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International Journal of Public Health Mar 2019This study presents a scoping review of evidence relating to knowledge and experiences of puberty and menstruation among females aged 10-14 years in low- and... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This study presents a scoping review of evidence relating to knowledge and experiences of puberty and menstruation among females aged 10-14 years in low- and middle-income countries.
METHODS
Forty-four items from 12 countries were identified from a systematic scoping review and screening of 8083 items. Included studies were quality assessed.
RESULTS
A majority (40/44) of studies used school-based samples, and fifteen studies reported on interventions. Girls had inadequate knowledge about menstruation; menarche as a trigger for girls learning about menstruation was common. Adolescents struggled with menstrual hygiene. Negative emotions were associated with menarche and menstrual management. A minority of studies dealt explicitly with puberty. Most girls obtained information about menstruation and/or puberty from their mothers, although mothers were not necessarily girls' preferred source for learning about these topics.
CONCLUSIONS
Young adolescent girls are under-prepared for puberty and menstruation. Predominantly school-based studies mean we know little about young out-of-school adolescents. The evidence base lags behind the rise in interest from practitioners as well as the development (and evaluation) of puberty and/or menstruation interventions.
Topics: Adolescent; Child; Female; Health Knowledge, Attitudes, Practice; Humans; Income; Menarche; Menstruation; Poverty; Puberty
PubMed: 30740629
DOI: 10.1007/s00038-019-01209-0 -
Acta Dermatovenerologica Croatica : ADC Dec 2016Hidradenitis suppurativa (HS) is an inflammatory skin disease. Several observations imply that sex hormones may play a role in its pathogenesis. HS is more common in... (Review)
Review
Hidradenitis suppurativa (HS) is an inflammatory skin disease. Several observations imply that sex hormones may play a role in its pathogenesis. HS is more common in women, and the disease severity appears to vary in intensity according to the menstrual cycle. In addition, parallels have been drawn between HS and acne vulgaris, suggesting that sex hormones may play a role in the condition. The role of androgens and estrogens in HS has therefore been explored in numerous observational and some interventional studies; however, the studies have often reported conflicting results. This systematic review includes 59 unique articles and aims to give an overview of the available research. Articles containing information on natural variation, severity changes during menstruation and pregnancy, as well as articles on serum levels of hormones in patients with HS and the therapeutic options of hormonal manipulation therapy have all been included and are presented in this systematic review. Our results show that patients with HS do not seem to have increased levels of sex hormones and that their hormone levels lie within the normal range. While decreasing levels of progesterone and estrogen seem to coincide with disease flares in premenopausal women, the association is speculative and requires experimental confirmation. Antiandrogen treatment could be a valuable approach in treating HS, however randomized control trials are lacking.
Topics: Adult; Age Distribution; Androgens; Chronic Disease; Denmark; Estrogens; Female; Hidradenitis Suppurativa; Humans; Metformin; Middle Aged; Prognosis; Quality of Life; Role; Severity of Illness Index; Sickness Impact Profile
PubMed: 28128074
DOI: No ID Found -
Psychiatry Research Mar 2016This systematic review examines adjunctive metformin therapy for the treatment of antipsychotic-induced hyperprolactinemia. A computerized search of databases in Chinese... (Review)
Review
This systematic review examines adjunctive metformin therapy for the treatment of antipsychotic-induced hyperprolactinemia. A computerized search of databases in Chinese and the international databases in English provided three trials with a total of 325 patients including one randomized clinical trial (RCT) and two observational studies (single-group, before-after design). A meta-analysis could not be conducted. The quality of evidence ranged from "very low" to "moderate". Metformin patients had a significant decrease in serum prolactin level with a mean of 54.6μg/l in the three trials. In the RCT, menstruation restarted in 67% of those with menstrual disturbances versus 5% in placebo. In one observational study, 91% of patients no longer had signs or symptoms of galactorrhea. In the RCT, adverse drug reactions (ADRs) occurred at similar incidence rates among metformin and placebo patients, except that no significant increases in nausea, insomnia and agitation occurred which were not associated with discontinuations. Our systematic review indicated that adjunctive metformin significantly lowered prolactin level and relieved prolactin-related symptoms in patients with antipsychotic-induced hyperprolactinemia. Future higher quality RCTs need to verify the currently available limited evidence based on three trials which suggest that adjunctive metformin may be used effectively and safely for antipsychotic-induced hyperprolactinemia.
Topics: Antipsychotic Agents; Clinical Trials as Topic; Female; Humans; Hyperprolactinemia; Hypoglycemic Agents; Male; Metformin; Prolactin
PubMed: 26822064
DOI: 10.1016/j.psychres.2016.01.031 -
PloS One 2021Disposal and washing facilities and services for menstrual materials are often designed based upon technical specifications rather than an in-depth understanding of what...
