The Impact of Dysmenorrhoea on Pain, Sleep, and Anxiety among Young Adults-An Institutional based Pilot Study.
1Dr. Varsha S Mishra, 2Siddhi Dalvi, 3Triveni Gosavi and 4Shruti Soni
1Assistant Proffesor, 2,3,4(Final Year BPT), MGM School Of Physiotherapy,Aurangabad
ABSTRACT BACKGROUND:
Dysmenorrhea is one of the most common gynaecological health conditions which primarily influences approximately more than half of reproductive age. The purpose of this study is also to investigate the impact of pain on anxiety and sleep quality among young adults.
AIM & OBJECTIVE- To investigate the correlation between dysmenorrhic pain, anxiety and sleep quality in young adults.
MATERIALS AND METHODOLOGY-
This institutional based pilot study was conducted on 10 girls who’s age ranges between 18-25 years, having diagnosis of dysmenorrhea. All participants were recruited from the physiotherapy college, located in Aurangabad city. These 10 participants were asked to fill out the Menstrual Symptoms Questionnaire (MSQ), for assessing their pain intensity, Hamilton Anxiety Rating Scale (HAM-A) for assessing anxiety and Insomnia Severity Index(ISI) for assessing their sleep quality. Prior to filling of the above questionnaires, a brief orientation were given to the participants and written informed consent were obtained from all the study participants prior to the commencement of this study.
RESULTS- In the present study of 10 participants, anxiety domains has been noted markedly in the age group of 18-20, while among 21-25 age group, insomnia was the most bothered issue, whereas there was strong positive correlation between dysmenorrhea and sleep quality (r = 0.5).
CONCLUSION: There is a strong correlation between Pain, Anxiety and Sleep Quality in young adults having primary dysmenorrhea.
KEYWORDS: Primary Dysmenorrhea, Pain, Sleep Quality, Anxiety INTRODUCTION
Dysmenorrheaisacommongynaecologicalproblemwhichaffects50percent of menstruating women.
Itisclassifiedintomainlytwotypesi.e.primarydysmenorrheaand secondary dysmenorrhea.
Primarydysmenorrheaisapainfulmenstruationwithnormalanatomyof pelvisbeginusuallyinthefemalepubertyitsonsetusuallybeginfrom6to12
monthsaftermenarcheinprimarydysmenorrheapainisspasmodicin character and felt mainly in the lower abdomen. Secondarydysmenorrheaisdefinedasmenstrualpainassociatedwith underline pathology such as endometriosis. Prevalenceofprimarydysmenorrheagreaterinthewomenamongage group between 17-25yrs and estimate ranging from 67 to 90 percent. Thepathophysiologyofprimarydysmenorrheaisprimarylinkedto elevatedlevelsofprostaglandin[PGF2]thatinducehyper-contractilityof the myometrium leading to ischaemic and hypoxia of the uterine muscle.
METHODOLOGY StudyDesign: Observationalstudy
•Typeofstudy:Pilot study
•Studypopulation-Young adultfemalesof MGM school of physiotherapy.
•LocationofStudy:MGM School of Physiotherapy, Aurangabad.
PROCEDURE
This institutional based pilot study was conducted on 10 girls who’s age rangesbetween 18-25 years, having diagnosis of dysmenorrhea. All participants wererecruited from the physiotherapy college, located in
Aurangabad city. These 10participants were asked to fill out the Menstrual Symptoms Questionnaire (MSQ), forassessing their pain intensity, Hamilton Anxiety Rating Scale (HAM-A) for assessinganxiety and Insomnia Severity Index(ISI) for assessing their sleep quality. Prior tofilling of the above questionnaires, a brief orientation were given to the participantsand written informed consent were obtained from all the study participants prior tothe commencement of this study.
Inclusion Criteria: -
Women age 18-25yrs with regular menstrual cycle.
Primarydysmenorrheawithmenstrualpainscoreover4cmon10-pointVAS[Visual analogue scale] for pain intensity.
Exclusion Criteria:-
Pregnancy
Pelvic diseases
Abdominal and pelvic surgeries
Genitourinarysystemdiseases[e.g.pelvicinflammatorydiseases and urinary tract infections
Severe psychological stress
Results
In the present study of 10 participants, anxiety domains have been noted markedly in the age group of 18-25 years, while among 21-25 age group insomnia was the most bothered issue, whereas there was strong correlation between dysmenorrhea and sleep quality[r=0.5]
Graph:1-IndicatesreadingsofMSQ,whichdescribesabouttypeofpainin dysmenorrhea.Thisgraphshowsthatspasmodicpainishigherthancongestive pain.
