|
|
Premenstrual Syndrome and Primary Dysmenorrhoea among Female Medical Students
|
Abstract:
Introduction: For the Arabic-speaking nations, a region with distinctive cultural and social traits that might affect expectations and self-perception of health problems, research on risk factors for premenstrual syndrome (PMS) and primary dysmenorrhoea (PD) is sparse. We investigated the relationship between the frequency of PMS and PD and potential risk factors for the illness. Aim: This paper aims to identify the prevalence, risk factors, and impacts of PMS and PD on female medical students’ quality of life (QoL) and academic performance. Subjects and Methods: A cross-sectional, survey-based study involved 300 undergraduate female medical students (out of 431 female students) at one of the private medical colleges in Jeddah, Saudi Arabia, “The Batterjee Medical College”. Results: Both PMS and PD are very common among female medical students in Saudi Arabia. The prevalence of PMS was 78.33%, while that of PD was 75.67%. The main predictors for both were young age, unmarried females, exposure to stress, excess unhealthy fatty meals, and coffee intake. Positive family history, nulliparity, and negative Rhesus factor D (RhD) were among the significant associated factors. Non-steroidal anti-inflammatory drugs (NSAIDs) were the common medication used to cope with the problem. Conclusion: The high incidence of PMS and PD among female medical students calls for effective measures to minimise their impact on students (physiologically and psychologically) and on their academic performance in medical schools. Educational awareness seminars, the provision of medical healthcare services, and different stress-relieving events such as aerobic exercises are recommended.
| [1] | Maity, S., Wray, J., Coffin, T., Nath, R., Nauhria, S., Sah, R., Waechter, R., Ramdass, P. and Nauhria, S. (2022) Academic and Social Impact of Menstrual Disturbances in Female Medical Students: A Systematic Review and Meta-Analysis. Frontiers in Medicine, 9, Article 821908. https://doi.org/10.3389/fmed.2022.821908 |
| [2] | Syed, A. and Rao, S.B. (2020) Prevalence of Premenstrual Syndrome and Dysmenorrhea among Medical Students and Its Impact on Their College Absenteeism. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 9, 1377-1381. https://doi.org/10.18203/2320-1770.ijrcog20201042 |
| [3] | Seedhom, A.E., Mohammed, E.S. and Mahfouz, E.M. (2013) Life Style Factors Associated with Premenstrual Syndrome among El-Minia University Students, Egypt. ISRN Public Health, 2013, Article ID: 617123. https://doi.org/10.1155/2013/617123 |
| [4] | Rasheed, P. and Al-Sowielem, L.S. (2003) Prevalence and Predictors of Premenstrual Syndrome among College-Aged Women in Saudi Arabia. Annals of Saudi Medicine, 23, 381-387. https://doi.org/10.5144/0256-4947.2003.381 |
| [5] | Monday, N., Member, D.A., Chubiyojo, S.D., Talemoh, D.M., Yewande, A.H., et al. (2023) Prevalence and Factor Analysis of Symptoms Associated with Premenstrual Syndrome among University Students in Nigeria. Medical Journal of Obstetrics and Gynecology, 11, Article 1168. |
| [6] | Goweda, R.A., Alkot, M.M., Alturkistani, F.A., et al. (2016) Prevalence of Premenstrual Dysphoric Disorder among Medical Students of Umm Al-Qura University, Makkah Al-Mukaramah, Kingdom of Saudi Arabia. Middle East Journal of Family Medicine, 14, 14-20. https://doi.org/10.5742/MEWFM.2015.92785 |
