Menstrual Dysfunction Research Articles

Menstrual dysfunction in adolescent girls who are overweight: a literature review

This study aimed to review the modern literature on the problems of adolescent obesity and the pathogenesis of menstrual dysfunction in overweight adolescents and women of reproductive age. In recent years, a large number of works have been published on the relationship of hyperinsulinemia with ovarian hyperandrogenism. Most authors recognize that insulin resistance and hyperinsulinemia contribute to polycystic ovary syndrome formation. The formation of menstrual disorders in overweight girls is based on the violation of gonadotropin secretion, insulin resistance, and hyperinsulinemia, which over time lead to hyperandrogenism. A decreased level of somatotropic hormone and insulin-like growth factor and an increased level of leptin leads to malfunctions in the correct functioning of the hypothalamic-pituitary system. These changes disturb the ovulatory function and, consequently, adolescent reproductive health. The relationship between obesity and depression is actively discussed by foreign authors, and the obtained results often contradict each other. Most studies suggest that excessive weight gain during adolescence can lead to depression, negative mood, and low self-esteem.
 This study analyzes the results of research by domestic and foreign authors on the issues of diagnosis and treatment. Menstrual disorder therapy against the background of overweight adolescent girls is a matter of dispute among clinicians. With weight loss in adolescents, a significant improvement is found in carbohydrate and lipid metabolism, decreased levels of hepatic transaminases, and a decreased severity of obstructive sleep apnea syndrome.

Assessment of knowledge, awareness and practice of dental practitioners on the relationship between poly cystic ovarian syndrome (PCOS) in periodontally compromised women-A questionnaire based survey

Polycystic Ovary Syndrome (PCOS) is a common endocrinal disorder of uncertain etiology characterized by hyperandrogenism, anovulatory infertility, menstrual dysfunction, hirsutism, alopecia and acne. Periodontitis is a common chronic infection characterized by an exaggerated gingival inflammatory response against pathogenic bacterial microflora, resulting in alveolar bone and eventually tooth loss. The relationship of PCOS in periodontally compromised women are very distinctly studied.A cross-sectional survey study design was conducted with closed it's close ended questions. The question were self-prepared, validated and made reliable. Data collection done and analyzed using the SPSS software. Descriptive and inferential statistical analyses were determined.95 percent of the participants were aware of a condition called PCOS. A total of 71 percent of participants have expressed that they carry out routine screening in their clinical practice. However, only a total of 57% of the total participants were able to diagnose PCOS in their clinical practice. A total of 64% of the participants have expressed that intrigue knowledge on the oral manifestations of PCOS have helped diagnose PCOS in their patients. 63 percent of the total participants were aware of the medical specialty of choice to consult for patients diagnosed with PCOS of which only 28 percent of the total participants were aware of the clinical grading of PCOS.This survey helps conclude that even though knowledge of PCOS, clinical manifestations and oral manifestations of PCOS are aware for majority, only 10% achieve to diagnose it in daily practice. This study hopes to shed light on the relationship between Poly Cystic Ovarian Syndrome (PCOS) in periodontally compromised women to better enhance the diagnosis, treatment planning and the systemic corelation of the oral manifestations of the condition.

The Use of a Two-Phase Online Delphi Panel Methodology to Inform the Concurrent Development of a School-Based Ovulatory Menstrual Health Literacy Intervention and Questionnaire.

IntroductionThere are a high prevalence of ovulatory-menstrual (OM) dysfunction and low levels of menstrual health literacy in adolescents, yet few evidence-based OM health education resources for schools.MethodThis two-phase study used an online Delphi methodology to build consensus across thirty-five purposively selected professionals from the diverse professions of health and education. The panellists were tasked to inform the development of a school-based OM health literacy resources.ResultsIn Round One, 86% of panellists determined the scope of these resources using guided and open-ended questions. The study then split into two phases which ran concurrently. In the first phase informing the intervention's development, 57% of panellists participated in Round Two, and 29% reviewed selected lessons. In the second phase informing the questionnaire's development, 51% of panellists participated in Round Two, and 69% in Round Three. The overall consensus reached for the intervention phase and questionnaire phase were 82% and 84%, respectively. The Panel's recommendations included a strengths-based position to counter menstrual stigma, teaching accurate self-report of cycle biomarkers, addressing multiple menstrual dysfunctions and adopting a whole-school approach.ConclusionAlthough time-consuming and requiring a sustained interest, this two-phase Delphi methodology offered anonymity to panellists from distinct professions which facilitated their independent contribution to developing OM health literacy school resources.

