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Current Epidemiology Reports Dec 2023a)The modifiable and non-modifiable determinants and the currently available methods of assessment of menstrual blood flow will be discussed, with the goal of helping...
PURPOSE OF REVIEW
a)The modifiable and non-modifiable determinants and the currently available methods of assessment of menstrual blood flow will be discussed, with the goal of helping healthcare providers, researchers, and those interested in public health.
RECENT FINDINGS
b)Several factors can impact menstruation. The determinants include modifiable factors such as smoking, nutrition, exercise, stress, weight fluctuation, and benign gynecologic diseases, and non-modifiable factors such as age, race, and the individual's genes. The intertwined dynamic among these determinants needs more critical attention. Currently, the methods for the assessment of menstruation all have advantages and disadvantages, often with a tradeoff between practicality and accuracy.
SUMMARY
c)Considered by many as the fifth vital, menstruation provides a window to an individual's general health. The discussion of its determinants and assessment can be more appropriate for individual contexts, especially from a public health perspective as it can improve the reproductive health of the population.
PubMed: 38275001
DOI: 10.1007/s40471-023-00332-0 -
Journal of Ovarian Research Sep 2023Whether pretreatment with gonadotropin-releasing hormone agonist (GnRHa) can improve the pregnancy outcomes in frozen-thawed embryo transfer (FET) cycles is...
BACKGROUND
Whether pretreatment with gonadotropin-releasing hormone agonist (GnRHa) can improve the pregnancy outcomes in frozen-thawed embryo transfer (FET) cycles is controversial. The inconsistencies in the results of different studies would be related to the characteristics of the included patients and the protocol of GnRHa use. In this study, we investigated the efficacy of pretreatment with a long-acting GnRH agonist in the early follicular phase of FET cycles and determined which population was suitable for the protocol.
RESULTS
We retrospectively included 630 and 1141 patients in the GnRHa FET and hormone replacement treatment (HRT) FET without GnRHa groups respectively, between October 2017 and March 2019 at a university-affiliated in vitro fertilization center. On the second or third day of menstruation, 3.75 mg of leuprorelin was administered. After 14 days, HRT was initiated for endometrial preparation. No significant differences were observed between the two groups in terms of patient characteristics. However, the GnRHa FET group showed a higher percentage of endometrium with a triple line pattern (94.8% vs 89.6%, p < 0.001) on the day of progesterone administration, with increased implantation (35.6% vs 29.8%, p = 0.005), clinical pregnancy (49.8% vs 43.3%, p = 0.008), and live birth rate (39.4% vs 33.7%, p = 0.016), than the HRT FET cycles with similar endometrial thickness, ectopic pregnancy and early miscarriage rates. Binary logistic regression analysis showed the GnRHa FET group to be associated with an increased chance of clinical pregnancy (P=0.028, odds ratio [OR] 1.32, 95% confidence interval [CI] 1.03-1.70) and live birth (P=0.013, odds ratio [OR] 1.34, 95% confidence interval [CI] 1.06-1.70) compared to the HRT FET without GnRHa group. After subgroup analysis, we found that the GnRHa FET group showed a significantly higher live birth rate in the subgroups of age < 40 years, primary infertility, with polycystic ovary syndrome (PCOS), and irregular menstruation.
CONCLUSIONS
Pretreatment with a long-acting GnRHa during the early follicular phase improved the live birth rate in FET cycles. Age < 40 years, primary infertility, PCOS, and irregular menstruation are effective indications for endometrial preparation with GnRHa pretreatment in FET cycles. However, further randomized controlled trials are required to verify these results.
Topics: Female; Pregnancy; Humans; Adult; Live Birth; Retrospective Studies; Embryo Transfer; Polycystic Ovary Syndrome; Infertility; Gonadotropin-Releasing Hormone
PubMed: 37743479
DOI: 10.1186/s13048-023-01277-0 -
JNMA; Journal of the Nepal Medical... Dec 2023Herlyn-Werner-Wunderlich syndrome is a rare congenital malformation of the Mullerian ducts characterized by uterine didelphys with obstructed hemivagina and ipsilateral...
