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Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain
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Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 60009

Special Issue Editors

Dr. Mike Armour

E-Mail Website
Guest Editor
Associate Professor, NICM Health Research Institute, Western Sydney University, Sydney, NSW 2145, Australia
Interests: pelvic pain; dysmenorrhea; endometriosis
Special Issues, Collections and Topics in MDPI journals
Dr. Carolyn Ee

E-Mail Website
Assistant Guest Editor
NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
Interests: obesity; overweight; women’s health; polycystic ovarian syndrome (PCOS); breast cancer; integrative healthcare; Type 2 Diabetes Mellitus

Special Issue Information

Dear Colleagues,

Women’s health conditions such as primary dysmenorrhea, pre-menstrual syndrome (PMS), polycystic ovarian syndrome (PCOS), and various causes of chronic or persistent pelvic pain such as endometriosis and vulvodynia affect millions of women worldwide. Endometriosis and chronic pelvic pain cost 9.7 billion dollars a year in Australia alone, mostly due to lost productivity, while young women around the world report regularly missing school or university due to menstrual symptoms. Despite this, there is often a lack of institutional support at school and in the workplace to help women reduce the potential impact of their menstrual symptoms.

While there is an assumption that reliable information on women’s health is available via the internet, most young women have poor menstrual health literacy and often normalise their menstrual symptoms, even when quite severe. This is often compounded by family, friends, and even medical professionals either dismissing or minimising their symptoms. The consequence of this is that women often are left to manage their own symptoms, and this in turn can lead to inadequate pain and symptom management, potential issues with fertility, as well as the potential for missing or delaying diagnosis for more serious underlying conditions.

This Special Issue is open to any subject area related to the diagnosis, impact, treatment, or experience of women with menstrual disorders, endometriosis, or Chronic Pelvic Pain in low-, middle-, or high-income countries. Both quantitative and qualitative research submissions from the areas of public health, medicine, psychology, psychiatry, sociology, social work, and law are encouraged, and systematic or narrative reviews are welcome. The keywords provided are just an example of some of the common conditions that fall within the broad scope of this area.

Dr. Mike Armour
Dr. Carolyn Ee
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • dysmenorrhea
  • pelvic pain
  • pre-menstrual syndrome
  • health literacy
  • endometriosis
  • PCOS
  • vulvodynia
  • adenomyosis

Published Papers (15 papers)

