Menstrual Cycle Pattern Research Articles

Does Covid-19 vaccination affect menstruation pattern?

Background: As Millions of people are receiving COVID-19 vaccine around the world, a number of side effects are being reported. Menstrual cycle disturbance is also a side effect reported by hundreds of women on social media. The objective of this study was to assess the association of menstrual abnormalities with COVID-19 vaccination.
 Subjects and methods: This descriptive cross sectional study was conducted in Obstetrics and Gynecology OPD of Mufti Mehmood Hospital D.I. Khan from March 2021 to June 2021. The health care workers who received Sinopharm COVID-19 vaccine and consented were included. Data was collected about change in menstrual cycle pattern after COVID-19 vaccination.
 Results: A total of 80 subjects were included in the study with mean age of 32.6 +7.89 years. There were 36 (45.0%) doctors, 33 nurses (41.25%), 6 (7.5%) paramedics and 5 (6.25%) medical students. According to their marital status, 51 (63.75%) were married and 29 (36.25%) were unmarried. Out of 80 subjects, 16 (20%) reported disturbance in menstrual cycle pattern, 13 (81.2%) after first dose and 3 (18.75%) after both first and second dose. Among these 9 (56.25%) reported heavy menstrual bleeding, 4 (25%) had prolonged bleeding days while 3 (18.75%) had irregular bleeding pattern.
 Conclusion: Menstrual cycle disturbance is a reported side effect of COVID-19 vaccination. It is more commonly reported after first dose and heavy menstrual bleedings is the most common pattern followed by prolonged/irregular bleeding.

Menstrual Cycle Patterns After Concussion in Adolescent Patients

To describe menstrual cycle patterns in adolescents with concussion and investigate whether menstrual cycle phase at injury influenced postconcussion cycle pattern changes or concussion symptoms. Data were collected prospectively from patients aged 13-18years presenting to a specialty care concussion clinic for an initial visit (≤28days postconcussion) and, if clinically indicated, at a follow-up visit 3-4months postinjury. Primary outcomes included menstrual cycle pattern change since injury (change/no change), menstrual cycle phase at time of injury (calculated using date of last period before injury), and symptom endorsement and severity, measured by Post-Concussion Symptom Inventory (PCSI). Fisher exact tests were used to determine the association between menstrual phase at injury and change in cycle pattern. Multiple linear regression was used to determine whether menstrual phase at injury was associated with PCSI endorsement and symptom severity, adjusting for age. Five hundred twelve postmenarchal adolescents were enrolled (age15.2±1.4years), with 111 (21.7%) returning for follow-up at 3-4months. Menstrual pattern change was reported by 4% of patients at initial visit and 10.8% of patients at follow-up. At 3-4months, menstrual phase at injury was not associated with menstrual cycle changes (P=.40) but was associated with endorsement of concussion symptoms on the PCSI (P=.01). At 3-4months' postconcussion, 1 in 10 adolescents experienced a change in menses. Menstrual cycle phase at injury was associated with postconcussion symptom endorsement. Leveraging a large sample of postconcussion menstrual patterns, this study represents foundational data regarding potential menstrual cycle effects of concussion in female adolescents.

Possible menstrual cycle changes after COVID 19 vaccination a questionnaire-based study among vaccinated women

On January 21 2021, India granted emergency use authorization to Covishield (non-replicating adenovirus vaccine) and Covaxin (viral inactivating vaccination). Reports till 02 Jan 2023 suggest a cumulative total of 2,20,10,77,192 vaccination doses administered among the Indian Population. A sore arm, fever, and myalgia are the most common side effects of covid-19 immunization, according to the UK's Medicines and Healthcare Products Regulatory Agency (MHRA). COVID-19 vaccination has not been shown to negatively affect fertility in any of the clinical trials. However, patients who have encountered alterations in their menstrual cycle and bleeding patterns quickly after vaccination are increasingly approaching primary care providers and reproductive health professionals Therefore, our study aims in collecting data from pre-menopausal, vaccinated women regarding alterations in their menstrual cycle post COVID-19 Vaccination through a self-administered pre-validated Questionnaire. Our study implies that almost 77.9% of the study participants did not observe any menstrual changes while 23.1% of the reported abnormal menstruation cycles which included delayed cycles, early cycles, less bleeding than normal and change in blood color. Our study’s conclusion highlights the need for larger studies to identify the possibility for a relationship to exist between COVID 19 Vaccination and Menstrual cycle.

Symptom experience during the late reproductive stage versus the menopausal transition in the Spanish-language Women Living Better survey.

