Irregular Menstruation
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2021 ◽  
Junyan Sun ◽  
Yihui Fan ◽  
Ying Guo ◽  
Huiying Pan ◽  
Chen Zhang ◽  

Abstract Background Premature ovarian insufficiency (POI) has serious physical and psychological consequences due to estrogen deprivation, leading to increased morbidity and mortality. However, the causes of most POI cases remain unknown (idiopathic POI). Environmental factors play an important role in the occurrence of complex diseases. To explore whether chronic and cumulative adverse life events occur in patients before POI diagnosis. Searching for the potential relative risk factors may find an intervention strategy to prevent POI in young women.Results Forty-three women (mean age=33·8 years) were recruited who were newly- diagnosed with idiopathic POI in a Chinese Ob/Gyn hospital to participate in semi-structured interviews through convenience sampling. The main questions covered by the topic guide were designed to explore adverse life events prior to POI diagnosis. Interviews were audio recorded, transcribed and analyzed thematically. Data were analyzed from June 2019 to August 2020. Among the POI patients, the mean age at diagnosis of POI was 33·8 years (range from 19 to 39 years), and the average time between the onset of irregular menstruation and POI diagnosis was 2.3 years. These patients had a relatively normal menstrual cycle before the diagnosis of POI. A number of stressful life events prior to POI diagnosis were discussed by them as important factors influencing their health and well-being. Four core themes emerged: 1) persistent exposure to workplace stress, 2) persistent exposure to family stress, 3) chronic sleep problem/disturbance existed in patients before POI diagnosis, and 4) participants' general cognition and concerns about POI. Conclusions Persistent exposures to adverse life events related to work stress, family stress and sleep disturbance exist in idiopathic POI patients. In addition, patients and their families generally have incorrect cognition of POI disease and its treatment. Future case-control studies should demonstrate whether chronic and cumulative adverse life events are risk factors of POI disease. Provision of tailored interventions (i.e. preventing or mitigating impact of adverse life events) aimed at high-risk populations is urgently needed to prevent new POI cases and promoting understanding of disease may improve health conditions of POI patients.

Faizah Mughal ◽  
Ashok Kumar ◽  
Jai Dev Maheshwari ◽  
Ali Nawaz Bijarani ◽  
Tayyaba Kazmi ◽  

Background: The menstrual cycle describes the healthy reproductive system of the women which is controlled by different hormones. Aim: The goal of the study is to evaluate the prevalence of irregular menstruation in different endocrine changes and to identify their association with the age of women in reproductive life. Methodology: It was a cross-sectional study conducted on women attending the gynecological clinic of Karachi from March 2019 to June 2019. Of the 165 women with different hormonal changes 100 presented with menstrual cycle abnormality. Results: Among the women with menstrual irregularities 51% women presented with insulin resistance, 23% with hyperandrogenism, 19% with hypothyroidism and 7% hyperprolactinemia. Age-related association was observed in menstrual irregularities women with insulin resistant and hyperandrogenism. Conclusion: Menstrual cycle is a physiological process, any irregularities in cycle can be caused by  even  minimal  hormonal  imbalance.  As  a  result,  it  is  critical  to  address  endocrine abnormalities in order to improve women's reproductive health.

Libia Sina ◽  
Alariqi Reem ◽  
Wadee Abdullah Al-Shehari ◽  
Wadhah Hassan Edrees ◽  
Raba’a Mohammed Jumaan ◽  