| [7] | Alshammari, E. and Aldossary, K. (2022) Premenstrual Symptoms Screening and Self-Medication among Women in Riyadh, Saudi Arabia. Military Medical Science Letters, 91, 274-281. https://doi.org/10.31482/mmsl.2022.002 |
| [8] | Mirghafourvand, M., Asghari Jafarabadi, M. and Ghanbari-Homayi, S. (2015) Comparison of the Diagnostic Values of Premenstrual Syndrome Screening Tool (PSST) and Daily Record of Severity of Problems (DRSP). Journal of Babol University of Medical Sciences, 17, 27-33. |
| [9] | Henz, A., Ferreira, C.F., Oderich, C.L., et al. (2018) Premenstrual Syndrome Diagnosis: A Comparative Study between the Daily Record of Severity of Problems (DRSP) and the Premenstrual Symptoms Screening Tool (PSST). Revista Brasileira de Ginecologia e Obstetrícia, 40, 20-25. https://doi.org/10.1055/s-0037-1608672 |
| [10] | Akpoigho, E.C. and Ukamaka, N.C. (2022) Assessment of Premenstrual Syndrome and Coping Strategies among Female Students of the School of Basic Medical Sciences, University of Benin, Benin City, Nigeria. Bayero Journal of Nursing and Health Care, 4, 927-938. https://doi.org/10.4314/bjnhc.v4i1.2 |
| [11] | Khalilzadeh, P., Amirzadehiranagh, J., Khalkhali, H.R. and Maheri, M. (2023) Evaluating the Effect of Educational Intervention Based on the Health Belief Model on the Lifestyle Related to Premenstrual Syndrome and Reduction of Its Symptoms among the First-Grade High School Girls. BMC Public Health, 23, Article No. 1001. https://doi.org/10.1186/s12889-023-15950-y |
| [12] | Kannan, L.S., Hassan, E.G., Lewis, S., et al. (2020) Dysmenorrhea among Female Medical Sciences Students in Machs: Prevalence, Predictors, and Outcome. Asian Journal of Pharmaceutical and Clinical Research, 13, 216-218. https://doi.org/10.22159/ajpcr.2020.v13i6.38190 |
| [13] | Benita, E., Kusumosih, T.A. and Nugroho, D.C. (2020) The Risk Factors of Primary Dysmenorrhea among Female Medical Students in Universitas Kristen Duta Wacana, Yogyakarta. Berkala Ilmiah Kedokteran Duta Wacana, 5, 22-28. https://doi.org/10.21460/bikdw.v5i1.148 |
| [14] | Alateeq, D., Binsuwidan, L., Alazwari, L., et al. (2022) Dysmenorrhea and Depressive Symptoms among Female University Students: A Descriptive Study from Saudi Arabia. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 58, Article No. 106. https://doi.org/10.1186/s41983-022-00542-1 |
| [15] | Parveen, N., Majeed, R. and Rajar, U.D.M. (2009) Familial Predisposition of Dysmenorrhea among the Medical Students. Pakistan Journal of Medical Sciences, 25, 857-860. |
| [16] | Sima, R.-M., Sulea, M., Radosa, J.C., et al. (2022) The Prevalence, Management and Impact of Dysmenorrhea on Medical Students’ Lives—A Multicenter Study. Healthcare, 10, Article 157. https://doi.org/10.3390/healthcare10010157 |
| [17] | Morimoto, A., Watanabe, T., Morimoto, K., Nakamori, T. and Murakami, N. (1991) Possible Involvement of Prostaglandins in Psychological Stress-Induced Responses in Rats. The Journal of Physiology, 443, 421-429. https://doi.org/10.1113/jphysiol.1991.sp018841 |
| [18] | Katwal, P.C., Karki, N.R., Sharma, P. and Tamrakar, S.R. (2016) Dysmenorrhea and Stress among the Nepalese Medical Students. Kathmandu University Medical Journal, 56, 318-321. |
| [19] | Bakhsh, H., Algenaimi, E., Aldhuwayhi, R. and Abu-Wadaan, M. (2022) Prevalence of Dysmenorrhea among Reproductive Age Group in Saudi Women. BMC Women’s Health, 22, Article No. 78. https://doi.org/10.1186/s12905-022-01654-9 |
