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Ghitha N, Vathania N, Wiyono L, Pulungan A. Delayed menarche in children and adolescents with type 1 diabetes mellitus: a systematic review and meta-analysis. Clin Pediatr Endocrinol 2024; 33:104-112. [PMID: 38993726 PMCID: PMC11234191 DOI: 10.1297/cpe.2023-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/26/2024] [Indexed: 07/13/2024] Open
Abstract
Several studies have reported an association between age at menarche and the onset of type-1 diabetes mellitus (T1DM). This review compared the age at menarche in patients who had menarche after T1DM diagnosis with that of patients who were healthy and/or had menarche before T1DM diagnosis. Searches were conducted using four databases. The outcome was the age at menarche of patients who had menarche after T1DM diagnosis and patients who were healthy and/or had menarche before T1DM diagnosis. A qualitative analysis was performed using the JBI (Joanna Briggs Institute) Critical Appraisal. Quantitative analysis of the mean differences was performed using Revman 5.4 tool. A total of 1952 studies were obtained from the initial search. The final results were 13 articles that met the inclusion criteria for the qualitative assessment and eight for the quantitative assessment. Eight studies included 1030 patients who had menarche after being diagnosed with T1DM and 1282 patients who were healthy and/or had menarche before T1DM diagnosis. The meta-analysis showed a cumulative effect on a mean difference of 0.87 (95% CI: 0.75; 0.99, p-value < 0.00001), indicating a later age at menarche in patients who had menarche after T1DM diagnosis. The age at menarche was later in patients who had menarche after T1DM diagnosis compared to healthy subjects and those who had menarche beforehand.
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Affiliation(s)
- Nida Ghitha
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Nabila Vathania
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Lowilius Wiyono
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Aman Pulungan
- Division of Endocrinology, Department of Child's Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Gambadauro P, Hadlaczky G, Wasserman D, Carli V. Menstrual symptoms and subjective well-being among postmenarchal adolescents. AJOG GLOBAL REPORTS 2024; 4:100304. [PMID: 38304304 PMCID: PMC10830861 DOI: 10.1016/j.xagr.2023.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Menstrual symptoms are predominantly studied among adults but may occur directly after menarche. Adolescent menstrual healthcare, however, faces specific obstacles and more research into menstrual symptoms as a determinant of adolescent well-being is therefore advocated. OBJECTIVE This study aimed to investigate menstrual symptoms and their impact on everyday life and well-being among postmenarchal adolescents. STUDY DESIGN A survey was delivered to a random sample of 1644 schoolgirls, drawn from a population-based project involving 116 lower secondary education schools (7th and 8th grade) in Stockholm, Sweden. Menstrual symptoms (ie, dysmenorrhea, heavy bleeding, irregular periods, mood disturbance, other general symptoms) were investigated through multiple choice questions and defined according to their impact on everyday life as mild (seldom affected), moderate (affected but possible to cope) and severe (affected and difficult to cope). Subjective well-being was measured with the World Health Organization Five Well-Being index. Postmenarchal respondents were eligible for analysis; those with incomplete outcome data or using hormonal contraception were excluded. The frequency and severity of symptoms across different postmenarchal years (1st, 2nd, 3rd, 4th, or 5th+ year after menarche) were studied with Chi-square and Kendall's tau statistics. Analysis of variance was used to study the association between menstrual symptoms and World Health Organization Five Well-Being index scores. A composite menstrual health index variable was obtained through principal component analysis and used to study the overall impact of menstrual symptoms on well-being in regression analyses. RESULTS Of 1100 postmenarchal girls (mean age, 14.1±0.7 years), 93.2% reported menstrual symptoms, 81.3% had at least 1 moderate symptom and 31.3% had at least 1 severe symptom. The most frequent symptoms were dysmenorrhea (80.4%) and mood disturbance (81.1%), followed by irregular periods (67.9%), heavy bleeding (60.4%), and other general symptoms (60.4%). Throughout postmenarchal years, there was a significant increase in frequency and severity (P<.001) of dysmenorrhea (τ=0.148), heavy bleeding (τ=0.134), mood disturbance (τ=0.117), and other general symptoms (τ=0.110), but not irregular periods (τ=-0.0201; P=.434). Girls with menstrual symptoms had significantly lower World Health Organization Five Well-Being index scores than those without symptoms (mean difference, -17.3; 95% confidence interval, -22.4 to -12.3). Analysis of variance showed significant associations (P<.001) with World Health Organization Five Well-Being index scores for each of the examined menstrual symptoms. In post hoc pairwise comparisons with peers without symptoms, the greatest reductions in World Health Organization Five Well-Being index score were found among girls with severe symptoms (mean difference for: dysmenorrhea, -20.72; heavy bleeding, -15.75; irregular periods, -13.81; mood disturbance, -24.97; other general symptoms, -20.29), but significant differences were observed even for moderate or mild symptoms. The composite menstrual health index was significantly associated with World Health Organization Five Well-Being index scores in regression analysis, independently of age, age at menarche, body mass index, smoking, physical activity, own and parental country of birth, biparental care, and socioeconomic status. CONCLUSION Despite growing awareness about the relevance of menstruation to women's health, unmet menstrual health needs are a potential threat to the well-being of adolescents. Education, screening, and clinical competence are important tools to reduce the burden of menstrual symptoms during adolescence and to prevent long-term consequences. The development of novel person-centered strategies should be a priority for clinical practice and research in adolescent menstrual health.
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Affiliation(s)
- Pietro Gambadauro
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, Wasserman, and Carli)
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden (Dr Gambadauro)
- Stockholm Health Care Services, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, and Carli)
- Res Medica Sweden, Uppsala, Sweden (Dr Gambadauro)
| | - Gergö Hadlaczky
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, Wasserman, and Carli)
- Stockholm Health Care Services, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, and Carli)
| | - Danuta Wasserman
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, Wasserman, and Carli)
| | - Vladimir Carli
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, Wasserman, and Carli)
- Stockholm Health Care Services, Stockholm, Sweden (Drs Gambadauro, Hadlaczky, and Carli)
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Di Maio S, Marzuillo P, Daar S, Kattamis C, Karimi M, Forough S, Banchev A, Kaleva V, Christou S, Fortugno C, Delaporta P, Soliman AT, Tzoulis P, de Sanctis V. A Multicenter ICET-A Study on Age at Menarche and Menstrual Cycles in Patients with Transfusion-Dependent Thalassemia (TDT) who Started Early Chelation Therapy with Different Chelating Agents. Mediterr J Hematol Infect Dis 2023; 15:e2023058. [PMID: 38028391 PMCID: PMC10631706 DOI: 10.4084/mjhid.2023.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/15/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction To evaluate the effect of early chelation therapy (≤ 3 years) with a variety of chelating agents on age at menarche and menstrual characteristics in patients with transfusion-dependent thalassemia (TDT). Design A retrospective multicenter study promoted by the International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescent Medicine (ICET-A). Setting Eight of 13 International Thalassemia Centers (61.5%) in the ICET-A Network participated. Patients Fifty-seven female TDT patients, aged 11 to 26 years, and with early iron chelation therapy, were eligible for the present study. They were enrolled from one center from Iran (33 patients), 3 centers from Bulgaria (9), 1 from Greece (8), one from Oman (4), 1 from Cyprus (2), and 1 from Italy (1). Seven patients were excluded, four still prepubertal (age 12-14 years) and 3 with primary amenorrhea. Therefore 50 patients were finally enrolled. Results All fifty TDT patients developed spontaneous menarche at a mean age of 14.2 ± 2.24 years (range 9 - 20). A significant positive correlation was observed between age at menarche and serum ferritin levels (r: 0. 41, p=0.005). Regular menstrual cycles were reported from 32 (64%) patients, of whom 28 (83.3%) get menarche at age ≤ 14 years. Complications were more frequent in patients older than 14 years at menarche and in those with secondary amenorrhea. Conclusions Age at menarche greater than 14 years was a forerunner of menstrual irregularities and associated complications in 36% of patients despite precocious chelation therapy. The poor adherence to treatment, to be demonstrated in future studies, could explain the finding.
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Affiliation(s)
- Salvatore Di Maio
- Emeritus Director in Pediatrics, Children’s Hospital “Santobono-Pausilipon,” Naples, Italy
| | - Pierluigi Marzuillo
- Department of Woman, Child, General and Specialized Surgery, University “Luigi Vanvitelli,” Naples, Italy
| | - Shahina Daar
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman and Wallenberg Research Centre, Stellenbosch Institute for Advanced Study, Stellenbosch University, Stellenbosch, South Africa
| | - Christos Kattamis
- First Department of Paediatrics, National Kapodistrian University of Athens, Athens, Greece
| | - Mehran Karimi
- Department of Hematology-Oncology, American Hospital Dubai, UAE
| | - Saki Forough
- Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Atanas Banchev
- Expert Center for Haemophilia, Thalassemia and Other Rare Benign Haematological Disorders, Department of Paediatric Haematology and Oncology, University Hospital “Tzaritza Giovanna – ISUL,” Medical University, Sofia, Bulgaria
| | - Valeria Kaleva
- Expert Center for Coagulopathies and Rare Anemias, Varna, Bulgaria
| | | | - Carmelo Fortugno
- Department of Pediatric Haematoncology, Thalassaemia and Prenatal Diagnosis Regional Center, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | - Polyxeni Delaporta
- Thalassemia Unit, First Department of Pediatrics National Kapodistrian University of Athens, Athens, Greece
| | | | - Ploutarchos Tzoulis
- Department of Endocrinology, Whittington Hospital, University College London, London, UK
| | - Vincenzo de Sanctis
- Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy
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Rager TL, Compton SD, Winfrey OK, Rosen MW. Norethindrone dosing for adequate menstrual suppression in adolescents. J Pediatr Endocrinol Metab 2023; 36:732-739. [PMID: 37279406 DOI: 10.1515/jpem-2023-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/28/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES We sought to study factors predictive of achieving menstrual suppression with norethindrone vs. norethindrone acetate in adolescents, as optimal dosing is unknown. Secondary outcomes included analyzing prescriber practices and patient satisfaction. METHODS We performed a retrospective chart review of adolescents ages <18 years presenting to an academic medical center from 2010 to 2022. Data collected included demographics, menstrual history, and norethindrone and norethindrone acetate use. Follow-up was measured at one, three, and 12 months. Main outcome measures were starting norethindrone 0.35 mg, continuing norethindrone 0.35 mg, achieving menstrual suppression, and patient satisfaction. Analysis included Chi-square and multivariate logistic regression. RESULTS Of 262 adolescents initiating norethindrone or norethindrone acetate, 219 completed ≥1 follow-up. Providers less often started norethindrone 0.35 mg for patients with body mass index ≥25 kg/m2, prolonged bleeding, or younger age at menarche, but more often for patients who were younger, had migraines with aura, or were at risk of venous thromboembolism. Those with prolonged bleeding or older age at menarche were less likely to continue norethindrone 0.35 mg. Obesity, heavy menstrual bleeding, and younger age were negatively associated with achieving menstrual suppression. Patients with disabilities reported greater satisfaction. CONCLUSIONS While younger patients more often received norethindrone 0.35 mg vs. norethindrone acetate, they were less likely to achieve menstrual suppression. Patients with obesity or heavy menstrual bleeding may achieve suppression with higher doses of norethindrone acetate. These results reveal opportunities to improve norethindrone and norethindrone acetate prescribing practices for adolescent menstrual suppression.
