Confidence to manage menstruation among university students in Australia: Evidence from a cross-sectional survey

Objectives: There has been increased attention to university students’ experiences of menstrual disorders, and access to menstrual products, in high-income countries. Less attention has been directed to other aspects of their menstrual experience, including confidence for menstrual management. This study aimed to understand the factors affecting university students’ confidence to manage menstruation at university. Methods: An online survey was completed by 410 participants (age range: 16–46 years, mean = 20.1 years) who menstruate and study at an Australian university. Participants reported demographic characteristics, confidence to manage menstruation at university, and personal, physical and environmental factors. A Mann–Whitney U-test analysed differences in confidence between groups of students. Pearson’s correlation coefficient and bivariate linear regressions determined associations between factors and confidence. Statistically significant associations were inputted into a multiple linear regression model. P-values less than 0.05 were considered significant. Results: A minority of students (16.2%) felt completely confident to manage their menstruation at university. Menstrual knowledge, positive perceptions of menstruation and comfort to discuss menstruation with others positively predicted confidence. Physical menstrual symptoms, negative perceptions of menstruation, perceived stigma and using a menstrual cup or period underwear predicted lower confidence. In multiple regression, private and clean and sanitary university bathroom facilities, changing menstrual products at university, perceived stigma and negative perceptions of menstruation remained significant predictors. Conclusion: Most students did not have complete confidence to manage their menstruation at university. Several personal, physical and environmental factors were related to students’ confidence to manage menstruation. Assessment of these factors in future research with university students is recommended to enable a comprehensive understanding of their menstrual needs, and inform interventions aimed at improving their menstrual management confidence at university.

Exploration of the experiences of working stressors and coping strategies associated with menstrual symptoms among nurses with shifting schedules: a Q methodology investigation

Background The essence and workload of nursing can easily lead to burdens associated with female nurses’ menstrual symptoms, and consequently, result in decreased working performance. Without effective support this can lead to resignation due to maladaptation. This study adopted Q methodology to explore the experience of working stressors and coping strategies associated with menstrual symptoms among nurses with shifting schedules. Methods Data were collected in two stages. First, in-depth interviews were conducted to collect nurses’ experiences. Sentences that best fit the study’s purpose were extracted for the construction of Q statements. Second, nurses were allowed to subjectively rank these Q statements by using Q-sorts. A total of 90 participants ranked the designed Q statements. The Q factor analysis revealed a five-factor solution that accounted for 48.90% of the total variance. Results The five evident factors included: menstrual symptoms interfering in collaboration with colleagues, deficiency of professional function and stress due to symptoms burden, diverse experiences without a clear pattern, adapted self-management with and without medication use, and stress due to symptoms burden and using medication for self-management. Conclusions The identification of these five groups may facilitate the development of responsive strategies to meet nurses’ preferences. Furthermore, identifying workplace factors that are associated with the adverse effects of menstrual symptoms on nurses will be helpful for nursing supervisors and hospital managers. Additionally, strategies that can be implemented to create supportive work environments are discussed.

Electrical Muscle Stimulation to Develop and Implement Menstrual Simulator System

Menstrual symptoms and cycles are complex, and the associated discomfort is difficult to quantify. Therefore, men, and some women, do not completely understand them. Here, we propose a system that simulates menstruation-like cramps through electrical muscle stimulation (EMS). We conducted an experiment to compare and evaluate the natural and electrically stimulated menstrual cramps. The results show that menstrual cramps using EMS can reproduce the nature of periodic dull pain. However, in this study, the position where the pain occurred was shallow. Furthermore, we constructed a demonstration system based on the proposed method. From the exhibition, we confirmed that this experience can help verbalize menstrual-related discomfort and allow people to better understand menstrual symptoms. In other words, this experience will help eliminate negative perception of menstruation.