| [20] | Teherán, A.A., Piñeros, L.G., Pulido, F., et al. (2018) WalIDD Score, a New Tool to Diagnose Dysmenorrhea and Predict Medical Leave in University Students. International Journal of Women’s Health, 10, 35-45. https://doi.org/10.2147/IJWH.S143510 |
| [21] | Mitsuhashi, R., Sawai, A., Kiyohara, K., Shiraki, H. and Nakata, Y. (2023) Factors Associated with the Prevalence and Severity of Menstrual-Related Symptoms: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 20, Article 569. https://doi.org/10.3390/ijerph20010569 |
| [22] | Salem, I.M., Alsamti, M.Y. and Murad, M.A. (2020) Predictors of Premenstrual Syndrome among Female Students at Governmental Secondary Schools in Jeddah, Saudi Arabia: A Cross-Sectional Study. The Egyptian Journal of Hospital Medicine, 78, 337-347. |
| [23] | Dinh Trieu Ngo, V., Bui, L.P., Hoang, L.B., Tran, M.T.T, Nguyen, H.V.Q., Tran, L.M., et al. (2023) Associated Factors with Premenstrual Syndrome and Premenstrual Dysphoric Disorder among Female Medical Students: A Cross-Sectional Study. PLOS ONE, 18, e0278702. https://doi.org/10.1371/journal.pone.0278702 |
| [24] | Rafique, N. and Al-Sheikh, M. (2018) Prevalence of Menstrual Problems and Their Association with Psychological Stress in Young Female Students Studying Health Sciences. Saudi Medical Journal, 39, 67-73. https://doi.org/10.15537/smj.2018.1.21438 |
| [25] | Al-Shahrani, A.M., Miskeen, E., Shroff, F., et al. (2021) Premenstrual Syndrome and Its Impact on the Quality of Life of Female Medical Students at Bisha University, Saudi Arabia. Journal of Multidisciplinary Healthcare, 14, 2373-2379. https://doi.org/10.2147/JMDH.S327893 |
| [26] | Altamimi, L.A., Aseeri, A.S., Kamran, Z., Kazi, A. and AlQuaiz, A.M. (2022) Prevalence of Premenstrual Syndrome and Associated Factors amongst Women Belonging to King Saud University in Riyadh, Saudi Arabia: A Cross-Sectional Study. International Journal of Women’s Health and Reproduction Sciences, 10, 194-201. https://doi.org/10.15296/ijwhr.2022.33 |
| [27] | Suboohi, S., Pario, S., Nasim, G., Abbasi, S. and Siddiqui, S.H. (2019) Assessment of Premenstrual Syndrome in Medical Students and Its Association with Progression of Academic Years. The Journal of Bahria University Medical and Dental College, 9, 210-213. https://doi.org/10.51985/JBUMDC2018123 |
| [28] | Yunus, S., Bano, B., Farooq, A. and Zarreen, A. (2020) Frequency and Severity of Premenstrual Syndrome among Undergraduate Medical Students. Esculapio, 16, 29-32. |
| [29] | Hussein, E.A., Hassan, I.T., Issa, H.S. and Mohammed, D.Q. (2023) Premenstrual Symptoms and Cycle Regularity: A Cross-Sectional Study among Iraqi University Students during the COVID-19 Pandemic. Journal of Medicinal and Chemical Sciences, 6, 228-235. |
| [30] | Yanjmaa, E., Ogawa, S., Tsogbadrakh, B., et al. (2022) Prevalence of Premenstrual Syndrome and Premenstrual Dysphoric Disorder among Mongolian College Students. The Kitakanto Medical Journal, 72, 43-48. https://doi.org/10.2974/kmj.72.43 |
| [31] | Govind, L.K.V. and Chellamma, V.K. (2023) Prevalence, Pattern, and Predictors of Premenstrual Syndrome and Premenstrual Dysphoric Disorder among College Girls. Asian Journal of Pharmaceutical and Clinical Research, 16, 124-126. https://doi.org/10.22159/ajpcr.2023.v16i2.46373 |
| [32] | Mohamed, A.A., Alanazi, M.S., Alsubhi, R.S., et al. (2022) Premenstrual Syndrome: Existence, Knowledge, and Attitude among Female University Students in Hail. International Journal of Medicine in Developing Countries, 6, 1097-1101. https://doi.org/10.24911/IJMDC.51-1656111075 |
