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e
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i
c
o
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de
(
NO
)
a
n
d
i
nhi
bi
t
i
ng
pa
i
n
[
4]
.
S
tr
e
t
c
hi
ng
i
s
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r
e
l
a
x
a
t
i
o
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hni
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e
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r
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pa
i
n
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he
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b
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m
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pa
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h
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o
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r
e
a
s
e
d
pr
o
duc
t
i
o
n
o
f
e
n
do
r
phi
ns
[
5]
.
E
n
do
r
phi
ns
a
r
e
e
n
do
ge
n
o
us
pe
pt
i
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o
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o
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n
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o
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t
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e
r
s
.
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n
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phi
n
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h
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v
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m
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t
r
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t
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r
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m
o
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p
hi
ne
,
a
dr
ug
us
e
d
f
o
r
pa
i
n
r
e
li
e
f
[
6]
.
S
tr
e
t
c
hi
ng
i
s
n
o
t
pe
r
m
i
t
t
e
d
dur
i
n
g
m
e
n
s
t
r
ua
t
i
o
n
.
T
h
e
r
e
s
u
l
t
s
o
f
t
hi
s
s
t
udy
a
r
e
s
t
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t
c
hi
n
g
i
s
e
f
f
e
c
t
i
v
e
in
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e
duc
i
n
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h
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n
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e
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t
y
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n
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dur
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t
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o
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o
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pa
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n
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do
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t
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t
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pr
i
m
a
r
y
d
y
s
m
e
n
o
r
r
h
e
a
[
7]
.
R
e
s
e
a
r
c
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o
n
f
e
m
a
l
e
s
t
ude
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t
s
i
n
I
r
a
n
wh
o
a
r
e
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o
t
a
t
hl
e
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e
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r
e
ga
r
di
n
g
t
h
e
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f
f
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c
t
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o
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phy
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i
c
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l
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t
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vi
t
y
o
n
pr
i
m
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y
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o
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u
l
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h
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h
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e
i
s
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g
ni
f
i
c
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n
t
r
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duc
t
i
o
n
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n
pa
i
n
a
f
t
e
r
phy
s
i
c
a
l
a
c
t
i
vi
t
y
[
8]
A
do
l
e
s
c
e
n
c
e
i
s
a
t
r
a
n
s
i
t
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o
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pe
r
i
o
d
f
r
o
m
c
hil
dr
e
n
t
o
a
dul
t
s
[
9]
.
I
n
do
n
e
s
i
a
h
a
s
a
po
pu
l
a
t
i
o
n
o
f
10
-
19
y
e
a
r
o
l
d
s
r
e
a
c
hi
n
g
43
mi
ll
i
o
n
pe
o
p
l
e
o
r
18%
o
f
t
h
e
269
mi
ll
i
o
n
I
n
do
n
e
s
i
a
n
po
pu
l
a
t
i
o
n
[
10]
.
I
n
do
n
e
s
i
a
n
He
a
l
t
h
P
r
o
f
il
e
Da
t
a
2017,
t
h
e
n
u
m
b
e
r
o
f
g
i
r
l
s
a
ge
d
15
-
19
y
e
a
r
s
i
s
10,
847,
326
m
il
li
o
n
[
11]
.
S
t
a
t
i
s
t
i
c
a
l
C
e
n
t
r
a
l
B
i
r
o
o
f
W
e
s
t
Nus
a
T
e
n
gga
r
a
in
2016
s
t
a
t
e
s
t
h
a
t
t
h
e
n
u
m
be
r
o
f
g
i
r
l
s
a
ge
d
15
-
19
y
e
a
r
s
i
s
218,
014
pe
o
pl
e
[
12]
.
A
t
t
h
i
s
t
i
m
e
t
h
e
r
e
i
s
a
d
y
na
mi
c
de
v
e
l
o
p
m
e
n
t
ph
a
s
e
i
n
t
h
e
li
f
e
o
f
a
n
i
nd
i
vi
dua
l
in
c
l
ud
i
ng
pub
e
r
t
y
t
h
a
t
i
s
s
e
x
ua
l
m
a
t
ur
i
t
y
w
hi
c
h
i
s
m
a
r
ke
d
by
t
h
e
pr
e
s
e
n
c
e
o
f
m
e
n
a
r
c
h
e
(
f
i
r
s
t
m
e
n
s
t
r
ua
ti
o
n
)
[
9]
.
