Cyclic perimenstrual pain and discomfort: The scientific basis for practice

Objective: To review and organize the science related to cyclic perimenstrual pain and discomfort for the fifth research-based practice project of the Association of Women's Health, Obstetric and Neonatal Nurses. Data Sources: Computerized searches in CINAHL, MEDLINE, and the Cochrane Library as well as hand searches of cited references. Keywords included cyclic pelvic pain, comfort, pain guidelines, and dysmenorrhea. Data Extraction: All relevant articles prior to 1999 were considered. Thirty-three research-based articles (1992-1999) were reviewed for relevance by the science team as part of the fifth research-based practice project of the Association of Women's Health, Obstetric and Neonatal Nurses. Data Synthesis: The literature review and synthesis resulted in a cogent description of cyclic perimenstrual pain and discomfort and the development of three nursing diagnoses: perimenstrual cyclic pelvic pain, perimenstrual discomfort, and perimenstrual negative affect. Cyclic pelvic pain is a new concept, developed by the science team during the project. Perimenstrual cyclic pelvic pain is an acute, subjective experience defined by pelvic pain that presents in a repeating time frame associated with the menstrual cycle. It is usually clustered with other discomforts and appreciably affects a woman's quality of life. Because the science about interventions is complex and extensive, data synthesis led to organization of the interventions within seven categories. Conclusions: Translation of research into practice is essential. Cyclic perimenstrual pain and discomfort is an important clinical issue, yet the science had not previously been comprehensively reviewed with the mission to translate it for nursing practice. Translation of this complex literature was accomplished though an innovative clinical practice guideline and subsequently evaluated in nursing practice through the research-based practice project.