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Current Epidemiology Reports Dec 2023Menstruation touches all spheres of human society, including psychology, education, business, policy, race, and religion. This narrative review aims to describe the...
PURPOSE OF REVIEW
Menstruation touches all spheres of human society, including psychology, education, business, policy, race, and religion. This narrative review aims to describe the relationship menstruation holds with these spaces.
RECENT FINDINGS
First, menstruation plays many roles in psychology - premenstrual syndrome affects psychological wellbeing and in turn, psychological stress impacts menstruation. Functional hypothalamic amenorrhea can result when stress hormones inhibit the Hypothalamus-Pituitary-Ovarian axis. Furthermore, menstruation has many implications for all aged individuals, especially adolescents and those who are menopausal. These implications underscore the importance of proper education surrounding menstruation, which can be achieved via social media, school systems, family, and clinicians. However, menstrual health education is highly variable depending on the state and family that someone is raised in. Additionally, menstruation can pose a financial burden as menstrual products can be expensive and access to these products is limited for those who are homeless, incarcerated, and low-income. Recent public policy measures in various states have aimed to achieve "menstrual equity," by requiring public schools to supply free menstrual products in bathrooms. Furthermore, racial disparities exist with menstrual disorders. Uterine fibroids occur more frequently in Black menstruators compared to White menstruators, and Black women experience worse outcomes overall with fibroids and endometriosis management. Finally, analysis of religion and its relationship to menstruation underscores the immense stigma and "impurity" associated with menstruation.
SUMMARY
Overall, this review highlights the universality of menstruation in society. As a "fifth vital sign", there is significant room for improvement in terms of education, research, and cultural acceptance of menstruation. Future research should explore interventions to reduce these gaps.
PubMed: 38275000
DOI: 10.1007/s40471-023-00333-z -
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 -
Frontiers in Nutrition 2023Premenstrual syndrome disorder (PMS) is a condition that affects health-related quality of life (HRQoL) and encompasses a variety of symptoms, including psychological,...
Does an alternate-day modified fasting diet improve premenstrual syndrome symptoms and health-related quality of life in obese or overweight women with premenstrual syndrome? A randomized, controlled trial.
BACKGROUND
Premenstrual syndrome disorder (PMS) is a condition that affects health-related quality of life (HRQoL) and encompasses a variety of symptoms, including psychological, physical, and behavioral symptoms. Some evidence suggests that an increase in body mass index (BMI) can reduce both HRQoL and menstrual quality. This is because the body fat tissue can affect menstrual cycles by changing the estrogen/progesterone ratio. This study investigated the impact of two diets alternate-day modified fasting (ADMF) and daily calorie restriction (DCR) - on PMS syndrome and HRQoL.
METHODS
The study was a randomized controlled, open-label trial that lasted for 8 weeks and involved 60 obese/overweight women. Participants were recruited from the Health Service Centers of Kashan University of Medical Sciences using simple random sampling. The study compared the impact of the ADMF and DCR diets on HRQoL and PMS symptoms. Patients were classified based on their BMI and age and then allocated to either the intervention (ADMF) or control (DCR) group using a random numbers table. The study measured HRQoL, PMS severity, weight, BMI, body fat mass, waist circumference, fat-free mass, and skeletal muscle mass before and after the study. The study had an almost 18% dropout rate.
RESULTS
Significant improvements were observed in mood lability ( = 0.044) and expressed anger ( < 0.001) in relation to PMS symptoms. However, no significant differences were detected in the changes of other COPE subscales. The ADMF diet had a significant impact on the 12-item Short-Form Health Survey (SF-12) total score ( < 0.001) and physical function subscales ( = 0.006) as well as mental health ( < 0.001) when compared to the control diet. This implies that the ADMF diet increased both SF-12 total score and its subscales. The intervention led to improvements in HRQoL, physical function, and mental health. Additionally, significant improvements in BMI and weight were observed between the two groups pre- and post-study ( < 0.001). Anthropometric data, including body fat mass and waist circumference, showed a significant improvement ( < 0.001 and = 0.029, respectively) before and after the study. However, there were no significant changes in fat-free mass ( = 0.936) and skeletal muscle mass ( = 0.841) between the two groups.
