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Canadian Medical Association Journal Mar 1964One hundred and eighty-five women were followed up for periods up to 15 months (a total of 964 menstrual cycles) to determine the contraceptive efficacy and side effects...
One hundred and eighty-five women were followed up for periods up to 15 months (a total of 964 menstrual cycles) to determine the contraceptive efficacy and side effects of 2 mg. norethindrone with 0.1 mg. mestranol, as well as other therapeutic benefits. No pregnancies occurred in those using this method alone for contraception. Side effects were minimal. This low dosage was also useful in the management of dysmenorrhea, menorrhagia and irregular menses.
Topics: Contraception; Contraceptive Agents; Contraceptives, Oral; Dysmenorrhea; Female; Humans; Menstruation Disturbances; Mestranol; Norethindrone; Ovulation Inhibition; Toxicology
PubMed: 14130491
DOI: No ID Found -
Reproductive Biology and Endocrinology... May 2011Menarche delay has been reported in adolescent females with type 1 diabetes (T1DM), perhaps due to poor glycemic control. We sought to compare age at menarche between... (Review)
Review
BACKGROUND
Menarche delay has been reported in adolescent females with type 1 diabetes (T1DM), perhaps due to poor glycemic control. We sought to compare age at menarche between adolescent females with T1DM and national data, and to identify factors associated with delayed menarche and menstrual irregularity in T1DM.
METHODS
This was a cross-sectional study and females ages 12- 24 years (n = 228) with at least one menstrual period were recruited during their outpatient diabetes clinic appointment. The National Health and Nutrition Examination Survey (NHANES) 2001-2006 data (n = 3690) for females 12-24 years were used as a control group.
RESULTS
Age at menarche was later in adolescent females with T1DM diagnosed prior to menarche (12.81 +/- 0.09 years) (mean+/- SE) (n = 185) than for adolescent females diagnosed after menarche (12.17 0.19 years, p = 0.0015) (n = 43). Average age of menarche in NHANES was 12.27 +/- 0.038 years, which was significantly earlier than adolescent females with T1DM prior to menarche (p < 0.0001) and similar to adolescent females diagnosed after menarche (p = 0.77). Older age at menarche was negatively correlated with BMI z-score (r = -0.23 p = 0.0029) but not hemoglobin A1c (A1c) at menarche (r = 0.01, p = 0.91). Among 181 adolescent females who were at least 2 years post menarche, 63 (35%) reported usually or always irregular cycles.
CONCLUSION
Adolescent females with T1DM had a later onset of menarche than both adolescent females who developed T1DM after menarche and NHANES data. Menarche age was negatively associated with BMI z-score, but not A1c. Despite improved treatment in recent decades, menarche delay and high prevalence of menstrual irregularity is still observed among adolescent females with T1DM.
Topics: Adolescent; Adult; Child; Cross-Sectional Studies; Diabetes Mellitus, Type 1; Female; Humans; Menarche; Menstruation Disturbances; Nutrition Surveys; Puberty, Delayed; Young Adult
PubMed: 21548955
DOI: 10.1186/1477-7827-9-61 -
Fertility and Sterility May 1989Congenital anomalies of the müllerian system, the most common of which are uterine malformations, are associated with fertility problems. Multifactorial polygenic and... (Review)
Review
Congenital anomalies of the müllerian system, the most common of which are uterine malformations, are associated with fertility problems. Multifactorial polygenic and familial factors are involved in their formation. The result may be deficient development (agenesis, rudimentary horn, unicornuate uterus), nonfusion (didelphys or bicornuate uterus), or defective canalization of the müllerian ducts (septate uterus). The principal diagnostic procedures include HSG, laparoscopy, hysteroscopy, and US. The clinical presentation varies from symptoms of obstruction of the menstrual flow in adolescence to hypomenorrhea and fertility problems in adult life. Repeated fetal loss, after excluding other reasons, is usually the indication for surgical intervention. Uterine septa should be resected hysteroscopically. A prophylactic cerclage has been suggested by various authors, including those of this work, in cases of symmetric uterine anomalies, especially bicornuate uteri, as a simple and effective treatment to be tried before embarking on major surgery such as metroplasty.
