Association Between Menstrual Patterns and Adverse Pregnancy Outcomes in Patients With Polycystic Ovary Syndrome

ObjectiveTo investigate the results of in vitro fertilization among polycystic ovary syndrome (PCOS) patients using the long-acting long protocol regarding the relationship between menstrual patterns and adverse pregnancy outcomes.DesignRetrospective cohort study.SettingUniversity-affiliated reproductive medical center.BackgroundThe menstrual patterns of patients with PCOS is considered related to metabolism; however, no study has analyzed the outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in patients with PCOS who have different menstrual patterns. This study aimed to observe the outcomes of IVF/ICSI in patients with PCOS with different menstrual patterns who used the long-acting long protocol.MethodsThis was a retrospective analysis in the first cycle of IVF/ICSI at the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019. In total, 1834 patients with PCOS were classified into the regular menstruation group (n=214), the oligomenorrhea group (n=1402), and the amenorrhea group (n=218).ResultsPCOS patients who used the long-acting long protocol of IVF/ICSI had similar clinical pregnancy rates and live birth rates despite having different menstrual patterns. The overall incidence of adverse pregnancy outcomes, including abortion, spontaneous preterm birth (sPTB), gestational diabetes(GDM), hypertensive disorder inpregnancy (HDP), and premature rupture of membranes(PROM, was significantly higher in the amenorrhea group than in the regular menstrual and oligomenorrhea groups (25.88% vs. 30.41% vs. 43.69%; P = 0.013). Additionally, the rates of GDM (2.35% vs. 6.10% vs. 13.79%; P=0.015) and macrosomia (5.26% vs. 10.94% vs. 18.39%; P=0.026) in the amenorrhea group were significantly higher than those in the other two groups. Correction for confounding factors showed that menstrual patterns are related to the occurrence of adverse pregnancy outcomes. Amenorrhea is an independent risk factor for adverse pregnancy outcome (OR [odds ratio]: 2.039, 95% CI [confidence interval]: 1.087-3.822), GDM (OR: 5.023, 95% CI: 1.083–23.289), and macrosomia (OR: 4.918, 95% CI: 1.516–15.954).ConclusionsIVF/ICSI can achieve similar pregnancy and live birth rates in PCOS patients with different menstrual patterns. However, the overall incidence of adverse pregnancy outcomes in PCOS patients with amenorrhea is higher than that in patients with regular menstruation or oligomenorrhea.

Kepatuhan Konsumsi Tablet Tambah Darah terhadap Anemia Remaja Putri

The consumption iron tablets for adolescent girls is one indicator of improving community nutrition. Research data in various regions in Indonesia shows the prevalence of anemia in adolescents girls ranges from 32.4% to 61%. The main causes of nutritional anemia in adolescents girls are due to lack of nutrient intake through food, iron loss in adolescents girls with more menstrual patterns and longer periods. Another reason is adolescents girls often maintain their appearance, the desire to stay slim or thin so that they go on a diet and eat less. The purpose of this study was to determine the compliance of iron tablet consumption on the incidence of anemia in adolescents girls. The research design was analytical observation with a cross sectional study approach for 12 weeks.. The number of sample in this study are 104 respondents (total sampling). The results showed that most of the adolescents ages 12-18 years (86.4%), 83 (79.8%) of the adolescents girls were anemia before consumption iron tablets. After consumption iron tablets for 12 weeks and mentoring as many as 69 people (66.3%) were obedient in consuming iron tablets and most of the adolescents girls (81.2%) weren’t anemia after consuming iron tablets for 12 weeks.

Durasi Kembalinya Kesuburan Paska KB Cyclofem dan Depo Medroksiprogesteron Asetat

Cyclofem and Depo Medroxy Progesterone Acetate (DMPA) are the most common types of contraception and are widely used, although there are still drawbacks such as disturbing menstrual patterns, weight gain, and delayed return of fertility. This study aims to determine the difference in the return of fertility between post-Cyclofem and DMPA acceptors in Gorontalo. 40 pregnant women were used in this study with the sampling technique used is purposive sampling. The study was conducted from May 25 to June 8, 2018. The data obtained were then analyzed using the independent t-test. The results showed that the return of fertility after Cyclofem was 7.1 months, and DMPA was 12.9 months. The value of t-count = 3.058 and sig. 0.004. There is a difference in the length of return of fertility between post-Cyclofem and DMPA family planning acceptors in Gorontalo. A larger research sample is needed so that the results obtained are better.

