背景:慢性盆腔疼痛是一种常见疾病,在发达国家影响约4%的育龄妇女。这个数字在发展中国家估计更高,对女性产生重大的个人和社会经济负面影响。几个国家缺乏这方面的数据,特别是那些处于发展中的人以及土著等社会和生物弱势群体,很难引导公共政策。
目的:评估慢性盆腔痛(痛经,性交困难,非周期性疼痛),并确定哪些变量与Otavalo-Ecuador土著妇女的病情独立相关。
方法:进行了一项横断面研究,包括2429名14至49岁的育龄妇女的样本,从2022年4月至2023年3月获得。使用了定向问卷,由社区本身的双语采访者(Kichwa和西班牙语)收集;通过随机抽样选择患者人数,与通过样本计算估计的女性人数成比例。数据以病例患病率表示,赔率比,95%的置信区间,p<0.05。
结果:原发性痛经的患病率,非周期性盆腔疼痛,性交困难,分别,26.6%,8.9%,和3.9%。所有形式的慢性疼痛彼此独立相关.此外,痛经与高血压独立相关,肠道症状,错杀,长周期,以前怀孕,使用避孕药和梨体形。其他部位疼痛,月经初潮较晚,锻炼,梨体形与非周期性盆腔疼痛有关。And,泌尿症状,先前的怀孕损失,错杀,梨形与性交困难有关。
结论:原发性痛经和非周期性慢性盆腔痛的患病率明显较高,与报告的性交困难的频率相反。简而言之,我们的结果表明痛经与炎症和/或全身代谢紊乱相关的疾病之间存在关联,包括与其他骨盆疼痛表现的潜在因果关系,以及非周期性盆腔疼痛和提示中枢致敏的体征/症状之间。性交困难的报道可能受到当地文化价值观和信仰的影响。
BACKGROUND: Chronic pelvic pain is a common disease that affects approximately 4% of women of reproductive age in developed countries. This number is estimated to be higher in developing countries, with a significant negative personal and socioeconomic impact on women. The lack of data on this condition in several countries, particularly those in development and in socially and biologically vulnerable populations such as the indigenous, makes it difficult to guide public policies.
OBJECTIVE: To evaluate the prevalence of chronic pelvic pain (dysmenorrhea, dyspareunia, non-cyclical pain) and identify which variables are independently associated with the presence of the condition in indigenous women from Otavalo-
Ecuador.
METHODS: A cross-sectional study was carried out including a sample of 2429 women of reproductive age between 14 and 49 years old, obtained from April 2022 to March 2023. A directed questionnaire was used, collected by bilingual interviewers (Kichwa and Spanish) belonging to the community itself; the number of patients was selected by random sampling proportional to the number of women estimated by sample calculation. Data are presented as case prevalence, odds ratio, and 95% confidence interval, with p < 0.05.
RESULTS: The prevalence of primary dysmenorrhea, non-cyclic pelvic pain, and dyspareunia was, respectively, 26.6%, 8.9%, and 3.9%.all forms of chronic pain were independently associated with each other. Additionally, dysmenorrhoea was independently associated with hypertension, intestinal symptoms, miscegenation, long cycles, previous pregnancy, use of contraceptives and pear body shape. Pain in other sites, late menarche, exercise, and pear body shape were associated with non-cyclic pelvic pain. And, urinary symptoms, previous pregnancy loss, miscegenation, and pear body shape were associated with dyspareunia.
CONCLUSIONS: The prevalence of primary dysmenorrhea and non-cyclical chronic pelvic pain was notably high, in contrast with the frequency of reported dyspareunia. Briefly, our results suggest an association between dysmenorrhoea and conditions related to inflammatory and/or systemic metabolic disorders, including a potential causal relationship with other manifestations of pelvic pain, and between non-cyclical pelvic pain and signs/symptoms suggesting central sensitization. The report of dyspareunia may be influenced by local cultural values and beliefs.