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Women's Health (London, England) 2024Being aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period is often overlooked but remains a significant...
BACKGROUND
Being aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period is often overlooked but remains a significant contributor to unintended pregnancies and may lead to maternal and neonatal comorbidities. Exploring the extent of awareness and associated factors could help tailor more interventions toward reducing the rates of short-interval unplanned pregnancies.
OBJECTIVE
This study explores the extent to which Ghanaian women are aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period and its associated factors.
DESIGN
A cross-sectional study was conducted using the 2017 Ghana Maternal Health Survey. The women participants were sampled using a two-stage cluster sampling design.
METHODS
We analyzed the 2017 Ghana Maternal Health Survey data of 8815 women who had given birth and received both antenatal care and postnatal checks after delivery in health facilities (private and public) and responded to questions on being aware of short interpregnancy intervals. A multivariable survey logistic regression was used for the analysis.
RESULTS
Of the 8815 women, approximately 62% of women who received both antenatal care and postnatal examinations before discharge reported being aware of short interpregnancy intervals. Postnatal examination before discharge but not antenatal care was associated with a higher awareness of short interpregnancy intervals. Women who received a postnatal examination were more aware of short interpregnancy intervals than their counterparts (adjusted odds ratio = 1.29, 95% confidence interval: 1.03-1.61). Also, awareness of short interpregnancy intervals increased with age, education, knowledge of the fertile period, contraceptive use, and delivery via cesarean section.
CONCLUSION
Over a decade following the initiation of Ghana's free maternal health policy, there remains a significant gap in the awareness of short interpregnancy intervals, even among women who received both antenatal pregnancy care and postnatal examinations before discharge. The unawareness of the short interpregnancy interval observed in approximately 38% of women raises concerns about the effectiveness of counseling or education provided during antenatal care and immediate post-partum care regarding birth spacing, contraceptive use, the timing of resumption of sexual activity, and the extent to which women adhere to such guidance.
Topics: Humans; Female; Adult; Ghana; Pregnancy; Cross-Sectional Studies; Pregnancy, Unplanned; Health Knowledge, Attitudes, Practice; Counseling; Young Adult; Prenatal Care; Adolescent; Birth Intervals; Middle Aged
PubMed: 38778791
DOI: 10.1177/17455057241255655 -
Journal of Science and Medicine in Sport Apr 2024To identify what coaches, support staff, and athletes believe should be considered when implementing menstrual cycle tracking in sport.
OBJECTIVES
To identify what coaches, support staff, and athletes believe should be considered when implementing menstrual cycle tracking in sport.
DESIGN
Concept mapping (mixed-methods participatory approach).
METHODS
Participants brainstormed statements in response to the focus prompt "What should be considered when tracking menstrual cycles in sport?" Participants then sorted the statements into groups according to meaning and rated each statement on its importance and feasibility to address.
RESULTS
Twenty-six participants (12 athletes and 14 coaches/support staff) generated 53 ideas that the research team synthesised to 57 unique statements. Sixteen participants sorted the statements into an average of 8 (±4) groups. Six clusters were identified as the most appropriate representation of the sorting data following multidimensional scaling and hierarchical cluster analysis: 1) Ethics, 2) Tracking Tools and Methods, 3) Performance and Health, 4) Education, 5) Interpretation and Framing and 6) Communication. Participants rated each statement based on their importance (n = 12) and feasibility (n = 10), respectively. The most important (mean = 3.88 out of 5) and feasible (mean = 3.85 out of 5) cluster was Ethics, whilst the least important (mean = 3.17) and feasible (mean = 3.04) was Communication.
CONCLUSIONS
Ethical considerations pertaining to privacy, consent, and scope of practice should be prioritised when tracking menstrual cycles in sport. A low burden method of tracking, which allows for some individualisation based on athletes' preferences or needs, and menstrual health education should also be undertaken to improve the uptake and impact of menstrual cycle tracking.