Recommendations and Nutritional Considerations for Female Athletes: Health and Performance

Optimal nutrition is an important aspect of an athlete’s preparation to achieve optimal health and performance. While general concepts about micro- and macronutrients and timing of food and fluids are addressed in sports science, rarely are the specific effects of women’s physiology on energy and fluid needs highly considered in research or clinical practice. Women differ from men not only in size, but in body composition and hormonal milieu, and also differ from one another. Their monthly hormonal cycles, with fluctuations in estrogen and progesterone, have varying effects on metabolism and fluid retention. Such cycles can change from month to month, can be suppressed with exogenous hormones, and may even be manipulated to capitalize on ideal timing for performance. But before such physiology can be manipulated, its relationship with nutrition and performance must be understood. This review will address general concepts regarding substrate metabolism in women versus men, common menstrual patterns of female athletes, nutrient and hydration needs during different phases of the menstrual cycle, and health and performance issues related to menstrual cycle disruption. We will discuss up-to-date recommendations for fueling female athletes, describe areas that require further exploration, and address methodological considerations to inform future work in this important area.

Analysis of Adolescent Hemoglobin Levels on Knowledge, Body Mass Index, and Menstrual Patterns

Anemia can be related to several factors, including knowledge, body mass index, and menstrual patterns. Adolescent girls are a high-risk group who experience anemia. This study aims to analyze the hemoglobin levels of adolescent girls about knowledge, body mass index, and patterns menstrual. Information on the relationship between hemoglobin levels and these factors expects to be a reference for strategies to overcome anemia in adolescent girls. The sample of this research is the students of Martapura Indonesia vocational high school, totaling 45 people. Data collection includes weight and height measurements, hemoglobin examination (using Easy Touch GCHb), and questionnaires. Data analysis used bivariate analysis of chi-square test with 0.05 with 95% confidence degree. Results Respondents had fewer hemoglobin levels 47%, normal 53%. The body mass index value of respondents is less than 85%, normal 13%, excess 2%. The respondent's menstrual pattern obtained 26% abnormal data, 74% normal data. Knowledge of anemia of respondents with enough category 34%, good category 66%. The conclusion is that there is no relationship between hemoglobin levels and body mass index (p-value 0.281), menstrual patterns (p-value 0.073), and knowledge of anemia (p-value 0.402) in adolescent girls. Hemoglobin levels may more influence by the consumption pattern of foods containing iron, so it recommends that young women consume more iron-rich foods and avoid the simultaneous consumption of substances that inhibit their absorption, such as tea and coffee.

Association Between Menstrual Patterns and Adverse Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome Undergoing in Vitro Fertilization/Intracytoplasmic Sperm Injection Embryo Transfer Cycles with The Long-Acting Long-Term Follicular Phase: A Retrospective Analysis

Background Menstrual patterns of patients with polycystic ovary syndrome (PCOS) is considered to be related to metabolism, but no study has analyzed the outcome of in vitro fertilization in patients with PCOS who have different menstrual patterns. This study aimed to observe the outcomes of in vitro fertilization in patients with PCOS with different menstrual patterns and infertility who used the long-acting long-term follicular phase Methods This was a retrospective analysis of the first cycle of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) at the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019. The clinical data of 1620 patients with PCOS with oligomenorrhea or amenorrhea in the long-acting regimen. According to menstrual patterns, they were divided into the oligomenorrhea group and the amenorrhea group. Clinical characteristics, pregnancy outcome and fetal birth weight were compared between both groups. According to the pregnancy outcome of clinical pregnancy, participants were divided into the normal pregnancy group and the unfavorable pregnancy group. Logistic regression was used to analyze the relationship between menstrual patterns and the relevance of adverse pregnancy outcomes. Results Clinical pregnancy rates of patients with PCOS treated using long-acting long-term follicular phase were similar between the two groups (76.86% vs. 76.86%, p = 0.999). However, the incidence of adverse pregnancy outcomes in the amenorrhea group was higher than that in the oligomenorrhea group (p = 0.009). The incidences of macrosomia and very low birth weight in infants were also higher. Adjustment for confounding factors showed that menstrual patterns could influence the occurrence of adverse pregnancy outcomes (odds ratio = 0.643; 95% confidence interval, 0.406–0.961; p = 0.045). The body mass index, endometrial thickness on the day of hCG administration, and the number of eggs harvested were also independent predictors of poor pregnancy outcomes. Conclusion(s): Among PCOS patients with different menstrual patterns, IVF/ICSI assisted pregnancy can achieve similar pregnancy rates. However, patients with PCOS who have amenorrhea have a higher incidence of adverse pregnancy outcomes than those with oligomenorrhea. Perinatal surveillance should be strengthened during pregnancy to reduce the incidence of maternal and neonatal adverse outcomes.

