• Circadian rhythm
• Heart rate
• Machine learning
• Menstrual cycle tracking
• Ovulation day detection
• Wearable sensor
• XGBoost

• Humans
• Female
• Menstrual Cycle/physiology
• Adult
• Heart Rate/physiology
• Machine Learning
• Sleep/physiology
• Young Adult
• Ovulation/physiology
• Adolescent
• Circadian Rhythm/physiology

• Diet
• Food
• Menstrual cycle
• Supplement
• Symptoms
• Women

• Humans
• Female
• Menstrual Cycle
• Dietary Supplements
• Diet
• Vitamin D/administration & dosage
• Menstruation Disturbances
• Zinc/administration & dosage

• LEP treatment
• patients with dysmenorrhea
• retrospective study
• telemedicine

• activated protein C resistance
• endometriosis
• estetrol/drospirenone combination
• ethinyl estradiol/drospirenone combination
• venous thromboembolism

• Humans
• Female
• Fibrinolysis/drug effects
• Adult
• Blood Coagulation/drug effects
• Androstenes/pharmacology
• Androstenes/therapeutic use
• Estetrol/pharmacology
• Estetrol/therapeutic use
• Endometriosis/drug therapy
• Endometriosis/blood
• Ethinyl Estradiol/therapeutic use
• Ethinyl Estradiol/pharmacology
• Contraceptives, Oral, Combined/pharmacology
• Contraceptives, Oral, Combined/therapeutic use

• Fuji Pharma

• dysmenorrhoea
• help-seeking
• menstrual pain
• menstruation
• pain interference

• Adolescent
• Adult
• Female
• Humans
• Young Adult
• Cross-Sectional Studies
• Dysmenorrhea/therapy
• Dysmenorrhea/psychology
• Health Knowledge, Attitudes, Practice
• Help-Seeking Behavior
• Patient Acceptance of Health Care/statistics & numerical data
• Self Efficacy
• Social Support
• Surveys and Questionnaires
• Models, Theoretical

• Healthcare avoidance behavior
• Healthcare seeking behavior
• Menopausal symptoms
• Menstrual disorders
• Women’s health

• Adolescent
• Menstruation
• Quality of life

• Adolescent
• Female
• Humans
• Cross-Sectional Studies
• East Asian People
• Health Knowledge, Attitudes, Practice
• Menstruation
• Quality of Life
• Students
• Surveys and Questionnaires

• heavy menstrual bleeding
• patient-reported outcomes
• quality of life
• uterine fibroids
• work performance

• Female
• Humans
• Quality of Life
• Uterine Neoplasms/diagnosis
• Uterine Neoplasms/therapy
• East Asian People
• Leiomyoma/diagnosis
• Leiomyoma/therapy
• Surveys and Questionnaires

• ASKA Pharmaceutical Co., Ltd.

Period poverty is a global health and social issue that needs to be addressed. It has been reported that many females compromise their education, employment, and social commitments during their menstruation days due to a number of reasons, including lack of access to toilets or menstrual products.

To provide a comprehensive understanding on period poverty, including outcomes associated with menstruation.

All observational and randomised clinical trials reporting menstruation challenges, menstrual poverty and menstrual products were included. Our search strategy included multiple electronic databases of PubMed, Web of Science, ScienceDirect, ProQuest and EMBASE. Studies published in a peer review journal in English between the 30^th of April 1980 and the 30^th of April 2022 were included. The Newcastle-Ottawa Scale was used to assess the risk of bias of the systematic included studies. Pooled odds ratios (ORs) together with 95% confidence intervals (CIs) are reported overall and for sub-groups.

A total of 80 studies were systematically selected, where 38 were included in the meta-analysis. Of the 38 studies, 28 focused on children and young girls (i.e., 10-24 years old) and 10 included participants with a wider age range of 15-49 years. The prevalence of using disposable sanitary pads was 45% (95%CI: 0.35-0.58). The prevalence of menstrual education pre-menarche was 68% (95%CI: 0.56-0.82). The prevalence of good menstrual hygiene management (MHM) was 39% (95%CI: 0.25-0.61). Women in rural areas (OR = 0.30, 95%CI: 0.13-0.69) were 0.70 times less likely to have good MHM practices than those living in urban areas.

