare cases of women with severe dysmenorrhea refractory to treatment.

Resumo Dismenorreia primária é definida como dormenstrual na ausência de patologia pélvica. Caracteriza-se pelo excesso de produção de prostaglandinas pelo endométrio que provocam hipercontractilidade uterina, resultando em isquemia e hipoxia do músculo uterino e, subsequentemente, dor. É a patologia ginecológica mais comum em mulheres em idade fértil e uma das causas mais frequentes de dor pélvica; contudo, é subdiagnosticada, subtratada, e até desvalorizada pelas próprias mulheres, que a aceitam como parte do ciclo menstrual. A dismenorreia tem grandes implicações na qualidade de vida, como limitação das atividades diárias e estresse psicológico, sendo uma das principais causas de absentismo escolar e laboral. O seu diagnóstico é essencialmente clínico, baseando-se na história clínica e num exame físico sem alterações. É importante excluir causas secundárias de dismenorreia. O tratamento pode ter diferentes abordagens (farmacológica, não farmacológica e cirúrgica), sendo que a primeira linha de tratamento consiste na utilização de anti-inflamatórios não esteroides (AINEs) e, em casos de mulheres que desejem contracepção, no uso de anticoncepcionais hormonais. Tratamentos alternativos, como a utilização de calor tópico, modificação do estilo de vida, estimulação elétrica nervosa transcutânea, suplementos alimentares, acupuntura e acupressão, podem ser uma opção nos casos de contraindicação da utilização dos tratamentos convencionais. O tratamento cirúrgico apenas se encontra indicado em casos raros de mulheres com dismenorreia grave e refratária aos tratamentos.

Dysménorrhée chez les élèves et étudiantes à Yaoundé : facteurs associés et aspects socioculturels

Introduction.: la dysménorrhée est une situation fréquente chez les femmes en âge de procréer. Elle affecte la qualité de vie des filles et est la principale cause d'absentéismes scolaires chez les adolescentes. Notre étude avait pour objectif d'analyser les facteurs associés à la dysménorrhée et les aspects psychosociaux de la dysménorrhée chez les élèves et étudiantes à Yaoundé. Méthodologie. L'étude était transversale analytique, réalisée dans 2 établissements secondaires et un établissement supérieur de la ville de Yaoundé, du 1er Décembre 2017 au 30 Juin 2018 soit une durée de 6 mois. Étaient incluses toutes les élèves et étudiantes âgées de 15 ans et plus, ayant leurs menstruations et au moins un niveau d'instruction de la classe de seconde. L'échantillonnage était stratifié en grappe de 2 niveaux dans l'un des établissements et consécutif dans un autre. Le rapport de côte a été utilisé pour rechercher les associations entre les variables et la valeur P ˂ 0,05 était considérée significative. Résultats. Parmi les 1059 participantes, 800 avaient des dysménorrhées soit une prévalence de 75,5%. La moyenne d'âge était de 18,88 ± 3,62 ans avec des extrêmes allant de 15 à 45 ans. Les facteurs de risque de la dysménorrhée étaient : indépendamment associés aux dysménorrhées étaient les antécédents familiaux de dysménorrhée [OR (IC à 95%) : 4,20(3,02-5,83)] et le stress [OR (IC à 95%) : 2,16(1,55-3,02] ; tandis que la durée des règles ≤ 3 jours [OR (IC 95%) : 0,31(0,12-0,82)] est un facteur protecteur. La dysménorrhée était considérée comme un sujet tabou par 23,6 % des participantes. Conclusion. Les antécédents familiaux de dysménorrhée et le stress sont des facteurs de risque de la dysménorrhée. Certaines personnes affectées préfèrent ne pas en parler. Nous recommandons de sensibiliser les femmes sur la dysménorrhée et les aider à lutter contre le stress

Manejo laparoscópico multidisciplinario de la endometriosis profunda del 2010 al 2017: estudio de cohorte retrospectivo / Multidisciplinary laparoscopic management of deep infiltrating endometriosis from 2010 to 2017: A retrospective cohort study

