Menstrual Research Articles

Hubungan HUBUNGAN INDEKS MASA TUBUH DENGAN PREMENSTRUAL SYNDROME (PMS)

PMS often occurs in teenage girls which appears with a set of symptoms both mental and physical and behavioral during the luteal phase of the menstrual cycle around 7-10 days before menstruation and disappears when menstrual blood comes out. One of the factors causing the syndrome is Body Mass Index. The aim of this study was to determine the relationship between Body Mass Index and premenstrual syndrome. The formula used in selecting respondents was total sampling with a cross-sectional approach. The assessment form used is SPAF and data analysis used Spearman rank to measure the relationship between Body Mass Index and PMS in Harapan Bangsa University. The conclusion of this study there is a relationship between BMI and PMS p: 0.00 and the relationship is quite close (0.456). Women with PMS disorders have low serotonin levels which causes early or late ovulation. This can trigger the hormones estrogen and progesterone, which cause complaints such as breast pain and bloating. At the same time, an increase in the hormone prostaglandin causes the uterus to contract which causes abdominal pain during the menstrual cycle.
 Keywords: Body Mass Indeks, premenstrual syndrome, female student

A 52-mg levonorgestrel-releasing intrauterine system vs bipolar radiofrequency nonresectoscopic endometrial ablation in women with heavy menstrual bleeding: long-term follow-up of a multicenter randomized controlled trial

BACKGROUNDThe symptom of heavy menstrual bleeding has a significant impact on professional, physical and social functioning. In 2021, results from a randomized controlled trial comparing a 52 mg levonorgestrel-releasing intrauterine system and radiofrequency non-resectoscopic endometrial ablation as treatments for women with heavy menstrual bleeding were published. Both treatment strategies were equally effective in treating heavy menstrual bleeding during a two-year follow-up. However, long-term results are also relevant for both patients and health care providers. OBJECTIVEThe aim of this study was to assess long-term differences in reintervention risk and menstrual blood loss in women with the symptom of heavy menstrual bleeding treated according to a strategy starting with a 52 mg levonorgestrel-releasing intrauterine system or radiofrequency non-resectoscopic endometrial ablation. STUDY DESIGNThis study was a long-term follow-up study of a multi-center randomized controlled trial (MIRA trial) in which women were allocated to either a 52 mg levonorgestrel-releasing intrauterine device (n=132) or radiofrequency non-resectoscopic endometrial ablation (n=138). Women from the original trial were contacted to fill out six questionnaires. The primary outcome was reintervention rate after allocated treatment. Secondary outcomes included surgical reintervention rate, menstrual bleeding measured by the Pictorial Blood Loss Assessment Chart, (disease-specific) quality of life, sexual function and patient satisfaction. RESULTSFrom the 270 women that were randomized in the original trial, 196 women (52 mg levonorgestrel-releasing intrauterine system group: n=94; radiofrequency non-resectoscopic endometrial ablation group: n=102) participated in this long-term follow-up study. Mean follow-up duration was 7.4 years (range 6-9 years). The cumulative reintervention rate (including both medical and surgical reinterventions) was 40.0% (34/85) in the 52 mg levonorgestrel-releasing intrauterine system group and 28.7% (27/94) in the radiofrequency non-resectoscopic endometrial ablation group (relative risk: 1.39; 95% confidence interval: 0.92-2.10). The cumulative rate of surgical reinterventions only was significantly higher for patients with a treatment strategy starting with a 52 mg levonorgestrel-releasing intrauterine system compared to radiofrequency non-resectoscopic endometrial ablation (35.3% [30/85] vs. 19.1% [18/94]; relative risk: 1.84; 95% confidence interval: 1.11-3.10). However, hysterectomy rate was similar: 11.8% [10/94] in the 52 mg levonorgestrel-releasing intrauterine system group and 18.1% [17/102] in the radiofrequency non-resectoscopic endometrial ablation group (relative risk: 0.65; 95% confidence interval: 0.32-1.34). Most reinterventions took place during the first 24 months of follow-up. A total of 171 Pictorial Blood Loss Assessment Chart scores showed a median bleeding score of 0.0. No clinically relevant differences were found regarding quality of life, sexual function and patient satisfaction. CONCLUSIONThe overall risk of reintervention after long-term follow-up was not different for women treated according to a treatment strategy starting with a 52 mg levonorgestrel-releasing intrauterine system as compared to a strategy starting with radiofrequency non-resectoscopic endometrial ablation. Yet, women allocated to a treatment strategy starting with a 52 mg levonorgestrel-releasing intrauterine system had a significantly higher risk for surgical reintervention, which was driven by an increase in subsequent endometrial ablation. Both treatment strategies remain effective in lowering menstrual blood loss over the long-term. The results of this long-term follow-up study help physicians to optimize counseling of women suffering from the symptom of heavy menstrual bleeding. Optimized counseling will enable women to make a well-informed choice regarding treatment.