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Affiliation(s)
| | - Sarah D Compton
- Department of Obstetrics and Gynecology, Michigan Medicine, Ann Arbor, MI, USA
| | - Olivia K Winfrey
- Department of Obstetrics and Gynecology, Michigan Medicine, Ann Arbor, MI, USA
| | - Monica W Rosen
- Department of Obstetrics and Gynecology, Michigan Medicine, Ann Arbor, MI, USA
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Dhar S, Mondal KK, Bhattacharjee P. Influence of lifestyle factors with the outcome of menstrual disorders among adolescents and young women in West Bengal, India. Sci Rep 2023; 13:12476. [PMID: 37528155 PMCID: PMC10393940 DOI: 10.1038/s41598-023-35858-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/24/2023] [Indexed: 08/03/2023] Open
Abstract
Menstruation is a natural phenomenon for every female, starting from adolescents to menopausal age. Any disturbances in menstrual patterns can eventually affect one's physical as well as psychological health which in turn hamper the quality of life of women. Several factors including genetic predisposition as well as lifestyle modifications adversely affect normal menstrual patterns. Hence, this study aims to evaluate the prevalence of menstrual disorders among adolescents and young women as well as the associated risk factors. A cross-sectional random survey was conducted from January 2020 to January 2022 in various schools and colleges. A structured questionnaire was prepared which include anthropometric details, demographic information, and lifestyle patterns. The data were extracted for further statistical analysis. In the overall study population, the prevalence of PCOS, Dysmenorrhea, Menorrhagia, Polymenorrhea, Hypomenorrhea and the irregular menstrual cycle was found at 14.14%, 15.14%, 6.29%, 3.70%, 5.16% and 44.83% respectively. The mean BMI of the study population was 19.949 ± 4.801 kg/m2 and the mean WHr was 0.872 ± 0.101, indicating a moderate to high risk of metabolic disorder among the study population. Increased BMI, short sleep, and sedentary and vigorous physical activity can contribute to the risk of developing menstrual disorders. Unhealthy food habits are a major risk factor for menstrual disorders. Lifestyle modifications like healthy food habits, sleeping patterns, physical activity, etc. can effectively reduce the risk of menstrual disorders and also cut down the severity of more complex health problems. In-depth biochemical and molecular analysis is required to identify specific biomarkers.
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Affiliation(s)
- Shrinjana Dhar
- Environmental Epigenomics Laboratory, Department of Environmental Science, University of Calcutta, 37, Ballygunge Circular Road, Kolkata, West Bengal, 700019, India
| | - Kousik Kr Mondal
- Environmental Epigenomics Laboratory, Department of Environmental Science, University of Calcutta, 37, Ballygunge Circular Road, Kolkata, West Bengal, 700019, India
- Department of Zoology, Mugberia Gangadhar Mahavidyalaya, Vidyasagar University, Bhupati Nagar, Purba Medinipur, West Bengal, 721425, India
| | - Pritha Bhattacharjee
- Environmental Epigenomics Laboratory, Department of Environmental Science, University of Calcutta, 37, Ballygunge Circular Road, Kolkata, West Bengal, 700019, India.
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Casale S, Assirelli V, Pizza F, Balsamo A, Gennari M, Pession A, Plazzi G, Cassio A. Auxological and endocrine findings in narcolepsy type 1: seventeen-year follow-up from a pediatric endocrinology center. Front Endocrinol (Lausanne) 2023; 14:1037398. [PMID: 37396177 PMCID: PMC10311432 DOI: 10.3389/fendo.2023.1037398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Narcolepsy Type 1 (NT1) is a rare hypersomnia of central origin linked to hypocretin deficiency, most frequently arising at pediatric age. NT1 could be associated with endocrine comorbidities involving the neuroendocrine axis, predominantly obesity, and Central Precocious Puberty (CPP). The primary aim of this study is the evaluation of endocrine and auxological parameters at diagnosis and during follow-up in patients with NT1, treated with Sodium Oxybate (SO) or not. Methods We retrospectively evaluated the auxological, biochemical, and radiological parameters of 112 patients referred to our Center between 2004-2022. The design of our study is cross-sectional at the time of diagnosis followed by a longitudinal follow-up. Results Our study confirms an increased frequency of CPP and obesity in patients with NT1. At first evaluation, obesity was found in 31.3% of patients, while overweight was found in 25.0%. A diagnosis of CPP was made in 19.6% of patients. Interestingly, this group showed a significantly lower level of CSF-hypocretin (hrct-1) at diagnosis compared to others. We found an improvement in BMI SDS in the SO-treated group compared to untreated patients, and this trend persisted also at 36 months of follow-up (0.0 ± 1.3 vs 1.3 ± 0.4; p<0.03). Sixty-three patients reached their final height, with a median SDS of 0.6 ± 1.1 in boys and 0.2 ± 1.2 in girls. Discussion To our knowledge, these are the first results regarding the final height in a large series of pediatric patients with NT1, with a normal range of IGF1-SDS levels and stature SDS.
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Affiliation(s)
- Sara Casale
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Valentina Assirelli
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Antonio Balsamo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Monia Gennari
- Pediatric Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Pession
- Pediatric Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Bologna, Bologna, Italy
| | - Giuseppe Plazzi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy
| | - Alessandra Cassio
- Pediatric Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Bologna, Bologna, Italy
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7
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Rathod H, Rathi S, Tiwari S, Borgaonkar C. Study of Menstrual Patterns, Abnormalities, and Irregularities in Students. Cureus 2023; 15:e40206. [PMID: 37435243 PMCID: PMC10331512 DOI: 10.7759/cureus.40206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction One-third to one-half of females with primary dysmenorrhea are missing school or work at least once per cycle, and more frequently 5% to 14% of them. Dysmenorrhea is one of the most common gynecologic disorders among young girls and is the major cause of activity restriction and college absence. A direct link between primary menstrual abnormalities and chronic conditions such as obesity has been established, though the exact pathology behind it is yet unknown. Method A total of 420 female students between 18 and 25 years of age from various professional colleges in a metro city were included in the study. Semi-structured questionnaire was used. Students were examined for height and weight. Results History of dysmenorrhea was given by 82.6% students. Out of these, 30% had severe pain and required medication. Only 20% took professional help for the same. There was a high prevalence of dysmenorrhea in participants who ate food outside frequently. Prevalence of irregular menstruation was more (41.94%) in girls having junk food three to four times a week. Conclusion The prevalence of dysmenorrhea and premenstrual symptoms were much higher as compared to the other menstrual abnormalities. The study revealed a direct association between consumption of junk food and an increase in dysmenorrhea.
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Affiliation(s)
- Hetal Rathod
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Shreya Rathi
- Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Shashank Tiwari
- Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Chaitali Borgaonkar
- Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
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Hobbs AK, Cheng HL, Tee EY, Steinbeck KS. Menstrual Dysfunction in Adolescents with Chronic Illness: A Systematic Review. J Pediatr Adolesc Gynecol 2023:S1083-3188(23)00337-6. [PMID: 37192680 DOI: 10.1016/j.jpag.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/24/2023] [Accepted: 05/08/2023] [Indexed: 05/18/2023]
Abstract
STUDY OBJECTIVE Menstrual dysfunction can impact both the physical and emotional health of young people1. Multiple chronic disease have been associated with menstrual dysfunction in adults2, however there is little research in adolescents, despite non adherence and sub-optimal illness control in this group. We aimed to identify the impact chronic illness has on the age of menarche (AAM) and the menstrual cycle in adolescents. METHODS Studies were extracted of female adolescents aged 10-19 who had a chronic physical illness. Data included outcomes on age of menarche and/or menstrual cycle quality. Exclusion criteria aimed to exclude diseases where menstrual dysfunction was a known part of the disease pathophysiology i.e. polycystic ovarian syndrome3, or in which medications were used that directly impacted gonadal function4. A literature search (to January 2022) was performed on EMBASE, PubMed and Cochrane library databases. Two widely used modified quality analysis tools were used. RESULTS Our initial search netted 1451 articles, of which 95 full texts were examined and 43 met inclusion criteria. 27 papers focussed on Type 1 Diabetes (T1D), with 8 papers examining adolescents with cystic fibrosis (CF) and the remaining studying inflammatory bowel disease (IBD), juvenile idiopathic arthritis (JIA), coeliac disease and chronic renal disease. Metanalysis of 933 patients with T1D versus 5244 controls demonstrated a significantly later AAM in T1D (by 0.42 years; p=<0.00001). There was also a significant association between higher HbA1c and insulin dose (IU/kg) and later age of menarche. Eighteen papers reviewed other aspects of menstruation, including dysmenorrhoea, oligomenorrhoea, amenorrhoea and ovulatory function, with variable findings. CONCLUSION The majority of studies were small and in single populations. Despite this, there was evidence of delayed menarche and some evidence of irregular menses in those with CF and T1D. Further structured studies are needed to evaluate menstrual dysfunction in adolescents and how it relates to their chronic illness.
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Affiliation(s)
- Annabelle K Hobbs
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia; Department of Endocrinology and Diabetes, Queensland Children's Hospital, Brisbane, QLD 4101.
| | - Hoi Lun Cheng
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Elizabeth Yf Tee
- The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Katharine S Steinbeck
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
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Li Y, Kang B, Zhao X, Cui X, Chen J, Wang L. Association between depression and dysmenorrhea among adolescent girls: multiple mediating effects of binge eating and sleep quality. BMC Womens Health 2023; 23:140. [PMID: 36978063 PMCID: PMC10043526 DOI: 10.1186/s12905-023-02283-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Dysmenorrhea has a significant negative impact on teenagers' quality of life, and its prevalence is increasing annually. Although studies have explored the factors affecting dysmenorrhea, it remains unclear how these factors interact with one another. This study aimed to explore the mediating role of binge eating and sleep quality between depression and dysmenorrhea. METHODS This cross-sectional study recruited adolescent girls from the Health Status Survey of adolescents in Jinan, Shandong Province, and used multistage stratified cluster random sampling. Data was collected using an electronic questionnaire between March 9, 2022, and June 20, 2022. The Numerical Rating Scale and Cox Menstrual Symptom Scale were used to assess dysmenorrhea and the Patient Health Questionnaire-9 to assess depression. The mediation model was tested by Mplus 8.0, and the mediating effect was analyzed using the Product of Coefficients approach and the Bootstrap method. RESULTS Among the total of 7818 adolescent girls included in this study, the prevalence of dysmenorrhea is 60.5%. A significant positive association was found between dysmenorrhea and depression. Binge eating and sleep quality seemingly mediate this association. The mediating effect of sleep quality (21.31%) was greater than that of binge eating (6.18%). CONCLUSIONS The findings of this study point in the right direction for preventing and treating dysmenorrhea in adolescents. For adolescent dysmenorrhea, mental health should be considered and proactive steps taken for educating adolescents on healthy lifestyles to reduce negative consequences of dysmenorrhea. Longitudinal studies on the causal link and influence mechanisms between depression and dysmenorrhea should be conducted in the future.
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Affiliation(s)
- Yingzhen Li
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Baixue Kang
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Xueyan Zhao
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Xuena Cui
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Jie Chen
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
| | - Lijie Wang
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China.
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Alateeq D, Binsuwaidan L, Alazwari L, Algarni M, Al Hussain M, Alzahrani R, Aljohani R. Dysmenorrhea and depressive symptoms among female university students: a descriptive study from Saudi Arabia. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022; 58:106. [PMID: 36090615 PMCID: PMC9447356 DOI: 10.1186/s41983-022-00542-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/30/2022] [Indexed: 11/26/2022] Open
Abstract
Background Dysmenorrhea has significantly increased in prevalence. There is also evidence of the coexistence of dysmenorrhea and psychological disorders. This study aims to explore the prevalence of dysmenorrhea and investigate its correlation with depressive symptoms among Princess Nourah bint Abdulrahman University (PNU) students. All participants (N = 487) in this cross-sectional study provided sociodemographic data, menstrual and medical history, and completed the Patient Health Questionnaire (PHQ-9) scale and (working ability, location, intensity, days of pain, dysmenorrhea [WaLIDD]) scale on a self-administered online questionnaire. Results The mean age of the females was 20.64 ± 2.38 years, and 40.7% were from health colleges. Severe dysmenorrhea requiring medical attention and pain killers or herbs was reported by 30.8% of the students. Significant predictors of severe dysmenorrhea were: younger age, earlier menarche, pain killers and herbs used for menstrual pain, a doctor visit for menstrual pain, and depression. In addition, significant protective factors of depression were: later menarche age, having a regular menstrual cycle, and longer duration. Conclusions Students with severe dysmenorrhea have a higher risk of depression than other students. The findings stress the importance of awareness, education, a multidisciplinary approach to women's health, and early detection to prevent future complications.