The aim of this study was to characterize and compare the symptoms women self-report during the late reproductive stage and the menopausal transition. This cross-sectional analysis used data from the Spanish-language Women Living Better survey. Women aged 35 to 55 years completed an 82-item online survey to assess menstrual cycle patterns, changes, and 61 symptoms sometimes associated with menopause. Women's menstrual patterns were classified as late reproductive stage or menopausal transition using the Stages of Reproductive Aging Workshop. Demographic and health-related data were collected, including age, country of residence, race/ethnicity, education, parity, smoking, and alcohol use. Descriptive statistics characterized reported symptoms, and logistic regression models examined associations between reproductive stage and symptoms. Of 853 respondents, 358 women were included in the sample analyzed. Participants were on average 40 ± 4.1 years old, 46% reported difficulty paying for basics, 34% lived in Spain, and 20% lived in Mexico. A similar proportion of women in the late reproductive stage and menopausal transition reported 8 of 18 symptom groups. Women in the late reproductive stage had a lower age-adjusted odds of musculoskeletal pain (odds ratio, 0.35; 95% CI, 0.19-0.66) and lower odds of decreased interest in sex (odds ratio, 0.49; 95% CI, 0.25-0.92). Both groups of women reported a similar interference with personal relationships. Late-reproductive-stage women experience multiple symptoms often associated with menopause. A better understanding of symptoms experienced among Spanish-speaking women may lead to more personalized health care and facilitate anticipatory guidance about menopause. Future cross-cultural studies focusing on symptoms during the late reproductive stage are necessary.

The Quality of Life of and Social Determinants Affecting Menopausal Women in Aseer's Healthy Cities in Saudi Arabia: A Cross-Sectional Study.

Introduction Menopause is an important period in a woman's life. It is the permanent cessation of menses for 12 months or more. Menopause can develop over a long period of time. The average age for menopause to start is 52 years, but it can begin at any time from age 40 to 58 years. Many symptoms are related to postmenopausal syndrome: hot flashes, irritability, mood swings, insomnia, dry vagina, difficulty concentrating, mental confusion, stress incontinence, urge incontinence, osteoporotic symptoms, depression, headache, and vasomotor symptoms. Quality of life (QOL) has been defined by the World Health Organization (WHO) as an "individual's perceptions of their position in life in the context of the cultural and value systems in which they live and in relation to their goals, expectations, standards, and concerns." Methods A cross-sectional study was conducted among participants from Aseer's Healthy Cities. The sample was calculated using the formula ofSwinscow and Cohen, and a total of 823 main cities were the target sample size. The sample was simply picked at random from October to December 2021. The Menopause Rating Scale (MRS)-related questionnaire is used to evaluatethe symptoms of menopause in people who answer the questions themselves. Result The study included 869 participants, 98.3% of which are Saudi nationals. Of the participants, 82.1% were married. As regards the lifestyle of the participants in the study, 69% live with a husband and children. The mean age of the study participants was 42.5 (standard deviation (SD):8.883) years. The mean number of participants with somatic vasomotor symptoms was 0.74 (SD: 94). The majority of the participants have sleep issues such as difficulty falling asleep, difficulty sleeping through the night, and waking up early (mean: 0.97, SD: 1.3), followed by hot flashes and sweating (mean: 0.65, SD: 1.165), and heart discomfort (mean: 0.63, SD: 12). Psychosocial symptoms are also common (mean: 0.95, SD: 1.16); the majority have depressive moods (mean: 1.09, SD: 1.35), followed byirritability (mean: 0.93, SD: 1.2), and anxiety (mean: 0.84, SD: 1.22). Physical symptoms are also prevalent, with a mean and SD of 0.91 and 1.03, respectively, with bladder problems having a mean and SD of 0.55 and 1.017, respectively. Finally, there were also sexual symptoms (mean: 0.70, SD: 1.09), with sexual problems having a mean and SD of 0.81 and 1.28, respectively. Conclusion The study found a high percentage of unawareness about menopause and a need to improve healthcare access and symptomatic treatment. The regression model of psychosocial risk factors is found to have a significant association with the increase of symptoms and using other medications for any reason, menstrual cycle pattern, and marital status.