BACKGROUND
Disposal and washing facilities and services for menstrual materials are often designed based upon technical specifications rather than an in-depth understanding of what drives peoples' choices of practices.
OBJECTIVES AND DATA SOURCES
This systematic review identified and summarised the main behavioural drivers pertaining to the choice of disposal and washing practices of menstrual materials through the thematic content analysis and study appraisal of 82 publications (80 studies) on menstrual health and hygiene published since 1999, reporting the outcomes of primary research across 26 countries.
RESULTS
Disposal and washing behaviours are primarily driven by the physical state of sanitation facilities; however, this is intrinsically linked to taboos surrounding and knowledge of menstruation.
IMPLICATIONS
Using reasons given for disposal and washing practices by menstruators or those who know them well, or inferred by authors of the reviewed studies, we identify the key considerations needed to design facilities and services which best suit the desired behaviours of both planners and those who menstruate.
INCLUSIVITY
The term menstruators is used throughout to encompass all those mentioned in the studies reviewed (girls and women); although no studies explicitly stated including non-binary or transgender participants, this review uses inclusive language that represents the spectrum of genders that may experience menstruation.
REGISTRATION
The review protocol is registered on PROSPERO: 42019140029.
Topics: Adolescent; Adult; Developing Countries; Female; Health Knowledge, Attitudes, Practice; Humans; Hygiene; Menstrual Hygiene Products; Menstruation; Middle Aged; Sanitation
PubMed: 34860828
DOI: 10.1371/journal.pone.0260472 -
Obstetrics and Gynecology Sep 2023The diagnosis of endometriosis, a common gynecologic condition, is characterized by delays of up to 11 years. During this time, women may experience persistent symptoms...
OBJECTIVE
The diagnosis of endometriosis, a common gynecologic condition, is characterized by delays of up to 11 years. During this time, women may experience persistent symptoms that affect their quality of life, productivity, and relationships, and the disease may progress. It is therefore a priority to understand the factors that contribute to this delay to help improve the diagnostic pathway. Our objective was to describe the diagnosis barriers of endometriosis from the patient and health care professional perspectives using a qualitative evidence synthesis.
DATA SOURCES
We searched MEDLINE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature using combinations of the synonyms of endometriosis, diagnosis, and qualitative research. The search was restricted to English-language articles from database creation until May 2022.
METHODS OF STUDY SELECTION
The initial search yielded 899 articles. Studies were included if they explored the experiences or views of affected women or health care professionals on the diagnosis of endometriosis and used qualitative methods for data collection and data analysis. Risk of bias was assessed with the Critical Appraisal Skills Programme checklist.
TABULATION, INTEGRATION, AND RESULTS
Thirty-seven articles were considered for full review, with 13 eligible articles identified for inclusion. Thematic synthesis was used to identify four key themes: 1) individual factors (n=6), 2) interpersonal influences (n=6), 3) health system factors (n=13), and 4) factors specific to endometriosis (n=13). These encompassed 12 subthemes that represented barriers to the diagnosis of endometriosis: 1) difficulty establishing pathologic symptoms from normal menstruation and the use of self-care techniques; 2) menstrual stigma and the normalization of menstrual pain; 3) attitudes and lack of training for health care professionals, delayed referrals to specialist services, and poor explanation of oral contraceptive pill use in the diagnostic process; and 4) variability in presenting symptoms, overlap with other conditions, lack of a noninvasive method of diagnosis, and concerns about the value of a diagnosis.
CONCLUSION
This review identified barriers to the timely diagnosis of endometriosis from the perspective of affected individuals and health care professionals. It highlights areas for improvement along the diagnostic pathway, which may guide future strategies to reduce delays.
Topics: Humans; Female; Endometriosis; Quality of Life; Menstruation; Dysmenorrhea; Health Personnel
PubMed: 37441792
DOI: 10.1097/AOG.0000000000005255 -
The Cochrane Database of Systematic... Aug 2017Emergency contraception (EC) is using a drug or copper intrauterine device (Cu-IUD) to prevent pregnancy shortly after unprotected intercourse. Several interventions are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Emergency contraception (EC) is using a drug or copper intrauterine device (Cu-IUD) to prevent pregnancy shortly after unprotected intercourse. Several interventions are available for EC. Information on the comparative effectiveness, safety and convenience of these methods is crucial for reproductive healthcare providers and the women they serve. This is an update of a review previously published in 2009 and 2012.
