Incidence Of Menstrual Irregularities Research Articles

Increased vitamin D intake may reduce psychological anxiety and the incidence of menstrual irregularities in female athletes.

Vitamin D deficiency has been associated with major depression and premenstrual mood symptoms, and menstrual irregularity has been correlated with mental anxiety. However, the potential effect of increased vitamin D intake on reducing the risk of menstrual irregularities by decreasing psychological anxiety is yet to be fully elucidated. The existence of such a relationship in athletes with high levels of psychological anxiety and adequate dietary intake remains unknown. Therefore, this study aimed to examine the effects of vitamin D intake on psychological anxiety levels and the risk of menstrual irregularities in healthy college-and international-level female athletes. Female intercollege-level track and field and international-level rowing athletes (n = 107) aged 15-24 years were included in this study. Their nutritional intake, body mass, body fat, mental anxiety, and menstrual irregularities were investigated. A generalized linear mixed model (GLMM) was used to examine the effects of several parameters on menstrual irregularities. The independent variables introduced into the GLMM were determined based on Akaike's information criterion. The GLMM identified a significant interaction effect of vitamin D intake and state anxiety on menstrual irregularities, with a p-value of 0.049 and an odds ratio of 0.423. The study results suggest that increased vitamin D intake in relatively young endurance athletes may reduce mental anxiety, consequently decreasing menstrual irregularities.

ASSESSMENT OF MENSTRUAL HEALTH AND ANALGESICS USAGE IN YOUNG AGE WOMEN

Objective: The study focuses on assessing the incidence of menstrual irregularity among young women and the factors for a disturbance with the rationale to assess the use of analgesic drugs during Premenstrual Syndrome (PMS).
 Methods: A cross-sectional study was used. A total of 2500 randomly selected young female between the age of 11 and 30 y completed the study questionnaire to assess lifestyle pattern, variations in menstrual pattern, perceived stress, and to capture information about their menstrual cycle and related problems. In addition, the questionnaire assessed the use of analgesics for PMS.
 Results: 2481 participants completed the questionnaire. The mean age of participants’ menarche was 12.85±1.432 y. The prevalence of menstrual irregularities was 25.0 % (n=621) and about 8.5% (n=211) of respondents had severe pain that was not relieved by the use of analgesics. On the other hand, 50.9 % (n=1262) reported severe pain that was relieved by analgesics. A total of 1279 (51.6 %) of participants in this study used Over The Counter (OTC) analgesics to relieve PMS.
 Conclusion: Dysmenorrhea is the most common complaint among young females in Saudi Arabia. Low Body Mass Index (BMI), sedentary lifestyle, stress and early age of menarche are the most important factors associated with menstrual irregularities. Proper education programs and awareness among young girls about their menstrual health, and the provision of guidance in choosing effective analgesics and treatment options for dysmenorrhea are highly recommended.

Assessment of anxiety, stress and depression in primary dysmenorrhic females

Background: Dysmenorrhea is the most common gynecological complaint, adversely affects the quality life and work productivity in females of reproductive age. Risk factors for primary dysmenorrhea include age, early menarche, low body mass index (BMI), menorrhagia, family history, smoking, nulliparity, depression and stress. This study was carried to find out the pattern of dysmenorrhea in young Pakistani females, and to determine its association with stress, depression and anxiety.
 Methodology: This was a cross sectional questionnaire based study conducted on 300 female participants of age 20-30 years studying at the local university. Healthy, nulliparous females with the occurrence of dysmenorrhea were included in the study whereas those females who had gynecological, psychological or other medical problems were excluded from the study. Students were asked to provide the information about their socioeconomic status, dysmenorrheal symptoms, mental health status, their habits and other medical characteristics. To evaluate the effect of stress, depression and anxiety, Depression, Anxiety Stress Scale (DASS) was used. All statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 16.
 Results: Of the total dysmenorrhic females 31% were married, 57% had positive family history of dysmenorrhea, 18% of the subjects had BMI<18Kg/m2 while 39% reported high waist hip ratio (WHR). The incidence of menstrual irregularity and menorrhagia was identified in 67% and71%, respectively while passing of clots were found to be in 71% subjects. Significant differences were observed in terms of anxiety (p=0.025) and stress (p=0.028) between the two groups but there was no statistical difference in the levels of depression (p=0.11). It was found that depression is a common complaint irrespective of presence or absence of dysmenorrhea during periods.
 Conclusion: This study shows that high stress level and anxiety were positively associated with primary dysmenorrhea in young adolescent females. Therefore, mental health promotion and counselling measures should be taken to lessen the severity of dysmenorrhea.