Features of changes in hormonal homeostasis among patients with acne

Objective. To evaluate the nature of changes in hormonal homeostasis among patients with acne, depending on menstrual function disorders. Acne is a common skin disease characterized by the development of an inflammatory process in the sebaceous glands; at the age of 1224, it is equally observed in boys and girls, and at an older age, it mainly affects women. Acne has a complex pathogenesis, in which hereditary, metabolic, immune and endocrine mechanisms are realized. It is often found in women with a violation of menstrual function. The aim of the study was to evaluate the nature of changes in hormonal homeostasis among patients with acne, depending on menstrual function disorders.
 Materials and methods. The study involved 65 patients with acne, who were divided into two groups: group I was formed by 40 patients with acne having menstrual disorders; group II included 35 patients with acne without menstrual function disorders. The groups were comparable by social status and age; all were residents of the Perm Region, all gave voluntary written consent to participate in the study. The study included general clinical techniques, dermatological status and laboratory methods including biochemical blood analysis with indicators of lipid spectrum, glucose, total protein, zinc, liver enzymes, pituitary hormones (FSH, LH, TSH, prolactin) and sex hormones. Methods of parametric and nonparametric statistics were used to analyze the data obtained.
 Results. In patients with acne, minor metabolic changes were detected, equally with and without menstrual cycle disorders. In the study of hormonal homeostasis, it was noted that in acne patients with menstrual cycle disorders, hyperprogesteronemia was determined much more often (80.0 6.3 %). The remaining sex hormones and pituitary hormones had insignificant changes in both the groups studied.
 Conclusions. Acne, accompanied by a disturbance of menstrual function, is characterized by change in hormonal homeostasis in the form of an increased level of blood progesterone. In acne patients with a normal menstrual cycle, hormonal changes are insignificant. The metabolic disorders observed in acne do not depend on the character of the menstrual cycle. Patients with acne having menstrual dysfunction require joint management and treatment by both dermatovenerologist and gynecologist. In other cases, dermatological tactics is the basic one.

Mental Health and PCOS Information-Sharing: Interviews with Health Care Providers in a Low-Income Urban Community.

Polycystic ovary syndrome (PCOS) is a female metabolic-endocrine disorder typically characterized by menstrual dysfunction, hyperandrogenism, and/or polycystic ovaries. While comorbidity with poor mental health is often observed, it is less understood if women of color are given information on PCOS, mental health, or both by healthcare providers. This paper examines the information-sharing practices of healthcare providers serving a low-income, predominantly Latino/Hispanic municipality in Southeast Los Angeles, CA. Of 65 providers identified across 27 clinics in the service area, four participated in one-on-one semi-structured interviews. Four themes relating to PCOS and mental health information were identified using content analysis. Results suggest that information-sharing on PCOS is limited to symptomatic patients and varies by provider specialization. Poor mental health as a side effect of PCOS is not elaborated on during patient-provider interactions within the explored service area. Implications and directions for further research are discussed, including mixed methods approaches for contextual information on PCOS among women of color and recommendations for improving communication among healthcare providers.

Effect of Menstrual Dysfunction in Adolescent Concussion Patients on Length of Time to Recovery and Symptom Burden

Background:Concussions are one of the most common sport-related-injuries seen in the adolescent population. It is well known that female athletes are at higher risk for concussion, but factors that influence this risk, including hormonal influences, are not entirely known. There is no literature to date that explores the relationship between menstrual dysfunction (MD) and outcome measures of concussion.Hypothesis/Purpose:Our primary purpose is to determine if MD predicts prolonged recovery from concussion and our secondary purpose is to determine if MD predicts a higher initial symptom burden.Methods:Patients who presented to a pediatric sports medicine concussion clinic for an initial visit, were ≤18 years-old, and were at least 2 years post-menarchal were included in the study. Those who reported taking any hormonal medications, were pregnant, or who suffered symptoms greater than 180 days were excluded. Subjects who were >15 years old at menarche, experienced <10 menstrual periods per year or >35 days between cycles were categorized as having MD. Two linear regressions were analyzed to determine differences in initial symptom score and time to recovery between those with and without MD while controlling for age, history of headaches, and history of prior concussions.Results:A total of 801 participants were included in the study (697 controls and 108 MD patients). There was no statistically significant difference in time to recovery between the groups (p=0.12). However, MD patients took 5 days longer to recover than controls (51.23 vs. 46.42 days). There was no statistical difference in initial symptom score between the MD and control groups (p=0.67, 56.04 for controls and 58.47 for MD).Conclusion:No statistically significant differences were found in time to recovery after concussion or in initial symptom burden between subjects with MD and controls. Additional study is warranted to further characterize these relationships.

