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American Journal of Obstetrics and... May 2024Adults with developmental disabilities often have less access to reproductive health services than adults without these disabilities. However, little is known about how...
BACKGROUND
Adults with developmental disabilities often have less access to reproductive health services than adults without these disabilities. However, little is known about how adolescents with developmental disabilities, including autism, access reproductive healthcare.
OBJECTIVE
We aimed to characterize the use of reproductive healthcare services among adolescents with autism and those with other developmental disabilities in comparison with adolescents with typical development.
STUDY DESIGN
We conducted a cohort study of a sample of adolescents who were continuously enrolled members of Kaiser Permanente Northern California, an integrated healthcare system, from ages 14 to 18 years. The final analytical sample included 700 adolescents with autism, 836 adolescents with other developmental disabilities, and 2187 typically developing adolescents who sought care between 2000 and 2017. Using the electronic health record, we obtained information on menstrual conditions, the use of obstetrical-gynecologic care, and prescriptions of hormonal contraception. We compared healthcare use between the groups using chi-square tests and covariate-adjusted risk ratios estimated using modified Poisson regression.
RESULTS
Adolescents with autism and those with other developmental disabilities were significantly more likely to have diagnoses of menstrual disorders, polycystic ovary syndrome, and premenstrual syndrome than typically developing adolescents. These 2 groups also were less likely than typically developing peers to visit the obstetrician-gynecologist or to use any form of hormonal contraception, including oral contraception, hormonal implants, and intrauterine devices. Adolescents in all 3 groups accessed hormonal contraception most frequently through their primary care provider, followed by an obstetrician-gynecologist.
CONCLUSION
Adolescents with autism and those with other developmental disabilities are less likely than their typically developing peers to visit the obstetrician-gynecologist and to use hormonal contraception, suggesting possible care disparities that may persist into adulthood. Efforts to improve access to reproductive healthcare in these populations should target care delivered in both the pediatric and obstetrics-gynecology settings.
Topics: Humans; Adolescent; Female; Developmental Disabilities; Autistic Disorder; Cohort Studies; Reproductive Health Services; California; Menstruation Disturbances; Polycystic Ovary Syndrome; Health Services Accessibility; Case-Control Studies; Contraception
PubMed: 38218512
DOI: 10.1016/j.ajog.2024.01.005 -
Journal of Psychosomatic Obstetrics and... Dec 2024To elucidate the impact of long COVID on menstruation and mental health, medical records of patients with long COVID were evaluated.
PURPOSE
To elucidate the impact of long COVID on menstruation and mental health, medical records of patients with long COVID were evaluated.
METHODS
Symptoms of long COVID, QOL, mental health, and related endocrine data were compared between two groups with and without menstrual disturbances.
RESULTS
Of 349 female patients who visited our clinic between February 2021 and March 2023, 223 patients with long COVID (aged 18-50 years) were included. Forty-four (19.7%) of the patients had menstrual symptoms associated with long COVID. The patients with menstrual symptoms were older than those without menstrual symptoms (42.5 38 years). The percentage of patients with menstrual symptoms was higher during the Omicron phase (24%) than during the Preceding (13%) and Delta (12%) phases. Cycle irregularity was the most frequent (in 63.6% of the patients), followed by severe pain (25%), heavy bleeding (20.5%), perimenopausal symptoms (18.2%), and premenstrual syndrome (15.9%). Fatigue and depression were the most frequent complications. Scores for fatigue and for QOL were significantly worse in long COVID patients with menstrual symptoms. Results of endocrine examinations showed significantly increased cortisol levels in patients with menstrual complaints.
CONCLUSION
Long COVID has an impact on menstrual conditions and on QOL related to menstrual conditions.
Topics: Humans; Female; Retrospective Studies; COVID-19; Japan; Post-Acute COVID-19 Syndrome; Quality of Life; Ambulatory Care Facilities; Fatigue; Menstruation Disturbances
PubMed: 38270210
DOI: 10.1080/0167482X.2024.2305899 -
Healthcare (Basel, Switzerland) Jul 2023The effect of Pilates on dysmenorrhea has been little studied. The purpose of this study was to evaluate the effect of Pilates on menstrual pain and symptoms,...
