Primary dysmenorrhea is defined as painful menstrual cramps of uterine origin in the absence of pelvic pathology and is the most common gynecological disorder among women of reproductive age. The aim of this study was to systematically review case-control studies that have investigated the oxidative stress, antioxidant status, and inflammation markers among women with primary dysmenorrhea and controls. The study protocol was registered with PROSPERO (no. CRD42020183104). By searching PubMed and Scopus databases as well as reference lists, six case-control studies with fifteen eligible markers (seven oxidative stress, seven antioxidant status, one inflammation) were included in this review. The quality of the included studies was assessed as medium or high. The systematic review included 175 women with primary dysmenorrhea and 161 controls. The results indicate an elevated level of oxidative stress, especially of lipid peroxidation among dysmenorrheal women. For the antioxidant status, limited evidence was found for a lower status among primary dysmenorrhea women, and only one study examined one inflammation marker (hs-CRP), which makes it impossible for such a conclusion. To establish whether oxidative stress, antioxidant status or inflammation participate in the pathophysiology of primary dysmenorrhea, high-quality studies with larger study groups and clear case definitions are needed.

中文翻译：

---

与氧化应激和抗氧化状态有关的原发性痛经：病例对照研究的系统评价

原发性痛经的定义是在没有盆腔病理的情况下子宫痛引起的月经来潮，是育龄妇女中最常见的妇科疾病。这项研究的目的是系统地回顾病例对照研究，该研究调查了原发性痛经和对照女性的氧化应激，抗氧化剂状态和炎症标志物。该研究方案已在PROSPERO（编号CRD42020183104）中注册。通过搜索PubMed和Scopus数据库以及参考列表，本评价包括六项具有十五个合格标记的病例对照研究（七个氧化应激，七个抗氧化剂状态，一个炎症）。纳入研究的质量评估为中级或高级。系统评价包括175名原发性痛经妇女和161名对照。结果表明，痛经女性的氧化应激水平升高，尤其是脂质过氧化。对于抗氧化剂状态，在原发性痛经妇女中发现较低状态的证据有限，只有一项研究检查了一种炎症标志物（hs-CRP），因此无法得出这一结论。为了确定氧化应激，抗氧化剂状态或炎症是否参与原发性痛经的病理生理，需要有较大研究组的高质量研究和明确的病例定义。这使得不可能得出这样的结论。为了确定氧化应激，抗氧化剂状态或炎症是否参与原发性痛经的病理生理，需要有较大研究组的高质量研究和明确的病例定义。这使得不可能得出这样的结论。为了确定氧化应激，抗氧化剂状态或炎症是否参与原发性痛经的病理生理，需要有较大研究组的高质量研究和明确的病例定义。