Menstrual and psychosocial characteristics associated with high-risk of premenstrual dysphoric disorder among university students: a cross-sectional study

ABSTRACT Up to 92 percent of Chinese women of reproductive age have pre-menstrual syndrome (PMS). The severe form of PMS (i.e. pre-menstrual dysphoric disorder [PMDD]) negatively affects women’s everyday functioning and reproductive health. This study examined the relationships between menstrual, psychosocial characteristics and the risk of PMDD among young Chinese women. A cross-sectional online survey was conducted among Chinese university students in Hong Kong. Logistic regression was used to compute adjusted odds ratio (aOR) for the association of high-risk PMDD with menstrual and psychosocial characteristics. A total of 541 Chinese university students were recruited. Approximately 53 percent of female students were at high risk of developing PMDD. The high-risk PMDD group was significantly associated with a heavy volume of menstrual flow (aOR = 2.17, 95 percent CI 1.06–4.45), irregular menstrual cycle (1.72, 1.17–2.52), high dysmenorrhea (2.80, 1.95–4.04) and older ages of menarche (0.67, 0.45–0.98) in the menstrual characteristics. In the psychosocial characteristics, high-risk PMDD was significantly associated with symptoms of anxiety (2.19, 1.48–3.32) and depression (2.22, 1.48–3.32), high loneliness (1.94, 1.34–2.79) and low resilience (2.21, 1.52–3.23) levels. Additionally, resilience had a potential moderating effect on the associations between the high risk of PMDD and anxiety, depression and loneliness. The development and delivery of interventions that can enhance resilience and manage psychological distress would be beneficial for young Chinese women’s reproductive health.

PEMBERIAN PILATES EXERCISE TERHADAP PENURUNAN NYERI HAID

Dysmenorrhea is a disruption in menstrual blood flow/menstrual pain. If dysmenorrhea pain is not treated immediately, it will affect the individual's mental and physical function so that non-pharmacological measures are needed. Non-pharmacological therapy that can be done is Pilates exercise.. The aim of providing pilates exercise is to reduce menstrual pain at SMPN 7 Kota Kediri. Method of providing pilates exercise counseling to reduce menstrual pain to 15 female students at SMPN 7 Kota Kediri. The results of counseling on providing pilates exercise to reduce menstrual pain in teenagers at SMPN 7 Kota Kediri, can apply pilates exercise to reduce dysmenorrhea pain which does not cause side effects in reducing the incidence of dysmenorrhea pain.Conclusion Giving pilates exercuse can reduce menstrual pain in adolescents at SMPN 7 Kota Kediri, so adolescents are advised to apply pilates exercise to reduce dysminorea pain that does not cause side effects in reducing dysminorea pain

Pengaruh Pemberian Susu Kedelai Terhadap Tingkat Tekanan Darah Pada Wanita Perimenopause Di Desa Ensalang Tahun 2022

Perimenopause is a transitional phase between premenopause and postmenopause. This phase is characterized by an irregular menstrual cycle with prolonged heavy menstrual bleeding and relatively large amounts of menstrual blood, sometimes accompanied by menstrual pain (dysmenorrhea). In certain women, vasomotor complaints and complaints of premenstrual syndrome have arisen (Baziat, Ali. 2020). The most common complaints include vasomotor symptoms such as hot flushes, night sweats, insomnia, fatigue and palpitations.

