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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary dysmenorrhea is experienced by 40-80% of adolescent females. Traditionally, the literature discussing the etiology and management of this entity has given greater weight to psychologic than to physiologic factors. However, four previous studies addressing psychosocial variables failed to show a relationship to primary dysmenorrhea. In this study, personality factors and certain attitudinal variables were not found to be significantly related to the presence of primary dysmenorrheic pain. Current evidence strongly suggests that uterine contractility, hormone variables, and prostaglandins are causative in most cases of primary dysmenorrhea. Therefore, it is recommended that primary dysmenorrhea be regarded and managed as a physiologic phenomenon in the majority of adolescent females.
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PMID:Primary dysmenorrhea. Relationship to personality and attitudes in adolescent females. 733 23

Primary dysmenorrhea is defined as cramping pain in the lower abdomen occurring just before or during menstruation, in the absence of other diseases such as endometriosis. Prevalence rates are as high as 90 percent. Initial presentation of primary dysmenorrhea typically occurs in adolescence. It is a common cause of absenteeism and reduced quality of life in women. The problem is often underdiagnosed and undertreated. Women with primary dysmenorrhea have increased production of endometrial prostaglandin, resulting in increased uterine tone and stronger, more frequent uterine contractions. A diagnostic evaluation is unnecessary in patients with typical symptoms and no risk factors for secondary causes. Nonsteroidal anti-inflammatory medications are the mainstay of treatment, with the addition of oral contraceptive pills when necessary. About 10 percent of affected women do not respond to these measures. It is important to consider secondary causes of dysmenorrhea in women who do not respond to initial treatment. Many alternative treatments (ranging from acupuncture to laparoscopic surgery) have been studied, but the supporting studies are small, with limited long-term follow-up.
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PMID:Primary dysmenorrhea. 1046 24

Primary dysmenorrhea is characterized by painful uterine cramps, near and during menstruation, that have an impact on personal life and productivity. The effect on sleep of this recurring pain has not been established. We compared sleep, nocturnal body temperatures, and hormone profiles during the menstrual cycle of 10 young women who suffered from primary dysmenorrhea, without any menstrual-associated mood disturbances, and 8 women who had normal menstrual cycles. Dysmenorrheic pain significantly decreased subjective sleep quality, sleep efficiency, and rapid eye movement (REM) sleep but not slow wave sleep (SWS), compared with pain-free phases of the menstrual cycle and compared with the controls. Even before menstruation, in the absence of pain, the women with dysmenorrhea had different sleep patterns, nocturnal body temperatures, and hormone levels compared with the controls. In the mid-follicular, mid-luteal, and menstrual phases, the dysmenorrheics had elevated morning estrogen concentrations, higher mean in-bed temperatures, and less REM sleep compared with the controls, as well as higher luteal phase prolactin levels. Both groups of women had less REM sleep when their body temperatures were high during the luteal and menstrual phases, implying that REM sleep is sensitive to elevated body temperatures. We have shown that dysmenorrhea is not only a disorder of menstruation but is manifest throughout the menstrual cycle. Furthermore, dysmenorrheic pain disturbs sleep, which may exacerbate the effect of the pain on daytime functioning.
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PMID:High nocturnal body temperatures and disturbed sleep in women with primary dysmenorrhea. 1060 Jul 89