UNLABELLED
Herlyn-Werner-Wunderlich syndrome is a rare congenital malformation of the Mullerian ducts characterized by uterine didelphys with obstructed hemivagina and ipsilateral renal agenesis. Commonly, such patients present with pelvic pain, dysmenorrhea following menarche, and an abdominal mass secondary to hematometrocolpos. In this report, a case of a 14-year-old female presented with abdominal pain, back pain and acute urinary retention. She attained menarche at the age of 10 years; however, symptoms of dysmenorrhea only appeared 4 years later. She was eventually diagnosed with the help of ultrasound and computed tomography urogram. She was managed conservatively with an incision and drainage procedure and was also advised for resection of vaginal septum. The nonspecific nature of symptoms such as regular menstruation with cyclical abdominal pain impedes the diagnosis which can lead to an array of complications. Awareness of this syndrome can help avoid misdiagnosis and allow for early surgical intervention.
KEYWORDS
case reports; dysmenorrhea; uterine didelphys.
Topics: Female; Humans; Child; Adolescent; Dysmenorrhea; Vagina; Uterine Didelphys; Kidney; Kidney Diseases; Abnormalities, Multiple; Abdominal Pain; Urogenital Abnormalities; Uterus
PubMed: 38289750
DOI: 10.31729/jnma.8376 -
Culture, Health & Sexuality Jul 2024Menstruation is an embodied experience that influences menstruators' perceptions of the self and body. The stigma surrounding menstruation and its negative...
Menstruation is an embodied experience that influences menstruators' perceptions of the self and body. The stigma surrounding menstruation and its negative representation in popular culture has consequences for women's sexual and reproductive health. In this study, semi-structured interviews were conducted with forty 18-50 year old participants who used reusable menstrual products to examine their experience of menstruation and how their use of these products shaped their self-body image. Data were analysed using thematic analysis. Participants commonly reported physical, medical and emotional improvement in menstrual experience and improved acceptance of the menstrual body alongside changes in feeling towards menstrual products and related issues. The participants described menstruation, menstrual blood, and the menstrual body more positively than before, reported a high comfort level with and in their bodies, and rejected common representations of menstruation. Findings suggest that using reusable menstrual products can contribute to body appreciation. Given these benefits, further research is needed to assess how knowledge of alternative menstrual products can stimulate positive views about the menstruating body and contribute to menstrual health.
Topics: Humans; Female; Menstruation; Adult; Qualitative Research; Menstrual Hygiene Products; Israel; Body Image; Middle Aged; Adolescent; Young Adult; Interviews as Topic
PubMed: 37782548
DOI: 10.1080/13691058.2023.2260465 -
International Journal of Women's Health 2023Menstruation is a universal, natural, unique, and physiological phenomenon. Despite the fact that menstruation is a natural fact of life, it is still considered taboo in...
BACKGROUND
Menstruation is a universal, natural, unique, and physiological phenomenon. Despite the fact that menstruation is a natural fact of life, it is still considered taboo in Afghanistan and other developing countries.
OBJECTIVE
To assess knowledge, beliefs, and practices related to menstruation among female students of Kabul University of Medical Sciences (KUMS).
METHODS
A cross-sectional descriptive study design was conducted at KUMS in 2022, and a quota sampling technique was used.
RESULTS
In this study, 339 students participated out of the 346-sample size. The majority of participants (70.02%), were over 20 years of age. About (59.60%) of participants were aware of menstruation before menarche. The main source of their information was their mothers (37.50%). The average age of menarche was 13.5 years old. Above 70% of respondents had normal patterns of menstruation. More than half of them (51.90%) had dysmenorrhea. Frequent menstrual disorders were abdominal pain (58.1%), and backache (56.1%). The majority of respondents had good and acceptable knowledge of menstruation (33.6%), and (63.1%) respectively. A statistically significant relationship between knowledge and academic year was observed (P value = 0.005). The majority of respondents (92.6%) had poor menstrual beliefs. A statistically significant relationship between respondents' age and beliefs was observed (P value = 0.004). Mother education did not affect respondents' level of beliefs (P value = 0.4). In addition, respondents had good practice of menstruation (75%).
CONCLUSION
In general participants had a good and acceptable level of knowledge with good practice related to menstruation. Despite the good knowledge and practice, the respondents' beliefs related to menstruation were poorer than what was expected from medical disciplines students. Their frequent source of information was their mothers, which highlights the provision of information and education for mothers and all females.
