An endocrine perspective on menstrual suppression for adolescents: achieving good suppression while optimizing bone health

Suppression of menstruation and/or ovarian function in adolescent girls may be desired for a variety of reasons. Numerous medical options exist. The choice of the appropriate modality for an individual patient depends on several factors based on differences in the efficacy of achieving menstrual suppression as well as in their side effect profiles. Adolescence is also a period of bone mass accrual in girls, and several of these modalities may negatively influence peak bone mass. This review focuses on the efficacy of achieving menstrual suppression and the effect on bone health of the various options through an overview of the current literature and also highlights areas in need of further research.

Scoping Review on Menstrual Suppression Among U.S. Military Service Members

ABSTRACT Introduction The purpose of this scoping review was to systematically evaluate literature addressing menstrual suppression in the military population and to identify gaps in the literature. Materials and Methods A scoping review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines was completed. Quality appraisal was conducted using the Johns Hopkins Evidence-Based Practice (EBP) Evidence Level and Quality Guide. Results Thirteen research articles and nine non-research articles were included. The themes identified were methods for menstrual suppression, barriers to menstrual suppression, and educational recommendations. Conclusions Six gaps were identified: (1) readiness, (2) single branch of service, (3) options for suppression, (4) hesitance to suppress, (5) provider practices, and (6) stagnant research. Recommendations for future research, practice, and military health policy are provided. Expanding research on menstrual suppression in U.S. military service members will enhance the health of military service members, provider practices, and military health policy to promote military readiness.

Menstrual Suppression Practice among Female Malaysian Pilgrims

INTRODUCTION: Performing the Hajj or pilgrimage is obligatory for all Muslims. Certain Hajj religious rites cannot be performed during menstruation. Hence, it is common for female pilgrims to seek a doctor’s advice on methods of menstrual suppression during Hajj. This exploratory study aimed to determine the prevalence and usage profile of menstrual suppression practices among Malaysian women performing Hajj and their associated factors. MATERIALS AND METHODS: An observational cohort study involved 437 women aged 18-55 years old who attended compulsory pre-Hajj courses in Klang Valley, Malaysia. The self-administered questionnaires contained sociodemographic information, and biomedical characteristics were obtained. A follow-up call was made after their return from Hajj to obtain information regarding practice, medication is taken, and their intended duration of menstrual suppression. Descriptive and inferential analysis were done. RESULTS: Post Hajj, about 81.3% (347/437) of women were contactable and completed their menstrual calendar and 17.6% (62/347) of female pilgrims practiced menstrual suppression. The mean duration of hajj was 44 days and 77.4% (48/61) intended to suppress their menstruation throughout the whole of their Hajj travel. Previous use of contraception was associated with menstrual suppression practice (p<0.001). The commonest method of menstrual suppression was combined oral contraceptive pills (53.2%) followed by oral progestogens only pill (35.5%). CONCLUSION: Almost one-fifth of Malaysian female Hajj pilgrims practiced menstrual suppression. Previous use of contraception was associated with menstrual suppression practice. Combined oral contraceptive pills were the commonest method used and the method was chosen was based on the individual desired duration of menstrual suppression. ><0.001). The commonest method of menstrual suppression was combined oral contraceptive pills (53.2%) followed by oral progestogens only pill (35.5%). CONCLUSION: Almost one-fifth of Malaysian female Hajj pilgrims practiced menstrual suppression. Previous use of contraception was associated with menstrual suppression practice. Combined oral contraceptive pills were the commonest method used and the method was chosen was based on the individual desired duration of menstrual suppression.