Da
t
a
f
r
o
m
t
h
e
I
n
do
n
e
s
i
a
n
De
m
o
gr
a
p
hi
c
a
n
d
He
a
l
t
h
S
ur
v
e
y
i
n
2012
s
t
a
t
e
d
t
h
a
t
95
%
o
f
g
i
r
l
s
e
x
p
e
r
i
e
n
c
e
d
m
e
n
a
r
c
h
e
a
ge
d
12
-
15
y
e
a
r
s
[
13]
.
M
e
n
a
r
c
h
e
i
n
f
i
r
s
t
m
e
n
s
t
r
ua
t
i
o
n
i
s
o
n
e
s
i
g
n
o
f
a
r
e
pr
o
duc
t
i
v
e
pe
r
i
o
d
i
n
g
i
r
l
s
[
14]
.
F
ur
t
h
e
r
m
o
r
e
,
t
hi
s
m
e
ns
t
r
ua
l
pr
o
c
e
s
s
t
a
ke
s
p
l
a
c
e
r
e
gu
l
a
r
l
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e
ve
r
y
m
o
n
t
h
s
t
a
r
t
i
n
g
a
b
o
ut
14
da
y
s
a
f
t
e
r
o
v
u
l
a
t
i
o
n
.
B
ut
m
a
ny
o
f
t
h
e
m
i
n
t
hi
s
m
e
n
s
t
r
ua
l
pe
r
i
o
d
e
x
p
e
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e
nc
e
pr
o
bl
e
m
s
,
e
s
p
e
c
i
a
ll
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n
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do
l
e
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e
n
c
e
o
f
t
e
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e
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p
e
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i
e
nc
e
m
e
ns
t
r
ua
l
pa
i
n
(
d
y
s
m
e
n
o
r
r
h
e
a
)
[
15]
.
D
y
s
m
e
n
o
r
r
h
e
a
c
o
m
e
s
f
r
o
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t
h
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Gr
e
e
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l
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gua
ge
,
d
y
s
m
e
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o
r
r
h
e
a
l
,
w
hi
c
h
a
c
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o
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d
i
n
g
t
o
t
h
e
m
e
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ni
ng
o
f
t
h
e
wo
r
d
c
o
n
s
i
s
t
s
o
f
“
d
y
s
”
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e
a
n
s
t
h
a
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i
t
i
s
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i
f
f
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m
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e
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ns
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h
e
m
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a
n
d
“
r
r
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m
e
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ns
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h
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o
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h
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e
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o
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do
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i
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l
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i
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o
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i
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f
r
o
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ut
e
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e
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r
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ps
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d
o
c
c
ur
s
dur
i
n
g
m
e
n
s
t
r
ua
ti
o
n
[
16]
.
P
a
i
n
i
n
pr
i
m
a
r
y
d
y
s
m
e
n
o
r
r
h
e
a
a
n
d
ot
h
e
r
s
y
s
t
e
m
i
c
s
ym
pt
o
m
s
i
s
c
a
us
e
d
by
hi
g
h
l
e
v
e
l
s
o
f
pr
o
s
t
a
g
l
a
n
d
i
ns
,
e
s
pe
c
i
a
ll
y
pr
o
s
t
a
gl
a
n
d
i
n
F
2α
(
P
G
F
2α
)
i
n
e
p
i
t
he
l
i
a
l
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e
ll
s
.
P
r
o
s
t
a
gl
a
n
d
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2α
c
a
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s
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s
my
o
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e
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r
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to
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t
r
a
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t
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a
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do
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e
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r
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ue
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s
c
h
e
mi
a
,
bl
e
e
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i
ng
a
n
d
pa
i
n
[
17]
.
T
h
e
i
nc
i
de
n
c
e
o
f
d
y
s
m
e
n
o
r
r
h
e
a
i
n
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do
n
e
s
i
a
wa
s
64.
25%
whi
c
h
c
o
ns
i
s
t
e
d
o
f
54.
89%
pr
i
m
a
r
y
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y
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m
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o
r
r
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e
a
a
n
d
9.
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s
e
c
o
n
da
r
y
d
y
s
m
e
n
o
r
r
h
e
a
[
18]
.
P
r
i
m
a
r
y
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y
s
m
e
n
o
r
r
h
e
a
us
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ur
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o
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r
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m
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a
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e
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o
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u
l
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t
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o
n
s
t
a
r
t
s
r
e
gu
l
a
r
ly
.
