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Is your menstrual pain “normal”?

Written by Mansi Patel

It can be argued that, in part under the influence of patriarchy, women may have felt the need to suppress their emotions and behave according to accepted gender norms (1,2). For instance, women may tend to default to an assumption that their level of menstrual pain is average and expected (2). This may limit the potential for women to benefit from helpful diagnoses and treatments to alleviate menstrual pain (1).

The diagnosis of dysmenorrhea is based on severe and frequent pain in the lower abdomen that may radiate to the inner thighs and back during the menstrual cycle (3). Other symptoms include vomiting, diarrhea, and even fainting (3). There is evidence that most women fitting these characteristics (up to 86%) in the U.S. do not seek care (1).

Reasons to consider seeking care include the potential for correctable pathophysiologies such as secondary dysmenorrhea or treatable associated conditions such as endometriosis or ovarian cysts (4). Endometrial ablation, destruction of the uterine lining, or hysterectomy (removal of the uterus) may be available treatment options to prevent further complications of any underlying conditions (3).

Given that most menstrual pain is not pathological, it can also be helpful for women to be aware of simple techniques they can use to alleviate menstrual pain. For instance, numerous randomized trials have demonstrated the effectiveness of relaxation exercises for alleviation of symptoms of primary dysmenorrhea, mostly within four weeks, compared to control groups receiving no intervention or regular care (5).Nonsteroidal medications can also help alleviate symptoms (3,5).

Accommodation and personal health agency are effective health strategies that are helpful no matter the diagnosis identified, and treatment selected. Women can be aware of the option of medical care to be sure specific treatable pathophysiologies are not overlooked. Beneath what may appear to be part of an expected monthly cycle that women accommodate, there is the option to seek care or try treatments at home. Before assuming nothing can be done for strong menstrual pain, think twice!

References:
1. Chen CX, Shieh C, Draucker CB, Carpenter JS. Reasons women do not seek health care for dysmenorrhea. J Clin Nurs. 2018; 27: e301–e308. https://doi.org/10.1111/jocn.13946

2. Getahun, S. B., Berhe, S., Mekonnen, B., & Melaku, G. (2023). Reasons for Not Seeking Healthcare Among Students with Dysmenorrhea: A Qualitative Study. International journal of women’s health, 15, 1733–1744. https://doi.org/10.2147/IJWH.S437233

3. John Hopkins Medicine. “Dysmenorrhea” https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysmenorrhea

4. Coco A. S. (1999). Primary dysmenorrhea. American family physician, 60(2), 489–496.

5. Tsai, I. C., Hsu, C. W., Chang, C. H., Lei, W. T., Tseng, P. T., & Chang, K. V. (2024). Comparative Effectiveness of Different Exercises for Reducing Pain Intensity in Primary Dysmenorrhea: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. Sports medicine – open, 10(1), 63. https://doi.org/10.1186/s40798-024-00718-4

Is eating raw eggs good for you, and can it help build muscle?

Recent social media trends have shown influencers consuming raw eggs, particularly after workouts. That has been popular at times over the years, and was featured in the original Rocky movie. It has returned and become a phenomenon to include raw eggs in protein shakes or smoothies. However, given the potential consequences of eating raw eggs, it is important to think twice about this issue. Is it good for you to eat raw eggs, and can it really help build muscle mass?

According to the Cleveland Clinic, it is not safe to consume raw eggs under any circumstance (1). Most eggs are pasteurized, meaning they are heated in a warm water bath to kill bacteria that could make you sick. However, even pasteurized eggs can still contain Salmonella, which can lead to diarrhea, cramps, or more serious illness. In a 2019 report by the European Food Safety Authority, eggs and egg products comprise 5.3% of all foodborne Salmonella outbreaks and are the foods most commonly associated with Salmonella (2). Therefore, physicians recommend eating eggs that are both pasteurized AND cooked.

