Effects of Modified Wenjing Decoction Combined with Online Publicity and Education on the Treatment of Primary Dysmenorrhea of Cold Coagulation and Blood Stasis

Objective. To explore the effects of modified Wenjing decoction combined with online publicity and education on the treatment of primary dysmenorrhea of cold coagulation and blood stasis. Methods. The materials of 111 patients with primary dysmenorrhea of cold coagulation and blood stasis in the outpatient department (January 2019–June 2021) were collected to conduct the retrospective study. The 111 patients were randomized into treatment group (n = 59) and control group (n = 52). The control group received online publicity and education and conventional treatment, and the treatment group received online publicity and education and modified Wenjing decoction. The patients in the two groups were continuously treated for three menstrual cycles. The treatment effects, the dosage of analgesics, the scores of associated symptoms before and after treatment, and other indexes were compared between the two groups. Results. The differences in the efficacy on abdominal pain were statistically significant between the two groups P < 0.05 . Compared with the control group, the treatment group had lower scores of associated symptoms after treatment p < 0.5 . After the treatment of three menstrual cycles, 54 patients in the treatment group stopped taking ibuprofen, and the average ibuprofen dosage of the other 5 patients was (0.24 ± 0.16)g. The 52 patients in the control group still needed to take ibuprofen, and the mean dosage was (0.51 ± 0.05)g. The differences in the ibuprofen dosage between the two groups had remarkable difference P < 0.001 . Conclusion. Modified Wenjing decoction combined with online publicity and education can obviously improve the clinical symptoms of the patients with primary dysmenorrhea of cold coagulation and blood stasis and reduce the dosage of analgesics. It is worth promoting and applying in practice.

Comparative advantage of anti-Mullerian hormone over other ovarian reserve metric (basal hormonal test) in prediction of fertility in women with varying menstrual cycle

Objective: Anti-Mullerian hormone has been indicated as a novel biomarker for ovarian reserve assessment. This study aimed to determine the comparative advantage of serum levels of AMH, FSH, LH, E2, and LH/FSH ratio among women with varying menstrual cycles and duration of menstruation. Material and Method: A total of 90 subjects, which consisted of sixty subjects and thirty healthy subjects as control, were recruited. Blood samples were collected on day 3 of the menstrual cycle and evaluated for ovarian markers using the ELISA technique. All data were analyzed using SPSS version 23.0. Results: AMH and LH/FSH levels were lower in women with varying menstrual cycles than in the control group. FSH, LH, and E2 levels were significantly higher in women with varying menstrual cycles and flow duration than in the control group(P<0.05). AMH was negatively correlated with age (r= -0.72), BMI( r= -0.4), FSH(r= - 0.3), LH(r = -0.2) (p<0.05) and E2(r= -0.2, p>0.05). Also age was positively correlated with FSH(r=0.5,p<0.05), E2(r=0.3, p<0.05) and BMI(r=0.4, p<0.05). The level of AMH was not significant with cycle length and days of flow(p>0.05). This implies that AMH can be measured independently of the cycle phase. This show that AMH was lower in women with varying menstrual cycle with an increase in gonadotrophin and E2. The strong negative relationship between age and AMH implies that age is determining factor of ovarian reserve. Conclusion: AMH combined with age and FSH may improve ovarian reserve evaluation, making AMH a better marker

Internet-based cognitive-behavioral therapy for premenstrual syndrome: a randomized controlled trial

Background Premenstrual syndrome (PMS) is a common problem of women of reproductive age, affecting various aspects of their lives. However, limited studies have investigated the effect of internet-based cognitive-behavioral therapy (ICBT) on PMS. Therefore, we aimed to assess whether ICBT can reduce symptom severity of women with PMS and improve their quality of life during the perimenstrual and late follicular phases of menstrual cycle. Methods The study included 92 university students aged 18–35 years who had moderate to severe PMS. The participants were allocated into two groups of 46 using block randomization. The intervention group underwent ICBT for two menstrual cycles, while the control group received no intervention. Before and after the intervention, all participants filled the Daily Record of Severity of Problems (DRSP) for two menstrual cycles and the Quality of Life Enjoyment and Satisfaction Questionnaire—Short Form (Q-LES-Q-SF) on days 1–2 and 11–13 of the menstrual cycle. Data were analyzed using univariate general linear models. Results Four students in the intervention group were lost to follow-up. Following the intervention, the mean score of total PMS symptoms was significantly lower in the intervention group than in the control group (10.4 vs. 20.2, adjusted difference: − 9.9 [95% CI − 13.3 to − 6.6]), and the score of perimenstrual quality of life was significantly higher (64.2 vs. 50.3, 14.1 [8.5 to 19.8]). However, there was no significant intergroup difference in the late follicular quality of life (68.3 vs. 67.3, 1.9 [− 4.4 to 8.1]). Conclusions The ICBT could reduce the symptom severity of women suffering from PMS while improving their perimenstrual quality of life. However, it had no significant effect on the late follicular quality of life. Therefore, this intervention can be used for women with PMS. Trial registration The Iranian Registry of Clinical Trials, Identifier: IRCT20100414003706N34, Registered prospectively on 19 June 2019, https://www.irct.ir/trial/38394.