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Azhary JMK, Leng LK, Razali N, Sulaiman S, Wahab AVA, Adlan ASA, Hassan J. The prevalence of menstrual disorders and premenstrual syndrome among adolescent girls living in North Borneo, Malaysia: a questionnaire-based study. BMC Womens Health 2022; 22:341. [PMID: 35964024 PMCID: PMC9375346 DOI: 10.1186/s12905-022-01929-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/08/2022] [Indexed: 11/12/2022] Open
Abstract
Background This study aimed to determine menstrual characteristics and related morbidities among adolescent girls living in Sabah, North Borneo, a less-developed state in Malaysia. Methods Data were obtained from a quantitative survey conducted in three government high schools located in Ranau, Sabah. The participants were adolescent girls who had attained menarche between the ages of 14 and 19. Results Based on the analysis of questionnaires completed by 757 adolescent girls, the mean age at the time of the survey was 17 ± 1.4 years, and the mean menarche age was 12.2 ± 1.1 years. Our data demonstrated that 85.7% of the participants experienced dysmenorrhoea, of which at least 42.1% (mean pain score ± SD: 4.81 ± 0.76, 95% confidence interval (CI) 4.72, 4.90) experienced moderate dysmenorrhoea, and 11.2% (mean pain score ± SD: 7.86 ± 0.94, 95% CI 7.64, 8.08) experienced severe dysmenorrhoea. Over 70% of these girls complained of tiredness, headache, and appetite changes during menses. Conclusions The prevalence of menstrual disorders and related morbidities was high among the girls residing in Sabah. Reproductive health issues in rural and socioeconomically deprived areas remains poorly addressed. The main consequence of neglecting menstrual disorders and their related morbidities is impaired future sexual reproductive health in adults. Thus, addressing adolescent reproductive health issues is crucial, especially for girls living in areas where access to healthcare is difficult. The information gathered from this study can be used to strategize effective interventions to improve adolescents' reproductive health status in rural areas.
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Shinde N, Kanabar DJ, Miles LJ. Narrative review of the prevalence and distribution of acute pain in children in the self-care setting. PAEDIATRIC & NEONATAL PAIN 2022; 4:169-191. [PMID: 36618510 PMCID: PMC9798044 DOI: 10.1002/pne2.12085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/16/2022] [Accepted: 07/20/2022] [Indexed: 01/11/2023]
Abstract
Acute pain among children is common, yet it may be underestimated and undertreated if the pain is not recognized. Assessing and managing pediatric pain can be complicated, and as such, measuring the prevalence of acute pain in children can be challenging. We sought to provide a consolidated review of the available data on the prevalence of commonly occurring acute pain in children in the self-care setting. An extensive literature search was performed to determine the prevalence of acute pain at multiple bodily locations in children aged between 3 months and 18 years. We considered the influence of age, sex, and sociodemographic factors on prevalence estimates. We also sought to identify some of the challenges involved in assessing and managing pediatric pain, thus shedding light on areas where there may be clinical and medical unmet needs. In general, a high prevalence of acute pain in children was detected, particularly headache, menstruation-related pain, and dental and back pain. Older age, female sex, and lower socioeconomic status were associated with increased pain prevalence. Risk factors were identified for all pain types and included psychological issues, stress, and unhealthy lifestyle habits. Owing to the heterogeneity in study populations, the prevalence estimates varied widely; there was also heterogeneity in the pain assessment tools utilized. The paucity of information regarding pain prevalence appears to be out of proportion with the burden of acute pain in children. This could indicate that clinicians may not be equipped with an optimal pain management strategy to guide their practice, especially regarding the use of developmentally appropriate pain assessment tools, without which prevalence data may not be captured. If acute pain is not accurately identified, it cannot be optimally treated. Further investigation is required to determine how the information from prevalence studies translates to the real-world setting.
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Affiliation(s)
- Nutan Shinde
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
| | | | - Lisa J. Miles
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
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Nardon M, Venturelli M, Ruzzante F, Longo V, Bertucco M. Response to: Dealing with menstrual cycle in sport: stop finding excuses to exclude women from research. Eur J Appl Physiol 2022; 122:2491-2492. [PMID: 35918557 DOI: 10.1007/s00421-022-05015-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Mauro Nardon
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Felice Casorati 43, 37131, Verona, Italy
| | - Massimo Venturelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Felice Casorati 43, 37131, Verona, Italy
| | - Federico Ruzzante
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Felice Casorati 43, 37131, Verona, Italy
| | - Valter Longo
- Longevity Institute and Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA.,IFOM, FIRC Institute of Molecular Oncology, 20139, Milan, Italy
| | - Matteo Bertucco
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Felice Casorati 43, 37131, Verona, Italy.
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Bigambo FM, Wang D, Zhang Y, Mzava SM, Dai R, Wang X. Current situation of menstruation and gynecological diseases prevalence among Chinese women: a cross-sectional study. BMC Womens Health 2022; 22:270. [PMID: 35787274 PMCID: PMC9254498 DOI: 10.1186/s12905-022-01860-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background Gynecological diseases have been taken attention and studied worldwide. Although, no recent studies have delineated the magnitude of gynecological diseases among Chinese women. This study aims to evaluate the current situation of menstruation and gynecological diseases prevalence among Chinese women. Methods A cross-sectional study was conducted at a hospital affiliated with Nanjing medical university in Nanjing, China between September 2021 and February 2022. A sample size of 977 women aged 18–52 years participated in a face-to-face interview questionnaire. Logistic regression was performed to determine whether pubertal timing and menstrual characteristics were associated with gynecological diseases. Results The most prevalent gynecological disease was dysmenorrhea (45.96%), followed by polycystic ovary syndrome, PCOS (19.04%), uterine fibroids (14.23%), spontaneous abortion (13.20%), trouble conceiving (12.59%), ovarian dysfunction (11.16%) and endometriosis (4.09%). In the adjusted model, heavy bleeding with large clots was associated with an increased risk of dysmenorrhea (odds ratio, OR = 5.01, 95% Confidence interval, CI 2.26, 11.10; p = 0.000), while history of precocious puberty diagnosis was associated with a reduced risk of dysmenorrhea (OR = 0.50, 95%CI: 0.26, 0.94; p = 0.031). Regular menstrual cycle in the past 12 months and regular menstrual periods were associated with decreased risk of PCOS (OR = 0.44, 95%CI 0.30, 0.65; p = 0.000) and (OR = 0.52, 95%CI 0.36, 0.74; p = 0.000), respectively. Histories of early thelarche, early menarche, and precocious puberty diagnosis were associated with increased risk of ovarian dysfunction (OR = 1.96, 95%CI 1.25, 3.08, p = 0.004), (OR = 2.26, 95%CI 1.24, 4.13; p = 0.008) and (OR = 2.79, 95%CI 1.36, 5.74; p = 0.005), respectively. Heavy bleeding and heavy bleeding with large clots were associated with endometriosis (OR = 4.92, 95%CI 1.50, 16.15, p = 0.009) and (OR = 5.67, 95%CI 1.42, 22.56; p = 0.014), respectively. Conclusions The prevalence of gynecological diseases is increasing among Chinese women and pubertal timing and menstrual characteristics may be associated with some gynecological diseases, specifically dysmenorrhea, PCOS, ovarian dysfunction, and endometriosis. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01860-5.
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Affiliation(s)
| | - Dandan Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Rd, Nanjing, 210008, China
| | - Yuqing Zhang
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | | | - Rongrong Dai
- Nanjing Pukou Central Hospital, PuKou Branch Hospital of Jiangsu Province Hospital, Nanjing, China.
| | - Xu Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Rd, Nanjing, 210008, China.
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Singh P, Sharma C, Krishna S, Mishra V, Yadav G, Patwa P, Gothwal M, Jhirwal M. Lifestyle and Prevalence of Menstrual Disorders among Undergraduate Medical and Nursing Students: Can We Bring a Change? J Obstet Gynaecol India 2022; 72:326-333. [PMID: 35928060 PMCID: PMC9343510 DOI: 10.1007/s13224-021-01606-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives Menstruation is a normal physiological phenomenon, but sometimes the abnormalities and pain associated with it can severely affect the daily routine of women and may create a stressful environment for them. The objective of this study was to conduct a comparative evaluation of the pattern of menstruation, lifestyle and the outlook toward menstruation among undergraduate female medical and nursing students. Methods It was a descriptive cross-sectional study conducted among the undergraduate medical and nursing students of a tertiary care Institute. A semi-structured questionnaire was used to collect the data. Of the 400 students approached, 188 completed the questionnaire. Results The mean age of the participants was 21.23 ± 1.47 years. The mean age of menarche was 12.65 ± 1.24 years among the medical students and 13.69 ± 1.38 years among the nursing students (P < 0.05). Overall, the common menstrual abnormalities observed were dysmenorrhea (71.2%) and premenstrual syndrome (70.2%) followed by menstrual irregularity (14.8%). On correlating lifestyle with menstrual abnormalities, no significant association was found. However, the most common reason for college absenteeism in both groups was dysmenorrhea and fear of unexpected heavy bleeding. Conclusion Despite having a medical background and knowledge about the physiology of menstruation, medical and nursing students do carry certain myths regarding menstruation which are being carried forward in society. Small roleplays in the OPD (Outpatient Department) area and public awareness lectures should be planned. They will not only develop confidence and better understanding among the students but also create social awareness.
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Marques P, Madeira T, Gama A. Menstrual cycle among adolescents: girls' awareness and influence of age at menarche and overweight. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2022; 40:e2020494. [PMID: 35019010 PMCID: PMC8734600 DOI: 10.1590/1984-0462/2022/40/2020494] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/07/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To characterize the menstrual cycle (regularity and menstrual flow length), the prevalence of dysmenorrhea and self-monitoring of the cycle in students from Lisbon region, and explore the effect of chronological age, age at menarche and body mass index (BMI) on menstrual disorders. METHODS This is a cross-sectional study with 848 girls aged 12-18 years. A questionnaire about the sociodemographic context and characteristics of the menstrual cycle, and weight and height measures were assessed. BMI was classified according to International Obesity Taskforce criteria. A descriptive analysis of the variables was made, and Odds Ratios (ORs) and 95% confidence intervals (95%CIs) were determined. RESULTS Mean age at menarche was 12.4 years and mean BMI was 22.0kg/m2. Among adolescents, 59% have regular menstrual cycle, 83% have menstrual flow length of ≤6 days. 88% suffered from dysmenorrhea, among which 8,7% declare absenteeism from school and 49% took pain medication, and 65% self-monitor their menstrual cycle. Higher maternal education was associated with a higher self-monitoring of menstrual cycle among the sample (OR 1.60; 95%CI 1.15-2.17). Girls with menarche <12 years-of-age are more likely to have menstrual flow length of >6 days (OR 1.73; 95%CI 1.19-2.51) and dysmenorrhea (OR 1.87; 95%CI 1.11-3.16) than those with menarche ≥12 years-of-age. No significant association between BMI and menstrual cycle variables was observed. CONCLUSIONS The results suggest that menstrual disorders are frequent and may be associated with early menarche, but not with BMI. It is important to encourage self-monitoring of the menstrual cycle to detect menstrual disorders timely and promote health and well-being.
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Affiliation(s)
- Patrícia Marques
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal
| | - Tiago Madeira
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal
| | - Augusta Gama
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal
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Hadjou OK, Jouannin A, Lavoue V, Leveque J, Esvan M, Bidet M. Prevalence of dysmenorrhea in adolescents in France: Results of a large cross-sectional study. J Gynecol Obstet Hum Reprod 2021; 51:102302. [PMID: 34973478 DOI: 10.1016/j.jogoh.2021.102302] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/28/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUNDS Dysmenorrhea is the most common gynecological complaint in young women but is overlooked by recent studies. Our objective was to evaluate the prevalence of dysmenorrhea in adolescents in France and its impact on daily living. METHODS It was a cross-sectional study conducted between April-May 2019, in eight randomly selected high schools in France. Participants were randomly selected post-menarche girl pupils 15-19 years who completed a 50-item questionnaire. Dysmenorrhea severity was assessed with the Numerical Rating Scale (NRS) and Verbal Multidimensional Scoring System Scale (VMSS). RESULTS Questionnaires from 953 girls were analyzed (mean age: 16.9 years). The prevalence of dysmenorrhea was 92.9% with 8.9% describing their pain as severe. Impact on quality of life was significant: 43.3% reported school absences because of dysmenorrhea, 74.9% difficulties in attending classes and 77.2% difficulties in sports activities. Risk factors of severe dysmenorrhea in multivariate analysis were heavy menstrual bleeding (OR 2.02, 95%CI [1.12; 3.63] p = 0.0192), early menarche (OR 0.68, 95%CI [0.57; 0.81] p<0.0001), chronic pelvic pain (OR 2.60, 95%CI [1.10; 6.11] p = 0.0274), BMI (BMI<18, OR 1.94, 95%CI [1.03; 3.66] p = 0.0335). Of the 50.4% who had consulted a physician, 45.4% had seen a general practitioner. Among the girls who had not consulted, 55.1% reported that menstruation was a "woman's burden". CONCLUSIONS Dysmenorrhea is highly prevalent in adolescents in France and has a real impact on daily living with social repercussions. As such, it should be treated as a public health problem with educational and information campaigns targeting the girls themselves, their families and healthcare professionals.