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Research

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18 pages, 745 KiB  
Article
Mixed Method Evaluation of My Vital Cycles®: A Holistic School-Based Ovulatory Menstrual Health Literacy Program
by Felicity Roux, HuiJun Chih, Jacqueline Hendriks and Sharyn Burns
Int. J. Environ. Res. Public Health 2023, 20(11), 5964; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20115964 - 26 May 2023
Cited by 1 | Viewed by 1636
Abstract
There is a high prevalence of ovulatory menstrual (OM) dysfunctions among adolescents, and their menstrual health literacy is poor. The OM cycle can be used as a personal health monitor provided that the skills to understand it are correctly taught. My Vital Cycles [...] Read more.
There is a high prevalence of ovulatory menstrual (OM) dysfunctions among adolescents, and their menstrual health literacy is poor. The OM cycle can be used as a personal health monitor provided that the skills to understand it are correctly taught. My Vital Cycles®, a holistic school-based OM health literacy program, was trialed with a Grade 9 cohort in one single-sex school in Western Australia using the Health Promoting School framework. A validated OM health literacy questionnaire was administered pre- and post-program with 94 participants. Functional OM health literacy improved overall, with 15 out of 20 items showing improvement post-program (p < 0.05). In addition, 19 out of 53 items for interactive OM health literacy, and 18 out of 25 items for critical OM health literacy improved (p < 0.05). The improvement in mood concerns (p = 0.002) was unexpected. Thematic analysis of three focus groups of 18 girls revealed four themes of increasing comfort levels; finding the program informative; inclusion of non-teaching support such as healthcare professionals; and suggestions for future refinements. Overall, this Western Australian PhD project which developed and trialed My Vital Cycles® improved OM health literacy and was positively received. Future research possibilities include understanding the program’s impact on mental health and further trials in co-educational settings; amongst different populations; and with extended post-program testing. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
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12 pages, 341 KiB  
Article
Living with Endometriosis: A Narrative Analysis of the Experiences of Kenyan Women
by Sadie Bergen, Doris Murimi, Caitlin Gruer, Gibson Munene, Atunga Nyachieo, Maureen Owiti and Marni Sommer
Int. J. Environ. Res. Public Health 2023, 20(5), 4125; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20054125 - 25 Feb 2023
Viewed by 4309
Abstract
Despite the high global prevalence of endometriosis, little is known about the experiences of women living with the disease in low- and middle-income contexts, including in Kenya and other countries across sub-Saharan Africa. This study captures the perspectives and recommendations of Kenyan women [...] Read more.
Despite the high global prevalence of endometriosis, little is known about the experiences of women living with the disease in low- and middle-income contexts, including in Kenya and other countries across sub-Saharan Africa. This study captures the perspectives and recommendations of Kenyan women living with endometriosis through written narratives about the impact of the disease on their daily lives and their journeys through diagnosis and treatment. Thirty-seven women between the ages of 22 and 48 were recruited from an endometriosis support group in Nairobi and Kiambu, Kenya (February–March of 2022) in partnership with the Endo Sisters East Africa Foundation. Narrative data (written anonymous stories submitted through Qualtrics) were analyzed using a deductive thematic analysis methodology. Their stories revealed three themes related to their shared experiences with endometriosis: (1) stigma and disruption to quality of life, (2) barriers to acceptable healthcare, and (3) reliance on self-efficacy and social support to cope with the disease. These findings demonstrate a clear need for improved social awareness of endometriosis in Kenya and the establishment of clear, effective, and supportive pathways, with trained, geographically and financially accessible health care providers, for endometriosis diagnosis and treatment. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
14 pages, 718 KiB  
Article
Current Awareness Status of and Recommendations for Polycystic Ovarian Syndrome: A National Cross-Sectional Investigation of Central Jordan
by Nadia Muhaidat, Shahd Mansour, Majid Dardas, Jamil Qiqieh, Zeina Halasa, Leen Al-Huneidy, Jehad Samhouri, Rama Rayyan, Wahid AlOweiwi, Jamil AlMohtasib, Mohammad A. Alshrouf, Ghayda’a M. Al-Labadi, Layla H. Suboh and Abdallah Al-Ani