INTRODUCCIÓN La laparoscopía es actualmente el estándar en el manejo de la endometriosis profunda. Sin embargo, requiere de un entrenamiento específico e involucra la realización de procedimientos complejos y asociados a una alta tasa de complicaciones. Por lo anterior en Chile y Latinoamérica, la endometriosis profunda es frecuentemente manejada de manera inadecuada. OBJETIVO Describir nuestra experiencia en el enfrentamiento clínico y manejo quirúrgico laparoscópico de la endometriosis profunda, durante los últimos siete años. MÉTODOS Estudio de cohorte retrospectivo de 137 pacientes consecutivas operadas y con confirmación histológica de endometriosis profunda. Se recolectaron los datos demográficos, datos quirúrgicos, complicaciones, resultados reproductivos y seguimiento. RESULTADOS Todas las cirugías fueron completadas por laparoscopía, sin conversión. La dismenorrea y la dispareunia fueron los síntomas más frecuentes en 85,4 y 56,9%, respectivamente. La localización más frecuente de endometriosis profunda fueron los ligamentos úterosacros, coexistiendo un endometrioma en 48,9% de los casos. La mediana de tiempo operatorio fue de 140 minutos, siendo significativamente más prolongado en casos con compromiso intestinal (p < 0,0001). Quince pacientes (10,9%) presentaron complicaciones. El seguimiento medio fue de 24,5 meses. La tasa de embarazo fue de 58,1% y 90% de las pacientes reportó una mejoría significativa de su sintomatología. CONCLUSIONES El manejo laparoscópico de la endometriosis profunda es efectivo y seguro, pero debe reservarse a centros especializados y con disponibilidad de equipo multidisciplinario.

BACKGROUND Laparoscopy has become the standard of care in the surgical management of deep infiltrating endometriosis (DIE). However, it is a challenging procedure with a high complication rate. Despite the benefits of the minimally invasive approach, DIE resection is often performed by surgeons without adequate training, especially in developing countries like Chile. OBJECTIVE To asses our experience in the diagnosis and laparoscopic management of DIE during seven years. METHODS A retrospective cohort study of data including 137 patients with pathology-proven DIE. Surgical and fertility outcomes were evaluated. RESULTS All procedures were performed laparoscopically without conversion. Dysmenorrhea and dyspareunia were the most common symptoms in 85.4% and 56.9%, respectively. Uterosacral ligaments were the most common DIE location. Endometrioma was present in 48.9% of cases. Median operative time was 140 minutes; however, it was longer in cases requiring bowel surgery (p < 0.0001). The complication rate was 10.9%. Median follow-up was 24.5 months. The pregnancy rate was 58.1% and 90% of patients reported significant symptom relief after surgery. CONCLUSION Laparoscopic surgical management of DIE is effective and safe but it must be performed in tertiary centers with the availability of multidisciplinary teams.

Dismenorreia / Dysmenorrhoea

O artigo discorre sobre a dismenorreia, patologia de origem primária ou secundária que acomete mulheres no período fértil, tanto as que ainda não menstruam quanto as que já menstruaram. Caracteriza-se por dor intensa, em forma de cólica durante a menstruação, manifestada em região do baixo ventre ou lombar. Trata-se de um grande problema de Saúde Pública, gerador de prejuízos econômicos por provocar absenteísmo na vida profissional e escolar das mulheres acometidas. Diversos fatores estão envolvidos nessa patologia, como a produção e a liberação de prostanoides, que promovem um desequilíbrio hormonal. Hoje, é designada como de causa endócrino-ginecológica e está relacionada com outros hormônios da mulher.(AU)

The article describes the dysmenorrhea, pathology of primary or secondary origin which affects women in the fertile period, both those that still do not menstruate as those that have already menstruated. It is characterized by severe pain, colic so during menstruation, manifested in the lower abdomen or lower back. It is a major Public Health problem, economic losses generator for causing absenteeism at work and school life of the women affected. Several factors are involved in this pathology, such as the production and release of prostanoids, which promote a hormonal imbalance. Today, it is known as a gynecological endocrine cause and is related to other hormones of women.(AU)