OBJECTIVES
To determine which EC method following unprotected intercourse is the most effective, safe and convenient to prevent pregnancy.
SEARCH METHODS
In February 2017 we searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, Popline and PubMed, The Chinese biomedical databases and UNDP/UNFPA/WHO/World Bank Special Programme on Human Reproduction (HRP) emergency contraception database. We also searched ICTRP and ClinicalTrials.gov as well as contacting content experts and pharmaceutical companies, and searching reference lists of appropriate papers.
SELECTION CRITERIA
Randomised controlled trials including women attending services for EC following a single act of unprotected intercourse were eligible.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures recommended by Cochrane. The primary review outcome was observed number of pregnancies. Side effects and changes of menses were secondary outcomes.
MAIN RESULTS
We included 115 trials with 60,479 women in this review. The quality of the evidence for the primary outcome ranged from moderate to high, and for other outcomes ranged from very low to high. The main limitations were risk of bias (associated with poor reporting of methods), imprecision and inconsistency. Comparative effectiveness of different emergency contraceptive pills (ECP)Levonorgestrel was associated with fewer pregnancies than Yuzpe (estradiol-levonorgestrel combination) (RR 0.57, 95% CI 0.39 to 0.84, 6 RCTs, n = 4750, I = 23%, high-quality evidence). This suggests that if the chance of pregnancy using Yuzpe is assumed to be 29 women per 1000, the chance of pregnancy using levonorgestrel would be between 11 and 24 women per 1000.Mifepristone (all doses) was associated with fewer pregnancies than Yuzpe (RR 0.14, 95% CI 0.05 to 0.41, 3 RCTs, n = 2144, I = 0%, high-quality evidence). This suggests that if the chance of pregnancy following Yuzpe is assumed to be 25 women per 1000 women, the chance following mifepristone would be between 1 and 10 women per 1000.Both low-dose mifepristone (less than 25 mg) and mid-dose mifepristone (25 mg to 50 mg) were probably associated with fewer pregnancies than levonorgestrel (RR 0.72, 95% CI 0.52 to 0.99, 14 RCTs, n = 8752, I = 0%, high-quality evidence; RR 0.61, 95% CI 0.45 to 0.83, 27 RCTs, n = 6052, I = 0%, moderate-quality evidence; respectively). This suggests that if the chance of pregnancy following levonorgestrel is assumed to be 20 women per 1000, the chance of pregnancy following low-dose mifepristone would be between 10 and 20 women per 1000; and that if the chance of pregnancy following levonorgestrel is assumed to be 35 women per 1000, the chance of pregnancy following mid-dose mifepristone would be between 16 and 29 women per 1000.Ulipristal acetate (UPA) was associated with fewer pregnancies than levonorgestrel (RR 0.59; 95% CI 0.35 to 0.99, 2 RCTs, n = 3448, I = 0%, high-quality evidence). Comparative effectiveness of different ECP dosesIt was unclear whether there was any difference in pregnancy rate between single-dose levonorgestrel (1.5 mg) and the standard two-dose regimen (0.75 mg 12 hours apart) (RR 0.84, 95% CI 0.53 to 1.33, 3 RCTs, n = 6653, I = 0%, moderate-quality evidence).Mid-dose mifepristone was associated with fewer pregnancies than low-dose mifepristone (RR 0.73; 95% CI 0.55 to 0.97, 25 RCTs, n = 11,914, I = 0%, high-quality evidence). Comparative effectiveness of Cu-IUD versus mifepristoneThere was no conclusive evidence of a difference in the risk of pregnancy between the Cu-IUD and mifepristone (RR 0.33, 95% CI 0.04 to 2.74, 2 RCTs, n = 395, low-quality evidence). Adverse effectsNausea and vomiting were the main adverse effects associated with emergency contraception. There is probably a lower risk of nausea (RR 0.63, 95% CI 0.53 to 0.76, 3 RCTs, n = 2186 , I = 59%, moderate-quality evidence) or vomiting (RR 0.12, 95% CI 0.07 to 0.20, 3 RCTs, n = 2186, I = 0%, high-quality evidence) associated with mifepristone than with Yuzpe. levonorgestrel is probably associated with a lower risk of nausea (RR 0.40, 95% CI 0.36 to 0.44, 6 RCTs, n = 4750, I = 82%, moderate-quality evidence), or vomiting (RR 0.29, 95% CI 0.24 to 0.35, 5 RCTs, n = 3640, I = 78%, moderate-quality evidence) than Yuzpe. Levonorgestrel users were less likely to have any side effects than Yuzpe users (RR 0.80, 95% CI 0.75 to 0.86; 1 RCT, n = 1955, high-quality evidence). UPA users were more likely than levonorgestrel users to have resumption of menstruation after the expected date (RR 1.65, 95% CI 1.42 to 1.92, 2 RCTs, n = 3593, I = 0%, high-quality evidence). Menstrual delay was more common with mifepristone than with any other intervention and appeared to be dose-related. Cu-IUD may be associated with higher risks of abdominal pain than mifepristone (18 events in 95 women using Cu-IUD versus no events in 190 women using mifepristone, low-quality evidence).
