Menstrual Cycle Characteristics Research Articles

Novel correlates between antimüllerian hormone and menstrual cycle characteristics in African-American women (23–35 years-old)

To characterize normative antimüllerian hormone (AMH) levels and ascertain which factors are associated with AMH inalarge cohort of reproductive-age women. Cross-sectional study. Not applicable. A total of 1,654 African-American women (AAW) ages 23-34 at recruitment. Not applicable. Serum AMH measured using an ultrasensitive ELISA. The median AMH was 3.18ng/mL, and there was a significant, but nonlinear, relationship between age and AMH, with levels peaking at age 25. As AMH was not normally distributed, log transformation was performed and used for all analyses. In a multivariable age-adjusted model, body mass index, current use of hormonal contraception, and history of a thyroid condition were inversely associated with AMH, while history of abnormal menstrual bleeding and menstrual cycles longer than 35days were positively associated with AMH. While age is correlated with AMH, it accounts for only a portion of the variation seen. This study adds valuable information to the existing literature on normative AMH levels in young reproductive-age women. While our findings fill a critical data gap for ovarian reserve in AAW, the insights gained will be of benefit for all women.

Abstract B37: Menstrual cycle characteristics, PCOS, and ovarian cancer risk.

Abstract Background: Long and irregular menstrual cycles, a hallmark of polycystic ovary syndrome (PCOS), have been associated with higher androgen and lower sex hormone binding globulin levels (SHBG) and this altered hormonal environment may increase the risk of specific histologic subtypes of ovarian cancer. Methods: We investigated the association between menstrual cycle characteristics and PCOS among 2071 women with epithelial ovarian cancer and 2100 controls in the New England Case-Control Study (1992-2008). Women self-reported menstrual cycle irregularity, menstrual cycle length, and previous diagnosis of PCOS. We used unconditional logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (95% CIs) for ovarian cancer risk overall, and polytomous logistic regression to evaluate whether the associations differed across histologic subtypes. Results: Overall, we observed no difference in ovarian cancer risk between women who reported periods that were never regular and women who did not report menstrual cycle irregularity (multivariable OR=0.87; 95% CI=0.69-1.10). A similar association was observed for those reporting an average menstrual cycle length of greater than 35 days with a multivariable OR of 0.87 (95% CI=0.47-1.60). In addition, no association was observed with self-reported PCOS and ovarian cancer (multivariable OR=0.96; 95% CI=0.60-1.54). When we examined the associations by histologic subtype, we observed significant differences in the association with menstrual cycle irregularity as the exposure (pheterogeneity=0.007) but not for cycle length >35 days or self-reported PCOS. Menstrual cycle irregularity was protective for serous invasive tumors (OR=0.66; 95% CI=0.47-0.91) but was associated with a non-significant increase in risk of serous borderline tumors (OR=1.32; 95% CI=0.86-2.03). Conclusions: Our results suggest that menstrual cycle characteristics may have influences on ovarian cancer risk that vary by histologic subtype. Future research in a large collaborative consortium may help clarify these associations. Citation Format: Holly R. Harris, Linda J. Titus, Daniel W. Cramer, Kathryn L. Terry. Menstrual cycle characteristics, PCOS, and ovarian cancer risk. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: Exploiting Vulnerabilities; Oct 17-20, 2015; Orlando, FL. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(2 Suppl):Abstract nr B37.

Familial Predisposition of Primary Dysmenorrhea among Senior High School Girl Students

Background : Dysmenorrhea is a common female reproductive problem in women of active reproductive age which is characterized by menstrual pain or cramps in a women’s lower abdomen or back. Dysmenorrhea can be classified into primary and secondary. One of the associated risk factor of primary dysmenorrhoeais the family history, however the study on the family history of primary dysmenorrhea with recurrent menstrual pain is limited. This study was conducted to identify the correlation between family history and primary dysmenorrhea in high school girls. Methods : This cross sectional study was conducted at several senior high schools in Jatinangor from April−June 2013. One hundred and sixty two students were included in this study. The sample size was calculated based on the unpaired−dichotomous variable for the two−sided formula. A self administered questionnaire was distributed to the senior high school girl students who were in their menarche age, menstrual cycle characteristics, presence or absence of dysmenorrhea, severity of pain and presence dysmenorrhea in mothers and in sisters were inquired. Data were analyzed using chi square test. Results : Overall, there were association between positive family history and primary dysmenorrhea among the students with (p<0.001). The prevalence of dysmenorrhea in the students was 92.6% with 95% confidence interval which was 87.5−95.7%. The prevalence rate was 67.9% in mothers with 95% confidence interval which is 60.4−74.6% and 80.2% prevalence of primary dysmenorrhoea in sisters with 95% confidence interval which is 73.4−85.6%. Conclusions : There is a significant association between positive family history and primary dysmenorrhea.[ AMJ .2015;2(4):579–83] DOI: 10.15850/amj.v2n4.643

Menstrual cycle characteristics in women with persistent schizophrenia.

