Epidemiology of Menstrual Disorders in Developing Countries: a Systematic Review
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Prolactin Level in Women with Abnormal Uterine Bleeding Visiting Department of Obstetrics and Gynecology in a University Teaching Hospital in Ajman, UAE
Prolactin level in women with Abnormal Uterine Bleeding visiting Department of Obstetrics and Gynecology in a University teaching hospital in Ajman, UAE Jayakumary Muttappallymyalil1*, Jayadevan Sreedharan2, Mawahib Abd Salman Al Biate3, Kasturi Mummigatti3, Nisha Shantakumari4 1Department of Community Medicine, 2Statistical Support Facility, CABRI, 4Department of Physiology, Gulf Medical University, Ajman, UAE 3Department of OBG, GMC Hospital, Ajman, UAE *Presenting Author ABSTRACT Objective: This study was conducted among women in the reproductive age group with abnormal uterine bleeding (AUB) to determine the pattern of prolactin level. Materials and Methods: In this study, a total of 400 women in the reproductive age group with AUB attending GMC Hospital were recruited and their prolactin levels were evaluated. Age, marital status, reproductive health history and details of AUB were noted. SPSS version 21 was used for data analysis. Descriptive statistics was performed to describe the population, and inferential statistics such as Chi-square test was performed to find the association between dependent and independent variables. Results: Out of 400 women, 351 (87.8%) were married, 103 (25.8%) were in the age group 25 years or below, 213 (53.3%) were between 26-35 years and 84 (21.0%) were above 35 years. Mean age was 30.3 years with a standard deviation 6.7. The prolactin level ranged between 15.34 mIU/l and 2800 mIU/l. The mean and SD observed were 310 mIU/l and 290 mIU/l respectively. The prolactin level was high among AUB patients with inter-menstrual bleeding compared to other groups. Additionally, the level was high among women with age greater than 25 years compared to those with age less than or equal to 25 years. -
The Prevalence of and Attitudes Toward Oligomenorrhea and Amenorrhea in Division I Female Athletes
POPULATION-SPECIFIC CONCERNS The Prevalence of and Attitudes Toward Oligomenorrhea and Amenorrhea in Division I Female Athletes Karen Myrick, DNP, APRN, FNP-BC, Richard Feinn, PhD, and Meaghan Harkins, MS, BSN, RN • Quinnipiac University Research has demonstrated that amenor- hormone and follicle-stimulating hormone rhea and oligomenorrhea may be common shut down stimulation to the ovary, ceasing occurrences among female athletes.1 Due production of estradiol.2 to normalization of menstrual dysfunction The effect of oral contraceptives on the within the sport environment, amenorrhea menstrual cycle include ovulation inhibi- and oligomenorrhea tion, changes in cervical mucus, thinning may be underreported. of the uterine endometrium, and motility Key PointsPoints There are many underly- and secretion in the fallopian tubes, which Lean sport athletes are more likely to per- ing causes of menstrual decrease the likelihood of conception and 3 ceive missed menstrual cycles as normal. dysfunction. However, implantation. Oral contraceptives contain a a similar hypothalamic combination of estrogen and progesterone, Menstrual dysfunction is one prong of the amenorrhea profile is or progesterone only; thus, oral contracep- female athlete triad. frequently seen in ath- tives do not stop the production of estrogen. letes, and hypothalamic Menstrual dysfunction is one prong of the Menstrual dysfunction is often associated dysfunction is com- female athlete triad (triad). The triad is a with musculoskeletal and endothelial monly the root of ath- syndrome of linking low energy availability compromise. lete’s menstrual abnor- (EA) with or without disordered eating, men- malities.2 The common strual disturbances, and low bone mineral Education and awareness of the accultur- hormone pattern for density, across a continuum. -
Prevalence of Menstrual Irregularities in Correlation with Body Fat Among Students of Selected Colleges in a District of Tamil Nadu, India