Low energy availability surrogates associated with lower bone mineral density and bone stress injury site

Exercise is an osteogenic stimulus that should increase bone mineral density (BMD) and protect against injury. However, some female athletes have lower BMD and increased bone stress injury (BSI) risk. Impaired bone health seen in athletes may be explained by low energy availability as described by concepts of Relative Energy Deficiency in Sport (RED-S) and Female Athlete Triad (Triad). To elucidate the relationship between RED-S/Triad risk factors and BSI to high-risk (femoral neck, sacrum) and low-risk (other) bones. Cross-sectional survey and retrospective chart review. Tertiary care academic center. Female athletes aged 15-30 years participating in ≥4h/week of exercise presenting to sports medicine/orthopedics clinic who had a self-reported BSI and available dual-energy x-ray absorptiometry (DXA) measurement of BMD. Not applicable. Location of BSI. In 127 athletes, high-risk BSI was associated with surrogates of low energy availability (p=.032) and having a DXA Z-score < -1 (p=.035) but not a current/past history of menstrual dysfunction (p=.348). Accumulating RED-S/Triad risk factors increase the odds of incurring a high-risk BSI (p=.048). Adolescent/young female athletes who sustain BSI at high-risk sites (femoral neck, sacrum) may have underlying risk factors (eg, low energy availability, poor overall bone health) that should prompt further workup and referral to optimize health in these athletes.

Female Reproductive Health Disturbance Experienced During the COVID-19 Pandemic Correlates With Mental Health Disturbance and Sleep Quality.

The COVID-19 pandemic has adversely affected population mental health. Periods of psychological distress can induce menstrual dysfunction. We previously demonstrated a significant disruption in women’s reproductive health during the first 6 months of the pandemic. The present study investigates longer-term reproductive and mental health disturbances. A cross-sectional online survey was completed by 1335 women of reproductive age in April 2021. It included validated standardized measures of depression (PHQ-9), anxiety (GAD-7) and sleep quality (PSQI). 581 (56%) of women reported an overall change in their menstrual cycle since the beginning of the pandemic. There was no change in median cycle length [28 days (28-30)] or days of menses [5 (4-5)], but there was a wider variability in minimum (p<0.0001) and maximum (p<0.0001) cycle length. There was a significant increase in heavy menstrual bleeding, painful periods and missed periods compared to pre-pandemic (all p<0.0001). 64% of women reported worsening pre-menstrual symptoms. Rates of severe depression, anxiety and poor sleep were more than double those from large scale representative community samples. Poor sleep quality was an independent predictor of overall change in menstrual cycle (OR=1.11, 95%CI 1.05-1.18), and missed periods (OR=1.11, 95%CI 1.03-1.19) during the pandemic. Increased anxiety was independently associated with a change from non-painful to painful periods (OR=1.06, 95%CI 1.01-1.11) and worsening of pre-menstrual symptoms (OR=1.06, 95%CI 1.01-1.07) during the pandemic. The COVID-19 pandemic continues to bear a significant impact on female reproductive health. Increased levels of psychological distress and poor sleep are associated with menstrual cycle disruption.

