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Iranian Journal of Psychiatry Oct 2022Methylphenidate, a psychostimulant agent, is used in first-line psychopharmacological treatment in children and adolescents with attention-deficit/hyperactivity...
Methylphenidate, a psychostimulant agent, is used in first-line psychopharmacological treatment in children and adolescents with attention-deficit/hyperactivity disorder. Common side effects associated with methylphenidate use in children and adolescents are insomnia, anorexia, headache, and nausea. Thrombocytopenia, nasal bleeding and menstrual bleeding disorders are very rarely reported during methylphenidate use. One of the least expected side effects during methylphenidate usage is menorrhagia. In this article, we report methylphenidate monotherapy-induced menorrhagia in two adolescent identical twins. To our knowledge, this is the first report of menorrhagia associated with methylphenidate use in children and adolescents. In both cases, menorrhagia has started after methylphenidate monotherapy and stopped after discontinuation. Other possible etiologies have excluded with clinical and laboratory evaluations. Naranjo Adverse Drug Reaction Probability Score was found 7, indicates probable side effect. Menorrhagia is a rare adverse effect of methylphenidate use and clinicians should be aware of this phenomenon.
PubMed: 36817810
DOI: 10.18502/ijps.v17i4.10698 -
Cureus Jul 2021A strong association is noted between depression and early perimenopause as well as menopause. The association was found to be the greatest in women with natural... (Review)
Review
A strong association is noted between depression and early perimenopause as well as menopause. The association was found to be the greatest in women with natural menopause at the age less than 40 years. Excessive corticotropin-releasing hormone (CRH) levels in depression lead to inhibition of the hypothalamic-pituitary-gonadal (HPG) axis and increased cortisol levels which further inhibits the action of gonadotropin-releasing hormone (GnRH) neurons, gonadotrophs, and gonads. The resulting changes in luteinizing hormone (LH) amplitude, follicle-stimulating hormone (FSH) levels, and LH pulse frequency were noted in patients with depression. Besides depression, earlier surgical menopause is associated with cognitive decline. In addition, it is seen that menopausal changes predisposed females to an increased risk of depression. The association between dysmenorrhea and depression was found to be bidirectional and congruent in most studies. Patients with dysmenorrhea and coexisting depression had enhanced pain perception along with a poor response to pain relief measures. Even the treatment of underlying depression has been shown to cause menorrhagia. On the other hand, amenorrhea has also been reported as a side effect of sertraline and electroconvulsive therapy. Menstrual disorders contribute to a significant number of outpatient gynecological visits per year in the United States. Co-existing or history of depression can either be the cause of or interfere in the treatment of these disorders. Furthermore, the treatment of depression can be the etiology of various menstrual abnormalities, while menstrual disorders themselves could be the cause of depression. The increasing prevalence of depression, women's health, multiple female-specific subtypes, and the preexisting burden of menstrual disorders necessitates more detailed studies on the effects of depression on the menstrual cycle.
PubMed: 34430141
DOI: 10.7759/cureus.16532 -
Vacunas 2022The objective of this systematic review is to give a comprehensive interpretation of menstrual cycle changes after the COVID-19 vaccination. Additionally, it is... (Review)
Review
The objective of this systematic review is to give a comprehensive interpretation of menstrual cycle changes after the COVID-19 vaccination. Additionally, it is imperative to assess reports of menstrual changes following vaccination to dispel concerns that COVID-19 vaccines hinder the likelihood of pregnancy in the long run. A literature review was conducted using digital databases to systematically identify the studies reporting any menstrual abnormalities after the COVID-19 vaccine. Detailed patient-level study characteristics including the type of study, sample size, administered vaccines, and menstrual abnormalities were abstracted. A total of 78 138 vaccinated females were included in this review from 14 studies. Of these, 39 759 (52.05%) had some form of a menstrual problem after vaccination. Due to the lack of published research articles, preprints were also included in this review. Menorrhagia, metrorrhagia, and polymenorrhea were the most commonly observed problems and the overall study-level rate of menstrual abnormality ranged from 0.83% to 90.9%. Age, history of pregnancy, systemic side-effects of COVID-19, smoking, and second dose of COVID-19 vaccine were predictors of menstrual problems after vaccination.