The effect of Pilates on dysmenorrhea has been little studied. The purpose of this study was to evaluate the effect of Pilates on menstrual pain and symptoms, premenstrual syndrome, and risk factors of dysmenorrhea. Thirty young women with primary dysmenorrhea were randomly assigned into a Pilates group (PG; = 15) and a waitlist control group (CG; = 15). The Pilates was performed twice a week for 12 weeks. Menstrual pain and symptoms were measured by visual analogue scale (VAS) and the Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed using the premenstrual symptoms screening tool (PSST). Additionally, back flexibility, hip muscle strength, sleep duration and quality, perceived stress, state-trait anxiety, and depression were evaluated. The VAS, CMSS severity and frequency, and PSST symptoms and functional impairments decreased in the PG compared to the CG ( < 0.001 or < 0.01) with large effect sizes. Back flexibility and the strength of hip flexors, hip extensors, and hip abductors significantly increased in the PG compared to the CG (all < 0.01) with large effect sizes. Sleep quality ( < 0.01) and stress ( < 0.05) improved in the PG. Sleep duration, anxiety, and depression did not change in either group. In conclusion, the 12-week Pilates intervention ameliorates dysmenorrhea, partly mediated by improved physical function and sleep quality.
PubMed: 37510517
DOI: 10.3390/healthcare11142076 -
JMIR MHealth and UHealth Mar 2024Despite its importance to women's reproductive health and its impact on women's daily lives, the menstrual cycle, its regulation, and its impact on health remain poorly... (Observational Study)
Observational Study
BACKGROUND
Despite its importance to women's reproductive health and its impact on women's daily lives, the menstrual cycle, its regulation, and its impact on health remain poorly understood. As conventional clinical trials rely on infrequent in-person assessments, digital studies with wearable devices enable the collection of longitudinal subjective and objective measures.
OBJECTIVE
The study aims to explore the technical feasibility of collecting combined wearable and digital questionnaire data and its potential for gaining biological insights into the menstrual cycle.
METHODS
This prospective observational cohort study was conducted online over 12 weeks. A total of 42 cisgender women were recruited by their local gynecologist in Berlin, Germany, and given a Fitbit Inspire 2 device and access to a study app with digital questionnaires. Statistical analysis included descriptive statistics on user behavior and retention, as well as a comparative analysis of symptoms from the digital questionnaires with metrics from the sensor devices at different phases of the menstrual cycle.
RESULTS
The average time spent in the study was 63.3 (SD 33.0) days with 9 of the 42 individuals dropping out within 2 weeks of the start of the study. We collected partial data from 114 ovulatory cycles, encompassing 33 participants, and obtained complete data from a total of 50 cycles. Participants reported a total of 2468 symptoms in the daily questionnaires administered during the luteal phase and menses. Despite difficulties with data completeness, the combined questionnaire and sensor data collection was technically feasible and provided interesting biological insights. We observed an increased heart rate in the mid and end luteal phase compared with menses and participants with severe premenstrual syndrome walked substantially fewer steps (average daily steps 10,283, SD 6277) during the luteal phase and menses compared with participants with no or low premenstrual syndrome (mean 11,694, SD 6458).
CONCLUSIONS
We demonstrate the feasibility of using an app-based approach to collect combined wearable device and questionnaire data on menstrual cycles. Dropouts in the early weeks of the study indicated that engagement efforts would need to be improved for larger studies. Despite the challenges of collecting wearable data on consecutive days, the data collected provided valuable biological insights, suggesting that the use of questionnaires in conjunction with wearable data may provide a more complete understanding of the menstrual cycle and its impact on daily life. The biological findings should motivate further research into understanding the relationship between the menstrual cycle and objective physiological measurements from sensor devices.
Topics: Humans; Female; Feasibility Studies; Prospective Studies; Menstrual Cycle; Fitness Trackers; Premenstrual Syndrome
PubMed: 38470472
DOI: 10.2196/50135 -
Archives of Gynecology and Obstetrics May 2024To evaluate clinical characteristics, quality of life (QoL) and effectiveness in patients with menstrual cycle disorders (MCDs) including abnormal uterine bleeding,...