Primary dysmenorrhea is a syndrome characterized by painful uterine contractility caused by a hypersecretion of endometrial prostaglandins; non-steroidal anti-inflammatory drugs are the first choice for its treatment. However, in vivo and in vitro studies have demonstrated that myometrial cells are also targets of the relaxant effects of nitric oxide (NO). The aim of the present study was to determine the efficacy of glyceryl trinitrate (GTN), an NO donor, in the resolution of primary dysmenorrhea in comparison with diclofenac (DCF). A total of 24 patients with the diagnosis of severe primary dysmenorrhea were studied during two consecutive menstrual cycles. In an open, cross-over, controlled design, patients were randomized to receive either DCF per os or GTN patches the first days of menses, when menstrual cramps became unendurable. In the subsequent cycle the other treatment was used. Patients received up to 3 doses/day of 50 mg DCF or 2.5 mg/24 h transdermal GTN for the first 3 days of the cycle, according to their needs. The participants recorded menstrual symptoms and possible side-effects at different times (0, 30, 60, 120 minutes) after the first dose of medication on the first day of the cycle, with both drugs. The difference in pain intensity score (DPI) was the main outcome variable. Both treatments significantly reduced DPI by the 30th minute (GTN, -12.8 +/- 17.9; DCF, -18.9 +/- 16.6). However, DCF continued to be effective in reducing pelvic pain for two hours, whereas GTN scores remained more or less stable after 30 min and significantly higher than those for DFC (after one hour: GTN, -12.8 +/- 17.9; DFC, -18.9 +/- 16.6 and after two hours: GTN, -23.7 +/- 20.5; DFC, -59.7 +/- 17.9, p = 0.0001). Low back pain was also relieved by both drugs. Headache was significantly increased by GTN but not by DCF. Eight patients stopped using GTN because headache--attributed to its use--became intolerable. These findings indicate that GTN has a reduced efficacy and tolerability by comparison with DCF in the treatment of primary dysmenorrhea.
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PMID:A comparison of glyceryl trinitrate with diclofenac for the treatment of primary dysmenorrhea: an open, randomized, cross-over trial. 1191 80

Dysmenorrhoea, pain during menstruation, affects 40-95 per cent of menstruating women, and has been reported as the most common causes of regular absenteeism among young women. There are two types of dysmenorrhoea: primary and secondary. Primary dysmenorrhoea is a painful menstruation with no detectable organic disease and is more common in adolescent women. Secondary dysmenorrhoea is painful menstruation that is frequently associated with a pelvic pathology. The symptoms that present with dysmenorrhoea, the management and treatment options that are available, and the implications for nursing practice are discussed.
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PMID:Managing the pain of primary and secondary dysmenorrhoea. 1504 80

Many women suffer from pelvic pain, and a great many visit their family doctor for diagnosis and treatment. Two common causes are primary dysmenorrhea and endometriosis. Primary dysmenorrhea is best treated by prostaglandin inhibition from nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase-2 (COX-2)-specific inhibitors. Oral contraceptives can be added to improve pain control. Endometriosis can be treated with NSAIDs and COX-2-specific inhibitors as well but can also be treated with hormonal manipulation or surgery. Empiric treatment for endometriosis in selected patients is now accepted, making the disorder easier for family physicians to manage.
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PMID:Management of pelvic pain from dysmenorrhea or endometriosis. 1557 29

Primary dysmenorrhea occurs in as many as 50% of female adolescents and is associated with significant decreases in academic performance, sports participation, and socialization with peers. Complementary and alternative medicine treatment options are of interest to patients and health care providers. The use of rose tea to alleviate menstrual pain has long been a part of folk knowledge around the world but has not been studied scientifically. To determine the effectiveness of drinking rose tea as an intervention for reducing pain and psychophysiologic distress in adolescents with primary dysmenorrhea, 130 female adolescents were randomly assigned to an experimental (n = 70) and a control (n = 60) group. Preintervention and postintervention data at 1 month, 3 months, and 6 months were gathered on the biopsychosocial outcomes of dysmenorrhea. The results showed that compared with the control group, the experimental group perceived less menstrual pain, distress, and anxiety and showed greater psychophysiologic well-being through time, at 1, 3, and 6 months after the interventions. Findings suggest that drinking rose tea is a safe, readily available, and simple treatment for dysmenorrhea, which female adolescents may take to suit their individual needs.
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PMID:Rose tea for relief of primary dysmenorrhea in adolescents: a randomized controlled trial in Taiwan. 1615 59