A retrospective cohort study to examine factors affecting live birth following hysteroscopic treatment of intrauterine adhesions

To evaluate independent factors that affect the chance of live birth following hysteroscopic adhesiolysis in patients with intrauterine adhesions (IUAs). Retrospective cohort study SETTING: Hysteroscopic center of Fuxing Hospital in Beijing, China. Patients diagnosed with Asherman syndrome between June, 2020, and February, 2022. Hysteroscopic adhesiolysis followed by second look hysteroscopy to assess outcome and follow-up for a year. Live birth rate without the use of assisted reproductive technologies at 12 months follow-up. (s): Of the 544 women included in the cohort, the pregnancy rate at the end of one year follow-up was 47.6% (95%CI 45.5%-49.7%) and the live birth rate was 41.0% (95%CI 38.9%-43.1%). Stepwise multiple logistic regression analysis identified 3 independent predictors of live birth in decreasing order of significance: increase in menstrual flow after surgery (OR 3.69, 95%CI 1.77-8.21), postoperative endometrial thickness in the mid-luteal phase (OR 1.53, 95%CI 1.31-1.80), and the severity of recurred adhesion at second-look hysteroscopy (OR 0.62, 95%CI 0.50-0.76). Among subjects with good independent prognostic factors, namely, increased menstrual flow after surgery, postoperative endometrial thickness in the mid luteal phase greater than 6mm, no or minimal recurrence of adhesions at second-look hysteroscopy, the live birth rate was 69.0% (95%CI 65.4%-72.6%). On the other hand, in women (n=26) without any of the three good prognostic factors, none had a successful live birth (0%). (s): Overall, the live birth rate following treatment of Asherman syndrome was 41.0%. The prognosis is dependent on three outcome measures following surgery, namely, improvement in menstrual flow, post-operative endometrial thickness and minimal degree of recurrent adhesions at second-look hysteroscopy.

MANAGEMENT OF ASRIGDRA W.S.R. TO DUB- CASE STUDY

In Ayurveda, the most common bleeding disorders in women are referred to as Asrigdara and are characterised by Pradirana (excess excretion) of Raja (menstrual blood). In modern medicine, it is called "Dysfunctional Uter-ine Bleeding." Despite their high costs, hormonal therapy, anti-prostaglandins, and anti-fibrinolytic agents have not proven their definitive efficacy in modern medicine; their side effects have resulted in hormonal imbalances. In Ayurvedic classics, all gynaecological disorders are classified as Yonivyapad. Charaka Acharya Raktapra-dara is described as Pradara Roga by Charaka Aacharya. Excessive vaginal white discharge is referred to as Shweta Pradara and excessive or heavy menstrual bleeding is referred to as Raktapradara. It is known as Pra-dara due to pradirana (excessive excretion) of raja (menstrual blood) and Asrigdara due to dirana (excessive excretion) of Asrk (menstrual blood). Menorrhagia is treated with Haemostatic, analgesic, and hormonal thera-pies in modern medicine, which has limitations. As a result, an integrated and comprehensive therapeutic inter-vention in Ayurveda is required to prevent recurrence. Sodhana and Shamana therapies are recommended, but if Rugnabala is low, only Shamana is recommended. Many herbals and herbo-mineral preparations are mentioned in Ayurveda to treat Asrgdara and related symptoms, and these can be used according to Anubandha Dosha and Lakshana. Because Asrgdara is primarily caused by Vata Pitta Dosha, Kashaya Rasa and Pittashamaka Chikitsa may be used. Ayurvedic formulations aid in the breakdown of Asrgdara pathogeneses and their recur-rence.

Effect of jigsaw teaching strategy on internship nursing students’ health literacy regarding menstrual blood banking

Effect of jigsaw teaching strategy on internship nursing students’ health literacy regarding menstrual blood banking