There was a lack of evidence, especially from low- and middle- income countries. Further research to better understand the scope and prevalence of period poverty should be considered. This will enable the development of improved policies to increase access to menstrual products and medical support where necessary.

• Period poverty
• Menstruation
• Mental health
• Menstrual education
• Menstrual hygiene

• Intention to leave
• Menstruation
• Nurse
• Physical workloads
• Psychological workloads
• Somatic symptoms

• Depression
• menstrual cycle
• menstruation
• nurses
• premenstrual syndrome

• 16S rRNA
• endometriosis
• microbiome
• ovarian cystic fluid
• peritoneal fluid

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.

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.

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.

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.

• Female fertility cycle
• Healthcare
• Workload

The association between sleep disturbance and the menstruation in the young women population has been scarcely studied. The aim of this study is to assess the association between sleep status and phase of the menstrual cycle in healthy, young, ovulating women.

This cross-sectional study used the data collected from healthy young, ovulating Chinese females from September to December 2018. The association was analyzed by using linear regression and binary logistic analyses.

2260 women aged 17 to 30 were included in the analysis. The average sleep duration of the respondents was 7.24 hours (SD = 0.92). 61.7% of them admitted that they were accompanied by at least one of sleep symptoms including difficulty initiating sleep, difficulty maintaining sleep, dreaminess, early morning awakening, and somnolence. Sleep quality was significantly associated with dysmenorrhea (OR [95%CI] = 1.74 [1.40-2.17], P < 0.001) and self-awareness menstrual regularity (OR [95%CI] = 1.29 [1.06-1.56], P = 0.011).

This study found that poor sleep quality is significantly associated with dysmenorrhea and self-awareness menstrual irregularity among healthy, young, ovulating, Chinese females.

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.

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).

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.

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.

• EQ-5D
• EQ-5D-3L
• Health economic evaluations
• Health related quality of life (HRQoL)
• Japan
• Menstrual symptoms
• Menstruation
• Quality of life (QoL)
• Utility values

The aim of the present study was to investigate the association among lunar cycle, menstrual cycle onset, and subjective sleep quality. Menstrual cycle onset data from the six most recent menstrual cycles were obtained for 529 women (aged 25–39 years) using the smartphone app Luna Luna. We also collected questionnaire survey data on sleep quality from each participant. Overall, there was no association between the onset of menstrual cycle and lunar phase. Interestingly, the proportion of good sleepers with menstrual cycle beginning during the light period was significantly higher than that during the dark period, while the proportion of poor sleepers with menstrual cycle beginning during the dark period was significantly higher than that during the light period. When participants were categorized by the combination of lunar phases (light, dark, neutral periods) in the two most recent menstrual cycle onsets, the “both dark period” group and the “other (light and dark) period” group showed the lowest proportion of good sleepers. Menstrual cycle onset in the dark period was associated with a deterioration in subsequent subjective sleep quality, which was more apparent with consecutive onsets in the dark period or at a rapidly changing lunar phase.

• human
• lunar rhythms
• menstrual cycle
• menstruation
• moon
• reproductive health
• sleep quality

Childhood maltreatment history has known relationships with various mental and physical diseases; however, little is known about its association with premenstrual syndrome (PMS). In this study, we investigated the association between childhood maltreatment history and PMS among young women in Japan. In a Japanese city, we approached 3815 women aged 10–60 years who visited a gynecology clinic and one general practice clinic. A questionnaire on childhood maltreatment history and PMS was administered to them. We observed that women with histories of childhood maltreatment demonstrated a significantly increased risk of PMS compared with those without such histories (odds ratio: 1.47, 95% confidence interval: 1.20–1.81). Particularly, women with childhood physical or emotional abuse demonstrated a stronger association with PMS, whereas other forms of childhood maltreatment (emotional neglect, witnessing of intimate-partner violence, or sexual abuse) were not associated with PMS. Our results illustrate that childhood maltreatment may be a risk factor for PMS.