Oestradiol has been implicated in the pathogenesis of schizophrenia. Women with schizophrenia often suffer with menstrual dysfunction, usually associated with low oestradiol levels, but whether menstrual dysfunction has an effect on their psychiatric symptoms is not well researched. The aim of this study is to document the menstrual characteristics of women with chronic schizophrenia with focus upon menstrual regularity, menstrual cycle length and menstrual symptoms. To determine which patient characteristics are associated with irregular menses and whether irregular menses are associated with the severity of psychotic symptoms, menstrual symptoms or depressive symptoms. Cross-sectional analyses using baseline data of women enrolled in a clinical trial. Inclusion criteria include Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Text Revision diagnosis of schizophrenia, schizoaffective or schizophreniform disorder; aged between 18 and 51 years; residual symptoms of psychosis despite treatment with a stable dose of antipsychotic medication for at least 4 weeks. Menstrual cycle characteristics including regularity, cycle length and menstrual associated symptoms were documented. Symptoms of schizophrenia were measured using Positive and Negative Syndrome Scale, cognition was measured using Repeatable Battery for the Assessment of Neuropsychological Status and depression was assessed using the Montgomery-Asberg Depression Rating Scale. Blood samples were collected at baseline for hormone assays. Of the 139 women, 77 (55.4%) had regular menses, 57 (41%) had irregular menses and 5 (3.6%) women had missing data on their menstrual cycle. Use of atypical antipsychotics associated with hyperprolactinaemia was positively associated with irregular menses (odds ratio = 4.4, 95% confidence interval = [1.8, 10.9], p = 0.001), while age more than 30 years was negatively associated (odds ratio = 0.3, 95% confidence interval = [0.1, 0.6], p = 0.004). Women with irregular cycles had significantly lower oestradiol levels than women with regular cycles (213.2 ± 25.0 vs 299.0 ± 27.3, p = 0.03), but there was no difference in Positive and Negative Syndrome Scale, Montgomery-Asberg Depression Rating Scale or Repeatable Battery for the Assessment of Neuropsychological Status between those with regular and irregular cycles. The most common menstrual associated symptoms were decrease in mood with the menstrual cycle (64.8%), bloating (64.8%), cramps (59.7%), back pain (37.6%) and worsening of psychosis symptoms (32.4%). Regular menses are associated with higher oestradiol levels and higher rates of cyclical mood symptoms but are not associated with Positive and Negative Syndrome Scale scores. Understanding the effect the menstrual cycle can have on psychiatric illness, such as premenstrual exacerbations, is important for the holistic care of women with schizophrenia.

Folic acid supplement use and menstrual cycle characteristics: a cross-sectional study of Danish pregnancy planners

PurposeTo examine the association between folic acid (FA) supplementation obtained through either single FA tablets or multivitamins (MVs) and menstrual cycle characteristics among 5386 women aged 18–40 years, enrolled in an Internet-based study of Danish women attempting pregnancy during 2007–2011. MethodsIn a cross-sectional study, we used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of FA supplementation with menstrual cycle regularity; short (<27 days), long (30–33 days), and very long (≥34 days) cycle lengths; and duration and intensity of menstrual bleeding. ResultsCompared with nonuse, FA supplementation was associated with reduced odds of short cycle length (OR = 0.80, 95% CI: 0.68–0.94) and a trend toward increased odds of very long cycle length (OR = 1.21, 95% CI: 0.87–1.68) compared with cycle length of 27–29 days. The inverse association with short cycle length was stronger among 18- to 30-year-old women (OR = 0.68, 95% CI: 0.53–0.87), nulliparous women (OR = 0.66, 95% CI: 0.52–0.84), and women who used both FA and MVs (OR = 0.75, 95% CI: 0.60–0.95). We found no clear association between FA supplementation and cycle regularity and duration and intensity of menstrual bleeding. ConclusionsFA supplementation was inversely associated with short menstrual cycle length. This association was strongest among women aged 18–30 years, nulliparous women, and women who used both FA and MVs.

