Patel V, Tanksale V, Sahasrabhojanee M, Gupte S, Nevrekar P
London School of Hygiene & Tropical Medicine, London, UK.
BJOG. 2006 Apr;113(4):453-63. doi: 10.1111/j.1471-0528.2006.00874.x. Epub 2006 Feb 20.
To describe the prevalence and determinants of dysmenorrhoea, the most common menstrual complaint, in a community in India.
Cross-sectional survey.
Catchment area of primary health centre in Goa, India.
Three thousand women aged 18-45 years randomly selected. A total of 2494 women consented to participate (83.1%).
Eligible participants were asked standardised questions regarding menstrual complaints over the past 12 months, and socio-demographic, psychosocial and reproductive risk factors. Vaginal or urine specimens were collected for the diagnosis of reproductive tract infections.
Dysmenorrhoea of moderate to severe intensity.
A total of 2262 women were eligible. More than half reported dysmenorrhoea; moderate to severe dysmenorrhoea was reported by 755 participants (33.4%, 95% CI 31.4-35.4). There was a linear association between severity of pain and impact (medication and taking rest) and the onset of pain (premenstrual onset associated with more severe pain). On multivariate analyses, the risk of moderate-severe dysmenorrhoea was associated with the experience of violence (OR 2.23, 95% CI 1.5-34); other somatic complaints (OR 3.67, 95% CI 2.7-4.9 for highest somatoform symptom score category compared with the lowest); gynaecological complaints (non-menstrual lower abdominal pain: OR 1.78, 95% CI 1.3-2.3; dysuria: OR 1.98, 1.4-2.7); menorrhagia (OR 1.92, 95% CI 1.4-2.6); and illiteracy (OR 1.32, 95% CI 1.0-1.7). Having had a pregnancy (OR 0.53, 95% CI 0.4-0.7), older age of menarche (OR 0.70, 95% CI 0.5-0.9, for age >14 compared with <13 years) and older age (OR 0.43, 0.3-0.6 for age 40-50, compared with 18-24 years) were protective.
The burden of dysmenorrhoea is greater than any other gynaecological complaint, and is associated with significant impact. Social disadvantage, co-morbidity with other somatic syndromes and reproductive factors are determinants of this complaint.
描述印度某社区中最常见的月经问题——痛经的患病率及其决定因素。
横断面调查。
印度果阿邦初级卫生中心的服务区域。
随机选取3000名年龄在18 - 45岁的女性。共有2494名女性同意参与（83.1%）。
符合条件的参与者被问及有关过去12个月月经问题以及社会人口学、心理社会和生殖风险因素的标准化问题。收集阴道或尿液样本以诊断生殖道感染。
中度至重度痛经。
共有2262名女性符合条件。超过半数报告有痛经；755名参与者报告有中度至重度痛经（33.4%，95%可信区间31.4 - 35.4）。疼痛严重程度与影响（用药和休息）以及疼痛发作（经前发作与更严重疼痛相关）之间存在线性关联。多因素分析显示，中度至重度痛经的风险与暴力经历相关（比值比2.23，95%可信区间1.5 - 3.4）；其他躯体不适（最高躯体形式症状评分类别与最低类别相比，比值比3.67，95%可信区间2.7 - 4.9）；妇科问题（非经期下腹痛：比值比1.78，95%可信区间1.3 - 2.3；排尿困难：比值比1.98，1.4 - 2.7）；月经过多（比值比1.92，95%可信区间1.4 - 2.6）；以及文盲（比值比1.32，95%可信区间1.0 - 1.7）。有过妊娠史（比值比0.53，95%可信区间0.4 - 0.7）、初潮年龄较大（14岁及以上与13岁以下相比，比值比0.70，95%可信区间0.5 - 0.9）和年龄较大（40 - 50岁与18 - 24岁相比，比值比0.43，0.3 - 0.6）具有保护作用。
痛经的负担比任何其他妇科问题都更重，且会产生重大影响。社会劣势、与其他躯体综合征共病以及生殖因素是这一问题的决定因素。
