The role of water intake in the severity of pain and menstrual distress among females suffering from primary dysmenorrhea: a semi-experimental study

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Abstract

Background

Dysmenorrhea is the most common health problem among women of reproductive age. The aim of the present study was to investigate the modifying role of water intake in menstrual distress and severity of pain among young female adolescents.

Method

A semi-experimental study was conducted on a sample of undergraduate female students aged 18–30 years in Isfahan, Iran from 2016 to 2019. Volunteers who had history of suffering from primary dysmenorrhea and drank less than 1600 ml water per day were assigned into water intake (n = 70) and control (n = 70) groups. Participants could select the group in which they desired to be considered. The water intake group was asked to drink water regularly based on a protocol for two menstrual periods while the control group did not receive any form of intervention. Demographic information and menstrual characteristics and severity of menstrual pain (based on a visual analogue scale), were obtained using a short questionnaire. The data were compared between and within two groups before and after intervention using chi-square test, Mann–Whitney U test, and the Friedman’s analysis of variance.

Results

The mean age (SD) of participants was 22.0 (2.7) years and 77 students reported normal duration of menstrual bleeding. The number of students who had normal duration of menstrual bleeding (4–6 days) in water intake group increased after intervention (39 vs. 49 after first and 46 after second cycles of menstruation). However, the interval of menstrual cycle did not change significantly in either groups. Considerable decrease in using pain killer was observed in water intake group ( p < 0.001). No significant differences were observed between control and water intake groups before intervention in pain intensity (pain mean score 7.64 vs. 7.06), but within group comparison showed that pain intensity was significantly decreased among water intake group ( p < 0.0001) while for control group only a significant decrease was observed for the first day of menstrual bleeding.

Conclusion

The findings suggest that water intake might have modifying role in reducing menstrual bleeding duration, pain killer utilization, and pain intensity during menstrual period.

Trial registration

IRCT20180708040377N1, 16 April 2020, Retrospectively registered, at https://www.irct.ir/trial/32446

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Most cited references 27

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Hydration biomarkers in free-living adults with different levels of habitual fluid consumption

Erica Perrier, Sébastien Vergne, Alexis Klein … (2012)

Little is known about the impact of habitual fluid intake on physiology. Specifically, biomarkers of hydration status and body water regulation have not been adequately explored in adults who consume different fluid volumes in everyday conditions, without prolonged exercise or environmental exposure. The purpose of the present study was to compare adults with habitually different fluid intakes with respect to biomarkers implicated in the assessment of hydration status, the regulation of total body water and the risk of kidney pathologies. In the present cross-sectional study, seventy-one adults (thirty-two men, thirty-nine women, age 25–40 years) were classified according to daily fluid intake: thirty-nine low drinkers (LD; ≤ 1·2 litres/d) and thirty-two high drinkers (HD; 2–4 litres/d). During four consecutive days, urinary parameters (first morning urine (FMU) on day 1 and subsequent 24 h urine (24hU) collections), blood parameters, and food and beverage intake were assessed. ANOVA and non-parametric comparisons revealed significant differences between the LD and HD groups in 24hU volume (1·0 (se 0·1) v. 2·4 (se 0·1) litres), specific gravity (median 1·023 v. 1·010), osmolality (767 (se 27) v. 371 (se 33) mOsm/kg) and colour (3·1 (se 0·2) v. 1·8 (se 0·2)). Similarly, in the FMU, the LD group produced a smaller amount of more concentrated urine. Plasma cortisol, creatinine and arginine vasopressin concentrations were significantly higher among the LD. Plasma osmolality was similar between the groups, suggesting physiological adaptations to preserve plasma osmolality despite low fluid intake. The long-term impact of adaptations to preserve plasma osmolality must be examined, particularly in the context of renal health.

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The normal menstrual cycle in women.