Adverse childhood event experiences, fertility difficulties and menstrual cycle characteristics

Introduction: Increased childhood adversity may be affect adult fertility, however, the mechanism through which this occurs is unclear. Menstrual cycle abnormalities are predictive of fertility difficulties, and stress influences menstrual cycle characteristics. Here, we assess whether adverse childhood experiences (ACEs) are associated with fertility difficulties and menstrual cycle dysregulation, offering a plausible mechanism for the link between lifetime stress and fertility.Methods: From April 2012 to February 2014, 742 pregnant and non-pregnant women aged 18–45 years residing in southeastern Louisiana provided information on childhood adversity and reproductive history. Associations between ACEs and fertility difficulties and menstrual cycle patterns were evaluated.Results: As the number of ACEs increased, risk of fertility difficulties and amenorrhea increased (RR = 1.09, 95% CI 1.05–1.13 and RR = 1.07, 95% CI 1.04–1.10, respectively), while fecundability decreased [fecundability ratio (FR) = 0.97, 95% CI 0.95–1.00]. Compared to women with no adversity, women in the high adversity group were more likely to experience both infertility and amenorrhea (RR = 2.75, 95% CI 1.45–5.21 and RR = 2.54, 95% CI 1.52–4.25, respectively), and reduced fecundability (FR = 0.75, 95% CI 0.56–1.00). Although similar patterns were seen for menstrual cycle irregularity, associations were diminished. Associations did not materially change following adjustment for age, body mass index, race, education, smoking and income. Results are constrained by the self-report nature of the study and the limited generalizability of the study population.Discussion: To our knowledge, this is the first study to present evidence of a link between childhood stressors, menstrual cycle disruption and fertility difficulties. The effect of childhood stress on fertility may be mediated through altered functioning of the HPA axis, acting to suppress fertility in response to less than optimal reproductive circumstances.

Work schedule and physically demanding work in relation to menstrual function: the Nurses' Health Study 3.

This study aimed to evaluate occupational exposures and menstrual cycle characteristics among nurses. Using cross-sectional data collected in 2010-2012 from 6309 nurses aged 21-45 years, we investigated nurses' menstrual function in the Nurses' Health Study 3. We used multivariable regression modeling to analyze the associations between occupational exposures and prevalence of irregular cycles and long and short cycle lengths. The cohort reported cycle length as <21 (1.5%), 21-25 (15.6%), 26-31 (69.7%), and 32-50 (13.2%) days. In addition, 19% of participants reported irregular cycles. Working ≥41 hours/week was associated with a 16% [95% confidence interval (95% CI): 4-29%] higher prevalence of irregular cycles and a higher prevalence of very short (<21-day) cycles [prevalence odds ratio (OR) 1.93, 95% CI 1.24-3.01] in adjusted models. Irregular menstrual cycles were more prevalent among women working nights only (32% higher; 95% CI 15-51%) or rotating nights (27% higher, 95% CI 10-47%), and was associated with the number of night shifts per month (P for trend <0.0001). Rotating night schedule was associated with long (32-50 day) cycles (OR 1.28, 95% CI 1.03-1.61). Heavy lifting was associated with a higher prevalence of irregular cycles (34% higher), and the prevalence of cycles <21 days and 21-25 day cycles increased with increasing heavy lifting at work (P for trend <0.02 for each endpoint). Night work, long hours, and physically demanding work might relate to menstrual disturbances.

Maternal exposure to perfluorinated chemicals and reduced fecundity: the MIREC study.

