Prevalence of menstrual pain in young women: what is dysmenorrhea

Objectives: This study aimed to determine the frequency of dysmenorrhea, as identified by different definitions, in a population of young women, and to investigate factors associated with this complaint.Materials and methods: A final group of 408 young women completed a self-assessment questionnaire. This was a cross-sectional analytical study.Results: Menstrual pain was reported by 84.1% of women, with 43.1% reporting that pain occurred during every period, and 41% reporting that pain occurred during some periods. Women with menstrual pain had an earlier menarche (P = 0.0002) and a longer menstrual flow (P = 0.006), and this group was characterized as having a higher prevalence of smokers (P = 0.031) and a lower prevalence of hormonal contraception users (P = 0.015). Pain intensity was correlated (r = 0.302, P < 0.0001) positively with menstrual flow length (CR = 0.336), history of abortions (CR = 3.640), and gynecological pathologies (CR = 0.948), and negatively with age at menarche (CR = \u20130.225), use of hormonal contraception (CR = \u20130.787), and history of gynecological surgery (CR = \u20132.115). Considering the parameters of menstrual pain, a need for medication, and inability to function normally (absenteeism from study or social activities) alone or together, the prevalence of dysmenorrhea is 84.1% when considering only menstrual pain, 55.2% when considering the association between menstrual pain and need for medication, 31.9% when considering the association between menstrual pain and absenteeism, and 25.3% when considering the association between menstrual pain, need for medication, and absenteeism (P < 0.0001). The probability of having more severe dysmenorrhea is directly related to pain intensity as measured by a visual analog scale, but does not coincide with it.Conclusion: Menstrual pain is a very common problem, but the need for medication and the inability to function normally occurs less frequently. Nevertheless, at least one in four women experiences distressing menstrual pain characterized by a need for medication and absenteeism from study or social activitie

Honey bee foraging distance depends on month and forage type

To investigate the distances at which honey bee foragers collect nectar and pollen, we analysed 5,484 decoded waggle dances made to natural forage sites to determine monthly foraging distance for each forage type. Firstly, we found significantly fewer overall dances made for pollen (16.8 %) than for non-pollen, presumably nectar (83.2 %; P < 2.2 × 10−23). When we analysed distance against month and forage type, there was a significant interaction between the two factors, which demonstrates that in some months, one forage type is collected at farther distances, but this would reverse in other months. Overall, these data suggest that distance, as a proxy for forage availability, is not significantly and consistently driven by need for one type of forage over the other

The Controversial History of Hormone Replacement Therapy

The history of hormone replacement therapy (HRT) started in the 1960s, with very high popularity in the 1990s. The first clinical trials on HRT and chronic postmenopausal conditions were started in the USA in the late 1990s. After the announcement of the first results of the Women's Health Initiative (WHI) in 2002, which showed that HRT had more detrimental than beneficial effects, HRT use dropped. The negative results of the study received wide publicity, creating panic among some users and new guidance for doctors on prescribing HRT. The clear message from the media was that HRT had more risks than benefits for all women. In the following years, a reanalysis of the WHI trial was performed, and new studies showed that the use of HRT in younger women or in early postmenopausal women had a beneficial effect on the cardiovascular system, reducing coronary disease and all-cause mortality. Notwithstanding this, the public opinion on HRT has not changed yet, leading to important negative consequences for women's health and quality of life

New needs for menopausal women during covid-19 pandemic. A physician-based investigation

It was evaluated whether the COVID-19 pandemic may have influenced the manifestation of menopausal symptoms. In a web interview, 143 physicians, experts on the menopause, were asked to rate their perceived prevalence of hot flush, sleep disorder, sexual disturbance, anxiety and depression as ‘rare’, ‘seldom’, ‘frequent’ and ‘very frequent’ in patients they managed prior to and during the COVID-19 pandemic. According to physicians, there was no major change in the prevalence of hot flush, sleep disorder and sexual disturbance but prevalence of anxiety (39-8% vs 75.5%; p &lt; 0.0001) and depressive (35.6% vs 72.0%; p &lt; 0.0001) symptoms increased during COVID-19 pandemic. COVID-19 pandemic has changed the composite picture of menopausal symptoms, challenging physicians to adjust their therapeutic approach to the new need. Approaches capable to treat vasomotor symptoms but also highly effective on mood disturbance should be preferred

Ospemifene in the management of vulvar and vaginal atrophy: Focus on the assessment of patient acceptability and ease of use

Endocrinological changes that occur with menopause lead to a chronic and progressive condition named vulvar and vaginal atrophy (VVA). This disease is characterized by symptoms such as dryness, dyspareunia, itching, burning, and dysuria. According to recent epidemiological studies, VVA has a high prevalence and can also occur in younger women prior to the menopause, negatively affecting quality of life, sexual function, intimacy and relationship with the partner. Accordingly, therapy should be effective, initiated early and continued for as long as possible. Up to recent years, available therapeutic options have included over-the-counter lubricants and moisturizers, vaginal oestrogens and systemic hormones. These products are not indicated for all women. Hormones are mostly contraindicated in women with a history of hormone-sensitive cancer and are frequently not accepted even by women without contraindications. Local therapies are frequently considered uncomfortable, difficult to apply, and messy. Indeed, these treatments have a high spontaneous discontinuation rate, mostly due to dissatisfaction, safety concern, side effects and difficulty in vaginal placement. Recently, ospemifene, a new non-hormonal systemic remedy, was approved by FDA (Food and Drug Administration) and EMA (European Medicines Agency) for the treatment of the two most bothersome symptoms of VVA: dryness and dyspareunia. Because ospemifene is a selective estrogen receptor modulator (SERM), it can be administered also in women with a history of breast cancer, and this makes it more acceptable by any woman. In addition, its route of administration minimizes those bothersome side effects intrinsic to the vaginal route of administration. Available data indicate that women using ospemifene have higher adherence to treatment, higher persistence and lower discontinuation rate. Satisfaction is higher than with other local therapies and overall health care cost is lower