Abnormal uterine bleeding diagnoses and care following COVID-19 vaccination

BackgroundThere is evidence suggesting that COVID-19 vaccination may be associated with small, transitory effects on uterine bleeding, possibly including menstrual timing, flow, and duration, in some individuals. However, changes in health care seeking, diagnosis, and workup for abnormal uterine bleeding in the COVID-19 vaccine era are less clear. ObjectivesTo assess the impact of COVID-19 vaccination on incident abnormal uterine bleeding diagnosis and diagnostic evaluation in a large integrated health system. Study DesignUsing segmented regression, we assessed whether the availability of COVID-19 vaccines was associated with changes in monthly, population-based rates of incident abnormal uterine bleeding diagnoses compared to the pre-pandemic period in health system members ages 16-44 years who were not menopausal. We also compared clinical and demographic characteristics of patients diagnosed with incident abnormal uterine bleeding between December 2020 through October 13, 2021 by vaccination status (never vaccinated, vaccinated in the 60 days prior to diagnosis, vaccinated more than 60 days prior to diagnosis) and conducted detailed chart review of patients diagnosed with abnormal uterine bleeding within 1-60 days of COVID-19 vaccination in the same time period. ResultsIn monthly populations ranging from 79,000 to 85,000 female health system members, incidence of abnormal uterine bleeding diagnosis per 100,000 person-days ranged from 8.97 to 19.19. There was no significant change in the level or trend in the incidence of abnormal uterine bleeding diagnoses between the pre-pandemic (January 2019-January 2020) and post-COVID-19 vaccine (December 2020-December 2021) periods. A comparison of clinical characteristics of 2,717 abnormal uterine bleeding cases by vaccination status suggested that abnormal bleeding among recently vaccinated patients was similar or less severe than abnormal bleeding among patients who had never been vaccinated patients or those vaccinated more than 60 days prior. There were also significant differences in age and race of patients with incident abnormal uterine bleeding diagnoses by vaccination status: never vaccinated patients were the youngest and those vaccinated more than 60 days prior were the oldest; the proportion of patients who were Black/African American was highest among never vaccinated patients, and the proportion of Asian patients was higher among vaccinated patients. Chart review of 114 confirmed post-vaccination abnormal uterine bleeding cases diagnosed from December 2020 through October 13, 2021 found that the most common symptoms reported were changes in timing, duration, and volume of bleeding. Approximately one-third of cases received no diagnostic workup; 57% had no etiology for the bleeding documented in the electronic health record. In 12% of cases, the patient mentioned or asked about a possible link between their bleeding and their recent COVID-19 vaccine. ConclusionsThe availability of COVID-19 vaccination was not associated with a change in incidence of medically attended abnormal uterine bleeding in our population of over 79,000 female patients of reproductive age. Additionally, among 2,717 patients with abnormal uterine bleeding diagnoses in the period following COVID-19 vaccine availability, receipt of the vaccine was not associated with greater bleeding severity.

ANALYSIS OF WOMEN'S FIQIH TAHARAH STUDY IN ISLAMIC EDUCATION

Fiqh Thaharah has a broad discussion including thaharah haqiqiyah, namely thaharah rather than najis and thaharah hukmiyyah, namely thaharah rather than hadas. This research is a qualitative type through literature study with a content analysis process. Then, data or material from various primary and secondary sources is collected to provide accurate data regarding the research theme. In this discussion, there are three special bloods for women, namely menstrual blood, postpartum blood and istihadaha.

Effect of topical application of a modified dosage form of granulocyte-colony stimulating factor in complex therapy of Ascherman syndrome

The effectiveness of the use of a modified intrauterine gel form of granulocyte colony stimulating factor in the complex treatment of Ascherman syndrome is evaluated. The study involved 31 patients with a history of Ascherman syndrome. For 6 months, the patients underwent weekly intrauterine administration of 1 ml of gel with a concentration of granulocyte colony stimulating factor of 9 million IU/ml using an intrauterine catheter. Monthly M-echo was evaluated on the 19th–22nd day of the menstrual cycle, as well as the volume of menstrual blood loss according to the Pictorial Blood Loss Assessment Chart. After the treatment was completed, a control hysteroscopy was performed. There is a statistically significant increase in M-echo from 2. 61 ± 1. 71 to 6. 52 ± 1. 23 mm (p 0. 001). At the same time, the proportion of patients with M-echo 6 and 7 mm increased from 6. 45 and 0% to 80. 65 and 51. 61, respectively, over the 6 months of the study. There is also a statistically significant increase in menstrual blood loss from 24. 9 ± 2. 6 to 53. 5 ± 3. 4 points on the Pictorial Blood Loss Assessment Chart (p 0. 001). A response to therapy was achieved in 17 patients, among them 12 patients were diagnosed with pregnancy that occurred spontaneously (17. 65%) or as a result of in vitro fertilization protocol (52. 9%). The data obtained indicate that intrauterine administration of a gel with granulocyte colony stimulating factor promotes endometrial regeneration in patients suffering from Ascherman syndrome, which is expressed in an increase in M-echo and the volume of menstrual blood loss. Thus, adjuvant use of a hydrogel with granulocyte colony stimulating factor and hyaluronic acid is an effective treatment option in restoring reproductive function and preventing recurrence of adhesiogenesis after surgical treatment of Ascherman syndrome. In general, the proposed gel form with granulocyte colony stimulating factor allows us to reduce the frequency of administration of the drug, which theoretically can increase both the compliance of patients primarily by reducing the number of invasive procedures, and reduce treatment costs.