Int. J. Environ. Res. Public Health 2023, 20(5), 4018; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20054018 - 23 Feb 2023
Viewed by 2514
Abstract
Polycystic ovary syndrome (PCOS) is a common reproductive disorder that is related to a number of health issues and has an influence on a variety of metabolic processes. Despite its burden on the health of females, PCOS is significantly underdiagnosed, which is associated [...] Read more.
Polycystic ovary syndrome (PCOS) is a common reproductive disorder that is related to a number of health issues and has an influence on a variety of metabolic processes. Despite its burden on the health of females, PCOS is significantly underdiagnosed, which is associated with lack of disease knowledge among females. Therefore, we aimed to gauge the awareness of PCOS in both the male and female population in Jordan. A descriptive cross-sectional study was conducted, targeting individuals over the age of 18 from Jordan’s central region. Participants were recruited through stratified random sampling. The questionnaire consisted of two domains, including demographics and knowledge of PCOS domains. A total of 1532 respondents participated in this study. The findings revealed that participants have overall adequate knowledge regarding PCOS’s risk factors, etiology, clinical presentation, and outcomes. However, participants demonstrated subpar familiarity of the association between PCOS and other comorbidities and the effect of genetics on PCOS. Women had more knowledge than men about PCOS (57.5 ± 6.06 vs. 54.1 ± 6.71, p = 0.019). In addition, older, employed, and higher-income populations showed significantly better knowledge than younger, unemployed, self-employed, and lower-income populations. In conclusion, we demonstrated that Jordanian women demonstrate an acceptable yet incomplete level of knowledge towards PCOS. We recommend establishing educational programs by specialists for the general population as well as medical personnel to spread accurate medical information and clarify common misconceptions about signs, symptoms, management, and treatment of PCOS, and nutritional knowledge. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
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15 pages, 727 KiB  
Article
COVID-Related Distress Is Associated with Increased Menstrual Pain and Symptoms in Adult Women
by Laura A. Payne, Laura C. Seidman, Boyu Ren and Shelly F. Greenfield
Int. J. Environ. Res. Public Health 2023, 20(1), 774; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20010774 - 31 Dec 2022
Cited by 2 | Viewed by 1496
Abstract
The COVID-19 pandemic resulted in heightened stress for many individuals, with women reporting more stress than men. Although a large body of evidence has demonstrated that stress, in general, can impact the menstrual cycle, it is not yet clear if COVID-specific stress would [...] Read more.
The COVID-19 pandemic resulted in heightened stress for many individuals, with women reporting more stress than men. Although a large body of evidence has demonstrated that stress, in general, can impact the menstrual cycle, it is not yet clear if COVID-specific stress would impact women’s menstrual health. The current study explored the relationship between COVID-related stress and distress and menstrual variables (menstrual pain, number and severity of menstrual symptoms, and menstrual pain interference) in a sample of reproductive-age adult women. Seven-hundred fifteen women completed the initial survey and were re-contacted to complete the same survey three months later. Of those recontacted, 223 completed the follow-up survey. Results indicated that COVID-related stress and distress was associated with higher levels of menstrual pain, more frequent and more severe menstrual symptoms, and greater menstrual pain interference, even after accounting for age, hormonal use, bodily pain, and pain catastrophizing. Our findings suggest that women experience unique vulnerabilities that directly impact their health and functioning, and both research and clinical care should address these symptoms through careful assessment and treatment of menstrual pain and symptoms, particularly during and after periods of high stress and distress. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
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20 pages, 1270 KiB  
Article
A Global Survey of Ethnic Indian Women Living with Polycystic Ovary Syndrome: Co-Morbidities, Concerns, Diagnosis Experiences, Quality of Life, and Use of Treatment Methods
by Vibhuti Samarth Rao, Stephanie Cowan, Mike Armour, Caroline A. Smith, Birinder S. Cheema, Lisa Moran, Siew Lim, Sabrina Gupta, Michael De Manincor, Vikram Sreedhar and Carolyn Ee
Int. J. Environ. Res. Public Health 2022, 19(23), 15850; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192315850 - 28 Nov 2022
Cited by 3 | Viewed by 3570