Primary dysmenorrhea is painful menstrual cramps without any evident pathology to account for them, and it occurs in up to 50% of menstruating females and causes significant disruption in quality of life and absenteeism. Current understanding implicates an excessive or imbalanced amount of prostanoids and possibly eicosanoids released from the endometrium during menstruation. The uterus is induced to contract frequently and dysrhythmically, with increased basal tone and increased active pressure. Uterine hypercontractility, reduced uterine blood flow, and increased peripheral nerve hypersensitivity induce pain. Diagnosis rests on a good history with negative pelvic evaluation findings. Evidence-based data support the efficacy of cyclooxygenase inhibitors, such as ibuprofen, naproxen sodium, and ketoprofen, and estrogen-progestin oral contraceptive pills (OCPs). Cyclooxygenase inhibitors reduce the amount of menstrual prostanoids released, with concomitant reduction in uterine hypercontractility, while OCPs inhibit endometrial development and decrease menstrual prostanoids. An algorithm is provided for a simple approach to the management of primary dysmenorrhea.
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PMID:Primary dysmenorrhea: advances in pathogenesis and management. 1688 Mar 17

Primary dysmenorrhea, menstrual cramps in otherwise well women, produces mild to debilitating cramping of the uterus. More than half, and by some estimates 90% of all American women experience menstrual cramps during the first several days of menstruation. About one in ten women are unable to perform their normal routine for one to three days each menstrual cycle due to severe uterine cramping. Although the uterus contracts and relaxes routinely, during menstruation the contractions are much stronger producing pain and "cramps". Women with dysmenorrhea have high levels of prostaglandins, hormones believed to cause menstrual cramping. Prostaglandins are believed to temporarily reduce or stop blood supply to the uterus, thus depriving the uterus of oxygen resulting in contractions and pain. One would expect zinc, like the non-steroidal anti-inflammatory drugs used to treat cramping, to reduce the production of prostaglandins. Zinc inhibits the metabolism of prostaglandins ruling out this mechanism of action, suggesting erroneously that zinc deficiency would prevent cramping. However, it is shown by case histories that zinc, in 1-3 30-mg doses given daily for one to four days prior to onset of menses, prevents essentially all to all warning of menses and all menstrual cramping. One hypothesis for a mechanism of action is that a precursor (COX-2) or metabolite of prostaglandins causes menstrual cramping and not prostaglandins themselves. Another hypothesis is that zinc has antioxidant and anti-inflammatory actions in the uterus. Improvement in micro-vessel circulation by zinc may help prevent cramping and pain. In patients consuming 31 mg of zinc per day, premenstrual tension (PMT) symptoms did not occur, while in patients consuming 15 mg of zinc, PMT symptoms did occur (P<0.001). Protocols using 30 mg of zinc once to three times a day for one to four days immediately prior to menses to prevent dysmenorrhea are described and they are recommended for additional study. The side effect from the absence of all warning of pending menses due to zinc treatment was concern of possible pregnancy. The United States RDA for zinc appears to be too low to optimize women's health and prevent menstrual cramps.
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PMID:Zinc treatment prevents dysmenorrhea. 1728 85

Primary dysmenorrhoea (PD) is chronic, cyclic, pelvic, spasmodic pain associated with menstruation in the absence of identifiable pathology and is typically known as menstrual cramps or period pain. PD is the most common gynaecological disorder in menstruating women. Despite treatments being available for PD, relatively few women consult a clinician about their symptoms, preferring not to use treatment, or to self-treat using non-pharmacological or over-the-counter interventions. The notion that exercise is effective in preventing and treating symptoms has prevailed for many years and led to the promotion of anecdotal belief that exercise is beneficial. Behavioural interventions such as exercise may not only reduce dysmenorrhoea, but also eliminate or reduce the need for medication to control menstrual cramps and other associated symptoms. With emphasis on data from experimental studies, this report seeks to review the available evidence regarding the role of exercise in the management of PD and menstruation-related symptomatology. Using key search terms, online bibliographical databases were searched from the beginning of each database to 1 April 2007. Despite the widespread belief that exercise can reduce PD, empirical support is limited. Evidence from observational studies was mixed. Several observational studies reported that physical activity/exercise was associated with reduced prevalence of dysmenorrhoea, although numerous other studies found no significant association between outcomes. Evidence from controlled trials suggests that exercise can reduce PD and associated symptoms, but these have been small and of low methodological quality. There are, however, several plausible mechanisms by which exercise might be effective in the management of PD. A large randomized controlled trial is required before women and clinicians are advised that exercise is likely to be effective in reducing PD and related menstrual symptoms.
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PMID:Exercise and primary dysmenorrhoea : a comprehensive and critical review of the literature. 1862 Apr 66


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