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Menstrual disturbances are common among adolescents with a prevalence rate of 11.3–26.7%. The most frequent menstrual irregularities are oligomenorrhea, menorrhagia, polymenorrhoea, and hypomenorrhea. PCOS (polycystic ovarian syndrome) is now recognized as the most prevalent endocrine disorder among the women of reproductive age. The current study was planned to evaluate socio-demographic factors, endocrine profiles, and ovarian morphology among adolescent girls with menstrual irregularities and compare these parameters in different phenotypes of adolescent PCOS cases. It is a hospital-based cross-sectional study among 248 adolescent girls (10–19 years) with menstrual irregularities. After obtaining informed consent, history and clinical examination findings were recorded on preform proforma. All girls were assessed on day 2/3 of the menstrual cycle for hormonal profile (serum TSH, FSH, LH, prolactin, and serum testosterone) and ovarian morphology (by transabdominal ultrasonography). All participating girls were divided into three groups (groups 1, 2, and 3) corresponding to phenotypes A, B, & D as per the Rotterdam criteria. In the study, oligomenorrhea was the most common menstrual disorder (70.97%). Biochemical hyperandrogenism and thyroid dysfunction were reported in 14.91% and 8.46% of girls, respectively. Our study noted that phenotype D ,i.e., group 3 (MI + PCOM-HA; 49.43%) was the most common phenotype in the study. In a comparative analysis of different groups, significant differences ( p < 0.05 ) in hormonal and metabolic parameters showed highest in group 2, which represents phenotype B of PCOS (hyperandrogenic anovulation). This analysis revealed that adolescent hyperandrogenism (phenotypes A and B) is associated with a more deranged hormonal and metabolic profile than nonandrogenic PCOS (phenotype D). To prevent long-term sequelae, lifestyle changes, early treatment, and close follow-up are recommended in this subset of girls.

BACKGROUND: Energy deficiency can result in menstrual disturbances and compromised bone health in women, a condition known as the Female Athlete Triad. OBJECTIVES: The REFUEL randomized controlled trial assessed the impact of increased energy intake on bone health and menstrual function in exercising women with menstrual disturbances. METHODS: Exercising women with oligomenorrhea/amenorrhea (Oligo/Amen) were randomly assigned to an intervention group (Oligo/Amen + Cal, n = 40, mean ± SEM age: 21.3 ± 0.5 y; weight: 55.0 ± 1.0 kg; BMI: 20.4 ± 0.3 kg/m(2)) who increased energy intake 20%–40% above baseline energy needs for 12 mo or a control group (Oligo/Amen Control, n = 36; mean ± SEM age: 20.7 ± 0.5 y; weight: 59.1 ± 1.3 kg; BMI: 21.3 ± 0.4 kg/m(2)). Energy intake and expenditure, metabolic and reproductive hormones, body composition, and areal bone mineral density (aBMD) were assessed. RESULTS: Oligo/Amen + Cal improved energy status [increased body mass (2.6 ± 0.4 kg), BMI (0.9 ± 0.2 kg/m(2)), fat mass (2.0 ± 0.3 kg), body fat percentage (2.7% ± 0.4%), and insulin-like growth factor 1 (37.4 ± 14.6 ng/mL)] compared with Oligo/Amen Control and experienced a greater likelihood of menses (P 0.05). Both groups demonstrated decreased femoral neck aBMD at month 6 (−0.006 g/cm(2); 95% CI: −0.011, −0.0002 g/cm(2) ; time main effect P = 0.043) and month 12 (−0.011 g/cm(2); 95% CI: −0.021, −0.001 g/cm(2); time main effect P = 0.023). Both groups demonstrated a decrease in total hip aBMD at month 6 (−0.006 g/cm(2); 95% CI: −0.011, −0.002 g/cm(2); time main effect P = 0.004). CONCLUSIONS: Although higher dietary energy intake increased weight, body fat, and menstrual frequency, bone mineral density was not improved, compared with the control group. The 12-mo intervention may have been too short and the increase in energy intake (∼352 kcal/d), although sufficient to increase menstrual frequency, was insufficient to increase estrogen or improve aBMD. Future research should refine the optimal nutritional and/or pharmacological interventions for the recovery of bone health in athletes and exercising women with Oligo/Amen. This trial was registered at clinicaltrials.gov as NCT00392873.

To determine the variation in anti-Mullerian hormone (AMH) and androstenedione (A4) concentrations in adolescent girls, with or without menstrual cycle disorder in relation to phenotypic features of. PCOS.Adolescent girls (n = 129), age range 14-19 years, were recruited in the cohort study. All participants were in the 4th or 5th year after menarche. Sixty-eight had menstrual irregularities, usually oligomenorrhea (OM), and 61 had regular menstruation (RM). AMH and A4 concentrations were measured. Hirsutism was recorded. Polycystic ovarian morphology (PCOM) was evaluated by transabdominal pelvic ultrasonography. Polycystic ovary syndrome (PCOS) features were defined according to Rotterdam consensus criteria.AMH and A4 were significantly higher in adolescent girls with OM than in girls with RM (p 0.05). A4 and body mass index (BMI) of adolescents with OM was significantly higher in those with hirsutism than those without hirsutism (p = 0.01 and 0.008, respectively). There was a positive correlation between A4 and BMI (r: 0.327, p 0.01). Logistic regression showed that the frequency of OM in the presence of PCOM was 10.8 times (95% CI 2.04-12.09) compared to those without PCOM. The highest AMH concentrations were found in girls with OM, hirsutism, and PCOM (p 0.05).AMH and A4 are elevated in adolescents with oligomenorrhoea. High A4 is more prominent in the presence of hirsutism and is associated with increased BMI. PCOM, increases the likelihood of oligomenorrhea by about 10 times. AMH increase as the combination of clinical features of PCOS increases in adolescents with menstrual irregularity.

To evaluate whether the health-related quality-of-life (HRQoL) scores would be different for adolescents with menstrual problems as compared to those with normal menstruation after taking into account clinical, socio-demographic and life-style factors.The Paediatric Quality of Life Inventory 4.0 scale was used to assess HRQoL in 126 schoolgirls of 16 ± 0.4 years old. The adolescents completed semi-structured questionnaires containing information on social and demographic characteristics, life-style features and menstrual questionnaires that included the following: age of menstruation, menstrual cycle length, duration of production, the number of pads used per day, menstrual pain and drug administration to relieve dysmenorrhea. The menstrual problems were classified into three main groups: dysmenorrhoea, oligomenorrhoea, and heavy menstrual bleeding. Anthropometric measurements were performed by a physician. Medical history was obtained from school medical charts.Ninety-seven (77%) girls had menstrual problems. Dysmenorrhoea (n = 92, 73%) was the most frequent of these, followed by oligomenorrhoea (n = 13, 10.3%) and heavy menstrual bleeding (n = 6, 4.8%). Thirteen (10.3%) girls had combined disorders. A multivariate analysis adjusted for life-style factors found an independent association of any menstrual problems, oligomenorrhoea and dysmenorrhoea with low HRQoL scores in the emotional functioning domain. For adolescents with oligomenorrhoea, an association with low total scale scores was also shown but it did not reach statistical significance.The prevalence of menstrual problems is high among schoolgirls. Medical professionals working with adolescents should know that girls with menstrual problems are highly likely to have a poor quality of life, especially those with oligomenorrhoea.