National Journal of Physiology, Pharmacy and Pharmacology RESEARCH ARTICLE Prevalence of menstrual irregularities in correlation with body fat among students of selected colleges in a district of Tamil Nadu, India Sherly Deborah G1, Siva Priya D V2, Rama Swamy C2 1Department of Physiology, Faculty of Medicine, AIMST University, Bedong, Kedah, Malaysia, 2Department of Physiology, Saveetha Medical College, Chennai, Tamil Nadu, India Correspondence to: Sherly Deborah G, E-mail: [email protected] Received: March 05, 2017; Accepted: March 22, 2017 ABSTRACT Background: Menstrual irregularities are usually due to imbalance of hormones. Although menstrual irregularities may be normal during the early postmenarchal years, pathological conditions require proper and prompt management. Obesity associated with many health consequences including hormonal imbalance has a direct effect on menstrual cycle. Hence, attention to obesity is obligatory for the inclusion of diagnosis and treatment of menstrual complaints which has become a leading issue in women’s life. Aims and Objectives: The aims and objectives of the study are to assess the menstrual irregularities and to find the association between menstrual irregularities and body fat among students. Materials and Methods: A cross-sectional study was conducted in three selected colleges in a district of Tamil Nadu in India. A total of 399 samples were included in the study. A 10-item questionnaire was administered to assess the menstrual irregularity in each student. The demographic variables along with anthropometric measurements were collected. Anthropometric measurements were taken to calculate the body fat percentage using modified YMCA formula. Results: The prevalence of menstrual irregularities was high in obesity compared with those with normal body fat and particularly oligomenorrhea, amenorrhea, and hypomenorrhea had statistically significant increase in obese students. -
(IJCRI) Abdominal Menstruation
www.edoriumjournals.com CASE SERIES PEER REVIEWED | OPEN ACCESS Abdominal menstruation: A dilemma for the gynecologist Seema Singhal, Sunesh Kumar, Yamini Kansal, Deepika Gupta, Mohit Joshi ABSTRACT Introduction: Menstrual fistulae are rare. They have been reported after pelvic inflammatory disease, pelvic radiation therapy, trauma, pelvic surgery, endometriosis, tuberculosis, gossypiboma, Crohn’s disease, sepsis, migration of intrauterine contraceptive device and other pelvic pathologies. We report two rare cases of menstrual fistula. Case Series: Case 1: A 27- year-old nulliparous female presented with complaint of cyclical bleeding from the abdomen since three years. There was previous history of hypomenorrhea and cyclical abdominal pain since menarche. There is history of laparotomy five years back and laparoscopy four years back in view of pelvic mass. Soon after she began to have blood mixed discharge from scar site which coincided with her menstruation. She was diagnosed to have a vertical fusion defect with communicating left hypoplastic horn and non-communicating right horn on imaging. Laparotomy with excision of fistula and removal of right hematosalpinx was done. Case 2: 25-year-old female presented with history of lower segment caesarean section (LSCS) and burst abdomen, underwent laparotomy and loop ileostomy. Thereafter patient developed cyclical bleeding from scar site. Laparotomy with excision of fistulous tract and closure of uterine rent was done. Conclusion: Clinical suspicion and imaging help to clinch the diagnosis. There is no recommended treatment modality. Surgery is the mainstay of management. Complete excision of fistulous tract is mandatory for good long-term outcomes. International Journal of Case Reports and Images (IJCRI) International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties. -
Polycystic Ovary Syndrome, Oligomenorrhea, and Risk of Ovarian Cancer Histotypes: Evidence from the Ovarian Cancer Association Consortium
Published OnlineFirst November 15, 2017; DOI: 10.1158/1055-9965.EPI-17-0655 Research Article Cancer Epidemiology, Biomarkers Polycystic Ovary Syndrome, Oligomenorrhea, and & Prevention Risk of Ovarian Cancer Histotypes: Evidence from the Ovarian Cancer Association Consortium Holly R. Harris1, Ana Babic2, Penelope M. Webb3,4, Christina M. Nagle3, Susan J. Jordan3,5, on behalf of the Australian Ovarian Cancer Study Group4; Harvey A. Risch6, Mary Anne Rossing1,7, Jennifer A. Doherty8, Marc T.Goodman9,10, Francesmary Modugno11, Roberta B. Ness12, Kirsten B. Moysich13, Susanne K. Kjær14,15, Estrid Høgdall14,16, Allan Jensen14, Joellen M. Schildkraut17, Andrew Berchuck18, Daniel W. Cramer19,20, Elisa V. Bandera21, Nicolas Wentzensen22, Joanne Kotsopoulos23, Steven A. Narod23, † Catherine M. Phelan24, , John R. McLaughlin25, Hoda Anton-Culver26, Argyrios Ziogas26, Celeste L. Pearce27,28, Anna H. Wu28, and Kathryn L. Terry19,20, on behalf of the Ovarian Cancer Association Consortium Abstract Background: Polycystic ovary syndrome (PCOS), and one of its cancer was also observed among women who reported irregular distinguishing characteristics, oligomenorrhea, have both been menstrual cycles compared with women with regular cycles (OR ¼ associated with ovarian cancer risk in some but not all studies. 