Graph-2:The above graph shows that there is strong correlation between anxiety anddysmenorrhea
Graph: 3the above graph shows sleep quality in young adults was affected andwas found to be correlated in dysmenorrhea
STATISTICALANALYSIS
StatisticalanalysisforthepresentstudywasdoneusingonlinePearsoncorrelation coefficientcalculator.Forthispurpose,thedatawasenteredintoanexcelspreadsheet, tabulatedandsubjectedtostatisticalanalysis.Probabilityvalueof[r=0.43]were
consideredmoderatelystrongcorrelationandprobabilityvalueof[r=0.5]were considered moderately strong correlation.
REVIEW OF LITRATURE: -
1. NilferSahinet.,al (2018) conducted a study Assessment of anxiety-depression levels and perceptions of quality of life in adolescents with dysmenorrhea they concluded that In dysmenorrhea management, it is important to enhance awareness among pediatric clinicians and gynecologists regarding the associations between dysmenorrhea and mental problems.
2. P. sudhakaret,.al(2021) conducted a cross sectional study on the prevalence of primary dysmenorrhea is found to be highly prevalent among college going girls .
3. Serkanbaduret,.al(2017) conducted a cross sectional analysis of consideration on pathophysiology of primary dysmenorrhea under the light of alterations in complete count parameters concluded that leukocytosis and increased mpvareassociated with the pathogenesis of 1 0 dysmenorrhea.
4. Mohammed abadialsameemet,.al(2018) conducted an exploratory study on dysmenorrhea associated symptoms and management among students concluded that dysmenorrhea is a very common problem in student and increasing awareness can help in relieving burden of common health problems.
5. Ahmed arafa et.,(2020) conducted an study on association of sleep duration and insomnia with menstrual symptoms among young women in upper Egypt the concluded that insomnia has shown to be significantly associated with premenstrual symptoms and dysmenorrhea but no substantial relationship has been indicated between hours of sleep and most menstruation symptoms
6. Nlifersahimet,.al(2018) conducted a study on assessment of anxity depression levels and perception of QOL in adolescents with dysmenorrhea concluded that it is important to enchance awareness among pediatric clinicians and gynecologist regarding the association between dysmenorrhea and mental problems.
DISCUSSION
Ourstudywhichassessdysmenorrheapain,anxietyandsleepqualityinyounger adultswithdysmenorrheafoundthattheanxietyscoreswerehigherwithin19-20 agegroupandinsomniawashigherinyoungeradultswithdysmenorrhea.In
additionitwasshownthatthepain,anxietyandinsomniaincreasedwith increasing severity of dysmenorrhea.
•Araujoetal2011conductedastudyondysmenorrheaandsleepqualityindicating
thatpainfulmenstruationdoesnotchangethesleepinghabitinadultwomen.Bakeretal2008conductedastudyonsleepdi sturbancewasdeterminedin approximately 25% women with primary dysmenorrhea.
InthisstudybyOzturkA2004conductedastudywasreported tocausesleepdisturbanceinwomen.Studyindicateda significantassociationbetweeninsomnia,sleepandmenstrual
pain.Sobiologicallythephysicalandemotionalchangesofthe menstrualcyclearecontrolledbyseveralhormones.Hormones donotonlyregulatereproductivefunctionbutalsoaffectsthe
sleep.Therefore,thedisturbanceofhormonescanleadtoboth anxiety, poor sleep and menstrual pain.
Inourstudy,thereismoderateclinicalsignificancedifference identifiedbetweenthedysmenorrhea,anxietyandsleepqualitywith respecttotheage.Nilferetalconductedastudyon,anxietyand insomnia,daytimesleepinessweresignificantlyhigherinthe dysmenorrheagroupthannormalcontrolgroup.Itisthoughtthat dysmenorrheadisturbshealthyphysicalandmentaldevelopmentin youngeradultbyimpairingthequalityoflife.Althoughthe
mechanismunderlyingtherelationshipbetweendysmenorrheaand psychological problems has not yet been fully elucidated.
Conclusion
There isa strong correlation between pain, anxiety and sleep quality in young adults having primary dysmenorrhea.
Limitations
Itscross-sectionaldesignandsmallsamplesizearemain limitations.Webelievethatfurtherstudieswithlargersample sizeareneededtoclarifytherelationshipbetweenpain,anxiety, sleep and dysmenorrhea.
FutureScopeofStudy
Webelievethatfurtherstudieswithalargersamplesizeare
neededtoclarifytherelationshipbetweenpain,anxietyandsleep in dysmenorrhea.
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