Edukasi Penatalaksanaan Keputihan dengan Pemanfaatan Rebusan Air Daun Sirih

Vaginal discharge or flour albus is an excessive discharge from the vagina that is not menstrual blood. Pathological fluoride albus caused by vaginal infections (fungi, bacteria, parasites, viruses). The prevalence of causes is 25%-50 candidiasis, 20%-40% bacterial vaginosis and 5%-15% trichomoniasis. The characteristics of pathological vaginal discharge are smelly, itchy, yellowish or greenish, thick and cloudy and large in quantity. If this condition does not receive immediate treatment, it will have a negative impact on women's health. Infection will develop and affect the function of the reproductive organs. Medical treatment efforts include administering drugs in the form of capsules, tablets and ovules (vaginal tablets). Meanwhile, for non-medical or complementary therapy, betel leaf decoction can be used (Dame, 2023). The aim of this outreach is to provide education about the benefits of boiled betel leaves for vaginal discharge in women of childbearing age. The activity was carried out at PMB Masdewati Pohan in July 2023, the subject was women of childbearing age in the PMB Masdewati Pohan area. Activity results: Counseling participants learned about the benefits of boiled betel leaf water for vaginal discharge. The results of the questionnaire measuring knowledge before and after counseling showed an increase in knowledge of women of childbearing age by an average of 78%. It is hoped that women of childbearing age can maintain personal hygiene to prevent vaginal discharge and can use boiled water from betel leaves to treat vaginal discharge that occurs.

Human Endometrial Regenerative Cells for Neurological Disorders: Hype or Hope?

Despite enormous efforts, no effective medication has been found to significantly halt or even slow the progression of neurological diseases, such as acquired (e.g., traumatic brain injury, spinal cord injury, etc.) and chronic (e.g., Parkinson's disease, Alzheimer's disease, etc.) central nervous system disorders. So, researchers are looking for alternative therapeutic modalities to manage the disease's symptoms and stop it from worsening. Concerning disease-modifying capabilities, stem cell therapy has emerged as an expanding domain. Among different types of stem cells, human endometrial regenerative cells have excellent regenerative properties, making them suitable for regenerative medicine. They have the potential for self-renewal and differentiation into three types of stem cells: epithelial stem cells, endothelial side population stem cells, and mesenchymal stem cells (MSCs). ERCs can be isolated from endometrial biopsy and menstrual blood samples. However, there is no comprehensive evidence on the effects of ERCs on neurological disorders. Hence, we initially explore the traits of these specific stem cells in this analysis, followed by an emphasis on their therapeutic potential in treating neurological disorders.

Effect of Jigsaw Teaching Strategy on Internship Nursing Students’ Health Literacy Regarding Menstrual Blood Banking

Effect of Jigsaw Teaching Strategy on Internship Nursing Students’ Health Literacy Regarding Menstrual Blood Banking

A Comparative Study on the Effects of Mesenchymal Stem Cells and Their Conditioned Medium on Caco-2 Cells as an In Vitro Model for Inflammatory Bowel Disease.