Avaliação da relação entre síndrome pré-menstrual e dismenorreia primária em mulheres com fibromialgia / Evaluating the relation of premenstrual syndrome and primary dysmenorrhea in women diagnosed with fibromyalgia

RESUMOObjetivoInvestigar a presença de síndrome pré-menstrual (SPM), dismenorreia primária (DP) e depressão em mulheres com fibromialgia (FM) e mulheres saudáveis e determinar possíveis fatores relacionados com a SPM e a DP na FM.MétodoEste estudo foi feito com 98 pacientes do sexo feminino com diagnóstico de FM e 102 controles saudáveis pareados por idade e sexo. Todas as pacientes foram avaliadas à procura de síndrome pré-menstrual (SPM) e dismenorreia primária (DP). A síndrome pré-menstrual foi determinada pela presença de um ou mais sintomas afetivos ou somáticos nos cinco dias anteriores à menstruação. O diagnóstico de dismenorreia primária foi definido como a presença de dor abdominal ou lombar com duração mínima de dois dias durante o período menstrual. A dismenorreia foi avaliada pela escala visual analógica. A dismenorreia foi classificada pelo Sistema de Pontuação Multidimensional. A Escala de Depressão de Hamilton foi aplicada a todas as pacientes.ResultadosA dismenorreia primária foi encontrada em 41% das pacientes com FM e 28% do grupo controle. Encontrou-se diferença estatisticamente significativa na DP entre os dois grupos (p = 0,03). A SPM foi detectada em 42% das pacientes com FM e 25% do grupo controle. Houve diferença estatisticamente significativa na SPM entre os dois grupos (p = 0,03).ConclusãoHá um aumento na frequência de síndrome pré-menstrual e dismenorreia em pacientes com FM. Aquelas com escore de gravidade dos sintomas elevado e altas pontuações de depressão entre as pacientes com FM estão em risco de SPM e DP.

ABSTRACTObjectiveIn this study, we aimed to investigate the presence of premenstrual syndrome (PMS), primary dysmenorrhea (PD) and depression among women with fibromyalgia (FM) and healthy females and to determine possible factors related with PMS and PD in FM.MethodThe present study was conducted on 98 female patients diagnosed with FM and 102 age and sex-matched healthy controls. All patients were evaluated for premenstrual syndrome (PMS) and primary dysmenorrhea (PD). Premenstrual syndrome was assessed among the patients for the presence of one or more affective or somatic symptoms within the five days preceding menses. The diagnosis of primary dysmenorrhea was defined as having abdominal pain or lower back pain lasting at least two days during a menstrual period. Dysmenorrhea was assessed via visual analog scale. Dysmenorrhea was rated via Multidimensional Scoring System. The Hamilton depression scale was applied to all patients.ResultsPrimary dysmenorrhea was established in 41% of FM patients and 28% of the control group. A statistically significant difference was found in PD between the two groups (p = 0.03). PMS was established in 42% of the FM patients and 25% of the control group. A statistically significant difference was found in PMS between the two groups (p = 0.03).ConclusionThere is an increased frequency of premenstrual syndrome and dysmenorrhea in FM patients. The patients with high symptom severity scores and high depression scores among the FM patients are at risk of PMS and PD.

Perfil epidemiológico das pacientes inférteis com endometriose / Epidemiological profile of infertile patients with endometriosis

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.

Prevalence and pattern of menstrual disorders among Lebanese nursing students

Menstrual disorders frequently affect the quality of life of adolescents and young adult women and can be indicators of serious underlying problems. The objective of this study was to determine the prevalence and pattern of menstrual symptoms among nursing students in Beirut, Lebanon. Of 352 students completinga written questionnaire, the most common menstrual disorders were irregular frequency of menstruation [80.7%] premenstrual syndrome [54.0%], irregular duration of menstruation [43.8%], dysmenorrhoea [38.1%], polymenorrhoea [37.5%] and oligomenorrhoea [19.3%]. On logistic regression analysis, there were significant associations between irregular cycles and marital status [OR 2.18] and menarcheal age [OR 4.76]; oligomenorrhoea and residency [OR 2.06] and menarcheal age [OR 3.17]; abnormal blood loss and menarcheal age [OR 6.92]; dysmenorrhoea and marital status [OR 8.93] and residency [OR 2.04]; and premenstrual syndrome and marital status [OR 2.10]. Dysmenorrhoea and premenstrual symptoms were serious enough to affect daily activities or academic attendance in many cases and this is a concern for policy-makers