Dienogest-based hormonal contraception induced changes in the ultrasound presentation of the uterus and menstrual pain

Background: In young women, combined hormonal contraceptives can ameliorate menstrual pain and reduce menstrual loss, but their efficacy in adenomyosis has not been proven. The aim of this study was to investigate whether ultrasound features of adenomyosis are modified by a combined hormonal contraceptive containing dienogest. Methods: Fifty-eight out of 173 premenopausal women consecutively attending our university hospital outpatient service for contraception were enrolled in this observational study. Women with menstrual pain or heavy menstrual bleeding underwent ultrasonography. An expert sonographer diagnosed or excluded adenomyosis and fibroids via morphological uterus sonographic assessment (MUSA). The intensity of menstrual pain was quantified by each patient on a visual analogue scale (VAS). A total of 38 women with and 20 without ultrasound features of adenomyosis received dienogest-based hormonal contraceptive and had a follow-up ultrasound after 6 months of treatment. Results: During treatment, uterine volume decreased by –13.1 ± 22.1% (p = 0.001) in women with adenomyosis features, while it tended to increase in controls. Hypoechoic striation of myometrium present in 95% of cases and myometrial cysts in 5% of cases, respectively, at baseline, had completely disappeared by 6 months. Asymmetry of uterine walls decreased, with the anterior/posterior wall ratio declining from 2.8 ± 0.8. to 1.9 ± 0.7 (p = 0.0001). Heterogeneous myometrial texture, globous uterine morphology, and junctional zone alteration remained unchanged. In women with baseline adenomyosis, VAS score for menstrual pain decreased by –4.0 ± 3.6 (p = 0.0001). During treatment, a VAS score for menstrual pain close to 0 was found in all women without adenomyosis. Days of menstrual flow decreased in women with (p = 0.0001) and without (p = 0.003) adenomyosis. Conclusions: Dienogest-based hormonal contraceptives improve the sonographic features of adenomyosis and improve symptoms. Prospective data are needed to confirm these findings

EUROBEAR: Collaborative science for spatial brown bear ecology

The consequences of anthropogenic impacts on ecosystems are driving species adaptation and persistence worldwide. While local studies can help unveil fine-scale processes, robust assessment of broader processes are possible when pooling ecological data from a variety of environmental contexts. This is especially important for wide-ranging species, which are exposed to a large variety of conditions and stressors in space and time. The brown bear, the most extensively distributed ursid, is a prime example: it occupies various ecosystems, including forests, deserts, and tundras, at elevations ranging from sea level to 5000 meters, and within a latitude range of approximately 25° to 70°N. Building on the Euromammals initiative, which has been pioneering collaborative science in spatial animal ecology since 2007, the aim of this project is to establish a network of interested parties and build a long-term, secure sharing platform for researchers and managers to investigate biological, ecological, and management questions for brown bears in Europe. This is achieved by analyzing data across populations and with the field knowledge gained by managers and researchers working with bears in different socio-ecological contexts. The initiative builds on previous EU-wide collaborations, such as Biodiversa+ BearConnect and EU co-funded LIFE+ projects, and cloud-based data management infrastructure at Euromammals. Eurobear relational spatial database ensures the collection, quality control, standardization, and sharing of data necessary to actualize the collaboration, while the Term of Use allows partners to join the network while maintaining full ownership and responsibility for their data

Effect of deer density on tick infestation of rodents and the hazard of tick-borne encephalitis. II: Population and infection models

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Bridging human mobility to animal activity: when humans are away, bears will play

In the Anthropocene, findings on animal behavioral flexibility in response to anthropogenic changes are accumulating: human presence and activity affect the distribution, movement, activity rhythm, physiology, and diet of animal species. However, conclusions are limited by the lack of simultaneous quantitative data on both the animal and human side. Hence, the dynamic link between animal behavior and human activity and mobility is often poorly estimated. Based on long-term monitoring of a wild bear population in the Trentino region (10 bears monitored from 2006 to 2019; 20 bear-years) combined with human mobility data (Cumulative Outdoor activity Index, derived from the Strava Global Heatmap) and tourist count records, we investigated how spatial behavior and activity rhythms of bears change with variations in experienced human disturbance. We found that bears were mainly nocturnal and that, on an annual scale, nocturnality was associated with movement behavior, but both were independent of experienced human disturbance. Furthermore, nocturnality tended to increase in periods of more intense exploitation of outdoor areas by humans. Overall, these preliminary findings show that bears exhibit a notable behavioral flexibility to minimize their exposure to human presence. Through the application of different sources of human activity data, this work showcases that the integration of high resolution animal movement data with dynamic data on human mobility is crucial to meaningfully catch wildlife responses to anthropisation