The purpose of this project is to know the effectiveness of an intervention based on the consumption of fresh strawberries from the Huelva region on menstrual pain and menstrual distress in young university students with primary dysmenorrhea, compared to a control group of students. The participants with dysmenorrhea will be divided into two groups, the assignment will be random to the intervention group with strawberry intake for a month and comparing its effect with de control group. The results of the evaluations carried out prior, to the month and 2 months of the intervention will be compared.
Dysmenorrhea is a prevalent problem among women of childbearing age; previous studies carried out among young university students have identified that it affects 74% of them. Dysmenorrhea can also be accompanied by the well-known menstrual distress, which has been estimated to affect between 75 and 94% of women. The symptoms included in menstrual distress are diverse, including irritability, nausea, vomiting, abdominal pain, general weakness or fatigue, among others. Dysmenorrhea and distress have a significant impact on the lives of women who suffer from it, affecting their social life, quality of life and academic and work performance. The methods that women use to relieve dysmenorrhea are usually pharmacological, with NSAIDs (Non Steroidal Anti-Inflammatory Drugs) and hormonal contraceptives, but these are not free of adverse effects, so more and more studies are investigating non-pharmacological methods to relieve pain. Menstrual distress is also being included as an object of study. A healthy lifestyle has been shown to be beneficial in relieving primary dysmenorrhoea. In particular, exercise and eating at least 2 pieces of fruit per day have been identified as protective habits. Most of the studies that evaluate food intake in women with dysmenorrhea are observational and the few clinical trials that exist are with small samples. Strawberries are rich in flavonoids and phenolic acids, giving them anti-inflammatory and antioxidant properties. Studies carried out with strawberries have shown their benefits against chronic inflammatory and cardiovascular diseases. For these reasons, it is necessary a clinical trial to evaluate the benefits of strawberry in relieving dysmenorrhea and menstrual distress. Carrying out a clinical trial with strawberries is a challenge. Firstly, there is no consensus on the optimal dose that should be ingested to influence health biomarkers. On the other hand, the use of fresh strawberries involves a significant cost, in addition to the fact that it is a seasonal fruit, which is why the most of trials with strawberries are carried out with freeze-dried strawberry powder. The aim of this study is to analyze the benefits of strawberry consumption in relieving menstrual pain using the VAS (Visual Analogue Scale) scale and menstrual distress using the MEDI-Q scale, previously validated in Spanish in a previous phase of the study in female university students. The results obtained will be compared between the intervention group belonging to the intake of strawberry (specifically the "Fortuna" variety) and with a control group that will continue with their usual diet during the same period of time. They will be evaluated previously, one month and two months after receiving the intervention. The project has been approved by the Andalusian Ethics and Research Committee. For the design of the clinical trial, previous studies on food intake and dysmenorrhea, as well as studies on the health benefits of strawberries, have been taken into account. The "Fortuna" strawberry variety will be provided by the association Fres Huelva and must be eaten daily for a month. Participants will be provided with a menstrual diary in order to avoid forgetfulness bias. Participants who are part of the intervention group will be invited to participate in focus groups in order to know about their experiences during the trial. Our hypothesis is that women who regularly consume strawberries in their diet will improve their pain intensity and levels of menstrual distress, as well as other symptoms associated with dysmenorrhea.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
64
This is an intervention based on the intake of strawberry, specifically the "Fortuna" variety. This intervention is based on the intake of 250 g of fresh strawberries per day for a month. The amount and duration of strawberry intake has been consulted in other studies carried out with strawberries.
Universidad de Huelva
Huelva, Spain
Pain intensity
Pain intensity will be evaluated with the Visual Analog Scale (VAS). This is a self-administered, single-item measurement scale. Located on a horizontal or vertical line 10 cm (100mm) long, whose values range from 0 ("no pain") to 10 ("the worst pain imaginable"). Participants will be asked to write down the maximum perceived pain during the first 3 days of menstruation.
Time frame: Change from baseline pain intensity at 1 month and 2 months.
Distress menstrual
Menstrual distress will be assessed using the MEDI-Q scale, which will be validated in Spanish in a previous phase of this study. This questionnaire evaluates symptoms in the premenstrual, menstrual and intermenstrual phases through a total of 25 items. The score ranges between 0 (absence of symptoms that cause distress during menstruation in the last year) and 125 (presence of all symptoms in more than half of menstruations in the last 12 months).
Time frame: Change from baseline distress menstrual at 1 month and 2 months.
Changes in Quality of life
To assess quality of life, EuroQol-5D (EQ-5D) will be used. It is an element for measuring HRQoL (health-related quality of life) that measures 5 dimensions of health (mobility, personal care, usual activities, pain and discomfort and, finally, anxiety and depression). In the first part, the participant must evaluate their health status through the dimensions, the second part must evaluate their health status through a visual analog scale from 0 (worst imaginable health status) to 100 (best imaginable health status).
Time frame: Baseline, 1 month and 2 months.
Anxiety State and Anxiety Trait
Anxiety will be measured through the Spanish version of the State/Trait Anxiety Inventory (STAI), made up of the Anxiety/State and Anxiety/Trait scales, with 20 items each and a Likert-type response from 0 (not at all) to 3 (very much), obtaining a total score between 0 and 60. A higher score indicates a higher level of anxiety.
Time frame: Baseline, 1 month and 2 months.
Perceived well-being
Well-being will be measured with the Spanish version of the Warwick-Edinburgh Mental Well-being Scale (EBMWE). This scale consists of 14 items, with a Likert-type response option from 1 to 5. With a total score range between 14 and 70, a higher score indicates greater mental well-being.
Time frame: Baseline, 1 month and 2 months.
Sleep quality
Sleep quality will be measured with the Pittsburgh Sleep Quality Index (PSQI). It is a self-report scale to assess sleep quality divided into 7 parts with 19 items, associated in 10 questions, each of which is scored between 0 (ease) and 3 (severe difficulty). The total score ranges from 0 (ease of sleeping) to 21 (difficulty in all areas).
Time frame: Baseline, 1 month and 2 months.
Changes amount of bleeding
Changes in the amount of bleeding will be measured through questions about the number of sanitary towels at day in relation to the last menstruation.
Time frame: Baseline, 1 month and 2 months.
Changes menstrual issues
Menstrual issues will be assessed through questions about days of menstruation, and length of cycle (in days) in relation to the last menstruation.
Time frame: Baseline, 1 month and 2 months.
Changes in menstrual pain management
Questions will be asked to know the method used to relieve menstrual pain; in the case of pharmacological pain relief, the dose and type of drug, and the effectiveness of the method will be asked.
Time frame: Baseline, 1 month and 2 months.
Changes in absenteeism and presenteeism days
Absenteeism and presenteeism will be consulted, through questions regarding the number of days that absenteeism or presenteeism has occurred in relation to the last menstruation.
Time frame: Baseline, 1 month and 2 months.
The impact on daily and academic activities
The impact on daily and academic activities will be evaluated with specific questions that will be answered on a scale of 0-10 (where 0 is not having a limitation and 10 is the impossibility of doing it) in relation to different situations and activities with respect to the last menstruation
Time frame: Baseline, 1 month and 2 months.
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