Abstract
Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy that is highly prevalent in women of Indian ethnicity. Clinical practice guidelines do not adequately consider ethnic–cultural differences in the diagnosing and care of women with PCOS. This study aimed to understand co-morbidities, key [...] Read more.
Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy that is highly prevalent in women of Indian ethnicity. Clinical practice guidelines do not adequately consider ethnic–cultural differences in the diagnosing and care of women with PCOS. This study aimed to understand co-morbidities, key concerns, quality of life (QoL), and diagnosis experiences of ethnic Indian women living with PCOS. Methods: Global online survey of ethnic Indian women of reproductive age living with PCOS. Results: Respondents (n = 4409) had a mean age of 26.8 (SD 5.5) years and reported having a family history of type 2 diabetes (43%) and PCOS (18%). Most of them (64%) were diagnosed with one or more co-morbidities (anxiety/depression being the most common). Irregular periods, cysts on the ovaries, and excess unwanted facial hair growth were their three top concerns. On average, women experienced symptoms of PCOS at the age of 19.0 (SD 5.0) and were diagnosed at the age of 20.8 years (SD 4.8). We report a one-year delay in seeking medical help and a seven-month diagnostic delay, which were associated with poor satisfaction with the information provided related to PCOS and its treatment options (p < 0.01). Women living outside India reported difficulty losing weight as their most key concern; however, they had lesser satisfaction with the information provided on diet (OR, 0.74; 95% CI, 0.6 to 0.8; p = 0.002), exercise (OR, 0.74; 95% CI, 0.6 to 0.9; p = 0.002) and behavioural advice (OR, 0.74; 95% CI, 0.6 to 0.9; p = 0.004) than women living in India. Most women reported poor QoL in weight and emotion domains. Conclusions: Ethnic Indian women experience early onset of PCOS symptoms and delay in seeking professional help. Timely diagnosis, providing cultural-specific education related to lifestyle and weight management, and improving psycho-emotional support are key areas that should be addressed in clinical practice and future research. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
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12 pages, 1246 KiB  
Article
Development of the Korean Medicine Core Outcome Set for Primary Dysmenorrhea (COS-PD-KM) for Herbal Medicine Treatment of Primary Dysmenorrhea in Primary Clinics
by Pyung-Wha Kim, Sungha Kim, Dong-Il Kim, Jiyun Cha, He-Sol Lee, Mi Mi Ko, Soobin Jang, Changsop Yang and Myeong Soo Lee
Int. J. Environ. Res. Public Health 2022, 19(22), 15321; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192215321 - 19 Nov 2022
Viewed by 1572
Abstract
The aim of this study was to develop a Korean medicine (KM) core outcome set (COS) for primary dysmenorrhea to evaluate the effectiveness of herbal medicine (HM) in treating primary dysmenorrhea in patients visiting KM primary clinics. Previously reported outcomes were identified through [...] Read more.
The aim of this study was to develop a Korean medicine (KM) core outcome set (COS) for primary dysmenorrhea to evaluate the effectiveness of herbal medicine (HM) in treating primary dysmenorrhea in patients visiting KM primary clinics. Previously reported outcomes were identified through a literature review to define outcomes and effect modifiers (EMs) for the questionnaire. Experts were invited to conduct modified Delphi consensus exercises, and primary care clinicians were invited to conduct Delphi consensus exercises to evaluate suitability and feasibility. Finally, an additional round of a modified Delphi exercise was conducted with experts to obtain a final agreement on the COS. Seventeen outcomes and 15 EMs were included from a literature review, and one effect modifier was suggested by the experts (Phase 1). In Phase 2, after the modified Delphi consensus exercises by experts, 10 outcomes and 11 EMs were included in the COS. The clinicians all agreed on the feasibility of COS (Phase 3). Finally, 10 outcomes and 6 EMs were included in the COS-PD-KM after the final modified Delphi consensus exercise (Phase 4). The effectiveness of HM used in primary clinics could be evaluated with this COS in patients with primary dysmenorrhea. Further studies that involve more relevant stakeholder groups, such as patient representatives and gynecological experts, are needed. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
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11 pages, 359 KiB  
Article
The Role of Cadherin 12 (CDH12) in the Peritoneal Fluid among Patients with Endometriosis and Endometriosis-Related Infertility