PURPOSE
To evaluate clinical characteristics, quality of life (QoL) and effectiveness in patients with menstrual cycle disorders (MCDs) including abnormal uterine bleeding, dysmenorrhea and mastodynia/mastalgia related to premenstrual syndrome taking the Vitex agnus-castus (VAC) products Cyclodynon® or Mastodynon® in a real-world setting.
METHODS
A single-center retrospective longitudinal cohort study (3 ± 1 months), using data obtained from healthcare data archive and telephone interviews. The main study variables were changes in bleeding, menstrual pain, breast tenderness and patients' QoL.
RESULTS
Data from 1700 women with a mean age of 30.2 years (± 6.3) were analyzed. The most common MCDs were dysmenorrhea (43.8%) and mastodynia/mastalgia (21.1%). Three-month treatment with VAC extract substantially decreased the percentage of patients with irregular cycle (from 9.1% to 0.1%) and breast tenderness (from 39.9% to 0.8%). Improvement in bleeding intensity, frequency and menstrual pain was experienced by 83.4%, 79.2%, and 85.2% of the patients, respectively. When analyzed by disease category, these parameters improved in almost all dysmenorrhea patients, while they improved to a lesser extent in mastodynia/mastalgia patients. QoL improved in all aspects, but was reported by a higher proportion of dysmenorrhea patients compared to mastodynia/mastalgia patients. Treatment was overall well tolerated with a favorable safety profile.
CONCLUSION
These real-world data demonstrate the effectiveness of the VAC-containing products Cyclodynon® and Mastodynon® in the three-month treatment of MCDs, with a pronounced improvement in key disease symptoms and QoL. Intriguingly, while QoL was generally greatly improved, the response to VAC therapy varied depending on the type of underlying MCD.
Topics: Humans; Female; Adult; Mastodynia; Dysmenorrhea; Vitex; Quality of Life; Longitudinal Studies; Retrospective Studies; Menstruation Disturbances; Menstrual Cycle
PubMed: 38393671
DOI: 10.1007/s00404-023-07363-4 -
Healthcare (Basel, Switzerland) Jan 2024Migraine is a common health condition in both men and women. Premenstrual syndrome (PMS) affects many women during their menstrual cycle, with around 50-60% of women...
BACKGROUND
Migraine is a common health condition in both men and women. Premenstrual syndrome (PMS) affects many women during their menstrual cycle, with around 50-60% of women with migraine attacks experiencing menstrual headaches. Most have mild symptoms, but 5-8% suffer from moderate to severe symptoms, causing distress and functional issues. Pure menstrual migraine (PMM) occurs in about 50% of women with migraine, and it can be debilitating in terms of frequency and severity. This information is crucial for Saudi Arabian medical professionals to provide better care and support, improving the quality of life for women with PMS and menstrual migraine (MM) attacks.
OBJECTIVES
To estimate the prevalence of MM in women, to evaluate the severity and frequency of MM in women with PMS, and to identify potential risk factors aggravating MM in women with PMS in Saudi Arabia.
METHODOLOGY
A cross-sectional community-based study was conducted on reproductive-aged (18-50 years) women who had regular menstrual cycles and were diagnosed with PMS, using a self-administered questionnaire between December 2022 to May 2023 in Saudi Arabia.
RESULTS
Out of the 2130 female participants, 397 (18.6%) had migraine. Among these 397 migraine sufferers, 230 (57.9%) experienced MM, while 167 (42.1%) had non-MM. In reproductive women in general, MM occurred in 10.7% of cases, while non-MM was observed in 7.8%. There is a correlation between increasing BMI and an increased incidence of MM. About one-third of the participants experienced moderate disability due to migraine attacks, with 134 (33.8%) individuals affected. Additionally, most MM sufferers missed at least 3 days of work in the last 3 months due to their condition.
CONCLUSIONS
Migraine attacks occurring during the menstrual cycle impair the ability to engage in social, physical, household, and academic activities, often hindering the fulfillment of professional commitments. To gain a deeper understanding of menstrual and non-menstrual migraine attacks, it is essential to conduct extensive prospective studies aimed at developing effective management strategies.
PubMed: 38338202
DOI: 10.3390/healthcare12030317 -
JAMA Network Open May 2024Premenstrual disorders (PMDs) adversely affect the quality of life of millions of women worldwide, yet research on the long-term consequences of PMDs is limited, and the...