Background. In reproductive women, transplant disturbs the menstrual cycle pattern. The two major conditions usually encountered are amenorrhea and menorrhagia.The objective of the study was to assess the pattern of menstrual cycle after kidney transplant in reproductive women.Materials and methods. This cross-sectional study was carried out in a public sector hospital of Karachi, Pakistan. A total 69 patients of reproductive age were included who underwent living kidney donor transplant for more than a year ago. Women having genital tract infection, using hormonal treatment, organic cause of genital tract, clotting disorder and severe cardiac and/ or peripheral vascular disease were excluded. Frequency and percentages were calculated for demographic characteristics. Correlation and association analysis was calculated for type of menstruation with menstrual cycle pattern. A P-value less than 0.05 was considered statistically significant.Results. Majority of female included in the study aged between 35–39 years (36, 52.2%). The most frequent menstrual disturbance observed was heavy menstrual bleeding (22, 31.9%) and amenorrhea (21, 30.4%). Only 2.9% cases showed normal menstrual pattern. The cross tabulation indicated that 26.1% patients had amenorrhea, 24.6% had oligomenorrhea and 31.9% had menorrhagia. The Durbin–Watson value of 0.656 indicated a strong positive relationship between menstruation cycle pattern (dependent variable) and type of menstruation, marital status, donor’s age, children and living location of the patients (independent variables).Conclusion. From the result of the present study, it is concluded that the reproductive age women have shown a disturbed pattern of menstrual cycle after kidney transplant. The major observation was that such patients reported amenorrhea, menorrhagia, oligomenorrhea and hypomenorrhea.

Research objective:to determine the frequency of vitamin D deficiency and insufficiency to identify its association with reproductive hormones in adolescent girls with oligomenorrhea. Materials and methods.The work was carried out according to the results of clinical and instrumental examination of 68 adolescent girls 12–18 years old with oligomenorrhea, who were treated at the Department of Pediatric Gynecology of the State Institution “Institute for Children and Adolescents Health Care of the NAMS of Ukraine”. Patients were divided into two groups depending on the body mass index (BMI): group I – with a body weight deficit (BMI 16.31 ± 0.18 kg/m2), group II – with a BMI within physiological norm (20.0 ± 0.25 kg/m2). All patients underwent a comprehensive clinical and laboratory examination: luteinizing, follicle-stimulating hormones, prolactin, estradiol, testosterone, cortisol, 25(OH)D were determined in blood serum. Multivariate regression analysis was using for analyze the association of gonаdotropic, steroid hormones with vitamin D. The main characteristics of the object discrimination model are presented in the form of tables. Results.The article provides a comparative analysis of the hormonal profile and vitamin D level depending on BMI. It was revealed that a reduced 25(OH)D value was characteristic not only in patients with menstrual dysfunction, but also in peers with normal menstrual function. Schemes that characterize the pituitary-gonadal association with vitamin D were constructed based on the results of multiple regression analysis. Their features were determined in girls with different body weights. In patients with low energy resources there were direct associations between individual indicators of gonadotropins (follicle-stimulating hormone), steroid hormones (estradiol, cortisol) and vitamin D. An inverse association was observed between vitamin D and cortisol and prolactin in girls with balanced energy status. Conclusions.The reduced content of vitamin D is characteristically for patients with menstrual dysfunctions by the type of oligomenorrhea. Associations of gonadotropic, steroid hormones and vitamin D, depending on the energy status (nutrition) of patients with oligomenorrhea were revealed.

In recent years in Ukraine and in the world there has been a clear tendency towards deterioration in the indicators of the somatic health of children and adolescents, that is negatively affects the processes of reproductive health formation and it state in the future. Concern for adolescent girl's health, including their reproductive system, forms an enormous contribution to the society future. That's why big attention is paid to the formation and saving reproductive health of adolescent girls. The period of sexual development is defining in a woman's life and is considered a key moment on the path of reproductive maturity. Today it has been established that the reproductive health formation is influenced by environmental, socio-economic factors and the presence of somatic diseases. Despite the fact that the pathogenetic mechanisms of the reproductive system formation are extremely complex and sensitive to the effects of negative factors, the appearance of destructive factors at this time can disrupt the physiological chain of functioning of the hormonal mechanisms which regulate the reproductive system. Disorders of the menstrual cycle is one of the most common pathological conditions, combining pathogenetically different diseases, which are manifested by a violation of the menstrual duration and frequency, amount of menstrual flow. According to domestic literature, hypomenstrual syndrome (oligomenorrhea, amenorrhea) is in the first place among menstrual dysfunctions in adolescent girls in the structure of gynecological morbidity and is up to 45%. Menstrual irregularities that occur during adolescence often persist into the future, causing infertility, obstetric pathology, perinatal loss and other reproductive health problems during childbearing years. The problem of the menstrual cycle formation has been little studied, but it is socially significant, very relevant and requires further study. Thus, girls with menstrual disorders constitute a group of increased risk of gynecological diseases in women of reproductive age, since many chronic diseases of adults are a protracted pathology of adolescents. Therefore, adolescent girls should be examined and treated by a specialist in pediatric and adolescent gynecology, pediatric endocrinologist, pediatrician and family doctor.

STUDY QUESTION Does maternal polycystic ovarian syndrome (PCOS) affect the timing of pubertal development in daughters and sons? SUMMARY ANSWER Maternal PCOS was associated with earlier adrenarche in daughters. WHAT IS KNOWN ALREADY Female adolescents with PCOS often experience earlier adrenarche compared to adolescents without PCOS, due to hyperandrogenism. Likewise, they usually have hyperandrogenism during pregnancy, which might potentially affect the development of the foetus, including its future reproductive health. STUDY DESIGN, SIZE, DURATION In this population-based cohort study, we included 15 596 mothers–child pairs from the Danish National Birth Cohort (DNBC) Puberty Cohort, who were followed from foetal life until full sexual maturation or 18 years of age. PARTICIPANTS/MATERIALS, SETTING, METHODS Using register-based and self-reported information on maternal PCOS and menstrual irregularities, collected during pregnancy, we categorized the mothers as having PCOS (n = 251), oligomenorhoea (n = 134), ‘other menstrual irregularities’ (n = 2411) or no menstrual abnormalities (reference group, n = 12 800). The children provided self-reported information on pubertal development every 6 months from the age of 11 years. The main outcome measures were adjusted mean age differences (in months) at attaining several individual pubertal milestones using an interval-censored regression model, as well as the average difference in age at attaining all pubertal milestones combined into a single estimate using Huber–White robust variance estimation. MAIN RESULTS AND THE ROLE OF CHANCE We found that maternal PCOS was associated with an accelerated pubertal development in daughters with an overall average difference of −3.3 (95% CI: −6.3; −0.4) months based on all pubertal milestones compared to the reference group. When further looking into the average difference for adrenarche only (pubarche, axillary hair and acne), the average difference was −5.4 (95% CI: −8.7; −2.1) months compared to the reference group; whereas thelarche and menarche did not occur earlier in daughters of mothers with PCOS (average difference: −0.8 (95% CI: −3.9; 2.4) months). Oligomenorrhoea and ‘other menstrual irregularities’ were not associated with pubertal development in daughters. Neither PCOS, oligomenorrhoea nor ‘other menstrual irregularities’ were associated with pubertal development in sons. LIMITATIONS, REASONS FOR CAUTION We expect some degree of non-differential misclassification of maternal PCOS and menstrual irregularities as well as pubertal development in the children. WIDER IMPLICATIONS OF THE FINDINGS Maternal PCOS might accelerate adrenarche in daughters. Whether this is due to genetics, epigenetics or prenatal programming by hyperandrogenism in foetal life remains unsolved. The results from the present study can be generalized to Caucasian populations. STUDY FUNDING/COMPETING INTEREST(S) The study is funded by the Faculty of Health at Aarhus University. The authors have no financial relationships or competing interests to disclose. TRIAL REGISTRATION NUMBER N/A.

