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Sleep Medicine Clinics Sep 2018Subjective and objective sleep changes occur during the menstrual cycle. Poorer sleep quality in the premenstrual phase and menstruation is common in women with... (Review)
Review
Subjective and objective sleep changes occur during the menstrual cycle. Poorer sleep quality in the premenstrual phase and menstruation is common in women with premenstrual symptoms or painful menstrual cramps. There is increased sleep spindle activity from follicular to luteal phase, potentially progesterone related. Luteal phase changes also include blunted temperature rhythm amplitude and reduced rapid eye movement sleep. Women with polycystic ovary syndrome should be screened for sleep disordered breathing. Short sleep duration is associated with irregular menstrual cycles, which may impact reproductive health. Menstrual cycle phase and menstrual-related disorders should be considered when assessing women's sleep complaints.
Topics: Adult; Female; Humans; Menstrual Cycle; Menstruation Disturbances; Polycystic Ovary Syndrome; Sleep Wake Disorders
PubMed: 30098748
DOI: 10.1016/j.jsmc.2018.04.002 -
Fertility and Sterility May 2023To evaluate the efficacy and safety of acupuncture in the treatment of endometriosis-associated pain. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To evaluate the efficacy and safety of acupuncture in the treatment of endometriosis-associated pain.
DESIGN
A multicenter, randomized, single-blind, placebo-controlled trial.
INSTITUTIONS
Four tertiary hospitals in Jiangxi and Hainan Provinces.
SUBJECTS
Women with endometriosis-associated pain aged between 20 and 40 years.
INTERVENTION
Subjects were assigned randomly to receive either acupuncture or sham acupuncture treatment for 12 weeks, starting one week before each expected menstruation and administered as a 30-minute session once per day, 3 times a week. During the menstruation period, acupuncture was administered daily when pelvic pain associated with endometriosis occurred. After acupuncture or sham acupuncture treatment, the subjects were followed for another 12 weeks.
MAIN OUTCOME MEASURES
Changes in maximum pain as assessed with the visual analog scale (VAS) for various pelvic pain, duration of dysmenorrhea, and scores on the Multidimensional Pain Inventory, Beck Depression Inventory, Profile of Mood States, and Endometriosis Health Profile from baseline to week 12 and week 24.
RESULTS
A total of 106 women were assigned randomly to the acupuncture and sham groups. In the acupuncture group, the reduction in the dysmenorrhea VAS score was significantly greater after treatment, but not at the end of the trial, compared to the sham group. The duration of pain was significantly shorter in the acupuncture group. All test scores were improved to a significantly greater extent in the acupuncture group than in the sham group at week 12 but not at week 24. Changes in nonmenstrual pelvic pain and dyspareunia VAS scores were not different between the groups. No severe adverse events or differences in adverse events were recorded.
CONCLUSION
Acupuncture is an effective and safe method of relieving dysmenorrhea, shortening the pain duration, and improving wellbeing and quality of life in women with endometriosis-associated pain, although its efficacy fades after treatment is discontinued.
CLINICAL TRIAL REGISTRATION NUMBER
NCT03125304.
Topics: Female; Humans; Young Adult; Adult; Endometriosis; Dysmenorrhea; Quality of Life; Single-Blind Method; Pelvic Pain; Acupuncture Therapy; Treatment Outcome
PubMed: 36716811
DOI: 10.1016/j.fertnstert.2023.01.034 -
Women's Health (London, England) 2022After COVID-19 vaccination, women of reproductive age reported changes in their menstrual cycle.
INTRODUCTION
After COVID-19 vaccination, women of reproductive age reported changes in their menstrual cycle.
MATERIALS AND METHODS
A retrospective study was carried out after a survey on social networks that included women aged 18-41 years with normal cycles according to International Federation of Gynecology and Obstetrics and who were vaccinated (complete schedule for two doses, except J&J/Janssen or incomplete with a single dose). Women with following conditions were excluded: pregnant or lactating women; history of diseases that cause menstrual irregularities or early menopause: anorexia, bulimia, polycystic ovary syndrome, hypothyroidism, obesity, or low weight; hysterectomized or oophorectomized patients; and high performance athletes.
RESULTS
Overall, 950 women completed the survey between July and September 2021. In total, 408 women met the inclusion criteria, and 184 reported the following characteristics: frequency (normal 43.47%, infrequent 25%, and frequent 31.53%), regularity (regular 51.08%, irregular 42.93%, and absent/amenorrhea 5.97%), duration (normal 65.21%, prolonged 26.08%, absent/amenorrhea 8.69%), and volume (heavy 41.84%, light 20.65%, and absent/amenorrhea 6.52%).
CONCLUSIONS
SARS-CoV-2 infection and COVID-19 vaccination can influence the menstrual cycle and cause alterations.
Topics: COVID-19; COVID-19 Vaccines; Female; Humans; Menstrual Cycle; Menstruation Disturbances; Retrospective Studies; SARS-CoV-2; Vaccination
PubMed: 35796571
DOI: 10.1177/17455057221109375 -
JAMA Internal Medicine Apr 2015The expected duration of menopausal vasomotor symptoms (VMS) is important to women making decisions about possible treatments. (Observational Study)
Observational Study
IMPORTANCE
The expected duration of menopausal vasomotor symptoms (VMS) is important to women making decisions about possible treatments.
