Dysmenorrhea often significantly reduces the quality of women’s life and is still an important public health problem. Despite numerous studies, the pathomechanism of dysmenorrhea is not fully understood. Previous research indicates the complexity of biochemical reactions between the endocrine, vascular, and immune systems. Prostaglandins play a major role in the pathomechanism of dysmenorrhea. In contrast, cytokines and other proinflammatory factors in primary dysmenorrhea are less studied. In addition to the applied pharmacotherapy, more and more studies proving the effectiveness of non-pharmacological methods appear. Therefore, the present work contains a review of the latest research concerning factors involved in dysmenorrhea, as well as therapeutic options. In the literature search, authors used online databases, PubMed, and clinitrials.gov and browsed through individual gynecology, physiotherapy journals and books.

Purpose. The aim of the research was to conduct an assessment of the prevalence of dysmenorrhea and associated factors among Polish women. Patients and Methods. A cross-sectional study was conducted among Polish women using an online questionnaire. The mean age of the participants was 23 ± 4 years. Out of the total of 1,317 women who took part in the study, 1,127 were included in the analysis, and 190 were excluded due to incomplete answers. The questionnaire consisted of 19 questions that were grouped into three parts. The first concerned sociodemographic data such as age, weight, education, and residence (urban or rural). The second part of the questionnaire pertained to the factors of dysmenorrhea (premenstrual syndrome, age of menarche, and family history of dysmenorrhea.). In the third part, the women were asked about their diet, alcohol intake, cigarette smoking, and physical activity. Results. Dysmenorrhea affected 94% of the interviewed women. Dysmenorrhea was most likely to occur among respondents whose mothers had a history of dysmenorrhea (p<0.005). Significant relationship between the occurrence of dysmenorrhea among respondents and their sisters was also observed (p<0.005). The prevalence of premenstrual syndrome (PMS) was significantly higher in women reporting dysmenorrhea (p<0.005). Other significant factors associated with dysmenorrhea were age of menarche (p<0.005), stress frequency (p=0.005), lack of physical activity (p=0.037), and self-esteem (p=0.042). However, in the respondents, no significant relationship was observed between dysmenorrhea and diet, smoking, body mass index, and alcohol intake. Conclusion. The study points to the fact that the problem of dysmenorrhea affects many Polish women. Women with dysmenorrhea were characterized with a family history of dysmenorrhea, occurrence of PMS, early age of menarche, stressful lifestyle, lack of physical activity, and low self-esteem. We suggest that further assessment of factors contributing for dysmenorrhea among women is necessary.

Background: The study aimed to assess if manual therapy, compared to ibuprofen, impacts the concentration of inflammatory factors, sex hormones, and dysmenorrhea in young women Methods: Thirty-five women, clinically diagnosed with dysmenorrhea, were included in the study. They were divided into group A—manual therapy (n = 20) and group B—ibuprofen therapy (n = 15). Inflammatory factors such as vascular endothelial growth factor (VEGF), C-reactive protein (CRP), prostaglandin F2α (PGF_2α), E2 (PGE2) and sex hormones levels were measured. Dysmenorrhea assessed with the numerical pain rating scale (NPRS), myofascial trigger points, and muscle flexibility were examined before and after the interventions. Results: The difference in the level of 17-β-estradiol after manual and ibuprofen therapy was significant, as compared to baseline (p = 0.036). Progesterone levels decreased in group A (p = 0.002) and B (p = 0.028). The level of CRP was negatively correlated with sex hormones. Decrease in dysmenorrhea was significant in both groups (group A p = 0.016, group B p = 0.028). Non-significant differences were reported in prostaglandins, VEGF and CRP levels, in both groups. Conclusions: There were no significant differences in CRP, prostaglandins and VEGF factors after manual or ibuprofen therapy. It has been shown that both manual therapy and ibuprofen can decrease progesterone levels. Manual therapy had a similar effect on the severity of dysmenorrhea as ibuprofen, but after manual therapy, unlike after ibuprofen, less muscles with dysfunction were detected in patients with primary dysmenorrhea.