Levonorgestrel-releasing IUD versus coper IUD in control of dysmenorrhea, satisfaction and quality of life in women using IUD

The levonorgestrel-releasing IUD can help the treatment of dysmenorrheal by reducing the synthesis of endometrial prostaglandins as a conventional treatment. This study was performed to assess the frequency of dysmenorrheal, satisfaction and quality of life in women using Mirena IUDs as compared to those using copper IUDs. This double-blind randomized clinical trial was performed between 2006 and 2007 on 160 women aged between 20 to 35 years who attended Shahid Ayat Health Center of Tehran, and they were clients using IUDs for contraception. 80 individuals in group A received Mirena IUD and 80 individuals in group B received copper [380-A] IUD. Demographic data, assessment of dysmenorrheal, and follow-up 1, 3 and 6 months after IUD replacement were recorded in questionnaires designed for this purpose. To assess the quality of life, SF36 questionnaire was answered by the attending groups, and to assess satisfaction, a test with 3 questions was answered by clients. Dysmenorrheal significantly was decreased in both groups six months after IUD insertion as compared to the first month [p<0.001]. However, statistically, Mirena reduced dysmenorrheal faster and earlier compared to cupper IUD [<0.003]. There isn't any significant difference between these two groups in satisfaction and quality of life outcomes. There is no difference between these two groups in terms of the satisfaction and quality of life, therefore the usage of Mirena IUD is not a preferred contraception method

Recidivas de endometriomas ováricos tras cirugía laparoscópica / Ovarian endometrioma: recurrence after laparoscopic surgery

Objetivo: Analizar las variables que influyen en la recurrencia tras la extirpación laparoscópica de endometriomas ováricos. Métodos: Se estudiaron retrospectivamente 214 pacientes, intervenidas por laparoscopia entre los años 2005 y 2006 en el Hospital La Paz y seguidas por 5 años. Como criterios de recurrencia se consideraron: dolor, hallazgo ecográfico y elevación de Ca 125. Resultados: El 30,8 por ciento (66/214) presentaron recurrencia del dolor, el 28 por ciento (60/214) recidiva ecográfica y el 16,8 por ciento (36/214) Ca 125 elevado. Las pacientes con recidiva sintomática presentaron mayor dismenorrea y dispareunia previas a la cirugía (6,8 +/- 2,5 y 1,3 +/- 2,5 frente a 3,8 +/- 3,4 y 0,2 +/- 1,0 en las no recurrencias (p=0,0001; p=0,0001). La puntuación de dis-menorrea y dispareunia previas también fue superior en recidiva ecográfica (5,9 +/- 3,3 y 1,2 +/- 2,5 frente a 4,3 +/- 3,4 y 0,2 +/- 1,1 en ausencia de recidiva) (p=0,003; p=0,002). La recurrencia de dismenorrea fue mayor en jóvenes (31,3 +/- 5,4 años versus 34,3 +/- 7,8; p=0,02), con quistectomía (35 por ciento versus 16,7 por ciento en anexectomía; p=0,02) y adherensiolisis (46,4 por ciento versus 23,4 por ciento; p=0,001) y con tratamiento médico posquirúrgico (41,5 por ciento frente 22,5 por ciento; p=0,004). El tiempo medio de no recurrencia sintomática fue 44 meses (IC95 por ciento: 41-47) y el de no recidiva ecográfica de 47 meses (IC95 por ciento:45-50). Conclusión: El grado de dismenorrea y dispareunia previas a la cirugía fue el factor más claramente asociado a la recidiva.