Characteristics Of Menstrual Cycle And Hormonal Contraceptive Use In Collegiate Female Athletes In The United States

BACKGROUND: Menstruation is an important metric to assess and monitor optimal health in female athletes. Phases of the menstrual cycle are also correlated with variations in performance outcomes. Historically, collegiate-level athletes have relied on hormonal contraceptives (HC) to promote menstrual cycle regularity and reduce dysfunction. However, global trends indicate a decrease in HC use in female athletes, but this has not been quantified in collegiate NCAA athletes. Therefore, the purpose of this study is to quantify HC vs. non-use, and to characterize menstrual cycle patterns of non-HC users, in a diverse population of NCAA female athletes. METHODS: Female NCAA athletes (N = 410) from four universities, across 13 sports assessed, completed a questionnaire through the WHOOP application platform. Responses were categorized by groups using oral contraceptives (OC) (n = 175), other forms of HC (n = 60), and non-users of HC (n = 175). The group using other forms of HC were subcategorized into IUD, implant, ring, or other, groups. The number of typical bleeding days per cycle, and cycles in the past year, were examined in non-HC users only. Prevalence and type of HC use and non-use is reported as percentage of total sample and HC population, respectively. Days of menstruation is reported as percentage of the non-HC user population, by day ranges. RESULTS: HC use was 57% (n = 235, age = 21 ± 2 yrs.) of total population, of which 74% (n = 175) used OC, 7% (n = 31) used IUDs, 3% (n = 16) used a hormonal implant, and 2% (n = 11) reported other HC use. Non-HC users were 42% (n = 175, age = 21 ± 2 yrs.) of which 60 % (n = 105) reported normal bleed patterns of 3 to 6 days, while 1% (n = 2) reported 1 to 2 days, and 6% (n = 10) reported 7 to 8 days. Of the non-HC users, 3% (n = 6) reported 5 or less periods in the last year, while 74% (n = 130) reported 9 or more in the last year. CONCLUSIONS: This is the first study to investigate HC vs. non-HC use, as well as menstrual cycle patterns in female NCAA athletes from a wide range of sports. Knowledge of HC use and menstrual cycle patterns in female athletes is important for developing appropriate monitoring and management practices. Future outcomes of this dataset will investigate menstrual cycle irregularities across the season, variations by sport, and changes due to stress, training modalities, and lifestyle behaviors.

Menstrual Cycle Function Following Concussion In Adolescent Patients

Purpose: This study sought to describe menstrual cycle patterns in acutely concussed adolescents and to investigate if cycle phase at injury influenced post-concussion cycle pattern changes or symptom endorsement. Methods: Data were collected prospectively from patients aged 13-18 years presenting to a specialty care concussion clinic for initial visit within 28 days of concussion and a follow-up visit 3-4 months post-injury. Primary outcomes included changes in menstrual cycle pattern since injury (change/no change), menstrual cycle phase at time of injury, calculated using date of last period prior to injury, and symptom severity, measured by the Post-Concussion Symptom Inventory (PCSI). Fisher’s exact tests were used to determine the association between menstrual phase at injury and change in cycle pattern at follow-up. Multiple linear regression was used to determine if menstrual phase at injury was associated with subsequent PCSI symptom severity, adjusting for age. Results: Five hundred ninety-eight post-menarchal adolescents were enrolled (mean age 15.4 ± 1.4 years) with 136(22.7%) returning for follow-up. At time of injury, 108(18.9%) were in the menstruation phase, 269(47.0%) were in the follicular phase, 105(18.4%) were in the early luteal phase, and 90(15.7%) were in the late luteal phase. Menstrual pattern change was reported in 4% of patients at initial visit and 12.5% of patients at follow-up. At 3-4 months, menstrual phase at injury was not associated with menstrual cycle changes (p = 0.18) but was associated with PCSI severity (p = 0.03). Patients injured in the early luteal phase reported the highest symptom severity at follow-up. Conclusions: One in eight adolescents reporting to clinic at 3-4 months post-concussion had experienced a change in menses. Menstrual cycle phase at time of injury was associated with post-concussion symptom severity, but not a change in menstrual pattern. Leveraging the largest study sample of post-concussion menstrual patterns to date, this study represents important foundational data regarding potential hormonal effects of concussion in adolescents. Supported by NIH R01NS097549 and T32NS043126

Factors associated with regularity and length of menstrual cycle: Korea Nurses’ Health Study