• abuse
• adverse childhood experience
• child maltreatment
• premenstrual syndrome

• Adolescent
• Adult
• Adult Survivors of Child Abuse
• Child
• Child Abuse
• Female
• Humans
• Intimate Partner Violence
• Japan/epidemiology
• Middle Aged
• Premenstrual Syndrome/epidemiology
• Young Adult

Dysmenorrhea is the most common gynecological disorder for women in the reproductive age. Study has indicated that dysmenorrhea might be a general risk factor of chronic pelvic pain and even chronic non-pelvic pain, such as fibromyalgia. We used the Longitudinal Health Insurance Database 2000 from the Taiwan National Health Research Institutes Database to investigate whether women with dysmenorrhea have a higher risk of fibromyalgia and whether treatment of dysmenorrhea reduced the risk of fibromyalgia. The dysmenorrhea cohort was matched with a non-dysmenorrhea cohort at a 1:1 ratio based on gender, age, and the year of entry study by frequency matching. Multivariable Cox proportional hazard regression models were used to assess the risk of fibromyalgia, with controlling for potential confounding variables such as age, comorbidities, and medication use. After controlling confounding variables, results revealed that women with dysmenorrhea have a significantly higher risk of fibromyalgia than women without dysmenorrhea. However, only treatment of dysmenorrhea with hormonal contraceptives reduce the risk of fibromyalgia. These results indicated that dysmenorrhea may be a risk factor of fibromyalgia, whereas personalized medicine for treatment of dysmenorrhea may be the key to reduce the risk of fibromyalgia. Future studies are needed to identify the causes and prevention strategies in detail.

• dysmenorrhea
• fibromyalgia
• hormonal contraceptives
• risk factor

• exercise physiology
• female
• sports and exercise medicine
• women in sport

• Abdominal Pain/drug therapy
• Abdominal Pain/epidemiology
• Absenteeism
• Adult
• Affect/physiology
• Analgesics/therapeutic use
• Anxiety/epidemiology
• Competitive Behavior/physiology
• Exercise/physiology
• Exercise/psychology
• Fatigue/epidemiology
• Feeding Behavior
• Female
• Health Surveys
• Humans
• Menstrual Cycle/physiology
• Menstrual Cycle/psychology
• Mobile Applications
• Prevalence
• Sports/physiology
• Sports/psychology

• dysmenorrhea
• menstrual pain
• pain management
• qualitative research

• Delivery of Health Care
• Dysmenorrhea/epidemiology
• Education, Nursing, Baccalaureate
• Female
• Health Personnel
• Humans
• Spain
• Students, Nursing

• Adolescent
• Internet
• addictive behaviour
• dysmenorrhoea
• pain

Although Abnormal Uterine Bleeding (AUB) can have serious medical consequences and significantly impacts daily life, the overall trend is that most women do not seek care for these symptoms. The objective of this review was to synthesise factors impeding women’s access care for AUB.

Systematic literature review of qualitative studies (interview and focus group) regarding the lived in experiences of women with abnormal menstrual symptoms, followed by a thematic analysis of these studies. We screened CINAHL, SCOPUS, ProQuest, OVID and Pubmed for qualitative studies. Studies were assessed using the Clinical Appraisal Skills Programme checklist and thematic synthesis was used to develop themes from the findings of the studies.

The review yielded 12 studies that satisfied the inclusion criteria. Three themes were developed that described barriers for women seeking care for AUB: health literacy (understanding of normal periods, role of cervical Pap smears and lack of access to appropriate information), taboo/normalisation (fear and embarrassment of symptoms, prioritising others) and health care provider (lack of accessible and trusted female GPs and poor experiences with GPs).

For 20 years women have consistently reported poor experiences in accessing care for AUB. The findings from our review indicate that drivers to impeding access are multiple; therefore any approaches to improve access will need to be multi-level – from comprising local sociocultural considerations to improved GP training.

• Abnormal uterine bleeding
• Qualitative
• Review
• Women

• Women’s Health
• consumer health information
• decision-making
• dysmenorrhoea
• information quality
• internet information
• pain
• readability

• Consumer Health Information/standards
• Dysmenorrhea
• Female
• Humans
• Internet

• KL2 TR002530 NCATS NIH HHS
• UL1 TR002529 NCATS NIH HHS

• dysmenorrhea
• premenstrual syndrome
• school absenteeism
• schoolgirls

• Menorrhagia
• Singapore
• qualitative
• women

• I10
• I12
• Mobile application
• O33
• cost-effectiveness
• menstrual cycle
• menstruation-associated symptoms
• randomized controlled trial
• self-health management