Recent research indicates that mesenchymal stem cells (MSCs), known for their anti-inflammatory and anti-infectious properties, could be a promising alternative for treating inflammatory diseases such as inflammatory bowel disease (IBD). This study examined how MSCs and their derivatives, when cocultured with interleukin-1β (IL-1β)-stimulated Caco-2 cells, affect the expression of genes related to inflammation, microbes, and apoptosis. In the experiment, Caco-2 cells were exposed to 10 ng/mL of IL-1β for 24 h. MSCs were sourced from human bone marrow, adipose tissue (AD-MSC), and menstrual blood. These MSCs and their conditioned medium (CM) were then cocultured with the IL-1β-induced Caco-2 cells. After 48 h, gene expression levels were analyzed using real-time PCR, and the data were statistically evaluated using T-tests, U-Mann-Whitney, and Tukey's post hoc analyses. The results indicated that IL-1β at 10 ng/mL was the optimal concentration for inducing Caco-2 cells with the highest viability and minimal damage. Among the MSCs tested, AD-MSCs were the most effective in regulating gene expression. Specifically, AD-MSC treatment significantly reduced the mRNA expression of TNF-α and IL-1β, both of which are crucial in sustaining inflammatory responses (p ≤ 0.05). This study concludes that AD-MSCs have superior effects compared to other MSC sources in modulating genes associated with inflammation, antibacterial effects, and apoptosis in an in vitro model of IBD using Caco-2 cells.

Endo Time: Endometriosis and the Flow of Recognition

AbstractThe relation between time and gender has been extensively discussed in feminist theory, from Simone de Beauvoir to recent studies of queer temporality and crip time. In this article, I explore gender as “lived time” in relation to a pressing feminist issue: social recognition of the chronic illness endometriosis (endo). Based on my interviews with individuals diagnosed with endo, I argue that lived time can be studied by approaching becoming as a dynamic process or flow of recognition, creating certain temporal patterns in the lifeworld. I propose the concept of “endo time” as a phenomenological conception of the lived time of endo. I identify three temporal patterns that characterize endo time: waiting time (I), cyclical or chronic time (II), and sedimented time (III). The analysis contributes to feminist philosophy by detailing how gender appears as a specific orchestration of time. Because of its connection to feminized pain and menstrual flow on the one hand and social recognition on the other, endo presents an illuminating case for exploring the relation between gender, recognition, and lived time.

Endometriosis at the level of uterine isthmocele: Case report

An isthmocele is a reservoir-type defect in the fornix of the cul-de-sac in the anterior wall of the isthmus at the site of the previous cesarean scar. It’s appearance is related to the accumulation of menstrual blood flow through the cervix and with the presence of fibrotic tissue and pelvic pain. We present the case of a 33-year-old patient, with a history of a cesarean section 2 years ago, who presents for preconceptional counseling complaining of abnormal uterine bleeding and dysmenorrhea since surgery. In imaging studies, she was diagnosed with uterine isthmocele, with minimal remaining tissue, a combined hysteroscopic and laparoscopic repair was performed. Endometriosis was identified in the istmocele scar tissue.

Changing Trends of Tubercular Assault on Reproduction

Background and Objectives. Genital tuberculosis (GTB) is a rare disease in developed countries but is an important cause of subclinical chronic pelvic inflammatory state and infertility in 1–18% of women, being as high as 18 % in India. What we are observing nowadays GTB is changing its way of assault to reproductive process less by infection but more by infestation of the genital tract and thereby leading to harmful molecular changes or may be immunomodulation locally. Reduction of infection may be due to increased surveillance, treatment or use of antibiotics for other reasons indiscriminately, which may make the bacteria dormant. It is being observed as a silent invader of the genital tract of both the female and male partners. It is to be kept in mind that mycobacteria, non- pathogenic to humans, may also cause molecular assault on reproduction. At present, our cohort of patients can be categorized in three groups a) Frank tuberculosis b) LGTB infection c) LGTB infestation There has been extensive research about the involvement of genital tuberculosis in female infertility. Various studies have been undertaken to screen and detect latent genital tuberculosis in apparently normal infertile couples intervening fertility at molecular level. The adverse effects of latent genital tuberculosis, as found in current researches, on the female and male reproductive process has been addressed in the current review. Methods Endometrial aspirates at mid-luteal phase and samples of menstrual blood were collected aseptically from each of those women enrolled in this study and stored at - 80°C for DNA-PCR (Polymerase chain reaction test) and cytokine study. Multiplex polymerase chain reaction (PCR) were performed. DNA-PCR test and sperm DNA fragmentation tests were carried out in semen samples, collected according to WHO guidelines, from male partners in question. Observation. It is being observed that pro-inflammatory cytokines showed significantly different values in TB-PCR- positive and TB-PCR-negative groups. Sperm DNA fragmentation index also appears to be quite high in TB- PCR positive males.Conclusion. LGTB infestation has been found to be responsible for unfavourable molecular changes in reproductive tract and thereby causing a negative impact on fertility. Keywords: latent genital tuberculosis, infertility, cytokine, tubercular infestation, tuberculosis- polymerase chain reaction,