Evaluation of the Efficacy and Threshold of Serum Anti-mullerian Hormone (AMH) Levels for Diagnosis and Prediction of Polycystic Ovary Syndrome (PCOS) Among Indian Women.

Purpose: PCOS women exhibit higher levels of AMH and has been proposed to add value to diagnosis of PCOS incase ambiguity. However, variable cutoffs of AHM for PCOS prediction have been reported. This study was designed to determine diagnostic threshold of serum AMH levels and its correlation with clinical, hormonal and ultrasonographic parameters among women with PCOS.Materials: In this prospective study, 113 women with PCOS as per Rotterdam criteria 2003 and 75 normo-ovulatory women were included. Clinical, biochemical, hormonal and sonographic assessment in addition to serum AMH levels were determined using standard methodology.Results: Mean age was comparable (23.43±3.42vs.24.21±3.18 years) between cases and controls. The mean number of menstrual cycles per year were lower while as mean BMI, FG score, and serum testosterone were higher in cases than controls (p<0.05). The mean serum AMH level was significantly higher in PCOS group (7.84±3.67vs. 3.23 ±1.56 ng/mL) than controls. The serum AMH levels showed a positive correlation(p<0.05) with LH/FSH ratio (r = 0.206, p = 0.029), number of ovarian follicles(r=0.461) and volume,(r=0.521), but no correlation significant with age and BMI. As per receiver operating characteristic (ROC) curve, cut-off was worked out to be 3.76 ng/mL with 86.7% sensitivity and 62.7% specificity. Conclusion: Serum AMH levels correlate positively with PCOM among PCOS women and may be a potent diagnostic marker of ovarian dysfunction either alone or in conjunction with other tools to ensure timely diagnosis and early treatment of the disorder.

Menstrual irregularity as a biological limit to early pregnancy awareness

US state legislatures have proposed laws to prohibit abortion once the earliest embryonic electrical activity is detectable (fetal “heartbeat”). On average, this occurs roughly 6 wk after the last menstrual period. To be eligible for abortion, people must recognize pregnancy very early in gestation. The earliest symptom of pregnancy is a missed period, and irregular menstrual cycles—which occur frequently—can delay pregnancy detection past the point of fetal cardiac activity. In our analysis of 1.6 million prospectively recorded menstrual cycles, cycle irregularity was more common among young women, Hispanic women, and women with common health conditions, such as diabetes and polycystic ovary syndrome. These groups face physiological limitations in detecting pregnancy before fetal cardiac activity. Restriction of abortion this early in gestation differentially affects specific population subgroups, for reasons outside of individual control.

Not so hysterical now? Psychotherapy, menopause, and hysterectomy

In the context of the body, the essentially female; wombs, menstrual cycles, and concurrent hormones, have seen women ascribed madness, insatiability, untrustworthiness, and danger. Female bodies have been identified in selective parts, considered in abstract, or envisaged as having overwhelming power over the mind. “Hysteria”, the problematic neurosis of uterine origin was at the heart of early psychoanalysis. This diagnosis enshrines a slippage from the physical to the fantastical, and ultimately to the denial of the lived reality of women’s and girl’s bodies. In apparent collusion with patriarchy the neglect of some female bodily experience is perpetuated in contemporary psychoanalytic theory. Nowhere is this more evident than around menopause and hysterectomy (as experienced by either client or therapist). There has been little or no exploration of how practitioners might best support clients for whom menopause is significant, or how we might facilitate women before or after gynaecological surgery. It is as if removal and psychological loss of the same female body parts that our forebears used to so neatly differentiate, diagnose, and pathologise women are now not of note. I am interested as to how we as psychotherapists reclaim female body narratives from this outdated theoretical paradigm to best serve clients experiencing menopause, gynaecological surgery, and mid life in the twenty-first century.

A Case Report on Ayurvedic Management of Perimenopausal Bleeding

Perimenopausal period is the transitional period where a woman passes from the reproductive to the non-reproductive stage. Abnormal uterine bleeding in the perimenopausal period accounts for 70% of all gynecological problems. Most of the abnormal uterine bleeding in this period is due to endometrial abnormalities. In Ayurveda the condition can be correlated to Asrigdhara. This is the case report of a 54 year aged lady who presented with complaints of excessive bleeding and frequent menstrual cycles since three months. Investigations were done to rule out malignancy. USG report showed endometrial hyperplasia of 17mm with bulky uterus. Pap smear and Colposcopy reports showed inflammatory and CIN I changes with HPV flat lesions respectively. Bleeding stopped after two weeks of internal medication. USG done after six months showed significant reduction in endometrial thickness. Pronounced changes were also seen in Pap smear and Colposcopy findings.