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Affiliation(s)
- Oum-Keltoum Hadjou
- Department of General Medicine, University of Rennes 1, 2 Avenue du Professeur Leon Bernard, Rennes Cedex 35 043, France
| | - Adeline Jouannin
- Department of General Medicine, University of Rennes 1, 2 Avenue du Professeur Leon Bernard, Rennes Cedex 35 043, France; University of Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes University Hospital, CHU Pontchaillou, 2, rue Henri Le Guilloux, Rennes Cedex 9 35033, France
| | - Vincent Lavoue
- Department of Obstetrics and Gynecology, Rennes University Hospital, CHU Hôpital Sud, 16 Bd de Bulgarie, Rennes Cedex 2 35 200, France.
| | - Jean Leveque
- Department of Obstetrics and Gynecology, Rennes University Hospital, CHU Hôpital Sud, 16 Bd de Bulgarie, Rennes Cedex 2 35 200, France
| | - Maxime Esvan
- University of Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes University Hospital, CHU Pontchaillou, 2, rue Henri Le Guilloux, Rennes Cedex 9 35033, France
| | - Maud Bidet
- Department of Pediatrics, Rennes University Hospital, CHU Hôpital Sud, 16 Bd de Bulgarie, Rennes Cedex 2 35 200, France
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Prevalence of dysmenorrhea among female students at the University of Riau-Indonesia. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2021.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mao L, Xi S, Bai W, Yao C, Zhou Y, Chen X, Sun Y. Menstrual patterns and disorders among Chinese women of reproductive age: A cross-sectional study based on mobile application data. Medicine (Baltimore) 2021; 100:e25329. [PMID: 33879662 PMCID: PMC8078451 DOI: 10.1097/md.0000000000025329] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/19/2021] [Indexed: 01/04/2023] Open
Abstract
Menstruation is an important indicator of women's health. Identification of abnormal menstrual patterns in adolescence may improve early diagnosis of potential health concerns in adulthood. This study aimed to evaluate menstrual patterns and disorders of Chinese women of reproductive age based on an APP.From December 2015 to January 2016, a cross-sectional study was conducted. We utilized a mobile application (APP) to collect information about participants' age at menarche, length of menstruation, duration of menstruation, amount of menstrual flow, regularity of menstrual cycle, prevalence of abnormal uterine bleeding and dysmenorrhoea.A total of 156,055 women (25,716 from the questionnaire survey and 130,000 from the mobile APP users) participated in the study. The average age of the subjects was 26.32 ± 6.97 years (median age, 25 years). Mean age at menarche was 13.08 ± 1.87 years; average length of menstrual cycle, 30.9 ± 4.28 days (median 30 days); and average duration of menstruation, 5.01 ± 1.13 days (median 5 days). Women with irregular menstrual cycles accounted for 36.41%. Women aged < 18 years and > 30 years were more likely to experience irregular menstrual cycles. The prevalence of secondary amenorrhoea was 4.07%. More than 20% of women reported abnormal menstrual flow. About 20.11% of women had abnormal uterine bleeding, and 77.65% had dysmenorrhoea. A hot compress was the most commonly used approach to ameliorate dysmenorrhoea. Women with low education and low income and those with high education and high income tended to have menstrual problems.A mobile APP as a survey tool has the advantages of large sample size, low cost, and high efficiency. The use of a mobile APP is an emerging approach for collecting big data in the field of health research. The results showed that the prevalence of menstrual disorders among Chinese reproductive women was high. Healthcare providers should educate girls and their caregivers about menstrual physiology, normal menstrual pattern, and reproductive health to prevent long-term diseases.
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Affiliation(s)
- Lele Mao
- Department of Obstetrics and Gynecology, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Capital Medical University
| | - Sisi Xi
- Department of Obstetrics and Gynecology, Peking University First Hospital
| | - Wenpei Bai
- Department of Obstetrics and Gynecology, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Capital Medical University
| | - Chen Yao
- Department of Medical Statistics, Peking University First Hospital, Beijing, China
| | - Yingfang Zhou
- Department of Obstetrics and Gynecology, Peking University First Hospital
| | - Xing Chen
- Department of Obstetrics and Gynecology, Peking University First Hospital
| | - Yu Sun
- Department of Obstetrics and Gynecology, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Capital Medical University
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Park YJ, Shin H, Jeon S, Cho I, Kim YJ. Menstrual Cycle Patterns and the Prevalence of Premenstrual Syndrome and Polycystic Ovary Syndrome in Korean Young Adult Women. Healthcare (Basel) 2021; 9:healthcare9010056. [PMID: 33430265 PMCID: PMC7825721 DOI: 10.3390/healthcare9010056] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 11/16/2022] Open
Abstract
Menstruation is one of the important indicators of reproductive health. Therefore, in order to improve the reproductive health of women in puberty and early adulthood, it is necessary to investigate menstrual health and symptoms. This cross-sectional descriptive correlational study was conducted to identify young women’s menstrual cycle patterns, prevalence of Premenstrual Syndrome (PMS), Polycystic Ovary Syndrome (PCOS) and the relationships of health-related factors according to menstrual regularity and PCOS. 462 women participated in the first phase of the study and completed the menstrual health and health-related behaviors questionnaire. In the second phase, 88 women with irregular menstruation in phase one had blood tests taken and body composition measured. As a result, Menarche was slightly later in irregular menstruation group. Women with regular menstruation had a mean number of 11.7 menstrual cycles over the past year, 93.0% of them reported a normal menstruation cycle frequency (21–35 days), 95.2% reported a normal duration (2–7 days) and 55.9% of participants had heavy menstrual bleeding. In the irregular menstrual group, there were higher percentages of underweight and obese women as well as more women experiences weight and diet changes. The estimated prevalence rates of PMS and PCOS were 25.5%, 5.2% respectively. This study provides updated basic data about menstrual health among Korean young women but more extensive and sophisticated studies are needed in the future.
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Affiliation(s)
- Young-Joo Park
- College of Nursing, Korea University, Seoul 02841, Korea; (Y.-J.P.); (H.S.); (I.C.)
| | - Hyunjeong Shin
- College of Nursing, Korea University, Seoul 02841, Korea; (Y.-J.P.); (H.S.); (I.C.)
| | - Songi Jeon
- College of Nursing, Korea University, Seoul 02841, Korea; (Y.-J.P.); (H.S.); (I.C.)
- Correspondence:
| | - Inhae Cho
- College of Nursing, Korea University, Seoul 02841, Korea; (Y.-J.P.); (H.S.); (I.C.)
| | - Yae-Ji Kim
- Health Insurance Review & Assessment Service, Kangwon 26465, Korea;
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Kim YJ, Park YJ. Menstrual Cycle Characteristics and Premenstrual Syndrome Prevalence Based on the Daily Record of Severity of Problems in Korean Young Adult Women. J Korean Acad Nurs 2020; 50:147-157. [PMID: 32131079 DOI: 10.4040/jkan.2020.50.1.147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/31/2019] [Accepted: 01/19/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE This descriptive study aimed to identify the menstrual cycle characteristics and premenstrual syndrome (PMS) prevalence in Korean young adult women using the retrospective and prospective Daily Record of Severity of Problems (DRSP). METHODS In the first stage, participants included 151 nursing students studying in a university located in Seoul. Data were collected from April 20 to June 2, 2017, using the questionnaire on menstrual characteristics, pictorial blood assessment chart, and retrospective DRSP. In the second stage, participants included 17 students with PMS, based on the screening conducted in the first stage. Data were collected using the prospective DRSP from May 29 to 2 September 2, 2017. RESULTS Of the study sample, 104 participants (68.9%) had regular periods. Those with regular periods had 11.97 periods annually with a menstrual cycle of 29.38 days and a period duration of 5.72 days. Fifty-five participants (37.4%) showed menorrhagia. Sixty-four participants (42.4%) were found to have PMS based on their retrospective DRSP. When the ratio of women (52.9%) with PMS shown in the prospective DRSP was used as a positive predictive value, the estimated PMS prevalence was 22.4%. CONCLUSION This study provides clinically significant PMS prevalence among Korean young adult women, positive predictive value of the retrospective DRSP, and valid data to basically understand the menstrual cycle characteristics experienced by these women.
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Affiliation(s)
- Yae Ji Kim
- Health Insurance Review & Assessment Service, Seoul, Korea
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Rosso G, Aragno E, Mehanović E, Di Salvo G, Maina G. Age at Menarche in Women With Bipolar Disorder: Correlation With Clinical Features and Peripartum Episodes. Front Psychiatry 2020; 11:00851. [PMID: 33033479 PMCID: PMC7509456 DOI: 10.3389/fpsyt.2020.00851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/04/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is related to reproductive cycles. However, findings on putative correlation between age at menarche and course of BD are particularly scarce and conflicting. The aim of the present study is to analyze the relationship between age at menarche and characteristics of BD, including comorbid medical conditions and peripartum mood episodes. METHODS The study sample consists of 288 women with BD type I, II, or not otherwise specified (NOS). Age at menarche was both considered as a continuous variable and categorized into three groups: early menarche (≤11 years), normal menarche (12-14 years), and late menarche (≥15 years). The study focused on two sets of comparisons, by age at menarche and women with vs. without children. Spearman correlation matrix was produced to calculate correlations between the variables of interest. Socio-demographic and clinical characteristics between early, normal and late menarche, and women with vs. without children were examined through descriptive statistics. Finally, adjusted logistic regression analysis was run to examine the association between variables. RESULTS Out of 288 women included in the study, 21.5% had early menarche, 55.6% had normal, and 22.9% had late menarche. Women with early menarche had higher rates of metabolic syndrome compared to women with normal menarche even after adjustment for age. The subgroup of women with children does not present clinical differences compared to women without children except a lower rate of psychiatric comorbidities. At least one mood episode with peripartum onset occurred in 29.6% of the women with children. After controlling for confounding variables, women with late menarche were associated with lower probability of BD peripartum episodes compared to women with normal menarche. CONCLUSION Age at menarche may be related to specific characteristics of women with BD. The results deserve to be deepened in further studies.
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Affiliation(s)
- Gianluca Rosso
- Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy.,Psychiatric Unit, San Luigi Gonzaga University Hospital, Torino, Italy
| | - Elena Aragno
- Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Emina Mehanović
- Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Gabriele Di Salvo
- Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Giuseppe Maina
- Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy.,Psychiatric Unit, San Luigi Gonzaga University Hospital, Torino, Italy
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Abstract
BACKGROUND Menstrual pain is one of the common gynaecological presentations of women of reproductive age to health care physicians. In Ghana, there exist a paucity of research on the risk factors of dysmenorrhea among older females. OBJECTIVES Very few studies in Ghana have addressed the risk factors for severe dysmenorrhea among University students. This study aims to identify the common risk factors and associated symptoms of menstrual pain which have been previously not caught the attention of researchers in Ghana. METHODOLOGY The study was a descriptive cross-sectional study involving to two hundred female undergraduate students of the University of Cape Coast (UCC), Ghana. Data collected and analysed using standardized and acceptable statistical tools. Verbal multidimensional scoring system for assessment of dysmenorrhoea severity was used in this study to assess the severity of dysmenorrhoea. RESULTS More than half (57.3%) of the respondents having pain beginning within the first two days of their menses. The common risk factors that predicted severity of dysmenorrhea (p<0.05) were quantity of menstrual flow and family history of menstrual pain. The common symptoms that accompanied dysmenorrhea were tiredness, loss of appetite, backache, dizziness, diarrhoea and mood changes (p<0.05). CONCLUSION Dysmenorrhea is a serious public health problem which can be incapacitating. We advocate for more attention to reduce the burden of its negative consequences.