| [33] | Minichil, W., Eskindir, E., Demilew, D., et al. (2020) Magnitude of Premenstrual Dysphoric Disorder and Its Correlation with Academic Performance among Female Medical and Health Science Students at University of Gondar, Ethiopia, 2019: A Cross-Sectional Study. BMJ Open, 10, e034166. https://doi.org/10.1136/bmjopen-2019-034166 |
| [34] | Tolossa, F.W. and Bekele, M.L. (2014) Prevalence, Impacts and Medical Managements of Premenstrual Syndrome among Female Students: Cross-Sectional Study in College of Health Sciences, Mekelle University, Mekelle, Northern Ethiopia. BMC Women’s Health, 14, Article No. 52. https://doi.org/10.1186/1472-6874-14-52 |
| [35] | Alshdaifat, E., Absy, N., Sindiani, A., et al. (2022) Premenstrual Syndrome and Its Association with Perceived Stress: The Experience of Medical Students in Jordan. International Journal of Women’s Health, 14, 777-785. https://doi.org/10.2147/IJWH.S361964 |
| [36] | Mohamed, M.A., Alrashed, G.I. and Albilasi, N.Q. (2021) Premenstrual Syndrome and Its Potential Functioning Impact among Female Pharmacy Students at Jouf University, Saudi Arabia: A Cross Sectional Study. PharmacologyOnLine, 2, 215-222. |
| [37] | Unsal, A., Tozun, M., Ayranci, U. and Orsal, O. (2012) Connection between Dysmenorrhea and Depression among a Group of Turkish High School Female Students. Pakistan Journal of Medical Sciences, 28, 424-427. |
| [38] | Rigon, F., De Sanctis, V., Bernasconi, S., Bianchin, L., Bona, G., Bozzola, M., et al. (2012) Menstrual Pattern and Menstrual Disorders among Adolescents: An Update of the Italian Data. Italian Journal of Pediatrics, 38, Article No. 38. https://doi.org/10.1186/1824-7288-38-38 |
| [39] | Ibrahim, N.K., Al-Ghamdi, M.S., Al-Shaibani, A.N., et al. (2015) Dysmenorrhea among Female Medical Students in King Abdulaziz University: Prevalence, Predictors and Outcome. Pakistan Journal of Medical Sciences, 31, 1312-1317. |
| [40] | Hashim, R.T., Alkhalifah, S.S., Alsalman, A.A., Alfaris, D.M., Alhussaini, M.A., Qasim, R.S., et al. (2020) Prevalence of Primary Dysmenorrhea and Its Effect on the Quality of Life amongst Female Medical Students at King Saud University, Riyadh, Saudi Arabia a Cross-Sectional Study. Saudi Medical Journal, 41, 283-289. https://doi.org/10.15537/smj.2020.3.24988 |
| [41] | Abdel-Salam, D.M., Alnuman, R.W., Alrwuaili, R.M., Alrwuaili, G.A. and Alrwuaili, E.M. (2018) Epidemiological Aspects of Dysmenorrhea among Female Students at Jouf University, Saudi Arabia. Middle East Fertility Society Journal, 23, 435-439. https://doi.org/10.1016/j.mefs.2018.08.001 |
| [42] | Nur Azurah, A.G., Sanci, L., Moore, E. and Grover, S. (2013) The Quality of Life of Adolescents with Menstrual Problems. Journal of Pediatric and Adolescent Gynecology, 26, 102-108. https://doi.org/10.1016/j.jpag.2012.11.004 |
| [43] | Agarwal, A.K. and Agarwal, A. (2010) A Study of Dysmenorrhea during Menstruation in Adolescent Girls. Indian Journal of Community Medicine, 35, 159-164. https://doi.org/10.4103/0970-0218.62586 |
| [44] | Harlow, B.L., Cohen, L.S., Otto, M.W., Spiegelman, D. and Cramer, D.W. (2004) Early Life Menstrual Characteristics and Pregnancy Experiences among Women with and without Major Depression: The Harvard Study of Moods and Cycles. Journal of Affective Disorders, 79, 167-176. https://doi.org/10.1016/S0165-0327(02)00459-7 |