MENSTRUAL HYGIENE AND COMMON ADOLESCENT GYNECOLOGICAL PROBLEMS - A BIRD’S EYE VIEW

Menstrual disorders are a common problem in adolescents the world over. Though the onset of menstruation is part of the normal maturation process, Menstrual disorders form the commonest gynecological complaint (45-58 %) among adolescents. The series of natural changes occurring to the uterus and body starting from the first day(1) of periods until the day before next periods can be called as menstrual cycle. It consists of “menstruation” in which inner layers of uterus sheds along with blood, and “ovulation” in which the ovum is released from the ovary. Men- strual hygiene deals with special healthcare needs and requirements of women during monthly menstruation or menstrual cycle. Unhygienic menstruation is the prime cause of menstrual diseases. Abnormalities in menstrual cycle are increased or decreased menstrual flow and increased or decreased intervals between two menstrual cycles. Menstrual abnormalities are common pathological problems associated with women of puberty age, which is en- hanced by disturbed dietary and daily regimens. It requires early attention and interventions to protect them from having undesired health events in the future. In addition to this appropriate Ayurveda medicines are required to bring the body in a balanced state. Here an attempt is made to compile the ideas of Acharya about menstrual health problems for their proper understanding and treatment through Ayurveda- the science which survived the time. Keywords: Normal menstruation, Menstrual hygiene, Adolescent girls, Menstrual disorders, Treatment and pre- vention, Ayurveda, Ritu

Association between halitosis and female fecundability in China: a prospective cohort study

Background Periodontal diseases and poor oral hygiene are potentially associated with decreased female fecundability. Fecundability refers to the probability of conception during a given period measured in months or menstrual cycles. This study aims to examine whether halitosis is associated with female fecundability in a large sample of Chinese women who planned to be pregnant. Methods In 2012, a total of 6319 couples came for preconception care in eight districts in Shanghai, China and were followed by telephone contact. Three thousand nine hundred fifteen women who continued trying to be pregnant for up to 24 months remained for final statistical analyses. Halitosis was self-reported at the preconception care visit. Time to pregnancy (TTP) was reported in months and was censored at 24 months. Fecundability ratio (FR) was defined as the ratio of probability of conception among those with and without halitosis. FR and 95% confidence interval (CI) were estimated using the discrete-time Cox model. Results 80.1 and 86.1% of women had self-reported clinically confirmed pregnancy within 12 and 24 months, respectively. Halitosis was reported in 8.7% of the women. After controlling for potential confounders, halitosis was associated with a reduced probability of spontaneous conception (for an observation period of 12 months: adjusted FR 0.82, 95% CI 0.72–0.94; for an observation period of 24 months: adjusted FR 0.84, 95% CI 0.74–0.96). Conclusions Halitosis is associated with reduced fecundability in Chinese women.

A Comparison between the Effectiveness of Norethisterone and Dydrogesterone for treatment of Irregular Menstrual Cycle

Background: Abnormal uterine bleeding is defined as irregularities in the menstrual cycle involving frequency, regularity, duration, and volume of flow outside of pregnancy. Up to 1/3rd of women experience abnormal uterine bleeding in their life, with irregularities most commonly occurs at menarche and perimenopause due to disruption of the hypothalamic-pituitary-ovarian axis. Aim: To compare the effectiveness of Norethisterone and Dydrogesterone for the treatment of irregular menstrual cycles due to abnormal uterine bleeding of ovulatory or endometrial dysfunction and to check for patient satisfaction after the use of prescribed hormones by taking their feedback. Methods: This observational, comparative, cohort-prospective study was conducted on 100 nonpregnant women between the ages of 15-45 years who presented with complaints of irregular menstruation in gynae outdoor of AMTH for 6 months from April 2021 to September 2021. After excluding pelvic pathology, known thyroid disease, coagulation disorder, or use of the contraceptive method, the participants were divided into Group A and Group B, each having 50 participants. Results: The mean age±SD of the participants in Group A was 29±3.4 while Group B had mean age±SD was 29.5±3.6. In Group A, 38(76%) patients reported a regular menstrual cycle after 3 months of use while 12(24%) patients complained of persistent irregular menstrual cycle despite 3 months use of Norethisterone with compliance in Group B using Dydrogesterone, 22(44%) patients had regular menstrual cycles while 28(56%) patients had persistent irregular menstrual cycles after three months of use. Conclusion: So we concluded from our study that Norethisterone had a better cycle control than Dydrogesterone. Keywords: Abnormal uterine bleeding of ovulatory and/or endometrial dysfunction, Norethisterone, Dydrogesterone,