The aim of this study was to rapidly review the literature on the prevalence of menstrual disorders in female athletes from different sports modalities. Articles were searched in the Web of Science and PubMed database in May 2022. A total of 1309 records were identified, and 48 studies were included in the final stage. The menstrual disorders described in the included studies were primary (in 33% of included studies) and secondary amenorrhea (in 73% of included studies) and oligomenorrhea (in 69% of included studies). The prevalence of menstrual disorders among the studies ranged from 0 to 61%. When data were pooled according to discipline (mean calculation), the highest prevalence of primary amenorrhea was found in rhythmic gymnastics (25%), soccer (20%) and swimming (19%); for secondary amenorrhea in cycling (56%), triathlon (40%) and rhythmic gymnastics (31%); and oligomenorrhea in boxing (55%), rhythmic gymnastics (44%) and artistic gymnastics (32%). Based on the results of this review, the study supports the literature of the higher prevalence of menstrual disorders in gymnastics and endurance disciplines. However, team sports modalities such as volleyball and soccer also presented a considerable percentage of menstrual disorders compared to the general population. It reinforces the importance of coaches and physicians paying attention to athletes’ menstrual cycle as the occurrence of menstrual disorders can be associated with impairment on some health components.

STUDY QUESTION Does increased daily energy intake lead to menstrual recovery in exercising women with oligomenorrhoea (Oligo) or amenorrhoea (Amen)? SUMMARY ANSWER A modest increase in daily energy intake (330 ± 65 kcal/day; 18 ± 4%) is sufficient to induce menstrual recovery in exercising women with Oligo/Amen. WHAT IS KNOWN ALREADY Optimal energy availability is critical for normal reproductive function, but the magnitude of increased energy intake necessary for menstrual recovery in exercising women, along with the associated metabolic changes, is not known. STUDY DESIGN, SIZE, DURATION The REFUEL study (trial # NCT00392873) is the first randomised controlled trial to assess the effectiveness of 12 months of increased energy intake on menstrual function in 76 exercising women with menstrual disturbances. Participants were randomised (block method) to increase energy intake 20–40% above baseline energy needs (Oligo/Amen + Cal, n = 40) or maintain energy intake (Oligo/Amen Control, n = 36). The study was performed from 2006 to 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were Amen and Oligo exercising women (age = 21.0 ± 0.3 years, BMI = 20.8 ± 0.2 kg/m2, body fat = 24.7 ± 0.6%) recruited from two universities. Detailed assessment of menstrual function was performed using logs and measures of daily urinary ovarian steroids. Body composition and metabolic outcomes were assessed every 3 months. MAIN RESULTS AND THE ROLE OF CHANCE Using an intent-to-treat analysis, the Oligo/Amen + Cal group was more likely to experience menses during the intervention than the Oligo/Amen Control group (P = 0.002; hazard ratio [CI] = 1.91 [1.27, 2.89]). In the intent-to-treat analysis, the Oligo/Amen + Cal group demonstrated a greater increase in energy intake, body weight, percent body fat and total triiodothyronine (TT3) compared to the Oligo/Amen Control group (P LIMITATIONS, REASONS FOR CAUTION While we had a greater than expected dropout rate for the 12-month intervention, it was comparable to other shorter interventions of 3–6 months in duration. Menstrual recovery defined herein does not account for quality of recovery. WIDER IMPLICATIONS OF THE FINDINGS Expanding upon findings in shorter, non-randomised studies, a modest increase in daily energy intake (330 ± 65 kcal/day; 18 ± 4%) is sufficient to induce menstrual recovery in exercising women with Oligo/Amen. Improved metabolism, as demonstrated by a modest increase in body weight (4.9%), percent body fat (13%) and TT3 (16%), was associated with menstrual recovery. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the U.S. Department of Defense: U.S. Army Medical Research and Material Command (Grant PR054531). Additional research assistance provided by the Penn State Clinical Research Center was supported by the National Center for Advancing Translation Sciences, National Institutes of Health, through Grant UL1 TR002014. M.P.O. was supported in part by the Loretta Anne Rogers Chair in Eating Disorders at University of Toronto and University Health Network. All authors report no conflict of interest. TRIAL REGISTRATION NUMBER NCT00392873 TRIAL REGISTRATION DATE October 2006 DATE OF FIRST PATIENT’S ENROLMENT September 2006

Since the definition of secondary amenorrhea is cessation of regular menses for more than 3 months, it is likely that athletes with irregular menstrual cycles, including oligomenorrhea, do not consider the condition as serious. However, the consequences of untreated oligomenorrhea have not been investigated in elite track and field athletes. The cohort consisted of 91 elite-level track and field athletes. Body compositions, including bone parameters and bone turnover markers (BTMs), were measured. Among the 91 participants, 52 were eumenorrheic and 33 were oligomenorrheic. The eumenorrheic athletes had significantly higher bone mineral density (BMD) and bone mineral content (BMC) of the lumbar spine, lower extremities, and whole body than had the oligomenorrheic athletes (p

Background Current evidence supports the adoption of healthy diet and physical activity (PA) behaviors in patients with polycystic ovary syndrome (PCOS), given the positive effects of those behaviors on physical well-being. An improved understanding of the associations between diet and PA with PCOS is needed to ascertain whether tailored dietary and PA recommendations are needed for this population. Thus, we investigated the associations of diet and PA with PCOS and its isolated features. Methods Cross-sectional study. Of the 748 women who were included in this study from the Coronary Artery Risk Development in Young Adults (CARDIA) Women’s Study, 40 were classified as having PCOS, 104 had isolated hyperandrogenism (HA) and 75 had isolated oligomenorrhea (OA). Dietary intake was measured using the CARDIA diet history questionnaire and diet quality was scored using the Alternative Healthy Eating Index 2010; a higher score indicated a better quality diet. Self-reported PA was measured using a validated interviewer-administered questionnaire. Polytomous logistic regression analyses examined the associations between diet and PA with PCOS, HA, and OA status (outcomes), adjusting for age, race, total energy intake, education, and/or body mass index. The threshold for statistical significance was set at p Results Mean age of the participants was 25.4 years (SD 3.6) and 46.8% of participants were Black women. There was little to no association of total energy intake, nutrients, diet quality, and PA with PCOS, HA or OA status. Conclusion Energy intake, nutrient composition, diet quality, and PA were not associated with PCOS, supporting recent PCOS guidelines of using national recommendations for the general population to encourage health-promoting behaviors among women with PCOS. However, longitudinal studies evaluating changes in diet and physical activity in relation to the development and/or the progression of PCOS are needed to establish a causal association.

