Musa BÜYÜK, Kamuran SUMAN, Ebru GÖK, Pınar BÜTÜN, Zafer BÜTÜN, Murat SUMAN

Primer Dismenorede D Vitaminin Rolü

Primer dismenore, pelvik hastalık olmaksızın menstrüasyon sırasında veya öncesinde ortaya çıkan ve suprapubik ağrıya neden olan uterus kramplarıdır. Dismenore nedenlerini araştırırken, birkaç çalışma D vitamini (vit D) eksikliğinin rolünü vurgulamıştır. Vit D, ağrıya neden olan prostaglandinlerin sentezini baskılayarak etki eder. Çalışmamızın amacı D vitamini düzeyinin primer dismenoreyi etkileyip etkilemediğini araştırmaktır. Bu amaçla primer dismenoresi olan hastalarda ve dismenoresi olmayan kontrol grubunda vit D 3 düzeyi çalışılacaktır. Bu retrospektif, randomize, vaka kontrollü çalışma, Ocak 2020 ile Ağustos 2021 arasında iki farklı merkezde gerçekleştirildi. Etik kurul tarafından onaylandı. Bilgi, çalışma için uygun deneklerle görüşülerek elde edildi ve bilgilendirilmiş onam alındı. Araştırmaya katılan merkezlerin jinekoloji bölümlerine 750 kadın başvurdu. 16-35 yaş arası araştırmaya dahil edilmiştir. Pediatri kliniklerinden benzer semptomlarla 18 yaş altı hasta sevk edildi. 325 kadın dismenore grubuna atandı. Tüm hastalarda düzenli bir adet döngüsü ve adetten bir gün önce başlayan ağrı vardı. Dismenore ile ilgisi olmayan 325 hasta kontrol grubu olarak rastgele seçildi. Çalışmamızdaki katılımcılar dismenore grubu ve kontrol grubu olarak rastgele seçilmiş ve klinik özellikleri Tablo 1 ve 2'de karşılaştırılmıştır. Dismenore hastaları ile sağlıklı kontrol grupları karşılaştırıldığında anlamlılık dikkat çekiciydi. 25-hidroksivitamin D3 eksikliği olan dismenore hastalarının süt ürünlerini önemli ölçüde daha az tükettiği görülmüştür.Bu gurupta VAS değerleri daha yüksekti ve yetersiz eğitim ve işsizlik de önemli ölçüde daha yaygındı. Düşük serum D vitamini seviyeleri ve dismenore güçlü bir şekilde ilişkilidir. D vitamini düzeyleri, VAS skoru ve primer dismenore arasında anlamlı bir ilişki olduğu açıktır. Primer dismenorede vit D'nin etkinliğinin altını çizmek için daha büyük ölçeklerde daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler:

D Vitamini, Primer Dismenore, Süt Ürünleri

Vitamin D Role in Primary Dysmenorrhea

Primary dysmenorrhea is uterine cramping that occurs during or before menstruation without pelvic disease and causes suprapubic pain. In researching the causes of dysmenorrhea, several studies have highlighted the role of lacking vitamin D (vit D). Vit D acts by suppressing the synthesis of prostaglandins that cause pain. Our study aims to investigate whether vit D level affects primary dysmenorrhea. For this purpose, vit D 3 level will be studied in patients with primary dysmenorrhea and a control group without dysmenorrhea. This retrospective, randomized, case-controlled study was conducted between January 2020 and August 2021 at two different centers. It was approved by the ethics committee. Information was obtained by interviewing eligible subjects for the study, and informed consent was obtained. 750 women presented to the gynecology departments of the participating centers involved in the study. Ages between 16-35 are included in the study. Under 18 patients were referred from pediatric clinics with similar symptoms. 325 women were assigned to the dysmenorrhea group. All patients had a regular menstrual cycle and pain that began the day before menstruation. 325 patients unrelated to dysmenorrhea were selected randomly as a control group. The participants in our study were randomly selected into the dysmenorrhea group and the control group, and their clinical characteristics were compared in Tables 1 and 2. Significance was remarkable comparing the dysmenorrhea patients with the healthy control groups. That dysmenorrhea patients with 25-hydroxyvitamin D3 deficiency had significantly less consumption of dairy products. VAS values were higher, and undereducation and unemployment were also significantly more common. Low serum vit D levels and dysmenorrhea are strongly related. It is obvious that there is a significant relationship between vit D levels, VAS score, and primary dysmenorrhea. More studies at larger scales are needed to underline the efficiency of vit D in primary dysmenorrhea.

