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Published by: Livianty Hukubun on Oct 24, 2012
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World Applied Sciences Journal 17 (10): 1246-1252, 2012ISSN 1818-4952© IDOSI Publications, 2012
Corresponding Author:
Noorbakhsh Mahvash, College of Physical Education and Sport Sciences,Islamic Azad University, Karaj Branch, Iran, POST: 17- Shenasa Street, Valye Asr Ave, Tehran, Iran.Tel: +021-22058101, Cell: +09166148819
The Effect of Physical Activity on Primary Dysmenorrheaof Female University Students
 Noorbakhsh Mahvash, Alijani Eidy, Kohandel Mehdi,
 Mehdizadeh Toorzani Zahra, Mirfaizi Mani and Hojat Shahla
College of Physical Education and Sport Sciences, Islamic Azad University - Karaj Branch, Iran
Department of Midwifery, Islamic Azad University - Karaj Branch, Iran
Primary dysmenorrhea is one of the most common complains and gynecological problem worldwideamong young females. Findings claimed that exercise may positively affect this problem. Therefore, the mainpurpose of this study was to examine the effect of 8 weeks physical activity on primary dysmenorrhea of femalestudents. Based on McGill’s questionnaire 50 students having moderate to severe primary dysmenorrhea took part in this study and randomly were divided into experimental (N=25) and control (N=25) groups. Theexperimental group participated in a physical activity program for 8 weeks, 3 sessions a week and 90 minutesper session. The results revealed that performing a regular physical activity significantly reduced type of drugsconsumed (p
0.08), number of drugs consumed (p
0.01), volume of bleeding (p
0.002), rate of bleeding (p
0.005), length of menstruation pain (p
0.001) and total and present pain intensity (p
0.01, p
0.05) inexperimental group when comparing with control group or when comparing pre and post-test findings of experimental group. Overalls, the results of this study indicated that participating in physical activity programis likely an approach to reduce the detrimental effect of primary dysmenorrhea symptoms in young females.
Key words:
Physical Activity
Primary Dysmenorrhea
University Students
next day. Dysmenorrhea pains are felt in lower abdominIn the past two decades, the relation betweenpercentage of cases, girls may experience systematicphysical activity and menstrual disorders includingsymptoms such as backache, nausea, vomiting, diarrhea,primary dysmenorrhea has significantly been studied.fatigue and headache [6]. With severe pain, the suffersResearch findings have indicated that exercise can affectmay be absent from school or work for one or two days [3]menstruation in many ways including inducingand it could have negative impact on academic, social andamenorrhea in athletes and it may decrease symptoms ofsports activities of young girls [7].premenstrual syndrome and dysmenorrhea [1]. PrimaryAlthough primary dysmenorrhea is not a real threatdysmenorrhea or painful menstruation, in absence of anyof life, but can impact on the quality of female life and inspecific pelvic diseases, is one of the most commoncase of severity it may lead to disability and inefficiencycomplaints of women and is also the most common[8, 9]. On the other hand, dysmenorrhea can causegynecological problem worldwide [2, 3]. Primarypsychological problems in some of the females resultingdysmenorrhea begins when young girls first experiencein their loneliness and inactive participation in differentthe ovulatory cycles and its prevalence increases duringsocial activities [10]. The detrimental impact of adolescence (15-17 years) and reaches to its highest in 20-dysmenorrhea on the lives of women has been considered24 years and decreases progressively thereafter [4, 5]. Inby most of the researchers in this area. In many countries,primary dysmenorrhea pain begins few hours before orprimary dysmenorrhea is the leading cause of recurrentafter the onset of menstruation and lasts for 24-48 hours.short-term school and work absenteeism in young girlsThe pain is more in the first day and rarely continues toand women [7, 11]. Data from few longitudinal studiesand may radiate into inner parts of thighs. In a high