Diagnostic Evaluation of Polycystic Ovarian Disease

Background: Polycystic ovary syndrome is a heterogeneous endocrine disorder that affects about one in 15 females worldwide. The major endocrine disruption is excessive androgen secretion or activity, and a large proportion of women also have abnormal insulin activity. Many body systems are affected, resulting in several health complications, including menstrual dysfunction, infertility, hirsutism, acne, obesity, and metabolic syndrome. Several biochemical tests play an important role in diagnosing and predicting health consequences of this disease. Aims: To determine the signs and symptoms of polycystic ovarian syndrome in gynaecology outpatient department of Jinnah Hospital Lahore and to describe the clinical presentations, biochemical findings and ultrasound findings in patients with polycystic ovarian syndrome. Design Descriptive case series Setting: Department of Obstetrics &amp; Gynecology, Jinnah Hospital Lahore from 1st March 2018 to 28th February 2019. Methodology: One hundred patients of reproductive age group with signs and symptoms of polycystic ovarian syndrome were included. A detailed history and examination was carried out. Then diagnosis of polycystic ovarian syndrome was confirmed by laboratory tests and ultrasound findings. Results: 72% patients presented with menstrual irregularities.56% patients had BMI&gt; 25kg/m2 .72% patients had hirsutism. Out of total patients 62% patients were married and 38% were unmarried. Among those who were married 24(38.7%) patients presented with primary infertility and 17(27.4%) presented with secondary infertility.44% patients had raised total serum testosterone. Diabetes mellitus was present in 14% of patients. Ultrasound criteria were fulfilled in 77% patients with polycystic ovarian disease. Conclusion: Most common clinical presentations of polycystic ovarian disease were found to be menstrual irregularities, hirsutism and obesity. Hyperinsulinemia and hyperandrogenism was also more commonly found in obese XIV and hirsute women. Also ultrasound is a very useful diagnostic tool for polycystic ovarian disease. Keywords: Polycystic ovarian disease, diagnostic evaluation, health consequences, diabetes mellitus, insulin resistance.

Lightweight rowers' perspectives of living with Relative Energy Deficiency in Sport (RED-S).

ObjectiveTo compete in lightweight rowing, strict limits are placed on the maximum body weight of each individual. As a result, lightweight rowers commonly restrict calorie intake despite high energy expenditure. This can result in Relative Energy Deficiency in Sport (RED-S). The aim of this study is to investigate the physical and psychosocial impact of RED-S, from the perspective of lightweight rowers.DesignSemi-structured individual qualitative interviews.ParticipantsAdults living in the United Kingdom who are current or former lightweight rowing participants and experienced ≥1 symptom of RED-S.MethodAudio-recorded semi-structured individual telephone interviews were performed. Data was analysed using an inductive thematic approach, coding was iterative and data-driven, facilitated by NVivo software.ResultsTwelve current or former lightweight rowers (intermediate to international standard, 67% female, aged 19–32 years) participated. Participants restricted calories and increased energy expenditure to elicit weight-loss in order to meet weight requirements. This resulted in psychosocial implications (reduced social interaction, difficulty maintaining relationships, poor emotional regulation, low mood, poor concentration, disordered eating, guilt and anxiety around food, and a negative body image). Some psychosocial implications persisted after retirement from lightweight rowing. Participants described a range of physical implications, including disrupted sleep, decreased performance and recovery, bowel disruption, menstrual dysfunction, fatigue, musculoskeletal pain, injury and weakened immune systems.ConclusionsThis study describes short and long-term physical and psychosocial impacts of RED-S from the perspective of lightweight rowers. Findings highlight the importance of effective RED-S prevention and management strategies for lightweight rowers. These findings may be used to educate health-care professionals, coaches and athletes on the personal impacts and serious health consequences of RED-S.

Structure of Gynecological Diseases and Comorbidity in Women with HIV Infection and Reproductive Disorders

Background: The increase in the number of HIV-infected women of fertile age, as well as their reproductive plans to have healthy children, was the reason for studying the features of reproductive health disorders and comorbid conditions in women with HIV infection. Methods and Results: Women meeting the inclusion criteria were divided into two groups: Group 1 included 27 HIV-infected women (average age of 30.8±2.9 years) with reproductive disorders; Group 2 included 23 HIV-infected women (average age of 31.4±7.1 years) without reproductive disorders. In study groups, the main route of HIV transmission was sexual contact. When assigning women to a particular category (fertile or infertile), the WHO classification of fertility was used: fertile, presumably fertile, primarily infertile, secondarily infertile, women with unknown fertility. There was a statistically significant difference in the incidence of medical abortion in the HIV-infected women with secondary infertility [14(60.9%)], compared to Group 2 [8(29.6%)] (P=0.026). There were no statistically significant differences in the incidence of chronic co-morbidities (ENT disorders, gastritis/duodenitis, pancreatitis, cystitis, viral hepatitis (B, C), papillomavirus infection) in Groups 1 and 2 (P&gt;0.05). The incidence of pelvic inflammatory diseases was 2 times higher in Group 1 than in Group 2. No statistically significant differences in the incidence of uterine myoma, chronic cervicitis, chronic endometritis, vulvovaginal candidiasis,, and cervical dysplasia were found. A significant prevalence of chronic salpingo-oophoritis, secondary dysmenorrhea, secondary amenorrhea, opsomenorrhea, and secondary oligomenorrhea was detected significantly more frequently in Group 1 than in Group 2. The syndrome of hyperprolactinemia was also 2.6 times more frequent in Group 1 than in Group 2. Reproductive disorders in HIV-infected women were associated with a high incidence of STI combinations (trichomoniasis, gonorrhea, syphilis, chlamydia). Conclusion: Early detection of menstrual dysfunctions, prevention of abortion and sexually transmitted diseases, and timely treatment of infertility, are essential for women living with HIV.