STUDY QUESTIONWhat is the effect of maternal exposure to perfluorooctane sulfonate (PFOS), perflurooctanoic acid (PFOA) and perfluorohexane sulfonate (PFHxS) on female fecundity?SUMMARY ANSWERIncreasing concentrations of PFOA or PFHxS in maternal plasma were associated with reduced fecundability and infertility.WHAT IS KNOWN ALREADYPerfluorinated chemicals (PFCs) are a group of synthetic compounds used in industrial production. There is a concern about the effect of PFCs on fecundity, as measured by time-to-pregnancy (TTP). Although some recent studies suggest that increasing concentrations of PFCs may decrease fecundity, divergence in the methodological approaches used to evaluate this association have prevented firm conclusions being reached.STUDY DESIGN, SIZE, DURATIONThe Maternal-Infant Research on Environmental Chemicals (MIREC) Study is a cohort study of 2,001 women recruited before 14 weeks of gestation in 10 cities across Canada between 2008 and 2011.PARTICIPANTS/MATERIALS, SETTING, METHODSA questionnaire was administered and medical chart data and biospecimens were collected from participants. After excluding women who withdrew, those for whom data were incomplete, those whose pregnancies followed birth control failure, and accounting for male fertility, 1743 participants remained. TTP was defined as the number of months of unprotected intercourse needed to become pregnant in the current pregnancy, as self-reported in the first trimester of pregnancy. Plasma concentrations of PFOA, PFOS and PFHxS measured in the first trimester were considered as a surrogate of preconception exposure. Fecundability odds ratios (FORs) were estimated using Cox proportional hazard models for discrete time. FOR < 1 denote a longer TTP and FORs >1 denote a shorter TTP. The odds of infertility (TTP > 12 months or infertility treatment in the index pregnancy) were estimated using logistic regression. Each chemical concentration (ng/ml) was log-transformed and divided by its SD.MAIN RESULTS AND THE ROLE OF CHANCEThe cumulative probabilities of pregnancy at 1, 6 and 12 months were 0.42 (95% confidence interval (CI) 0.40–0.45), 0.81 (95% CI 0.79–0.83) and 0.90 (95% CI 0.89–0.92), respectively. The mean maternal age was 32.8 (SD 5.0) years. The geometric means (ng/ml) of PFOA, PFOS and PFHxS were 1.66 (95% CI 1.61–1.71), 4.59 (95% CI 4.46–4.72) and 1.01 (95% CI 0.97–1.05), respectively. After adjustment for potential confounders, PFOA and PFHxS were associated with a 11 and 9% reduction in fecundability per one SD increase (FOR = 0.89; 95% CI 0.83–0.94; P < 0.001 for PFOA and FOR = 0.91; 95% CI 0.86–0.97; P = 0.002 for PFHxS), while no significant association was observed for PFOS (FOR = 0.96; 95% CI 0.91–1.02; P = 0.17). In addition, the odds of infertility increased by 31% per one SD increase of PFOA (odds ratio (OR) = 1.31; 95% CI 1.11–1.53; P = 0.001) and by 27% per one SD increase of PFHxS (OR = 1.27; 95% CI 1.09–1.48; P = 0.003), while no significant association was observed for PFOS (OR = 1.14; 95% CI 0.98–1.34; P = 0.09).LIMITATIONS, REASONS FOR CAUTIONWomen with the highest concentrations of PFCs might have been excluded from the study if there is a causal association with infertility. The MIREC study did not assess concentrations of PFCs in males, semen quality, menstrual cycle characteristics or intercourse frequency.WIDER IMPLICATIONS OF THE FINDINGSOur results add to the evidence that exposure to PFOA and PFHxS, even at lower levels than previously reported, may reduce fecundability.STUDY FUNDING/COMPETING INTEREST(S)The MIREC study is supported by the Chemicals Management Plan of Health Canada, the Canadian Institutes for Health Research (CIHR, grant no. MOP – 81285) and the Ontario Ministry of the Environment. M.P.V. was supported by a CIHR Fellowship Award, and a CIHR-Quebec Training Network in Perinatal Research (QTNPR) Ph.D. scholarship. W.D.F. is supported by a CIHR Canada Research Chair. There are no conflicts of interest to declare.

Клинические и эндокринные особенности менструального цикла женщин

Клинические и эндокринные особенности менструального цикла женщин

Menstrual Cycle Changes in Women with Inflammatory Bowel Disease

The effect of the inflammatory bowel diseases (IBD) on menstrual function is largely unknown. The aims of this study were to determine whether changes in menstrual function occur in the year before IBD diagnosis or in the initial years after diagnosis. Women aged 18 years and older in the Ocean State Crohn's and Colitis Area Registry with at least 2 years of follow-up were eligible for this study. All patients were enrolled within 6 months of IBD diagnosis and followed prospectively. Menstrual cycle characteristics were retrospectively assessed. To assess for changes over time, general linear models for correlated data were used for continuous outcomes, and generalized estimating equations were used for discrete outcomes. One hundred twenty-one patients were studied. Twenty-five percent of patients experienced a change in cycle interval in the year before IBD diagnosis and 21% experienced a change in the duration of flow. Among women with dysmenorrhea, 40% experienced a change in the intensity of their menstrual pain and 31% experienced a change in its duration. Overall cycle regularity increased over time. Quality of life was significantly lower in women without regular cycles across all time points. Changes in menstrual function occur frequently in the year before IBD diagnosis; therefore, screening for menstrual irregularities should be considered in women with newly diagnosed IBD. Patients can be reassured that cycles typically become more regular over time.