Topics: Abnormalities, Multiple; Diagnosis; Endometriosis; Female; Genitalia, Female; Humans; Menstruation Disturbances; Mullerian Ducts; Urinary Tract; Uterus
PubMed: 2651163
DOI: 10.1016/s0015-0282(16)60660-x -
Journal of Pediatric Surgery Jun 2012We aimed to assess the late effects of ovarian salvage or oophorectomy on gonadal function and fertility as measured by menstrual regularity. (Review)
Review
PURPOSE
We aimed to assess the late effects of ovarian salvage or oophorectomy on gonadal function and fertility as measured by menstrual regularity.
METHODS
We performed a 10-year retrospective review of females aged 20 years or younger who required surgery to treat an ovarian disorder. A mail survey was distributed to these patients to evaluate the effects of ovarian surgery on menarche, menstrual regularity, and pregnancy.
RESULTS
A total of 180 females had surgery to treat an ovarian disorder. Eighty-six of these underwent unilateral oophorectomy (48%), whereas 94 (52%) had an ovary sparing procedure. Eighty-one patients (45%) returned completed surveys. Of the respondents, 44 had oophorectomy, and 37 had ovarian salvage. Ages of menarche were similar between surgical groups. Symptoms of menstrual irregularity differed most significantly according to painful menses (oophorectomy, 27.3%; salvage, 59.5%; P < .04). Interestingly, continuation of regular menses after surgery was higher in the oophorectomy group (oophorectomy, 70%; salvage, 15%; P = .013).
CONCLUSIONS
Unilateral oophorectomy does not appear to impair late gonadal function when compared with ovarian salvage. Surprisingly, oophorectomy appears to maintain more normal ovarian activity as estimated by menstrual regularity. Oophorectomy may be performed without apparent adverse effect on gonadal activity.
Topics: Adolescent; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Infertility, Female; Menarche; Menstruation; Menstruation Disturbances; Organ Sparing Treatments; Ovarian Diseases; Ovariectomy; Ovary; Postoperative Complications; Pregnancy; Retrospective Studies; Salpingectomy; Surveys and Questionnaires; Torsion Abnormality; Young Adult
PubMed: 22703805
DOI: 10.1016/j.jpedsurg.2012.03.038 -
Medical Science Monitor : International... Dec 2022BACKGROUND Endometriosis is a progressive disease, and early detection and early treatment are particularly important. The purpose of this study was to investigate the...
BACKGROUND Endometriosis is a progressive disease, and early detection and early treatment are particularly important. The purpose of this study was to investigate the effect of the timing of laparoscopy on the spontaneous pregnancy rate of primary infertile patients complicated with pelvic effusion within 6 months after surgery. MATERIAL AND METHODS We enrolled 330 primary infertile patients with pelvic effusion and bilateral patent fallopian tubes. They were divided into 3 groups based on retrospective analysis of clinical data. Study Group 1 underwent laparoscopy 1 month after hysterosalpingography (HSG), Study Group 2 received laparoscopy after trying to conceive for 3 months, and the Control Group did not undergo laparoscopy. According to the specific conditions during laparoscopy, repair and plastic surgery of fallopian tube, electrocautery of endometriosis and uterine suspension were performed. The main observation indicators were proportions of retrograde menstruation, peritoneal endometriosis, and tubal adhesions in laparoscopy groups, and spontaneous pregnancy rates within 6 months. RESULTS The proportions of retrograde menstruation were 92.2% and 93.1% in Study Group 1 and Study Group 2, respectively, with no statistical significance. The proportions of peritoneal endometriosis were 51.0% and 64.7%, with a statistically significant difference. The proportions of tubal adhesions were 31.4% and 36.2%, with no statistical significance. The pregnancy rates within 6 months were 73.9%, 52.6%, and 13.1%, with a statistically significant difference for pairwise comparisons. CONCLUSIONS The pregnancy rate of primary infertile patients with patent fallopian tubes complicated with pelvic effusion can be significantly improved through early laparoscopic surgery (exploration and treatment).