Context Anti-Müllerian hormone (AMH) measured in adolescence as biomarker for prediction of adult polycystic ovary syndrome (PCOS) is doubtful but not substantiated. Objective To investigate whether serum AMH levels and other PCOS-associated features in adolescence can predict the presence of PCOS in adulthood. Design and Setting A long-term follow-up study based on a unique adolescent study on menstrual irregularities performed between 1990 and 1997. Participants and interventions AMH was assayed in 271 adolescent girls. Data on PCOS features were combined with AMH levels. In 160 of the 271 (59%) participants, we collected information in adulthood about their menstrual cycle pattern and presence of PCOS (features) by questionnaire 2 decades after the initial study. Results AMH was higher in adolescent girls with oligomenorrhea compared with girls with regular cycles, median (interquartile range): 4.6 (3.1-7.5) versus 2.6 (1.7-3.8) μg/L (P Conclusions Adolescent AMH either alone or adjuvant to adolescent oligomenorrhea does not contribute as prognostic marker for PCOS in adulthood. Therefore, we do not recommend routine its use in clinical practice.

As in women with polycystic ovary syndrome (PCOS), hyperinsulinemia is associated with anovulation in PCOS-like female rhesus monkeys. Insulin sensitizers ameliorate hyperinsulinemia and stimulate ovulatory menstrual cycles in PCOS-like monkeys. To determine whether hyperinsulinemia (>694 pmol/L), alone, induces PCOS-like traits, five PCOS-like female rhesus monkeys with minimal PCOS-like traits, and four control females of similar mid-to-late reproductive years and body mass index, received daily subcutaneous injections of recombinant human insulin or diluent for 6–7 months. A cross-over experimental design enabled use of the same monkeys in each treatment phase. Insulin treatment unexpectedly normalized follicular phase duration in PCOS-like, but not control, females. In response to an intramuscular injection of 200 IU hCG, neither prenatally androgenized nor control females demonstrated ovarian hyperandrogenic responses while receiving insulin. An intravenous GnRH (100 ng/kg) injection also did not reveal evidence of hypergonadotropism. Taken together, these results suggest that experimentally induced adult hyperinsulinemia, alone, is insufficient to induce PCOS-like traits in female rhesus monkeys and to amplify intrinsic PCOS-like pathophysiology.

In this study, we aimed to investigate the relationship between body mass index (BMI), waist circumference (WC) or waist-to-hip ratio (WHR) and oligomenorrhea or irregular menstruation in Chinese women of childbearing age. A total of 1,423 Han women aged 19–39 years who were routinely examined at the Physical Examination Center of Peking University People's Hospital were enrolled by convenience sampling method. All participants were asked to fill up menstrual questionnaires. Binary logistic regression models were used to assess the odds ratio (OR) of different BMI, WC and WHR groups for the prevalence of oligomenorrhea and irregular menstruation. Moreover, we used the ROC curves to compare the predictive effects of BMI, WC and WHR on oligomenorrhea and irregular menstruation. Among the 1,423 participants, 93 women (6.5%) had BMI ≥ 30 kg/m2, 6.5% of the participants had oligomenorrhea, and 22.6% had irregular menstrual menstruation. Overall, those with BMI ≥30 kg/m2 (OR = 2.543; 95%CI 1.332–4.856; p = .005) or WC ≥ 90 cm (OR = 2.023; 95%CI 1.198–3.416; p = .008) were more likely to have long menstrual cycle. The prevalence of irregular menstruation was higher in the BMI ≥30 kg/m2 (OR = 2.509; 95%CI 1.591–3.958; p < .001), WC ≥ 90 cm (OR = 2.299; 95%CI 1.619–3.265; p < .001) and WHR ≥ 0.86 (OR = 1.739; 95%CI 1.293–2.339; p < .001) groups. The ROC curve showed that all three anthropometric indices had predictive effect, while there was no significant difference in predicting oligomenorrhea. WC was a better predictor for irregular menstruation compared with BMI. Obesity, oligomenorrhea and irregular menstruation were common in Chinese women of childbearing age, and obesity was associated with oligomenorrhea and irregular menstruation. Abdominal obesity might have a stronger predictive effect on irregular menstruation.

Aim: to study the peculiarities of the formation of secondary sexual characteristics and menstrual function in girls with hyperandrogenism (HA) during puberty.Materials and methods. We examined 137 adolescent girls with HA aged 12–17 years. All examined girls were divided into 3 groups: 12–13 years (Group I, n = 27); 14–15 years (Group II, n = 63); 16–17 years (Group III, n = 47). The intensity of secondary sexual characteristics was determined by Tanner scale; the severity of hirsutism was assessed by Ferriman–Galway scale. The studied parameters were compared with previously published data from 42 girls without HA symptoms with normal indicators of physical and sexual development that were also divided into 3 age groups: 12–13 years (n = 16), 14–15 years (n = 14), 16–17 years (n = 12).Results. Girls with HA in puberty, starting from 14–15 years, had marked reduction of mammary glands and enhancement of axillary and suprapubic hair growth. In 32.8 % of girls with HA menstrual function was normal; in 67.1 % menses disorders and menstrual irregularities were observed that manifested by opsomenorrhea (31.5 %), juvenile bleedings (19.6 %), oligomenorrhea (18.5 %), amenorrhea (16.3 %), algodismenorrhea (14.1 %).Conclusion. HA in puberty, regardless of origin that caused this pathology, is a high risk factor for pathologies of sexual development and the formation of menstrual dysfunction.

Introduction. Gynecological morbidity in adolescents and young women is presented predominantly by functional disorders that do not have a distinct organic substrate and develop as response to stress factors. Objective: to evaluate the response of the menstrual cycle to the cyclic intake of vitamins and plant extracts in adolescents and young women with stress-dependent menstrual disorders. Materials and methods: The observational study included 40 women aged 16–28 years with anovulatory normogonadotropic ovarian dysfunction that clinically manifested as abnormal uterine bleeding (n = 7), oligomenorrhea (n = 29), or amenorrhea (n = 4). The subjects were recommended a 12-week administration of Time Factor vitamin-plant complex as a food supplement. The examination included the assessment of clinical parameters, hormonal blood profile and autonomic balance, ultrasound monitoring before use and in the 3rd cycle of Time-Factor complex administration. Results: the autonomic dysfunction symptoms reversed to an acceptable level in 62.5% of patients, the average score of autonomic dysfunction decreased from 33.8 ± 11.7 to 16.8 ± 3.87 points (p < 0.001) in 12 weeks’ time. The menstrual intervals reduced from 51.2 ± 11.5 to 32.5 ± 16.2 days (p < 0.01) in 65% of women. Ovulation in the final complex administration cycle was reported in 25% of women. Positive dynamics of folliculogenesis, endometrial thickness and hormone levels in plasma were also observed. Conclusion. The use of Time Factor biologically active complex in adolescents and young women with stress-dependent menstrual disorders improves autonomic balance, quality of life and has a positive effect on the menstrual cycle characteristics. The method is effective for oligomenorrhea-type menstrual disorders and should not be used as the only remedy in patients with amenorrhea or abnormal uterine bleeding.