Hysteroscopic and morphological evaluation of endometrium in reproductive age women with comorbid polycystic ovarian syndrome and chronic endometritis in the protocols of in vitro fertilization

Summary. Today, infertility, which is associated with polycystic ovary syndrome, is a pressing problem in obstetrics, gynecology and reproductive medicine. Polycystic ovary syndrome (PCOS) is a common endocrine disease that affects about 6 to 20 % of women of childbearing potential. Its main signs are ovulatory and menstrual dysfunction (including anovulation), increased levels of gonadotropin-releasing hormone, hypersecretion of luteinizing hormone, hyperandrogenemia, metabolic disorders and morphological changes in the endometrium and ovaries. The aim of the study – to evaluate hysteroscopic and morphological changes in the endometrium of women with infertility against the background of PCOS and chronic endometritis and to analyze the effect of a modified treatment regimen in the protocols of in vitro fertilization on the manifestations of chronic endometritis. Materials and Methods. We examined 140 women with endocrine infertility against the background of PCOS and chronic endometritis, which were divided into 2 study groups, depending on the cause and treatment approach for infertility, as well as 35 women with male-caused infertility who comprised the control group. All examined patients underwent hysteroscopy, targeted biopsy and immunohistochemical study of the endometrium. Histological study of the endometrium was performed by staining the tissue with hematoxylin and eosin according to a standard protocol in order to understand the structural changes of the endometrium in women of the study groups. Immunohistochemical testing involved the detection of CD138 using standard Daco antibody kits (Denmark). Results. Patients with PCOS and chronic endometritis used standard anti-inflammatory treatment which followed our modified protocol. This resulted in significantly reduced manifestations of chronic endometritis. The modified protocol includes inositol and alpha-lipoic acid in pre-pregnancy preparation; PRP therapy of the uterine cavity; and lipofundin infusions on day 2–3 of the menstrual cycle and on the day of embryo transfer. Conclusions. Histological examination of the endometrium with manifestations of stromal-adenomatous polyps revealed reduced signs of cytogenic stroma proliferation, decreased perivascular edema and the number of erythrocyte diapedesis. The number of glandular elements and the size of the glands also decreased

Impact of Low Energy Availability on Skeletal Health in Physically Active Adults.

For decades researchers reported that pre-menopausal women who engage in extensive endurance exercise and have menstrual dysfunction can develop low bone mineral density (BMD) or osteoporosis. More recently, low energy availability has been recognized as the initiating factor for low BMD in these women. Furthermore, the relationship between low energy availability and poor skeletal health is not exclusive to women engaging in endurance exercise. Rather, both males and females commonly experience endocrine dysfunction resulting from low energy availability and high exercise levels that degrades skeletal health. Consequences to skeletal health can range from short-term changes in bone metabolism and increased risk of bone stress injuries to long-term consequences of low BMD, such as osteoporosis and related fragility fractures. The degree to which low energy availability degrades skeletal health may be dependent on the length and extent of the energy deficit. However, the complex relationships between under-fueling, short- and long-term skeletal consequences and the factors that mediate these relationships are not well described. In this review, we discuss the consequences of low energy availability on sex hormones and skeletal health in two highly-active populations-athletes and military trainees-and provide a summary of existing knowledge gaps for future study.

Effect of calcium and vitamin D supplementation on the clinical, hormonal, and metabolic profile in non-obese women with polycystic ovary syndrome