Topics: Pregnancy; Female; Humans; Fallopian Tubes; Fallopian Tube Diseases; Endometriosis; Retrospective Studies; Infertility, Female; Laparoscopy; Tissue Adhesions; Menstruation Disturbances
PubMed: 36518029
DOI: 10.12659/MSM.938637 -
Clinical Obstetrics and Gynecology Mar 2021Polycystic ovarian syndrome (PCOS) is a common endocrinopathy with many clinical manifestations. The effects on women's lives start at puberty and can last throughout...
Polycystic ovarian syndrome (PCOS) is a common endocrinopathy with many clinical manifestations. The effects on women's lives start at puberty and can last throughout her lifetime. Women frequently experience anovulatory menstrual cycles, infertility, hirsutism, obesity and increased risk of diabetes mellitus, hypertension, lipid abnormalities, and metabolic syndrome. PCOS is a heterogenous disorder, and a diagnosis of exclusion. In general, women afflicted will have menstrual irregularities, ultrasound findings of abnormal ovarian size and morphology, and clinical or laboratory evidence of hyperandrogenism. This chapter reviews the current understanding of PCOS, associated metabolic abnormalities, and diagnosis in reproductive-aged women, as well as adolescents.
Topics: Adolescent; Adult; Female; Hirsutism; Humans; Hyperandrogenism; Menstruation Disturbances; Metabolic Syndrome; Polycystic Ovary Syndrome
PubMed: 32701517
DOI: 10.1097/GRF.0000000000000563 -
Reproductive Biology and Endocrinology... Jan 2022Moving from the correlation between insulin-resistance and PCOS, metformin has been administered in some PCOS women improving ovulatory and metabolic functions and... (Clinical Trial)
Clinical Trial
BACKGROUND
Moving from the correlation between insulin-resistance and PCOS, metformin has been administered in some PCOS women improving ovulatory and metabolic functions and decreasing androgen levels. Inconsistency and unpredictability of response to metformin limit its extensive use. Aim of this study was to identify reliable predictors of response to metformin therapy for weight loss and reduction in plasma androgen levels using ANNs (artificial neural networks).
METHODS
One hundred eight consecutive women with PCOS (ESHRE/ASRM 2003 Rotterdam criteria) treated with metformin 1500 mg/day, at inclusion and every 6 months underwent to a complete clinical, endocrine/metabolic assessment and ultrasonographic evaluation. Therapy outcomes were BMI reduction (≥1 kg/m) in overweight/obese and free-androgen-index (FAI) decrease (≥1%) in hyperandrogenemic women. Semantic connectivity maps (SCMs) were obtained through Auto-CM, a fourth generation ANN, to compare patients' baseline clinical features to the treatment outcomes. Multivariate logistic regression analysis was used to assess the major predictor in drop-out patients and the associated risk.
RESULTS
At 6 months 54 out of 103 (52,4%) obese patients showed BMI reduction and 45 out of 89 (50,6%) hyperandrogenemic women showed FAI decrease. The further response rates at 12 months were 30,6 and 47%, respectively. SCMs showed a clear polarization for both the outcomes with elevated accuracy. Treatment responsiveness resulted strictly related to oligo-amenorrhea and hyperandrogenemia at baseline. In addition, lower serum testosterone levels at baseline were found to be the major predictor of treatment discontinuation.
CONCLUSIONS
In women with PCOS, menstrual pattern imbalance and ovarian androgens excess are the best predictors of metformin response. They may pave the way for a rethinking of the criteria for evaluating hyperandrogenism in order to better define the large population included in the diagnosis of PCOS. Baseline plasma testosterone level can serve as a sensitive marker to predict treatment compliance.