Another reason physicians recommend not consuming raw eggs is that you can receive the same benefits from eating a cooked egg. One study compared muscle growth in 45 young men randomly assigned to consume 5 raw eggs or 5 hard boiled eggs after exercise (3). Between the two groups, researchers found no significant difference in muscle protein synthesis rates between young men who ate raw versus hard boiled eggs, suggesting that eating raw eggs did not offer an advantage for building muscle.

In this vein, another study showed that raw egg is more poorly absorbed during digestion than cooked egg, and cooking eggs can facilitate more complete digestion (4). However, this study investigated digestion of 5 participants, so more research is needed to conclude how raw versus cooked eggs are digested. Nevertheless, cooking is known to increase digestion of many foods.

Given this research, you don’t need to follow influencers by consuming raw eggs or put them in protein shakes to build muscle mass. A hard- boiled egg will do the trick! Remember to always Think Twice!

Sources

Cleveland Clinic. “Is Eating Raw Eggs Bad?” April 6, 2022. https://health.clevelandclinic.org/can-you-eat-raw-eggs

Oh, Hyemin et al. “Quantitative risk assessment of foodborne Salmonella illness by estimating cooking effect on eggs from retail markets.” Journal of animal science and technology vol. 65,5 (2023): 1024-1039. doi:10.5187/jast.2023.e18

Fuchs, Cas J et al. “Raw Eggs To Support Postexercise Recovery in Healthy Young Men: Did Rocky Get It Right or Wrong?.” The Journal of nutrition vol. 152,11 (2022): 2376-2386. doi:10.1093/jn/nxac174

Evenepoel P, Geypens B, Luypaerts A, Hiele M, Ghoos Y, Rutgeerts P. Digestibility of cooked and raw egg protein in humans as assessed by stable isotope techniques. J Nutr. 1998 Oct;128(10):1716-22. doi: 10.1093/jn/128.10.1716. PMID: 9772141.

Can cranberry juice treat urinary tract infections?

Over Thanksgiving, we might indulge in cranberry sauce or cranberry juice as part of our holiday traditions. While some love cranberry products and others do not, are there benefits to consuming cranberries? Specifically, can cranberry juice prevent urinary tract infections?

Urinary tract infections (UTIs) are bacterial infections that occur when bacteria enter the urethra (part of the urinary tract) from the skin or rectum (1). UTIs are often treated by a short course of antibiotics and will clear up within a few days of treatment (2). It is often stated that drinking cranberry juice can help prevent or clear up UTIs. Let’s think twice.

A 1998 systematic review found no randomized controlled trials of cranberry juice as treatment for UTIs (3), and we couldn’t find any done since. Cranberry juice is not a treatment for UTI.

In terms of prophylaxis, a meta-analysis of randomized controlled trials found a 54% lower rate of UTIs with cranberry juice consumption and a 49% lower rate with other liquids (4). Greater liquid intake is associated with fewer UTIs, but it’s not clear that cranberry juice is more effective than other liquids for prophylaxis.

One limitation of studies of the relationship between UTIs and cranberry is the use of a variety of cranberry products, for example, juice or capsules (5). Though you are likely not preventing a UTI, you can indulge in cranberry foods this season for the sake of holiday tradition.

1. Centers for Disease Control and Prevention. “Urinary Tract Infection Basics.” Jan. 2024. https://www.cdc.gov/uti/about/index.html

2. May Clinic. “Urinary Tract Infection (UTI).” Sep. 2022. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/diagnosis-treatment/drc-20353453

3. Jepson, R G et al. “Cranberries for treating urinary tract infections.” The Cochrane database of systematic reviews vol. 1998,2 (2000): CD001322. doi:10.1002/14651858.CD001322

4. Moro, Christian et al. “Cranberry Juice, Cranberry Tablets, or Liquid Therapies for Urinary Tract Infection: A Systematic Review and Network Meta-analysis.” European Urology Focus, S2405-4569(24)00122-6. 18 Jul. 2024, doi:10.1016/j.euf.2024.07.002

5. R. Raz, B. Chazan, M. Dan, Cranberry Juice and Urinary Tract Infection, Clinical Infectious Diseases, Volume 38, Issue 10, 15 May 2004, Pages 1413–1419, https://doi.org/10.1086/386328?