IMPORTANCE
Premenstrual disorders (PMDs) adversely affect the quality of life of millions of women worldwide, yet research on the long-term consequences of PMDs is limited, and the risk of mortality has not been explored.
OBJECTIVE
To estimate the associations of PMDs with overall and cause-specific mortality.
DESIGN, SETTING, AND PARTICIPANTS
This nationwide, population-based, matched cohort study used data from population and health registers in Sweden. Participants included women of reproductive age with a first diagnosis of PMDs between January 1, 2001, and December 31, 2018. Data analysis was performed from September 2022 to April 2023.
EXPOSURES
PMDs were identified through inpatient and outpatient diagnoses and drug dispensing.
MAIN OUTCOMES AND MEASURES
Dates of death and underlying causes were ascertained from the National Cause of Death Register. Conditional Cox regression was used to estimate the hazard ratios (HRs) of overall and cause-specific death (eg, death due to natural or nonnatural cause, suicide, or cardiovascular events), adjusting for age, socioeconomic status, and somatic and psychiatric comorbidities; in a separate sibling comparison, models were also adjusted for all factors that sisters share.
RESULTS
A total of 67 748 women with clinically diagnosed PMDs and 338 740 matched unaffected women were included, for a total of 406 488 women. Women with PMDs received a diagnosis at a mean (SD) age of 35.8 (8.2) years. During a mean (SD) follow-up of 6.2 (4.6) years (range, 1-18 years), 367 deaths were observed among women with PMDs (rate, 8.4 deaths per 10 000 person-years; 95% CI, 7.6-9.3 deaths per 10 000 person-years), and 1958 deaths were observed among women without PMDs (rate, 9.1 deaths per 10 000 person-years; 95% CI, 8.7-9.6 deaths per 10 000 person-years). Compared with unaffected women, women with PMDs had increased risk of death due to nonnatural causes (HR, 1.59; 95% CI, 1.25-2.04), particularly suicide (HR, 1.92; 95% CI, 1.43-2.60), but they did not have increased risk of overall mortality (adjusted HR, 0.91; 95% CI, 0.82-1.02). Notably, women who received a diagnosis before the age of 25 years experienced higher all-cause mortality (HR, 2.51; 95% CI, 1.42-4.42) and death from both suicide (HR, 3.84; 95% CI, 1.18-12.45) and natural causes (HR, 2.59; 95% CI, 1.21-5.54).
CONCLUSIONS AND RELEVANCE
The findings of this matched cohort study suggest that women with PMDs are not at increased risk of early death overall. However, the risk was elevated among young women and for death by suicide. This supports the importance of careful follow-up for young patients and highlights the need to develop suicide prevention strategies for all women with PMDs.
Topics: Humans; Female; Sweden; Adult; Cause of Death; Premenstrual Syndrome; Middle Aged; Cohort Studies; Registries; Young Adult; Risk Factors; Proportional Hazards Models; Adolescent
PubMed: 38805225
DOI: 10.1001/jamanetworkopen.2024.13394 -
Reproductive Sciences (Thousand Oaks,... Mar 2024To determine the relationships between luteal-phase steroidal hormonal profile and PMS for a large number of women attending a dedicated fertility clinic. This was a...
To determine the relationships between luteal-phase steroidal hormonal profile and PMS for a large number of women attending a dedicated fertility clinic. This was a retrospective cross-sectional study on women attending a hospital-based clinic for fertility concerns and/or recurrent miscarriage. All participants were assessed with a women's health questionnaire which also included evaluation of premenstrual symptoms. Day of ovulation was identified based on the peak mucus symptom assessed by the woman after instruction in a fertility awareness-based method (FABM). This enabled reliable timing of luteal-phase serum hormone levels to be taken and analysed. Between 2011 and 2021, 894 of the 2666 women undertaking the women's health assessment had at least one evaluable serum luteal hormone test. Serum progesterone levels were up to 10 nmol/L lower for symptomatic women compared with asymptomatic women. This difference was statistically significant (p < 0.05) for the majority of PMS symptoms at ≥ 9 days after the peak mucus symptom. A similar trend was observed for oestradiol but differences were generally not statistically significant. ROC curves demonstrated that steroid levels during the luteal phase were not discriminating in identifying the presence of PMS symptoms. Blood levels for progesterone were lower throughout the luteal phase in women with PMS, with the greatest effect seen late in the luteal phase.