• Absenteeism
• Adult
• Cost-Benefit Analysis
• Depression/economics
• Depression/therapy
• Dysmenorrhea/economics
• Dysmenorrhea/therapy
• Efficiency
• Female
• Humans
• Japan
• Menstruation/physiology
• Menstruation/psychology
• Middle Aged
• Mobile Applications/economics
• Models, Econometric
• Women, Working
• Young Adult

• Administrative claims database
• Healthcare costs
• Healthcare resource
• Heavy menstrual bleeding
• I10
• I19
• Menorrhagia
• Prescribing patterns
• Real-world data

• Adolescent
• Adult
• Estrogens/economics
• Estrogens/therapeutic use
• Female
• Health Resources/economics
• Health Resources/statistics & numerical data
• Hemostatics/economics
• Hemostatics/therapeutic use
• Humans
• Japan
• Medicine, Chinese Traditional/economics
• Medicine, Chinese Traditional/methods
• Menorrhagia/economics
• Menorrhagia/therapy
• Middle Aged
• Models, Econometric
• Progestins/economics
• Progestins/therapeutic use
• Retrospective Studies
• Young Adult

• hormonal therapy
• intrauterine system
• menstrual cramps
• oral regimen
• patient preference
• treatment administration
• treatment attributes

This study aims to assess the cost-effectiveness of early physician consultation and guideline-based intervention to prevent endometriosis and/or disease progression using oral contraceptive (OC) and progestin compared to follow-up of self-care for dysmenorrhea in Japan.

A yearly-transmitted Markov model of five major health states with four sub-medical states was constructed. Transition probabilities among health and medical states were derived from Japanese epidemiological patient surveys and converted to appropriate parameters for inputting into the model. The dysmenorrhea and endometriosis-associated direct costs included inpatient, outpatient visit, surgery, and medication (OC agents, over-the-counter drugs), etc. The utility measure for patients with phase I–IV endometriosis comprised a visual analogue scale. We estimated the cost per quality-adjusted life year (QALY) at a time horizon of 23 years. An annual discount rate at 3% for both cost and outcome was considered.

The base case outcomes indicated that the intervention would be more cost-effective than self-care, as the incremental cost-effectiveness ratio (ICER) yielded 115,000 JPY per QALY gained from the healthcare payers’ perspective and the societal monetary value (SMV) was approximately positive 3,130,000 JPY, favoring the intervention in the cost–benefit estimate. A tornado diagram depicting the stochastic sensitivity analysis of the ICER and SMV from both the healthcare payers’ and societal perspectives confirmed the robustness of the base case. A probabilistic analysis resulting from 10,000-time Monte Carlo simulations demonstrated efficiency at willingness-to-pay thresholds in more than 90% of the iterations.

The present analysis demonstrated that early physician consultation and guideline-based intervention would be more cost-effective than self-care in preventing endometriosis and/or disease progression for patients with dysmenorrhea in Japan.

• Cost-effectiveness
• Dysmenorrhea
• Endometriosis
• Guideline-based intervention
• Self-care

• dysmenorrhea
• health care-seeking behaviour
• pain management
• qualitative research
• women's health

This study aimed to describe treatment patterns and estimate health care resource utilization and associated costs among Japanese women with dysmenorrhea, using a claims database.

This was a retrospective analysis using health insurance data from the Japan Medical Data Center, assessing female patients aged 18–49 years with newly diagnosed primary or secondary dysmenorrhea. Treatment pattern analyses focused on hormonal medications, analgesics, hemostatic agents, traditional Chinese medicine (TCM), and gynecological surgeries. Data were collected on health care resource utilization and costs associated with medications, imaging procedures, and inpatient and outpatient care in both patients and matched controls.

The analysis included 6,315 women with dysmenorrhea (3,441 primary; 2,874 secondary). The most commonly prescribed initial therapies were low-dose estrogen progestins (LEPs, 37.7%) and TCM (30.0%), with substantial differences between primary (LEPs: 27.4%, TCM: 38.8%) and secondary (LEPs: 50.2%, TCM: 19.5%) dysmenorrhea cohorts. Surgery was conducted in <5% of all patients. Both primary and secondary cohorts of dysmenorrhea had significantly higher mean total health care costs compared to controls within the 1-year period following diagnosis (Case-primary: 191,680 JPY [1,916 USD]; secondary: 246,488 JPY [2,465 USD], Control-primary: 83,615 JPY [836 USD]; secondary: 90,711 JPY [907 USD]) (p<0.0001). After adjusting for baseline characteristics, these costs were 2.2 and 2.9 times higher for primary and secondary dysmenorrhea cohorts, respectively, compared with matched controls, (both p<0.0001). The main driver of these excess costs was outpatient care, with eight additional physician visits per year among dysmenorrhea patients compared to controls (p<0.0001).