World Appl. Sci. J., 17 (10): 1246-1252, 2012
1247showed that the absenteeism from school due to primaryIn spite of the fact that many findingsdysmenorrhea is 34 to 50 percent [12, 13]. Indeed, asreported by many studies, there is a considerable cost toboth the individual and society as a result of dysmenorrhea.It is believed that symptoms of primary dysmenorrheastem from raised concentrations of prostaglandins F2
) resulting in uterine contractions and ischemia[14]. One likely mechanism for increasing prostaglandinsis that, during premenstrual phase, progesteronedecreases which results in the synthesis of prostaglandins in endometrial cells by membranephospholipids. This process is supported by the ability of prostaglandin synthesis inhibitors in pain relief. As theseinhibitors only provide pain relief in 70% to 75% of women, other factors may also be involved [1]. Theresults of studies carried out in North America, China,Australia, Turkey and Iran have shown that theprevalence of primary dysmenorrhea and percentage of women involved are different from society to society [15-19]. Based on findings of these and other studies,dysmenorrhea is one of the most important health issuesof young girls which must be considered because manyresearchers claimed that primary dysmenorrhea affectsbetween 50 to 90% of general population [7, 13, 20- 25].Due to its importance, different treatments includingmedical and non-medical treatment such as taking non-steroidal anti-Inflammatory drugs (NSAIDS), herbal,dietary therapies, yoga, meditation and acupuncture havebeen used to reduce the effects of dysmenorrhea [18, 21,26- 28].Although these treatments are generally thought toreduce the discomfort associated with dysmenorrhea, it isbelieved that participation in regular physical activity isanother positive way of dysmenorrhea treatment by whichit may diminish the symptoms of dysmenorrhea inexercising young girls and women. Shavandi
et al
. (2009)studied the effect of 8 weeks isometric exercise on primarydysmenorrhea and reported that intensity and duration of pain-induced by primary dysmenorrhea are reduced andless medicine is taken, but it has no effect on the amountof bleeding [19]. Shahrjerdi and Sheikh Hoseini (2010)reported that the severity and length of pain due toprimary dysmenorrhea in young girls following 8 weeksstretching exercises are diminished and they takesignificantly less medicine [29]. However, a number of studies have shown a correlation between life stress andgynecological symptoms. Similarly, women who trainintensively have been found to experience fewersymptoms than women who take part in physical activitiesoccasionally or not taking part at all [30].support the positive effect of physical activities onprimary dysmenorrhea few studies results showed noeffect of physical activities on primary dysmenorrhea[31, 32].Due to the fact that dysmenorrhea has been treatedsuccessfully with stress reduction techniques [33, 34],physical activities and exercise are widely accepted asa means of moderating stress and stress- relatedsymptoms. Exercise is known to cause the release of endorphins hormones in brain that raise the painthreshold and is shown to improve mood of exercising subjects. However, because of highprevalence of primary dysmenorrhea in differentsocieties and the potential benefits of exercise foundin treating dysmenorrhea and also existence of fewstudies which claimed that physical activity has noeffect on primary dysmenorrhea the purpose of thisstudy was to investigate the effects of physical activitieson primary dysmenorrhea of Iranian female universitystudents.