| [45] | Fathi, M., Davoodi, P., Semyari, N., et al. (2022) Dysmenorrhea and Quality of Life: A Cross-Sectional Survey among Medical Students. Interventional Pain Medicine and Neuromodulation, 2, e132793. https://doi.org/10.5812/ipmn-132793 |
| [46] | Mohamed, E.M. (2012) Epidemiology of Dysmenorrhea among Adolescent Students in Assiut City, Egypt. Life Science Journal, 9, 348-353. |
| [47] | Mukattash, T.L., Tahaineh, L., AlRawi, N., Jarab, A., Hammad, H. and Nuseir, K. (2013) Behaviors and Attitudes towards Dysmenorrhea; a Cross-Sectional Survey of 2,000 Jordanian University Students. Jordan Medical Journal, 171, 26-34. https://doi.org/10.12816/0001066 |
| [48] | Yesuf, T.A., Eshete, N.A. and Sisay, E.A. (2018) Dysmenorrhea among University Health Science Students, Northern Ethiopia: Impact and Associated Factors. International Journal of Reproductive Medicine, 2018, Article 9730328. https://doi.org/10.1155/2018/9730328 |
| [49] | Amaza, D.S., Sambo, N., Zirahei, J.V., et al. (2012) Menstrual Pattern among Female Medical Students in University of Maiduguri, Nigeria. Journal of Advances in Medicine and Medical Research, 2, 327-337. https://doi.org/10.9734/BJMMR/2012/1018 |
| [50] | Mohapatra, D., Mishra, T., Behera, M. and Panda, P. (2016) A Study of Relation between Body Mass Index and Dysmenorrhea and Its Impact on Daily Activities of Medical Students. Asian Journal of Pharmaceutical and Clinical Research, 9, 297-299. https://doi.org/10.22159/ajpcr.2016.v9s3.14753 |
| [51] | Ju, H., Jones, M. and Mishra, G.D. (2015) A U-Shaped Relationship between Body Mass Index and Dysmenorrhea: A Longitudinal Study. PLOS ONE, 10, e0134187. https://doi.org/10.1371/journal.pone.0134187 |
| [52] | Chang, P.J., Chen, P.C., Hsieh, C.J. and Chiu, L.T. (2009) Risk Factors on the Menstrual Cycle of Healthy Taiwanese College Nursing Students. Australian and New Zealand Journal of Obstetrics and Gynaecology, 49, 689-694. https://doi.org/10.1111/j.1479-828X.2009.01097.x |
| [53] | Mesele, T.T., Dheresa, M., Oljira, L., et al. (2022) Prevalence of Dysmenorrhea and Associated Factors among Haramaya University Students, Eastern Ethiopia. International Journal of Women’s Health, 14, 517-527. https://doi.org/10.2147/IJWH.S333447 |
| [54] | Anastasakis, E., Kingman, C.E., Lee, C.A., Economides, D.L. and Kadir, R.A. (2008) Menstrual Problems in University Students: An Electronic Mail Survey. In Vivo, 22, 617-620. |
| [55] | Tavallaee, M., Joffres, M.R., Corber, S.J., Bayanzadeh, M. and Rad, M.M. (2011) The Prevalence of Menstrual Pain and Associated Risk Factors among Iranian Women. Journal of Obstetrics and Gynaecology Research, 37, 442-451. https://doi.org/10.1111/j.1447-0756.2010.01362.x |
| [56] | Al-Dabal, B.K., Koura, M.R., Rasheed, P., Al-Sowielem, L. and Makki, S.M. (2010) A Comparative Study of Perceived Stress among Female Medical and Non-Medical University Students in Dammam, Saudi Arabia. Sultan Qaboos University Medical Journal, 10, 231-240. |
| [57] | Ozerdogan, N., Sayiner, D., Ayranci, U., Unsal, A. and Giray, S. (2009) Prevalence and Predictors of Dysmenorrhea among Students at a University in Turkey. International Journal of Gynecology & Obstetrics, 107, 39-43. https://doi.org/10.1016/j.ijgo.2009.05.010 |
| [58] | El-Gilany, A.H., Badawi, K. and El-Fedawy, S. (2005) Epidemiology of Dysmenorrhea among Adolescent Students in Mansoura, Egypt. Eastern Mediterranean Health Journal, 11, 155-163. |