PubMed: 38777738
DOI: 10.1016/j.jsams.2024.04.003 -
Women's Health (London, England) 2024Science and society typically respond to dysmenorrhea-or painful menstrual cramps-as a normal, natural, and inevitable part of menstruation. This normalization has... (Review)
Review
Science and society typically respond to dysmenorrhea-or painful menstrual cramps-as a normal, natural, and inevitable part of menstruation. This normalization has greatly contributed to the systemic dismissal of painful menstrual cramps. Stigma, secrecy, and the expectation to "cope" fuel the normalization of menstrual pain. In this article, I argue that the normalization of menstrual pain restricts the ability to share an excruciating menstrual pain in a way that would otherwise elicit alarm or concern. This can cause clinicians to downgrade menstrual pain, and even menstruating persons to downgrade their own pain. I refer to the dismissal of menstrual pain as an example of a A pain-related motivational deficit describes instances in which an utterance fails to motivate due to societal practices and ideas that make it difficult to recognize the import of the embodied experience being shared.
Topics: Humans; Female; Dysmenorrhea; Menstruation; Motivation; Social Stigma; Adaptation, Psychological
PubMed: 38773901
DOI: 10.1177/17455057241255646 -
BMC Women's Health May 2024Regularity of menstrual cycles is an important indicator of women's health and fertility, and female workers are exposed to several factors, such as sleep disorders,...
BACKGROUND
Regularity of menstrual cycles is an important indicator of women's health and fertility, and female workers are exposed to several factors, such as sleep disorders, stress, and shift work, that affect their menstrual regularity. This makes it necessary to comprehensively identify the determinants of menstrual regularity. Therefore, this study identified the factors affecting menstrual regularity among female workers from physiological, psychological, and situational dimensions based on the theory of unpleasant symptoms.
METHODS
This was a secondary analysis of the 2010-2012 Korea National Health and Nutrition Examination Survey and utilized the data of 2418 female workers. Based on the theory of unpleasant symptoms, physiological factors included age, age at menarche, childbirth experience, body mass index, and sleep duration. Psychological factors included stress level, depressive mood, and suicidal ideation. Situational factors included education level, household income, consumption of alcohol, engagement in smoking, and work schedule. The χ²-test and hierarchical logistic regression analysis were performed, reflecting the complex sample design.
RESULTS
Age at menarche, childbirth experience, and body mass index among physiological factors and education level and work schedule among situational factors were found to be related to menstrual regularity. A higher risk of menstrual irregularities was found among those who had given birth (versus those who had not), had a high age at menarche (versus those with a low age at menarche), were obese (versus those who had a normal body mass index), had elementary school-level or lesser educational achievements (versus those with college graduate-level or higher educational achievements), and who had a shift work schedule (versus those with a fixed schedule).
CONCLUSIONS
Intervention is needed for female workers who have these risk factors, and special attention must be paid to female workers who have a shift work schedule. Additionally, since body mass index can be controlled, intervention concerning body mass index is necessary to reduce menstrual irregularity.
Topics: Humans; Female; Cross-Sectional Studies; Adult; Republic of Korea; Menstruation Disturbances; Menarche; Body Mass Index; Menstruation; Menstrual Cycle; Young Adult; Nutrition Surveys; Middle Aged; Stress, Psychological; Age Factors; Women, Working
PubMed: 38769497
DOI: 10.1186/s12905-024-03142-8 -
La Clinica Terapeutica 2024The combination of femininity and inequality is an increasingly studied in the field of social medicine, even more if the girls or women in question experience... (Review)
Review
OBJECTIVE
The combination of femininity and inequality is an increasingly studied in the field of social medicine, even more if the girls or women in question experience conditions of disability or neurodivergence. The onset of menstruation, menarche, constitutes a significant and transformative event in women's lives comprising a true and proper watershed in mental and reproductive health and sexual welfare. The onset of menstruation has a profound effect not just for girls but, in the case of disabled girls, for the whole family. In this scoping review, we have researched the literature in studies which consider the issue of menstruation and autism. The works in scientific literature have been selected which, in the last 5 years, investigated the issue of menstrua-tion for autistic girls and/or women.