AUTHORS' CONCLUSIONS
Levonorgestrel and mid-dose mifepristone (25 mg to 50 mg) were more effective than Yuzpe regimen. Both mid-dose (25 mg to 50 mg) and low-dose mifepristone(less than 25 mg) were probably more effective than levonorgestrel (1.5 mg). Mifepristone low dose (less than 25 mg) was less effective than mid-dose mifepristone. UPA was more effective than levonorgestrel.Levonorgestrel users had fewer side effects than Yuzpe users, and appeared to be more likely to have a menstrual return before the expected date. UPA users were probably more likely to have a menstrual return after the expected date. Menstrual delay was probably the main adverse effect of mifepristone and seemed to be dose-related. Cu-IUD may be associated with higher risks of abdominal pain than ECPs.
Topics: Contraception, Postcoital; Contraceptives, Postcoital; Drug Administration Schedule; Estradiol; Female; Humans; Intrauterine Devices, Copper; Intrauterine Devices, Medicated; Levonorgestrel; Mifepristone; Norpregnadienes; Pregnancy; Pregnancy Rate; Randomized Controlled Trials as Topic; Unsafe Sex
PubMed: 28766313
DOI: 10.1002/14651858.CD001324.pub5 -
Journal of Medical Internet Research Feb 2024Emerging digital health technology has moved into the reproductive health market for female individuals. In the past, mobile health apps have been used to monitor the...
BACKGROUND
Emerging digital health technology has moved into the reproductive health market for female individuals. In the past, mobile health apps have been used to monitor the menstrual cycle using manual entry. New technological trends involve the use of wearable devices to track fertility by assessing physiological changes such as temperature, heart rate, and respiratory rate.
OBJECTIVE
The primary aims of this study are to review the types of wearables that have been developed and evaluated for menstrual cycle tracking and to examine whether they may detect changes in the menstrual cycle in female individuals. Another aim is to review whether these devices are effective for tracking various stages in the menstrual cycle including ovulation and menstruation. Finally, the secondary aim is to assess whether the studies have validated their findings by reporting accuracy and sensitivity.
METHODS
A review of PubMed or MEDLINE was undertaken to evaluate wearable devices for their effectiveness in predicting fertility and differentiating between the different stages of the menstrual cycle.
RESULTS
Fertility cycle-tracking wearables include devices that can be worn on the wrists, on the fingers, intravaginally, and inside the ear. Wearable devices hold promise for predicting different stages of the menstrual cycle including the fertile window and may be used by female individuals as part of their reproductive health. Most devices had high accuracy for detecting fertility and were able to differentiate between the luteal phase (early and late), fertile window, and menstruation by assessing changes in heart rate, heart rate variability, temperature, and respiratory rate.
CONCLUSIONS
More research is needed to evaluate consumer perspectives on reproductive technology for monitoring fertility, and ethical issues around the privacy of digital data need to be addressed. Additionally, there is also a need for more studies to validate and confirm this research, given its scarcity, especially in relation to changes in respiratory rate as a proxy for reproductive cycle staging.
Topics: Female; Humans; Fertility; Heart Rate; Menstrual Cycle; Menstruation; Reproductive Health; Wearable Electronic Devices
PubMed: 38358798
DOI: 10.2196/45139 -
Women & Health Sep 2023Primary dysmenorrhea (PD) has a significant impact on women's lives, especially among young women who miss school and work due to painful periods. Experiences and how...
Primary dysmenorrhea (PD) has a significant impact on women's lives, especially among young women who miss school and work due to painful periods. Experiences and how women manage PD have been explored to some extent, but the evidence has not been systematically collated and reviewed to allow health professionals to better understand women's experiences of and perceptions about PD. Hence, we aim to synthesize the qualitative evidence related to women's experiences of PD and associated symptoms. For this purpose, seven databases (Ovid MEDLINE®, PubMed, Embase, APA PsycINFO, Web of Science, CINAHL and OpenGrey) were searched for relevant papers published in English, Spanish, Greek and Chinese between January 1997 and May 2021. All studies investigating women's experiences with PD were included; besides, The Critical Appraisal Skills Programme (CASP) tool for qualitative studies was used to critically appraise the papers. A data extraction form was developed using JBI template and findings from the papers were analyzed and synthesized using meta-aggregation. Sixteen articles were included and during the analysis five themes were identified: Experiencing pain and associated symptoms, the psychological dimension of PD, knowledge and support, day-to-day living with PD, and coping strategies. We concluded taboos and deeply rooted beliefs around menstruation can potentially lead to gender inequalities; hence, women's common concerns and their experiences with PD need to be considered. Training and treatment protocols for health practitioners are needed. Future research should focus on development and testing of protocols for diagnosis, pharmacological and non-pharmacological management and men's perceptions of menstruation of their lovers.