by Ksawery Goławski, Robert Soczewica, Joanna Kacperczyk-Bartnik, Grzegorz Mańka, Mariusz Kiecka, Michał Lipa, Damian Warzecha, Robert Spaczyński, Piotr Piekarski, Beata Banaszewska, Artur Jakimiuk, Tadeusz Issat, Wojciech Rokita, Jakub Młodawski, Maria Szubert, Piotr Sieroszewski, Grzegorz Raba, Kamil Szczupak, Tomasz Kluz, Marek Kluza, Mirosław Wielgoś, Ewa Koc-Żórawska, Marcin Żórawski and Piotr Laudańskiadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2022, 19(18), 11586; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191811586 - 14 Sep 2022
Cited by 10 | Viewed by 1875
Abstract
Cadherin 12 (CDH 12) can play a role in the pathogenesis of endometriosis. The aim of this study was to compare the levels of cadherin 12 in the peritoneal fluid between women with and without endometriosis. This was a multicenter cross-sectional study. Eighty-two [...] Read more.
Cadherin 12 (CDH 12) can play a role in the pathogenesis of endometriosis. The aim of this study was to compare the levels of cadherin 12 in the peritoneal fluid between women with and without endometriosis. This was a multicenter cross-sectional study. Eighty-two patients undergoing laparoscopic procedures were enrolled in the study. Cadherin 12 concentrations were determined using the enzyme-linked immunosorbent assay. The level of statistical significance was set at p < 0.05. No differences in cadherin 12 concentrations between patients with and without endometriosis were observed (p = 0.4). Subgroup analyses showed that CDH 12 concentrations were significantly higher in patients with infertility or primary infertility and endometriosis in comparison with patients without endometriosis and without infertility or primary infertility (p = 0.02) and also higher in patients with stage I or II endometriosis and infertility or primary infertility than in patients without endometriosis and infertility or primary infertility (p = 0.03, p = 0.048, respectively). In total, CDH 12 levels were significantly higher in patients diagnosed with infertility or primary infertility (p = 0.0092, p = 0.009, respectively) than in fertile women. Cadherin 12 can possibly play a role in the pathogenesis of infertility, both in women with and without endometriosis. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
21 pages, 1230 KiB  
Article
Determinants of Pain-Induced Disability in German Women with Endometriosis during the COVID-19 Pandemic
by Roxana Schwab, Kathrin Stewen, Tanja Kottmann, Susanne Theis, Tania Elger, Bashar Haj Hamoud, Mona W. Schmidt, Katharina Anic, Walburgis Brenner and Annette Hasenburg
Int. J. Environ. Res. Public Health 2022, 19(14), 8277; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19148277 - 06 Jul 2022
Cited by 4 | Viewed by 1876
Abstract
(1) Background: The main aim of this research was to examine the factors leading to pain-induced disability by assessing the impact of demographic, endometriosis-specific, pandemic-specific, and mental health factors. (2) Methods: Women with endometriosis who attended online support groups were invited to respond [...] Read more.
(1) Background: The main aim of this research was to examine the factors leading to pain-induced disability by assessing the impact of demographic, endometriosis-specific, pandemic-specific, and mental health factors. (2) Methods: Women with endometriosis who attended online support groups were invited to respond to an online survey during the first wave of the COVID-19 pandemic in Germany. The Pain Disability Index (PDI) was employed to assess disability-related daily functioning. Independent predictors of pain-induced disability were determined using univariate and multivariate logistic regression analyses. (3) Results: The mean PDI score of the study population was 31.61 (SD = 15.82), which was significantly higher (p < 0.001) than that reported in a previously published normative study of the German population. In the present study, a high level of pain-induced disability, as defined by scores equal to or higher than the median of the study population, older age (OR 1.063, 95% CI 1.010–1.120, p = 0.020), dysmenorrhea (OR 1.015, 95% CI 1.005–1.026, p = 0.005), dysuria (OR 1.014; 95% CI 1.001–1.027, p = 0.029), lower back pain (OR 1.018, 95% CI 1.007–1.029, p = 0.001), and impaired mental health (OR 1.271, 95% CI 1.134–1.425, p < 0.001) were found to be independent risk factors. Pandemic-specific factors did not significantly influence the pain-induced disability of the participants in this study. (4) Conclusions: The level of pain-induced disability was significantly higher among the women with endometriosis than among women in the normative German validation study. Our findings identified risk factors for experiencing a high level of pain-induced disability, such as demographic and specific pain characteristics. Pandemic-specific factors did not significantly and independently influence the pain-induced disability during the first wave of the COVID-19 pandemic in Germany. Impaired mental health negatively influenced functioning during daily activities. Thus, women with endometriosis should be managed by a multidisciplinary team of healthcare professionals to prevent negative effects of pain-induced disability on their quality of life. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