Assessment Of Adolescent Student's Knowledge Toward Premenstrual Syndrome In Nursing Secondary Schools At Al-Diwanyia Governorate

Abstract: Objective: to Assess Adolescent Student's Knowledge toward Premenstrual Syndrome in Nursing Secondary Schools at Al- Diwanyia Governorate . Methodology: ِA descriptive analytic study was carried out to assess adolescent student's knowledge toward premenstrual syndrome in nursing secondary schools at Al- Diwanyia governorate from February 2013 to July 2013.A purposive sample consist of (282) adolescent student with premenstrual syndrome in nursing secondary schools at Al-Diwanyia governorate (Al-Diwanyia- Al-Hamzah- Al- Shamyia- Afak).A questionnaire was constructed for the purpose of the study, it was composed of three parts, part one: consist of demographic information, part two: consist of menstrual cycle characteristics ,part three: consist of questions regarding adolescent student's knowledge toward premenstrual syndrome, it comprise of one main domain and five sub domains. Reliability of the questionnaire is determined through the pilot study and the validity through a panel of (13) experts. Descriptive statistical analysis procedures and inferential statistical analysis procedures were employed for data analysis, all the statistic procedures were tested at P≤0.05 .                       Results: The result revealed that the majority of the study sample 44.6 % had insufficient knowledge toward premenstrual syndrome. The assessment of knowledge is not affected by demographic characteristics and menstrual cycle characteristics, that mean the studied questionnaire can be amend for all individuals of the studied population . Recommendations: The study recommended to development of school health services for better detection and management of PMS in the adolescent population .Curriculum of nursing secondary schools should contain efficient knowledge about menstrual cycle disorders especially PMS  . Encouraged affected girls to seek medical advise from the medical staff .Enhance adolescents students knowledge regarding PMS as well as adapt healthy life style through booklet, educating programs, mass media, articles. Key words: Assessment, Premenstrual syndrome, Adolescent Student, Knowledge

The influence of perinatal and current dioxin and PCB exposure on reproductive parameters (sex-ratio, menstrual cycle characteristics, endometriosis, semen quality, and prematurity): a review

AbstractPolychlorinated biphenyls (PCBs) and dioxins (PCDDs/Fs) are well-known endocrine disrupters. This paper strives to elucidate the data on reproductive consequences of perinatal dioxin and PCB exposure in men and women. We focused on the following end-points: sex-ratio, endometriosis, menstrual cycle characteristics, sperm quality, and prematurity. We summarize 46 papers and compare their results including effects seen after exposure to background concentrations. Seven of twelve studies showed a decrease in sex-ratio after parental dioxin or PCB exposure. In three of the seven studies, effects were seen after paternal exposure and in three after maternal exposure. In eight of the nine studies on menstrual cycle characteristics, abnormalities were associated with PCB or dioxin exposure, however the results differed. In three studies PCB and TCDD were associated with longer menstrual cycles, while three studies indicated that an increase in PCB/PCDF exposure was associated with shorter cycles. Five studies showed effects on menstrual bleeding with higher PCB or dioxin exposure. A higher rate of irregular menstrual cycles in exposed women was seen in four studies. The conflicting outcomes probably result from variability in study design, timing of exposure and endocrine disrupting properties of the measured congeners. Nine of sixteen studies detected higher PCB or dioxin exposure in women with endometriosis. However, the manner of diagnosing endometriosis and the character of the studies varied from prospective to retrospective. Five of eight studies focusing on sperm quality showed that men, with higher serum concentrations of PCBs and/or PCB congeners and/or PCDFs, had reduced sperm quality, including increased abnormal morphology and reduced motility. The exposure timeframe seemed important here. There are two studies addressing preterm birth in relation to PCBs, one mentioned a shortening of three days of gestational age, two other studies did not find a relation. Recently one study related a shorter gestational age of half a week with overall dioxin activity measured with the CALUX method in cord blood, particularly in boys. In conclusion, exposure to PCBs and dioxins has a negative effect on the reproductive systems of human populations. Although some speculations have been made, the exact mechanism of these effects and the interactions of these compounds with other endocrine disruptors are not yet known. Age at exposure and congener specific properties are probably crucial in interpreting the observed results.