0.83; 95% CI ¼ 0.76–0.89). No significant association was However, these associations have been rarely examined by observed between self-reported PCOS and invasive ovarian cancer ovarian cancer histotypes, which may explain the lack of clear risk (OR ¼ 0.87; 95% CI ¼ 0.65–1.15). There was a decreased risk associations reported in previous studies. of all individual invasive histotypes for women with menstrual Methods: We analyzed data from 14 case–control studies cycle length >35 days, but no association with serous borderline including 16,594 women with invasive ovarian cancer (n ¼ tumors (Pheterogeneity ¼ 0.006). -
Consensus Statement
CONSENSUS STATEMENT ISUOG Consensus Statement on rationalization of gynecological ultrasound services in context of SARS-CoV-2 INTRODUCTION Given the challenges of the current coronavirus (SARS-CoV-2) pandemic and to protect both patients and ultrasound providers (physicians, sonographers, allied professionals), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) has compiled the following expert-opinion-based guidance for the rationalization of ultrasound investigations for gynecological indications. While the provision of ultrasound is an essential service and all individuals with gynecological complaints deserve high-quality investigation, the current coronavirus disease 2019 (COVID-19) pandemic warrants triaging of referrals for gynecological ultrasound assessment. This is based on the following principles related to a pandemic: 1. Medical resources should be spared and prioritized. 2. Maximum care should be taken to avoid unnecessary contact between (potentially infected) medical personnel and (potentially infected) patients. The risk of transmission is particularly high during ultrasound investigations as neither the medical personnel nor the patient can abide by the social distancing recommendations. 3. Visits should be limited to those strictly necessary to avoid spread of the virus. Therefore, ultrasound appointments for gynecological indications should be triaged based on the clinical scenario, as follows: 1. Ultrasound assessments that should be performed without delay (NOW); 2. Ultrasound assessments -
Vaginitis and Abnormal Vaginal Bleeding
UCSF Family Medicine Board Review 2013 Vaginitis and Abnormal • There are no relevant financial relationships with any commercial Vaginal Bleeding interests to disclose Michael Policar, MD, MPH Professor of Ob, Gyn, and Repro Sciences UCSF School of Medicine [email protected] Vulvovaginal Symptoms: CDC 2010: Trichomoniasis Differential Diagnosis Screening and Testing Category Condition • Screening indications – Infections Vaginal trichomoniasis (VT) HIV positive women: annually – Bacterial vaginosis (BV) Consider if “at risk”: new/multiple sex partners, history of STI, inconsistent condom use, sex work, IDU Vulvovaginal candidiasis (VVC) • Newer assays Skin Conditions Fungal vulvitis (candida, tinea) – Rapid antigen test: sensitivity, specificity vs. wet mount Contact dermatitis (irritant, allergic) – Aptima TMA T. vaginalis Analyte Specific Reagent (ASR) Vulvar dermatoses (LS, LP, LSC) • Other testing situations – Vulvar intraepithelial neoplasia (VIN) Suspect trich but NaCl slide neg culture or newer assays – Psychogenic Physiologic, psychogenic Pap with trich confirm if low risk • Consider retesting 3 months after treatment Trichomoniasis: Laboratory Tests CDC 2010: Vaginal Trichomoniasis Treatment Test Sensitivity Specificity Cost Comment Aptima TMA +4 (98%) +3 (98%) $$$ NAAT (like GC/Ct) • Recommended regimen Culture +3 (83%) +4 (100%) $$$ Not in most labs – Metronidazole 2 grams PO single dose Point of care – Tinidazole 2 grams PO single dose •Affirm VP III +3 +4 $$$ DNA probe • Alternative regimen (preferred for HIV infected -
LNG-IUS) in Patients Affected by Menometrorrhagia, Dysmenorrhea and Adenomimyois: Clinical and Ultrasonographic Reports