Objective: To analyze the variables influencing recurrence after laparoscopic excision of ovarian endome-trioma. Methods: We retrospectively studied 214 cases who underwent laparoscopic surgery between 2005 and 2006 in the Hospital La Paz and followed for 5 years. As recurrence criteria were considered: pain, ultrasound finding and Ca125 elevation. Results: 30.8 percent (66/214) of patients presented pain recurrence, 28 percent (60/214) ultrasound recurrence and 16.8 percent (36/214) Ca 125 elevation. Patients with symptomatic recurrence had a bigger degree of dysmenorrhea and dyspareunia before surgery (6.8 +/- 2.5 and 1.3 +/- 2.5 against 3.8 +/- 3.4 and 0.2 +/- 1.0 in no recurrence ones (p=0.0001; p=0.0001). Previous dysmenorrheal and dyspareunia punctuation was also greater in ultrasound recurrences (5.9 +/- 3.3 and 1.2 +/- 2.5 against 4.3 +/- 3.4 and 0.2 +/- 1.1 of those with no recurrence) (p=0.003; p=0.002). Dysmenorrhea recurrence was greater in young (31.3 +/- 5.4 years old versus 34.3 +/- 7.8; p=0.02), with cystectomy (35 percent versus 16.7 percent in adnexectomy; p=0.02), adhesiolysis (46.4 percent versus 23.4 percent; p=0.001) and with medical treatment after surgery (41.5 percent against 22.5 percent; p=0.004). The mean time of no symptomatic recurrence was 44 months (CI95 percent:41-47) and the no ultrasound recurrence was 47 months (CI95 percent:45-50). Conclusion: The degree of dysmenorrhea and dyspareunia before surgery was the factor most clearly associated with recurrence.

Dismenorrea primaria en adolescentes: revisión de la literatura / Primary dysmenorrhea in adolescent: literature review

En la población adolescente, la dismenorrea es la principal causa de consulta ginecológica y también de ausentismo escolar, laboral o de otras actividades. Aproximadamente el 10 por ciento de las adolescentes que refieren dismenorrea presentan una causa orgánica secundaria. Dismenorrea primaria comienza a manifestarse característicamente con la menarca o poco tiempo después de ésta, que coincide con la aparición del ciclos ovulatorios regulares. El clínico debe ser capaz de diferenciar las múltiples etiologías del dolor pélvico crónico: una historia clínica detallada y un buen examen físico pueden ser suficientes para diagnosticar esta entidad. Pese a la alta prevalencia de dismenorrea en las adolescentes, es alto el porcentaje que no solicita atención médica o es subtratada, por lo que el objetivo de esta revisión fue presentar una actualización de lo publicado en la literatura sobre la fisiopatología, enfrentamiento y manejo de la dismenorrea primaria, desde tratamientos clásicos a la medicina más alternativa. De esta manera podremos entregar a la adolescente un manejo más integral, y así, disminuir el impacto que provoca la dismenorrea primaria (DP) en la vida de nuestras pacientes.

Dysmenorrhea in adolescent is an important cause of gynecological consult, school and employment absenteeism. Approximately 10 percent of adolescents who report dysmenorrhoea have an organic cause. Primary dysmenorrhea begins to manifest characteristically with menarche or shortly thereafter, coinciding with the onset of regular ovulatory cycles. The clinician should beable to differentiate multiple etiologies of chronic pelvic pain: a detailed history and physical exam may be sufficient to diagnose this entity. Despite the high prevalence of dysmenorrhea in adolescent girls, a high percentage doesn’t seek medical treatment or are undertreated. The objective of this review was to provide an update of the pathophysiology, and management of primary dysmenorrhea, from traditional treatments to alternative medicine. In this way adolescent can obtain a more integrated management, and improve her life quality.

Problems related to menstruation amongst adolescent girls.