All single and non-athlete female university studentsfrom Islamic Azad University-Karaj Branch aged 23.34 ±2.35 years who enrolled in Physical Education Courses of the first semester of academic year of 2010-2011 (N=256)as research population took part in this semi-experimentalstudy. Using Mc Gill’s questionnaire [35], 50 studentswith moderate to severe primary dysmenorrhea wereselected as samples and based on their menstrual historyand data obtained from this questionnaire, were randomlydivided into experimental (N=25) and control (N=25)groups. After obtaining ethical clearance fromUniversity’s committee for research on human subjects allsubjects participated in an introductory session. Purposesand methods of study were explained. Thereafter, allsubjects completed the different parts of questionnaire. Inthe first part of the questionnaire demographiccharacteristics regarding age, mass body index anduniversity subject were assessed. In the second part of the questionnaire menstrual characteristics including typeand number of drugs consumed, volume (quality andquantity) and rate of bleeding and onset of menstruationand length of menstruation pain were evaluated. In thethird part, female students were asked to quantify theirmenstrual characteristics including pain intensity by PainRate Index (PRI), Visual Analog Scale (VAS) and PresentPain Intensity (PPI) and total pain according to Mc Gill’s
World Appl. Sci. J., 17 (10): 1246-1252, 2012
1248short form questionnaire. Total pain score is equal to the
Physical Activities-Induced Changes in Primary
total scores obtained from all dimensions of pain. Final
Dysmenorrhea Symptoms:
When comparing differentscores calculated from the third part of questionnaire weretypes of drugs consumed by experimental and controlfrom 0 to 60; from 0 to 45 was considered for PRI, from 0group, significant difference was found between twoto 10 was considered for VAS and from 0 to 5 wasgroups (p=0.057). In pre-test Ibuprofen as a drug wasconsidered for PPI. The reliability of McGill questionnaireused by most subjects in both groups. But whenwas confirmed (r = 0.93).comparing the findings of post-test after 8 weeks o
Physical Activity Protocol:
Experimental group took partexperimental group (p=0.08) and type of drug consumedin training program for 8 weeks, 3 sessions a week, 90was changed from Ibuprofen to Acetaminophen inminutes in a session in two cycles under supervision ofexperimental group without change in control groupPhysical Education experts. Control group only took part(Table 2).in ordinary class which was one session a week. PhysicalWhen comparing the volume of bleeding in bothactivity program included 5-10 minutes warm up, 30-45groups no significant difference was found in pre-testminutes progressive stretching exercises specified for(p=0.1) but a significant decrease was seen in post-testpelvic region, 10-15 minutes stretching exercises usingcomparing experimental and control groups (p=0.002)partner, 10-15 minutes resistant exercises focusing on hip(Table 2).girdle muscles and 5-10 minutes cool down. At the end ofIn relation to the onset of menstruation pain, theprogram, the questionnaires were completed by subjectsfindings showed no significant differences between twoas post- test by both groups. Subjects in control groupgroups in pre-test (p=0.43) and post-test (p=0.27)were requested not to take part in any regular exercise(Table 2).program except their one university session up to the endWhen comparing the number of drugs consumed byof the study. both groups, there were no significant differencesTo check the normality of data Kolmogorov-Smirnovbetween experimental and control groups in pre-testtest was used in order to analyze the findings [36]. Chi-(p=0.754) and post-test (p=0.175) (Table 3).square and independent and dependent t-test atBut comparing number of drugs used by experimentalsignificant level of P
0.05 were also used.group in pre and post-test, significant difference was
When comparing the rate of bleeding based on the
Demographic Characteristics of Subjects:
As shown inexperimental and control groups was found (p=0.005)Table 1, there were no significant differences in the(Table 3).The findings also showed a significantdemographic characteristics between subjects of thedifference between pre and post-test of experimentalexperimental and control groups.group (p=0.05) (Table 4).physical activities, no significant difference was found infound (p=0.01) (Table 4).number of pads used, a significant difference between
Table 1: Comparison of characteristics between experimental and control groups
VariablesExperimental Group N=25Control Group P-value N=25
Age (years, Mean±SD)22.84 ± 1.79 23.8 4 ± 2.91 p> 0.05Weight (Kg, Mean±SD)56.39 ± 9.0560.63 ± 9.27 p> 0.05Height (Cm, Mean±SD)169.26 ± 5.53163.86 ± 4.64 p> 0.05Body Mass Index (K g/m², Mean±SD)22.07 ± 3.6122.64 ± 3.37 p>0.05Age at onset of menstruation (years, Mean±SD)13.43 ± 1.812.77 ± 1.47 p> 0.05Length of menstruation cycle (days, Mean±SD)6.78 ± 1.275.86 ± 1.28 p> 0.05Length of menstruation phase (days, Mean±SD)25.87 ± 3.6826.54 ± 3.93 p> 0.05Table 2: Comparison of primary dysmenorrhea characteristics between experimental and control groups based on Chi-square analysisVariablesK²dfp-valueType of drugs consumptionPre-test2.940.57Post-test8.140.08Volume of bleeding (quality)Pre-test4.60420.10Post-test15.2130.002Onset of menstruation painPre-test2.7430.43Post-test3.8530.27

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