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a
i
n
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a
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o
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pa
ni
e
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by
na
us
e
a
,
v
o
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t
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r
h
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e
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da
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he
,
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o
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r
b
a
c
k
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i
n
,
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r
r
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t
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bil
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.
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o
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t
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n
t
h
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f
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r
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t
24h
our
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d
c
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n
l
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s
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f
o
r
48
-
72
h
o
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r
s
.
[
19]
.
D
y
s
m
e
n
o
r
r
h
e
a
c
a
us
e
s
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n
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n
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e
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n
a
c
t
i
vi
t
y
,
w
hi
c
h
r
e
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u
l
t
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n
a
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o
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k
o
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s
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h
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o
l
.
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his
c
a
us
e
s
a
de
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r
e
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s
e
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n
wo
r
k
o
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t
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t
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n
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t
r
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t
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l
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[
20]
.
T
h
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t
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e
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h
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n
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ua
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n
(
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r
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)
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a
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n
d
r
e
duc
e
s
t
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e
s
s
[
21]
.
2.
RE
S
E
AR
C
H
M
E
T
HO
D
T
hi
s
r
e
s
e
a
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c
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pe
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im
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r
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o
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o
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up
.
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l
e
by
li
ne
y
=
(
-
)
0.
015X
1
+(
-
)
0.
028X
2
+
2.
000
(
p≤
0.
005)
a
n
d
c
o
nt
r
i
b
ut
e
d
82.
9%
to
r
e
duc
e
t
h
e
pr
i
m
a
r
y
m
e
ns
t
r
ua
l
pa
i
n
s
c
a
l
e
i
n
a
do
l
e
s
c
e
n
t
gi
r
l
s
w
i
t
h
s
t
r
e
s
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
.
J
.
P
ubl
i
c
He
a
l
t
h
S
c
i
.
I
S
S
N:
2252
-
8806
R
e
duc
ing
pr
imar
y
dy
s
me
nor
r
he
a
among
adoles
c
e
n
t
gir
ls
w
i
th
mung
be
an
e
x
tr
ac
t
dr
inks
and…
(
B
aiq
De
w
i
S
)
61
T
a
bl
e
1.
Ge
n
e
r
a
l
c
h
a
r
a
c
t
e
r
i
s
t
i
c
s
o
f
r
e
s
po
n
de
n
t
s
G
e
ne
r
a
l
C
ha
r
a
c
te
r
is
ti
c
s
T
ot
a
l
(
n
=
87)
M
ung B
e
a
n E
x
t
r
a
c
t
D
r
in
k (
n
=
29)
S
tr
e
tc
hi
ng
(
n
=
29)
C
o
nt
r
o
l
(
n
=
29)
A
ge
(
y
e
a
r
s
)
15.90±0.61
15.72±0.
59
15.76±0.
58
16.21±0.
56
A
ge
(
f
ir
s
t
M
e
nar
c
he
)
12.98±0.93
12.66±0.97
13.00±0.96
13.28±0.75
S
tr
e
s
s
l
e
ve
l
27.46±6.59
27.62±6.
11
29.93±5.35
24.83±7.35
B
M
I
/Age
-
0.06±0.58
0.08±0.
60
-
0.19±0.52
-
0.08±0.61
T
a
bl
e
2.
T
e
s
t
t
h
e
n
o
r
m
a
li
t
y
a
n
d
h
o
m
o
ge
n
e
i
t
y
o
f
t
he
r
e
s
e
a
r
c
h
v
a
r
i
a
bl
e
s
I
nde
p
e
nd
e
nt
V
a
r
ia
bl
e
H
o
m
o
g
e
n
e
it
y
p
-
v
a
lu
e
N
o
r
ma
li
t
y
p
-
v
a
lu
e
C
o
nt
r
o
l
M
o
de
r
a
te
s
tr
e
s
s
(
be
f
or
e
a
nd a
f
te
r
)
0.565
0.065
S
e
ve
r
e
s
tr
e
s
s
(
be
f
o
r
e
a
nd a
f
t
e
r
)
0.851
0.151
M
ung B
e
a
n
E
xt
r
a
c
t
C
o
nt
r
o
l
a
nd b
e
f
o
r
e
mung b
e
a
n
e
x
tr
a
c
t
dr
in
ks
e
x
p
e
r
ia
nc
e
0.933
0.200
S
tr
e
tc
hi
ng
c
o
nt
r
o
l
a
nd b
e
f
o
r
e
s
tr
e
t
c
hi
ng
e
x
pe
r
ia
nc
e
0.109
0.534
T
a
bl
e
3.