Objective: To determine the frequency of polycystic ovarian syndrome in female medical students and the risk factors associated with polycystic ovarian syndrome. Study Design: A cross-sectional analytical study. Place and Duration of Study: Combined Military Hospital Lahore Medical College, from Apr to Dec 2017. Methodology: All female medical students studying MBBS in Combined Military Hospital Lahore Medical College in 2017 were included in the study. A structured questionnaire was administered to all female medical students and polycystic ovarian syndrome was diagnosed through Rotterdam criteria. An interview was scheduled with the students diagnosed with polycystic ovarian syndrome to assess the risk factors associated with this condition. Results: Two hundred and forty two students participated in the study with a mean age of 21 ± 1.6 years. The frequency of polycystic ovarian syndrome in female medical students in year 2017 was 19.4% as 47 female students out of 242 fit the rotterdam consensus criteria for polycystic ovarian syndrome. Mean age of the students diagnosed with polycystic ovarian syndrome was 20 ± 1.4 years. Six out of 47 patients (13%) had BMI >30. 37 out of 47 students (78%) used fats/oils/sweets daily or more than once a day. Family history of diabetes mellitus was positive in 34 out of 47 students (72%). Conclusion: Our study showed a high frequency of polycystic ovarian syndrome in female medical students, which calls for a national study to look at its prevalence in our young female population, as it has long-term consequences for their reproductive and metabolic health.

The efficiency of traditional Chinese medicine theory and acupoints shows once more its accurate regulatory capacity by improving women biological cycles with the use of electroacupuncture (EA). Results presented in a research study that preformed ovulation induction in women with anovulation due to polycystic ovary syndrome (PCOS), successfully provided data supporting acupuncture as a natural treatment for infertile women, with no significant side effects. The purpose of this study is to demonstrate how EA treatment can induce ovulation related to the hormonal and neuronal system in women affected by PCOS. This study introduces proof of effectivity and improvement based on the research of the University of Gothenburg, Sweden, that presents a study on how EA can be an alternative to ovulation-inducing drugs, to be considered as a possible holistic regulator of PCOS and symptoms. The study covered 24 women with PCOS and oligo-/amenorrhea who received EA in a low frequency of 2 Hz with a total of 14 treatments applied for 3 months. Samples were taken three times during the study to see fluctuations in hormonal, ovulatory, and symptomatic behavior of PCOS. Results demonstrated effective regular ovulatory inductions in more than a third of women.

STUDY QUESTION Is the severity of menstrual cyclicity related to hyperinsulinemia and dysglycemia in women with hyperandrogenic polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Hyperandrogenic PCOS women with amenorrhea, compared to those with oligomenorrhea or eumenorrhea, had a greater risk of post-challenge hyperinsulinemia, which may explain their higher prevalence of dysglycemia. WHAT IS KNOWN ALREADY PCOS is associated with metabolic dysregulation including insulin resistance (IR) and hyperinsulinemia, risk factors for type 2 diabetes mellitus (T2DM) and other vascular-metabolic morbidities. Although the severity of menstrual cyclicity is associated with IR in PCOS, it is unclear whether, and to what extent, it is related to hyperinsulinemia and glycemic abnormalities. STUDY DESIGN, SIZE, DURATION We prospectively compared the degree of menstrual cyclicity with the presence of dysglycemia (elevated 1-h plasma glucose ≥155 mg/dl; abnormal glucose tolerance [AGT], including prediabetes and T2DM; and AUC for glucose [G-AUC]) or dynamic state hyperinsulinemia (peak insulin levels either at 1 or 2 h of the oral glucose tolerance test (oGTT) and AUC for insulin [I-AUC]) in 333 hyperandrogenic PCOS women. PARTICIPANTS/MATERIALS, SETTING, METHODS In a tertiary care setting, hyperandrogenic PCOS participants with ovulatory eumenorrhea (Ov-Eumeno, n = 25), anovulatory eumenorrhea (Anov-Eumeno, n = 33), oligomenorrhea (Oligo, n = 150) and amenorrhea (Ameno, n = 125) underwent comprehensive phenotyping and a 2-h 75 g oGTT. MAIN RESULTS AND THE ROLE OF CHANCE Mean BMI was greater among Ameno women than among Oligo, Anov-Eumeno or Ov-Eumeno women. Adjusting for BMI, the Ameno group demonstrated higher mean 1- and 2-h insulin and glucose, peak insulin and I-AUC and G-AUC, and either had a higher, or tended toward having a higher, prevalence of elevated 1-h glucose level and prevalence of AGT than the Oligo, Anov-Eumeno or Ov-Eumeno groups. In logistic regression, adjusting for BMI, Ameno women were more likely to have: AGT than Oligo women (odds ratio [OR]: 2.3; 95% CI: 1.3 to 4.2); elevated 1-h glucose (OR: 10.2; CI: 1.3–79.7) than those with Ov-Eumeno; and both AGT (OR: 1.7; CI: 1.1–2.6) and elevated 1-h glucose (OR: 1.8; CI: 1.1–2.8) than those with Anov-Eumeno or Ov-Eumeno when combined. Race/ethnicity, age, waist-to-hip ratio, fasting insulin and glucose, and biochemical or clinical measures of hyperandrogenism were similar across the four menstrual categories. LIMITATIONS, REASONS FOR CAUTION Our study was limited by its cross-sectional nature and by studying women affected by PCOS as defined by the Androgen Excess & PCOS Society criteria (i.e. Rotterdam Phenotypes A, B and C) who were identified in the clinical setting. Consequently, extrapolation of the present data to other PCOS phenotypes (e.g. PCOS Phenotype D) should be made with caution. WIDER IMPLICATIONS OF THE FINDINGS In hyperandrogenic PCOS phenotypes, a history of amenorrhea, compared to oligomenorrhea or eumenorrhea, suggests a more severe cardiometabolic risk, including a higher degree of hyperinsulinemia and greater prevalence of glycemic abnormalities. These findings may assist in refining the treatment and screening guidelines for glycemic abnormalities in PCOS. STUDY FUNDING/COMPETING INTEREST(S) This work was supported in part by grants R01-DK073632 and R01-HD29364 from the NIH and an endowment of the Helping Hand of Los Angeles, Inc. (to R.A.). M.D.P. has no competing interests to declare. U.E. is an investor in Concentric Analgesics, Inc. R.A. serves as a consultant for Spruce Biosciences and Fortress Biotech and an advisor for Aurora Forge. TRIAL REGISTRATION NUMBER N/A.

