Jeong Jee Young, Kim Min Kyoung, Lee Inha, Yun Jisun, Won Young Bin, Yun Bo Hyon, Seo Seok Kyo, Cho SiHyun, Choi Young Sik, Lee Byung Seok
Department of Obstetrics and Gynecology, Severance Hospital, CHA University School of Medicine, Seoul, Korea.
Institute of Women's Life Medical Science, CHA University School of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2019 Sep;62(5):329-334. doi: 10.5468/ogs.2019.62.5.329. Epub 2019 Jul 22.
This study was aimed at identifying a correlation between polycystic ovarian morphology (PCOM) and the severity of primary dysmenorrhea in young Korean women.
A total of 592 patients who visited a tertiary hospital from March 2008 to March 2015 for dysmenorrhea were examined. After excluding those with secondary causes of menstrual pain (for example, myoma, adenomyosis, endometriosis, and pelvic inflammatory disease), 361 women were recruited and retrospectively analyzed. Severe dysmenorrhea was defined as a visual analog scale (VAS) score ≥6.
The mean patient age was 23.0±4.0 years, the average menstrual cycle length was 34.4±23.7 days, and the average pain intensity was VAS 6.7±0.1 at baseline. PCOM was assessed by ultrasound in 54 women (15%). Patients with severe menstrual pain were more likely to have irregular menstrual cycles (=0.03) and heavy menstrual flow (=0.01) than those with mild menstrual pain. After adjusting for weight, height, menstrual cycle interval, and menstrual flow in the logistic regression analysis, PCOM (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.05-4.97; =0.04) and heavy menstrual flow (OR, 1.85; 95% CI, 1.05-3.28; =0.04) were found to be significant independent factors influencing pain.
Our study shows that PCOM may have a correlation with the severity of primary dysmenorrhea. Since PCOM may play a role in the development of menstrual pain, patients with PCOM should be under active surveillance with resources for prompt pain management readily available. It may also be necessary to further investigate the molecular mechanisms of pain development in primary dysmenorrhea.
本研究旨在确定韩国年轻女性的多囊卵巢形态(PCOM)与原发性痛经严重程度之间的相关性。
对2008年3月至2015年3月期间因痛经前往三级医院就诊的592例患者进行检查。排除那些有继发性痛经原因(如肌瘤、子宫腺肌病、子宫内膜异位症和盆腔炎)的患者后,招募了361名女性并进行回顾性分析。严重痛经定义为视觉模拟量表(VAS)评分≥6分。
患者的平均年龄为23.0±4.0岁,平均月经周期长度为34.4±23.7天,基线时平均疼痛强度为VAS 6.7±0.1分。通过超声对54名女性(15%)进行了PCOM评估。与轻度痛经患者相比,严重痛经患者更易出现月经周期不规律(P = 0.03)和月经量多(P = 0.01)。在逻辑回归分析中,对体重、身高、月经周期间隔和月经量进行校正后,发现PCOM(比值比[OR],2.26;95%置信区间[CI],1.05 - 4.97;P = 0.04)和月经量多(OR,1.85;95% CI,1.05 - 3.28;P = 0.04)是影响疼痛的重要独立因素。
我们的研究表明,PCOM可能与原发性痛经的严重程度相关。由于PCOM可能在痛经的发生中起作用,对于患有PCOM的患者应进行积极监测,并随时准备好进行疼痛管理的资源。进一步研究原发性痛经疼痛发生的分子机制可能也很有必要。