Topics: Female; Humans; Progesterone; Cross-Sectional Studies; Retrospective Studies; Premenstrual Syndrome; Luteal Phase; Infertility; Abortion, Habitual
PubMed: 37853154
DOI: 10.1007/s43032-023-01375-w -
Journal of Traditional Chinese Medicine... Apr 2024To investigate the effectiveness and safety of Jiawei Xiaoyao pill (,JXP) in the treatment of symptoms associated with premenstrual syndrome (PMS). (Randomized Controlled Trial)
Randomized Controlled Trial
Effectiveness and safety of Jiawei Xiaoyao pill in the treatment of premenstrual syndrome (liver depression, spleen deficiency, and blood-heat syndrome): a multi-center, randomized, placebo-controlled trial.
OBJECTIVE
To investigate the effectiveness and safety of Jiawei Xiaoyao pill (,JXP) in the treatment of symptoms associated with premenstrual syndrome (PMS).
METHODS
A total of 144 regularly menstruating women with PMS were recruited at 8 sites in China from August 2017 to December 2018, and randomized to receive either a JXP or a matching placebo (12 g/d, 6 g twice a day) for 3 menstrual cycles. The primary indicator was the reduced Daily Record of Severity of Problems (DRSP) scores in the luteal phase after 3 months of treatment. The safety outcomes included clinical adverse events (AEs), adverse reactions (ARs), changes in vital signs, and laboratory tests.
RESULTS
JXP surpassed the placebo in reducing DRSP scores (psychological/somatic dysfunction) in the luteal phase over 3 menstrual cycles of treatment (PFAS = 0.002, PPPS = 0.001). Additionally, there were no significant differences in the incidence of AEs, severe AEs, withdrawal due to AEs and ARs between the two groups (all > 0.05), and no clinically significant adverse medical events related to the test drug observed.
CONCLUSIONS
JXP was superior to the placebo in relieving the symptoms associated with PMS, which signified that JXP may be effective, safe, and well-tolerated as an alternative therapy.
Topics: Female; Humans; Spleen; Depression; Hot Temperature; Premenstrual Syndrome; Liver; Double-Blind Method; Drugs, Chinese Herbal
PubMed: 38504543
DOI: 10.19852/j.cnki.jtcm.20231110.003 -
The European Journal of General Practice Dec 2023Women presenting with Premenstrual Disorder (PMD) to general practitioners (GPs) experience problems with their biopsychosocial functioning. PMD is a disorder consisting...
BACKGROUND
Women presenting with Premenstrual Disorder (PMD) to general practitioners (GPs) experience problems with their biopsychosocial functioning. PMD is a disorder consisting of physical and/or mood-based symptoms cyclically occurring with a significant impairment of daily life. Little is known about the symptoms and coping strategies of women with PMD and their experiences with their GPs.
OBJECTIVES
This present study aimed to improve understanding of the perspectives of women with PMD, their coping strategies and their expectations of the GP.
DESIGN
Qualitative study with semi-structured interviews.
SETTING
In 2017, Dutch women with symptoms of premenstrual disorder were recruited through local newspapers in the town of Nijmegen and the North-Holland region and social media. After checking the inclusion and exclusion criteria, we interviewed 20 women (between 27 and 49 years of age). The interviews took place at a location of the interviewees' preference.
RESULTS
PMD symptoms can strongly influence the quality of women's lives. Three themes emerged from our analysis: feelings of having two separate female identities, PMD as a life-controlling condition and different coping strategies. Most women used an active coping strategy. Women with PMD need recognition from their GPs and knowledge of proper treatment.
CONCLUSION
PMD symptoms can have a high impact on daily life. Women with PMD expressed their need for acknowledgement and a personalised approach from their GP. Greater awareness and knowledge among GPs may be helpful in this.
Topics: Female; Humans; Premenstrual Syndrome; Qualitative Research; Adaptation, Psychological; General Practitioners
PubMed: 36714999
DOI: 10.1080/13814788.2023.2166033