Polycystic ovary syndrome (PCOS) is one of the most common disorders of reproductive endocrinology affecting women of reproductive age. Our study aims to explore the feasibility of a full-scale trial to evaluate the efficacy and safety of acupuncture for PCOS.This study is a two-armed, parallel, multi-country, multi-center, pilot randomized controlled trial (RCT) for PCOS with oligomenorrhea. We will recruit 60 women aged 20 to 40 years with oligomenorrhea due to PCOS. The participants will be randomly assigned to acupuncture and control groups. The acupuncture group will undergo a total of 40 sessions for 16 weeks with usual care. The control group will be managed with usual care (regular meals, sufficient sleep, and appropriate exercise) only. The primary clinical outcome is mean change in menstrual frequency from baseline to 16 weeks and 32 weeks (follow-up) after the start of the trial. The secondary outcomes are menstrual period, levels of estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and total testosterone, LH/FSH ratio, antral follicle count and ovarian volume, body mass index, waist hip ratio, acne severity, and health-related quality of life questionnaire scores at 16 and 32 weeks after the start of the trial.This is the first protocol for multi-country, multi-center RCTs for PCOS in Korea and China. The control group in this study will be subjected to usual care (regular meals, enough sleep, and appropriate exercise). The results of this study will provide evidence for future clinical decisions and guidelines.This trial has been registered at ClinicalTrials.gov (Identifier: NCT04509817).

Background: Recent studies reported possible concerns following long-lasting treatments with high doses of D-chiro-inositol in women. However, to date, no clinical trial has investigated or validated these concerns. We addressed this issue both retrospectively and with a prospective pilot study. Methods: For the retrospective analysis, we searched our databases for insulin-resistant women who took 1200 mg/day D-chiro-inositol for 6 months. In our prospective study, we enrolled 10 healthy women to supplement with the same therapeutic scheme. We performed statistical analyses through the Wilcoxon Signed-Rank Test. A p-value < 0.05 was considered significant. Results: Twenty women underwent 6 months of 1200 mg/day D-chiro-inositol. The treatment significantly decreased BMI, glycemia, insulinemia, HOMA-IR, serum levels of LH, total testosterone, and DHEAS. Serum estradiol rose and menstrual abnormalities occurred following the treatment. In our prospective study, we observed increases in serum levels of total testosterone and asprosin in healthy women. Conclusions: This is the first clinical evidence demonstrating that long-term treatments with high dosages of D-chiro-inositol can predispose women to hormonal and menstrual abnormalities. Moreover, the accumulation of D-chiro-inositol following such treatment regimen may lead to detrimental effects in non-reproductive tissues, as demonstrated by the increase in asprosin levels.

Research objective: to determine the frequency of vitamin D deficiency and insufficiency to identify its association with reproductive hormones in adolescent girls with oligomenorrhea.Materials and methods. The work was carried out according to the results of clinical and instrumental examination of 68 adolescent girls 12–18 years old with oligomenorrhea, who were treated at the Department of Pediatric Gynecology of the State Institution “Institute for Children and Adolescents Health Care of the NAMS of Ukraine”. Patients were divided into two groups depending on the body mass index (BMI): group I – with a body weight deficit (BMI 16.31 ± 0.18 kg/m2), group II – with a BMI within physiological norm (20.0 ± 0.25 kg/m2). All patients underwent a comprehensive clinical and laboratory examination: luteinizing, follicle-stimulating hormones, prolactin, estradiol, testosterone, cortisol, 25(OH)D were determined in blood serum. Multivariate regression analysis was using for analyze the association of gonаdotropic, steroid hormones with vitamin D. The main characteristics of the object discrimination model are presented in the form of tables.Results. The article provides a comparative analysis of the hormonal profile and vitamin D level depending on BMI. It was revealed that a reduced 25(OH)D value was characteristic not only in patients with menstrual dysfunction, but also in peers with normal menstrual function. Schemes that characterize the pituitary-gonadal association with vitamin D were constructed based on the results of multiple regression analysis. Their features were determined in girls with different body weights. In patients with low energy resources there were direct associations between individual indicators of gonadotropins (follicle-stimulating hormone), steroid hormones (estradiol, cortisol) and vitamin D. An inverse association was observed between vitamin D and cortisol and prolactin in girls with balanced energy status.Conclusions. The reduced content of vitamin D is characteristically for patients with menstrual dysfunctions by the type of oligomenorrhea. Associations of gonadotropic, steroid hormones and vitamin D, depending on the energy status (nutrition) of patients with oligomenorrhea were revealed., Цель исследования: определение частоты дефицита и недостаточности витамина D и выявление его взаимосвязи с репродуктивными гормонами у девочек-подростков с олигоменореей.Материалы и методы. Работа выполнена по результатам клинического и инструментального обследования 68 девочек-подростков в возрасте 12–18 лет с олигоменореей, которые находились на лечении в отделении детской гинекологии ГУ «ИОЗДП НАМНУ». В зависимости от индекса массы тела (ИМТ) пациентки были разделены на две группы: I группа – с дефицитом массы тела (ИМТ 16,31 ± 0,18 кг/м2), II группа – с ИМТ в пределах физиологической нормы (20,0 ± 0,25 кг/м2). Выполняли комплексное клинико-лабораторное обследование: в сыворотке крови определяли уровни лютеинизирующего, фолликулостимулирующего гормонов, пролактина, эстрадиола, тестостерона, кортизола, 25(ОН)D. Связь гонадотропных, стероидных гормонов с уровнем витамина D анализировали с применением многомерного регрессионного анализа. Основные характеристики модели дискриминации объектов представлены в виде таблиц.Результаты. Проведен сравнительный анализ гормонального профиля и уровня витамина D в зависимости от ИМТ. Обнаружено, что снижение содержания 25(ОН)D было характерно не только для пациенток с нарушениями менструальной функции, но и для девочек с нормальной менструальной функцией. По результатам множественного регрессионного анализа построены схемы, характеризующие гипофизарно-гонадные взаимосвязи с витамином D. Определены их особенности у девочек с разной массой тела. У пациенток с пониженными энергетическими ресурсами наблюдались прямые связи между отдельными показателями гонадотропинов (фолликулостимулирующим гормоном), стероидными гормонами (эстрадиолом, кортизолом) и витамином D, а при сбалансированном энергетическом статусе отмечалась обратная связь между витамином D и кортизолом, пролактином.Выводы. Для пациенток с нарушениями менструальной функции по типу олигоменореи характерно снижение содержания витамина D. Выявлены особенности связей гонадотропных, стероидных гормонов и витамина D, зависящие от энергетического статуса (питания) пациенток с олигоменореей., Мета дослідження: визначення частоти дефіциту й недостатності вітаміну D і виявлення його взаємозв'язку з репродуктивними гормонами у дівчаток-підлітків із олігоменореєю. Матеріали і методи. Робота виконана за результатами клінічного та інструментального обстеження 68 дівчаток-підлітків віком 12–18 років з олігоменореєю, які перебували на лікуванні у відділенні дитячої гінекології ГУ «ІОЗДП НАМНУ». Залежно від індексу маси тіла (ІМТ) пацієнтки були розподілені на дві групи: I група – з дефіцитом маси тіла (ІМТ 16,31 ± 0,18 кг/м2); II група – з ІМТ в межах фізіологічної норми (20,0 ± 0,25 кг/м2). Усім хворим проводили комплексне клініко-лабораторне обстеження: у сироватці крові визначали рівні лютеїнізувального, фолікулостимулювального гормонів, пролактину, естрадіолу, тестостерону, кортизолу, 25(ОН)D. Зв’язок гонадотропних, стероїдних гормонів із рівнем вітаміну D аналізували з використанням багатовимірного регресійного аналізу. Основні характеристики моделі дискримінації об'єктів представлені у вигляді таблиць. Результати. Виконано порівняльний аналіз гормонального профілю та рівня вітаміну D залежно від ІМТ. Виявлено, що зниження вмісту 25(ОН)D було характерним не тільки для пацієнток із порушеннями менструальної функції, але й для дівчат із нормальною менструальною функцією. За результатами множинного регресійного аналізу побудовано схеми, що характеризують гіпофізарно-гонадні взаємозв’язки з вітаміном D. Визначено їхні особливості в дівчаток із різною масою тіла. У пацієнток зі зниженими енергетичними ресурсами простежувалися прямі зв'язки між окремими показниками гонадотропінів (фолікулостимулювального гормону), стероїдними гормонами (естрадіолом, кортизолом) і вітаміном D, а при збалансованому енергетичному статусі був наявний зворотний зв'язок між вітаміном D і кортизолом та пролактином.Висновки. Для пацієнток із порушеннями менструальної функції за типом олігоменореї характерне зниження вмісту вітаміну D. Виявлено особливості зв’язків гонадотропних, стероїдних гормонів і вітаміну D, що залежать від енергетичного статусу (харчування) пацієнток з олігоменореєю.