PubMed: 37492375
DOI: 10.2147/IJWH.S410660 -
Cureus Dec 2023Introduction Menstrual periods in young females can add a new challenge to the already difficult adolescent transition period. Menstrual health concerns can have extreme...
Introduction Menstrual periods in young females can add a new challenge to the already difficult adolescent transition period. Menstrual health concerns can have extreme physical and psychosocial impacts on adolescent girls. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are extremely common yet underestimated. Depression in adolescents is a mental and emotional disorder. The objective of the study was to find out the prevalence of PMS, PMDD, anxiety, and depression among rural menstruating adolescent girls and the factors associated with it. Methods This was a community-based cross-sectional study carried out among 20 rural schools for the period of one year. Sample size was calculated based on previous research. Adolescent females who had menstruated for one year were included and those with primary amenorrhea and previously diagnosed mental health abnormalities were excluded. Becks' Depression Inventory, Hamilton Anxiety Scale, and Premenstrual Symptoms Screening Tool (PSST-A) were used. Data were collected by interview technique and entered in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States), and analyzed using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, New York, United States). Results Out of 430 rural adolescent girls, 180 (41.9%) were 15 years, 277 (64.4%) belonged to nuclear families, 236 (54.9%) exercised less than 30 minutes, 144 (33.5%) had menarche at the age of 13 years, 288 (67%) had regular cycles, 266 (61.9%) had moderate flow during the menstrual cycle, 302 (70.2%) had a flow duration of less than seven days, and 243 (56.5%) had dysmenorrhea. Thirty-eight (8.8%) girls had PMDD and 75 (17.4%) had PMS. Age, family status, severity of menstrual flow, duration of cycle, and presence of dysmenorrhea, depression, and anxiety had a statistically significant association with PMDD. The class/grade in which studying, cycle regularity, flow during the menstrual cycle, duration of the cycle, dysmenorrhea, anxiety, and depression status had a statistically significant association with PMS. Conclusions The menstrual cycle's impact on the mental health of rural adolescent girls should not be ignored and schools can be instrumental in improving their quality of life. Regular counselling and mental health supervision by school teachers and peer groups can be beneficial.
PubMed: 38213363
DOI: 10.7759/cureus.50385 -
International Journal of Environmental... Jul 2023There are a variety of cultural and religious beliefs and customs worldwide related to menstruation, and these often frame discussing periods and any gynecological... (Review)
Review
There are a variety of cultural and religious beliefs and customs worldwide related to menstruation, and these often frame discussing periods and any gynecological issues as taboo. While there has been previous research on the impact of these beliefs on menstrual health literacy, this has almost entirely been confined to low- and middle-income countries, with very little information on high-income countries. This project used the Joanna Briggs Institute (JBI) scoping review methodology to systematically map the extent and range of evidence of health literacy of menstruation and gynecological disorders in Indigenous people in the colonized, higher-income countries of Australia, Canada, and New Zealand. PubMed, CINHAL, PsycInfo databases, and the grey literature were searched in March 2022. Five studies from Australia and New Zealand met the inclusion criteria. Only one of the five included studies focused exclusively on menstrual health literacy among the Indigenous population. Despite considerable research on menstrual health globally, studies focusing on understanding the menstrual health practices of the Indigenous populations of Australia, New Zealand, and Canada are severely lacking, and there is little to no information on how Indigenous beliefs of colonized people may differ from the broader society in which they live.
Topics: Female; Humans; New Zealand; Menstruation; Indigenous Peoples; Australia; Canada
PubMed: 37444168
DOI: 10.3390/ijerph20136321 -
BMC Women's Health Jul 2023Given the increase in the incidence of breast cancer during the past decades, several studies have investigated the effects of variables on breast cancer, especially... (Meta-Analysis)
Meta-Analysis
Given the increase in the incidence of breast cancer during the past decades, several studies have investigated the effects of variables on breast cancer, especially obesity. This systematic review and meta-analysis aims to evaluate any effects of obesity on breast cancer risk in women, before and after menopause, and in different continents.All forms of relevant literature examining any association between obesity and breast cancer, including cohort, case-control, and cross-sectional studies, were identified in the PubMed, Scopus, EMBASE, and Web of Science databases from January 1, 1990 until January 13, 2023. Body mass index (BMI) > 30 was used to indicate obesity. Every type of breast cancer was examined as outcome factors. The quality of the papers was evaluated using the Newcastle-Ottawa scale checklist. The Egger and Begg test was used to evaluate publication bias. To assess any extra impact of each research on the final measurement, a sensitivity analysis was carried out.One hundred and two studies were included in this meta-analysis. Respectively, 48 and 67 studies reported associations between obesity and breast cancer in pre and post menopausal women. Combining all studies, the pooled OR of the association between obesity and breast cancer in pre-menopausal women was OR = 0.93 CI: (0.85-1.1), (I = 65.4%), and for post-menopausal woman, OR = 1.26 CI: (1.19-1.34), (I = 90.5%).Obesity has a protective role in breast cancer among pre-menopausal women, but this relationship is statistically significant only in European women. The chance of developing breast cancer increases in post-menopausal women who are obese. This relationship is significant among Asian, North American, African and European women.
