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Current Opinion in Endocrinology,... Dec 2020This review seeks to evaluate the impact of environmental exposures on the menstrual cycle length detailing timing of exposure on pathophysiology. (Review)
Review
PURPOSE OF REVIEW
This review seeks to evaluate the impact of environmental exposures on the menstrual cycle length detailing timing of exposure on pathophysiology.
RECENT FINDINGS
Recent literature has examined the relationship between menstrual cycle length and environmental exposures including air pollutants, parabens, and polybrominated biphenyls.
SUMMARY
Research is limited but suggest importance of further research in evaluating environmental exposures and menstrual cycle length.
Topics: Environmental Exposure; Environmental Pollutants; Female; Humans; Menstrual Cycle; Menstruation Disturbances; Time Factors
PubMed: 33027071
DOI: 10.1097/MED.0000000000000579 -
American Family Physician Apr 2004Abnormal uterine bleeding is a common presenting symptom in the family practice setting. In women of childbearing age, a methodical history, physical examination, and... (Review)
Review
Abnormal uterine bleeding is a common presenting symptom in the family practice setting. In women of childbearing age, a methodical history, physical examination, and laboratory evaluation may enable the physician to rule out causes such as pregnancy and pregnancy-related disorders, medications, iatrogenic causes, systemic conditions, and obvious genital tract pathology. Dysfunctional uterine bleeding (anovulatory or ovulatory) is diagnosed by exclusion of these causes. In women of childbearing age who are at high risk for endometrial cancer, the initial evaluation includes endometrial biopsy; saline-infusion sonohysterography or diagnostic hysteroscopy is performed if initial studies are inconclusive or the bleeding continues. Women of childbearing age who are at low risk for endometrial cancer may be assessed initially by transvaginal ultrasonography. Postmenopausal women with abnormal uterine bleeding should be offered dilatation and curettage; if they are poor candidates for general anesthesia or decline dilatation and curettage, they may be offered transvaginal ultrasonography or saline-infusion sonohysterography with directed endometrial biopsy. Medical management of anovulatory dysfunctional uterine bleeding may include oral contraceptive pills or cyclic progestins. Menorrhagia is managed most effectively with nonsteroidal anti-inflammatory drugs or the levonorgestrel intrauterine contraceptive device. Surgical management may include hysterectomy or less invasive, uterus-sparing procedures.
Topics: Adult; Algorithms; Anovulation; Diagnosis, Differential; Endometrial Neoplasms; Endometrium; Female; Humans; Hysterosalpingography; Hysteroscopy; Menorrhagia; Menstruation Disturbances; Middle Aged; Postmenopause; Premenopause; Risk Factors; Uterine Hemorrhage
PubMed: 15117012
DOI: No ID Found -
Allergy May 2008Despite the identical immunological mechanisms activating the release of mediators and consecutive symptoms in immediate-type allergy, there is still a clear clinical... (Review)
Review
Despite the identical immunological mechanisms activating the release of mediators and consecutive symptoms in immediate-type allergy, there is still a clear clinical difference between female and male allergic patients. Even though the risk of being allergic is greater for boys in childhood, almost from adolescence onwards it seems to be a clear disadvantage to be a woman as far as atopic disorders are concerned. Asthma, food allergies and anaphylaxis are more frequently diagnosed in females. In turn, asthma and hay fever are associated with irregular menstruation. Pointing towards a role of sex hormones, an association of asthma and intake of contraceptives, and a risk for asthma exacerbations during pregnancy have been observed. Moreover, peri- and postmenopausal women were reported to increasingly suffer from asthma, wheeze and hay fever, being even enhanced by hormone replacement therapy. This may be on account of the recently identified oestradiol-receptor-dependent mast-cell activation. As a paradox of nature, women may even become hypersensitive against their own sex hormones, resulting in positive reactivity upon intradermal injection of oestrogen or progesterone. More importantly, this specific hypersensitivity is associated with recurrent miscarriages. Even though there is a striking gender-specific bias in IgE-mediated allergic diseases, public awareness of this fact still remains minimal today.
Topics: Adolescent; Adult; Allergens; Anaphylaxis; Asthma; Child; Child, Preschool; Estrogens; Female; Food Hypersensitivity; Gonadal Steroid Hormones; Humans; Hypersensitivity, Immediate; Male; Menstruation Disturbances; Pregnancy; Sex Characteristics
PubMed: 18394135
DOI: 10.1111/j.1398-9995.2008.01645.x -
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 -
Fertility and Sterility Sep 2022
Topics: DNA; Endometriosis; Female; Humans; Menstruation Disturbances
PubMed: 36116802
DOI: 10.1016/j.fertnstert.2022.07.012 -
Frontiers in Endocrinology 2024Observational studies have demonstrated associations between menstrual disorders, dysmenorrhea, and cardiovascular disease (CVD). However, it remains unclear whether...