M
e
a
n
o
f
b
e
f
o
r
e
a
n
d
a
f
t
e
r
f
o
r
p
r
i
m
a
r
y
m
e
ns
t
r
ua
l
p
a
i
n
o
f
m
u
n
g
b
e
a
n
e
x
t
r
a
c
t
d
r
i
n
ks
e
x
pe
r
i
e
n
c
e
I
nde
p
e
nd
e
nt
V
a
r
ia
bl
e
S
tr
e
s
s
L
e
ve
l
n
P
r
im
a
r
y
M
e
ns
tr
ua
l
P
a
in
S
c
a
l
e
P
a
ir
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d
-
T
e
s
t
(p
-
v
a
lu
e
)
be
f
o
r
e
a
f
t
e
r
D
e
lt
a
M
ung B
e
a
n
D
r
in
ks
M
o
de
r
a
te
s
tr
e
s
s
13
4.23±2.71
2.92±1.60
1.31±1.32
0.004
S
e
ve
r
e
s
tr
e
s
s
16
4.06±2.64
2.38±2.42
1.69±1.54
0.001
S
tr
e
tc
hi
ng
M
o
de
r
a
te
s
tr
e
s
s
8
3.88±1.89
1.38±0.92
2.5
0
±1.9
3
0.008
S
e
ve
r
e
s
tr
e
s
s
21
3.24±2.36
1.19±1.50
2.05±1.80
0.001
*
S
ig
ni
f
i
c
a
nc
e
p
=
0.05 le
ve
l
(
2
-
ta
il
e
d)
T
a
bl
e
4.
M
e
a
n
o
f
d
i
f
f
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r
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n
c
e
b
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t
we
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n
c
o
n
t
r
o
l
a
n
d
e
x
pe
r
i
e
n
c
e
w
i
t
h
m
u
n
g
b
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n
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x
t
r
a
c
t
d
r
i
n
k
s
o
n
p
r
i
m
a
r
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m
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n
s
t
r
ua
l
p
a
i
n
P
e
r
c
e
i
ve
d S
tr
e
s
s
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c
or
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n
P
r
im
a
r
y
M
e
ns
tr
ua
l
P
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in
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c
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l
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-
te
s
t
M
ung B
e
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n E
x
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r
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c
t
D
r
in
ks
C
o
nt
r
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l
M
o
de
r
a
te
S
tr
e
s
s
14
-
26
30
1.31±1.32
-
0.18±1.24
0.004
S
e
ve
r
e
S
t
r
e
s
s
27
-
40
28
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*
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ig
ni
f
i
c
a
nc
e
p
=
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ve
l
(
2
-
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il
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d)
T
a
bl
e
5.
M
e
a
n
o
f
D
i
f
f
e
r
e
n
c
e
b
e
t
we
e
n
c
o
n
t
r
o
l
a
n
d
e
x
pe
r
i
e
n
c
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w
i
t
h
s
t
r
e
t
c
hi
n
g
o
n
p
r
i
m
a
r
y
m
e
ns
t
r
ua
l
p
a
in
P
e
r
c
e
iv
e
d St
r
e
s
s
Sc
or
e
n
P
r
im
a
r
y
M
e
ns
tr
ua
l
P
a
in
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c
a
l
e
T
-
te
s
t
S
tr
e
tc
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ng
C
o
nt
r
o
l
M
o
de
r
a
te
S
tr
e
s
s
14
-
26
25
2.5
0
±1.9
3
-
0.18±1.24
p
=
0.002
S
e
ve
r
e
S
t
r
e
s
s
27
-
40
33
2.05±1.80
-
0.08±0.43
p
=
0.007
*
S
ig
ni
f
i
c
a
nc
e
p
=
0.05 le
ve
l
(
2
-
ta
il
e
d)
T
a
bl
e
6.