BackgroundMenstrual cycle characteristics are linked to reproductive function and long-term health outcomes. This study aimed to evaluate menstrual cycle patterns, characterized by regularity and length, and associated factors among women in the Korea Nurses’ Health Study.MethodsA total of 9335 premenopausal women aged 22–45 years were included in this cross-sectional study. Regularity and length of menstrual cycles were self-reported, and their associations with reproductive, lifestyle, and occupational factors were examined using binomial and multinomial logistic regression models. Adjusted least-square means of menstrual distress, depressive symptoms, stress, fatigue, anxiety, and sleep problems were estimated according to menstrual cycle characteristics using generalized linear models.ResultsTwenty-one percent of nurses reported having irregular menstrual cycles (variability > 7 days). Ten percent, 64%, and 26% had menstrual cycle length of < 26, 26–31, and 32–50 days, respectively. Variability and length of cycles decreased with age and increased with age at menarche. Parous women showed low tendency of irregular cycles. Women with body mass index (BMI) > 25 kg/m2 had higher odds of irregular (odds ratio [OR] 1.68; 95% confidence interval [CI] 1.40–2.03) and long cycles (OR 1.31; 95% CI 1.08–1.58) than those with BMI 18.5– < 23 kg/m2. Irregular cycles were less common in women performing vigorous physical activity, but more common in those with prolonged standing or frequent heavy lifting at work. Frequent rotating night shift was associated with irregular cycles among nulliparous women. Levels of menstrual and premenstrual distress, depressive symptoms, perceived stress, physical and mental fatigue, anxiety, and sleep problems were higher in women with irregular cycles than in those with regular cycles (p < 0.001, each).ConclusionsThe study suggests that irregular and long menstrual cycles are associated with reproductive, lifestyle, and occupational factors; also with menstrual distress and perceived health status. Our findings contribute to a better understanding of potential risk factors for menstrual dysfunction, and thus, may help improve women’s health.

GAMBARAN PENGETAHUAN SISWA KELAS VII TENTANG POLA SIKLUS MENSTRUASI DI SMP NEGERI 2 DOLOK PARDAMEAN KABUPATEN SIMALUNGUN TAHUN 2022

Background : Menstruation can be defined as regular bleeding from the uterus as a sign that the uterine organs are functioning properly or are ready to reproduce. Generally, teenagers who experience their first menstruation (menarche) are at the age of 12 to 16 years. A normal menstrual cycle will occur every 22-35 days with a menstrual period of approximately 2-7 days. Menstruation can be troublesome for girls, this is generally due to lack of or incorrect information about menstruation. Generally people are afraid to see blood, especially children. His ignorance can lead to it mistakenly, linking menstruation to illness or injury and even viewing it as something shameful, for not getting a proper explanation. Objective : To describe the knowledge of seventh grade students about menstrual cycle patterns in adolescents at SMP Negeri 2 dolok pardamean Research method : The design of this study user a quantitative descriptive method, with a Cross Sectional research design using a population of 45 and a sample of 45 samples, with a sampling technique. by Aqidental sampling, and in collecting data using a questionnaire with univariate analysis, frequency and percent. The conclusion is based on the results of the study with a sample of 45 respondents regarding the description of the knowledge of class VII students about the menstrual cycle pattern at SMP Negeri 2 Dolok Pardamean Simalungun Regency. Suggestion to learn all about the menstrual cycle pattern in schools at SMP Negeri 2 Dolok Pardamean, Simalungun Regency. It is hoped that there will be material about menstruation in learning outcomes in order to access some about menstruation both through books and social media.

Knowledge Level on the Association Between Body Mass Index (BMI), Menstrual Cycle and Lifestyle Patterns in Contributing the Development of Polycystic Ovarian Syndrome (PCOS) Among Female University Students

Introduction: Polycystic ovarian syndrome (PCOS) is a heterogeneous endocrine disorder characterized by anovulation, hyperandrogenism, infertility and metabolic dysfunction, that affect ladies in their adolescent period until menopause, specifically at reproductive age. The objective of this study was to determine the knowledge level of PCOS and the association between BMI, menstrual cycle and lifestyle pattern in contributing the development of PCOS and its relationship with sociodemographic characteristics among female students at International Islamic University Malaysia (IIUM), Kuantan, Pahang. Methods: A quantitative cross-sectional study using convenience sampling method was conducted among 245 female undergraduate students of IIUM Kuantan Campus, from April to May of 2021. Data were collected using Google Forms platform and a quantitative questionnaire which was available in English Language and distributed to all female undergraduate students in the campus. The set of questionnaires were taken from a research paper by Thomas et al. (2018). Data analysis was done by using SPSS version 21.0. Results: The majority of the participants have above-average knowledge level regarding PCOS and its association with BMI, menstrual cycle and lifestyle pattern (58.0%). The mean score on knowledge on the association between BMI and development of PCOS significantly different in between kulliyyah and year of study, with Kulliyyah of Medicine and students from Year 5 are higher compared to other Kulliyyah and year of study, respectively. For the association between menstrual cycle and development of PCOS, the mean score on knowledge is differed significantly across year of study. The mean score on knowledge on the association between lifestyle pattern and development of PCOS differed significantly across kulliyyah with Kulliyyah of Allied Health Science are higher compared to other kulliyyah.Conclusion: Female undergraduate students have above-average knowledge regarding PCOS and its association with BMI, menstrual cycle, and lifestyle patterns.