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11 pages, 314 KiB  
Article
“Should I Inhale?”—Perceptions, Barriers, and Drivers for Medicinal Cannabis Use amongst Australian Women with Primary Dysmenorrhoea: A Qualitative Study
by Justin Sinclair, Susanne Armour, Jones Asafo Akowuah, Andrew Proudfoot and Mike Armour
Int. J. Environ. Res. Public Health 2022, 19(3), 1536; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031536 - 29 Jan 2022
Cited by 7 | Viewed by 3087
Abstract
Objective: This study sought to investigate the perceptions, barriers, and drivers associated with medicinal cannabis use among Australian women with primary dysmenorrhea. A qualitative study via virtual focus groups involving 26 women experiencing regular, moderate, or greater menstrual pain explored categories including cost, [...] Read more.
Objective: This study sought to investigate the perceptions, barriers, and drivers associated with medicinal cannabis use among Australian women with primary dysmenorrhea. A qualitative study via virtual focus groups involving 26 women experiencing regular, moderate, or greater menstrual pain explored categories including cost, associated stigma, current drug driving laws, community and workplace ethics, and geographical isolation within the context of patient access under current Australian laws and regulations. Results: A qualitative descriptive analysis identified that dissatisfaction with current management strategies such as over-the-counter analgesic usage was the key driver for wanting to use medicinal cannabis. A number of significant barriers to use were identified including patient access to medical prescribers, medical practitioner bias, current drug driving laws, geographic location, and cost. Community and cultural factors such as the history of cannabis as an illicit drug and the resulting stigma, even when prescribed by a medical doctor, still existed and was of concern to our participants. Conclusion: Whilst medicinal cannabis is legal in all states and territories within Australia, several barriers to access exist that require government regulatory attention to assist in increasing patient adoption, including possible subsidisation of cost. The high cost of legal, medicinal cannabis was a key factor in women’s choice to use illicit cannabis. Overall, the concerns raised by our participants are consistent with the broader findings of a recent Australian Senate inquiry report into barriers to patient access to medicinal cannabis in Australia, suggesting many of the issues are systematic rather than disease-specific. Given the interest in use of medicinal cannabis amongst women with primary dysmenorrhea, clinical trials in this area are urgently needed. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
11 pages, 335 KiB  
Article
Insomnia, Inattention and Fatigue Symptoms of Women with Premenstrual Dysphoric Disorder
by Pai-Cheng Lin, Chih-Hung Ko, Yen-Ju Lin and Ju-Yu Yen
Int. J. Environ. Res. Public Health 2021, 18(12), 6192; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126192 - 08 Jun 2021
Cited by 9 | Viewed by 3588
Abstract
Aim: Premenstrual dysphoric disorder (PMDD) has predictable, cyclic, psychological, and somatic symptoms, such as sleep problems. They result in functional impairment, are aggravated in the late luteal phase of the menstrual cycle, and are resolved by menstruation. The present study evaluated the insomnia, [...] Read more.
Aim: Premenstrual dysphoric disorder (PMDD) has predictable, cyclic, psychological, and somatic symptoms, such as sleep problems. They result in functional impairment, are aggravated in the late luteal phase of the menstrual cycle, and are resolved by menstruation. The present study evaluated the insomnia, inattention, and fatigue symptoms of PMDD and their fluctuations during the menstrual cycle. Methods: A total of 100 women were diagnosed as having PMDD based on psychiatric interviews and a prospective investigation of three menstrual cycles. A total of 96 individuals without PMDD were recruited as controls. Their symptoms, namely insomnia, inattention, and fatigue as well as functional impairment were assessed by using the premenstrual symptoms screening tool, the Pittsburgh insomnia rating scale, the attention and performance self-assessment scale, and the fatigue-assessment scale during both premenstrual and follicular phases. Results: In both the premenstrual and follicular phases, women with PMDD experienced more severe insomnia, inattentiveness, and