The Menstrual Disorder of Teenagers (MDOT) Study No. 2: Period ImPact and Pain Assessment (PIPPA) Tool Validation in a Large Population-Based Cross-Sectional Study of Australian Teenagers

Parry

Curry

et al. 2022

Preprint

Menstrual cycle-related conditions, such as dysmenorrhea and heavy bleeding, are common amongst those under 25. Despite having significant impact on work, education, and social activities, most do not seek medical advice, preferring to self-manage their symptoms. We aimed to determine if access to a web-based resource could improve health literacy, reduce menstrual symptoms, and encourage health-seeking behaviour in those at risk of conditions such as endometriosis. People were eligible to participate if they were currently living in Australia, aged 14-25 yrs and had menstruated for at least 12 months. Access to the resource was for three menstrual cycles. Seventy-five participants with a mean age of 20.4 years enrolled to use the web-based resource. Forty-three percent visited their doctor regarding their menstrual symptoms during the study period, with 84% indicating that they made the appointment due to the resource; over half (56%) who visited their doctor received a referral to a gynaecologist. There were clinically relevant improvements in health literacy reflecting improved confidence of participants regarding having adequate information and skills to manage their symptoms. A low-cost, web-based resource can improve health literacy, provide effective options for self-management of menstrual cycle-related conditions, and motivate young people to see medical advice.

Section: Methodsmentioning

confidence: 99%

Evaluation of a Web-Based Resource to Improve Menstrual Health Literacy and Self- Management in Young Women

Parry

Curry

et al. 2022

Preprint

“…This tool may also be enhanced by adding other diagnostic, clinical information and demographics, which may be derived from large disease registries such as the National Endometriosis Clinical and Scientific Trials (NECST) Registry (see below). In young women, early screening of menstrual disturbance with tools such as the Period ImPact and Pain Assessment (PIPPA) tool (Parker, Kent, Sneddon, Wang, & Shadbolt, 2021) and a stepped pathway of first line treatment and emphasis on healthy lifestyle measures provides a lower cost diagnostic pathway for early management of painful periods and possible endometriosis. Given that over 50% of young women in Australia report regular non-menstrual pelvic pain (Armour, Ferfolja, et al, 2020), early screening and subsequent diagnosis, if warranted, is vital.…”

Section: The Changing Landscape Of Diagnosismentioning

confidence: 99%

“…In young women, early screening of menstrual disturbance with tools such as the Period ImPact and Pain Assessment (PIPPA) tool ( Parker et al 2021 ) and a stepped pathway of first-line treatment and emphasis on healthy lifestyle measures provides a lower-cost diagnostic pathway for the early management of painful periods and possible endometriosis. Given that over 50% of young women in Australia report regular non-menstrual pelvic pain ( Armour et al 2020 a ), early screening and subsequent diagnosis, if warranted, are vital.…”

Section: The Changing Landscape Of Diagnosismentioning

confidence: 99%

Lessons from implementing the Australian National Action Plan for Endometriosis

Reproduction and Fertility

Leonardi

Niekerk

et al. 2022

Endometriosis is a common yet under-recognised chronic disease with 1 in 9 (more than 830,000) women and those assigned female at birth diagnosed with endometriosis by the age of 44 years in Australia. In 2018 Australia was the first country to develop a roadmap and blueprint to tackle endometriosis in a nationwide, co-ordinated manner. This blueprint is outlined in the National Action Plan for Endometriosis (NAPE), created from a partnership between government, endometriosis experts and advocacy groups. The NAPE aims to improve patient outcomes in the areas of awareness and education, clinical management and care and research. As researchers and clinicians working to improve the lives of those with endometriosis, we discuss our experiences since the launch of the plan to highlight areas of consideration by other countries when developing research priorities and clinical plans. Historically, major barriers for those with endometriosis have been twofold; firstly, obtaining a diagnosis and secondly, effective symptom management post-diagnosis. In recent years, there have been calls to move away from the historically accepted “gold-standard” surgical diagnosis and single provider specialist care. As there are currently no reliable biomarkers for endometriosis diagnosis, specialist endometriosis scans and magnetic resonance imaging incorporating artificial intelligence offer a novel method of visualisation and promising affordable non-invasive diagnostic tool incorporating well established technologies. The recognised challenges of ongoing pain and symptom management, a holistic interdisciplinary care approach and access to a chronic disease management plan, could lead to improved patient outcomes while reducing healthcare cost.

“…Participants then completed baseline measures after their next menstrual period and subsequently provided with web-resource login and password. The Period ImPact and Pain Assessment (PIPPA) tool was previously developed to assist young women to determine normal from atypical period pain and interference [4,21]. At baseline, all participants lled in an online version of the PIPPA tool, which asked ve Y/N questions regarding the impact of their menstrual symptoms.…”

Section: Participants Recruitment and Study Owmentioning

confidence: 99%

“…A 5-item dichotomous Yes/No survey to measure pain and interference related menstrual disturbance. [4,21] Baseline Descriptive statistics, including frequencies and percentages, means and standard deviations, or median and interquartile range (IQR), were used to report recruitment and dropout rates and demographics information. All outcomes were determined a priori, and as this was a pilot study, all p-values are considered exploratory.…”

Section: Trial Exit Questionaairementioning

confidence: 99%

Using an online intervention to improve menstrual health literacy and self-management in young women: a pilot study

Parry

Curry

et al. 2021

Preprint

Introduction Menstrual cycle-related conditions, such as dysmenorrhea and heavy bleeding, are common amongst those under 25. Despite having significant impact on work, education and social activities, most do not seek medical advice, preferring to self-manage their symptoms. This pilot pre- and post-test study aimed to determine if a web-based intervention could improve health literacy, reduce menstrual symptoms, and encourage health-seeking behaviour in those at risk of conditions such as endometriosis. Methods A steering group of menstrual health experts, young women and teachers developed a web-based resource containing two sections: information on the menstrual cycle, including conditions such as dysmenorrhea; and self-management strategies including yoga, meditation, dietary advice, heat and acupressure. Recruitment was via social media. The intervention was undertaken for three menstrual cycles. Outcomes were collected on health literacy measures, doctors’ visits, symptom severity and self-care usage. Results Seventy-five women with a mean age of 20.4 years enrolled in the web-based resource, and 56 (75%) completed the intervention. Forty-three percent visited their doctor regarding their menstrual symptoms during the study period, with 84% indicating that they made the appointment due to the intervention; over half (56%) who visited their doctor received a referral to a gynaecologist. Self-care usage increased with 60% reporting changes in the way they managed their menstrual symptoms. There were clinically relevant improvements in health literacy reflecting improved confidence of participants regarding adequate information and skills to manage their symptoms. Almost half (48.8%) said the intervention had changed what they thought was a ‘normal’ period and over a third (35%) said it corrected previous misunderstandings they had about periods and the menstrual cycle. Ninety-four percent could identify the symptoms of endometriosis after using the intervention. Conclusion A low-cost, web-based intervention can improve health literacy, provide effective options for self-management of menstrual cycle-related conditions and motivate young women to see medical advice.