M Mihm, S Gangooly, S Muttukrishna (2011)

The menstrual cycle in women is characterised by high variability in cycle length (26-35 days), 5-day menses, a fertile phase from 5 days before to the day of ovulation, and low fertility which is dependent on cycle length and age. All women show an FSH rise at the luteal-follicular transition, stimulating a cohort of follicular growth and inhibin B secretion in the early follicular phase. The ovulatory dominant follicle (DF) is selected in the mid-follicular phase, and as this DF grows it increasingly secretes oestradiol and inhibin A for a week before ovulation. Gonadotrophin responsiveness, IGF binding protein expression and degradation, and vascularisation have been identified to be crucial for DF selection and progression. Two-thirds of women show two follicle waves and 1/3 show 3 follicle waves per cycle. Three-wave women have longer cycles, and a later oestradiol rise and LH surge. The corpus luteum secretes progesterone, oestradiol and inhibin A in response to LH pulses, and reaches its peak in terms of size, secretions, and vascularization 6-7 days after ovulation. Luteal regression is passive and independent of the uterus, but can be prevented by hCG, the luteotrophic signal from the trophoblast, from 8 days after conception. Reductions in systemic steroid and protein hormone concentrations may be responsible for the FSH rise characteristic of premenopausal women. The functional layer of the endometrium shows steroid hormone-dependent proliferation, differentiation, and shedding in the absence of the trophoblast. Menstruation is initiated by progesterone responsive decidual cells, and executed by PGE and PGF2α, vasoconstriction and matrix metalloprotease secretion by leukocytes. Ovarian function and also hormone fluctuations during the menstrual cycle are similar to oestrous cycles of cows and mares, justifying research into comparative aspects of menstrual and oestrous cycles in monovulatory species. Copyright © 2010 Elsevier B.V. All rights reserved.

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Human Water Needs

Michael N Sawka, Robert Carter, Samuel N. Cheuvront (2005)

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Author and article information

Contributors

Ali Montazeri:

ORCID: http://orcid.org/0000-0002-5198-9539

montazeri@acecr.ac.ir

Journal

Journal ID (nlm-ta): BMC Womens Health

Journal ID (iso-abbrev): BMC Womens Health

Title: BMC Women's Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6874

Publication date (Electronic): 28 January 2021

Publication date PMC-release: 28 January 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 40

Affiliations

[1 ]GRID grid.411757.1, ISNI 0000 0004 1755 5416, Community Health Research Center, Isfahan (Khorasgan) Branch, , Islamic Azad University, ; Isfahan, Iran

[2 ]GRID grid.464599.3, ISNI 0000 0004 0494 3188, Department of Midwifery, School of Medical Sciences, Tonekabon Branch, , Islamic Azad University, ; Tonekabon, Iran

[3 ]GRID grid.417689.5, Population Health Research Group, Health Metrics Research Center, , Iranian Institute for Health Sciences Research, ACECR, ; Tehran, Iran

[4 ]GRID grid.444904.9, Faculty of Humanity Sciences, , University of Science and Culture, ; Tehran, Iran

Author information

Ali Montazeri http://orcid.org/0000-0002-5198-9539

Article

Publisher ID: 1184

DOI: 10.1186/s12905-021-01184-w

PMC ID: 7845092

PubMed ID: 33509179

SO-VID: bba1d917-a3f6-4b1c-bd69-89e8c8579b70

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 29 March 2020

Date accepted : 19 January 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100009384, Islamic Azad University Isfahan (Khorasgan) Branch;

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: primary dysmenorrhea,pelvic pain,arginine vasopressin,water intake,dehydration

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ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: primary dysmenorrhea, pelvic pain, arginine vasopressin, water intake, dehydration

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The role of water intake in the severity of pain and menstrual distress among females suffering from primary dysmenorrhea: a semi-experimental study

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Abstract

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Trial registration

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Advocacy for Maternal and Women’s Health

Most cited references 27

Hydration biomarkers in free-living adults with different levels of habitual fluid consumption

The normal menstrual cycle in women.

Human Water Needs

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Cited by 4

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