OBJECTIVE: To study the types and frequency of problems related to menstruation in adolescent girls and the effect of these problems on daily routine. METHODS: Girls in the age group 13-19 years who had had menarche for at least one year at the time of study. 198 adolescent girls have been studied. Data was collected by personal interviews on a pre-tested, semi-structured questionnaire. The questions covered menstrual problems, regularity of menses in last three cycles of menstruation and the effect of these problems on the daily routine. Analysis was done using SPSS version 12. Percentages were calculated for drawing inferences. RESULTS: More than a third (35.9%) of the study subjects were in the age group 13-15 years followed by 17-19 years, 15-17 years respectively. Mean age of study participants was calculated to be 16.2 years. Dysmenorrhea (67.2%) was the commonest problem and (63.1%) had one or the other symptoms of Pre-menstrual syndrome (PMS). Other related problems were present in 55.1% of study subjects. Daily routine of 60% girls was affected due to prolonged bed rest, missed social activities/commitments, disturbed sleep and decreased appetite. 17.24% had to miss a class and 25% had to abstain from work. Mothers and friends were the most common source of information on the issue. CONCLUSION: Screen adolescent girls for menstruation related problems and provide them with counseling services and relevant information on possible treatment options. Besides, there is a need to emphasize on designing menstrual health programmes for adolescents.

[Evaluation of dysmenorrhea and premenstrual syndrome in high school girls in babol]

Dysmenonhea is painful menstruation and premenstrual syndrome defined as a combination of distressing psychosomatic changes which appear as a cyclic recurrence during the luteal phase of the menstrual cycle. In the majority of cases these can interfere with familial or social activities. The aim of this study is assessment of the problem in high school girls in Babol. This is a descriptive analytical study and a cross sectional survey, which has been done on 410 high school girls in Babol, selected with two stage cluster sampling. Information was collected with a questionnaire. Data was statistically analyzed by spss[10] [T-Test, Fisher's exact] and P<0.05 was significant. Mean age of 410 students was 16.03+./-1.15 [years]. Mean age of menarche was 12.84 +/- 1 [years]. 52% of girls had dysmenorrhea and 45.6% of them had irregular menses. In girls with dysmenorrhea, menarche began earlier [P=0.023], intermenstural intervals were shorter than in other girls [P=0.145], and menstrual day in each cycle was more [P=0.55]. The most common symptoms at the beginning of the menses were: generalized malasia [52.21%] and fatigue [30.39%]. 91.18% of persons had experienced at least one of the symptoms of premenstrual syndromes. The most common symptoms were: abdominal cramps [56.37%], fatigue [40.93%], loosening of efficacy [40.93%]. Scottom in visual field had the lowest prevalence [5.15%]. Often, there was statistically significant relation between dysmenorrhea and premenstural symptoms. Dysmenorrhea and premenstrual syndrome are one of the commonest gynecologic problems in high school girls, and these problems can interfere with familial, social or work - related activities. Therefore educative and informative programs can be provided a beneficial useful step in health of girl students

Prevalence of pre-menstrual syndrome in young girls

Prevalence of pre-menstrual syndrome[PMS] was determined in 100 girls in age group 16-22 years, belonging to a medical college. Out of total 66.66% had PMS. Major complaints were aches and pains, pre-menstrual dysmenorrhoea and mood swings

Prevalência de dismenorréia em pacientes avaliadas no Centro de Atendimento e Apoio ao Adoloscente da Universidade Federal de São Paulo / Prevalence of dysmenorrhea in Teenagers Assisted in the Federal University of São Paulo

Objetivo: determinar a prevalência de dismenorréia e suas características na população de adolescentes atendidas em ambulatório. Métodos: estudo retrospectivo, por meio de análise de prontuários das pacientes matriculadas no serviço de janeiro de 1997 a março de 2003. Resultados: dos 197 prontuários estudados, correspondentes a pacientes com menarca, 25 (12,7 por cento)não continham informação sobre a presença ou a ausência de dismenorréia; dos 172 nos quais havia essa informação, 104 (60,5 por cento) não apresentavam dismenorréia e 68 (39,5 por cento) revelavam sua existência, quando as adolescentes eram questionadas diretamente. Observou-se maior frequência de dismenorréia na faixa etária de 13 a 16 anos de idade. Com relação à intensidade da dor, 25 (78,1 por cento) consideravam fraca, 2 (6,2 por cento), moderada e 5 (15,7 por cento) forte. Das pacientes dismenorréicas, no tocante aos ciclos menstruais, 38 (63,3 por cento) apresentavam ciclos regulares e 22 (36,7 por cento) irregulares. Conclusão: há necessidade de interrogatório dirigido para diagnóstico e melhor caracterização da dismenorréia, visto que essa queixa quase não aparece espontaneamente em consultas de ambulatório geral.

