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Neuroscience and Biobehavioral Reviews Jun 2024Regular menstruation is a key indicator of general health and irregular menstrual parameters have been associated with elevated risk of adverse health outcomes. While... (Review)
Review
UNLABELLED
Regular menstruation is a key indicator of general health and irregular menstrual parameters have been associated with elevated risk of adverse health outcomes. While psychological stress is believed to contribute to abnormal menstruation, little is known of the effects of discrete psychological stressors, including the COVID-19 pandemic, on menstrual function. A systematic database search was performed and studies investigating the relation between psychological stress and menstrual cycle irregularity in otherwise healthy adults were included. Two independent investigators completed abstract and full-text screening, data extraction, and risk of bias assessment. In the 41 included studies, a variety of stressors were assessed, namely COVID-19 pandemic stress, academic stress, and occupational stress. Our review found most studies report an association between psychological stress and menstrual dysfunction, with the most common disruptions being irregular menstruation and abnormal menstrual flow. Our findings also underlined notable discrepancies in the operational definitions used in the study of menstrual disorders. These observations emphasize the importance of psychological stress as a modifiable risk factor associated with irregular menstruation.
PRISMA ABSTRACT
Background: Regular menstruation is a key indicator of general health and irregular menstrual parameters have been associated with elevated risk of adverse health outcomes. While psychological stress is believed to contribute to abnormal menstruation, little is known of the effects of discrete psychological stressors, including the COVID-19 pandemic, on menstrual function. As such, we aimed to systematically review the evidence on the associations between adulthood psychological stress and irregular menstruation.
METHODS
A systematic database search of MEDLINE, APA PsycInfo, Embase, Cochrane CENTRAL, CINAHL, and Web of Science was performed on May 18, 2023, and studies investigating the relation between psychological stress and menstrual cycle irregularity in otherwise healthy adults were included (PROSPERO record: CRD42023428005). Two independent investigators completed abstract and full-text screening, data extraction, and risk of bias assessment using the JBI critical appraisal checklist for analytical cross-sectional studies. Findings are summarized using descriptive statistics.
RESULTS
The review included 41 studies, totalizing 39,756 participants, which were recruited from 30 countries across the world. A variety of stressors were assessed, namely COVID-19 pandemic stress, academic stress, and occupational stress. Our review found most studies to report an association between psychological stress and increased menstrual dysfunction, with the most common disruptions being irregular menstruation and abnormal menstrual flow.
CONCLUSIONS
Our review underlined notable discrepancies in the operational definitions used in the study of menstrual disorders. Overall, these observations emphasize the importance of psychological stress as a modifiable risk factor associated with irregular menstruation.
PubMed: 38950686
DOI: 10.1016/j.neubiorev.2024.105784 -
Research and Practice in Thrombosis and... Jan 2024The effects of antiplatelet therapy on menstrual bleeding have not been well characterized.
BACKGROUND
The effects of antiplatelet therapy on menstrual bleeding have not been well characterized.
OBJECTIVES
To systematically review the effects of antiplatelet therapy on menstrual bleeding.
METHODS
A literature search was performed for studies of reproductive-aged women who received antiplatelet therapy. Characteristics of menstrual bleeding both before and after initiation of antiplatelet therapy and from comparison groups were collected. Two reviewers independently assessed the risk of bias in individual studies.
RESULTS
Thirteen studies with a total of 611 women who received antiplatelet therapy were included. Types of antiplatelet drugs used were aspirin ( = 8), aspirin and/or clopidogrel ( = 2), prasugrel ( = 1), and not specified ( = 2). Risk of bias was assessed at moderate ( = 1), serious ( = 8), critical ( = 2), and no information ( = 2). Three studies reported changes in menstrual blood loss volume. One of these showed no increase during antiplatelet therapy; the other 2 studies suggested that aspirin may increase menstrual blood loss volume. In 3 studies that assessed the duration of menstrual bleeding, up to 13% of women reported an increased duration of menstruation. In 5 studies that reported the intensity of menstrual flow, 13% to 38% of women experienced an increase in the intensity of flow. Five studies reported the prevalence of heavy menstrual bleeding in women who received antiplatelet therapy, with estimates ranging from 7% to 38%.
CONCLUSION
There is lack of high-quality data on the effects of antiplatelet therapy on menstrual bleeding. Aspirin may increase menstrual blood loss, at least in a minority of women, whereas the effects of P2Y12 inhibitors are unknown.
PubMed: 38268520
DOI: 10.1016/j.rpth.2023.102295