Topics: Female; Humans; Breast Neoplasms; Risk Factors; Cross-Sectional Studies; Menstruation; Obesity
PubMed: 37496015
DOI: 10.1186/s12905-023-02543-5 -
International Journal of Environmental... Nov 2023Period poverty is a global issue that needs to be addressed as a public health crisis. It is directly related to Sustainable Health Goals three, four, five, six, and... (Review)
Review
Period poverty is a global issue that needs to be addressed as a public health crisis. It is directly related to Sustainable Health Goals three, four, five, six, and eight. Period poverty adversely affects the health of anyone capable of menstruating, which is nearly half of the world population, at the physiological, emotional, and psychosocial level. Biases, cultural beliefs, ethical reproductive justice issues, social stigma, and systemic factors contribute to period poverty. Every month, certain menstruators are disproportionately impacted by period poverty and struggle to access basic hygienic necessities. Important stakeholders include not only the individual who experiences menses but also educators and school systems, healthcare professionals, policymakers, public health officials, and researchers. Everyone has a role in addressing period poverty by voting for officials that proactively support legislation, policy, and programs at all levels to effectively advocate for menstrual equity and address barriers contributing to period poverty. This includes policies that increase access to menstrual hygiene products, safe menstrual management methods, and reproductive and women's health education. Programs globally that focus on capacity building and sustainability strategies can be used as models to reduce period poverty, thereby fostering a sense of empowerment and menstruators' sense of autonomy, dignity, and equality.
Topics: Female; Humans; Menstruation; Public Health; Hygiene; Schools; Poverty; Health Knowledge, Attitudes, Practice
PubMed: 38063548
DOI: 10.3390/ijerph20237118 -
The Journal of Adolescent Health :... Apr 2024To identify sources of information, perceptions, and potential misinformation about menstruation among college-aged men in the United States.
PURPOSE
To identify sources of information, perceptions, and potential misinformation about menstruation among college-aged men in the United States.
METHODS
This is a mixed-methods cross-sectional survey study of students in the United States. Inclusion criteria included participants aged 17-29 years, male gender identity, enrolled as an undergraduate or graduate student, and no personal history of menstruation.
RESULTS
This study included 70 participants. Almost half of all participants (42.9%) first learned about menstruation from family members. More than two-thirds of respondents felt that menstrual education was essential or very important for all genders. The most common symptoms noted to be associated with periods included cramping (93.6%), mood changes (80.9%), and vague "hormonal" changes (36.2%). When asked how a menstrual period might affect someone's ability to perform daily activities, one-third reported debilitating or very burdensome symptoms, whereas one-fifth felt periods do not have much impact.
DISCUSSION
Comprehensive education and accurate reproductive health knowledge are critical in combating gender bias and stigma. Most males surveyed agree that education on menstruation is important, yet the majority do not have or do not remember formal education on this topic, instead relying on family members and friends as learning tools and resources. Most participants identified negative symptoms associated with menstrual periods, especially mental health concerns including mood changes and irritability. This association with mood changes, as well as vague "hormonal fluctuations," contributes to the societal bias against people who menstruate by marking them as prone to emotional instability, thereby exacerbating gender prejudices. It is therefore critical that accurate menstrual education be widely available for everyone, regardless of gender.
Topics: Female; Male; Humans; Young Adult; Menstruation; Cross-Sectional Studies; Gender Identity; Sexism; Attitude; Health Knowledge, Attitudes, Practice
PubMed: 38069935
DOI: 10.1016/j.jadohealth.2023.10.014