Study to determine the menarcheal age of school going girls at Jhalwar district, Rajasthan

Background: The onset of menstruation is part of the maturation process. However, variability in menstrual cycle characteristics and menstrual disorders are common. This variability depend on many factors. Aims & Objectives: The objectives of this study was to determine the menarcheal age of school going girls and also to evaluate the effect of factors like Socio-economic status, Nutritional status, and Participation in games/ physical activity on menarcheal age in school going girls in Jhalawar. Materials and Methods: A cross-sectional descriptive study was carried out on school going girls with age ranging from 12 to 16 years. Menarche data were obtained by the status-quo method regarding menarcheal age by asking a girl of her current status that is she has had her first menses by the time of assessment. Data were collected using a self-administered structured questionnaire on menstruation. Questionnaire included general demographic information, socioeconomic data, food habit and physical activity. Results: Out of 353 numbers of girls 58.07% (205) were from government school and 41.93% (148) from private school. 53.46% girls form government school and 77.03% girls from private school got menarche at

Onset of menstrual cycle and menses features among secondary school girls in Italy: A questionnaire study on 3,783 students.

Premise:Healthcare professionals need updated information about what is the range of “normal” variation of menstrual cycle features to support young girls and their parents in managing reproductive health, and to detect diseases early.Materials and Methods:This cross-sectional study aimed to provide an updated picture of age at menarche and main menstrual cycle characteristics and complaints in an Italian population-based sample of 3,783 adolescents attending secondary school. Girls filled in a self-administered anonymous questionnaire including questions about demography, anthropometry, smoking and drinking habits, use of contraceptive, socioeconomic status, age at menarche, menstrual pattern, and physical/psychological menstrual complaints. Mean age at menarche and prevalence of polymenorrhea (cycle length < 21 days), oligomenorrhea (cycle length > 35 days), irregularity, dysmenorrhea, and of physical/psychological complaints were computed. Factors associated with age at menarche and menstrual disturbances were explored by using multiple logistic models.Results:The girls’ mean age was 17.1 years (SD 1.4 years) and the mean age at menarche was 12.4 years (SD 1.3 years); menarche occurred with two monthly peaks of frequency in July–September and in December–January (P < 0.0001). Age at menarche was significantly associated with geographic genetics (as expressed by parents’ birth area), mother's menarcheal age, BMI, family size, and age at data collection. The prevalence of polymenorrhea was about 2.5%, oligomenorrhea was declared by 3.7%, irregular length by 8.3%, while long bleeding (>6 days) was shown in 19.6% of girls. Gynecological age was significantly associated with cycle length (P < 0.0001) with long cycles becoming more regular within the fourth year after menarche, while frequency of polymenorrhea stabilized after the second gynecological year. Oligomenorrhea and irregularity were both significantly associated with long menstrual bleeding (adjusted OR = 2.36; 95% CI = 1.55-3.60, and adjusted OR = 2.59; 95% CI = 1.95-3.44, respectively).Conclusions:The findings of the study support the levelling-off of secular trend in menarche anticipation in Italy and confirm the timing in menstrual cycle regularization. The study provides updated epidemiological data on frequency of menstrual abnormalities to help reproductive health professionals in managing adolescent gynecology.

Menstrual cycle and sport training: a look at the problem

El estudio de la relación entre el ciclo menstrual y el rendimiento deportivo está presente entre las últimas publicaciones sobre el deporte femenino, tratando de contribuir a un mejor proceso de preparación de las mujeres en las distintas modalidades deportivas y prevenir las posibles afecciones de la función menstrual. Las características del ciclo menstrual de las deportistas de alto nivel no poseen diferencias sustanciales con respecto a la función menstrual de las mujeres no deportistas; sin embargo, se presentan estadísticas de un mayor porcentaje de afecciones del aparato reproductor femenino en comparación con la población en general. Existen variaciones considerables de las características del ciclo al interior de los grupos estudiados, las cuales, se asocian por los autores con la ubicación en la “escala de feminidad”. Las fases premenstrual y menstrual, junto con la ovulatoria, son las que más dificultad reflejan para las deportistas a la hora de enfrentar las cargas de entrenamiento y de competencia. En lo referente a la menarquía, la maduración tardía es propia de las modalidades de iniciación temprana y donde se requiere mantener el bajo peso corporal. Se muestran las últimas tendencias y resultados de las investigaciones, en el campo del entrenamiento femenino.