Clinically Significant Bleeding in a Patient With von Willebrand Exon 28 Polymorphism D1472h: A Case Report

a malignancy should always be considered. We present three cases of genital malignancies presenting as vaginal bleeding occurring in infancy, childhood, and pubescence. Case 1: A 7 month old infant was initially seen in a primary care clinic with a three day history of blood in her diapers. An evaluation for urinary tract infection was negative and renal ultrasound showed no structural abnormalities. Multiple episodes of bleeding occurred over the next month. Pelvic ultrasound and vaginoscopy revealed a 2 centimeter friable vaginal mass consistent with a yolk sack tumor. Case 2: A 7 year old followed for congenital absence of the right kidney was noted to have new onset hematuria on urinanalysis. Due to an unclear etiology of the bleeding, a workup for precocious puberty was preformed and was negative. Pelvic ultrasound revealed an ill defined endometrial stripe with normal ovaries. Subsequent vaginoscopy and biopsy revealed clear cell carcinoma of the vagina. Case 3: A 13 year old presented with probable anovulatory estrogen withdrawal bleeding and severe anemia. She was treated on different occasions with an oral contraceptive pill taper, daily norethindrone acetate, and intravenous estrogen with minimal response. Pelvic ultrasound revealed a large clot in the uterine cavity. Patient underwent vaginoscopy with dilation and curettage. Findings at time of surgery and subsequent histology revealed a neuroendocrine tumor of the cervix. Comments: Vaginal bleeding in infancy or childhood is more alarming to a physician than abnormal menstruation in an adolescent. Despite the high incidence of menstrual irregularities in adolescents, continued symptoms should also trigger further investigation. These cases validate the necessity of complete evaluation of the genital tract when a premenarchal or adolescent child presents with vaginal bleeding. Malignancy ranks low on the list of differential diagnoses and is rare in this age group. However, there may be dire consequences to delayed diagnosis and therefore, a timely and thorough evaluation with vaginoscopy by a pediatric gynecologist is recommended.

Hypothalamic Suppression Decreases Bone Strength Before and After Puberty in a Rat Model

The incidence of menstrual irregularities, both primary and secondary amenorrhea, has been reported to be as high as 60%, with the highest incidence in younger athletes, suggesting possible adverse effects on bone development. It was hypothesized that in a rat model, suppressed hypothalamic activity via a gonadotropin-releasing hormone antagonist (GnRH-a) before onset of puberty would result in a relatively larger bone strength deficit compared with suppression after puberty. Hypothalamic suppression was achieved by providing GnRH injections. Animals received injections for 25 days either before puberty (pre group) (age 23-46 days) or after puberty (post group) (age 65-90 days). Body weights and uterine weights were measured. Serum estradiol was assayed. Mechanical strength of the right femora and histomorphometry of the left femur were measured. Suppression of the hypothalamic-pituitary-gonadal axis was confirmed by significant atrophy of uterine tissue and suppressed estradiol levels. The peak moment was significantly lower in the pre and post GnRH-a groups compared with control. The percentage difference of the average peak moment and stiffness values from the respective age-matched control groups yielded a greater percentage difference in the pre group. The cortical area was less in the GnRH-a-treated groups, but no significant difference between the relative deficits between pre and post groups were found. Hypothalamic-pituitary-gonadal axis suppression before puberty resulted in a significantly larger deficit in mechanical strength compared with postpubertal animals. The time before puberty may represent a time when skeletal strength is more compromised. Women experience both primary and secondary amenorrhea; however, the treatment may need to be different for each condition.

The female athlete.