R
e
gr
e
s
i
l
i
ne
a
r
f
o
r
m
u
n
g
b
e
a
n
e
x
t
r
a
c
t
d
r
i
nks
M
o
de
l
U
ns
ta
nda
r
di
z
e
d C
o
e
f
f
i
c
i
e
nt
s
S
ta
nda
r
di
z
e
d C
oe
f
f
i
c
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e
nt
s
t
p
-
v
a
lu
e
R
S
qua
r
e
B
S
td
. E
r
r
or
B
e
ta
M
o
de
l
1
0.413
C
o
ns
ta
nt
1.709
0.042
-
27.521
0.001
M
ung B
e
a
n E
x
t
r
a
c
t
D
r
in
ks
-
0.106
0.030
-
0.296
-
2.534
0.014
S
tr
e
tc
hi
ng
-
0.116
0.062
-
0.449
-
3.848
0.001
M
o
de
l
2
0.829
C
o
ns
ta
nt
2.000
0.630
-
3.177
0.003
M
ung B
e
a
n E
x
t
r
a
c
t
D
r
in
ks
-
0.015
0.029
-
0.043
-
0.530
0.001
S
tr
e
tc
hi
ng
-
0.028
0.021
-
0.107
-
1.334
0.001
A
ge
(
y
e
a
r
s
)
A
ge
(
f
ir
s
t
M
e
nar
c
he
)
0.038
0.038
0.069
0.997
0.324
S
tr
e
s
s
L
e
ve
l
-
0.003
0.005
-
0.039
-
0.564
0.575
B
M
I
/Age
-
0.046
0.054
-
0.055
-
0.839
0.406
*
S
ig
ni
f
i
c
a
nc
e
p
=
0.05 le
ve
l
(
2
-
ta
il
e
d)
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
S
N
:
2252
-
8806
I
n
t
.
J
.
P
ubl
i
c
He
a
l
t
h
S
c
i
.
Vo
l
.
8
,
N
o
.
1
,
M
a
r
c
h
201
9
:
58
–
64
62
4.
D
I
S
CU
S
S
I
ON
T
hi
s
s
t
ud
y
a
im
s
t
o
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n
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d
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g
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29
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7
da
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[
24]
.
S
t
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R
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[
25]
.
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de
c
r
e
a
s
e
d
lev
e
l
s
o
f
de
hy
dr
o
e
p
i
a
n
dr
o
s
t
e
r
o
n
e
(
DH
E
A
)
whi
c
h
h
a
s
a
n
a
na
b
o
l
i
c
e
f
f
e
c
t
a
s
o
pp
o
s
e
d
to
c
o
r
t
i
s
o
l
,
c
a
us
i
ng
d
i
s
r
upt
i
o
n
o
f
t
h
e
s
e
c
r
e
t
i
o
n
o
f
s
e
x
h
o
r
m
o
n
e
s
w
hi
c
h
r
e
s
u
l
t
s
i
n
d
e
c
r
e
a
s
e
d
l
e
v
e
l
s
o
f
pr
o
ge
s
t
e
r
o
n
e
.
P
r
o
ge
s
t
e
r
o
n
e
a
f
f
e
c
t
s
t
h
e
s
y
n
t
he
s
i
s
o
f
pr
o
s
t
a
gl
a
n
d
i
ns
P
G
F
2a
a
n
d
P
GE
2
a
n
d
t
h
e
bi
nd
i
n
g
o
f
pr
o
s
t
a
gl
a
n
d
i
ns
to
t
h
e
m
y
o
m
e
t
r
i
a
l
r
e
c
e
pto
r
s
.
P
r
o
s
t
a
gl
a
n
d
i
ns
a
f
f
e
c
t
t
h
e
ut
e
r
i
ne
m
u
s
c
l
e
s
a
n
d
v
a
s
c
u
l
a
r
t
o
n
e
[
26]
.
Hi
g
h
l
e
v
e
l
s
o
f
pr
o
s
t
a
gl
a
n
d
i
n
F
2α
(
P
GF
2α
)
i
n
e
p
i
t
h
e
li
a
l
c
e
ll
s
a
l
s
o
a
f
f
e
c
t
pa
i
n
dur
i
n
g
m
e
ns
t
r
u
a
t
i
o
n
due
t
o
m
y
o
m
e
t
r
i
a
l
hy
pe
r
t
o
n
us
a
n
d
v
a
s
o
c
o
n
s
t
r
i
c
t
i
o
n
c
a
us
i
ng
t
h
e
ut
e
r
i
ne
m
u
s
c
l
e
s
to
c
o
n
t
r
a
c
t
r
e
s
u
l
t
i
n
g
i
n
n
a
r
r
o
wi
n
g
o
f
t
h
e
e
n
do
m
e
t
r
i
a
l
bl
o
o
d
v
e
s
s
e
l
s
,
t
i
s
s
ue
i
s
c
h
e
mi
a
,
bl
e
e
d
i
ng
a
n
d
pa
i
n
[
9]
.