| [59] | Hamaideh, S.H., Al-Ashram, S.A. and Al-Modallal, H. (2014) Premenstrual Syndrome and Premenstrual Dysphoric Disorder among Jordanian Women. Journal of Psychiatric and Mental Health Nursing, 21, 60-68. https://doi.org/10.1111/jpm.12047 |
| [60] | Duenas, J.L., Lete, I., Bermejo, R., Arbat, A., Perez-Campos, E., Martinez-Salmean, J., et al. (2011) Prevalence of Premenstrual Syndrome and Premenstrual Dysphoric Disorder in a Representative Cohort of Spanish Women of Fertile Age. European Journal of Obstetrics and Gynecology and Reproductive Biology, 156, 72-77. https://doi.org/10.1016/j.ejogrb.2010.12.013 |
| [61] | Tabassum, S., Afridi, B., Aman, Z., Tabassum, W., Durrani, R. (2005) Premenstrual Syndrome: Frequency and Severity in Young College Girls. Journal of the Pakistan Medical Association, 55, 546-549. |
| [62] | Hillen, T.I.J., Grbavac, S.L., Johnston, P.J., Straton, J.A.Y. and Keogh, J.M.F. (1999) Primary Dysmenorrhea in Young Western Australian Women: Prevalence, Impact, and Knowledge of Treatment. Journal of Adolescent Health, 25, 40-45. https://doi.org/10.1016/S1054-139X(98)00147-5 |
| [63] | Bergsjø, P. (1979) Socioeconomic Implications of Dysmenorrhea. Acta Obstetricia et Gynecologica Scandinavica, 58, 67-68. https://doi.org/10.3109/00016347909157793 |
| [64] | Houston, A.M., Abraham, A., Huang, Z. and D’Angelo, L.J. (2006) Knowledge, Attitudes, and Consequences of Menstrual Health in Urban Adolescent Females. Journal of Pediatric and Adolescent Gynecology, 19, 271-275. https://doi.org/10.1016/j.jpag.2006.05.002 |
| [65] | Banikarim, C., Chacko, M.R. and Kelder, S.H. (2000) Prevalence and Impact of Dysmenorrhea on Hispanic Female Adolescents. Archives of Pediatrics & Adolescent Medicine, 154, 1226-1229. https://doi.org/10.1001/archpedi.154.12.1226 |
| [66] | Rostami, M. (2007) The Study of Dysmenorrhea in High School Girls. Pakistan Journal of Medical Sciences, 23, 928-931. |
| [67] | Asadi, J. and Abddul-Qadir, R. (2013) Dysmenorrhea and Its Impact on Daily Activities among Secondary School Students in Basra, Iraq. Journal of the Faculty of Medicine Baghdad, 55, 339-344. https://doi.org/10.32007/jfacmedbagdad.554576 |
| [68] | Al-Jefout, M., Seham, A.F., Jameel, H., Randa, A.Q., Ola, A.M., Oday, A.M., et al. (2015) Dysmenorrhea: Prevalence and Impact on Quality of Life among Young Adult Jordanian Females. Journal of Pediatric and Adolescent Gynecology, 28, 173-185. https://doi.org/10.1016/j.jpag.2014.07.005 |
| [69] | Vlachou, E., Owens, D.A., Lavdaniti, M., Kalemikerakis, J., Evagelou, E., Margari, N., et al. (2019) Prevalence, Wellbeing, and Symptoms of Dysmenorrhea among University Nursing Students in Greece. Diseases, 7, Article 5. https://doi.org/10.3390/diseases7010005 |
| [70] | Strine, T.W., Chapman, D.P. and Ahluwalia, I.B. (2005) Menstrual-Related Problems and Psychological Distress among Women in the United States. Journal of Women’s Health, 14, 316-323. https://doi.org/10.1089/jwh.2005.14.316 |
| [71] | Gagua, T., Tkeshelashvili, B., Gagua, D. and Mchedlishvili, N. (2013) Assessment of Anxiety and Depression in Adolescents with Primary Dysmenorrhea: A Case Control Study. Journal of Pediatric and Adolescent Gynecology, 26, 350-354. https://doi.org/10.1016/j.jpag.2013.06.018 |
| [72] | Joshi, T., Kural, M., Agrawal, D., Noor, N. and Patil, A. (2015) Primary Dysmenorrhea and Its Effect on Quality of Life in Young Girls. International Journal of Medical Science and Public Health, 4, 381-385. https://doi.org/10.5455/ijmsph.2015.0711201472 |