Behavioral effects of different contraceptive methods and HIV acquisition: an ancillary study of the ECHO randomized trial

Background The ECHO trial randomised 7829 women to depot medroxyprogesterone acetate (DMPA-IM), the copper intrauterine device (IUD) and the levonorgestrel (LNG) implant (1:1:1) and found no clear difference in HIV incidence between these three groups. We have previously hypothesized that oligo-amenorrhoea induced by DMPA-IM may have a protective effect on HIV acquisition. The aim of this ancillary study was to assess the effects of DMPA-IM, the IUD and the LNG implant on menstrual symptoms and sexual behavior and to correlate these with HIV acquisition. Methods At the Effective Care Research Unit (ECRU) in South Africa, of 615 women already randomised to DMPA-IM, the copper IUD and the LNG implant (1:1:1) 552 agreed to participate. Participants completed a 28-day symptom and behavior diary following their one-month ECHO trial visit and returning it at their 3-month follow-up visit. HIV acquisition data were retrieved from ECHO trial records. Results Of 552 women enrolled on the ancillary study, 390 (70.6%) completed their daily diary; 130, 133, and 127 received DMPA-IM, IUD, and LNG implant, respectively. Thirty-three (5.9%) of these women acquired HIV. Women on the progestin-only contraceptives were more likely to experience amenorrhoea, as expected, and were less likely to have intra-menstrual coitus than IUD users (p < 0.001 for DMPA-IM vs IUD and p = 0.002 for implant vs IUD). Overall coital frequency was highest and condom usage lowest among DMPA-IM users. Intra-menstrual coitus correlated positively, and duration of menstruation correlated negatively, with HIV acquisition, although these effects were not statistically significant (p = 0.09 and p = 0.079, respectively). Conclusions Findings support the hypothesis that oligo-amenorrhoea and the associated reduced intra-menstrual coitus may mitigate the potential for an increased biological risk of HIV acquisition with DMPA-IM but more evidence is needed. Study registration number PACTR201706001651380

Examining the association between menstrual symptoms and health-related quality of life among working women in Japan using the EQ-5D

Background Menstrual symptoms have been identified as a substantial burden among women of reproductive age, affecting their health status and quality of life globally. A range of menstrual symptoms have been studied as they affect the health-related quality of life (HRQoL), showing variations across specific menstrual symptoms and study settings. A major concern is demonstrated due to menstrual symptoms in women’s professional and social life, and consequently societal and economic loss for women and the society at large. Yet evidence is scarce that estimates the index form HRQoL score related to menstrual symptoms that is needed for health economic evaluations. Methods This study aims to investigate the association between menstrual symptoms and the HRQoL among working women in Japan in an index form, using a self-reporting questionnaire (n = 6048). The EQ-5D-3L (EuroQoL 5-dimension 3-level) is used that is a widely used tool to measure health outcomes for health economic evaluations globally. Multivariate regression analysis is conducted to assess the association between the HRQoL score and specific nineteen physical and mental conditions related to menstruation (e.g., pain, heavy bleeding, concentration, negative affect). Results The index form HRQoL score for menstrual symptoms is estimated as 0.682 in the study population (where a score one suggests perfect health). The association of the HRQoL score varies substantially across the menstrual symptoms. Several of the physical conditions and disorders show a substantial negative association with the HRQoL score. Also, most of the mental and psychological issues are significantly and negatively related to the HRQoL score. Conclusions This study suggests that HRQoL is substantially and negatively affected by menstruation among working women in Japan. Distinct variations of negative influences across menstrual symptoms underscore the multi-dimensional nature of menstruation and consequently the need of collective interventions to address these difficulties. The evidence of HRQoL continues to be an important area for future research on women’s health and health economic evaluations to inform effective and efficient resource allocations for relevant health policies and financing strategies.

Prevalence and Predictors of Dysmenorrhea, its Effects and Coping Mechanism among Adolescent