PubMed: 35873308
DOI: 10.1016/j.vacun.2022.07.001 -
Journal of Infection and Public Health May 2023COVID - 19 vaccine can lead to various local and systemic side effects, including menstrual irregularities in women. There is no robust quantitative evidence of the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
COVID - 19 vaccine can lead to various local and systemic side effects, including menstrual irregularities in women. There is no robust quantitative evidence of the association between the COVID - 19 vaccine and menstrual irregularities. A meta-analysis was performed to estimate the pooled prevalence of a range of menstrual disorders that may occur in women following COVID - 19 vaccination.
METHODS
After searching for epidemiological studies, we systematically performed a meta-analysis on PubMed/Medline, EMBASE, and Science Direct. Sixteen studies were finally included in the study. We estimated the pooled prevalence and corresponding 95 % confidence intervals (CIs) for a group of menstrual disorders, including menorrhagia, polymenorrhea, abnormal cycle length, and oligomenorrhea. Heterogeneity was assessed using the I statistic and the Q test.
RESULTS
Overall, the pooled prevalence of menorrhagia was 24.24 % (pooled prevalence 24.24 %; 95 % CI: 12.8-35.6 %). The pooled prevalence of polymenorrhea was 16.2 % (pooled prevalence: 16.2 %; 95 % CI: 10.7-21.6 %). The pooled prevalence of abnormal cycle length was relatively lower than that of the other disorders (pooled prevalence: 6.6 %; 95 % CI: 5.0-8.2 %). The pooled prevalence of oligomenorrhea was 22.7 % (95 % CI: 13.5-32.0 %).
CONCLUSION
The findings indicate that menorrhagia, oligomenorrhea, and polymenorrhea were the most common menstrual irregularities after vaccination. The findings also suggest that a relatively high proportion of women suffer from menstrual irregularities. Further longitudinal studies are needed to confirm the causal relationship between COVID-19 vaccination and menstrual irregularities.
Topics: Female; Humans; COVID-19; COVID-19 Vaccines; Menorrhagia; Menstruation Disturbances; Oligomenorrhea; Vaccination
PubMed: 36934644
DOI: 10.1016/j.jiph.2023.02.019 -
Expert Review of Hematology Jun 2023Women and girls with bleeding disorders face multiple bleeding challenges throughout their life. The most significant morbidity and mortality are due to heavy menstrual... (Review)
Review
INTRODUCTION
Women and girls with bleeding disorders face multiple bleeding challenges throughout their life. The most significant morbidity and mortality are due to heavy menstrual bleeding and postpartum hemorrhage in their reproductive years. The ASH/ISTH/NHF/WFH 2021 guidelines on diagnosing and managing von Willebrand disease (VWD) provide several new updates.
AREAS COVERED
Women with VWD have a higher prevalence of heavy menstrual bleeding. The subpopulation of adolescents is particularly vulnerable, as the diagnosis is often delayed with increased comorbidity of iron deficiency anemia and associated symptoms. A detailed review is done on the prevalence of bleeding-related complications, especially heavy menstrual bleeding (HMB) and post-partum hemorrhage (PPH). The management strategies are also reviewed in detail, with a specific focus on the target factor levels and the use of antifibrinolytics.
EXPERT OPINION
The 2021 ASH/ISTH/NHF/WFH diagnostic and management recommendations are reviewed with a specific focus on hormonal methods of HMB management and antifibrinolytics in this situation. The reviewed topics include neuraxial anesthesia, factor cutoff, and tranexamic acid use in the postpartum period.
Topics: Pregnancy; Adolescent; Female; Humans; von Willebrand Diseases; Menorrhagia; Antifibrinolytic Agents; Postpartum Hemorrhage
PubMed: 36609196
DOI: 10.1080/17474086.2023.2166925 -
The Journal of Family Practice Sep 2020
Review
Topics: Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Antifibrinolytic Agents; Contraceptive Agents, Hormonal; Danazol; Estrogen Antagonists; Female; Humans; Levonorgestrel; Menorrhagia; Tranexamic Acid; Young Adult
PubMed: 32936851
DOI: No ID Found -
Australian Prescriber Apr 2024
Review
PubMed: 38737374
DOI: 10.18773/austprescr.2024.013 -
Pediatric Annals Apr 2020Heavy menstrual bleeding (HMB) is a common complaint among adolescent girls. It reflects an abnormal volume of blood loss during the menstrual cycle. Abnormal uterine... (Review)
Review
Heavy menstrual bleeding (HMB) is a common complaint among adolescent girls. It reflects an abnormal volume of blood loss during the menstrual cycle. Abnormal uterine bleeding can manifest as HMB but includes menstrual irregularity. In many cases, immaturity of the hypothalamic-pituitary-ovarian axis or hormonal conditions like polycystic ovarian syndrome leading to anovulatory cycles are the underlying cause for heavy menses. However, in girls with HMB, especially those not responding to the usual hormonal attempts to manage HMB, an underlying bleeding disorder should be considered. Up to 62% of adolescents with HMB have a bleeding disorder, many without anemia at presentation. Evaluation for HMB in an adolescent girl should include referrals to an adolescent medicine specialist or gynecologist and pediatric hematologist. [Pediatr Ann. 2020;49(4):e163-e169.].