BACKGROUND
Observational studies have demonstrated associations between menstrual disorders, dysmenorrhea, and cardiovascular disease (CVD). However, it remains unclear whether these associations are causal. This study is to investigate whether menstrual disorders and dysmenorrhea causally affect the risk of CVD.
METHODS
The summary data for menstrual disorders (excessive menstruation and irregular menses) and dysmenorrhea were obtained from FinnGen study, summary data for CVD were obtained from UK Biobank and meta-analysis. The inverse-variance-weighted method was mainly used in the Mendelian randomization for causality analysis. Sensitivity analyses were performed by several methods under different model assumptions.
RESULTS
Genetic liability to excessive menstruation was associated with higher risk of atrial fibrillation (odds ratio (OR), 1.078 [95% confidence interval (CI), 1.015-1.145]; =0.014), but a lower risk of hypertension (OR, 0.994 [95% CI: 0.989-0.999]; =0.016). Irregular menses was associated with higher risk of atrial fibrillation (OR, 1.095 [95% CI: 1.015-1.182]; =0.02), hypertension (OR, 1.007 [95% CI: 1.000-1.013]; =0.047), myocardial infarction (OR, 1.172 [95% CI: 1.060-1.295]; =0.02), ischemic heart disease, (OR, 1.005 [95% CI: 1.000-1.010]; =0.037) and coronary heart disease (OR, 1.004 [95% CI: 1.001-1.008]; =0.026). Dysmenorrhea was associated with higher risk of atrial fibrillation (OR, 1.052 [95% CI: 1.014-1.092]; =0.008) and Ischemic stroke (cardioembolic) (OR, 1.122 [95% CI: 1.002-1.257]; =0.046). After Benjamini-Hochberg correction, irregular menses was associated with higher risk of myocardial infarction.
CONCLUSION
We confirmed a causal relationship of excessive menstruation, irregular menses and dysmenorrhea on cardiovascular outcomes independent of sex hormone levels, with an emphasis on the link between irregular menses and myocardial infarction. These clinical features can be utilized as markers to identify women at higher risk of developing CVD in the future, recommending early clinical intervention of menstrual diseases.
Topics: Female; Humans; Atrial Fibrillation; Cardiovascular Diseases; Dysmenorrhea; Hypertension; Mendelian Randomization Analysis; Menstruation Disturbances; Myocardial Infarction
PubMed: 38375191
DOI: 10.3389/fendo.2024.1302312 -
The Cochrane Database of Systematic... Nov 2011Side effects of oral contraceptive (OC) pills discourage adherence to and continuation of OC regimens. Strategies to decrease adverse effects led to the introduction of... (Review)
Review
BACKGROUND
Side effects of oral contraceptive (OC) pills discourage adherence to and continuation of OC regimens. Strategies to decrease adverse effects led to the introduction of the triphasic OC in the 1980s. Whether triphasic OCs have higher accidental pregnancy rates than monophasic pills is unknown. Nor is it known if triphasic pills give better cycle control and fewer side effects than the monophasic pills.
OBJECTIVES
To compare triphasic OCs with monophasic OCs in terms of efficacy, cycle control, and discontinuation due to side effects.
SEARCH METHODS
We searched the computerized databases of the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, POPLINE, EMBASE, and LILACS, as well as clinical trials databases (ClinicalTrials.gov and the World Health Organization Clinical Trials Registry Platform (ICTRP)) in May 2011. Additionally, we searched the reference lists of relevant articles. We also contacted researchers and pharmaceutical companies to identify other trials not found in our search.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) comparing any triphasic OC with any monophasic pill used to prevent pregnancy. Interventions had to include at least three treatment cycles.
DATA COLLECTION AND ANALYSIS
We assessed the studies found in the literature searches for possible inclusion and for their methodological quality. We contacted the authors of all included studies and of possibly randomized trials for supplemental information about the methods used and outcomes studied. We entered the data into RevMan and calculated odds ratios for the outcome measures of efficacy, breakthrough bleeding, spotting, withdrawal bleeding and discontinuation.
MAIN RESULTS
Of 23 trials included, 19 examined contraceptive effectiveness. The triphasic and monophasic preparations did not differ significantly. Several trials reported favorable bleeding patterns, that is less spotting, breakthrough bleeding or amenorrhea, in triphasic versus monophasic OC users. However, meta-analysis was generally not possible due to differences in measuring and reporting the cycle disturbance data as well as differences in progestogen type and hormone dosages. No significant differences were found in the numbers of women who discontinued due to medical reasons, cycle disturbances, intermenstrual bleeding or adverse events.
AUTHORS' CONCLUSIONS
The available evidence is insufficient to determine whether triphasic OCs differ from monophasic OCs in effectiveness, bleeding patterns or discontinuation rates. Therefore, we recommend monophasic pills as a first choice for women starting OC use. Large, high-quality RCTs that compare triphasic and monophasic OCs with identical progestogens are needed to determine whether triphasic pills differ from monophasic OCs. Future studies should follow the recommendations of Belsey or Mishell on recording menstrual bleeding patterns and the CONSORT reporting guidelines.
