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Contraception Aug 2022To address limitations that exist with existing definitions of menstrual bleeding changes that occur with contraceptive methods, we assembled a panel to develop new...
To address limitations that exist with existing definitions of menstrual bleeding changes that occur with contraceptive methods, we assembled a panel to develop new recommendations for standardization of bleeding data analyses associated with contraceptive use to better inform users, clinicians, investigators, pharmaceutical companies, and regulatory agencies. We propose three criteria for assessing bleeding outcomes: pattern, flow, and duration. The descriptors within each criterion depend on whether the contraceptive is designed to result in a predictable or unpredictable bleeding pattern. Predictable pattern outcomes quantify days of scheduled, unscheduled and no bleeding, while unpredictable pattern outcomes assess frequency. Flow is quantified based on patient comparisons to their typical flow when not using contraception, with spotting representing no menstrual products use. Duration of a prolonged bleeding and/or spotting episode is more than 7 days. Studies should assess bleeding characteristics for a minimum of 12 months for 21/7, 24/4, extended cycle or continuous regimens, two years for injectables, and the full duration of use for long-acting contraceptives. Describing pattern, flow and duration as independent categories allows a fuller understanding of the bleeding outcomes and better future assessments of acceptability and continuation. Standardization of outcomes permits better comparison between studies and data synthesis; standardization will also improve the ability of clinicians and patients to understand differences between products.
Topics: Contraceptive Agents; Contraceptive Devices; Data Analysis; Hemorrhage; Humans; Menstruation; Reference Standards
PubMed: 35640733
DOI: 10.1016/j.contraception.2022.05.011 -
Frontiers in Public Health 2022To investigate the epidemiological characteristics of constipation in people aged 65 years and older in several regions of China.
PURPOSE
To investigate the epidemiological characteristics of constipation in people aged 65 years and older in several regions of China.
PATIENTS AND METHODS
A cross-sectional study based on a cluster sampling design was conducted in four cities of China: Tianjin, Xiamen, Cangzhou and Harbin. A total of 5,222 cases (age ≥ 65 years) were recruited, and the survey was conducted centralized and household questionnaires that included the following: basic demographic characteristics such as sex, age, education, marital status, living status and occupation; social activities; duration of sleep at night; duration of menstruation and delivery times (in females); and if the participant had constipation symptoms, the severity of constipation. Constipation was diagnosed according to the Rome IV criteria.
RESULTS
Of the 5,222 participants, 919 were diagnosed with constipation. The prevalence of constipation was 17.60% in elderly people ≥65 years old. Prevalence increased with age and was significantly higher in females than males ( < 0.05). Prevalence was lower in the manual compared to the non-manual worker group, and significantly increased with decreasing duration of night sleep ( < 0.05). Older age, female sex and shorter sleep duration at night were risk factors for constipation in elderly people.
CONCLUSION
The prevalence of constipation in the elderly people in four cities of China was 17.60%, and was significantly affected by age, sex and sleep duration at night.
Topics: Aged; China; Constipation; Cross-Sectional Studies; Female; Humans; Male; Prevalence; Sleep Wake Disorders
PubMed: 35784241
DOI: 10.3389/fpubh.2022.823987 -
The British Journal of Nutrition Feb 2024Differences in blood concentration of sex hormones in the follicular (FP) and luteal (LP) phases may influence energy metabolism in women. We compared fasting energy...