Topics: Adolescent; Female; Humans; Medical History Taking; Menorrhagia; Physical Examination; Referral and Consultation
PubMed: 32275760
DOI: 10.3928/19382359-20200321-01 -
International Journal of Hyperthermia :... Sep 2021High intensity focused ultrasound (HIFU) uses about 800 times the diagnostic ultrasound power, which converges at a focal point to deliver energy above 60 degrees...
High intensity focused ultrasound (HIFU) uses about 800 times the diagnostic ultrasound power, which converges at a focal point to deliver energy above 60 degrees Celsius resulting in cell death by means of coagulation necrosis and cavitation destruction. This article is a reflection of my journey in gynaecological surgery, from basic laparotomy to minimally invasive surgery (MIS) to virtual surgery of noninvasive technology. This work also states an opinion shared by a lot of MIS colleagues in Asia. I am indeed fortunate to witness the transformation, revolution and disruption of surgery in gynecology in my lifetime. I think HIFU has allowed us to achieve the basic tenets of surgery, one of less pain, minimal complications, optimal destruction of a diseased organ, and optimal conservation of the human body. In this article, I will focus on HIFU treatment of uterine fibroids and adenomyosis. Uterine fibroids or myomas are common benign growths of the uterus and occurs in 20% to 50% of reproductive females. Adenomyosis involves endometrial lining cells that invade into the body of the uterus, like rust into the body of a car. Both uterine fibroids and adenomyosis can cause pain, heavy menstrual bleeding, and anemia. They can compress surrounding organs as they grow, leading to urinary, bowel, vascular and obstructive complications. Fertility may also be compromised.
Topics: Adenomyosis; Female; High-Intensity Focused Ultrasound Ablation; Humans; Leiomyoma; Menorrhagia; Treatment Outcome; Uterine Neoplasms
PubMed: 34420444
DOI: 10.1080/02656736.2021.1889697 -
Nature Communications Oct 2019Uterine leiomyomata (UL) are the most common neoplasms of the female reproductive tract and primary cause for hysterectomy, leading to considerable morbidity and high... (Meta-Analysis)
Meta-Analysis
Uterine leiomyomata (UL) are the most common neoplasms of the female reproductive tract and primary cause for hysterectomy, leading to considerable morbidity and high economic burden. Here we conduct a GWAS meta-analysis in 35,474 cases and 267,505 female controls of European ancestry, identifying eight novel genome-wide significant (P < 5 × 10) loci, in addition to confirming 21 previously reported loci, including multiple independent signals at 10 loci. Phenotypic stratification of UL by heavy menstrual bleeding in 3409 cases and 199,171 female controls reveals genome-wide significant associations at three of the 29 UL loci: 5p15.33 (TERT), 5q35.2 (FGFR4) and 11q22.3 (ATM). Four loci identified in the meta-analysis are also associated with endometriosis risk; an epidemiological meta-analysis across 402,868 women suggests at least a doubling of risk for UL diagnosis among those with a history of endometriosis. These findings increase our understanding of genetic contribution and biology underlying UL development, and suggest overlapping genetic origins with endometriosis.
Topics: Adult; Ataxia Telangiectasia Mutated Proteins; Endometriosis; Female; Forkhead Box Protein O1; Genome-Wide Association Study; Humans; Leiomyoma; Mendelian Randomization Analysis; Menorrhagia; Middle Aged; Polymorphism, Single Nucleotide; Proportional Hazards Models; Receptor, Fibroblast Growth Factor, Type 4; Signal Transduction; Telomerase; Uterine Neoplasms; White People
PubMed: 31649266
DOI: 10.1038/s41467-019-12536-4