In this study, we investigated the effect of calcium and vitamin D (Ca/Vit D) supplementation on the clinical, hormonal, and metabolic profile of patients with low vitamin D levels. In addition, we investigated the effect of Ca/Vit D supplementation on asymmetric dimethylarginine (ADMA) level in patients with polycystic ovary syndrome (PCOS). In total, 75 patients aged 19-35years, with a normal body mass index and a diagnosis of PCOS and Vit D deficiency/insufficiency, were included in the study. Patients received 50,000IU of vitamin D3 once a week for 8weeks. Afterward, 2500mg calcium carbonate equivalent to 1000mg calcium ion and 9.68mg cholecalciferol equivalent to 880IU vitamin D3 were administered orally as a maintenance treatment once a day. The mean age of the patients was 21.7 ± 3.5. After Ca/Vit D supplementation, Vit D levels significantly increased compared to baseline (8.6ng/ml) levels. An increase in SHBG levels (p < 0.001), a decrease in total testosterone, FAI (p = 0.042), and ADMA levels (p < 0.001) were observed in the first and third months compared to the onset. Significant improvement compared to baseline was observed in menstrual irregularity and median mFG score. Ca/Vit D supplementation can improve PCOS symptoms such as menstrual dysfunction, hirsutism, and hyperandrogenism. It may be effective in reducing the risk of cardiovascular disease in patients with PCOS later in life by decreasing ADMA levels, which is an indicator of endothelial dysfunction.

Melatonin status in obese patients with ovarian dysfunction at reproductive age

Melatonin is the main hormone of the pineal gland. By regulating circadian rhythms and being an immune regulator and antioxidant, this hormone takes part in the work of the ovaries: its high concentrations block apoptosis and neutralize reactive oxygen species involved in folliculogenesis, ovulation, egg maturation and corpus luteum formation. To study melatonin status and its relationship with menstrual dysfunction and sleep disorders in obese women of reproductive age. In a one-stage comparative study, women 18-35 years old took part: 30 patients with obesity and menstrual disorders of an inorganic nature and 30 healthy women in the comparison group with normal weight and regular menstrual cycle. All participants underwent a questionnaire to identify somnological disorders, and the level of melatonin in saliva and 6-sulfatoxymelatonin in urine was also investigated. In the group of patients with obesity (n=30), various sleep disorders were encountered in 47% of cases (p=0.003), including more often obstructive sleep apnea syndrome was recorded (30% of cases), and a correlation was found between the indicators of the questionnaire survey of subjective sleep characteristics and body mass index of patients (r=0.450, p=0.030) compared with a group of healthy women with normal weight (n=30). In the main group, the level of melatonin in saliva was statistically significantly lower than in the control: median 12.6 pg / ml and 25.5 pg / ml, respectively (p=0.008), the same pattern was recorded for 6-sulfatoxymelatonin: 14, 72 pg / ml and 31.12 pg / ml, respectively. Patients with obesity and menstrual dysfunction are more likely to suffer from various sleep disorders and have lower levels of melatonin in saliva and 6-sulfatoxymelatonin in urine.

Multiomics Analysis-Based Biomarkers in Diagnosis of Polycystic Ovary Syndrome.

Polycystic ovarian syndrome is an utmost communal endocrine, psychological, reproductive, and metabolic disorder that occurs in women of reproductive age with extensive range of clinical manifestations. This may even lead to long-term multiple morbidities including obesity, diabetes mellitus, insulin resistance, cardiovascular disease, infertility, cerebrovascular diseases, and ovarian and endometrial cancer. Women affliction from PCOS in midst assemblage of manifestations allied with menstrual dysfunction and androgen exorbitance, which considerably affects eminence of life. PCOS is recognized as a multifactorial disorder and systemic syndrome in first-degree family members; therefore, the etiology of PCOS syndrome has not been copiously interpreted. The disorder of PCOS comprehends numerous allied health conditions and has influenced various metabolic processes. Due to multifaceted pathophysiology engaging several pathways and proteins, single genetic diagnostic tests cannot be supportive to determine in straight way. Clarification of cellular and biochemical pathways and various genetic players underlying PCOS could upsurge our consideration of pathophysiology of this syndrome. It is requisite to know pathophysiological relationship between biomarker and their reflection towards PCOS disease. Biomarkers deliver vibrantly and potent ways to apprehend the spectrum of PCOS with applications in screening, diagnosis, characterization, and monitoring. This paper relies on the endeavor to point out many candidates as potential biomarkers based on omics technologies, thus highlighting correlation between PCOS disease with innovative technologies. Therefore, the objective of existing review is to encapsulate more findings towards cutting-edge advances in prospective use of biomarkers for PCOS disease. Discussed biomarkers may be fruitful in guiding therapies, addressing disease risk, and predicting clinical outcomes in future.

Examination of the Prevalence of Female Athlete Triad Components among Competitive Cheerleaders.