| [73] | Kannan, P., Chapple, C.M., Miller, D., Claydon-Mueller, L. and Baxter, G.D. (2019) Effectiveness of a Treadmill-Based Aerobic Exercise Intervention on Pain, Daily Functioning, and Quality of Life in Women with Primary Dysmenorrhea: A Randomized Controlled Trial. Contemporary Clinical Trials, 81, 80-86. https://doi.org/10.1016/j.cct.2019.05.004 |
| [74] | Abaraogu, U.O. (2016) Effectiveness of Exercise Therapy on Pain and Quality of Life of Patients with Primary Dysmenorrhea: A Systematic Review with Meta-Analysis. Turkish Journal of Physical Medicine and Rehabilitation, 62, 346-354. https://doi.org/10.5606/tftrd.2016.95580 |
| [75] | Ortiz, M.I., Cortes-Marquez, S.K., Romero-Quezada, L.C., MurguiaCanovas, G. and Jaramillo-Diaz, A.P. (2015) Effect of a Physiotherapy Program in Women with Primary Dysmenorrhea. European Journal of Obstetrics and Gynecology and Reproductive Biology, 194, 24-29. https://doi.org/10.1016/j.ejogrb.2015.08.008 |
| [76] | Onur, O., Gumus, I., Derbent, A., Kaygusuz, I., Simavli, S., Urun, E., et al. (2012) Impact of Home-Based Exercise on Quality of Life of Women with Primary Dysmenorrhoea. South African Journal of Obstetrics and Gynaecology, 18, 15-18. |
| [77] | Rakhshaee, Z. (2014) A Cross-Sectional Study of Primary Dysmenorrhea among Students at a University: Prevalence, Impact and of Associated Symptoms. Annual Research & Review in Biology, 4, 2815-2822. https://doi.org/10.9734/ARRB/2014/9646 |
| [78] | Alsaleem, M.A. (2018) Dysmenorrhea, Associated Symptoms, and Management among Students at King Khalid University, Saudi Arabia: An Exploratory Study. Journal of Family Medicine and Primary Care, 7, 769-774. https://doi.org/10.4103/jfmpc.jfmpc_113_18 |
| [79] | Omidvar, S., Bakouei, F., Amiri, F.N. and Begum, K. (2016) Primary Dysmenorrhea and Menstrual Symptoms in Indian Female Students: Prevalence, Impact and Management. Global Journal of Health Sciences, 8, 135-144. https://doi.org/10.5539/gjhs.v8n8p135 |
| [80] | Parker, M.A., Sneddon, A.E. and Arbon, P. (2010) The Menstrual Disorder of Teenagers (MDOT) Study: Determining Typical Menstrual Patterns and Menstrual Disturbance in a Large PopulationBased Study of Australian Teenagers. BJOG: An International Journal of Obstetrics & Gynaecology, 117, 185192. https://doi.org/10.1111/j.1471-0528.2009.02407.x |
| [81] | Sharma, A., Taneja, D.K., Sharma, P. and Saha, R. (2008) Problems Related to Menstruation and Their Effect on Daily Routine of Students of a Medical College in Delhi, India. Asia Pacific Journal of Public Health, 20, 234241. https://doi.org/10.1177/1010539508316939 |
| [82] | Avasarala, A.K. and Panchangam, S. (2008) Dysmenorrhoea in Different Settings: Are the Rural and Urban Adolescent Girls Perceiving and Managing the Dysmenorrhoea Problem Differently? Indian Journal of Community Medicine, 33, 246249. https://doi.org/10.4103/0970-0218.43231 |
| [83] | Gupta, S., Kaur, S., Sadiq, S. and Khajuria, V. (2018) Primary Dysmenorrhea: Evaluation and Treatment Pattern among Female Medical Students. International Journal of Basic & Clinical Pharmacology, 7, 1873-1876. https://doi.org/10.18203/2319-2003.ijbcp20183883 |
| [84] | Durand, H., Monahan, K. and McGuire, B.E. (2021) Prevalence and Impact of Dysmenorrhea among University Students in Ireland. Pain Medicine, 22, 2835-2845. https://doi.org/10.1093/pm/pnab122 |