RESULTS
Selected studies, although few in number, have all equally evidenced the total lack of in-depth understanding of this theme, notwithstanding the fact that females, girls and women with autism would benefit from specialized services if these existed. Families, girls and women involved, moreover, although not experiencing menstruation per se in a negative light, note a deterioration in their condition particularly in respect of sensorial perception and the intensification of anxious depressive instances. This work highlights the need to deepen the aspects concerning the period in autistic girls/women, up to now the question appears to have been little studied, investigated in an uneven way. We propose a social medical program to improve sexual-affective knowledge and body awareness in autistic people.
Topics: Humans; Female; Autistic Disorder; Menstruation; Menstrual Cycle; Menarche
PubMed: 38767074
DOI: 10.7417/CT.2024.5058 -
Revista Brasileira de Ginecologia E... 2024Dysmenorrhea is the pain related to menstruation; to screen for the symptoms, a working ability, location, intensity of days of pain, and dysmenorrhea (WaLIDD) score was...
OBJECTIVE
Dysmenorrhea is the pain related to menstruation; to screen for the symptoms, a working ability, location, intensity of days of pain, and dysmenorrhea (WaLIDD) score was created. The purpose of this work was to culturally adapt and assess the measurement properties of the WaLIDD score for dysmenorrhea in Brazilian women.
METHODS
In this cross-sectional online study, we evaluated women with and without dysmenorrhea. Criterion validity and construct validity were assessed, respectively, by the Receiver Operator Characteristic (ROC) curve and correlations with the bodily pain and social functioning domains of medical outcomes study 36-item short-form health survey (SF-36), self-report of absenteeism and Stanford Presenteeism Scale for presenteeism. Test-retest reliability and measurement errors were assessed, respectively, by intraclass correlation coefficient (ICC) and Bland and Altman Graph.
RESULTS
430 women completed the test, 238 (55.4%) women had dysmenorrhea, and 199 (46.3%) answered the questionnaire twice for the retest. The cutoff points ≥4, ≥5, and ≥5 could discriminate between women with and without dysmenorrhea, absenteeism, and presenteeism related to dysmenorrhea, respectively. Correlations between SF-36 - pain and social functioning domains and WaLIDD score were weak to strong and negative. For WaLIDD total Score, ICC was 0.95 and the limits of agreement were -1.54 and 1.62.
CONCLUSION
WaLIDD score is a short, valid and reliable instrument to screen and predict dysmenorrhea and could predict absenteeism and presenteeism related to dysmenorrhea in Brazilian women.
Topics: Humans; Female; Brazil; Cross-Sectional Studies; Dysmenorrhea; Adult; Translations; Young Adult; Reproducibility of Results; Absenteeism; Pain Measurement; Cultural Characteristics; Presenteeism; Surveys and Questionnaires; Adolescent; Middle Aged
PubMed: 38765510
DOI: 10.61622/rbgo/2024AO16 -
Frontiers in Immunology 2024At menstruation, the functional layer of the human endometrium sheds off due to the trigger of the release of inflammatory factors, including interleukin 6 (IL-6), as a...
BACKGROUND
At menstruation, the functional layer of the human endometrium sheds off due to the trigger of the release of inflammatory factors, including interleukin 6 (IL-6), as a result of a sharp decline in progesterone levels, leading to tissue breakdown and bleeding. The endometrial mesenchymal stem-like cells (CD140bCD146 eMSC) located in the basalis are responsible for the cyclical regeneration of the endometrium after menstruation. Endometrial cells from the menstruation phase have been proven to secrete a higher amount of IL-6 and further enhance the self-renewal and clonogenic activity of eMSC. However, the IL-6-responsive mechanism remains unknown. Thus, we hypothesized that IL-6 secreted from niche cells during menstruation regulates the proliferation and self-renewal of eMSC through the WNT/β-catenin signaling pathway.