Changes in the menstruation pattern after COVID infection

The pandemic of COVID 19 had tremendous impact on the physical, mental as well as the social well being of the people. It has affected the respiratory, cardiovascular as well as endocrine system. Menstruation which is a regular cyclical phenomenon seem in females of reproductive age group has also been affected because of COVID-19. A study was conducted in Dhiraj hospital to know about the affect of COVID on menstrual patterns of the women who were affected . At the end of the study we observed that the women who recovered from covid infection suffered from altered menstrual pattern in form of scanty menstrual blood flow and, prolonged cycles, few women experienced menorrhagia with excessive amount of blood loss. When followed up for 4 months almost all women regained their normal pattern of menstrual cycle suggesting that the covid 19 infection had transitory effect on menstrual pattern.

Laparoscopically Confirmed Endometriosis and Risk of Incident Stroke: A Prospective Cohort Study.

Prior research suggests that women with endometriosis are at greater risk of coronary heart disease. Therefore, our objective was to prospectively investigate the association between laparoscopically confirmed endometriosis and risk of incident stroke during 28 years of follow-up. Participants in the NHSII cohort study (Nurses' Health Study II) were followed from 1989 when they were between the ages of 25 to 42 until 2017 for development of incident stroke (ischemic and hemorrhagic). Cox proportional hazard models were used to calculate hazard ratios and 95% CI, with adjustment for potential confounding variables (alcohol intake, body mass index at age 18, current body mass index, age at menarche, menstrual cycle pattern in adolescence, current menstrual cycle pattern, parity, oral contraceptive use history, smoking history, diet quality, physical activity, NSAID use, aspirin use, race/ethnicity, and income). We estimated the proportion of the total association mediated by history of hypertension, hypercholesterolemia, hysterectomy/oophorectomy, and hormone therapy. We also tested for effect modification by age (<50, ≥50 years), infertility history, body mass index (<25, ≥25 kg/m2), and menopausal status. We documented 893 incident cases of stroke during 2 770 152 person-years of follow-up. Women with laparoscopically confirmed endometriosis had a 34% greater risk of stroke in multivariable-adjusted models (hazard ratio, 1.34 [95% CI, 1.10-1.62]), compared to those without a history of endometriosis. Of the total association of endometriosis with risk of stroke, the largest proportion was attributed to hysterectomy/oophorectomy (39% mediated [95% CI, 14%-71%]) and hormone therapy (16% mediated [95% CI, 5%-40%]). We observed no differences in the relationship between endometriosis and stroke by age, infertility history, body mass index, or menopausal status. We observed that women with endometriosis were at elevated risk of stroke. Women and their health care providers should be aware of endometriosis history, maximize primary cardiovascular prevention, and discuss signs and symptoms of cardiovascular disease.

O-181 The predictive value of the menstrual cycle pattern in adolescence on fertility and general health at age 40 years