CONCLUSION
The study suggested that ADMF can improve HRQoL, mood lability, and expressed anger. It also showed that ADMF can reduce waist circumference, weight, and body fat mass in obese/overweight women.
CLINICAL TRIAL REGISTRATION
The Iranian Registry of Clinical Trials (IRCT20220522054958N1).
PubMed: 38268675
DOI: 10.3389/fnut.2023.1298831 -
Korean Journal of Family Medicine Mar 2024Dysmenorrhea and premenstrual syndrome (PMS) are common periodic and frequent complications in women of reproductive age that can negatively affect health and quality of...
BACKGROUND
Dysmenorrhea and premenstrual syndrome (PMS) are common periodic and frequent complications in women of reproductive age that can negatively affect health and quality of life. The present study examined the effects of curcumin on the severity of dysmenorrhea and PMS symptoms.
METHODS
A systematic review and meta-analysis of randomized controlled trials was conducted by searching databases such as the Cochrane Library, EMBASE, Scopus, PubMed, and Web of Science from inception to January 2023. Article screening was performed using Endnote ver. X8 (Clarivate). Review Manager (RevMan ver. 5.3; Cochrane) was used for the quality assessment and meta-analysis. A total of 147 studies were screened, of which five were finally selected for quantitative and qualitative analyses. The studies were conducted between 2015 and 2021, and a total of 379 participants with a mean age of 23.33±5.54 years had been recruited in these studies.
RESULTS
The meta-analysis showed that curcumin consumption could significantly reduce the severity of dysmenorrhea (mean difference, -1.25; 95% confidence interval [CI], -1.52 to -0.98; three studies; I2=31%) and the overall score of PMS (standardized mean difference, -1.41; 95% CI, -1.81 to -1.02; two studies; I2=0%).
CONCLUSION
The reduction in the severity of PMS and dysmenorrhea has been attributed to curcumin's anti-inflammatory and antidepressant activities. Although the findings suggest that curcumin may be an effective treatment for reducing the severity of PMS and dysmenorrhea, further research with a larger number of participants from various socioeconomic levels and a longer duration of treatment is needed to evaluate the effective dose of curcumin.
PubMed: 38266637
DOI: 10.4082/kjfm.23.0184 -
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 -
Cephalalgia : An International Journal... Jan 2024Migraine is a common disorder, particularly affecting women during their reproductive years. This female preponderance has been linked to exposure to female sex hormones.
BACKGROUND
Migraine is a common disorder, particularly affecting women during their reproductive years. This female preponderance has been linked to exposure to female sex hormones.
METHODS
We used self-reported data from women born in 1943-1965 enrolled in the Norwegian Women and Cancer Study to examine the differences between women with migraine and women without migraine in a prospective design with respect to both endogenous and exogenous female sex hormone exposure.
RESULTS
In total, 62,959 women were included in the study, of whom 24.8% reported previous migraine (n = 15,635). Using a Cox proportional hazards model, we found that higher age at menarche reduced the risk of migraine (hazards ratio (HR) = 0.96, 95% confidence interval (CI) = 0.95-0.98) and that oral contraceptive use and parity increased the risk of migraine (HR = 1.12, 95% CI = 1.06-1.18 and HR = 1.37, 95% CI = 1.29-1.46, respectively).
CONCLUSIONS
Older age at menarche appears to reduce migraine risk, whereas oral contraceptive use and having children appear to increase the risk. Further research is required to investigate the causality of these associations.
Topics: Pregnancy; Child; Female; Humans; Aged, 80 and over; Menopause; Estrogens; Migraine Disorders; Risk Factors; Contraceptives, Oral
PubMed: 38215242
DOI: 10.1177/03331024231225972 -
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 -
Journal of Affective Disorders Mar 2024Premenstrual dysphoric disorder is characterised by symptoms confined to the premenstrual phase of the menstrual cycle. Confirmed diagnosis requires prospective... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Premenstrual dysphoric disorder is characterised by symptoms confined to the premenstrual phase of the menstrual cycle. Confirmed diagnosis requires prospective monitoring of symptoms over two cycles, otherwise the diagnosis is provisional. We aimed to measure the point prevalence of premenstrual dysphoric disorder.