fatigue than did women in the control group. A paired t-test demonstrated that women with PMDD had more severe severity insomnia, inattentiveness, and fatigue in the luteal phase than in the follicular phase. A repeated-measures analysis of variance demonstrated that the interaction period of PMDD and a menstrual cycle was significantly associated with insomnia, inattentiveness, and fatigue. A further correlation analysis demonstrated that all three symptoms were positively associated with self-reported functional impairment due to PMDD. Conclusions: Our results demonstrated that women with PMDD experienced an exacerbation of insomnia, memory problems, difficulty maintaining focus, and fatigue in the premenstrual phase. These symptoms are correlated with PMDD symptoms severity and functional impairment, and as such, they should be evaluated, and interventions should be employed in the late luteal phase of women with PMDD. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
11 pages, 321 KiB  
Article
The Role of Research in Guiding Treatment for Women’s Health: A Qualitative Study of Traditional Chinese Medicine Acupuncturists
by Mike Armour, Debra Betts, Kate Roberts, Susanne Armour and Caroline A. Smith
Int. J. Environ. Res. Public Health 2021, 18(2), 834; https://doi.org/10.3390/ijerph18020834 - 19 Jan 2021
Cited by 8 | Viewed by 4721
Abstract
Background: Surveys of acupuncture practitioners worldwide have shown an increase in the use of acupuncture to treat women’s health conditions over the last ten years. Published studies have explored the effectiveness of acupuncture for various conditions such as period pain, fertility, and labor [...] Read more.
Background: Surveys of acupuncture practitioners worldwide have shown an increase in the use of acupuncture to treat women’s health conditions over the last ten years. Published studies have explored the effectiveness of acupuncture for various conditions such as period pain, fertility, and labor induction. However, it is unclear what role, if any, peer-reviewed research plays in guiding practice. Methods: Acupuncturists with a significant women’s health caseload were interviewed online in three small groups to explore factors that contribute to acupuncturists’ clinical decision made around treatment approaches and research. Results: Eleven practitioners participated in the focus groups. The overarching theme that emerged was one of ‘Not mainstream but a stream.’ This captured two themes relating to acupuncture as a distinct practice: ‘working with what you’ve got’ as well as ‘finding the right lens’, illustrating practitioners’ perception of research needing to be more relevant to clinical practice. Conclusions: Acupuncture practitioners treating women’s health conditions reported a disconnect between their clinical practice and the design of clinical trials, predominantly due to what they perceived as a lack of individualization of treatment. Case histories were popular as a learning tool and could be used to support increasing research literacy. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
9 pages, 290 KiB  
Article
Association between Childhood Maltreatment History and Premenstrual Syndrome
by Kanako Ito, Satomi Doi, Aya Isumi and Takeo Fujiwara
Int. J. Environ. Res. Public Health 2021, 18(2), 781; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18020781 - 18 Jan 2021
Cited by 13 | Viewed by 2680
Abstract
Childhood maltreatment history has known relationships with various mental and physical diseases; however, little is known about its association with premenstrual syndrome (PMS). In this study, we investigated the association between childhood maltreatment history and PMS among young women in Japan. In a [...] Read more.
Childhood maltreatment history has known relationships with various mental and physical diseases; however, little is known about its association with premenstrual syndrome (PMS). In this study, we investigated the association between childhood maltreatment history and PMS among young women in Japan. In a Japanese city, we approached 3815 women aged 10–60 years who visited a gynecology clinic and one general practice clinic. A questionnaire on childhood maltreatment history and PMS was administered to them. We observed that women with histories of childhood maltreatment demonstrated a significantly increased risk of PMS compared with those without such histories (odds ratio: 1.47, 95% confidence interval: 1.20–1.81). Particularly, women with childhood physical or emotional abuse demonstrated a stronger association with PMS, whereas other forms of childhood maltreatment (emotional neglect, witnessing of intimate-partner violence, or sexual abuse) were not associated with PMS. Our results illustrate that childhood maltreatment may be a risk factor for PMS. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)