Differences in blood concentration of sex hormones in the follicular (FP) and luteal (LP) phases may influence energy metabolism in women. We compared fasting energy metabolism and sweet taste preference on a representative day of the FP and LP in twenty healthy women (25·3 (sd 5·1) years, BMI: 22·2 (sd 2·2) kg/m) with regular self-reported menses and without the use of hormonal contraceptives. From the self-reported duration of the three prior menstrual cycles, the predicted FP and LP visits were scheduled for days 5-12 and 20-25 after menses, respectively. The order of the FP and LP visits was randomly assigned. On each visit, RMR and RQ by indirect calorimetry, sweet taste preference by the Monell two-series forced-choice tracking procedure, serum fibroblast growth factor 21 by a commercial ELISA (FGF21, a liver-derived protein with action in energy balance, fuel oxidation and sugar preference) and dietary food intake by a 24-h dietary recall were determined. Serum progesterone and oestradiol concentrations displayed the expected differences between phases. RMR was lower in the FP . LP (5042 (sd 460) . 5197 (sd 490) kJ/d, respectively; = 0·04; Cohen effect size, = 0·33), while RQ showed borderline significant higher values (0·84 (sd 0·05) . 0·81 (sd 0·05), respectively; = 0·07; = 0·62). Also, in the FP . LP, sweet taste preference was lower (12 (sd 8) . 16 (sd 9) %; = 0·04; = 0·47) concomitant with higher serum FGF21 concentration (294 (sd 164) . 197 (sd 104) pg/ml; < 0·01; = 0·66). The menstrual cycle is associated with changes in energy expenditure, sweet taste preference and oxidative fuel partitioning.
Topics: Humans; Female; Taste; Menstrual Cycle; Energy Metabolism; Eating; Food
PubMed: 37641942
DOI: 10.1017/S0007114523001927 -
Journal of Sleep Research Feb 2022Female menstrual health and its relationship with sleep is an understudied subject. The aim of this investigation was to determine the association between the two in a...
Female menstrual health and its relationship with sleep is an understudied subject. The aim of this investigation was to determine the association between the two in a community sample. Data were obtained from n = 579 menstruating females who participated in the Sleep and Health Activity, Diet, Environment, and Socialization (SHADES) study, a community-based sample of adults aged 22-60 years. Participants were asked, "How regular is your period?", with response choices of "very regular", "mostly regular", "fairly regular" and "not regular". They were also asked, "How much bleeding do you usually experience during your period?" Response choices were: "very heavy", "heavy", "medium", "light" or "very light". These were evaluated as ordinal outcomes. Sleep-related predictors included sleep duration (in hr; ≤ 6 [short], 7-9 [normal] and ≥ 9 [long]), Insomnia Severity Index score, Pittsburgh Sleep Quality Index score, Epworth Sleepiness Scale score and Fatigue Severity Scale score. Covariates included age, education, income, race/ethnicity and body mass index. Short sleep duration was associated with heavier bleeding (odds ratio = 1.46, p = 0.026) and greater cycle irregularity (odds ratio = 1.44, p = 0.031) as compared with normal sleep. Higher Pittsburgh Sleep Quality Index score was associated with greater cycle irregularity (odds ratio = 1.05, p = 0.022). Higher Fatigue Severity Scale score was associated with heavier bleeding (odds ratio = 1.02, p = 0.003) and greater cycle irregularity (odds ratio = 1.02, p = 0.008). Long sleep, Insomnia Severity Index and Epworth Sleepiness Scale were not associated with either outcome. These results demonstrate an association between short sleep duration, poor sleep quality, fatigue, stress and depression with heavier bleeding and menstrual cycle irregularity, highlighting the need for further studies to improve treatment options.
Topics: Adult; Fatigue; Female; Humans; Menstruation; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Quality
PubMed: 34404109
DOI: 10.1111/jsr.13434 -
International Journal of Reproductive... Aug 2023Coronavirus disease 2019 (COVID-19) was detected in the throat, urine, and feces but has little evidence documented of sexual transmission.
BACKGROUND
Coronavirus disease 2019 (COVID-19) was detected in the throat, urine, and feces but has little evidence documented of sexual transmission.
OBJECTIVE
Here, we aimed to diagnose the presence of COVID-19 in vaginal fluids and menses blood. Menstrual cycle duration and sexual desire were the other aims.