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Affiliation(s)
| | - Martins Ekor
- School of Medical Sciences, University of Cape Coast, Ghana
- Department of Pharmacology, School of Medical Sciences, University of Cape Coast
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Borjigen A, Huang C, Liu M, Lu J, Peng H, Sapkota C, Sheng J. Status and Factors of Menstrual Knowledge, Attitudes, Behaviors and Their Correlation with Psychological Stress in Adolescent Girls. J Pediatr Adolesc Gynecol 2019; 32:584-589. [PMID: 31445139 DOI: 10.1016/j.jpag.2019.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/01/2019] [Accepted: 08/15/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Adolescent girls perceive menstruation as a negative experience, which can affect adolescents' physical and mental health. The aims of this study were to describe the menstrual knowledge, attitudes, and behaviors of adolescent girls in China and to examine their association with psychological stress. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A cross-sectional study was conducted among 1349 adolescent girls aged 11-14 years in Changsha, China. Participants anonymously completed questionnaires that assessed sociodemographic characteristics, menstrual knowledge and attitudes, dysmenorrhea self-care behaviors, and perceived stress. One-way analysis of variance and Pearson r correlation and multiple linear regression analyses were conducted to examine the differences and associations among variables. RESULTS The mean age of menarche was 11.70 (±0.82) years. A total of 1053/1349 (78.1%) of girls had a knowledge of menstruation before menarche and their mothers were the main source 931/1349 (69.0%) of their knowledge. More than half (53.4%) of adolescent girls experienced different degrees of dysmenorrhea. The mother's education, family monthly income, family type, and the girls' age, grade, menstrual status, age at menarche, sanitary napkin change frequency, menstrual restrictions, and dysmenorrhea influenced menstrual knowledge, attitudes, and practice. Psychological stress was affected by age, grade, age at menarche, sanitary napkin change frequency, menstrual restrictions, dysmenorrhea, and menstrual knowledge, attitudes, and practices. CONCLUSION Psychological stress management during menstruation should be a focus of health education programs for adolescent girls. During adolescence, health care providers should not only pay attention to the physical changes of adolescence girls, but also provide stress management skills to help them cope with menstrual-related concerns.
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Affiliation(s)
| | - Chi Huang
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Mengxiang Liu
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Jing Lu
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Huiting Peng
- Xiang Ya Nursing School, Central South University, Changsha, China
| | | | - Jiangming Sheng
- The Second Xiang Ya Hospital, Central South University, Changsha, China.
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Jiang Z, Wang J, Guo X, Feng L, Yu M, Zhou J, Ye Y, Mei L, Ju L, Yu D, Shi L, Lu Alex C, Yu W, Lou J. Menstrual disorders and occupational exposures among female nurses: A nationwide cross-sectional study. Int J Nurs Stud 2019; 95:49-55. [PMID: 31059897 DOI: 10.1016/j.ijnurstu.2019.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 04/04/2019] [Accepted: 04/15/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND The regularity of menstrual cycles is one of the important indicators of female reproductive health. However, the current evidence on the association of occupational exposures and menstrual disorders is scarce. OBJECTIVES This study aims to elucidate the relationship between occupational hazards and menstrual characteristics in female nurses and non-nurse health care workers in China. DESIGN We conducted a national cross-sectional study on the reproductive health of female nurses in China. SETTINGS A total of 1, 300 medical institutions in 15 provincial administrative regions in China participated in the study. PARTICIPANTS There were 8, 904 nurses and 3, 977 non-nurse health care workers who were selected using simple random sampling method. METHODS All participants were administered a face-to-face standardized questionnaire, including personal socio-demographic information, occupational activities, and self-reported menstrual characteristics. Univariate and multivariate logistic regressions were used for statistical analyses. RESULTS The results demonstrated that 41% of nurses experienced menstrual disorders. We found handling disinfectants was the most significant risk factor for menstrual disorders (OR = 1.53, 95% CI: 1.39-1.68), followed by abnormal workload (OR = 1.28, 95% CI: 1.19-1.39), and occupation as a nurse (OR = 1.28, 95% CI: 1.18-1.40). Noise, prolonged standing or frequent heavy lifting, night work, anti-cancer drug exposure, and overtime work were moderately associated with the occurrence of menstrual disorder (OR > 1). CONCLUSIONS This national-wide cross-sectional study has revealed the significant association between menstrual disorders and occupational hazards among female nurses in China.
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Affiliation(s)
- Zhaoqiang Jiang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China.
| | - Jing Wang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China.
| | - Xinnian Guo
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Lingfang Feng
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Min Yu
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Jianhong Zhou
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, 1 Xueshi Road, Hangzhou, 310006, China.
| | - Yan Ye
- Department of Occupational Health, Beijing Center for Diseases Prevention and Control, Beijing, China
| | - Liangying Mei
- Hubei Provincial Center for Disease Control and Prevention, Wu Han, China
| | - Li Ju
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Dandan Yu
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Li Shi
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China
| | - Chensheng Lu Alex
- Department of Environmental Health, Harvard T.H Chan School of Public Health, Boston, MA 02115, USA
| | - Wenlan Yu
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, 29 South Latitude Road, Xicheng District, Beijing, 100050, China.
| | - Jianlin Lou
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, China.
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Zakaria R, Amor H, Baali A. Age at menarche and place of residence (Marrakesh, Morocco). Arch Pediatr 2019; 26:30-33. [DOI: 10.1016/j.arcped.2018.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 10/14/2018] [Indexed: 10/27/2022]
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Bianchin L, Bozzola M, Battistella Pier A, Bernasconi S, Bona G, Buzi F, De Sanctis C, De Sanctis V, Tonini G, Radetti G, Rigon F, Perissinotto E. Menstrual Cycle and Headache in Teenagers. Indian J Pediatr 2019; 86:25-33. [PMID: 30637681 DOI: 10.1007/s12098-018-2829-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/28/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This population-based study on school-aged girls aimed to estimate the rate of peri-menstrual headache, evaluate headache pain pattern during the menstrual cycle, and verify its relationships with physical, psychosocial and life-style factors. METHODS The students (n = 4973) fulfilled a self-administered questionnaire on demographic and behavioral characteristics, menarche, menstrual pattern and features including headache and dysmenorrhea. The prevalence of headache and the mean pain intensity score at the three menstrual cycle phases (premenstrual, menstrual, in-between period) were estimated, both overall and by gynecological year. Furthermore, the prevalence of three different patterns of headache (peri menstrual/mid-cycle/acyclic) was evaluated, together with the mean pain intensity score. RESULTS The overall prevalence of headache at least once at any time during the menstrual cycle was 64.4%. At multivariable logistic analysis, gynecological age (OR 1.07; 95%CI 1.03-1.12), middle social level (1.24; 1.01-1.55, compared to high social level), physical activity (0.67; 0.51-0.89), oral contraceptive use (1.34; 1.04-1.73) and dysmenorrhea (2.30; 1.54-3.42) were significantly associated with headache. Among girls with headache, 83.4% had peri-menstrual headache (44.6% premenstrual, 38.8% menstrual), 3.5% mid-cycle headache and 13.2% acyclic headache. The gynaecological age and dysmenorrhea were significantly associated with the headache pattern (p = 0.03 and p < 0.0001, respectively). CONCLUSIONS This study suggests that peri-menstrual headache is highly prevalent among adolescents. In girls, the headache rate linearly raises with higher gynecological age; menses-related painful syndromes, such as headache and dysmenorrhea, are strongly interrelated. The anamnesis and monitoring of menstrual health should be mandatory when taking care of girls with headache.
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Affiliation(s)
- Luigi Bianchin
- Child Psychiatric Unit, Local Health and Social Care Services - ULSS 6 Euganea, Padua, Italy
| | - Mauro Bozzola
- Internal Medicine and Therapeutics, Section of Childhood and Adolescence, Foundation IRCCS San Matteo, University of Pavia, Pavia, Italy
| | | | | | - Gianni Bona
- Division of Pediatrics, Department of Mother and Child Health, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | - Fabio Buzi
- Department of Pediatrics, "Carlo Poma" Hospital, Mantova, Italy
| | - Carlo De Sanctis
- Department of Pediatric Endocrinology, Ospedale Infantile Regina Margherita, Turin, Italy
| | - Vincenzo De Sanctis
- Private Accredited Hospital Quisisana, Pediatric and Adolescent Outpatients Clinic, Ferrara, Italy
| | | | - Giorgio Radetti
- Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - Franco Rigon
- Department of Woman's and Child Health, University of Padua, Padua, Italy
| | - Egle Perissinotto
- Unit of Biostatistics, Epidemiology Public Health, Department of Cardiac, Thoracic, Vascular Science and Public Health, University of Padua, Padua, Italy.
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De Sanctis V, Rigon F, Bernasconi S, Bianchin L, Bona G, Bozzola M, Buzi F, De Sanctis C, Tonini G, Radetti G, Perissinotto E. Age at Menarche and Menstrual Abnormalities in Adolescence: Does it Matter? The Evidence from a Large Survey among Italian Secondary Schoolgirls. Indian J Pediatr 2019; 86:34-41. [PMID: 30628040 DOI: 10.1007/s12098-018-2822-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 11/16/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore the independent role of age at menarche on menstrual abnormalities among adolescents. METHODS The present study was a multicenter cross-sectional study on a large sample (n = 3782) of Italian girls aged 13-21 y attending secondary school who already had menarche. Girls were asked to fill in a questionnaire on menarcheal age and menstrual features during the latest three menses. The gynecological age was computed as the difference between age at the survey and the age at menarche. Main outcome measures were: prevalence of oligomenorrhea, polymenorrhea, menstrual cycle irregularity, abnormal bleeding length and dysmenorrhea. Irregularity in the recent past and since menarche was also studied. Multiple logistic models were used to identify any independent association between each abnormal feature and age at menarche or gynecological age. Adjusted ORs and 95%CI were performed. RESULTS After adjusting for covariates, menarcheal age was not independently associated with polymenorrhea (OR = 0.81; 95%CI 0.63-1.04), oligomenorrhea (OR = 1.16; 95%CI 0.94-1.43), menstrual cycle irregularity (OR = 0.99; 95%CI 0.86-1.14), abnormal bleeding length (OR = 0.96; 95%CI 0.87-1.06) and dysmenorrhea (OR = 1.03; 95%CI 0.85-1.24). The multivariate analysis suggests that the higher prevalence of oligomenorrhea and menstrual cycle irregularity among the girls who were older at menarche might be purely explained by their younger gynecological age. CONCLUSIONS No evidence of any independent influence of age at menarche on menstrual abnormalities among young girls was shown by the investigation. The findings suggest that, after menarche, adolescent girls' menstrual health should be checked to monitor the endocrine system maturation and to early intercept latent disorders becoming symptomatic.
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Affiliation(s)
- Vincenzo De Sanctis
- Private Accredited Hospital Quisisana, Pediatric and Adolescent Outpatients Clinic, Ferrara, Italy
| | - Franco Rigon
- Department of Women's and Child Health, University of Padua, Padua, Italy
| | | | - Luigi Bianchin
- Child Psychiatric Unit, Local Health and Social Care Services - ULSS 6 Euganea, Padua, Italy
| | - Gianni Bona
- Division of Pediatrics, Department of Mother and Child Health, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | - Mauro Bozzola
- Internal Medicine and Therapeutics, Section of Childhood and Adolescence, Foundation IRCCS San Matteo, University of Pavia, Pavia, Italy
| | - Fabio Buzi
- Department of Pediatrics, "Carlo Poma" Hospital, Mantova, Italy
| | - Carlo De Sanctis
- Department of Pediatric Endocrinology, Ospedale Infantile Regina Margherita, Turin, Italy
| | | | - Giorgio Radetti
- Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - Egle Perissinotto
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Science and Public Health, University of Padua, Padua, Italy.
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Gunn HM, Tsai MC, McRae A, Steinbeck KS. Menstrual Patterns in the First Gynecological Year: A Systematic Review. J Pediatr Adolesc Gynecol 2018; 31:557-565.e6. [PMID: 30064002 DOI: 10.1016/j.jpag.2018.07.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/13/2018] [Accepted: 07/22/2018] [Indexed: 01/15/2023]
Abstract
STUDY OBJECTIVE Understanding what constitutes a normal menstrual cycle during the first gynecological year (GY1) is a common concern of adolescents and clinicians. However, limited high-quality evidence exists. We aimed to summarize published literature regarding menstrual and ovulatory patterns in GY1. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Electronic databases (MEDLINE, Pre-MEDLINE, Embase, Web of Science, CINAHL, Cochrane Library) were systematically searched from database inception to 2018. Eligible studies described menstrual cycles, symptoms, or validated ovulatory data in healthy adolescents in GY1. Two authors independently screened studies, extracted data, and assessed methodological quality. RESULTS Twenty-two studies involving more than 2000 adolescents were included. Thirteen recorded menstrual cycle and/or symptom data and 14 measured ovulation. Mean cycle length ranged from 32 to 61 days and decreased throughout GY1. Mean menses length was 4.9 to 5.4 days. Frequent menstrual bleeding was reported in up to 23% of participants, infrequent menstrual bleeding in up to one-third, and "irregular menstrual bleeding" in up to 43%. Dysmenorrhea was reported by 30%-89% of participants. Prevalence of ovulatory cycles identified using luteal phase serum or salivary progesterone or urinary pregnanediol was 0 to 45% and increased throughout GY1. However, all used definitions that would be considered subovulatory in clinical practice. CONCLUSION Menstrual and ovulatory patterns in GY1 are diverse and differ from those of adults. A transitional phase of menstrual and ovulatory immaturity is common. However, ovulation, irregular cycles, and dysmenorrhea are not uncommon. As such, safe sexual practice should be advocated and prompt medical management should be accessible.