METHODS
In this study, the content of IL-6 across the menstrual phases was first evaluated. Coexpression of stem cell markers (CD140b and CD146) with interleukin 6 receptor (IL-6R) was confirmed by immunofluorescent staining. functional assays were conducted to investigate the effect of IL-6 on the cell activities of eMSC, and the therapeutic role of these IL-6- and WNT5A-pretreated eMSC on the repair of injured endometrium was observed using an established mouse model.
RESULTS
The endometrial cells secrete a high amount of IL-6 under hypoxic conditions, which mimic the physiological microenvironment in the menstruation phase. Also, the expression of IL-6 receptors was confirmed in our eMSC, indicating their capacity to respond to IL-6 in the microenvironment. Exogenous IL-6 can significantly enhance the self-renewal, proliferation, and migrating capacity of eMSC. Activation of the WNT/β-catenin signaling pathway was observed upon IL-6 treatment, while suppression of the WNT/β-catenin signaling impaired the stimulatory role of IL-6 on eMSC activities. IL-6- and WNT5A-pretreated eMSC showed better performance during the regeneration of the injured mouse endometrium.
CONCLUSION
We demonstrate that the high level of IL-6 produced by endometrial cells at menstruation can induce the stem cells in the human endometrium to proliferate and migrate through the activation of the WNT/β-catenin pathway. Treatment of eMSC with IL-6 and WNT5A might enhance their therapeutic potential in the regeneration of injured endometrium.
Topics: Female; Mesenchymal Stem Cells; Humans; Interleukin-6; Endometrium; Wnt Signaling Pathway; Menstruation; Animals; Cell Proliferation; Mice; Adult; Cells, Cultured; Cell Self Renewal
PubMed: 38765018
DOI: 10.3389/fimmu.2024.1378863 -
Journal of Endometriosis and Uterine... Jun 2024Abnormal uterine bleeding (AUB) is a bleeding from the uterine corpus that is abnormal in regularity, volume, frequency or duration. It encompasses heavy menstrual...
Abnormal uterine bleeding (AUB) is a bleeding from the uterine corpus that is abnormal in regularity, volume, frequency or duration. It encompasses heavy menstrual bleeding, irregular menstrual bleeding and intermenstrual bleeding, which are common symptoms among women of reproductive age, impacting their overall well-being. Menstruation involves interactions between endometrial epithelial and stromal cells, immune cell influx, and changes in endometrial vasculature. These events resemble an inflammatory response with increased vessel permeability, tissue breakdown, and the arrival of innate immune cells. However, the mechanisms of menstrual cessation are poorly understood. AUB can be related to structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural conditions (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic). While transvaginal ultrasound is the primary method for the screening of intracavitary lesions, saline infusion sonohysterography is more accurate to detect endometrial polyps and submucous leiomyomas, while hysteroscopy with biopsy remains the reference method for a definitive diagnosis. The main goals in managing AUB are addressing and correcting the underlying primary cause, if possible, and establishing a regular bleeding pattern or amenorrhea, which can be done with antifibrinolytic agents, progestins, gonadotropin-releasing hormone agonists and antagonists, or surgical interventions, each one with specific indications and limitations. Further research is necessary to assess the effectiveness and the long-term effects of various medical and surgical treatments. Meanwhile, the availability of diagnostic methods such as transvaginal ultrasound and hysteroscopy and the universal distribution of medical treatments for AUB should be prioritized by policymakers to minimize the diagnostic and treatment delay and thus reduce the risk of AUB-related anemia and the need of hysterectomy.
PubMed: 38764520
DOI: 10.1016/j.jeud.2024.100071 -
Neuropsychologia May 2024Current research suggests that menstruating female athletes might be at greater risk of musculoskeletal injury in relation to hormonal changes throughout the menstrual...