MATERIALS AND METHODS
In this cross-sectional study, 300 individuals with clinical approval of COVID-19 infection who were referred to the Alzahra hospital of Tabriz University of Medical Sciences, Tabriz, Iran were divided into mild (n = 178, partial pressure of oxygen 91) and severe (n = 122, partial pressure of oxygen 91) groups, also based on clinical signs and hospitalization, from January to May 2021. Demographic characteristics, menstruation, and sexual desire of individuals were recorded in the questionnaire blood sampling was done on days 2-4 for menses, and vaginal fluid after menses for polymerase chain reaction by using a Dacron tip swab.
RESULTS
Participants were studied in the mild (mean age: 43.32 7.41) and severe (mean age: 47.15 6.9) groups. COVID-19 infection resulted in shortening the menstrual cycle duration in the severe group (30.15 2.9 vs. 25.12 2.1 days, p = 0.01). Polymerase chain reaction test for vaginal fluid and menses blood was negative for all cases. Sexual desire declined in both groups, significantly.
CONCLUSION
This virus was not present in the menses blood and vaginal fluid of women with COVID-19 infection, which proposed a low risk of virus transmission via vaginal tracts. Severe COVID-19 infection may affect the menstrual duration.
PubMed: 37885972
DOI: 10.18502/ijrm.v21i8.14019 -
Human Reproduction (Oxford, England) Apr 2023Is there a possible etiologic link between cervical stiffness and adenomyosis?
STUDY QUESTION
Is there a possible etiologic link between cervical stiffness and adenomyosis?
SUMMARY ANSWER
Women with adenomyosis have a stiffer internal cervical os than those without adenomyosis.
WHAT IS KNOWN ALREADY
An increased myometrial contractility during menses, leading to breaches in the endometrial basal lamina and subsequent infiltration of endometrial cells into the myometrium, has been proposed as a possible pathogenic mechanism for adenomyosis. Intense menstrual pain has already been shown to be associated with an increased stiffness, at elastography, of the internal cervical os.
STUDY DESIGN, SIZE, DURATION
A cross-sectional study on 275 women was performed between 1 February and 31 July 2022.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Among the participants, 103 were and 172 women were not affected by adenomyosis as evaluated by ultrasonography. General and clinical characteristics of the patients were collected. Strain elastography was used to document tissue stiffness at different regions of interest of the cervix, i.e. the internal cervical os, the middle cervical canal, the anterior and the posterior cervical compartment. Tissue stiffness was expressed as a colour score from 0.1 = blue/violet (high stiffness) to 3.0 = red (low stiffness). Simple and multiple logistic regression analyses were used to evaluate the relation between the presence of adenomyosis, as the dependent variable, and independent factors.
MAIN RESULTS AND THE ROLE OF CHANCE
Women with adenomyosis had a higher prevalence (P = 0.0001) and intensity (P = 0.0001) of pain during menses, between menses and at intercourse compared to control. The internal cervical os colour score was lower (higher stiffness) in women with adenomyosis (0.55 ± 0.29 versus 0.67 ± 0.26; P = 0.001) and the middle cervical canal/internal cervical os colour score ratio was greater (3.32 ± 4.36 versus 2.59 ± 4.99; P = 0.008), compared to controls. Upon logistic regression modelling (R2 = 0.077), the internal cervical os stiffness was an independent factor related to adenomyosis (odds ratio (OR) 0.220, 95% CI 0.077, 0.627; P = 0.005) along with age (P = 0.005) and the use of gonadal steroid therapies (P = 0.002). We obtained the same results using a different logistic regression model (R2 = 0.069), by substituting the internal cervical os stiffness with the ratio of the middle cervical canal/internal cervical os stiffness (OR 1.157, 95% CI 1.024, 1.309; P = 0.019).
LIMITATIONS, REASONS FOR CAUTION
Women did not undergo surgery therefore we have no histological confirmation of the adenomyosis diagnosis. Strain elastography is a semiquantitative analysis and can be conditioned by the force applied by the operator during the analysis. The data were obtained mainly in White women in a single centre.