Topics: Adult; Biomarkers, Pharmacological; Blood Glucose; Female; Humans; Hyperandrogenism; Hypoglycemic Agents; Insulin Resistance; Italy; Longitudinal Studies; Menstruation Disturbances; Metformin; Polycystic Ovary Syndrome; Prognosis; Treatment Outcome; Young Adult
PubMed: 34983571
DOI: 10.1186/s12958-021-00876-0 -
Fertility and Sterility Jul 2009To summarize and evaluate the patient-based outcome measures (PBOMs) that have been used to study women with abnormal uterine bleeding (AUB). (Review)
Review
OBJECTIVE
To summarize and evaluate the patient-based outcome measures (PBOMs) that have been used to study women with abnormal uterine bleeding (AUB).
DESIGN
Systematic review.
SETTING
Original articles that used at least one PBOM and were conducted within a population of women with AUB.
PATIENT(S)
Women with AUB.
INTERVENTION(S)
The titles, abstracts, and studies were systematically reviewed for eligibility. The PBOMs used in eligible studies were summarized. Essential psychometric properties were identified, and a list of criteria for each property was generated.
MAIN OUTCOME MEASURE(S)
"Quality" of individual PBOMs as determined using the listed criteria for psychometric properties.
RESULT(S)
Nine hundred eighty-three studies referenced AUB and patient-reported outcomes. Of these, 80 studies met the eligibility criteria. Fifty different instruments were used to evaluate amount of bleeding, bleeding-related symptoms, or menstrual bleeding-specific quality of life. The quality of each of these instruments was evaluated on eight psychometric properties. The majority of instruments had no documentation of reliability, precision, or feasibility. There was no satisfactory evidence that any one instrument completely addressed all eight psychometric properties.
CONCLUSION(S)
Studies of women with AUB are increasingly using PBOMs. Many different PBOMs were used; however, no single instrument completely addressed eight important measurement properties.
Topics: Female; Humans; Menstruation Disturbances; Patient Selection; Quality of Life; Reproducibility of Results; Surveys and Questionnaires; Treatment Outcome; Uterine Hemorrhage
PubMed: 18635169
DOI: 10.1016/j.fertnstert.2008.04.023 -
Bulletin of the World Health... 1983
Review
Topics: Adult; Depressive Disorder; Female; Humans; Male; Menstruation Disturbances; Mothers; Postpartum Period; Pregnancy; Psychophysiology; Psychotic Disorders; Puerperal Disorders; Sexual Behavior; Sexual Dysfunction, Physiological; Sterilization, Reproductive
PubMed: 6349843
DOI: No ID Found -
Fertility and Sterility Dec 1981Since women have become more involved in physical fitness and competitive endurance sports, the incidence of menstrual dysfunction has increased. Long-distance running... (Review)
Review
Since women have become more involved in physical fitness and competitive endurance sports, the incidence of menstrual dysfunction has increased. Long-distance running and other sports may lead to alterations in gonadotropins, androgens, estrogens, progesterone, or prolactin, which in some women may directly or indirectly result in amenorrhea or infertility. The effects of running and strenuous exercise on the menstrual cycle and reproductive hormones remain controversial. Reported incidences of menstrual dysfunction vary widely, and many factors have been implicated in the onset of this problem. Exercise associated menstrual dysfunction seems to occur more frequently in nulliparous athletes, in athletes with delayed menarche, and in athletes with low body fat. It is important to realize that disruption of the menstrual cycle, ranging from mild changes in flow to amenorrhea, is a relatively common problem for the female athlete engaged in strenuous endurance sports. Yet no evidence exists at present to indicate conclusively that this menstrual dysfunction is harmful to the female athlete's reproductive system.
Topics: Adipose Tissue; Adolescent; Adult; Amenorrhea; Child; Female; Hormones; Humans; Infertility, Female; Menarche; Menstruation Disturbances; Pregnancy; Running; Sports Medicine
PubMed: 7030795
DOI: 10.1016/s0015-0282(16)45908-x