Current research suggests that menstruating female athletes might be at greater risk of musculoskeletal injury in relation to hormonal changes throughout the menstrual cycle. A separate body of work suggests that spatial cognition might also fluctuate in a similar manner. Changes in spatial cognition could, in theory, be a contributing risk factor for injury, especially in fast-paced sports that require precise, millisecond accuracy in interactions with moving objects in the environment. However, existing theories surrounding causes for increased injury risk in menstruating females largely focus on biomechanical mechanisms, with little consideration of possible cognitive determinants of injury risk. Therefore, the aim of this proof-of-principle study was to explore whether menstruating females exhibit fluctuations in cognitive processes throughout their cycle on a novel sport-oriented cognitive test battery, designed to measure some of the mental processes putatively involved in these sporting situations. A total of 394 participants completed an online cognitive battery, a mood scale and a symptom questionnaire twice, 14 days apart. After exclusions, 248 eligible participants were included in the analyses (mean: 28 ± 6 years) (male = 96, female(menstruating) = 105, female(contraception) = 47). Cycle phase for menstruating females was based on self-reported information. The cognitive battery was designed to measure reaction times, attention, visuospatial functions (including 3D mental rotation) and timing anticipation. Three composite scores were generated using factor analysis with varimax rotation (Errors, Reaction Time, Intra-Individual Variability). Mixed model ANOVAs and repeated measures ANOVAs were performed to test for between and within-subject effects. There was no group difference in reaction times and accuracy between males and females (using contraception and not). However, within subject analyses revealed that regularly menstruating females performed better during menstruation compared to being in any other phase, with faster reaction times (10ms c.ca, p < 0.01), fewer errors (p < 0.05) and lower dispersion intra-individual variability (p < 0.05). In contrast they exhibited slower reaction times (10ms c.ca, p < 0.01) and poorer timing anticipation (p < 0.01) in the luteal phase, and more errors in the predicted ovulatory phase (p < 0.01). Self-reported mood, cognitive and physical symptoms were all worst during menstruation (p < 0.01), and a significant proportion of females felt that their symptoms were negatively affecting their cognitive performance during menstruation on testing day, which was incongruent with their actual performance. These findings suggest that visuospatial and anticipatory processes may fluctuate throughout the menstrual cycle in the general population, with better performance during the menstrual phase and poorer performance during the luteal phase. If these extend to associations between phase-specific cognitive performance and injury incidence, they would support a cognitive theory of determinants of injury risk in cycling female athletes, opening an opportunity to develop mitigation strategies where appropriate.
PubMed: 38762068
DOI: 10.1016/j.neuropsychologia.2024.108909 -
Journal of Ayurveda and Integrative... May 2024Diffuse systemic sclerosis or scleroderma is a chronic connective tissue disorder involving many systems and visceral organs. The association of interstitial lung...
Diffuse systemic sclerosis or scleroderma is a chronic connective tissue disorder involving many systems and visceral organs. The association of interstitial lung disease carries high mortality risk. This is a case report of a patient aged 25-years, who was diagnosed as diffuse systemic sclerosis, a disease complex along with Interstitial Lung Disease (ILD), sclerodactyly. She also presented with digital ulcers and calcium deposits in the ulcers. The symptomatology was understood by analysing the dosha predominance and the composition of the different qualities of each dosha in the patient. This complicated case with a bad prognosis was managed with Ayurvedic treatment procedures and medicines. Matrabasti (medicated enema) with mahamasha taila and dhanvantara taila was given. yogabasti with dashamoola ksheera paka, dhanvantara taila and madhu (decoctive enema), along with other palliative medicines like rasna yoga raja, Yogendra rasa, vasakasava, drakshadi paka, kaishora guggulu, raktapachakaghana vati and Mahatiktaka ghrita were given to the patient. After 1-1.2 years of continuous treatments, patient started showing gradual changes in her health condition. Relief from joint pains, intake of normal food, weight gain, re-establishment of menstruation, healing of ulcers was some of the changes seen in the patient. This case report summaries the effective management of diffuse systemic sclerosis after deducing the complex disease structure to dosa and guna involved and treated by adopting ayurvedic medicine and treatment procedures.
PubMed: 38760244
DOI: 10.1016/j.jaim.2023.100883