Over the past 30 years, the number of women participating in organized sports has grown dramatically. Several forms of menstrual irregularities have been described in the female athlete: primary and secondary amenorrhoea, oligomenorrhoea, short luteal phases and anovulation. The incidence of menstrual irregularities is much higher in activities where a thin body is required for better performance. The hormonal pattern seen in these athletes is a hypothalamic amenorrhoea profile. There appears to be a decrease in gonadotrophin-releasing hormone (GnRH) pulses from the hypothalamus, which in turn decreases the pulsatile secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) and shuts down stimulation of ovary. Recently, another type of amenorrhoea has been described in swimmers which is characterized by mild hyperandrogenism. Athletes with low weight are at risk of developing the female athletic triad, which includes amenorrhoea, osteoporosis and disordered eating. Athletes with this triad are susceptible to stress fractures. Other issues include the pregnant athlete. Intensive exercise during pregnancy can cause bradycardia. Safe limits of aerobic exercise in pregnancy depend on previous exercise habits. Infertility, which may develop with exercise, is probably reversible with reduction of exercise or weight gain. High impact sports activities may produce urinary incontinence. Oestrogen replacement therapy is often prescribed in amenorrhoeic athletes, but bone loss may not be completely reversible.

Menstrual differences due to vegetarian and non vegetarian diets

We studied 41 nonvegetarian and 34 vegetarian premenopausal women whom we closely screened. The two groups were indistinguishable with respect to height, weight, body mass index, and menarche. The incidence of menstrual irregularity was 4.9% among nonvegetarians and 26.5% among vegetarians (P = 0.009). The vegetarian group consumed significantly greater amounts of polyunsaturated fatty acids, carbohydrates, vitamin B-6, and dietary fiber whereas the nonvegetarians reported greater intakes of saturated fatty acids, protein, cholesterol, caffeine and alcohol. Logistic-regression analyses showed that the probability of menstrual regularity among all study subjects (n = 75) was positively associated with increasing protein/kJ and increasing cholesterol/kJ intakes. The probability of being menstrually regular was negatively associated with increasing dietary fiber/kJ and increasing magnesium/kJ intakes. These results are consistent with the notion that menstrual regularity can be influenced by specific dietary nutrients that may have direct effects or exert their effects by modulating circulating sex steroid status.

Endocrinological Meaning of Hyperandrogenism in Patients with Polycystic Ovary

In the light of excessive ovarian androgen hormone production in cases of polycystic ovarian disease (PCO), we have made an endocrinological, symptomatological and morphological study of PCO in women with high serum testosterone levels. The following results were obtained: (1) High serum testosterone levels were found in 18.1% of the infertile women. (2) Morphologically, 44.4% of these women had PCO (the PCO group), and 55.6% did not have PCO (non-PCO group). (3) No significant differences between these groups were found in mean testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estrone (E1), 17 beta-estradiol (E2) levels, or the E1/E2 ratio, but the LH/FSH ratio was significantly higher in the PCO group. (4) The incidence of menstrual irregularities and hirsutism were significantly higher in the PCO group, but the incidence of obesity did not differ between the groups. (5) No correlation between testosterone and LH or E1 levels was found in the PCO group, but strong positive correlations were found in the non-PCO group. From the above findings it is suggested that in women with high peripheral blood testosterone levels, the presence of morphological abnormalities on the ovaries has effects on gonadotropin production and therefore on the incidence of menstrual irregularities and hirsutism.

Do clinical markers of hyperandrogenism relate to the response of acne to conventional therapy?

Sixty women with acne resistant to conventional antibiotic therapy were investigated to determine the incidence of clinical markers of hyperandrogenism and were compared with 60 women who had responded adequately to equivalent therapy. The mean hirsuties scores for the therapy-resistant and therapy-responsive groups were similar (2.0 and 2.1 respectively). The incidence of significnt hirsuties (score > 6) was low and not significantly different between the two groups (6.7% and 3.3% respectively). The two groups were also similar in respect of age at menarche, incidence of male and female pattern androgenetic alopecia, keratosis pilaris, acanthosis nigricans and hidradenitis suppurativa. The incidence of menstrual irregularity was lower in the therapy-resistant group but not significantly so. These results show that clinical features of hyperandrogenism and lack of response to conventional antibiotic therapy are not related. Thus clinical markers of hyperandrogenism cannot help the clinician in deciding wh...