Perineal pain occurs in 97% of women with episiotomy or first- and second-degree perineal tears on the first day after delivery. The study aimed to assess the impact of capacitive and resistive energy transfer (TECAR) on perineal pain and discomfort in the first two postpartum days. The prospective randomized double-blind study was performed with the pain and discomfort assessment using the Visual Analogue Scale at baseline and after both TECAR interventions. Characteristics data, delivery information, and the number of painkillers taken were collected. The assumed significance level was α < 0.05. The study included 121 women with a mean age of 30.7 ± 4.2 years and a median BMI of 26.1 kg/m² (24.1; 28.9). Pain reduction at rest, when walking, and discomfort reduction when walking were significantly higher in the TECAR group compared to the sham group (p < 0.05). After the first TECAR intervention, significant reduction in all measured parameters was observed in the study group (p < 0.03), whereas in the control group, it was observed in pain and discomfort while sitting (p < 0.04). The amount of ibuprofen taken on the second day was significantly reduced in the study group compared to the first day (p = 0.004). TECAR has been shown to provide more immediate and significant reduction in perineal pain and discomfort.

The aim of the study was to evaluate the effect of manual therapy and the use of ibuprofen on the severity of dysmenorrhea and changes in the level of sex hormones in young women with dysmenorrhea. Material and methods: The study included six women, aged 22 ± 2 years, with primary dysmenorrhea (PD). A physiotherapist examined the tenderness and flexibility of the muscles. The patients were subjected to a gynecological and physiotherapeutic examination; the concentrations of progesterone and 17-beta-estradiol were also determined. In subgroup A (n = 3), manual therapy was performed 3 × 45 min; in subgroup B (n = 3), the patients received ibuprofen 3 × 400 mg/day. Results: In subgroup A, all patients showed a decrease in the level of progesterone and an increase in the concentration of estradiol. In subgroup B, the concentration of progesterone and 17-beta estradiol decreased in two subjects. In subgroup A, manual therapy reduced the severity of headache, back pain, diarrhea, fatigue, and PMS. In subgroup B, the use of ibuprofen only alleviated back pain and fatigue. Moreover, in subgroup A, after the application of manual therapy, improvement in flexibility and pain relief of the examined muscles was demonstrated. On the other hand, in subgroup B, no improvement in flexibility or reduction in muscle soreness was found in patients who took ibuprofen. Conclusions: Manual therapy may reduce menstrual pain in women with dysmenorrhea. However, the results need to be confirmed in studies conducted on a larger group of patients with dysmenorrhea.

Background/Objectives: This study explores the diagnostic and management pathways for dyspareunia in women seeking specialist care, focusing on gynecologists’ feedback and women’s perceptions of their experience. Methods: An online survey was conducted among 225 sexually active women to explore their perceptions of dyspareunia, its impact on relationships, and experiences with healthcare feedback, diagnosis, and treatment. The Numeric Rating Scale (NRS) for pain assessment and the Female Sexual Function Index (FSFI) were used. Gynecologists’ feedback was classified as positive, neutral, or negative based on its influence on the therapeutic pathway. Results: Of 78 women reporting dyspareunia, 12 with pain level ≥5 on NRS were selected for in-depth analysis. The mean pain score was 7.0 ± 1.53, with symptoms lasting from several months to over two years and occurring during most sexual encounters. The mean FSFI score was 24.86 ± 4.54, with half of the participants scoring within the sexual dysfunction range. Qualitative findings revealed frequent dismissive responses from healthcare professionals and limited access to appropriate management. Common self-management strategies included changing sexual positions and using lubricants, while half of the participants had not undergone a formal diagnostic process. Most frequent diagnoses were hormonal disorders and recurrent genital tract infections, and women were advised to undergo pharmacological treatment. Half of the participants were unaware of the possibility of physiotherapeutic management. Conclusions: Women with dyspareunia often face an inadequate diagnostic and therapeutic process. The care received is often insufficient and not aligned with a biopsychosocial model.