Frecuencia de la dismenorrea y síntomas asociados en mujeres de 12 a 24 años / Frequency of dysmenorrhea and associated symptons in women of 12 to 24 years of age

Se aplicó un cuestionario a 1,066 estudiantes de la Ciudad de México. Este cuestionario incluyó información sobre datos generales de las adolescentes y sobre la presencia de 12 síntomas relacionados a la dismenorrea. La edad promedio de las participantes fue de 18 ñ 3.2 años. La edad promedio de menarca fue de 12.3 ñ 1.3 años. La prevalencia de dismenorrea fue de 52.1 por ciento para el grupo de edad de menos de 15 años; 63.8 por ciento para el grupo de 15 a 19 y 52.3 por ciento para las estudiantes de 20 a 24 años. La frecuencia de ausentismo como resultado de la dismenorrea fue de 4.3 por ciento en el grupo de estudiantes menores de 15 años; 9.3 por ciento en el grupo de 15 a 19 años y de 19.8 por ciento en el grupo de 20 a 24 años. Los síntomas más frecuentemente asociados a la dismenorrea fueron tension nerviosa, depresión, irritabilidad e insomnio. La automedicación fue muy frecuente y los fármacos más utilizados fueron los antiespasmódicos

Dismenorrea en la adolescencia

Determinar la prevalencia de la dismenorrea (DSM) en nuestra institución, estudiar sus características en la adolescencia, determinar las implicaciones de la DSM en el ausentismo escolar. La DSM, para nuestra institución contribuye la tercera causa de prevalencia, después del parasitismo instestinal y los problemas de visión. Es más frecuente durante la mestruación y no premestrual como es descrito. Las escalas visuales establecieron la intensidad del dolor, siendo leve y moderado en el 83.2 por ciento de las adolescentes en la literatura el resultado es inverso. Los ensayos infieren al dolor incapacitante en el 3 por ciento de los casos, en nuestro estudio el 7 por ciento de las adolescentes se incapacitan 2 y 3 días y el 12 por ciento un día, retrasando su proceso educativo. Las adolescentes refieren síntomas asociados a la DSM, en la literatura se menciona su hallazgo a edades mayores. El 41 por ciento se automedica, generando patologías iatrogénicas y consumistas, acostumbrándose a ingerir medicamentos sin considerar los riesgos futuros, sólo mejora el 36 por ciento, es otra pausa de lo mal orientado del tratamiento; aún más, sólo el 17 por ciento consultan al médico.(truncado 2500 caracteres)

Prevalencia de síntomas premenstruales y dismenorrea en mujeres de edad fértil y su relación con el ausentismo laboral / Prevalence of premenstrual symptoms and dysmenorrhea in plentiful women and their relationship with work absence

El presente estudio es de tipo descriptivo y transversal, fue realizado a través de una encuesta cuyo objetivo principal apuntó a conocer si existían o no síntomas premenstruales y/o dismenorrea y si éstos causan o no ausentismo laboral. Esta encuesta fue aplicada a 124 mujeres en edad fértil que trabajan en la Fábrica "Flores", siendo eliminadas 71 de ellas por no cumplir con los criterios de inclusión en él. la muestra resultó estar compuesta por 53 mujeres entre 19 y 45 años de edad. Dentro de los resultados obtenidos, se observa la relación de algunos factores asociados a la presencia de síntomas premenstruales y/o dismenorrea como la paridad, uso de dispositivo intrauterino y estado nutricional, tal como se describe en la literatura. Se obtuvo una mayor incidencia que la descrita en la literatura tanto de presencia de síntomas prementruales (100 por ciento) como de dismenorrea (67,92 por ciento), observándose que la sintomatología más frecuente en el período premenstrual es la relacionada con el ánimo y la conducta; durante la menstruación los síntomas del ánimo, la conducta y los somáticos se observan en similares porcentajes siendo que la literatura refiere predominio de éstos últimos durante este período. También se confirmó el hecho de que la dismenorrea va disminuyendo con la edad