S
o
m
e
n
ut
r
i
e
n
t
c
o
n
t
e
n
t
i
n
m
u
n
g
b
e
a
n
dr
i
n
k
s
h
a
v
e
a
po
s
i
t
i
v
e
e
f
f
e
c
t
o
n
de
c
r
e
a
s
i
n
g
m
e
ns
t
r
ua
l
pa
i
n
s
c
a
l
e
i
nc
l
ud
i
ng
f
l
a
v
o
n
o
i
d
c
o
n
t
e
n
t
c
a
n
i
nhi
b
i
t
pr
o
s
t
a
gl
a
n
d
i
n
bi
o
s
y
n
t
h
e
s
i
s
(
P
GE
2)
by
s
uppr
e
s
s
i
ng
t
h
e
a
c
t
i
vi
t
y
o
f
C
OX
-
2
e
n
z
ym
e
t
h
r
o
ugh
i
nhi
b
i
t
i
o
n
o
f
N
F
-
ĸB
ge
n
e
e
x
pr
e
s
s
i
o
n
.
An
t
i
o
xi
da
n
t
a
c
t
i
vi
t
y
i
n
f
l
a
v
o
n
o
i
ds
i
s
a
l
s
o
a
bl
e
to
i
nhi
b
i
t
r
e
a
c
t
i
ve
o
xy
ge
n
s
p
e
c
i
e
s
(
R
OS)
,
e
s
pe
c
i
a
ll
y
t
h
o
s
e
i
nv
o
l
v
e
d
i
n
pa
t
h
o
l
o
g
i
c
a
l
i
nf
l
a
mm
a
t
i
o
n
[
14
,
27]
.
I
n
c
r
e
a
s
e
d
i
n
t
a
ke
o
f
s
i
m
p
l
e
c
a
r
b
o
hy
dr
a
t
e
s
dur
i
n
g
t
h
e
l
ut
e
a
l
p
h
a
s
e
i
s
a
s
s
o
c
i
a
t
e
d
w
i
t
h
i
nc
r
e
a
s
e
d
m
o
o
d
d
ur
i
n
g
t
h
e
m
e
ns
t
r
ua
l
pe
r
i
o
d
b
e
c
a
u
s
e
c
a
r
b
o
hy
dr
a
t
e
s
i
nc
r
e
a
s
e
t
h
e
a
v
a
il
a
bil
i
t
y
o
f
t
r
y
pt
o
ph
a
n
a
s
a
s
e
r
oto
ni
n
pr
e
c
ur
s
o
r
i
n
t
h
e
b
r
a
i
n
[
15]
.
T
h
e
pr
e
s
e
n
c
e
o
f
vi
t
a
mi
n
C
i
n
m
u
n
g
b
e
a
n
i
s
us
e
f
u
l
a
s
a
n
a
n
t
i
-
de
pr
e
s
s
a
n
t
t
h
r
o
ugh
t
h
e
c
o
n
ve
r
s
i
o
n
o
f
do
pa
m
i
ne
to
n
o
r
e
p
i
n
e
p
h
r
i
n
e
a
n
d
a
s
a
c
o
f
a
c
t
o
r
o
f
t
r
y
pt
o
ph
a
n
-
5
-
hy
dr
o
xil
a
s
e
t
o
c
o
n
ve
r
t
t
r
y
pt
oph
a
n
to
5
-
hy
dr
o
xy
t
r
y
pt
o
ph
a
n
i
n
s
e
r
o
to
ni
n
pr
o
duc
t
i
o
n
t
o
m
a
ke
n
e
r
v
e
f
u
n
c
t
i
o
n
r
e
t
ur
n
to
n
o
r
m
a
l
,
t
hi
s
c
a
n
r
e
duc
e
s
t
r
e
s
s
l
e
v
e
l
s
[
28]
I
n
a
dd
i
t
i
o
n
,
vi
t
a
m
i
n
C
c
a
n
a
l
s
o
a
f
f
e
c
t
t
e
n
s
i
o
n
c
o
n
t
r
a
c
t
i
l
i
t
y
a
n
d
r
e
l
a
x
t
h
e
ut
e
r
i
n
e
s
m
o
o
th
m
us
c
l
e
t
h
us
r
e
duc
i
ng
s
t
r
e
s
s
a
n
d
i
nh
i
b
i
t
i
n
g
pr
o
s
t
a
gl
a
n
d
i
n
bi
o
s
y
n
t
h
e
s
i
s
[
14]
.