Review

Jump to: Research

18 pages, 8716 KiB  
Review
Factors Associated with the Prevalence and Severity of Menstrual-Related Symptoms: A Systematic Review and Meta-Analysis
by Risa Mitsuhashi, Akemi Sawai, Kosuke Kiyohara, Hitoshi Shiraki and Yoshio Nakata
Int. J. Environ. Res. Public Health 2023, 20(1), 569; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20010569 - 29 Dec 2022
Cited by 8 | Viewed by 5846
Abstract
This study aimed to identify factors associated with the prevalence and severity of menstrual-related symptoms. The protocol was registered in PROSPERO (CRD42021208432). We conducted literature searches of PubMed and Ichushi-Web and used the Jonna Briggs Institute critical appraisal checklist to assess the quality. [...] Read more.
This study aimed to identify factors associated with the prevalence and severity of menstrual-related symptoms. The protocol was registered in PROSPERO (CRD42021208432). We conducted literature searches of PubMed and Ichushi-Web and used the Jonna Briggs Institute critical appraisal checklist to assess the quality. Of the 77 studies included in the meta-analysis, significant odds ratios (ORs) were obtained for eight factors associated with primary dysmenorrhea (PD): age ≥ 20 years (OR: 1.18; 95% confidence interval [CI]: 1.04–1.34), body mass index (BMI) < 18.5 kg/m2 (OR: 1.51; 95% CI: 1.01–2.26), longer menstrual periods (OR: 0.16; 95% CI: 0.04–0.28), irregular menstrual cycle (OR: 1.28; 95% CI: 1.13–1.45), family history of PD (OR: 3.80; 95% CI: 2.18–6.61), stress (OR: 1.88; 95% CI: 1.30–2.72), sleeping hours < 7 h (OR: 1.19; 95% CI: 1.04–1.35), and bedtime after 23:01 (OR: 1.30; 95% CI: 1.16–1.45). Two factors were associated with severity of PD (moderate vs. severe): BMI < 18.5 kg/m2 (OR: 1.89; 95% CI: 1.01–3.54) and smoking (OR: 1.94; 95% CI: 1.08–3.47). PD severity (mild vs. severe) and prevalence of premenstrual syndrome were associated with BMI < 18.5 kg/m2 (OR: 1.91; 95% CI: 1.04–3.50) and smoking (OR: 1.86; 95% CI: 1.31–2.66), respectively. The identified risk factors could be utilized to construct an appropriate strategy to improve menstrual symptoms and support women’s health. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
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12 pages, 358 KiB  
Review
Stigma and Endometriosis: A Brief Overview and Recommendations to Improve Psychosocial Well-Being and Diagnostic Delay
by Omar T. Sims, Jhumka Gupta, Stacey A. Missmer and Irene O. Aninye
Int. J. Environ. Res. Public Health 2021, 18(15), 8210; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18158210 - 03 Aug 2021
Cited by 39 | Viewed by 10884
Abstract
Endometriosis is a chronic gynecological disease that affects approximately 1 in 10 women of reproductive age. Symptoms of severe pelvic pain, infertility, fatigue, and abnormal menstruation can cause significant negative effects on an individual’s physical and mental health, including interactions with their family, [...] Read more.
Endometriosis is a chronic gynecological disease that affects approximately 1 in 10 women of reproductive age. Symptoms of severe pelvic pain, infertility, fatigue, and abnormal menstruation can cause significant negative effects on an individual’s physical and mental health, including interactions with their family, friends, and health care providers. Stigma associated with endometriosis has been under-studied and is rarely discussed in current literature. Herein, this paper aims to provide a brief overview of published literature to explore and establish the plausibility of stigma as a driver of suboptimal psychosocial well-being and diagnostic delay among individuals living with endometriosis. We present the clinical characteristics and physical and mental health consequences associated with endometriosis, highlight several theoretical constructs of stigma, and review the limited studies documenting women’s lived experiences of endometriosis-related stigma. To mitigate harmful effects of this phenomenon, we recommend increasing efforts to assess the prevalence of and to characterize endometriosis-related stigma, implementing awareness campaigns, and developing interventions that combat the multidimensional negative effects of stigma on timely care, treatment, and quality of life for individuals living with endometriosis. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
13 pages, 654 KiB  
Review
Adolescent Menstrual Health Literacy in Low, Middle and High-Income Countries: A Narrative Review
by Kathryn Holmes, Christina Curry, Sherry, Tania Ferfolja, Kelly Parry, Caroline Smith, Mikayla Hyman and Mike Armour
Int. J. Environ. Res. Public Health 2021, 18(5), 2260; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052260 - 25 Feb 2021
Cited by 36 | Viewed by 8166
Abstract
Background: Poor menstrual health literacy impacts adolescents’ quality of life and health outcomes across the world. The aim of this systematic review was to identify concerns about menstrual health literacy in low/middle-income countries (LMICs) and high-income countries (HICs). Methods: Relevant social science and [...] Read more.
Background: Poor menstrual health literacy impacts adolescents’ quality of life and health outcomes across the world. The aim of this systematic review was to identify concerns about menstrual health literacy in low/middle-income countries (LMICs) and high-income countries (HICs). Methods: Relevant social science and medical databases were searched for peer-reviewed papers published from January 2008 to January 2020, leading to the identification of 61 relevant studies. Results: A thematic analysis of the data revealed that LMICs report detrimental impacts on adolescents in relation to menstrual hygiene and cultural issues, while in HICs, issues related to pain management and long-term health outcomes were reported more frequently. Conclusions: In order to improve overall menstrual health literacy in LMICs and HICs, appropriate policies need to be developed, drawing on input from multiple stakeholders to ensure evidence-based and cost-effective practical interventions. Full article
(This article belongs to the Special Issue Women's Health Care: Menstrual Disorders, Endometriosis and Chronic Pelvic Pain)
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