Keywords:

Vitamin D, Primary Dysmenorrhea, Dairy Products,

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1. Pakniat H, Chegini V, Ranjkesh F, et al. Comparison of the effect of vitamin E, vitamin D and ginger on the severity of primary dysmenorrhea: a single-blind clinical trial. Obstet Gynecol Sci. 2019;62(6):462-8.
2. Abdi F, Amjadi MA, Zaheri F, et al. Role of vitamin D and calcium in the relief of primary dysmenorrhea: a systematic review. Obstet Gynecol Sci. 2021;64(1):13-26.
3. Abdul‐Razzak KK, Ayoub NM, Abu‐Taleb AA, et al. Influence of dietary intake of dairy products on dysmenorrhea. J. Obstet. Gynaecol. Res. 2010;36(2):377-83.
4. Roy S. A review on the efficacy of fish oil and its components in alleviating the symptoms of primary dysmenorrhea. BLDE Univ J Health Sci. 2022;7(1):19.
5. Karacin O, Mutlu I, Kose M, et al. Serum vitamin D concentrations in young Turkish women with primary dysmenorrhea: a randomized controlled study. Taiwan J Obstet Gynecol. 2018;57(1):58-63.
6. Ayşegül Ö, Seda A, Şevket O, et al. A randomized controlled study of vitamin D in the treatment of primary dysmenorrhea. Duzce Med J. 2019;21(1):32-6.
7. Yu A. Complementary and alternative treatments for primary dysmenorrhea in adolescents. Nurse Pract. 2014;39(11):1-12.
8. Zarei S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, et al. Effects of calcium-Vitamin D and calcium-alone on pain intensity and menstrual blood loss in women with primary dysmenorrhea: A randomized controlled trial. Pain Med. 2017;18(1):3-13.
9. Naz MSG, Kiani Z, Fakari FR, et al. The effect of micronutrients on pain management of primary dysmenorrhea: a systematic review and meta‐analysis. J. Caring Sci. 2020;9(1):47.
10. Dawood MY. Primary dysmenorrhea: advances in pathogenesis and management. Obstet Gynecol. 2006;108(2):428-41.
11. Charandabi SMA, Mirghafourvand M, Nezamivand-Chegini S, et al. Calcium with and without magnesium for primary dysmenorrhea: a double-blind randomized placebo controlled trial. Int J Women’s Health Repro Sci. 2017;5(4):332-8.
12. Ferries-Rowe E, Corey E, Archer JS. Primary dysmenorrhea: diagnosis and therapy. Obstet Gynecol. 2020;136(5):1047-58.
13. Abdul-Razzak KK, Obeidat BA, Al-Farras MI, et al. Vitamin D and PTH status among adolescent and young females with severe dysmenorrhea. J Pediatr Adolesc Gynecol. 2014;27(2):78-82.
14. Bahrami A, Avan A, Sadeghnia HR, et al. High dose vitamin D supplementation can improve menstrual problems, dysmenorrhea, and premenstrual syndrome in adolescents. Gynecol Endocrinol. 2018;34(8):659-63.
15. Kulzhanova D, Amanzholkyzy A, Saparbaev S, et al. Vitamin D status in adolescent girls with primary dysmenorrhea. Issued since 1920. 2021;57(2):17.
16. Nasehi M, Sehhatie F, Zamanzadeh V, et al. Comparison of the effectiveness of combination of fennel extract/vitamin E with ibuprofen on the pain intensity in students with primary dysmenorrhea. Iran J Nurs Midwifery Res. 2013;18(5):355.
17. Kannan P, Cheung K-K, Lau BW-M. Does aerobic exercise induced-analgesia occur through hormone and inflammatory cytokine-mediated mechanisms in primary dysmenorrhea? Med Hypotheses. 2019;123:50-4.
18. Rajput V. An overview on dysmenorrhea. Int. J. Nurs. Educ. 2021;9(3):381-4.
19. Zarei S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, et al. Effects of calcium-vitamin D and calcium alone on pain intensity in women with primary dysmenorrhea: a randomized controlled trial. Pain Med. 2017;18(1):3-13.
20. Durain D. Primary dysmenorrhea: assessment and management update. J Midwifery Womens Health. 2004;49(6):520-8.
21. Núñez-Troconis J, Carvallo D, Martínez-Núñez E. Primary Dysmenorrhea: pathophysiology. Investig Clin. 2021(4):378-406.