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Affiliation(s)
- Harriet Mary Gunn
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, New South Wales, Australia; Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia; UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.
| | - Meng-Che Tsai
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Paediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Alexandra McRae
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, New South Wales, Australia; Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
| | - Katharine S Steinbeck
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, New South Wales, Australia; Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
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Epidemiological aspects of dysmenorrhea among female students at Jouf University, Saudi Arabia. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2018.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Omani Samani R, Almasi Hashiani A, Razavi M, Vesali S, Rezaeinejad M, Maroufizadeh S, Sepidarkish M. The prevalence of menstrual disorders in Iran: A systematic review and meta-analysis. Int J Reprod Biomed 2018; 16:665-678. [PMID: 30775681 PMCID: PMC6350848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Understanding the prevalence of menstrual disorders has important implications for both health service planning and risk factor epidemiology. OBJECTIVE The aim of this review is to identify and collate studies describing the prevalence of menstrual disorders in Iran. MATERIALS AND METHODS Studies with original data related to the prevalence of menstrual disorders were identified via searching six electronic databases and reviewing citations. All abstracts or titles found by the electronic searches were independently scrutinized by two reviewers. The Meta-analysis was performed with a random effects model, considering the remarkable heterogeneity among studies. A total of 35 eligible epidemiological studies were included in this review. RESULTS Overall, the pooled prevalence of primary dysmenorrhea was 73.27% (95% CI=65.12-81.42). The mean proportion of women with oligomenorrhea was 13.11% (95.5%, 95% CI: 10.04-16.19). We identified 16 studies that reported polymenorrhoea with a random effect of pooled prevalence estimate of 9.94% (95% CI 7.33%-12.56%). The prevalence estimate of hypermenorrhea was 12.94% (95% CI 9.31%-16.57%). Overall prevalence of hypomenorrhea was 5.25% (95% CI 3.20%-7.30%), ranging from 0.9- 12.90%. Pooling six studies that reported estimates for menorrhagia, the overall prevalence was 19.24% (95% CI 12.78-25.69). Overall, 6.04% (95% CI: 1.99-10.08) of the women were shown to have metrorrhagia. CONCLUSION This systematic review suggests that the average prevalence of menstrual disorders in Iran is substantial. It has been neglected as a fundamental problem of women's reproductive health. Diagnosis and treatment of these disorders should be included in the primary health care system of reproductive health.
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Affiliation(s)
- Reza Omani Samani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Amir Almasi Hashiani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Maryam Razavi
- Pregnancy Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Samira Vesali
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Mahroo Rezaeinejad
- Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Saman Maroufizadeh
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Mahdi Sepidarkish
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
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Negi P, Mishra A, Lakhera P. Menstrual abnormalities and their association with lifestyle pattern in adolescent girls of Garhwal, India. J Family Med Prim Care 2018; 7:804-808. [PMID: 30234057 PMCID: PMC6132013 DOI: 10.4103/jfmpc.jfmpc_159_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study tried to find out the prevalence of menstrual abnormalities in adolescent girls and their association with dietary and exercise pattern in Garhwal region of India. MATERIALS AND METHODS In this study, cross-sectional questionnaires survey was conducted in different schools of Garhwal. These questionnaires were based on socioeconomic data, dietary and physical activities, and menstrual abnormalities. RESULTS The age of menarche was 13.5 ± 0.64 years. Dysmenorrhea (62.75%), premenstrual syndrome (PMS) (40.42%), and irregular cycle (28.72%) were observed common problems among adolescent girls. The result showed that dysmenorrhea, PMS, and menstrual irregularities were directly associated with dietary habits and physical activities. Dysmenorrhea was associated with eating junk food (66.10%), and PMS was associated with lacking of physical activities (78.94%). CONCLUSION The result suggests that feeding habit and physical activities directly affecting the menstrual health of adolescent girls.
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Affiliation(s)
- Priyanka Negi
- Department of Zoology and Biotechnology, HNB Garhwal University, Srinagar, Uttarakhand, India
| | - Aprajita Mishra
- Department of Zoology and Biotechnology, HNB Garhwal University, Srinagar, Uttarakhand, India
| | - Pramesh Lakhera
- Department of Zoology and Biotechnology, HNB Garhwal University, Srinagar, Uttarakhand, India
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Association Between Menstrual Disorders and Obesity-Related Anthropometric Indices in Female High School Students: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2018. [DOI: 10.5812/intjsh.65716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Peña AS, Doherty DA, Atkinson HC, Hickey M, Norman RJ, Hart R. The majority of irregular menstrual cycles in adolescence are ovulatory: results of a prospective study. Arch Dis Child 2018; 103:235-239. [PMID: 28794095 DOI: 10.1136/archdischild-2017-312968] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 05/16/2017] [Accepted: 06/06/2017] [Indexed: 11/04/2022]
Abstract
PURPOSE While ovulation is most likely to occur in adolescent girls with regular menstrual cycles, there are limited data on the incidence of ovulation in girls with irregular menstrual cycles in early postmenarcheal years. The aim of the study was to evaluate the presence of ovulation in healthy postmenarcheal girls with irregular menstrual cycles. METHODS, DESIGN AND SUBJECTS Prospective cohort study over 12 weeks including 40 healthy postmenarcheal girls recruited from the population-based cohort of adolescents from Western Australian Pregnancy Cohort (Raine) Study with irregular menstrual cycles defined by either menstrual cycles <21 days or >35 days in duration or cycle length that varied from month to month by >4 days according to menstrual diaries. MAIN OUTCOME MEASURE Ovulation defined by urinary pregnanediol-3α-glucuronide/creatinine measurements higher than three times above minimum value obtained from 12 samples (1 per week). RESULTS Forty girls (37 Caucasians) with irregular menstrual cycles aged 15.1 (median (IQR) 14.9-15.4) years who were 2.3 (1.9-3.3) years postmenarche were assessed. Urinary pregnanediol-3α-glucuronide/creatinine values identified that 33 girls (82.5%) ovulated during the 3 months of observation and 7 girls had anovulatory cycles. Menstrual diaries collected for a median (IQR) of 159 (137.5-188.2) days showed median minimal and maximum menstrual cycle duration of 24 (11.5-29) and 38.5 (35-48) days, respectively. CONCLUSIONS A large proportion of healthy adolescent girls with irregular menstrual cycles are still ovulating despite irregular and infrequent menses.
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Affiliation(s)
- Alexia S Peña
- Discipline of Paediatrics, University of Adelaide, Adelaide, South Australia, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrine and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Dorota A Doherty
- School of Women's and Infants' Health, Women and Infants Research Foundation, University of Western Australia, Perth, Western Australia, Australia
| | - Helen C Atkinson
- School of Women's and Infants' Health, Women and Infants Research Foundation, University of Western Australia, Perth, Western Australia, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Robert J Norman
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Discipline of Obstetrics, University of Adelaide, Adelaide, South Australia, Australia
| | - Roger Hart
- School of Women's and Infants' Health, Women and Infants Research Foundation, University of Western Australia, Perth, Western Australia, Australia
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Zhang Y, Mao X, Su J, Geng Y, Guo R, Tang S, Li J, Xiao X, Xu H, Yang H. A network pharmacology-based strategy deciphers the underlying molecular mechanisms of Qixuehe Capsule in the treatment of menstrual disorders. Chin Med 2017; 12:23. [PMID: 28835770 PMCID: PMC5563918 DOI: 10.1186/s13020-017-0145-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 08/16/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND QiXueHe Capsule (QXHC) is a Chinese patent drug that is extensively used for the treatment of menstrual disorders. However, its underlying pharmacological mechanisms have not been fully elucidated. METHODS A list of QXHC putative targets were predicted using MetaDrug. An interaction network using links between QXHC putative targets and the known therapeutic targets of menstrual disorders was constructed. QXHC candidate targets were also identified via calculating the topological feature values of nodes in the network. Additionally, molecular docking simulation was performed to determine the binding efficiency of QXHC compound-putative target pairs. RESULTS A total of 1022 putative targets were predicted for 311 chemical components containing in QXHC. Following the calculation of topological features of QXHC putative target-known therapeutic target of menstrual disorder network, 66 QXHC candidate targets for the treatment of menstrual disorders were identified. Functionally, QXHC candidate targets were significantly associated with several biological pathways, such as VEGF and Chemokine signaling pathways, Alanine/aspartate/glutamate metabolism, Long-term depression and T/B cell receptor signaling pathway. Moreover, molecular docking simulation demonstrated that there were 20 pairs of QXHC chemical component-candidate target had the strong binding free energy. CONCLUSIONS This novel and scientific network pharmacology-based study holistically deciphers that the pharmacological mechanisms of QXHC in the treatment of menstrual disorders may be associated with its involvement into hemopoiesis, analgesia, nutrients absorption and metabolism, mood regulation, as well as immune modulation.
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Affiliation(s)
- Yanqiong Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, No. 16, Nanxiaojie, Dongzhimennei, Beijing, 100700 China
| | - Xia Mao
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, No. 16, Nanxiaojie, Dongzhimennei, Beijing, 100700 China
| | - Jing Su
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, No. 16, Nanxiaojie, Dongzhimennei, Beijing, 100700 China
| | - Ya Geng
- School of Basic Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250300 China
| | - Rui Guo
- College of Pharmacy, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193 China
| | - Shihuan Tang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, No. 16, Nanxiaojie, Dongzhimennei, Beijing, 100700 China
| | - Junfang Li
- College of Pharmacy, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193 China
| | - Xuefeng Xiao
- College of Pharmacy, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193 China
| | - Haiyu Xu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, No. 16, Nanxiaojie, Dongzhimennei, Beijing, 100700 China
| | - Hongjun Yang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, No. 16, Nanxiaojie, Dongzhimennei, Beijing, 100700 China
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Endocrine Abnormalities in Adolescents with Menstrual Disorders. J Obstet Gynaecol India 2017; 68:58-64. [PMID: 29391677 DOI: 10.1007/s13224-017-1035-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022] Open
Abstract
Purpose To look for endocrine abnormalities like thyroid disorders, hyperprolactinemia, hyperandrogenism and PCOS among adolescents with menstrual disorders and to compare the above endocrine status with those without menstrual disorders. Methods This was a case-control study carried out in adolescent girls aged 10-19 years in gynecology outpatient department of a tertiary care hospital. Sample of venous blood (5 ml) was taken for hormonal studies as clinically indicated-thyroid function test, serum prolactin, total testosterone, which were analyzed by chemiluminescence system. Results Oligomenorrhea was the most common menstrual abnormality in our study, the prevalence being 61.0% in cases followed by primary amenorrhea (16.4%). Thyroid dysfunction was found in 13.6% girls with menstrual disorders compared to 3.5% in those without menstrual disorders, and this was statistically significant (p = 0.006). Biochemical hyperandrogenism was seen in 9.04% cases compared to 0.7% controls (p = 0.001). The overall prevalence of hyperprolactinemia was 0.94%, and there was no statistically significant difference in girls with and without menstrual disorders. The prevalence of PCOS was 12.4% in the study population and 22.6% cases. Oligomenorrhea and PCOS were the most prevalent phenotypes in 52.5% of PCOS girls. No endocrine abnormality was detected in cases of polymenorrhea, hypomenorrhea and intermenstrual bleeding. Conclusions Although immaturity of hypothalamic pituitary ovarian axis is considered to be the most common cause of menstrual irregularities in adolescent girls, endocrine abnormalities, namely thyroid dysfunction and hyperandrogenism, may be responsible in some cases, thus warranting further evaluation.