Moderate alcohol intake and menstrual cycle characteristics

Does moderate alcohol intake affect menstrual cycle characteristics among women in the Danish population? Levels of alcohol exposure as seen in this study do not substantially affect the menstrual cycle. Animal studies indicate alcohol-induced disruptions of the reproductive system, but previous epidemiological studies addressing the possible association between alcohol intake and the menstrual cycle are sparse. A cross-sectional study with retrospectively collected data including 82 146 pregnant Danish women in the Danish National Birth Cohort (DNBC) enrolled during the years 1996-2002. Information on weekly alcohol consumption and menstrual cycle characteristics before pregnancy was obtained through a computer-assisted telephone interview in pregnancy Week 12-16. The associations between weekly alcohol consumption and menstrual cycle irregularity (≥7 days difference between cycles) and length (short cycle: ≤24 days, long cycle: ≥32 days) were analysed using logistic regression with weekly alcohol intake categorized into abstainers (0 drinks per week), low (0.5-2.0 drinks per week), moderate (2.5-14.0 drinks per week) and high (14.0-86.5 drinks per week). Estimates are given as adjusted odds ratios with 95% confidence intervals. The overall participation rate was 60% of the women invited. We found that a high weekly alcohol consumption was not associated with menstrual cycle disturbances. We observed higher odds of irregular and short cycles among abstainers when compared with women with a low weekly alcohol consumption, but found no trend of more cycle disturbances with higher alcohol consumption. Possible limitations in our study include a risk of selection bias due to the moderate participation rate and the use of retrospective information on alcohol exposure and menstrual cycle characteristics before getting pregnant. The higher odds of irregular and short cycles among abstainers may reflect other health problems in these women rather than an actual effect of alcohol on the menstrual cycle. The generalizability of the study results is restricted to women who manage to conceive and women who do not use oral contraceptives within 2 months before getting pregnant. This study suggests that the menstrual cycle is not substantially affected by higher alcohol consumption among the participating women. Supported by a scholarship from Aarhus University Research Foundation. The Danish National Research Foundation has established the Danish Epidemiology Science Centre that initiated and created the DNBC. The cohort is furthermore a result of a major grant from this Foundation. Additional support for the DNBC is obtained from the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation and the Health Foundation. No conflict of interest declared.

Menstrual cycle characteristics in fertile women from Greenland, Poland and Ukraine exposed to perfluorinated chemicals: a cross-sectional study

Does perfluorooctane sulfonate (PFOS) and perfluorooctanate (PFOA) exposure disrupt the menstrual cyclicity? The female reproductive system may be sensitive to PFOA exposure, with longer menstrual cycle length at higher exposure. PFOS and PFOA are persistent man-made chemicals. Experimental animal studies suggest they are reproductive toxicants but epidemiological findings are inconsistent. A cross-sectional study including 1623 pregnant women from the INUENDO cohort enrolled during antenatal care visits between June 2002 and May 2004 in Greenland, Poland and Ukraine. Information on menstrual cycle characteristics was obtained by questionnaires together with a blood sample from each pregnant woman. Serum concentrations of PFOS and PFOA were measured by liquid chromatography tandem mass spectrometry. Multiple imputations were performed to account for missing data. The association between PFOS/PFOA and menstrual cycle length (short cycle: ≤24 days, long cycle: ≥32 days) and irregularities (≥7 days in difference between cycles) was analyzed using logistic regression with tertiles of exposure. Estimates are given as adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Higher exposure levels of PFOA were associated with longer menstrual cycles in pooled estimates of all three countries. Compared with women in the lowest exposure tertile, the adjusted OR of long cycles was 1.8 (95% CI: 1.0; 3.3) among women in the highest tertile of PFOA exposure. No significant associations were observed between PFOS exposure and menstrual cycle characteristics. However, we observed a tendency toward more irregular cycles with higher exposure to PFOS [OR 1.7 (95% CI: 0.8; 3.5)]. The overall response rate was 45.3% with considerable variation between countries (91.3% in Greenland, 69.1% in Poland and 26.3% in Ukraine). Possible limitations in our study include varying participation rates across countries; a selected study group overrepresenting the most fertile part of the population; retrospective information on menstrual cycle characteristics; the determination of cut-points for all three outcome variables; and lacking information on some determinants of menstrual cycle characteristics, such as stress, physical activity, chronic diseases and gynecological disorders, thus confounding cannot be excluded. The generalizability of the study results is restricted to fertile women who manage to conceive and women who do not use oral contraceptives when getting pregnant or within 2 months before getting pregnant. To our knowledge only one previous epidemiological study has addressed the possible association between perfluorinated chemical exposure and menstrual disturbances. Though pointing toward different disturbances in cyclicity, both studies suggest that exposure to PFOA may affect the female reproductive function. This study contributes to the limited knowledge on effects of exposure to PFOA and PFOS on female reproductive function and suggests that the female reproductive system may be affected by environmental exposure to PFOA. Supported by a scholarship from Aarhus University Research Foundation. The collection of questionnaire data and blood samples was part of the INUENDO project supported by The European Commission (Contract no. QLK4-CT-2001-00 202), www.inuendo.dk. The Ukrainian part of the study was possible by a grant from INTAS (project 012 2205). Determination of PFOA and PFOS in serum was part of the CLEAR study (www.inuendo.dk/clear) supported by the European Commission's 7th Framework Program (FP7-ENV-2008-1-226217). No conflict of interest declared.