Comparison of efficacy between levonorgestrel intrauterine system and dienogest in adenomyosis: a randomized clinical trial.

Medical management of adenomyosis is an emerging perspective in modern gynecology. Though levonorgestrel intrauterine system (LNG-IUS) and dienogest (DNG) effectively relieve symptoms in adenomyosis, neither has been approved for the same indication. Our study aims to compare the efficacy and safety of these progestins in treating adenomyosis. To study the efficacy and safety of LNG-IUS versus DNG in patients with symptomatic adenomyosis. Open-labeled, parallel, single-centered, randomized clinical trial. Patients with adenomyosis-associated pain with or without abnormal uterine bleeding were randomly allocated to either LNG-IUS group or DNG group. The primary outcome was a reduction in painful symptoms after 12 weeks of treatment measured by visual analog scale (VAS) score. Changes in menstrual blood loss (MBL), improvement in quality of life (QoL), and adverse drug reactions were also analyzed. The VAS score significantly decreased from baseline in both groups. The baseline and post-treatment VAS scores in the LNG-IUS group were 6.41 ± 1.07 and 3.41 ± 1.04 (p = <0.001) and in the DNG group, were 6.41 ± 0.95 and 3.12 ± 1.40 (p = <0.001), respectively. A significantly greater proportion of patients in the LNG-IUS group experienced lighter MBL as compared to the DNG group [27/30 (90%) in the LNG-IUS group versus 17/22 (77.2%) in the DNG group (p = 0.006)]. Both the groups had improvement in QOL scores calculated by the World Heath Organisation QOL scale (WHOQOL BREF) questionnaire; however, it was more pronounced in the DNG group [(28.76 ± 30.47 in the LNG-IUS group versus 48.26 ± 44.91 in the DNG group (p = 0.04)]. Both the agents were safe as there were no reported major adverse drug reactions. DNG can be an effective and safe alternative to LNG-IUS for the medical management of adenomyosis. The trial was prospectively registered at the clinical trial registry - India (CTRI) vide CTRI number CTRI/2020/05/025186.

The effect of iron supplementation on menstrual bleeding volume and hemoglobin level during menstrual bleeding : A randomized clinical trial.

Many women around the world avoid taking iron supplements during their menstrual bleeding, thinking that menstrual bleeding will increase after taking these supplements. Due to the lack of relevant scientific evidence in this regard, this study was performed to determine the effect of iron supplementation on menstrual blood volume and hemoglobin level during menstrual bleeding. In this three-blind randomized clinical trial, 160 non-anemic female students of Rafsanjan University of Medical Sciences were selected through a public call and then they were randomly assigned to two intervention and control groups. The intervention group was given a ferrous sulfate tablet containsing 50 mg of elemental iron daily in the first four days of bleeding for three consecutive menstrual cycles, and the control group received a placebo simultaneously. Before and after the intervention, the level of hemoglobin was measured and the Higham chart was completed in each menstrual cycle by the participants of the two groups. The obtained data were analyzed using the SPSS software version 21 and Chi-square, independent t-test, paired t-test, analysis of variance with repeated measures, and nonparametric tests. Before performing the intervention, the mean Higham score and hemoglobin level of the two groups were not statistically significant (P = 0.307, P = 0.670). The mean Higham score after each intervention was not statistically significant between the two groups over time or when considering the interaction of the time group (P = 0.77, P = 0.916). The hemoglobin level of these two groups did not change significantly after the intervention compared with that before the intervention (P = 0.444). Compared with a placebo, taking iron supplements containing 50 mg of elemental iron during the first four days of menstrual bleeding in non-anemic women did not change the volume of menstrual bleeding and hemoglobin level.