WIDER IMPLICATIONS OF THE FINDINGS
To the best of our knowledge, this is the first study indicating that women with adenomyosis have an increased stiffness of the internal cervical os. The results indicate that a stiff internal cervical os, as determined by elastography, is a possible contributor to the development of adenomyosis. These findings may have clinical significance and should prompt further investigation.
STUDY FUNDING/COMPETING INTEREST(S)
None.
TRIAL REGISTRATION NUMBER
N/A.
Topics: Humans; Female; Adenomyosis; Elasticity Imaging Techniques; Cervix Uteri; Cross-Sectional Studies; Myometrium
PubMed: 36869770
DOI: 10.1093/humrep/dead014 -
Cureus Oct 2023Dysmenorrhea is a menstrual disorder characterized by painful uterine cramps that occur during menstruation. There are two types of dysmenorrhea, primary and secondary.... (Review)
Review
Dysmenorrhea is a menstrual disorder characterized by painful uterine cramps that occur during menstruation. There are two types of dysmenorrhea, primary and secondary. It affects 45-95% of all menstruating women worldwide. The prevalence in India is approximately 75%. Primary dysmenorrhea diagnosis is based on the patient's medical history and physical examination. If the history of start and duration of lower abdominal discomfort suggests secondary dysmenorrhoea or if the dysmenorrhoea does not respond to medical treatment, a pelvic examination is necessary to evaluate dysmenorrhoea. Because of the increasingly large number of women who are impacted by primary dysmenorrhea, it should be a public health concern that authorities must address. Abdominal stretching is a very simple, efficient, and risk-free workout. Some of the benefits of stretching exercises for dysmenorrhea include increased elasticity and strength of the spine and pelvic muscles and reduction in pain. The knee-to-chest exercise in combination with hydrocollator packs has a significant effect in improving the pain and the monthly irregularities in primary menstrual pain. Massage of connective tissue is a form of cutaneous stimulation that tries to stimulate the connective tissue's mechanical receptors. Connective tissue massage studies for treating a range of dysfunctions usually indicate that patients treated with this modality get pain alleviation and even complete remission.
PubMed: 37933353
DOI: 10.7759/cureus.46553 -
Journal of Pediatric and Adolescent... Apr 2020Adolescents with eating disorders and a history of overweight present with higher weights, longer duration of disease, but equally severe symptomatology compared with...
STUDY OBJECTIVE
Adolescents with eating disorders and a history of overweight present with higher weights, longer duration of disease, but equally severe symptomatology compared with previously normal weight patients. To better delineate treatment goals for this understudied population, we compared weight at menses resumption with premorbid maximum weight among previously overweight and normal weight patients.
DESIGN
Retrospective cohort study.
SETTING
Outpatient adolescent medicine clinic at an eating disorder referral center.
PARTICIPANTS
Postmenarchal patients meeting criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition eating disorders. History of overweight was defined as a body mass index (BMI) greater than or equal to the 85th percentile or 25 or more.
INTERVENTIONS AND MAIN OUTCOME MEASURES
Weight characteristics at presentation and menses resumption (BMI, BMI z-score, change from maximum weight to presentation weight) RESULTS: Previously overweight patients presented with greater mean weight, longer duration of disease, and higher BMI than previously normal weight patients. No difference was found in rates of amenorrhea at presentation or menses resumption. Previously overweight patients resumed menses at a younger age and higher BMI z-scores. The difference between weight at menses resumption and premorbid maximum weight was greater for previously overweight patients.
CONCLUSION
Previously overweight patients with eating disorders present differently than their normal-weight peers, so reliance on weight status as a screening criterion might result in underdiagnosis. Although BMI z-scores associated with menses resumption are higher for previously overweight patients, there is no difference in weight gain between presentation and menses resumption and time to menses resumption compared with previously normal-weight patients. Moreover, menses resumption occurred at weights significantly lower than premorbid maximum weight for previously overweight patients, so restoration to highest premorbid weight is not necessary.
