European Journal of Obstetrics & Gynecology and Reproductive Biology
Original ArticleInfluence of menstrual factors and dietary habits on menstrual pain in adolescence age
Introduction
Primary dysmenorrhea is a common gynaecological disorder in young women [1]. Generally, it begins within 6–12 months from the menarche. It is characterised by a particularly intense pain that is localised in the abdominal inferior quadrants and, that radiates in the inner thigh. This symptom begins many hours before menstruation or contemporaneously at the beginning of the same. It is intense in the first day; it rarely continues beyond the first day. In 50% of the cases, it is in partnership with systemic symptoms: nausea and vomiting (80%), diarrhoea (50%), headaches (60%), tiredness (45%), irritability (30%) and, less frequently, dizziness and collapse [2], [3].
Although medics of all epochs have studied this pathology, there is no clarity about its etyopathogenesis [4]. In 400 A.D., Hippocrates attributed the etiology of the dysmenorrhea to the cervical stenosis. An abnormal increase of the contractible uterine activity is observed in the women with dysmenorrhea [5]. This situation is due to an elevated production of prostaglandins E2 and F2α in the uterus, and accompanied by a diminution of the levels of ovary hormones during menstruation [6], [7]. In particular, in physiological conditions, after ovulation there is synthesis of phospholipids of the cell membranes beginning from fatty acids. An elevated introduction with a diet of fatty acids omega-6 determines a greater presence of these in the cell membranes [8]. After the onset of progesterone withdrawal before menstruation, these omega-6 fatty acids, arachidonic acids, are released, and a cascade of prostaglandins (E2–F2α) and leukotrienes is initiated. The increase of prostaglandins E2 and F2α causes vasoconstriction and myometrial contraction [9]. The increase of the leukotrienes of the fourth series determines the systemic symptoms of dysmenorrhea.
There is a vast amount of literature on the relationship between macro- and micronutrients and the symtoms commonly associated with menstruation and the menstrual cycle. For example, a lack of calcium or polyunsaturated fatty acid is correlated with the pathogenesis of dysmenorrhea [10].
Our study investigates the frequency of primary dysmenorrhea and the relationship between menstrual factor, dietary habits, and this pathology.
Section snippets
Material and methods
Adolescents are the subject of our study; we have examined a sample of this population. It consists of 356 students from a professional institute in Naples, whose ages are between the 14 and 21 years. We established meetings with 15 girls at a time. We asked antropometrics data and obtained an accurate family and personal anamnesis without neglecting the psychology of each subject. In particular, we used the Minnesota Multiphasic Personality Inventory (MMPI) to set a personality outline for
Results
The prevalence of dysmenorrhea in the population under investigation was found to be 85% (293 with primary dysmenorrhea; 9 with secondary dysmenorrhea; 54 without pain). Only the girls suffering from primary dysmenorrhea were included in our analysis.
For these girls, the frequency of the pain for each cycle was 75%.
The pain was more frequently anterior (83%); in the majority of cases, its beginning was precedent to the menstrual episode or in coincidence with menstruation (70%), its duration
Discussion
The results of this study confirm that dysmenorrhea is common in young women [12], [13]. This is in accordance with the results of numerous other studies [14], also from this analysis it is deduced that:
- 1.
teenagers that have a menarche early have menstrual pain more frequently, and this pain is more intense [15],
- 2.
menstruation of longer duration correlates to a higher severity of pain [16],
- 3.
the pain is more important as the flow becomes more abundant [17].
For a complete characterisation of a girl
Conclusion
Thanks to the results obtained from our investigation, it is possible to define the profile of an adolescent that has menstrual pains. She is a subject that had menarche at an early age, she has menstruation of long duration and abundant flows, she does not eat fish, eggs and fruit, and she drinks alcoholic drinks.
The results that have been obtained concerning relationships between dietary habits and primary dysmenorrhea are very interesting. We propose to continue this research, widening the
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- 1
Chief of the Department of Obstetrics and Gynaecology.