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      Integrating Lifestyle Focused Approaches into the Management of Primary Dysmenorrhea: Impact on Quality of Life


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          This narrative review aims to identify alternative ways to improve the symptoms of primary dysmenorrhea (PD).


          PD refers to endometrial painful cramps during the premenstrual period. This condition affects a lot of women worldwide and is accompanied with absenteeism and high economic costs, thus, risk-free, and effective therapeutic approaches are needed. Pharmacological agents such as non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptive pills (OCPs), which are widely prescribed for these women, demonstrate adequate efficacy in alleviating pain and discomfort. The long natural course of the disease dictates remedies that focus on lifestyle changes and on improvement of Quality-of-Life (QoL) for women suffering with PD.

          Materials and Methods

          Five major search engines, namely MEDLINE, PubMed, EMBASE, and Cochrane Library were searched for articles published prior to October 2020 focused in PD. A total of 74 paper were included.


          Physical activity, for instance yoga, aromatherapy massage, and other forms of relaxation, vitamins and dietary changes, acupressure and acupuncture,a and some psychological interventions are just few of the proposed health behavior targeted approaches in cases of PD. This review focuses on lifestyle changes and alternative methods that could potentially result in minimizing symptoms of PD and in improving overall QoL for these patients, by providing current scientific evidence on their efficacy.


          Complementary and alternative medicine practices (CAM) are widely accepted by women. International literature provides controversial scientific evidence, thus further studies need to be conducted in order to prove or disregard their efficacy in cases of PD.

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          Most cited references74

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          Prevalence and risk factors associated with primary dysmenorrhea among Chinese female university students: A cross-sectional study

          To examine prevalence and risk factors associated with primary dysmenorrhea among Chinese female university students in Hunan province, China.
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            Dysmenorrhea is the leading cause of recurrent short-term school absence in adolescent girls and a common problem in women of reproductive age. Risk factors for dysmenorrhea include nulliparity, heavy menstrual flow, smoking, and depression. Empiric therapy can be initiated based on a typical history of painful menses and a negative physical examination. Nonsteroidal anti-inflammatory drugs are the initial therapy of choice in patients with presumptive primary dysmenorrhea. Oral contraceptives and depo-medroxyprogesterone acetate also may be considered. If pain relief is insufficient, prolonged-cycle oral contraceptives or intravaginal use of oral contraceptive pills can be considered. In women who do not desire hormonal contraception, there is some evidence of benefit with the use of topical heat; the Japanese herbal remedy toki-shakuyaku-san; thiamine, vitamin E, and fish oil supplements; a low-fat vegetarian diet; and acupressure. If dysmenorrhea remains uncontrolled with any of these approaches, pelvic ultrasonography should be performed and referral for laparoscopy should be considered to rule out secondary causes of dysmenorrhea. In patients with severe refractory primary dysmenorrhea, additional safe alternatives for women who want to conceive include transcutaneous electric nerve stimulation, acupuncture, nifedipine, and terbutaline. Otherwise, the use of danazol or leuprolide may be considered and, rarely, hysterectomy. The effectiveness of surgical interruption of the pelvic nerve pathways has not been established.
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              Theory-Based Health Behavior Change: Developing, Testing, and Applying Theories for Evidence-Based Interventions


                Author and article information

                Int J Womens Health
                Int J Womens Health
                International Journal of Women's Health
                17 March 2021
                : 13
                : 327-336
                [1 ]Department of Obstetrics and Gynaecology, University Hospital of Ioannina , Ioannina, Greece
                [2 ]Department of Obstetrics and Gynaecology, University Hospitals of Birmingham , Birmingham, UK
                [3 ]School of Psychology, College of Human Sciences, Bangor University , Bangor, Wales, UK
                [4 ]Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina , Ioannina, Greece
                Author notes
                Correspondence: Orestis Tsonis Senior Registrar in Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, University Hospital of Ioannina , Stavrou Niarchou Avenue, Ioannina, 45500, GreeceTel +306986620604 Email orestis.tsonis@gmail.com
                Author information
                © 2021 Tsonis et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                : 25 November 2020
                : 04 February 2021
                Page count
                Figures: 2, References: 74, Pages: 10

                Obstetrics & Gynecology
                primary dysmenorrhea,quality-of-life,therapy,complementary and alternative medicine,pain relief


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