Considerable heterogeneity in treatment patterns was observed, with relatively low utilization of LEPs in patients with primary dysmenorrhea and those treated by internal medicine physicians. Total annual health care costs were approximately 2–3 times higher in patients with dysmenorrhea compared to women without the condition.

• database analysis
• dysmenorrhea
• economic burden
• resource use and costs
• treatment patterns
• women’s health

Dysmenorrhea is a highly prevalent complaint and highly undiagnosed gynecologic condition. Dairy products have a potential in the management of menstrual distress, and bovine lactoferrin can help the subjective dysphoria associated with dysmenorrhea. In the present study, we aimed to investigate the effects of a lactoferrin formulation isolated from cow’s milk on menstrual symptoms in volunteers. A double-blind, randomized, placebo-controlled, crossover study of the iron-lactoferrin complex (FeLf) was performed in thirty-five healthy Japanese women. Participants received the 150 mg FeLf (per day) or placebo from day ten of the luteal phase to day four of the follicular phase. The Moos Menstrual Distress Questionnaire (MDQ) was measured for menstrual distress, and heart rate variability was measured as an index of autonomic nerve balance during menses. A visual analog scale for menstrual pain, and a verbal rating scale for quality of life during the first three days of menstruation were measured. The MDQ score for the automatic nervous system subscale was lower and the parasympathetic nervous system activity was greater in FeLf than in placebo for intention-to-treat or per-protocol populations. The other variables were not different between the groups. No treatment-related side effects were observed during the study. The results indicate that FeLf can provide a beneficial effect on the psychological symptoms in women affected by menstrual distress.

• complex
• distress
• iron
• lactoferrin
• menses

• Adult
• Animals
• Cattle
• Cross-Over Studies
• Double-Blind Method
• Dysmenorrhea/psychology
• Female
• Health Surveys
• Heart Rate/drug effects
• Humans
• Iron/administration & dosage
• Iron/pharmacology
• Japan
• Lactoferrin/administration & dosage
• Lactoferrin/pharmacology
• Middle Aged
• Milk/metabolism
• Pain Measurement/drug effects
• Quality of Life/psychology
• Treatment Outcome

• Complementary and Alternative medicine
• Endometriosis
• Heavy periods
• Irregular periods
• Premenstrual syndrome
• Severe dysmenorrhoea

• Family medicine
• Japan
• Sexual health
• Standardized patient instructors

Premenstrual syndrome is a group of symptoms linked to the menstrual cycle, and edema is among these symptoms. Physiotherapy is often sought by many patients for the treatment of edema; however, for an adequate prescription of physiotherapeutic procedures, the distribution of edema throughout the body has yet to be characterized.

To determine the most frequent symptoms and body regions that present with edema in women during the premenstrual period.

Sixty women with a mean age of 24.6±4.7 years were evaluated during their premenstrual (between days 21 and 28) and menstrual period (between days 1 and 3), and the collected data included body mass, height, biotype (body-fat distribution), face, breast, limb-circumference measurements, and limb-volume estimate, and an adapted version of the Premenstrual Symptoms Screening Tool was used. Statistical analysis was performed using Student’s t-test and the test for equality of two proportions (P≤0.05).

Premenstrual syndrome was identified in 91.7% of the women, and the most frequent symptoms were irritability (73.33%) and physical symptoms, including swelling (65%), and anxiety (58.3%). Edema was detected in the following areas: facial, epigastric, mammary, umbilical, and pubic, the mid-third of the arms, distal forearm, in both thighs and in the mid-third of the legs determined by circumference measurements, and in both upper and lower limbs, according to the estimated volume.

In this study population, the most frequent symptoms were irritability, physical symptoms, and anxiety, with distribution of edema in the face, breast, abdomen, pubic area, distal upper limb, and proximal lower limb.

• affective symptoms
• body surface area
• edema
• menstrual cycle
• premenstrual syndrome
• women’s health