In recent years in Ukraine and in the world there has been a clear tendency towards deterioration in the indicators of the somatic health of children and adolescents, that is negatively affects the processes of reproductive health formation and it state in the future. Concern for adolescent girl's health, including their reproductive system, forms an enormous contribution to the society future. That's why big attention is paid to the formation and saving reproductive health of adolescent girls. The period of sexual development is defining in a woman's life and is considered a key moment on the path of reproductive maturity. Today it has been established that the reproductive health formation is influenced by environmental, socio-economic factors and the presence of somatic diseases. Despite the fact that the pathogenetic mechanisms of the reproductive system formation are extremely complex and sensitive to the effects of negative factors, the appearance of destructive factors at this time can disrupt the physiological chain of functioning of the hormonal mechanisms which regulate the reproductive system. Disorders of the menstrual cycle is one of the most common pathological conditions, combining pathogenetically different diseases, which are manifested by a violation of the menstrual duration and frequency, amount of menstrual flow. According to domestic literature, hypomenstrual syndrome (oligomenorrhea, amenorrhea) is in the first place among menstrual dysfunctions in adolescent girls in the structure of gynecological morbidity and is up to 45%. Menstrual irregularities that occur during adolescence often persist into the future, causing infertility, obstetric pathology, perinatal loss and other reproductive health problems during childbearing years. The problem of the menstrual cycle formation has been little studied, but it is socially significant, very relevant and requires further study.Thus, girls with menstrual disorders constitute a group of increased risk of gynecological diseases in women of reproductive age, since many chronic diseases of adults are a protracted pathology of adolescents. Therefore, adolescent girls should be examined and treated by a specialist in pediatric and adolescent gynecology, pediatric endocrinologist, pediatrician and family doctor., В последние годы в Украине и мире наметилась четкая тенденция к ухудшению показателей соматического здоровья детей и подростков, что негативно сказывается на процессах формирования и состоянии репродуктивного здоровья в будущем. Забота о здоровье девочек-подростков, включая их репродуктивную систему, вносит огромный вклад в будущее общества. Поэтому большое внимание следует уделять формированию и сохранению репродуктивного здоровья девочек-подростков. Период полового развития является определяющим в жизни женщины и считается ключевым на пути становления репродуктивной зрелости. Сегодня установлено, что на формирование репродуктивного здоровья влияют экологические, социально-экономические факторы и наличие соматических заболеваний. Ввиду того что патогенетические механизмы формирования репродуктивной системы чрезвычайно сложны и чувствительны к негативным воздействиям, появление деструктивных факторов в это время может нарушить физиологическую цепочку функционирования гормональных механизмов регуляции репродуктивной системы. Нарушение менструального цикла – одно из наиболее частых патологических состояний, сочетающее патогенетически разные заболевания, которые проявляются нарушением продолжительности и частоты менструаций, объема менструальных выделений. По данным отечественной литературы, гипоменструальный синдром (олигоменорея, аменорея) занимает первое место среди нарушений менструального цикла у девочек-подростков в структуре гинекологической заболеваемости – до 45%. Нарушения менструального цикла, возникшие в подростковом периоде, часто сохраняются в будущем, вызывая бесплодие, акушерскую патологию, перинатальные потери и другие нарушения репродуктивного здоровья в детородном возрасте. Проблема формирования менструального цикла мало изучена, но социально значима, очень актуальна и требует дальнейшего изучения. Таким образом, девушки с нарушением менструального цикла составляют группу повышенного риска развития гинекологических болезней у женщин репродуктивного возраста, поскольку многие хронические заболевания взрослых являются результатом затяжной патологии подростков. Поэтому следует проводить обследование и лечение девочек-подростков специалистом детской и подростковой гинекологии, детским эндокринологом, педиатром и семейным врачом., Останніми роками в Україні та світі спостерігається чітка тенденція до погіршення показників соматичного здоров'я дітей і підлітків, що негативно впливає на процеси формування та стан репродуктивного здоров'я в майбутньому. Турбота про здоров'я дівчат-підлітків, включно з їхньою репродуктивною системою, робить вагомий внесок у майбутнє суспільства. Тому слід приділяти велику увагу формуванню та збереженню репродуктивного здоров’я дівчат-підлітків. Період статевого розвитку є визначальним у житті жінки й уважається ключовим на шляху становлення репродуктивної зрілості. Сьогодні встановлено, що на формування репродуктивного здоров’я впливають екологічні, соціально-економічні чинники та наявність соматичних захворювань. Зважаючи на те що патогенетичні механізми формування репродуктивної системи є надзвичайно складними й чутливими до негативних впливів, поява деструктивних чинників у цей час може порушити фізіологічний ланцюг функціонування гормональних механізмів регуляції репродуктивної системи. Порушення менструального циклу є одним із найпоширеніших патологічних станів, що поєднує в собі патогенетично різні захворювання, які проявляються порушенням тривалості та частоти менструацій, обсягу менструальних виділень. Згідно з даними вітчизняної літератури, гіпоменструальний синдром (олігоменорея, аменорея) посідає перше місце серед менструальних порушень у дівчаток-підлітків у структурі гінекологічної захворюваності – до 45%. Порушення менструального циклу, що виникли в підлітковому періоді, часто зберігаються в майбутньому, спричиняючи безпліддя, акушерську патологію, перинатальні втрати та інші розлади репродуктивного здоров'я в дітородному віці. Проблема формування менструального циклу мало вивчена, але соціально значуща, дуже актуальна й потребує подальшого вивчення.Отже, дівчатка-підлітки з порушенням менструального циклу становлять групу підвищеного ризику розвитку гінекологічних хвороб у жінок репродуктивного віку, оскільки багато хронічних захворювань дорослих є результатом затяжної патології підлітків. Тому слід проводити обстеження та лікування дівчаток-підлітків фахівцем дитячої та підліткової гінекології, дитячим ендокринологом, педіатром і сімейним лікарем.