OBJECTIVES
To determine total duration of frequent VMS (≥ 6 days in the previous 2 weeks) (hereafter total VMS duration) during the menopausal transition, to quantify how long frequent VMS persist after the final menstrual period (FMP) (hereafter post-FMP persistence), and to identify risk factors for longer total VMS duration and longer post-FMP persistence.
DESIGN, SETTING, AND PARTICIPANTS
The Study of Women's Health Across the Nation (SWAN) is a multiracial/multiethnic observational study of the menopausal transition among 3302 women enrolled at 7 US sites. From February 1996 through April 2013, women completed a median of 13 visits. Analyses included 1449 women with frequent VMS.
MAIN OUTCOMES AND MEASURES
Total VMS duration (in years) (hot flashes or night sweats) and post-FMP persistence (in years) into postmenopause.
RESULTS
The median total VMS duration was 7.4 years. Among 881 women who experienced an observable FMP, the median post-FMP persistence was 4.5 years. Women who were premenopausal or early perimenopausal when they first reported frequent VMS had the longest total VMS duration (median, >11.8 years) and post-FMP persistence (median, 9.4 years). Women who were postmenopausal at the onset of VMS had the shortest total VMS duration (median, 3.4 years). Compared with women of other racial/ethnic groups, African American women reported the longest total VMS duration (median, 10.1 years). Additional factors related to longer duration of VMS (total VMS duration or post-FMP persistence) were younger age, lower educational level, greater perceived stress and symptom sensitivity, and higher depressive symptoms and anxiety at first report of VMS.
CONCLUSIONS AND RELEVANCE
Frequent VMS lasted more than 7 years during the menopausal transition for more than half of the women and persisted for 4.5 years after the FMP. Individual characteristics (eg, being premenopausal and having greater negative affective factors when first experiencing VMS) were related to longer-lasting VMS. Health care professionals should counsel women to expect that frequent VMS could last more than 7 years, and they may last longer for African American women.
Topics: Black or African American; Age Factors; Anxiety; Asian; Depression; Educational Status; Estrogen Replacement Therapy; Female; Hispanic or Latino; Hot Flashes; Humans; Kaplan-Meier Estimate; Longitudinal Studies; Menopause; Menstruation; Middle Aged; Postmenopause; Premenopause; Risk Factors; Self Report; Stress, Psychological; Sweating; Time Factors; United States; White People; Women's Health
PubMed: 25686030
DOI: 10.1001/jamainternmed.2014.8063 -
Journal of Acupuncture and Meridian... Aug 2018Dysmenorrhea constitutes one of the most frequent disorders in women of a fertile age. The present study was conducted to evaluate the efficacy of acupuncture in the... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Dysmenorrhea constitutes one of the most frequent disorders in women of a fertile age. The present study was conducted to evaluate the efficacy of acupuncture in the management of primary dysmenorrhea.
MATERIALS AND METHODS
Sixty females aged 17-23 years were randomly assigned to either a study group or a control group. The study group received acupuncture for the duration of 20 minutes/day, for 15 days/month, for the period of 90 days. The control group did not receive acupuncture for the same period. Baseline, during, and post assessments of both the groups were taken on day 1; day 30 and day 60; and day 90, respectively. Statistical analysis was performed by repeated measures of analysis of variance followed by post hoc analysis with Bonferroni adjustment for multiple comparisons, independent samples t test for visual analog scale score, and Mann-Whitney U test for rest of the variables using statistical package for the social sciences, version 16.
RESULTS
This study showed a significant reduction in all the variables such as the visual analog scale score for pain, menstrual cramps, headache, dizziness, diarrhea, faint, mood changes, tiredness, nausea, and vomiting in the study group compared with those in the control group.
CONCLUSION
Acupuncture could be considered as an effective treatment modality for the management of primary dysmenorrhea.
Topics: Acupuncture Points; Acupuncture Therapy; Adolescent; Adult; Dysmenorrhea; Female; Humans; Research Design; Treatment Outcome; Young Adult
PubMed: 29654840
DOI: 10.1016/j.jams.2018.04.001 -
Revista Do Colegio Brasileiro de... Jun 2018to report the characteristics, evolution and outcome of patients with primary umbilical endometriosis. (Observational Study)
Observational Study
OBJECTIVE
to report the characteristics, evolution and outcome of patients with primary umbilical endometriosis.
METHODS
an observational and descriptive study of patients with primary umbilical endometriosis diagnosed between 2014 and 2017. The clinical variables evaluated were age, clinical picture, lesion characteristics, diagnostic methods, treatment and recurrence.
RESULTS
six patients diagnosed with primary umbilical endometriosis aged 28 to 45 years were operated on during the study period. They had lesions ranging from one to 2.5cm in diameter, violet in five patients and erythematous-violaceous in one. The duration of the symptoms until diagnosis ranged from one to three years and in all the cases studied the diagnosis was made through the clinical manifestations and confirmed by histopathological analysis. No case was associated with neoplastic alterations. All patients evaluated had pain and umbilical bleeding in the menstrual period.
