METHODS: A nationwide cross-sectional study of women aged 18-25 years from the CONSTANCES cohort was constructed. Disability was assessed with the Global Activity Limitation Indicator question \'For the past 6 months, have you been limited in routine activities?Yes, severely limited/Yes, limited/ No, not limited\'. Dysmenorrhoea pain intensity and other chronic pelvic pain symptoms (dyspareunia and non-menstrual pain) were evaluated according to questions from a specific questionnaire. Probability of disability was estimated using a logistic prediction model according to dysmenorrhoea intensity, other indicators of pelvic pain symptoms and other obvious covariates. The results of the predictive model of disabling dysmenorrhoea were presented on a nomogram.
RESULTS: Among 6377 women, the rate of disability was estimated at 7.5%. Increased intensity of dysmenorrhoea (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04-1.13), increased frequency of dyspareunia (from OR 1.69, 95% CI 1.33-2.14 up to OR 3.41, 95% CI 2.16-5.38) non-menstrual chronic pelvic pain (OR 1.75, 95% CI 1.40-2.19), body mass index over 25 kg/m2 (OR 1.45, 95% CI 1.17-1.80) and non-use of the hormonal contraceptive pill (OR 1.29, 95% CI 1.05-1.59) were significantly associated with disability. According to the nomogram, a predicted probability of 15% or more could be chosen as a threshold. This represents almost 4.6% of young women in this sample being classified at risk of disabling dysmenorrhoea.
CONCLUSIONS: Dysmenorrhoea pain intensity and associated pelvic pain symptoms are warning indicators that can be measured to help screen young women who may suffer from disabling dysmenorrhoea.
方法:构建了一项针对CONSTANCES队列中18-25岁女性的全国性横断面研究。残疾是通过“过去6个月的全球活动限制指标”问题进行评估的,你在日常活动中受到限制吗?是的,严重受限/是,有限/否,不受限制\'。根据特定问卷的问题评估痛经疼痛强度和其他慢性盆腔疼痛症状(性交困难和非月经疼痛)。根据痛经强度使用logistic预测模型估计残疾概率,其他盆腔疼痛症状指标与其他明显协变量。致残性痛经的预测模型的结果显示在列线图上。
结果:在6377名女性中,残疾率估计为7.5%.痛经强度增加(比值比[OR]1.08,95%置信区间[CI]1.04-1.13),非月经性慢性盆腔疼痛(OR1.75,95%CI1.40-2.19),性交困难的频率增加(从OR1.69,95%CI1.33-2.14到OR3.41,95%CI2.16-5.38),体重指数超过25kg/m2(OR1.45,95%CI1.17-1.80)和未使用激素避孕药(OR1.29,95%CI1.05-1.59)与残疾显著相关.根据列线图,可以选择15%或更高的预测概率作为阈值。这代表该样本中几乎4.6%的年轻女性被分类为有使痛经致残的风险。
结论:痛经疼痛强度和相关的盆腔疼痛症状是警告指标,可以通过测量来帮助筛查可能患有致残痛经的年轻女性。