European Review for Medical and Pharmacological Sciences 2021; 25: 3432-3439 The treatment with Levonorgestrel Releasing Intrauterine System (LNG-IUS) in patients affected by menometrorrhagia, dysmenorrhea and adenomimyois: clinical and ultrasonographic reports F. COSTANZI, M.P. DE MARCO, C. COLOMBRINO, M. CIANCIA, F. TORCIA, I. RUSCITO, F. BELLATI, A. FREGA, G. COZZA, D. CASERTA Department of Surgical and Medical Sciences and Translational Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, Rome, Italy Abstract. – OBJECTIVE: Adenomyosis is p=0.025; p=0.014). The blood loss decreased the consequence of the myometrial invasion significantly in both the cohorts (p<0.001) and by endometrial glands and stroma. Transvag- particularly in adenomyotic patients. Pain relief inal ultrasonography plays a decisive role in was observed in all the patients (p<0.001). the diagnosis and monitoring of this patholo- CONCLUSIONS: LNG-IUS can be considered gy. Our study aims to evaluate the efficacy of an effective treatment for managing symptoms LNG-IUS (Levonorgestrel Releasing Intrauter- and improving uterine morphology. ine System) as medical therapy. We analyzed both clinical symptoms and ultrasonograph- Key Words: ic aspects of menometrorrhagia and dysmen- Benign disease of uterus, Dysmenorrhea, Gyne- orrhea in patients with adenomyosis and the cologic imaging, Leiomyomas of the uterus/adeno- control group. myosis. PATIENTS AND METHODS: A prospective co- hort study was carried out on 28 patients suf- fering from symptomatic adenomyosis treat- ed with LNG-IUS. Adenomyosis was diagnosed Introduction through transvaginal ultrasonography by an ex- pert sonographer. A control group of 27 symp- Adenomyosis is a benign gynecological dis- tomatic patients (menorrhagia and dysmenor- ease with a large variety of clinical manifestation; rhea) without a transvaginal ultrasonograph- the most frequent include menorrhagia, metror- ic diagnosis of adenomyosis was treated in the rhagia, dysmenorrhea and chronic pelvic pain1. -
Intermenstrual Bleeding (Bleeding Between Periods)
Intermenstrual Bleeding (Bleeding between periods) What is Intermenstrual bleeding? This is unscheduled bleeding that can occur in between periods. There are many different causes of bleeding between periods but seek medical advice if you are experiencing this, even if it is for reassurance in many situations. What is the nature of bleeding? Bleeding that occurs randomly without any relation to your monthly period should not be ignored, unless the cause is known. The bleeding may be light blood, spotting, a bloody or dark brown vaginal loss or heavy bleeding mimicking a period. Mid cycle pain and bleeding Mittelschmerz is one-sided, lower abdominal pain associated with ovulation, about 14 days before your next menstrual period. In most cases, mittelschmerz does not require medical attention and may be associated with light vaginal bleeding for a day or so. It may not occur every month. If you are concerned, seek advice. Spotting in the lead up to or at the end of the period Usually, this just suggests that levels of progesterone fall slightly more slowly in some cycles and can lead to spotting seen in the lead up to the proper menstrual flow. This is usually not a concern. Spotting or a brown vaginal loss as the period finishes is also not abnormal, unless lasting for days or associated with other symptoms. (See information on a normal menstrual cycle under the leaflet on Irregular Periods) What are the possible causes of bleeding between periods? (not an exhaustive list) Hormonal contraceptives, such as the combined or progesterone only pill, implant, injection, intrauterine system, patch, ring can all cause bleeding between cycles, especially in the first few months of starting them. -
Association Between Menstrual Disorders and Obesity