Background and Objectives: Polycystic ovary syndromes (PCOs) are the most complex endocrine disorders of the female reproductive system with metabolic and psychiatric manifestations. It affects 5%-10% of women of childbearing age. There are paucity of information on PCOs. Therefore the present study aimed at the effect of reproductive hormones, metabolic syndromes, smoking and khat chewing on the PCOs among women in Sana'a Subjects and Methods: The study included 45 Yemeni women of the age group 18-45 years with PCOS classified into two groups regarding age: Group I 18-29 years old, Group II 30-45 years old and underwent clinical assessment (waist, BMI and sex hormones, blood pressure, glucose, lipids, and insulin), and transvaginal ultrasound. Clinical data, history of other diseases and data of chewing and smoking also collected.” Also the study included 45 healthy control women matched in age with the cases. Results: The prevalence of MS among PCOs patients was 35% and the most prevalent MS risk factors among PCOs patients were waist circumference (WC) 64.4%, and HDL-C 64.4% respectively, while prevalence of triglycerides (TG), hypertension and fasting blood sugar (FBS) were 28.9%, 20% and 13.3%, respectively. PCOs patients had significant increase in serum levels of luteinizing hormone (LH) (p<0.001), Insulin (p<0.001), HOMA-IR (p<0.001), T testosterone (TT) (p<0.001), DHEA-S (p<0.001) and FBS (p<0.016). Lean PCOs patients had a significant increase in TT than overweight/obese PCOs (p < 0.045) and dehydroepiandrosterone sulfate (DHEA-S) was found to be significantly higher in PCOs women with MS (p<0.011). Insulin resistance was significantly higher in PCOs women with hypertension as compared to PCOs women without hypertension (p<0.023). Conclusion: There is a relationship between PCOS and reproductive hormone disorder. Patients had significant increases in serum levels of LH, LH/Follicle Stimulating Hormone (FSH), Insulin, TT, and DHEA-S. Also, a relationship was found between the syndrome and infertility, hirsutism, irregular menstruation, polycystic ovaries and multiple sclerosis.                    Peer Review History: Received: 10 July 2021; Revised: 12 August; Accepted: 6 September, Available online: 15 September 2021 Academic Editor:  Prof. Cyprian Ogbonna ONYEJI, Obafemi Awolowo University, Ile-Ife, Nigeria, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Prof. Dr. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, [email protected] Dr. DANIYAN Oluwatoyin Michael, Obafemi Awolowo University, ILE-IFE, Nigeria, [email protected] Similar Articles: A RETROSPECTIVE STUDY OF THE TREATMENT RESULTS OF 40 DIVERSE PATIENTS OF ANEMIA

2021 ◽  
pp. 3446-3452
Kshama Kulkarni ◽  
Rakesh Mishra ◽  
I.B. Kotturshetti

Menarche and Menopause are the two important landmarks of reproductive life cycle of woman's life. Menopause is the most significant event that brings physical and mental transformation in the body. It is a natural phenomenon occurs at the age 45-55 years. This phase is associated with manifestation of aging process along with other symptoms such as irregular menstruation, hot flashes, vaginal dryness, urinary problems, changes in appearance, GIT related problems, mood swings, sleep disturbances, palpitations, changes in sexual desire, osteoporosis, heart disease. The group of signs and symptoms associated with the menopausal phase are termed as menopausal syndrome. In Ayurvedic classics, Menopause is the termed as ‘Rajonivrutti’ and menopausal syndrome as ‘Rajonivrutti anubandhaja vyadhies’. Acharyas described as it is normal physiological state. In Ayurveda, Menopausal symptoms are regarded as imbalance of the Tridosha, Dhatukshaya and disturbance in Agni which occurs naturally as consequence of aging process. Modern medicine treat this condition with Hormone Replacement Therapy (HRT) which results in various complications, but it is effective therapy for a short term use. Considering the limitations of treatment with modern medicine, Ayurveda provides excellent solution & effective medicament for transition period i.e. menopause. Ayurvedic treatment for menopause involves correcting hormonal imbalance with proper diet, lifestyle modification, Shamana, Shodhan chikitsa, Rasayan therapy.