Abstract Study question What is the predictive value of the menstrual cycle pattern in adolescence on fertility, cardiovascular- and metabolic health at age 40 years Summary answer Adolescents with oligomenorrhea are more often treated to conceive, but, are as likely to have children as those with regular menstrual cycles. What is known already Polycystic ovary syndrome(PCOS) is the main endocrine disorder in women of reproductive age. Adolescents with oligomenorrhea have a high risk for PCOS and potential subfertility due to ovulatory disorders. PCOS is also associated with pregnancy complications as pregnancy induced hypertension, pre-eclampsia and gestational diabetes. Furthermore PCOS is related to long-term health risks such as cardiovascular disease and diabetes. Studies on longitudinal implications of adolescent oligomenorrhea for fertility are lacking. Data on long-term health consequences of PCOS usually describe the development of these diseases in adult PCOS patients and lack longitudinal input starting at adolescence. Study design, size, duration This is a long-term follow-up study based on a unique adolescent study on menstrual irregularities performed between 1990-1997, the Pubertal onset of Menstrual Cycle abnormalities, a prospective study, the POMP study. We contacted stratified samples of this studycohort two decades after the initial study for a questionnaire assessing PCOS features, fertility history, pregnancy outcome, metabolic and cardiovascular health. Participants/materials, setting, methods 160 of 271 of the invited adult participants completed the questionnaire; the mean adolescent age was 15.3 years and the women were 39.6 years at time of follow-up. 92 had a regular menstrual cycle as adolescent and also as adult (REGREG); 15 changed to oligomenorrhea in adulthood (REGOL); 21 oligoamenorrheic adolescents remained oligomenorrheic (OLOL),and 31 oligomenorrheic girls developed a regular menstrual cycle pattern (OLREG). Main results and the role of chance Of those with adolescent regular menstrual cycles(REGREG+REGOL) 12 never tried to conceive, 4 tried but never conceived and 92 of 96(95,8%) conceived, 89 of 96(92,7%) delivered at least one living child. The mean time to pregnancy (TTP) in the REGREG subgroup was 7.2(SD 11.2) months with 14.6% subfertility (TTP &amp;gt; 12 months) compared to a TTP of 14.9 (SD 19.5) months with 35.7% subfertility in the REGOLsubgroup. 47 of 52 adolescents with oligomenorrhea (OLOL+OLREG) tried to conceive and 45(95,6%) succeeded to have at least one full term pregnancy. The mean TTP was 12.8 months (SD 19.8) in the OLOL subgroup versus 13.6 (SD 18.2) months in the OLREG subgoup, respectively 30 % and 24 % had a TTP &amp;gt; 12 months (p = 0.17). The median number of children was two in all subgroups. The OLOL subgroup had more fertility treatments -40%- than the other subgroups (14-22%) (p = 0.08). BMI did not differ between the four subgroups. The risk for pregnancy induced hypertension or pre-eclampsia was comparable among all subgroups (14-20%). Gestational diabetes developed in 3 participants all part of the OLOLsubgroup. Adult diabetes (0-5%), hypertension(3-10%), hypercholesterolaemia(0-5%) were diagnosed most frequently in the OLOLsubgroup, Cardiovascular disease(0-1%) in the REGREG subgroup Limitations, reasons for caution The numbers in the study are small. However the small difference between the percentage with a least one living child of those with adolescent oligomenorhea versus those with adolescent regular menstrual cycles is reassuring. Time to pregnancy data may have been biased by early treatment of oligomenorrheic adults. Wider implications of the findings Oligomenorrheic adolescents may be reassured for their chance to have a live birth being comparable with those with a regular menstrual cycle. Trial registration number NTR5871

Association of Menstrual Cycle Pattern with Perceived Stress Score among Student and Staff Nurses

Aims: To determine the menstrual cycle patterns among student and staff nurses and to compare levels of perceived stressed score and determine its association with menstrual cycle pattern. Study design: Cross-sectional study Place and duration of study: Shaikha Fatima Institute of Nursing and Health Sciences Lahore from 1st February to 1st July 2021. Methodology: One hundred and fifty participants aged 18 years containing information related to menstrual cycle patterns and problems related to menstrual cycle and perceived stress scale questionnaire. Results: Most common premenstrual symptom was generalized pain was found in 20 (26.0%) of student nurses and 12 (16.0%) of staff nurses. Mood swing was found to be highest among the negative effects of menstrual cycle reported by 39 (52.0%) of students and 35 (46.7%) staff nurses. No statistically significant difference was found between perceive stress scores of student and staff nurses.27.3% of participants having high level of perceived stress score were also experiencing irregular cycle. It was observed that irregular patterns of menstrual cycle was highly associated with high perceived stress score (p &lt; 0.0001). Conclusion: Irregular menstrual cycle among student and staff nurses were strongly related with perceived stress score. Therefore, it was suggested that student and staff nurses should be counselled by psychologist as well as by a gynecologist in order to prevent future complications. Keywords: Perceived stress score, Menstrual cycle pattern, Menstrual irregularities

121 Steroid cell tumor of the ovary

Ovarian steroid cell tumors are rare. They are fewer than 5 percent of sex-cord stromal tumors and comprised of 0.1% of all ovarian tumors. The average age at diagnosis is the mid-twenties, but patients can present at virtually any age. This is a case of a 19-year-old nulligravid with secondary amenorrhea, excessive hair growth and deepening of the voice. Ultrasonography of the pelvic structures revealed a right ovarian new growth, a 2.4 × 2.3 × 2.2 cm solid mass. Tumor markers results are within normal limits. An exploratory laparotomy with frozen section biopsy was planned. Incidentally, there was a note of blood pressure elevation to 150–160/80–90, preoperatively and intraoperatively. The right adnexal solid mass of the ovary was submitted for frozen section which revealed sex cord stromal tumor. After resection of the mass, the blood pressure ranges from 120–130/60–80. Final biopsy revealed a sex cord stromal tumor favor steroid cell tumor, not otherwise specified. The patient was discharged and advised for follow up. Upon follow up, she is now normotensive, and there was a note of resolution of the symptoms of voice changes and regularization of the menstrual cycle pattern.