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Tondo L, Pinna M, Serra G, De Chiara L, Baldessarini RJ. Age at menarche predicts age at onset of major affective and anxiety disorders. Eur Psychiatry 2016; 39:80-85. [PMID: 27992810 DOI: 10.1016/j.eurpsy.2016.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 07/31/2016] [Accepted: 08/01/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Menarche age has been associated inconsistently with the occurrence, timing or severity of major depressive disorder (MDD), but rarely studied in women with bipolar (BDs) or anxiety disorders. METHODS We investigated women patients at a Sardinian mood disorder center for associations of age at menarche with age at illness onset for major affective or anxiety disorders, year of birth, and other selected factors, using bivariate comparisons and multivariate regression modeling. RESULTS Among women (n=1139) with DSM-IV MDD (n=557), BD-I (n=223), BD-II (n=178), or anxiety disorders (n=181), born in 1904-1998, of mean age 42.9 years, menarche age averaged 12.8 [CI: 12.7-12.9] years. Illness onset age averaged 30.9 [30.1-31.8] years, ranking: BD-I, 25.8; anxiety disorders, 28.0; BD-II, 30.3; MDD, 34.1 years. Menarche age declined secularly over birth years, and was associated with younger illness-onset, having no or fewer siblings, more psychiatrically ill first-degree relatives, living in rural environments, being suicidal, substance abuse, and being unemployed. Earlier menarche and earlier illness-onset were significantly associated for onset age groups of ≤ 20, 20-39, and > 40 years. Menarche age versus diagnosis ranked: BD-II<BD-I<anxiety disorders<MDD. CONCLUSIONS Age at menarche in Sardinia, as elsewhere, has declined over the past decades. It was strongly associated with age at onset of bipolar and anxiety, as well as major depressive disorders across the age range, suggesting sustained effects of biological maturational factors.
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Affiliation(s)
- L Tondo
- International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Lucio Bini Mood Disorder Centers, Cagliari and Rome, Italy.
| | - M Pinna
- Lucio Bini Mood Disorder Centers, Cagliari and Rome, Italy
| | - G Serra
- International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; NESMOS Department of Psychiatry, Faculty of Medicine, University (Sapienza) of Rome, Rome, Italy; Child Neuropsychiatry Unit, Department of Neuroscience, IRCCS Children Hospital Bambino Gesù, Rome, Italy
| | - L De Chiara
- NESMOS Department of Psychiatry, Faculty of Medicine, University (Sapienza) of Rome, Rome, Italy
| | - R J Baldessarini
- International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Ponziani V, Gennari M, Pizza F, Balsamo A, Bernardi F, Plazzi G. Growing Up with Type 1 Narcolepsy: Its Anthropometric and Endocrine Features. J Clin Sleep Med 2016; 12:1649-1657. [PMID: 27707443 DOI: 10.5664/jcsm.6352] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/31/2016] [Indexed: 12/22/2022]
Abstract
STUDY OBJECTIVES To evaluate the effect of type 1 narcolepsy (NT1) on anthropometric and endocrine features in childhood/adolescence, focusing on patterns and correlates of weight, pubertal development, and growth in treated and untreated patients. METHODS We collected anthropometric (height, weight, body mass index (BMI) z-scores), pubertal, metabolic, and endocrine data from 72 NT1 patients at diagnosis and all available premorbid anthropometric parameters of patients from their pediatric files (n = 30). New measurements at 1-y reassessment in patients undergoing different treatments were compared with baseline data. RESULTS We detected a high prevalence of overweight (29.2%), obesity (25%), metabolic syndrome (18.8%), and precocious puberty (16.1%), but no signs of linear growth alterations at diagnosis. According to anthropometric records, weight gain started soon after NT1 onset. At 1-y follow-up reassessment, sodium oxybate treatment was associated with a significant BMI z-score reduction (-1.29 ± 0.30, p < 0.0005) after adjusting for baseline age, sex, sleepiness, and BMI. CONCLUSIONS NT1 onset in children/adolescents is associated with rapid weight gain up to overweight/obesity and precocious puberty without affecting growth. In our study, sodium oxybate treatment resulted in a significant weight reduction in NT1 overweight/obese patients at 1-y follow-up.
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Affiliation(s)
- Virginia Ponziani
- Pediatric Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Monia Gennari
- Pediatric Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Fabio Pizza
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy.,IRCCS Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy
| | - Antonio Balsamo
- Pediatric Endocrinology Unit, Center for Rare Endocrine Diseases, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Filippo Bernardi
- Pediatric Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy.,IRCCS Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy
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Sharma S, Deuja S, Saha CG. Menstrual pattern among adolescent girls of Pokhara Valley: a cross sectional study. BMC WOMENS HEALTH 2016; 16:74. [PMID: 27938370 PMCID: PMC5148896 DOI: 10.1186/s12905-016-0354-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 12/03/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Menstruation is a normal physiological process occurring every month throughout the reproductive age of the females. However, significant variation in menstrual pattern is observed among adolescents. The objective of this study was to determine menstrual pattern among adolescent girls of Pokhara Valley. METHOD A cross sectional study was conducted in seven schools of Pokhara Valley. A total of 260 adolescent girls were included in the study. Girls were requested to complete questionnaire containing 19 items. Selected girls voluntarily agreed to answer questionnaire under the supervision of the researcher and then the data was analyzed. RESULTS Mean age of the girls was 14.0 ± 1.3 years. Mean age at menarche was 12.2 ± 0.9 years. The mean cycle length of the subjects was 34.8 ± 11.8 days. It was observed that as many as 167(64.2%) girls had irregular menstrual cycle and significant association was found between regularity of menstruation and ethnicity. Seven (2.7%) girls had a menstrual cycle length shorter than 21 days, 60(23.1%) had cycle longer than 35 days and 193(74.2%) had a normal cycle length between 21 and 35 days. Majority 231(88.8%) had normal duration of menstruation. Dysmenorrhoea was reported by more than half of the girls and significant association was found between severity of dysmenorrhoea with school absenteeism and treatment needed. CONCLUSION Dysmenorrhoea was the most common menstrual problem among adolescent girls. Girls' school attendance was affected due to menstrual pain. Girls with severe dysmenorrhea needed medical treatment. Irregular menstruation was reported by more than half of the girls and significant association was found with the ethnicity.
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Affiliation(s)
- Sudha Sharma
- Department of Physiology, Manipal College of Medical Sciences, Deep Height, P.O. Box 155, Pokhara, Nepal.
| | - Sajana Deuja
- Department of Physiology, Manipal College of Medical Sciences, Deep Height, P.O. Box 155, Pokhara, Nepal
| | - C G Saha
- Department of Physiology, Manipal College of Medical Sciences, Deep Height, P.O. Box 155, Pokhara, Nepal
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Tayebi N, Yazdznpanahi Z, Yektatalab S, Akbarzadeh M. The Association Between Menarche Age and Birth Weight, Mother and Older Sister’s Age of Menarche. RAZAVI INTERNATIONAL JOURNAL OF MEDICINE 2016. [DOI: 10.17795/rijm40320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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The Association Between Menarche Age and Birth Weight, Mother and Older Sister’s Age of Menarche. RAZAVI INTERNATIONAL JOURNAL OF MEDICINE 2016. [DOI: 10.5812/rijm.40320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Jung AN, Park JH, Kim J, Kim SH, Jee BC, Cha BH, Sull JW, Jun JH. Detrimental Effects of Higher Body Mass Index and Smoking Habits on Menstrual Cycles in Korean Women. J Womens Health (Larchmt) 2016; 26:83-90. [PMID: 27603944 DOI: 10.1089/jwh.2015.5634] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Alteration of menstrual cycle by individual lifestyles and unfavorable habits may cause menstrual irregularity. We aimed to investigate the relationship between lifestyle factors and menstrual irregularity in Korean women using data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012. MATERIALS AND METHODS This cross-sectional study included 3779 nondiabetic Korean women aged 19-49 years who did not take any oral contraceptives or sex hormonal compounds. We examined the association of menstrual irregularity with age, body mass index (BMI), drinking experience, and smoking habits. RESULTS Age, Asian BMI, marriage status, age at menarche, and smoking habits were significantly associated with menstrual cycle irregularity (p < 0.01). The prevalence of menstrual irregularity was significantly increased at younger ages: 18.4%, 10.3%, and 10.5% at 19-29, 30-39, and 40-49 years, respectively. Moreover, obesity groups, defined as per Asian BMI using modified WHO criteria, were strongly associated with menstrual irregularity. BMI 25.0-29.9 [obesity class I] (adjusted odds ratios [OR], 1.94; 95% confidence intervals [CI], 1.37-2.74) and ≥30.0 [obesity class II] (adjusted OR, 2.18; 95% CI, 1.22-3.91) presented significantly higher risk of menstrual irregularity compared with BMI 18.5-22.9 [normal weight]. Multivariable analysis revealed that high BMI in younger women aged 19-29 years (p < 0.001) and smoking habits in middle-aged women aged 30-39 years (p < 0.005) significantly predicted menstrual irregularity. CONCLUSION This study substantiated that menstrual irregularity was closely associated with higher BMI and smoking habits in nondiabetic Korean women. Weight loss and smoking cessation should be recommended to promote women's reproductive health.
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Affiliation(s)
- An Na Jung
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea.,2 Samkwang Medical Laboratories , Seoul, Korea
| | - Ju Hwan Park
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea.,3 Hankook Institute of Life Science , Seoul, Korea
| | - Jihyun Kim
- 4 Department of Senior Healthcare, BK21 Plus Program, Graduated School, Eulji University , Daejeon, Korea
| | - Seok Hyun Kim
- 5 Department of Obstetrics and Gynecology, Seoul National University College of Medicine , Seoul, Korea
| | - Byung Chul Jee
- 6 Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital , Seongnam-si, Gyeonggi-do, Korea
| | - Byung Heun Cha
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea
| | - Jae Woong Sull
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea.,4 Department of Senior Healthcare, BK21 Plus Program, Graduated School, Eulji University , Daejeon, Korea
| | - Jin Hyun Jun
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea.,4 Department of Senior Healthcare, BK21 Plus Program, Graduated School, Eulji University , Daejeon, Korea.,7 Eulji Medi-Bio Research Institute (EMBRI), Eulji University , Seongnam-si, Gyeonggi-do, Korea
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Su JJ, Lindell D. Promoting the menstrual health of adolescent girls in China. Nurs Health Sci 2016; 18:481-487. [PMID: 27325429 DOI: 10.1111/nhs.12295] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 04/24/2016] [Accepted: 04/26/2016] [Indexed: 01/04/2023]
Abstract
In China, nurses have limited presence in schools, thus, adolescent girls often lack accurate information about menstrual health, which may lead to incorrect and unhealthy menstrual-related behavior. This study investigated the effects of a culturally and developmentally tailored nursing intervention on the menstrual health of adolescent girls in China. Following institutional review board approval, adolescent girls aged 12-15 were recruited from two schools. A quasi-experimental, pretest-posttest design examined the effects of five interactive education sessions on menstrual health. The final sample included 116 adolescent girls. Significant improvement was observed in the intervention group regarding menstrual knowledge, confidence in performing menstrual healthcare behavior, and dysmenorrhea related self-care behavior. A nurse-managed education program improved adolescent girls' menstrual knowledge, promoted a more positive attitude, encouraged confidence, and improved pain relief practice. We recommend that professional nurses globally advocate for school nursing and routine menstrual health education for adolescent girls.
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Affiliation(s)
- Jing Jing Su
- HOPE School of Nursing, Wuhan University, Wuhan, China
| | - Deborah Lindell
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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Nooh AM, Abdul-Hady A, El-Attar N. Nature and Prevalence of Menstrual Disorders among Teenage Female Students at Zagazig University, Zagazig, Egypt. J Pediatr Adolesc Gynecol 2016; 29:137-42. [PMID: 26343844 DOI: 10.1016/j.jpag.2015.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/23/2015] [Accepted: 08/26/2015] [Indexed: 10/23/2022]
Abstract
STUDY OBJECTIVE To determine the nature and prevalence of menstrual disorders among teenage girls. DESIGN An observational descriptive cross-sectional study. SETTING Zagazig University Students' Hospital, Zagazig, Egypt. PARTICIPANTS A representative sample of female students who attended the university pre-enrollment medical examination. INTERVENTIONS Self-administered questionnaire covering items on the adolescents' demographic data and menstruation characteristics. MAIN OUTCOME MEASURES Information about menarche, body mass index, physical exercise, cycle length and regularity, duration of menses, menstrual blood loss, dysmenorrhea, and premenstrual syndrome. RESULTS A total of 285 questionnaires were analyzed. Mean age at menarche was 12.3 ± 1.5 years. Oligomenorrhea was reported by 18 participants (6.3%) and 5 others (1.8%) mentioned having polymenorrhea. Hypomenorrhea was noted in 25 students (8.8%), and hypermenorrhea was reported by 12 (4.2%). Irregular periods were mentioned by 24 students (8.4%). Dysmenorrhea was reported in 188 students (66.0%). Of these, 81 (28.4%) graded their pain as mild, 69 (24.2%) as moderate, and 38 (13.3%) as severe. Premenstrual syndrome was mentioned by 160 girls (56.1%). Consulting somebody regarding their menstrual problems was reported by 36 students (12.6%). CONCLUSION Our results are not greatly different from those in other parts of the world. Data on nature and prevalence of menstrual disorders and their effect on young women's health status, quality of life, and social integration suggest that management of these disorders should be given more attention within the available reproductive health care programs. Further research into prevalence of and risk factors for menstrual disorders and their morbidity is warranted and anxiously awaited.