METHODS
We searched for studies of prevalence using MEDLINE, EMBASE, PsycINFO and PubMed. For each study, the total sample size and number of cases were extracted. The prevalence across studies was calculated using random effects meta-analysis with a generalised linear mixed model. Potential sources of heterogeneity were explored by meta-regression and subgroup analyses. Pre-registration was with PROSPERO (CRD42021249249).
RESULTS
44 studies with 48 independent samples met inclusion criteria, consisting of 50,659 participants. The pooled prevalence was 3.2 % (95 % confidence intervals: 1.7 %-5.9 %) for confirmed and 7.7 % (95 % confidence intervals: 5.3 %-11.0 %) for provisional diagnosis. There was high heterogeneity across all studies (I = 99 %). Sources of heterogeneity identified by meta-regression were continent of sample (p < 0.0001), type of sample (community-based, university, high school) (p = 0.007), risk of bias (p = 0.009), and method of diagnosis (p = 0.017). Restricting the analysis to community-based samples using confirmed diagnosis resulted in a prevalence of 1.6 % (95 % confidence intervals: 1.0 %-2.5 %), with low heterogeneity (I = 26 %).
LIMITATIONS
A small number of included studies used full DSM criteria in community settings.
CONCLUSIONS
The point prevalence of premenstrual dysphoric disorder using confirmed diagnosis is lower compared with provisional diagnosis. Studies relying on provisional diagnosis are likely to produce artificially high prevalence rates.
Topics: Humans; Female; Premenstrual Dysphoric Disorder; Premenstrual Syndrome; Prevalence; Prospective Studies; Menstrual Cycle
PubMed: 38199397
DOI: 10.1016/j.jad.2024.01.066 -
Best Practice & Research. Clinical... Jan 2024Defining, diagnosing and managing premenstrual disorders (PMDs) remains a challenge both for general practitioners and specialists. Yet these disorders are common and... (Review)
Review
Defining, diagnosing and managing premenstrual disorders (PMDs) remains a challenge both for general practitioners and specialists. Yet these disorders are common and can have an enormous impact on women. PMDD (premenstrual dysphoric disorder), one severe form of PMD, has a functional impact similar to major depression yet remains under-recognised and poorly treated. The aim of this chapter is to give some clarity to this area, provide a framework for non-specialists to work towards, and to stress the importance of MDT care for severe PMDs, including PMDD.
Topics: Female; Humans; Premenstrual Dysphoric Disorder; Luteal Phase
PubMed: 38182436
DOI: 10.1016/j.beem.2023.101858 -
Frontiers in Neuroendocrinology Jan 2024The female reproductive years are characterized by fluctuations in ovarian hormones across the menstrual cycle, which have the potential to modulate neurophysiological... (Review)
Review
The female reproductive years are characterized by fluctuations in ovarian hormones across the menstrual cycle, which have the potential to modulate neurophysiological and behavioral dynamics. Menstrually-related mood disorders (MRMDs) comprise cognitive-affective or somatic symptoms that are thought to be triggered by the rapid fluctuations in ovarian hormones in the luteal phase of the menstrual cycle. MRMDs include premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and premenstrual exacerbation (PME) of other psychiatric disorders. Electroencephalography (EEG) non-invasively records in vivo synchronous activity from populations of neurons with high temporal resolution. The present overview sought to systematically review the current state of task-related and resting-state EEG investigations on MRMDs. Preliminary evidence indicates lower alpha asymmetry at rest being associated with MRMDs, while one study points to the effect being luteal-phase specific. Moreover, higher luteal spontaneous frontal brain activity (slow/fast wave ratio as measured by the delta/beta power ratio) has been observed in persons with MRMDs, while sleep architecture results point to potential circadian rhythm disturbances. In this review, we discuss the quality of study designs as well as future perspectives and challenges of supplementing the diagnostic and scientific toolbox for MRMDs with EEG.
Topics: Female; Humans; Mood Disorders; Premenstrual Syndrome; Menstrual Cycle; Electroencephalography; Hormones
PubMed: 38176542
DOI: 10.1016/j.yfrne.2023.101120