Menstruation-Related Disorders-Dysmenorrhea and Heavy Bleeding-as Significant Epiphenomena in Women With Rheumatic Diseases.

Background: In women with rheumatic diseases (RDs) menstruation-related disorders have never been investigated. The aim of this study was to evaluate gynecological symptoms/disorders in fertile age women with RDs. Materials and methods: All patients (n = 200) filled up a self-administered questionnaire on their gynecological history, menstrual cycle pattern, menstrual-related symptoms, and quality of life (QoL). The RD group was then compared to a control group of 305 age-matched fertile age women. Results: Among patients with RDs, 58% had arthritis, 40% connective tissue diseases (CTDs), and 1.5% systemic vasculitis. No differences were observed between CTDs and arthritis, except for a family history of HMB which was more common among women with CTDs (p < .01). When compared to controls, women with RDs reported more frequent heavy menstrual bleeding (HMB) during adolescence (51.7 and 25.4%, respectively; p = .0001) and adult life (37.7 and 25.9%, respectively; p = .0065). Also, dysmenorrhea in adolescence was significantly more common among cases (55.6 and 45.4%, respectively; p = .0338). Gynecological pain (dysmenorrhea, non-menstrual pelvic pain, dyspareunia, dysuria, and dyschezia) in patients with RDs was more frequent than in controls (p = .0001, .0001, .0001, .0001, .0002, respectively). Considering women who reported moderate and severe symptoms in RDs, dysmenorrhea and dyspareunia remain significantly more frequent in women with RDs than in controls (p = .0001; p = .0022; respectively). QoL scores were significantly reduced in women with RDs, either in physical (p = .0001) and mental domains (p = .0014) of short-form 12. Conclusion: Women affected by RDs frequently presented menstruation-related disorders; thus, female patients with RDs should be questioned about gynecological symptoms and referred to the gynecologist for an accurate evaluation.

Effect of Hypothyroidism on Menstrual Cycle Pattern and Fertility at a Tertiary Care Centre in South India

Introduction: Thyroid disorders are very common in females and are known to prevent ovulation. Thyroid disorders can impact menstrual cycles and causes menstrual irregularities and infertility in females. Aim: To determine effects of hypothyroidism on menstrual cycle pattern and prevalence of subfertility among women having thyroid dysfunction. Materials and Methods: This cross-sectional study was conducted in Department of Obstetrics and Gynaecology in collaboration with Department of Endocrinology in Government Medical College, Datia Madhya Pradesh, India from July 2019 to June 2021. A total of 205 patients aged 18-45 years were taken. Among them, 116 and 89 patients were of hypothyroid and euthyroid respectively. After properly selecting patients, detailed history of their menstrual cycles was taken and effect of thyroid dysfunction on menstrual irregularities was assessed. The collected data were evaluated and analyzed using Statistical Package of the Social Sciences (SPSS). Results: A total of 205 patients participated in present study. Mean age was 35+/-5 years. Among 205 subjects, 116 were hypothyroid and 89 were euthyroid. Among the hypothyroid subjects, 72 (62.1%) had normal menstrual cycles, 23 (19.8%) had history of oligomenorrhea, 12 (10.3%) had polymenorrhea, and 9 (7.7%) had amenorrhea, while among the thyroid subjects, 76 (85.4%) had normal menstrual cycle, 6 (6.7%) had oligomenorrhea, 5 (5.6%) had polymenorrhea, and 2 (2.2%) had amenorrhea, with statistically significant differences (p&lt;0.001). The proportions of primary 13 (11.2%) and secondary 9 (7.7%) subfertility were significantly higher among hypothyroid subjects compared with thyroid subjects (p&lt;0.05). The prevalence of subfertility was 7 (7.8%), 10 (14.28%), and 12 (26.08%) among the thyroid, overtly hypothyroid, and subclinical hypothyroid subjects, respectively. Conclusion: In this study, effects of thyroid dysfunction were presumably significant on menstrual cycle pattern and fertility; therefore, thyroid status should be assessed in all patients with menstrual disorders and appropriate treatment should be initiated early.