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Affiliation(s)
- Ahmed M Nooh
- Department of Obstetrics and Gynaecology, Zagazig University Students' Hospital, Zagazig, Egypt.
| | - Atiea Abdul-Hady
- Department of Medicine, Zagazig University Students' Hospital, Zagazig, Egypt
| | - Nadia El-Attar
- Department of Anesthesia, Zagazig University Students' Hospital, Zagazig, Egypt
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Ibrahim NK, AlGhamdi MS, Al-Shaibani AN, AlAmri FA, Alharbi HA, Al-Jadani AK, Alfaidi RA. Dysmenorrhea among female medical students in King Abdulaziz University: Prevalence, Predictors and outcome. Pak J Med Sci 2016; 31:1312-7. [PMID: 26870088 PMCID: PMC4744273 DOI: 10.12669/pjms.316.8752] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To determine the prevalence, predictors and outcome of dysmenorrhea among female medical students in King Abdulaziz University (KAU), Jeddah, Saudi Arabia. Methods: A cross-sectional study was conducted among 435 medical students at KAU, Jeddah selected through stratified random sample method. A pre-constructed, validated, self-administered questionnaire was used to collect personal and socio-demographic information. Data about menstrual history, stress, smoking were also collected. The severity of dysmenorrhea was scored by the “Visual Analogue Scale (VAS)”. Descriptive and analytical statistics were conducted. Results: The prevalence of dysmenorrhea was 60.9%. Logistic regression showed that heavy period was the first predictor of dysmenorrhea (aOR=1.94; 95% CI: 1.29- 2.91), followed by stress (aOR=1.90; 95% C.I.: 1.19-3.07). The prevalence of severe dysmenorrhea among the sufferers was 38.6%. Depressed mood was the commonest (80.8%) symptom accompanying dysmenorrhea. Regarding the outcome of dysmenorrhea, 67.5% of the sufferes reported emotional instability, while 28.3% reported absenteeism from the university. Conclusions: A high prevalence of dysmenorrhea was prevalent among medical students in King Abdulaziz University (KAU), Health promotion, screening programs, and stress management courses are recommended.
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Affiliation(s)
- Nahla Khamis Ibrahim
- Nahla Khamis Ibrahim, Professor, Family & Community Medicine Dept., Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Manar Saleh AlGhamdi
- Manar Saleh AlGhamdi, Fifth Year Medical Students, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alanoud Nawaf Al-Shaibani
- Alanoud Nawaf Al-Shaibani, Fifth Year Medical Students, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fatima Ali AlAmri
- Fatima Ali AlAmri, Fifth Year Medical Students, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Huda Abdulrahman Alharbi
- Huda Abdulrahman Alharbi, Fifth Year Medical Students, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Arwa Kheder Al-Jadani
- Arwa Kheder Al-Jadani, Fifth Year Medical Students, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Raghad Ahmed Alfaidi
- Raghad Ahmed Alfaidi, Fifth Year Medical Students, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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De Sanctis V, Soliman AT, Elsedfy H, Soliman NA, Soliman R, El Kholy M. Dysmenorrhea in adolescents and young adults: a review in different country. ACTA BIO-MEDICA : ATENEI PARMENSIS 2016; 87:233-246. [PMID: 28112688 PMCID: PMC10521891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/13/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Dysmenorrhea is still an important public health problem which may have a negative impact on female health, social relationships, school or work activities and psychological status. METHODS The aim of this review is a better understanding of the epidemiology of dysmenorrhoea and its effect on public health. Published studies in English providing relevant information on dysmenorrhea were identified by searching PubMed, Embase and Google; restricting the population to adolescents and young adult women and the year of publishing from 2010 to August 2015, based on the keywords 'dysmenorrhea', 'adolescents' and 'epidemiology'. In addition, the reference lists of the selected articles were examined. RESULTS We found 50 studies that met our inclusion criteria. The majority were cross-sectional studies on 41,140 adolescents and young women published from 2010 onward. The prevalence of dysmenorrhea varied from 34 % (Egypt) to 94% (Oman) and the number of participants, reporting very severe pain varied from 0.9 % (Korea) to 59.8% (Bangladesh). Adolescents who missed school due to dysmenorrhoea ranged from 7.7% to 57.8% and 21.5% missed social activities. About 50% of students (53.7%-47.4%) reported a family history of dysmenorrhea. Incidence of dysmenorrhea was 0.97 times lower as age in-creased (p <0.006). Despite the high prevalence of dysmenorrhea in adolescents, many girls did not receive professional help or treatment. Mothers were the most important persons the girls turned to for answers regarding menstruation, followed by peers (52.9%) and school nurse. From 21% to 96% practised self-medication either by pharmacological or non pharmacological interventions. The limitation of these studies was that they did not distinguish between primary dysmenorrhea and secondary dysmenorrhea. CONCLUSIONS The main gynecological complaint of adolescents is dysmenorrhea. Morbidity due to dysmenorrhea represents a substantial public health burden. It is one of the leading causes of absenteeism from school and work and is responsible for significant diminished quality of life. Despite its high prevalence and associated negative effects, many adolescents do not seek medical care for this condition. Appropriate counselling and management should be instituted among female students to help them cope with the challenges of dysmenorrhea. Information, education and support should also be extended to parents, school peer leaders, and hostel administrators in order to address the reproductive health needs of the female students.
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Nor Asyikin Y, Nani D, Nor Azwany Y, Shamsul Kamal A, Imran A, Shaiful Bahari I, Rosediani M. Knowledge of and attitudes towards of menstrual disorders adults in north-eastern state of Peninsular Malaysia. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2015; 10:2-10. [PMID: 27570602 PMCID: PMC4992348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION In Malaysia, the prevalence of menstrual disorders among adolescents and young adults is high. However, most of them are not aware of the signs and symptoms of menstrual disorders in terms of medical issue as well as Islamic ruling. Awareness of the menstrual disorder symptoms is important so that early and appropriate treatment can be given. OBJECTIVES The objective of the study was to compare the knowledge and attitude of premarital men and women on menstrual disorders. METHODS This was a comparative cross sectional study conducted in Kota Bharu, Kelantan. Selfadministered questionnaires were given for data collection. The questionnaires consisted of 3 parts that required information on the women's and men's socio-demographic data, women's menstrual history and information in knowledge and attitude of men and women on menstrual disorders. RESULTS A total of 460 respondents were involved in this study with a response rate of 93.5%. The prevalence of good knowledge was higher among women compared to men with 73.2% and 26.8%, respectively. There was a significant difference on knowledge and attitude on menstrual disorders between premarital men and women. CONCLUSION Both premarital men and women had low knowledge on menstrual disorder with men knowing less than the women.
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Affiliation(s)
- Y Nor Asyikin
- MMed (F Medicine) Department of Family Medicine School of Medical Science Universiti Sains Malaysia Health Campus,16150 Kubang Kerian, Kelantan, Malaysia
| | - D Nani
- (Corresponding author) MMed (F Medicine) Department of Family Medicine School of Medical Science Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Y Nor Azwany
- MCommMed (Epidemiology & Biostatistics) Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian,16150, Kelantan, Malaysia
| | - A Shamsul Kamal
- BA.Hons.Syariah Politeknik Kota Bharu, Km 24 Kok Lanas, 16450 Ketereh, Kelantan, Malaysia
| | - A Imran
- MMed (F Medicine) Department of Family Medicine School of Medical Science Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - I Shaiful Bahari
- MMed (F Medicine) Department of Family Medicine School of Medical Science Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - M Rosediani
- MMed (F Medicine) Department of Family Medicine School of Medical Science Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
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İşgüven P, Yörük G, Çizmecioğlu FM. Educational Needs of Adolescents Regarding Normal Puberty and Menstrual Patterns. J Clin Res Pediatr Endocrinol 2015; 7:312-22. [PMID: 26777043 PMCID: PMC4805219 DOI: 10.4274/jcrpe.2144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The study aimed to determine the level of knowledge and the sources of information about normal puberty and menstrual patterns in Turkish schoolgirls from İstanbul. METHODS The study sample was comprised of 922 randomly chosen schoolgirls. A questionnaire survey of knowledge of normal pubertal development and menstrual patterns was conducted. RESULTS The age of the girls ranged between 10 and 17 years and 82.3% had had menarche. The leading source of pubertal information was the mothers (84.2%). There was no statistically significant relationship between the mothers' education level and the level of knowledge of the students about pubertal development (p>0.05). The main source for 18% of students was their teacher, but only 6% had a preference for their teacher providing education on this topic. Students who attained menarche preferred education about puberty to be given by health professionals and to both genders at the same setting (p<0.01). A total of 31.5% of students thought that the first symptom of puberty was acne. Half (50.7%) of the students did not know the time period between the beginning of puberty and menarche. The girls who had attained menarche were more knowledgeable about puberty, largely through their own experience. CONCLUSION This study shows that schoolgirls have an insufficient level of knowledge about normal puberty. Education programs must be conducted for students and their parents.
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Affiliation(s)
- Pınar İşgüven
- Sakarya University Faculty of Medicine, Department of Pediatric Endocrinology, Sakarya, Turkey Phone: +90 216 495 68 26 E-mail:
| | - Göze Yörük
- Medeniyet University Faculty of Medicine, Göztepe Research and Education Hospital, Clinic of Pediatrics, İstanbul, Turkey
| | - Filiz Mine Çizmecioğlu
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
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Menstrual disorders among Zagazig University Students, Zagazig, Egypt. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2015. [DOI: 10.1016/j.mefs.2014.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Prevalence and correlates of anaemia in adolescents in Riyadh city, Kingdom of Saudi Arabia. Public Health Nutr 2015; 18:3192-200. [PMID: 25936397 DOI: 10.1017/s1368980015001214] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To determine the prevalence and correlates of anaemia in male and female adolescents in Riyadh, Kingdom of Saudi Arabia. DESIGN A cross-sectional community-based study. SETTING Five primary health-care centres in Riyadh. SUBJECTS We invited 203 male and 292 female adolescents aged 13-18 years for interview, anthropometric measurements and complete blood count. Blood Hb was measured with a Coulter Cellular Analysis System using the light scattering method. RESULTS Using the WHO cut-off of Hb<12 g/dl, 16·7 % (n 34) of males and 34·2 % (n 100) of females were suffering from anaemia. Mean Hb in males and females was 13·5 (sd 1·4) and 12·3 (sd 1·2) g/dl, respectively. Values for mean cell volume, mean cell Hb, mean corpuscular Hb concentration and red cell distribution width in male and female adolescents were 77·8 (sd 6·2) v. 76·4 (sd 10·3) μm(3), 26·1 (sd 2·7) v. 25·5 (sd 2·6) pg, 32·7 (sd 2·4) v. 32·2 (sd 2·6) g/dl and 13·9 (sd 1·4) v. 13·6 (sd 1·3) %, respectively. Multivariate logistic regression revealed that a positive family history of Fe-deficiency anaemia (OR=4·7; 95 % CI 1·7, 12·2), infrequent intake (OR=3·7; 95 % CI 1·3, 10·0) and never intake of fresh juices (OR=3·5; 95 % CI 1·4, 9·5) and being 13-14 years of age (OR=3·1; 95 % CI 1·2, 9·3) were significantly associated with anaemia in male adolescents; whereas in females, family history of Fe-deficiency anaemia (OR=3·4; 95 % CI 1·5, 7·6), being overweight (OR=3·0; 95 % CI 1·4, 6·1), no intake of fresh juices (OR=2·6; 95 % CI 1·4, 5·1), living in an apartment (OR=2·0; 95 % CI 1·1, 3·8) and living in a small house (OR=2·5; 95 % CI 1·2, 5·3) were significantly associated with anaemia. CONCLUSIONS Anaemia is more prevalent among Saudi female adolescents as compared with males. Important factors like positive family history of Fe-deficiency anaemia, overweight, lack of fresh juice intake and low socio-economic status are significantly associated with anaemia in adolescents.
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