2021 ◽  
Vol 8 ◽  
Si Chen ◽  
Xiao-Feng Chen ◽  
Pin Qiu ◽  
Yan-Xi Huang ◽  
Gao-Pi Deng ◽  

Purpose: The aim of this study was to evaluate white blood cell (WBC) count as a risk factor related to methotrexate (MTX) treatment failure in patients with ectopic pregnancy (EP).Methods: A total of 236 women diagnosed with EP and treated with a single dose of MTX were included. The exposure variable was WBC count at baseline, and the outcome was MTX treatment outcome. Both a multivariate binary logistics regression model and subgroup analysis were performed to evaluate the association between WBC and MTX non-response.Results: WBC count was associated with the risk of treatment failure, and the odds ratio (OR) in different multivariate models was stable [minimally adjusted model: OR 1.2, 95% confidence interval (CI): 1.0–1.3, p = 0.008; fully adjusted model: OR 1.2, 95% CI: 1.0–1.4, p = 0.026]. For WBCs in group T3 (&gt;8.9 × 109/L), the association between WBC count and treatment failure was significant (minimally adjusted model: OR: 2.0, 95% CI: 1.0–3.8, p = 0.050; fully adjusted model: OR: 2.2, 95% CI: 1.1–5.6, p = 0.034). Subgroup analysis showed that in participants with regular menstruation (OR 1.1, 95% CI: 1.0–1.3), WBC count was significantly different from irregular menstruation (OR 1.8, 95% CI: 1.2–2.8); p for interaction was 0.031.Conclusions: We found a reliable and non-linear relationship between WBC count and MTX treatment failure for EP.

Endocrines ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 293-300
Ikuko Ota ◽  
Yoshiaki Ota ◽  
Fuminori Taniguchi

A low dose of dienogest (DNG) 1 mg/day is useful for treating dysmenorrhea in young women. However, the effect of DNG on bone turnover during bone growth and formation, rather than at maturity, is currently unknown even at low doses. We investigated change in bone turnover after 3 months of DNG 1 mg/day. This retrospective cohort study included young women aged 10–24 years with dysmenorrhea and irregular menstruation. Gonadotropins and the bone metabolism markers TRACP-5b and BAP were compared before and at 3 months after administration of DNG 1 mg/day. There were no significant changes in TRACP-5b (before, 455.6 ± 323.6 mU/dL; 3 months after, 462.1 ± 346.1 mU/dL), BAP (before, 24.7 ± 19.0 μg/L; 3 months after, 25.2 ± 22.3 μg/L), or the TRACP-5b/BAP ratio (before, 22.1 ± 7.0; 3 months after, 21.5 ± 6.3). Administration of DNG 1 mg/day had no significant effect on bone turnover after 3 months during the bone-growth phase in young women.

Jin Ju Kim

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4–6 based on a lower percentile of 85%–90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

Sasan Amanat ◽  
Fatemeh Ashkar ◽  
Mohammad Hassan Eftekhari ◽  
Nader Tanideh ◽  
Saeid Doaei ◽  

Objective: Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, irregular menstruation, ovulatory dysfunction, and insulin resistance. Recent studies have reported the possible role of phytoestrogens in PCOS. This animal study aimed to evaluate the effects of genistein on insulin resistance, inflammatory factors, lipid profile, and histopathologic indices on PCOS. Methods: PCOS was induced by 1 mg/kg of letrozole in adult Sprague-Dawley rats. The rats then received normal saline (PCOS group), 150 mg/kg of metformin, or 20 mg/kg of genistein dissolved in 1% methylcellulose solution for 42 days. Body weight, the glycemic and lipid profile, and inflammatory, antioxidative, and histopathological parameters were assessed at the end of the intervention. Results: Treatment with genistein significantly alleviated the increased level of fasting blood insulin (p=0.16) and the homeostatic model assessment of insulin resistance (p=0.012). In addition, the genistein group had significantly lower levels of serum malondialdehyde (p=0.039) and tumor necrosis factor-alpha (p=0.003), and higher superoxide dismutase enzyme activity (p<0.001). Furthermore, the histopathological analysis indicated that genistein administration led to an increase in luteinization and the development of fewer cysts (p<0.05). Conclusion: Biochemical and histopathological analyses indicated that genistein administration to rats with PCOS induced significant remission in oxidative, inflammatory, and glycemic and histopathologic parameters (all p<0.05).

