How does my pain look like? Characterizing dysmenorrhea-related pain using the body map

Rodrigues, Jéssica Cordeiro; Avila, Mariana Arias; Reis, Felipe José Jandre dos; Degani, Adriana Menezes; Tavares de-Arruda, Guilherme; Driusso, Patricia

doi:10.5935/2595-0118.20230042-en

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ORIGINAL ARTICLE • BrJP 6 (2) • Apr-Jun 2023 • https://doi.org/10.5935/2595-0118.20230042-en copy

How does my pain look like? Characterizing dysmenorrhea-related pain using the body map

Authorship SCIMAGO INSTITUTIONS RANKINGS

HIGHLIGHTS

The correct assessment of dysmenorrhea-related pain is crucial to determine the best interventions to each case; pain is usually assessed by using many instruments, including body map (or pain drawing) in several diseases.
The use of body map to characterize dysmenorrhea-related pain showed that, during their menstrual cycle, women with primary dysmenorrhea showed pain not only on their lower abdomen, but also on their back and head.
We strongly recommend the clinical use of self-report body map to evaluate menstrual pain and help health providers to improve primary dysmenorrhea symptoms in this population.

ABSTRACT

BACKGROUND AND OBJECTIVES:

Primary dysmenorrhea (PD) is a common gynaecological disorder characterized by pain in the abdominal region without pelvic disease. Evidence suggests that PD-related pain may not be restricted to the pelvis region, hence body mapping could be helpful in assessing the subjective location, intensity, and distribution of pain areas in women with PD. The objective of this study was to characterize dysmenorrhea-related pain location and intensity using body map.

METHODS:

We conducted a web-based cross-sectional study for adult women to self-report menstrual pain during three menstrual cycles. Each participant was instructed through a messaging application to paint the body map after printing it and rank their pain according to the 11-point Numerical Rating Scale.

RESULTS:

Seventy-three women (24.1 ± 3.0 years) participated in the study. A considerable proportion of participants reported pain in the lower abdomen (90.4%) and other body areas, such as the lower back (82.1%), head (54.6%), breasts (32.9%), upper abdomen (31.5%), and legs (28.8%).

CONCLUSION:

Our findings revealed that women with PD also present pain outside the uterine referral area during their period. In this way, body maps can help healthcare professionals to record specific regions of pain and track changes or patterns in the location or intensity pain during menses, helping to determine treatment strategies appropriate to the individual needs of each woman with PD. Therefore, we strongly recommend the clinical use of the self-report body map to evaluate menstrual pain and help health providers to improve PD symptoms in this population.

Keywords
Dysmenorrhea; Pain; Women’s health

Sociodemographic characteristics
Age (years, SD)	24.1±3.0 years
Education (n, % of women)
High school	36 (49.3%)
College	34 (46.5%)
Not declared	3 (4.1%)
Clinical characteristics
Menstrual cycle length (days, SD)	28.2±3.4 days
Menstrual flow (n, %)
Light	12 (16.4%)
Moderate	43 (58.9%)
Intense	17 (23.2%)
Not declared	1 (1.3%)
Duration of menstrual flow (n, %)
Up to 3 days	7 (9.5%)
3 to 5 days	48 (65.7%)
More than 5 days	18 (24.6%)
Not declared	0 (0%)
Dysmenorrhea-related pain intensity in a 0-10 scale (points, SD)	6.6±1.8 points
Duration of menstrual cramps (n, %)
Less than 24 hours	26 (35.6%)
24 hours to 48 hours	33 (45.2%)
48 hours to 72 hours	14 (19.1%)
Not declared	0 (0%)
Use of drugs for dysmenorrhea (n, %)
Yes	61 (83.5%)
No	12 (16.4%)

Body area	n (%) of participants from the total sample	Number of participants
Body area	n (%) of participants from the total sample	NRS < 4	NRS ≥ 4
Head	40 (54.7%)^* * Means percentage of women reporting dysmenorrhea-related pain above 25%	25 out of 40 (62.5%)	15 out of 40 (37.5%)
Neck	8 (10.9%)	6 out of 8 (75.0%)	2 out of 8 (25.0%)
Shoulder	12 (16.5%)	8 out of 12 (66.7%)	4 out of 12 (33.3%)
Arm	6 (8.2%)	5 out of 6 (83.3%)	1 out of 6 (16.7%)
Hand	4 (5.5%)	4 out of 4 (100.0%)	0 out of 4 (0.0%)
Breasts	24 (32.9%)^* * Means percentage of women reporting dysmenorrhea-related pain above 25%	18 out of 24 (75.0%)	6 out of 24 (25.0%)
Upper abdomen	23 (31.5%)^* * Means percentage of women reporting dysmenorrhea-related pain above 25%	14 out of 23 (60.9%)	9 out of 23 (39.1%)
Lower abdomen	66 (90.4%)^* * Means percentage of women reporting dysmenorrhea-related pain above 25%	16 out of 66 (24.2%)	50 out of 66 (75.8%)
Upper back	7 (9.5%)	5 out of 7 (71.4%)	2 out of 7 (28.6%)
Lower back	60 (82.2%)^* * Means percentage of women reporting dysmenorrhea-related pain above 25%	22 out of 60 (36.7%)	38 out of 60 (63.3%)
Gluteus	18 (24.7%)	14 out of 18 (77.8%)	4 out of 18 (22.2%)
Hip	15 (20.5%)	10 out of 15 (66.7%)	5 out of 15 (33.3%)
Thigh	15 (20.5%)	10 out of 15 (66.7%)	5 out of 15 (33.3%)
Knee	6 (8.2%)	4 out of 6 (66.7%)	2 out of 6 (33.3%)
Popliteal fossa	6 (8.2%)	6 out of 6 (100.0%)	0 out of 6 (0.0%)
Leg	21 (28.8%)^* * Means percentage of women reporting dysmenorrhea-related pain above 25%	17 out of 21 (81.0%)	4 out of 21 (19.0%)
Ankle	6 (8.2%)	4 out of 6 (66.7%)	2 out of 6 (33.3%)
Foot	7 (9.6%)	6 out of 7 (85.7%)	1 out of 7 (14.3%)

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[1] Conflict of interests: none