The Effect of Anterior Uterocervical Angle on Primary Dysmenorrhea and Disease Severity

Abstract

Background Primary dysmenorrhea, defined as painful menstrual cramps originating in the uterus without underlying pathology, is a gynecological disease that affects quality of life and school success. Our goal was to determine the effect of anterior uterocervical angle on primary dysmenorrhea and disease severity. Methods A total of 200 virgin adolescents, 16 to 20 years of age, were included in the study. The Andersch and Milsom scale was used to determine dysmenorrhea severity. Those with pathologies causing secondary dysmenorrhea were excluded from the study. Study subjects were grouped based on severity of pain. Demographic characteristics and uterocervical ultrasonographic measurements were compared among groups. Results Of the 200 participants enrolled in the study, 50 were healthy controls and 150 had primary dysmenorrhea. Those with primary dysmenorrhea had a significant family history of primary dysmenorrhea compared with controls (P < 0.001). Age (P=0.668), body mass index (P=0.898), menarche age (P=0.915), and length of menstrual cycles (P=0.740) were similar in all groups. The uterine corpus longitudinal axis, uterine corpus transverse axis, and uterine cervix longitudinal axis were also similar (P=0.359, P=0.279, and P=0.369, resp.). The mean uterocervical angle was 146.8 ± 6.0 in controls and 143.3 ± 7.3 in those with mild pain with no significant difference between the groups. In those with moderate pain, the mean uterocervical angle was 121.2 ± 7.3 compared with 101 ± 9.2 in those with severe pain, which was a significant difference. Additionally, there was also a significant difference in the uterocervical angle among those with mild, moderate, and severe pain (P < 0.001). Conclusion Our results indicate that a narrower anterior uterocervical angle is associated with primary dysmenorrhea and disease severity.

Relation between uterine morphology and severity of primary dysmenorrhea

“…When the literature is reviewed, there is not much study investigating the effect of uterine length and volume on dysmenorrhea severity. However, a few studies have tried concluding the relation between uterine dimensions and pain severity by measuring only two markers including uterine or cervix length ( 9 , 10 ) , although some only measured the uterocervical angle (UCA) and others evaluated the uterus and cervix length. Unlike other studies, in the current study, we evaluated many parameters, such as uterine and cervical lengths, uterine volume, and uterine and cervix thickness.…”

“…A study conducted by Sahin et al ( 9 ) has only tried to conclude dysmenorrheal severity by measuring the UCA. They showed that a narrow anterior UCA is associated with primary dysmenorrhea and disease severity.…”

“…The number of studies evaluating the relationship between dysmenorrhea and uterine shape and diameters are small ( 9 , 10 ) . A significant relationship was found between dysmenorrhea severity and uterus corpus and cervix measurements in most of the studies.…”

Perception of Menstrual Normality and Abnormality in Spanish Female Nursing Students

“…The Andersch and Milsom Scale was also used to determine the severity of dysmenorrhea according to the following grades: grade 0 (menstruation is not painful and daily activity is unaffected), grade 1 (menstruation is painful but seldom inhibits normal activity, analgesics are seldom required and mild pain), grade 2 (daily activity affected, analgesics required and give relief so that absence from work or school is unusual and moderate pain), and grade 3 (activity clearly inhibited, poor effect of analgesics, vegetative symptoms, and severe pain). Four closed questions were included on: pain intensity (not painful/mild pain/moderate pain/severe pain), working ability (unaffected/rarely affected/moderately affected/clearly affected/clearly inhibited), systemic symptoms (none/few/apparent), need for analgesia (not required/rarely required/required/poor effect) [ 18 , 30 , 31 , 32 , 33 ]. Normal menstrual characteristics were considered regular cycles of 24 to 38 days, with bleeding lasting 4.5 to 8 days, and with 5 to 80 mL blood flow [ 1 , 2 ].…”

Dysmenorrhea and Associated Factors among Polish Women: A Cross-Sectional Study

“…However, it is known that susceptibility to dysmenorrhea may be associated with genetic factors [ 11 – 13 ]. It is also known that the occurrence of dysmenorrhea in women is associated with an elevated secretion of prostaglandins and other inflammatory factors [ 3 , 14 , 15 ]. Prostaglandins stimulate excessive contractile function of the uterus, that leads to the reduction of blood flow and hypoxia of this organ.…”