2021 ◽  
Junmiao Xiang ◽  
Wei Shen ◽  
Zongwen Liang ◽  
Qiong Zhang ◽  
Ping Duan

Abstract ObjectiveTo develop a model that uses hematological indexes and clinical characteristics to help estimate the probability of endometriosis in patients with ovarian cysts.MethodsA retrospective study was conducted on 2242 patients who underwent surgery for benign ovarian cysts from January 2008 to November 2016. Variables included in the model were serum tumor markers, blood routine test, age, BMI, reproductive history, history of hysteroscopy, menstrual episodes. Logistic regression was used to construct a predictive model for endometriosis, Receiver Operating Characteristic curves and the areas under the curve was used to verify the model’s validities. Ten-fold cross-validation was primarily used as an internal validation to evaluate the prediction accuracies of the model. Normalized mean square errors (NMSE) was obtained to compare the reliability of different models.Results978 (43.6%) patients with endometriosis were included in the strudy. Univariate analysis showed that age, BMI, delivery, dysmenorrhea, menstrual cycle, duration of menstrual flow, history of hysteroscopy, CA-125 and CA-19-9 (P < 0.001) are associated with endometriosis. The area under the receiver operating characteristic curve for the model with CA-125 alone was 0.888, with a sensitivity of 81.6% and specificity of 83.5%. After adjustment for other multiple covariates, including age, mature delivery, irregular menstruation, dysmenorrhea, menstrual period, history of hysteroscopy, CEA, CA-19-9, monocyte count, platelet count, the model obtained had an AUC of 0.916, with a sensitivity of 0.849 and specificity of 0.864.ConclusionsThe diagnostic prediction model can be used as a framework for potential improvement in diagnosis of endometriosis in patient with ovarian cyst.

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255830
Ishwarpreet Kaur ◽  
Vanita Suri ◽  
Satya Vati Rana ◽  
Amarjeet Singh

Background This study was undertaken to explore the treatment-seeking pathways traversed by women with PCOS and elicit their behavior, experiences and perspectives regarding it. Methods This concurrent mixed-method study was conducted on 18–40 years old women diagnosed with PCOS at the Gynecology outpatient department, PGIMER, Chandigarh, India. Of the 275 women, who were administered a questionnaire to elicit their treatment-seeking behavior, 62 willing participants were subjected to in-depth interviews. Quantitative responses were descriptively analyzed and presented as count, proportion, mean or median. Framework analysis was performed for the qualitative data. The findings of both types of data were triangulated to construct the pathways to treatment traversed by PCOS patients. Findings Many (~45%) respondents had no information regarding PCOS. Only 9.1% received some information from their doctors. Though the internet was the primary source of information for 37.5% of respondents, they expressed dissatisfaction with the quality of information. Multiple health care agencies were consulted by most (85.8%) of the respondents. Allopathy was the preferred choice of treatment. The average delay in initiating the treatment was 3 months. The major reasons for this were ignorance, the concept of ‘normality’ and ‘endurance’. Deviations from the normal self (like irregular-menstruation, obesity, hirsutism, infertility) were the concern that led them to consult a doctor. They were also dissatisfied with the treatment due to a late diagnosis, lack of relief, taboo, side-effects, expenses involved and the need for repeated laboratory tests. Participants’ course of treatment was influenced by the interplay of individual, distress, health-system, and social-economic factors. Conclusions Women with PCOS were dissatisfied with the quality of the information and treatment received. There were treatment delays. The patients consulted multiple health agencies, including indigenous therapies, in the hope of relief. The findings provide an empirical basis on points to focus on for building better coping strategies for managing the condition.

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