Background and Aim: Dysmenorrhea is one of the most common gynecological disorders in the world. The current study aims to know the prevalence of dysmenorrhea and its management practices among adolescent girls. The study also aim to assess predictors of dysmenorrhea treatment options. Materials and Methods: This institutional-based cross-sectional study was carried out at Obstetrics & Gynaecology department of Mardan Women Hospital, Sheikh Maltoon Town Mardan and Jinnah International Hospital, Abbottabad from June 2020 to November 2020. Pretested self-administrated and a semi-structured questionnaire was used for data collection from volunteer adolescent girls to take part in this study. The outcome and exposure variables association was evaluated through a multi regression model and chi-square test. Dysmenorrhea risk was reported by taking the odds ratio at a confidence interval of 95%. SPSS version 20 was used for data analysis and statistical significance was considered at p<0.05. Results: Of the total 680 questionnaires, 601 (88.4%) were completed. The response rate and dysmenorrhea prevalence were 88.4% and 53.3% respectively. The mean age of the adolescents was 16.3 ± 1.92. While mean age for Menarche was 12.41 ± 1.62. A significant difference (t= 5.78, p< 0.001) between dysmenorrhea and non-dysmenorrhea age girls was (16.81 ±1.98) and (12.56 ± 1.65) respectively. The common symptom of waist pain among participants was (345, 57.4%). The prevalence of participants taking Over-the-counter (OTC) drugs for menstrual symptoms was 191 (31.8%). Dysmenorrhea’s severity and age were the two significant predictors for the prospect of taking a dysmenorrhea pharmacological agent. Conclusion: Our study concluded that a higher prevalence of dysmenorrhea was observed among adolescents compared to Menarche which adversely affects the routine major activities. A significant association between self-reported dysmenorrhea and the abnormal menstrual cycle was found. Adolescents must be educated early on about the safety and efficacy of various dysmenorrhea management options. Keywords: Dysmenorrhea, Adolescence, Menarche

Prevelance of symptoms during menstruation and its management among adolescent girls

Background: Menstruation is a natural phenomena of the female reproductive cycle in which discharge of blood from the uterus exits through the vagina every month, it is the spontaneous onset of puberty. 75% of girls confront some problems associated with menstruation including delayed, irregular, painful and heavy menstrual bleeding. Menstruation can be accompanied with premenstrual and postmenstrual symptoms which include both physiological symptoms and psychological symptoms. It is important to treat both physiological and psychological symptoms with pharmacological and nonpharmacological treatment approaches.Methods: The study was a prospective observational study done with a sample size of 650 subjects of 9 to 18 age group in whom menstruation already occurred were recruited from five different schools in regions of Pathanamthitta and Alappuzha. The study was conducted in 3 phases, where initially a predesigned well-structured questionnaire was provided to assess the attitude, awareness and practices.Results: Subjects experienced some or other type of symptoms and had better knowledge regarding menstrual symptoms and its importance of management when compared to subjects from other regions of India which was imparted from a developed and supporting society but still, they lacked some adequate and updated information on symptoms and management of symptoms during menstruation.Conclusions: So, this study laid the groundwork for discussion on menstrual symptoms, various approaches of treatment to the adolescent girls, providing them the information they lacked and better guidance.

Effects Of Exogenous Melatonin On Sleep And Circadian Rhythms In Women With Premenstrual Dysphoric Disorder

We previously found normal polysomnographic (PSG) sleep efficiency, increased slow wave sleep (SWS) and a blunted melatonin secretion in women with premenstrual dysphoric disorder (PMDD) compared to controls. Here, we investigated the effects of exogenous melatonin in five patients previously studied. They took 2 mg of slow-release melatonin 1 hour before bedtime during their luteal phase (LP) for three menstrual cycles. At baseline, patients spent every third night throughout one menstrual cycle sleeping in the laboratory. Measures included morning urinary 6-sulfatoxymelatonin (aMt6), PSG sleep, nocturnal core body temperature (CBT), visual analogue scale for mood (VAS-Mood), Prospective Record of the Impact and Severity of Menstrual Symptoms (PRISM), and ovarian hormones. Participants also underwent two 24-hour intensive physiological monitoring (during the follicular phase and LP) in time-isolation/constant conditions to determine 24-hour plasma melatonin and CBT rhythms. The same measures were repeated during their third menstrual cycle of melatonin administration. In the intervention condition compared to baseline, we found increased urinary aMt6 (p&lt;0.001), reduced objective SOL (p=0.01), reduced SWS (p&lt;0.001) and increased Stage 2 sleep (p&lt;0.001). Increased urinary aMt6 was associated with reduced SWS (r=-0.51, p&lt;0.001). Circadian parameters derived from 24-hour plasma melatonin and CBT did not differ between conditions, except for an increased melatonin mesor in the intervention condition (p=0.01). Ovarian hormones were comparable between the conditions (p≥0.28). Symptoms improved in the intervention condition, as measured by the VAS-Mood (p=0.02) and the PRISM (p&lt;0.001). These findings support a role for disturbed melatonergic system in PMDD that can be partially corrected by exogenous melatonin.