Norplant®-2 rods: One year experience in Singapore

Norplant®-2 contraceptive implants consist of two silastic rods in which levonorgestrel has been incorporated with the polymer. This study describes our experience with 100 acceptors of the Norplant®-2 rods in Singapore. No pregnancies occurred during the first year of use. Menstrual irregularities was the main complaint associated with the use of Norplant®-2. However, the incidence of menstrual irregularities appeared to diminish with time and the continuation rate at the end of one year was 95.0 per cent. Thus, it appears that the Norplant®-2 rod systems offer a highly effective, convenient means of contraception which should be well accepted in future.

Norplant® contraceptive subdermal implants: One year experience in singapore

Norplant® contraceptive implants are silastic implants containing levonorgestrel. This study describes our experience with 100 acceptors of Norplant® implants in Singapore. There were no infections at the site after the implants were inserted. No pregnancies occurred during the first year of use. Disruptions of menstrual rhythm was the main complaint. However, the incidence of menstrual irregularities appeared to diminish with time. Implant users have tolerated this early disruption of their menstrual rhythm well and the continuation rate at the end of the year was 96.6 percent. Thus, it appears that Norplant® contraceptive implants offer a highly effective means of contraception which should become well accepted in the near future.

A Prospective Study of NORPLANT Implants and the TCu 380Ag IUD in Assiut, Egypt

This report describes the 1st year of experience of 250 acceptors of NORPLANT implants and 100 TCu380Ag IUD acceptors. The net cumulative 1 year pregnancy rate was about 1/100 women for each group. The continuation rate was 90/100 for implant users and 87/100 for IUD users. Disruption of menstrual rhythm was the main complaint of users of NORPLANT implants in the early months although complaints of menstrual irregularities were more frequent among users of the TCu 380Ag. The incidence of menstrual irregularities among implant users diminished with time. Implant users tolerated early disruption of their menstrual rhythm to a degree that surpassed expecations. There were no infections following placement of the implants. (authors modified)

The significance of hyperprolactinaemia: 2 years' experience

SummaryOver a 2-year period, 3104 patients (2606 women, 498 men) with a variety of abnormalities of reproductive function had serum prolactin measured by radio-immunoassay. After exclusion of other causes (pregnancy, drugs, hypothyroidism) of elevated prolactin levels, 185 patients (174 women, 11 men) were found to have at least one level greater than 500 mull. Prolactin measurement was found to be of no value in the investigation of potent, infertile men. Of the 61 women with at least two values greater than 500 mull, two grades of hyperprolactinaemia were identified: one in which the levels are greater than 1000 mu/1 with a high incidence of menstrual irregularity and a good chance of a response to bromocriptine therapy: and the second in which immunoreactive prolactin levels tend to be less than 1000 mull, there is a low incidence of menstrual irregularity and a poor response to bromocriptine therapy.

The influence of body weight on reproductive function in women.

SUMMARY The influence of weight on reproductive function is examined in a representative group of fertile women for whom data were recorded during pregnancy and for 2 years after delivery. The indices used were (a) the weight at the first antenatal examination (adjusted according to the number of days by which it preceded or followed the 124th day of gestation), and (b) an index of body build derived from the observed regression of the adjusted antenatal weight on height. Menstruation was recorded during the 12 months after delivery. Mean duration of postpartum amenorrhoea (Table 1) and mean cycle length (Tables 4–6) decreased with increasing body weight and with increasing degree of obesity. The incidence of menstrual irregularity appears to be unrelated to both indices (Table 3). Duration of gestation (Table 7), of labour (Table 8) and of lactation (Table 10), and the incidence of abortions, stillbirths and infant deaths in previous pregnancies (Table 9) were not consistently related to weight or body build. Birth weight of offspring increased with increasing degree of maternal obesity (Table 13) and was more closely associated with maternal weight than with maternal height (Table 11). The coefficient of correlation between birth weight and mother's weight (corrected for mother's height) is 0·20, and between birth weight and mother's height (corrected for mother's weight) is 0·09 (Table 12). It is concluded that the only evidence of variation with increasing degree of obesity in these features of reproductive function in a group of fertile women is a slight increase in frequency of menstruation and an increase in birth weight of offspring. The relation between weight and fertility was not examined and will be considered in a later communication.