Background: Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a rare congenital syndrome characterized by uterovaginal agenesis. Most patients are diagnosed during adolescence, when body image and sexual identity are shaped. Our main objective was to investigate how MRKH syndrome affects psychology, quality of life (QoL), and the sexual life of patients compared with non-affected individuals. Methods: Original peer-reviewed research papers examining psychological outcomes, QoL, and sexual function of MRKH patients were searched in PubMed. Titles, abstracts, and full text from potentially eligible records were reviewed by two independent reviewers. Case reports and papers published not in English were excluded. Results: Our search identified 63 records, of which 20 were included: 10 examined psychological and psychosocial outcomes, 14 examined sexual function outcomes, and 6 examined QoL outcomes. Results may be affected by selection bias and confounding due to differences between MRKH patients and controls. Conclusions: MRKH could be associated with a higher prevalence of anxiety and depression symptoms and social insecurity compared with women of a similar age without the condition. MRKH could also be associated with greater pain and discomfort during sexual intercourse and limitations in arousal, lubrication, and orgasm. MRKH patients more commonly experience impairment of mental-health-related QoL, but physical-health-related QoL is not affected.
The majority of young women will experience discomfort associated with menstrual cycles and miss out on education and social opportunities. Endometriosis, the presence of endometrial glands and stroma outside of uterus, is the most common cause of secondary dysmenorrhea and characterized by pain despite treatment with nonsteroidal anti-inflammatory drugs and hormonal agents. The true prevalence of adolescent endometriosis is not clear. Delay in diagnosis leads to persistent pain, affects quality of life, and potentially contributes to disease progression and subfertility. A laparoscopic diagnosis is the gold standard, but the surgical appearance may differ from adults, as endometriotic lesions are usually red or clear, making their identification a challenge for gynecologists who are unexperienced with endometriosis in adolescents. A personalized medical–surgical treatment is regarded as the most effective therapeutic strategy to achieve remission of symptoms, suppress disease progression, and protect future fertility. Studies have demonstrated how adolescent endometriosis negatively affects patients’ quality of life and psychosocial functioning. Development of therapeutic interventions targeting psychosocial function and quality of life is imperative for adolescent patients.
Background: Primary dysmenorrhea refers to the symptom of painful menstruation in the absence of identifiable pelvic or uterus pathology. Initial presentation usually occurs in adolescence and early adulthood. Medications used to treat primary dysmenorrhea include anti-inflammatory drugs, principally, ibuprofen and paracetamol. So far there has been no comparison of effectiveness and security profile between the two pharmaceutical substances. Objectives: Purpose of this prospective randomized crossover study was to compare the effectiveness and safety profile between those two pharmaceutical substances. Methods: In this clinical trial, 100 young women were included. The inclusion criteria was: a) age between 18–25 years old, b) no present or previous pelvic pathology, based on their medical history and an ultrasound examination which was performed in the 3–6th day of their menstrual circle, a month before the clinical trial. Vaginal discharge examination and also Papanicolaou test were held to exclude relevant pathology of the genital system. Participants were assessed and divided in two groups. The duration of the study was two months. The first group received ibuprofen for the first month and paracetamol for the second month while the second group received them vice versa (cross-over trial). Both groups filled in a questionnaire in regard to how they responded to each therapy. In addition, the security profile of the pharmaceutical drugs was compared as also their effect to the characteristics of menstruation and their probable side-effects. All participants filled in a questionnaire before the assignment into groups. For the comparison of the results, the 10% of the women with not painful menstruation, steadily every month, were removed and paired-samples t-test was used. Results: Ibuprofen has been proven as a safe and more effective therapeutic option than paracetamol in all parameters, when treating women with primary dysmenorrhea. After the administration of analgesics for the two following months, the comparison and statistical analysis of the new questionnaires revealed that, when Ibuprofen was compared to Paracetamol, the analgesic effectiveness was 98,9 and 91,1% respectively. Ibuprofen provided a maximum pain relief in 30 minutes – 53,3% of participants –when Paracetamol demonstrated the maximum pain relief in 60 minutes (64,4%). The pain was decreased “moderate” with the use of Paracetamol (37,8%) and “totally” with Ibuprofen (58,9%). The duration of analgesia with Ibuprofen was 4–8 hours –73,3% of participants– compared to 1–4 hours with Paracetamol (57,4%). Daily activity has been remarkably improved with the use of Ibuprofen (62%) compared to Paracetamol (only 9%). After the administration of Paracetamol 4% of the women appeared side-effects and none of the women appeared with the use of Ibuprofen. All the above results were statistically significant. Conclusions: Ibuprofen provides a significantly improved quality of life when compared to Paracetamol and no side effects have been noticed.
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