Topics: Female; Humans; Adaptation, Psychological; Dysmenorrhea
PubMed: 37726871
DOI: 10.1080/03630242.2023.2255289 -
Frontiers in Immunology 2022Intrauterine adhesions (IUAs) are a major cause of female infertility. Stem cells can be used to restore endometrial function owing to their regenerative abilities. We... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Intrauterine adhesions (IUAs) are a major cause of female infertility. Stem cells can be used to restore endometrial function owing to their regenerative abilities. We compared the safety and efficacy of autologous and allogeneic stem cell treatments in patients with recurrent IUA after conventional therapy based on a systematic review of the related literature.
METHODS
The PubMed, Embase, and Cochrane databases were systematically searched. All analysis were performed using Review Manager 5.4. We compared improvements in endometrial thickness, pregnancy rates, menstruation, and side effects after autologous and allogeneic stem cell therapy. The study was registered with PROSPERO, CRD 42022322870.
RESULTS
Our search returned 154 reports, 10 of which met the inclusion criteria, representing 116 patients. Of these, 44 patients in two studies were treated with allogeneic stem cells and 72 patients in eight studies were treated with autologous stem cells. Improvements in endometrial thickness and pregnancy rates after intrauterine device treatment were compared between the autologous and allogeneic stem cell groups. Endometrial thickness increased more after autologous stem cell IUA treatment (mean difference, 1.68; 95% confidence interval [CI]: 1.30-2.07; P < 0.00001), and the pregnancy rate was also improved (relative risk, 1.55; 95% CI: 1.19-2.02, P < 0. 001). No obvious and serious adverse reactions were observed during stem cell therapy in either group.
CONCLUSIONS
This meta-analysis and systematic review of the results of randomized trials of autologous and allogeneic stem cell treatments for IUA suggests that autologous stem cells have a better effect in improving the endometrium thickness and pregnancy rate.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022322870.
Topics: Female; Hematopoietic Stem Cell Transplantation; Humans; Pregnancy; Stem Cell Transplantation; Tissue Adhesions; Transplantation, Autologous; Uterine Diseases
PubMed: 35860277
DOI: 10.3389/fimmu.2022.899666 -
PloS One 2016Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls. (Review)
Review
BACKGROUND
Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls.
OBJECTIVES
To summarise and critically appraise evidence for the effectiveness of menstruation management interventions in improving women and girls' education, work and psychosocial wellbeing in low and middle income countries.
METHODS
Structured systematic searches were conducted in peer-reviewed and grey literature to identify studies evaluating education and resource provision interventions for menstruation management. Individual and cluster randomised controlled trials were eligible for inclusion, as were non-randomised controlled trials. Study characteristics, outcomes and risk of bias were extracted using a piloted form. Risk of bias was independently assessed by two researchers.
RESULTS
Eight studies described in ten citations were eligible for inclusion. Studies were highly heterogeneous in design and context. Six included assessment of education-only interventions, and three provided assessment of the provision of different types of sanitary products (menstrual cups, disposable sanitary pads, and reusable sanitary pads). A moderate but non-significant standardised mean difference was found for the two studies assessing the impact of sanitary pad provision on school attendance: 0.49 (95%CI -0.13, 1.11). Included studies were heterogeneous with considerable risk of bias. Trials of education interventions reported positive impacts on menstrual knowledge and practices, however, many studies failed to assess other relevant outcomes. No trials assessed or reported harms.
CONCLUSIONS
There is insufficient evidence to establish the effectiveness of menstruation management interventions, although current results are promising. Eight trials have been conducted, but a high risk of bias was found and clinical heterogeneity precluded synthesis of most results. Whilst trials provided some indication of positive results, further research is needed to establish the role of menstruation hygiene management in education performance, employment and other psychosocial outcomes. This review provides a concise summary of present trials and highlights improvements for future work.
Topics: Education; Female; Humans; Hygiene; Income; Menstruation; Outcome Assessment, Health Care
PubMed: 26862750
DOI: 10.1371/journal.pone.0146985