C
a
l
c
i
u
m
p
l
a
y
s
a
r
o
l
e
i
n
t
h
e
i
n
t
e
r
a
c
t
i
o
n
o
f
pr
ot
e
i
n
s
i
n
t
h
e
m
us
c
l
e
s
,
n
a
m
e
ly
a
c
t
i
n
a
n
d
m
y
o
s
i
n,
r
e
s
u
l
t
i
n
g
i
n
c
o
n
t
r
a
c
t
i
o
n
s
.
Af
t
e
r
l
e
s
s
t
h
a
n
a
s
e
c
o
n
d,
c
a
l
c
i
u
m
i
s
pu
m
p
e
d
b
a
c
k
i
n
t
o
t
h
e
s
a
r
c
o
p
l
a
s
m
i
c
r
e
t
i
c
u
l
u
m
wh
e
r
e
i
o
ns
a
r
e
s
to
r
e
d
un
t
i
l
t
h
e
n
e
w
a
c
t
i
o
n
po
t
e
n
t
i
a
l
o
f
t
h
e
m
us
c
l
e
r
e
t
ur
n
s
.
E
x
pul
s
i
o
n
o
f
c
a
l
c
i
u
m
i
o
ns
f
r
o
m
my
o
f
i
b
r
il
w
i
ll
c
a
u
s
e
m
u
s
c
l
e
c
o
n
t
r
a
c
t
i
o
ns
to
s
to
p
[
29
].
S
tr
e
t
c
hi
ng
h
a
s
a
po
s
i
t
i
v
e
e
f
f
e
c
t
o
n
d
y
s
m
e
n
o
r
r
h
e
a
by
i
nc
r
e
a
s
i
ng
c
i
r
c
u
l
a
t
or
y
m
e
t
a
b
o
l
i
s
m
o
f
pe
l
vi
c
bl
o
o
d
f
l
o
w
a
n
d
a
c
t
i
v
a
t
i
n
g
e
n
do
r
phi
ns
s
o
a
s
t
o
pr
e
v
e
n
t
a
n
i
nc
r
e
a
s
e
i
n
pr
o
s
t
a
gl
a
n
d
i
n
l
e
v
e
l
s
t
o
r
e
duc
e
i
s
c
h
e
mi
c
pa
i
n
dur
i
n
g
m
e
n
s
t
r
ua
t
i
o
n
[
30]
.
S
tr
e
t
c
hi
n
g
o
r
e
x
e
r
c
i
s
e
c
a
n
b
e
do
n
e
f
o
r
30
m
i
nut
e
s
e
ve
r
y
da
y
a
n
d
c
a
n
b
e
do
n
e
7
da
y
s
b
e
f
o
r
e
m
e
n
s
t
r
ua
t
i
o
n
.
Dur
i
n
g
e
x
e
r
c
i
s
e
,
e
n
do
r
phi
n
pr
o
duc
t
i
o
n
i
nc
r
e
a
s
e
s
a
n
d
w
il
l
b
e
r
e
l
e
a
s
e
d
a
n
d
c
a
pt
ur
e
d
by
r
e
c
e
pt
or
s
i
n
t
h
e
hy
po
t
h
a
l
a
m
u
s
a
n
d
l
im
b
i
c
s
y
s
t
e
m
.
T
he
e
n
do
r
phi
ns
w
il
l
f
u
nc
t
i
o
n
i
n
e
m
o
t
i
o
n
a
l
s
e
tt
i
n
g
s
r
e
s
u
l
t
i
n
g
i
n
a
de
c
r
e
a
s
e
i
n
pa
i
n
[
31]
.
E
n
do
r
phi
n
s
a
r
e
pr
o
duc
e
d
i
n
t
h
e
b
o
d
y
by
t
he
p
i
t
u
i
t
a
r
y
g
l
a
n
d.
E
n
do
r
phi
ns
i
nhi
b
i
t
t
h
e
r
e
l
e
a
s
e
o
f
ga
mm
a
a
mi
n
o
-
but
y
r
i
c
a
c
i
d
(
G
A
B
A
)
.