CONCLUSION
umbilical endometriosis is an uncommon disease and should be included in the differential diagnosis of women as umbilical nodules. The treatment of choice is the total exeresis of the lesion.
Topics: Adult; Diagnosis, Differential; Endometriosis; Female; Hemorrhage; Hernia, Umbilical; Humans; Menstruation; Pelvic Pain; Retrospective Studies; Umbilicus
PubMed: 29947647
DOI: 10.1590/0100-6991e-20181746 -
American Journal of Obstetrics and... Sep 2018Primary dysmenorrhea is cramping abdominal pain associated with menses. It is prevalent, affects quality of life, and can cause absenteeism. Although evidence-based... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Primary dysmenorrhea is cramping abdominal pain associated with menses. It is prevalent, affects quality of life, and can cause absenteeism. Although evidence-based medical treatment options exist, women may not tolerate these or may prefer to use nonmedical treatments. Physical activity has been recommended by clinicians for primary dysmenorrhea since the 1930s, but there is still no high-quality evidence on which to recommend its use.
OBJECTIVE
We sought to determine the effectiveness of physical activity for the treatment of primary dysmenorrhea.
STUDY DESIGN
Systematic literature searches of MEDLINE, Embase, Cochrane, Web of Science, CINAHL, PsycINFO, SPORTDiscus, PEDro, Allied and Complimentary Medicine Database, World Health Organization International Clinical Trials Registry Platform, Clinicaltrials.gov, and OpenGrey were performed, from database inception to May 24, 2017. Google searches and citation searching of previous reviews were also conducted. Studies were selected using the following PICOS criteria: participants were nonathlete females experiencing primary dysmenorrhea; intervention was physical activity delivered for at least 2 menstrual cycles; comparator was any comparator; outcomes were pain intensity or pain duration; and study type was randomized controlled trials. Study quality was assessed using the Cochrane risk of bias tool. Random effects meta-analyses for pain intensity and pain duration were conducted, with prespecified subgroup analysis by type of physical activity intervention. Strength of the evidence was assessed using GRADE.
RESULTS
Searches identified 15 eligible randomized controlled trials totaling 1681 participants. Data from 11 studies were included in the meta-analyses. Pooled results demonstrated effect estimates for physical activity vs comparators for pain intensity (-1.89 cm on visual analog scale; 95% CI, -2.96 to -1.09) and pain duration (-3.92 hours; 95% CI, -4.86 to -2.97). Heterogeneity for both of these results was high and only partly mitigated by subgroup analysis. Primary studies were of low or moderate methodological quality but results for pain intensity remained stable during sensitivity analysis by study quality. GRADE assessment found moderate-quality evidence for pain intensity and low-quality evidence for pain duration.
CONCLUSION
Clinicians can inform women that physical activity may be an effective treatment for primary dysmenorrhea but there is a need for high-quality trials before this can be confirmed.
Topics: Dysmenorrhea; Evidence-Based Medicine; Exercise; Exercise Therapy; Female; Humans; Pain Measurement; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 29630882
DOI: 10.1016/j.ajog.2018.04.001 -
Current Opinion in Obstetrics &... Aug 2019Sleep disturbances are increasing in prevalence in North America. There is growing evidence that poor sleep quality and short sleep duration may adversely affect... (Review)
Review
PURPOSE OF REVIEW
Sleep disturbances are increasing in prevalence in North America. There is growing evidence that poor sleep quality and short sleep duration may adversely affect circadian rhythms, which in turn may affect female reproduction. The objective of this review is to evaluate recent literature on the association between sleep disturbances and female reproduction.
RECENT FINDINGS
There is accumulating evidence that sleep quality and duration are important for female reproduction, but epidemiologic research is limited. Recent studies provide suggestive evidence that sleep disorders are associated with increased menstrual irregularity, subfertility/infertility, and poor pregnancy and birth outcomes. Mechanisms underlying these associations are likely to be multifactorial and complex. In addition to genetics, circadian disruption may impact reproductive outcomes through dysregulation of the hypothalamic-pituitary-adrenal axis, insulin resistance, oxidative stress, and systemic inflammation. Recommendations for future studies include: use of prospective study designs; assessment of populations not already experiencing reproductive disorders; more detailed and accurate assessments of sleep such as validated self-reported measures or objective sleep measures (e.g. actigraphy); comprehensive assessment of potential confounders and mediators; and elucidation of biologic mechanisms.
SUMMARY
There is a growing body of literature showing evidence that sleep disturbances influence female reproduction, although further epidemiologic research is needed.
Topics: Abortion, Spontaneous; Circadian Rhythm; Female; Fertility; Humans; Hypothalamo-Hypophyseal System; Infertility, Female; Male; Menstrual Cycle; Menstruation Disturbances; Pituitary-Adrenal System; Pregnancy; Pregnancy Outcome; Reproduction; Sleep; Sleep Wake Disorders
PubMed: 31082843
DOI: 10.1097/GCO.0000000000000554