ArchiveInt J School of Health SID. 2018 April; 5(2):e65716. doi: 10.5812/intjsh.65716. Published online 2018 April 17. Research Article Association Between Menstrual Disorders and Obesity-Related Anthropometric Indices in Female High School Students: A Cross-Sectional Study Mostafa Rad,1 Marzieh Torkmannejad Sabzevary,2 and Zahra Mohebbi Dehnavi3,* 1Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, IR Iran 2Mobini Hospital, Sabzevar University of Medical Sciences, Sabzevar, IR Iran 3Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran *Corresponding author: Zahra Mohebbi Dehnavi, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-9139752086, E-mail: [email protected] Received 2018 January 02; Revised 2018 April 11; Accepted 2018 April 13. Abstract Background: The menstrual cycle determines the health of women. Menstrual disorders are a major Geneologic problem among women, especially adolescents, which is a major source of anxiety for them and their families. Factors such as BMI, exercise, and stress can be related to menstrual disorders. As a result, this study was conducted to determine the association between menstrual disorders and anthropometric indices in Female High School Students. Methods: This descriptive cross-sectional study was conducted in Sabzevar on 200 high school female students in 2017. The partici- pants first completed the personal, midwifery, -
Impact of Anemia on Menstruation and Academic Performance of Adolescent Girls Attending Secondary Schools of Rural Wardha District 1Rufina Binoy,2 Neema Acharya
WJOA Impact of Anemia on Menstruation and Academic10.5005/jp-journals-10065-0001 Performance of Adolescent Girls ORIGINAL ARTICLE Impact of Anemia on Menstruation and Academic Performance of Adolescent Girls attending Secondary Schools of Rural Wardha District 1Rufina Binoy,2 Neema Acharya 3 ABSTRACT adolescents, and women of childbearing age group. Anemia is a common nutritional problem in adolescents.4 In this research, we hope to understand the Introduction: Very few studies focus on adolescent girls’ health, in view effect of anemia on the various menstrual parameters and disorders and on the academic performance of adolescent of that the present study was taken up to throw light on girls attending secondary schools of rural Wardha. the prevalence of anemia in the rural district of Wardha Materials and methods: Questionnaires were prepared and and to assess the effect of the same on their menstrual distributed to the female students who came to attend the health and academic performance. adolescent clinic in Acharya Vinoba Bhave Rural Hospital, Sawangi, India, for health checkup. Their hemoglobin was estimated and recorded in their respective questionnaires. MATERIALS AND METHODS Questionnaires were designed to understand in the best way possible the effects of anemia on the menstrual health and • Site: The research was conducted in Acharya Vinoba academic life of the adolescent girls. Bhave Rural Hospital (AVBRH), Sawangi, Wardha, Results: The results revealed a remarkable correlation India. between the grades of anemia and poor menstrual health; a • Type of study: Questionnaire-based study similar result was seen in case of academic performance as • Duration: 6 months well. -
Gynecology Revised: 11/2013
Emergency Medical Training Services Emergency Medical Technician – Paramedic Program Outlines Outline Topic: Gynecology Revised: 11/2013 21 questions on exam 8 from this outline • Menstruation - normal periodic discharge of blood, mucus, and cellular debris from uterus. The normal menstrual cycle lasts about 28 days. 25 to 60mL average flow. Flow lasts usually 4 to 6 days. Lining of the uterus is called endometrium. Onset of menses (menarche) begins around 12 years of age. Menopause starts at age 47 on average. But can range from 30 to 60 years of age. Estrogen stimulates endometrium to grow and increase in thickness. • Ovaries contain about 5 million cells to make oocytes (immature ova/eggs). At puberty 350,000 are present. In a lifetime the ovary will release 400 through menstruation • The release of the egg is termed ovulation. • The pituitary released FSH to stimulate the ovaries to produce estrogen. As a result of the estrogen builds up in blood stream just before ovulation the pituitary releases luteinizing hormone to initiate the release of eggs. • Up to seven days after ovulation (day 21) the uterus is ready to receive an embryo if fertilization has happened. • Recap: Day 14 ovulation. Up to day 21 fertilization window, day 22 thru 28 period if not pregnant. GYN emergencies are classified as: Non-traumatic • PID - infection entered the pelvis cavity. Most common causes are non-sterile exam equipment and if sexually transmitted is N. Gonorrhea and Chlamydia. Lower abdominal pain, hurts with sex, vaginal discharge and additional bleeding after period is over. Antibiotic therapy is needed. • Ovarian cyst - can be a bleeding/shock emergency.