To See the Correlation of Menstrual Cycle Factors with Time to Achieve a Pregnancy, in a Cross Sectional Survey of a Tertiary Care Hospital in Karachi

Objective: To see the correlation of menstrual cycle factors with time to achieve a pregnancy, in a cross sectional survey of a tertiary care hospital in karachi. Study Design: A cohort study and convenience sampling technique was used. Place and Duration of Study: The outpatient department of OBGYN, The Dow University Hospital, from June 2020 till June 2021. Methodology: All the women who were coming to antenatal clinic and were eligible with the inclusion criteria were interviewed in the OPD (outpatient department).The research instrument used for the study was a self-developed questionnaire, which comprised of demographics, reproductive and medical history and life style and behavioral factors in close ended questions on the menstrual cycle patterns. Results: among the participants with age of menarche ≤14 years old 98.2% reported for regular menstrual cycle, 6.5% reported for less than 25 days of cycle length, 5.3% reported for less than 3-days of bleeding duration, 68.8% were currently pregnant, out of which 53% conceived after trying for conception between 6-9 months. , in samples with menarche age more than 15-years old 90.3% reported for regular menstrual cycle, 33.3% reported for 27-29 days of cycle length, 31.9% reported for less than 3-days of bleeding duration, 72.2% were currently pregnant, 37% conceived after trying for conception from 6-9 months. Conclusion: Therefore from this study we concluded that late menarche (&gt;15 years), prolonged cycles and decrease bleeding days are the associated factors with decrease fecundity in terms of prolonged time to achieve pregnancy in our study population. KeyWords: Menarche, Time to pregnancy, fertility, menstrual cycle.

Comparison of two drospirenone-containing oral contraceptives for their effect on the ovary, menstrual cycle, acne, and side-effect profile: 20 µg ethinylestradiol/3 mg drospirenone (24/4) versus 30 µg ethinylestradiol/3 mg drospirenone (21/7)

Background/Aim: Serious side effects, depending on the length of the hormone-free interval and the estrogen dose, cause the discontinuation of combined oral contraceptives (COCs). Therefore, it is important to identify COCs with minimal side effects which provide effective contraception. This study aimed to compare the effects of two different drospirenone-containing oral contraceptives (COCs) on ovarian suppression, cycle control, premenstrual symptoms, pain, acne, and the incidence of side-effects. Methods: This prospective randomized controlled study was conducted with eighty women aged between 17-40 years. Patients were randomized to either 3mg drospirenone/30mcg ethinylestradiol (21/7 tablets) (Group 1) or 3mg drospirenone/20mcg ethinylestradiol (24/4 tablets) (Group 2) COCs. On Day-3 of the pre-treatment cycle, menstrual cycle patterns, serum hormone and lipid levels, menstrual complaints were recorded, followed by an evaluation of Day-21 progesterone levels, sonographic evaluation of endometrial thickness and the ovaries. Same assessment was repeated after pill use and the findings of the two cycles were compared. Results: Both COC formulations suppressed serum hormone levels, decreased endometrial thickness and reduced incidence of dysmenorrhea-dyspareunia, and acne while serum HDL-cholesterol level was increased. Progesterone, FSH and endometrial thickness were lower, and serum cholesterol level was higher in Group 2 (P=0.007, P=0.044, P

Relationship of Physical Activity with Pattern and Outcomes of Menstrual Cycle among Undergraduate Medical Students

Background: Menstrual cycle is affected by a number of factors either positively or negatively. Disturbed menstrual cycle impacts physical, mental and social well being of women. Physical activity and exercise affect pattern of menstrual cycle depending upon its intensity. Aim: To explore the relationship of physical activity and pattern of menstrual cycle particularly dysmenorrhea and its impact on absenteeism. Study Design: Cross-sectional study Place and Duration of the Study: Department of Community Medicine, HITEC-IMS Taxila from 1st March to 31st August 2020. Methodology: One hundred and six randomly selected female undergraduate medical students of 1st to 4th year. A self-reported structured questionnaire was used to collect the data. Results: Mean age of respondents was 21.1+1.6 years. Body mass index of 47.2% respondents was normal, 26.4% were overweight and 15.1% were obese. Menstrual flow was reported light by 11.3% respondents, 74.5% had moderate and 14.2% had heavy menstrual flow. Dysmenorrhea was reported by 85% respondents, 13% had mild, 14% had moderate and 33% had severe pain during menstruation. Absenteeism was reported by 28.3% participants and was found to be associated with dysmenorrhea. Statistically significant (p&lt;.05) association was found between physical activity and dysmenorrhea. Conclusion: Abnormalities of menstrual cycle among medical students can affect their physical well-being leading to class absenteeism. Regular and continuous physical activity can be of a great effect in improving menstrual pain and related problems. Keywords: Menstrual cycle, Dysmenorrhea, Physical activity, Undergraduate medical students