Topics: Contraception; Contraceptives, Oral, Hormonal; Drug Combinations; Ethinyl Estradiol; Female; Humans; Levonorgestrel; Menstruation Disturbances; Norethindrone; Patient Compliance; Randomized Controlled Trials as Topic
PubMed: 22071807
DOI: 10.1002/14651858.CD003553.pub3 -
International Journal of Environmental... Jul 2021Temporomandibular disorders (TMD) are a common reason for patients to present at dental offices. The majority of people with TMD are women between the age of 20 and 40...
BACKGROUND
Temporomandibular disorders (TMD) are a common reason for patients to present at dental offices. The majority of people with TMD are women between the age of 20 and 40 years. The purpose of this study was to assess the types and prevalence of temporomandibular disorders in female patients of reproductive age with menstrual disorders.
MATERIALS AND METHODS
The study involved 65 females of reproductive age (18-40 years, an average of 28.00 ± 6.27 years). The women who qualified for the study were patients of the University Center for Maternal and Newborn's Health hospitalized because of infertility or menstrual cycle disorders. Women with confirmed estrogen metabolism disorders participated in a clinical study with the use of Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).
RESULTS
In the studied female patients with menstrual disorders, temporomandibular disorders (92.3%) were frequent occurrences. The most common type was intra-articular joint disorders (68%). Other reported complaints included masticatory muscle pain (44.62%), and degenerative joint diseases (12.3%).
CONCLUSIONS
1. In women with menstrual disorders, TMD may exist. 2. In women with TMD symptoms, their medical history should be extended to include the diagnosis of female hormone disorders.
Topics: Adult; Facial Pain; Female; Humans; Infant, Newborn; Male; Masticatory Muscles; Menstruation Disturbances; Myalgia; Prevalence; Temporomandibular Joint Disorders; Young Adult
PubMed: 34299715
DOI: 10.3390/ijerph18147263 -
Annals of the New York Academy of... 2008Puberty and menstruation are difficult issues for teens with disabilities and for their families as well. Irregular bleeding, mood swings, and problems with hygiene... (Review)
Review
Puberty and menstruation are difficult issues for teens with disabilities and for their families as well. Irregular bleeding, mood swings, and problems with hygiene often complicate the delicate balance in the lives of these adolescents. The care provider is asked to help with the pubertal transition and the issues surrounding menstruation and reproductive health. This review will concentrate on the issues concerning menstruation that need special focus in teens with developmental disability (DD). The impact of the menstrual cycle on these teenagers, including hygiene issues, menstrual irregularities due to specific clinical circumstances, and treatment dilemmas associated with the use of hormonal medication will be discussed for this special group of teens.
Topics: Adolescent; Contraceptive Agents, Female; Developmental Disabilities; Female; Humans; Hygiene; Menstrual Cycle; Menstruation Disturbances; Puberty; Sex Education
PubMed: 18574229
DOI: 10.1196/annals.1429.020 -
Vaccine Aug 2023Many signals of menstrual disturbances as possible side effects of vaccination against COVID-19 have been reported. Our objective was to compare the risk of menstrual...
BACKGROUND
Many signals of menstrual disturbances as possible side effects of vaccination against COVID-19 have been reported. Our objective was to compare the risk of menstrual disturbances before and after vaccination among women aged 18-30 years in Oslo, Norway.
METHODS
We used electronic questionnaires to collect reports of menstrual disturbances from 3972 women aged 18-30 years, participating in the population-based Norwegian Young Adult Cohort. We examined the occurrence of menstrual disturbances (heavier bleeding than usual, prolonged bleeding, shorter interval between menstruations, longer interval between menstruations, spot bleedings, stronger pain during menstruation, period pain without bleeding) before and after the first and second dose of COVID-19 vaccine. Relative risks (RR) according to vaccination were estimated using a self-controlled case-series design. We performed additional analyses stratified by vaccine brand, contraception/hormone use, and presence of gynecological condition(s).
RESULTS
The prevalence of any menstrual disturbance was 36.7 % in the last menstrual cycle prior the first vaccine dose. The RR for heavier bleeding than usual was 1.90 (95 % CI: 1.69-2.13) after the first vaccine dose and 1.84 (95 % CI 1.66-2.03) after the second dose. Increased risks of prolonged bleeding, shorter interval between menstruations, and stronger pain during menstruation were also observed after both doses. The RRs did not differ with vaccine brand, contraception/hormone use, or presence of gynecological condition(s) for any of the menstrual disturbances.
CONCLUSION
Menstrual disturbances were common regardless of vaccination. We found increased risk of menstrual disturbances after vaccination, particularly for heavier bleeding than usual, prolonged bleeding, shorter interval between menstruations, and stronger period pain. In the future, menstrual characteristics should be included in vaccine trials.
Topics: Female; Humans; Young Adult; COVID-19; COVID-19 Vaccines; Hemorrhage; Hormones; Menstruation Disturbances; Vaccination
PubMed: 37451876
DOI: 10.1016/j.vaccine.2023.06.088