Topics: Adolescent; Amenorrhea; Body Mass Index; Case-Control Studies; Feeding and Eating Disorders; Female; Humans; Male; Menstruation; Overweight; Retrospective Studies; Time Factors; Weight Gain
PubMed: 31715368
DOI: 10.1016/j.jpag.2019.11.002 -
Menopause (New York, N.Y.) Apr 2023Sleep characteristics may potentially affect the hormonal environment related to follicular degeneration. The present study aimed to examine the association between...
OBJECTIVE
Sleep characteristics may potentially affect the hormonal environment related to follicular degeneration. The present study aimed to examine the association between sleep duration and the onset of menopause in Japanese women.
METHODS
We conducted a prospective study among 3,090 premenopausal Japanese women aged 35 to 56 years derived from participants in the Takayama Study. Habitual sleep duration was determined by a self-administered questionnaire at the baseline. Menopausal status was defined as the absence of menstruation for 12 months or more. The Cox proportional hazard model was used to estimate the hazard ratio of the occurrence of menopause for each category of sleep duration (≤6, 8, and ≥9 h) as compared with 7 hours of sleep after controlling for age, parity, body mass index, smoking status, years of education, and lifelong irregular menstrual cycle.
RESULTS
During the 10 follow-up years, 1,776 women experienced natural menopause. Sleep duration of ≤6 hours was significantly associated with decreased hazard ratio of menopause (0.88; 95% confidence interval, 0.78-0.99).
CONCLUSIONS
The data suggest that short sleep duration is associated with later onset of menopause.
Topics: Female; Humans; East Asian People; Menopause; Premenopause; Prospective Studies; Sleep Duration; Adult; Middle Aged
PubMed: 36787529
DOI: 10.1097/GME.0000000000002156 -
Healthcare (Basel, Switzerland) Jan 2022Dysmenorrhea is defined as the presence of painful menstruation, and it affects daily activities in different ways. The aims of this study were to assess the prevalence...
INTRODUCTION
Dysmenorrhea is defined as the presence of painful menstruation, and it affects daily activities in different ways. The aims of this study were to assess the prevalence and management of dysmenorrhea and to determine the impact of dysmenorrhea on the quality of life of medical students.
MATERIAL AND METHODS
The study conducted was prospective, analytical and observational and was performed between 7 November 2019 and 30 January 2020 in five university centers from Romania. The data was collected using an original questionnaire regarding menstrual cycles and dysmenorrhea. The information about relationships with family or friends, couples' relationships and university activity helped to assess the effects of dysmenorrhea on quality of life. The level of significance was set at < 0.05.
RESULTS
The study comprised 1720 students in total. The prevalence of dysmenorrhea was 78.4%. During their menstrual period, most female students felt more agitated or nervous (72.7%), more tired (66.9%), as if they had less energy for daily activities (75.9%) and highly stressed (57.9%), with a normal diet being difficult to achieve (30.0%). University courses (49.4%), social life (34.5%), couples' relationships (29.6%), as well as relationships with family (21.4%) and friends (15.4%) were also affected, depending on the duration and intensity of the pain.
CONCLUSION
Dysmenorrhea has a high prevalence among medical students and could affect the quality of life of students in several ways. During their menstrual period, most female students feel as if they have less energy for daily activities and exhibit a higher level of stress. The intensity of the symptoms varies considerably and, with it, the degree of discomfort it creates. Most student use both pharmacological and non-pharmacological methods to reduce pain (75.7%). University courses, social life, couples' relationships, as well as relationships with family and friends are affected, depending on the duration and intensity of the pain.
PubMed: 35052320
DOI: 10.3390/healthcare10010157