The purpose of this study was to examine individual and combined Female Athlete Triad components within collegiate cheerleaders, an at-risk group. Cheerleaders (n = 19; age: 20.3 ± 1.2 years) completed anthropometric measurements, health history questionnaires, resting metabolic rate, the eating disorder inventory-3 and symptom checklist, blood sample, and DXA scan. Participants completed dietary and exercise logs for 7 days and used heart rate monitors to track daily and exercise energy expenditure. Proportions were calculated for low energy availability (LEA) risk, disordered eating risk, and pathogenic behaviors. Chi-square analysis was used to determine the difference between cheerleaders who experience low EA with or without disordered eating risk. All cheerleaders demonstrated LEA for the days they participated in cheerleading practice, 52.6% demonstrated LEA with eating disorder risk and 47.4% demonstrated LEA without eating disorder risk, 52.6% self-reported menstrual dysfunction, 14% experienced menstrual dysfunction via hormonal assessment, and 0% demonstrated low bone mineral density. Overall, 47.7% presented with one Triad component, 52.6% demonstrated two Triad components using self-reported menstrual data, and 10.5% demonstrated two Triad components using hormonal assessments. All cheerleaders displayed LEA. These findings support the need for increased education on the individual components of the Triad and their potential consequences by qualified personal.

Association of severity of menstrual dysfunction with hyperinsulinemia and dysglycemia in polycystic ovary syndrome.

Is the severity of menstrual cyclicity related to hyperinsulinemia and dysglycemia in women with hyperandrogenic polycystic ovary syndrome (PCOS)? Hyperandrogenic PCOS women with amenorrhea, compared to those with oligomenorrhea or eumenorrhea, had a greater risk of post-challenge hyperinsulinemia, which may explain their higher prevalence of dysglycemia. PCOS is associated with metabolic dysregulation including insulin resistance (IR) and hyperinsulinemia, risk factors for type 2 diabetes mellitus (T2DM) and other vascular-metabolic morbidities. Although the severity of menstrual cyclicity is associated with IR in PCOS, it is unclear whether, and to what extent, it is related to hyperinsulinemia and glycemic abnormalities. We prospectively compared the degree of menstrual cyclicity with the presence of dysglycemia (elevated 1-h plasma glucose ≥155 mg/dl; abnormal glucose tolerance [AGT], including prediabetes and T2DM; and AUC for glucose [G-AUC]) or dynamic state hyperinsulinemia (peak insulin levels either at 1 or 2 h of the oral glucose tolerance test (oGTT) and AUC for insulin [I-AUC]) in 333 hyperandrogenic PCOS women. In a tertiary care setting, hyperandrogenic PCOS participants with ovulatory eumenorrhea (Ov-Eumeno, n = 25), anovulatory eumenorrhea (Anov-Eumeno, n = 33), oligomenorrhea (Oligo, n = 150) and amenorrhea (Ameno, n = 125) underwent comprehensive phenotyping and a 2-h 75 g oGTT. Mean BMI was greater among Ameno women than among Oligo, Anov-Eumeno or Ov-Eumeno women. Adjusting for BMI, the Ameno group demonstrated higher mean 1- and 2-h insulin and glucose, peak insulin and I-AUC and G-AUC, and either had a higher, or tended toward having a higher, prevalence of elevated 1-h glucose level and prevalence of AGT than the Oligo, Anov-Eumeno or Ov-Eumeno groups. In logistic regression, adjusting for BMI, Ameno women were more likely to have: AGT than Oligo women (odds ratio [OR]: 2.3; 95% CI: 1.3 to 4.2); elevated 1-h glucose (OR: 10.2; CI: 1.3-79.7) than those with Ov-Eumeno; and both AGT (OR: 1.7; CI: 1.1-2.6) and elevated 1-h glucose (OR: 1.8; CI: 1.1-2.8) than those with Anov-Eumeno or Ov-Eumeno when combined. Race/ethnicity, age, waist-to-hip ratio, fasting insulin and glucose, and biochemical or clinical measures of hyperandrogenism were similar across the four menstrual categories. Our study was limited by its cross-sectional nature and by studying women affected by PCOS as defined by the Androgen Excess & PCOS Society criteria (i.e. Rotterdam Phenotypes A, B and C) who were identified in the clinical setting. Consequently, extrapolation of the present data to other PCOS phenotypes (e.g. PCOS Phenotype D) should be made with caution. In hyperandrogenic PCOS phenotypes, a history of amenorrhea, compared to oligomenorrhea or eumenorrhea, suggests a more severe cardiometabolic risk, including a higher degree of hyperinsulinemia and greater prevalence of glycemic abnormalities. These findings may assist in refining the treatment and screening guidelines for glycemic abnormalities in PCOS. This work was supported in part by grants R01-DK073632 and R01-HD29364 from the NIH and an endowment of the Helping Hand of Los Angeles, Inc. (to R.A.). M.D.P. has no competing interests to declare. U.E. is an investor in Concentric Analgesics, Inc. R.A. serves as a consultant for Spruce Biosciences and Fortress Biotech and an advisor for Aurora Forge. N/A.