The Relationship between Menstrual Pattern and Menstrual Attitude Dimensions in Reproductive-age Women

Objective: Women's attitudes towards menstruation play a critical role in shaping their body and psychosocial integrity. Menstruation is affected by some bio-psychosocial factors; therefore, more in-depth understanding is needed to cope better with the consequent difficulties. This study aimed to investigate the relationship between menstrual patterns and menstrual attitude dimensions in reproductive-age women. Methods: An observational cross-sectional study was conducted on 170 women referred to the urban health centers of Torbat Heydariyeh, Iran, from January 2019 to December 2019. The Menstrual Attitudes Questionnaire (MAQ) and Verbal Multidimensional Scoring (VMS) systems were used to collect the required data. The features of the menstrual cycle were also recorded. Results: The overall response rate was 96.74%. Women with dysmenorrhea perceived menstruation as a more debilitating, bothersome, and predictable event and less denied any menstrual effect (p=0.001). The results also revealed that the subjective menstrual blood loss was associated with higher levels of perceiving menstruation as a natural (p=0.008), bothersome (p=0.026), and anticipatory event (p=0.021) and reporting less denial of any menstrual effect (p=0.001). Moreover, women rated menstruation as a more bothersome event by increasing the menstrual bleeding length (p=0.014). There was no significant relationship between the other features of the menstrual cycle with menstrual dimensions (p>0.05). Conclusion: The findings of this study suggest that women's attitudes towards menstruation was associated with menstrual pain, length, and subjective volume of menstrual flow. These factors could be used to modify women's attitudes towards the natural phenomenon of menstruation. Keywords: Attitude; Menstruation; Dysmenorrhea; Menarche; Menorrhagia.

Literature Review: Menopause and Sexual Disorders

Menopause is a permanent termination of the menstrual cycle caused by the loss of activity of ovarian follicles which is enforced when experiencing amenorrhea for 12 months. The mean age for women to stop menstruating was 51.5 years. The cause of menopause is a decrease in ovarian hormones. When the ovaries stop working and estrogen levels drop, a woman will experience several complaints such as changes in menstrual patterns, vasomotor, somatic, and psychological complaints, sleep disorders, sexual disorders, urogenital disorders, osteoporosis, and cardiovascular disease. Physical, psychological, social and cultural factors are factors that influence women’s sexual function. The ageing process is known to increase the prevalence of sexual dysfunction. Female sexual dysfunction prevalence is quite high, range from 38-85.2%. Sexual disorders can take many forms and clinical symptoms. Circulating estrogen levels have been shown to influence sexual desire, activity, experiences, and problems in sexually active postmenopausal women. Deficiency of estrogen will cause vaginal atrophy which can affect sexual dysfunction. Many factors influence sexual dysfunction, both biological and psychological, in postmenopausal women. The goal of managing sexual disorders in postmenopausal women is to maintain age-related function. Vulvovaginal complaints should be managed individualized and depends on the severity of symptoms, medical history and lifestyle of the patient.

Menstrual Patterns and Common Menstrual Problems Among Doctor of Physical Therapy Students

Objective: To observe the patterns and disorders of menstruation among physiotherapy undergraduates in Lahore city. Methods: A cross sectional survey was conducted at Riphah International University, Lahore from January 2020 to June 2020 after obtaining ethical approval. The data was collected through convenience sampling technique from two hundred physiotherapy undergraduate students by using anonymous questionnaire containing questions related to menstrual pattern, associated symptoms and heaviness of day wise bleeding. Informed consent was taken from all participants before data collection. Data was entered and analyzed on SPSS 21. Results: Menarche was found among 60% of undergraduates between the age of 13 and 14 and 24% of undergraduates between the ages of 15 and 17. A total of 71% of undergraduates had a regular menstruation cycle while 23% had irregular periods. 71% of undergraduates had a menstrual cycle of range between 21-28 days, 17% had irregular cycles, and 14% did not know how to go their menstrual duration. Most undergraduates have Bleeding for up to 1 week, with standard, medium, and restrained Bleeding. In 72% of undergraduates exploiting contains lumps, though 28.5% undergraduates do not experience exploiting. Because of their menses, 29% of undergraduates were incompetent to join university. 24% of undergraduates take leave from university because of painful menstruation whereas 9% take leave from university because of extreme blood flow. Dysmenorrhea signs were prevalent. Menses had a massive influence on societal lives and performances primarily on undergraduates. Conclusion: Dysmenorrhea and regular indiscretions were communal and mostly undergraduate’s responsiveness to menstruation signs was scarce. In its outcomes, there is entail for a teaching based program on menarche and menstrual issues. Keywords: Menarche, Dysmenorrhea, Undergraduates