Clinical outcome, fertility and uterine artery Doppler scans in women with obstetric bilateral internal iliac artery ligation or embolisation

The objective of our study was to report on the clinical outcome, fertility and uterine artery Doppler scans in patients with major postpartum haemorrhage, treated with bilateral internal iliac artery ligation or embolisation. We performed an observational analysis of successful bilateral internal iliac artery ligation or embolisation for postpartum haemorrhage in a tertiary hospital between 2001 and 2006. Clinical data and other medical/ surgical manoeuvres were recorded. Fertility data, menstrual cycle characteristics and uterine artery Doppler scans were assessed. Our success rate in bleeding control was 81%. Three patients got pregnant again 13, 16 and 23 months after the procedure. The one patient whose uterine artery was not identified in the Doppler scan was the only one who presented with secondary infertility. Three patients presented with secondary dysmenorrhoea. We concluded that internal iliac artery occlusion is an effective fertility-sparing procedure for postpartum haemorrhage. The absence of uterine revascularization could be a negative factor in future reproduction. Due to our limited sample size, larger studies are required to confirm these findings.

96 Menstrual cycle characteristics in European and Inuit women exposed to perfluorinated chemicals: preliminary findings from a cross-sectional study

ObjectivesPerfluorooctanate (PFOA) and perfluorooctane sulfonate (PFOS) are ubiquitous man-made compounds. Studies suggest that they are possible hormonal disruptors, but findings are inconsistent. We examined the association between measured PFOS and...

Gene x environment interactions impact endometrial function and the menstrual cycle: PROGINS, life history, anthropometry, and physical activity

We assessed the impact of a high frequency, functionally significant allelic variant of the progesterone receptor gene (PROGINS) on endometrial function and menstrual cycle characteristics. Further we asked whether PROGINS moderates the impact of life history characteristics, anthropometric measures, and physical activity on endometrial function. Fifty-two women were genotyped for the PROGINS variant, provided life history information, and had anthropometric measurements made. Women monitored their menstrual bleeding for three cycles, performed mid-cycle urinary ovulation tests, and recorded physical activity. A subset of women provided daily saliva samples and had mid-luteal endometrial thickness measurements taken during the third menstrual cycle. Salivary progesterone was assayed using ELISAs. The direct impact of PROGINS on endometrial and menstrual cycle characteristics was determined via independent t-tests with Bonferroni correction. Interactions between PROGINS and covariates were assessed by moderated regression. PROGINS did not directly impact any indicator of endometrial function. However, PROGINS caused an increase in menstrual cycle length with increasing mid-luteal progesterone levels; the opposite relationship was present in noncarriers (P < 0.05). Additionally, PROGINS interacted with four of six anthropometric measures (BMI, waist circumference, height, and waist-hip ratio) to impact endometrial function, however, interactions between PROGINS and life history variables, or physical activity was limited. The gene x environment interactions we report suggest that PROGINS alters endometrial sensitivity to maternal energetic condition. Thus, the possibility of genetically-based variation in sensitivity to energetic stress should be considered in future adaptive models of women's reproduction.