Features of the physical development of girls with different course of puberty and level of adaptive capabilities

The purpose of the study — to establish the features of the physical development of adolescent girls with the different course of puberty and to assess adaptive capabilities depending on the indicators of physical development and the course of puberty.Materials and methods: The examinations involved 57 girls aged 11 to 17 year who were divided into two groups depending on the presence of menstrual disorders. The first group included girls with physiological puberty. The second group consisted of girls with oligo­ or amenorrhea, and in isolated cases, with abnormal uterine bleeding, proio­ or polymenorrhea. The assessments included somatometric parameters, the results of the Ruffier test, the clinoortostatic test, cardiac morphometric indicators, and vascular reactivity according to Doppler ultrasound, the Kerdo index and Baevsky’s adaptive potential.Results and discussion. The significant frequency of tall and higher than average height was established as specific feature of girls regardless of the variant of puberty course (42.4 % with physiological and 42.8 % with pathological puberty). In general, the girls did not differ in height and body weight. In terms of Baevsky’s adaptive potential, 100 % of girls had a satisfactory adaptation level. The significant proportion of adolescent girls showed low exercise tolerance (63.7 % of girls with physiological and 50 % with pathological puberty). The high frequency of initial sympathy and the prevalence of normal vegetative support were recorded. Satisfactory and good results were more likely to be obtained by girls with puberty disorders. Girls with physiological puberty had a high incidence of hyperkinetic hemodynamic (37.5 % compared to 15.0 % in the second group, p &lt; 0.05).The adaptive capabilities of girls with average height did not differ between groups with various puberty course. The tall girls of the first group had the higher frequency of the hyperkinetic type of hemodynamics, combined with best indices of vascular reactivity: two thirds of subjects demonstrated adequate increase in the diameter of the brachial artery in the sample with reactive hyperemia. In girls with menstrual dysfunction, the acceleration of growth was not accompanied by activation of the sympathoadrenal system, but they showed better results of exercise test. It could be assumed that presence of sexual hormones’ imbalance with testosterone prevalence, promotes these results and increases endurance of girls. However, the isolated Ruffier test does not fully reflect the satisfactory adaptation of an adolescent’s body. It is necessary to compare the results of the functional study of adolescent girls with the peculiarities of their hormonal status.Conclusions. A big proportion of girls with tall and higher than average height is the peculiarity of physical development of modern female adolescents. In the absence of pathology of puberty, the adaptive reactions of a body of an adolescent girl are characterized by increased exposure to the sympathoadrenal system. The use of Baevsky’s adaptive potential, calculated for adolescent patients, does not allow even screening to identify individuals at risk of stress or adaptation failure, which indicates the need to expand the scope of examination of adolescents using functional tests and calculation coefficients.

Genital Tuberculosis and Infertility: A Comparative Analysis of Imaging Modalities

Background: Female genital tuberculosis is caused by Mycobacterium tuberculosis and occurs usually secondary to pulmonary tuberculosis or other organs with infection reaching through hematogenous route, lymphatic route or direct spread from abdominal tuberculosis. Diagnosis of genital tuberculosis is often made from history taking, meticulous clinical examination and use of investigations such as endometrial aspirate/biopsy and endoscopy. Female genital tuberculosis damages the genital organs causing menstrual dysfunction and infertility. The aim of the study was to evaluate co relation of genital tuberculosis with infertility and role of imaging modalities in diagnosing genital TB. During December 2020 we searched Google scholar, pub med, Medscape research articles from 2010 -2020. Genital TB is one most common cause of infertility in developing countries while diagnostic ultrasonography plays a limited role to diagnose. Laprohysteroscopy and histo-pathological analysis are confirmatory for genital tuberculosis. Keywords: Genital tuberculosis, Infertility, Pyosalpinx, Tubo-ovarian mass, Ultrasonography and Hysterosalpingography.