T
hi
s
i
nh
i
b
i
t
i
o
n
w
il
l
c
a
us
e
a
n
i
n
c
r
e
a
s
e
i
n
do
pa
m
i
ne
pr
o
duc
t
i
o
n
a
s
s
o
c
i
a
t
e
d
w
i
t
h
p
l
e
a
s
u
r
e
.
T
h
e
e
n
do
r
phi
ns
pr
o
duc
e
d
whe
n
e
x
e
r
c
i
s
i
ng
a
r
e
t
h
e
n
c
h
a
nne
l
e
d
t
h
r
o
ugh
o
u
t
t
h
e
b
o
d
y
a
n
d
a
c
t
a
s
n
a
t
ur
a
l
a
n
a
l
ge
s
i
c
s
i
n
t
h
e
b
o
d
y
[
32]
.
5.
CONC
L
USI
ON
T
h
e
r
e
s
e
a
r
c
h
s
ugge
s
t
e
d
t
h
a
t
gi
vi
ng
t
h
e
m
u
n
g
b
e
a
n
e
x
t
r
a
c
t
d
r
i
n
k
s
250
m
l
/da
y
f
o
r
7
da
y
s
b
e
f
o
r
e
m
e
ns
t
r
ua
t
i
o
n
h
a
s
a
s
i
g
nif
i
c
a
n
t
e
f
f
e
c
t
o
n
r
e
du
c
i
n
g
t
h
e
pr
i
m
a
r
y
d
y
s
m
e
n
o
r
r
h
e
a
a
m
o
n
g
a
do
l
e
s
c
e
n
t
gi
r
l
s
b
o
t
h
a
t
m
o
de
r
a
t
e
a
n
d
s
e
v
e
r
e
s
t
r
e
s
s
l
e
v
e
l
s
.
S
t
r
e
t
c
hi
n
g
wa
s
gi
ve
n
o
n
c
e
a
da
y
f
o
r
7
da
y
s
b
e
f
o
r
e
m
e
n
s
t
r
ua
t
i
o
n
a
f
f
e
c
t
e
d
o
n
r
e
du
c
i
n
g
t
h
e
pr
i
m
a
r
y
d
y
s
m
e
n
o
r
r
h
e
a
a
m
o
n
g
a
do
l
e
s
c
e
n
t
gi
r
l
s
b
o
t
h
a
t
m
o
de
r
a
t
e
a
n
d
s
e
v
e
r
e
s
t
r
e
s
s
l
e
v
e
l
s
.
M
un
g
b
e
a
n
e
x
t
r
a
c
t
d
r
i
n
k
s
a
n
d
s
t
r
e
t
c
hi
n
g
c
a
n
b
e
us
e
d
a
s
a
n
o
n
-
p
h
a
r
m
a
c
o
l
o
g
i
c
a
l
t
h
e
r
a
p
y
f
o
r
r
e
duc
i
n
g
m
e
ns
t
r
ua
l
p
a
i
n
i
n
a
do
l
e
s
c
e
n
t
g
i
r
l
s
.
F
ur
t
h
e
r
r
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;
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R
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5
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Sav
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a
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.
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.
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]
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C.
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F.
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l
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n
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1
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o
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s
c
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t
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fi
c
p
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rs
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3
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t
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m
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s
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d
p
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s
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d
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t
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3
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t
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as
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al
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k
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a
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3
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h
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v
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t
as
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as
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t
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fi
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3
).
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h
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).
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s
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s
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w
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n
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,
1
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2
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s
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d
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d
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as
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c
t
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rs
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t
as
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b
el
as
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1
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8
).
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n
t
e
r
n
al
M
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d
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s
t
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f
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c
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e,
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n
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t
as
G
ad
j
ah
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d
a
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8
8
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0
0
3
),
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s
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Pro
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ra
m
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M
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d
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as
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rl
a
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g
g
a
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1
0
)
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d
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n
d
o
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d
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f
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t
as
G
ad
j
ah
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a
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0
1
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e
h
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k
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d
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s
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m
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n
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8
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t
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rn
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l
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d
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v
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as
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9
8
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2
0
0
3
),
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n
d
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ri
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o
l
o
g
y
-
M
e
t
ab
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l
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s
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f
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t
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c
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n
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c
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ce
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r
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s
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/
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t
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f
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d
i
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,
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n
v
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rs
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t
as
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e
b
e
l
as
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e
t
(2
0
0
3
-
2
0
1
7
)
a
n
d
D
o
c
t
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ra
l
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ra
m
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f
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u
b
l
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c
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e
al
t
h
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