Background: Polycystic Ovary Syndrome is one of the most common cause of anovulation in women of reproductive age, with a prevalence of upto 10%. Oligomenorrhea, hirsutism and obesity together with enlarged polycystic ovaries are the diagnostic criteria of PCOS. These women are vulnerable to type II diabetes, dyslipidemia, premature arteriosclerosis, and endometrial carcinoma. Aims and Objectives: The aim and objective of this study was to see the various clinical profile of PCOS patients at a Medical College in Nepal and to make patients aware about the long term sequalae associated with it. Materials and Methods: This was a retrospective study conducted in the outpatient department of Obstetrics and Gynaecology at Manipal Teaching Hospital from January 2018 till June 2019. A total of 90 patients presenting with oligomenorrhoea, obesity, acne, infertility and hirsutism were included in the study. The exclusion criteria were young women who had their menarche less than 2 years back, women older than 45 years, and patients on exogenous estrogen or progesterone therapy. Results: Out of 90 patients studied, 37(41%) were married and 53(59%) were unmarried. There were many patients from urban compared to rural areas (67% vs 33%). Many patients were either overweight (22%) or obese (61%) and 6% of the patients were underweight. Mean age at the time of presentation was 31.66 years with many patients (37%) between 30-35 years age group. Majority of the patients were either oligomenorrhoeic or amenorrhoeic (78 %). Weight gain was present in 83% of the patients. Infertility was present in 81% of the married patients. Fifteen women (17%) had hypothyroidism and were receiving treatment for the same. Ultrasonography was done in all the patients and typical necklace pattern of follicular arrangement was seen in 70 (78%) patients. Conclusion: The diagnosis of PCOS can be reliably predicted with the help of clinical features and sonography in women according to Rotterdam criteria. Oligomenorrhoea or amenorrhea and weight gain were main symptoms in our patients. It is important to educate and make unmarried PCOS patients aware of its association with infertility and long-term medical problems.

In 1982, oral isotretinoin was first licensed as a treatment option for severe recalcitrant cystic acne in the United States. Since its introduction into the pharmaceutical market, several instances of amenorrhea in women of child-bearing age taking isotretinoin have been reported. In each documented instance, amenorrhea spontaneously resolved once the medication was discontinued. The Patient Introductory Brochure for iPLEDGE, the risk management distribution program mandated by the U.S. Food and Drug Administration for isotretinoin, does not currently include menstrual irregularities as a side effect of treatment; thus, patients who experience this side effect may also experience the unnecessary stress of a possible pregnancy, or, if a minor, explaining a lack of menses to their parent/guardian. This review synthesizes the limited literature available on this subject to advocate for more widespread acknowledgment of menstrual irregularities as a side effect of isotretinoin therapy. To perform the literature review, the search was conducted on June 13, 2020 on PubMed using the following search terms: (((isotretinoin) AND (oligomenorrhea))) OR ((isotretinoin) AND (amenorrhea)) OR ((isotretinoin) AND (PCOS)) OR ((isotretinoin) AND (menstrual irregularities)) OR ((isotretinoin) AND (polycystic ovary syndrome)). All years available were included. Articles were excluded if they were not published in English or did not address the topic of menstrual irregularities in the setting of isotretinoin, with or without the presence of polycystic ovary syndrome. A total of six articles met our criteria and are described.

Background: Adiposity rebound (AR), the second BMI rise in childhood at around the age of 6 years, is associated with obesity and metabolic alteration in later life. Given that polycystic ovary syndrome (PCOS) has a strong metabolic component, early life growth patterns could reveal a risk of PCOS. Thus, we aimed to investigate the associations between age at AR and PCOS diagnosis and BMI later in life. Materials and methods: This study is part of a prospective, population-based longitudinal study, where women with PCOS diagnosis by age 46 (n = 280) were compared with asymptomatic women (CTRLs, n = 1573). Weight and height data from birth to age 13 years, at age at menarche, and at ages 31 and 46 years were analyzed Results: Women with PCOS had lower birth weight (3357 +/- 477 vs. 3 445 +/- 505 g, p

Objective To test the hypothesis that the polycystic ovary syndrome (PCOS) phenotype, or its component features, is less severe in adolescents than in young adult patients, in a referred (clinical) population. Design Cross-sectional study. Setting Tertiary-care academic medical center. Patient(s) Two hundred seventy-four adolescents and young adults aged 13.0–24.9 years with PCOS according to the National Institute of Health 1990 criteria. Patients were categorized as adolescents (AD: 13.0–18.9 years; n=91) and young adults (YA: 19.0–24.9 years; n=183). Adolescents were further categorized as early adolescents (Early-AD: 13.0–15.9 years; n=31) and late adolescents (Late-AD: 16.0–18.9 years; n=60). Intervention(s) History, physical examination, hormonal assays with the use of standardized protocols. Main Outcome Measure(s) Unadjusted and adjusted odds ratios (ORs; adjusted for body mass index [BMI] when applicable) were calculated for biochemical hyperandrogenism (HA), hirsutism (HIR), acne, and degree of oligo/amenorrhea (OA). PCOS phenotypes were classified as HIR+HA+OA, HA+OA, and HIR+OA. Result(s) Our analysis demonstrated minimal significant difference in the prevalence of the three PCOS phenotypes, or component features, between AD and YA patients. The risks for obesity were higher for YA versus AD, and the risk of acne was lower for YA versus AD. There was no significant difference between Early-AD and Late-AD. BMI-adjusted models did not significantly modify the main findings. Conclusion(s) The present study suggests that the PCOS phenotype is established in early adolescence, remains constant into adulthood, and is not related to BMI.

To explore the independent role of age at menarche on menstrual abnormalities among adolescents. 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. 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. 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.

BACKGROUND We undertook the study to assess the clinical profile of adolescent girls in the age group of 10-19 years attending our gynaecology clinic at GMC Kottayam. The objective was to evaluate various clinical presentations and different modalities of management required for the girls in this group. MATERIALS AND METHODS We analysed 100 consecutive adolescent girls who visited our clinic at GMC Kottayam for a period of two years. They were evaluated prospectively for various clinical presentations at each visit. Specific proforma was filled for each patient which included their personal details, gynaecological problems with associated complaints, menstrual history, examination findings including height, weight and secondary sexual characteristics. Investigations such as haemogram, hormonal assay and USG were carried out as and when required. Counseling for good nutrition, physical fitness, exercise, responsible sexual behaviour and immunization was undertaken as per the need of the patient. RESULTS The commonest complaint was menstrual disorders 54% followed by ovarian tumours 25%. Other complaints included teenage pregnancy, sexual assault, leucorrhoea, vulval injury, Bartholin’s abscess etc. The incidence of severe anaemia was 7.4% in our study. Few suffered from hypothyroidism. There was one case of ITP and one case of CAH. 24% of girls had features of PCOD. CONCLUSION Over the last few years, Adolescent Gynaecology has emerged as a subspecialty in developing countries. Health professionals dealing with adolescent age group should have empathy, friendliness and non-judgemental attitude towards their parents. Confidentiality of young people should be maintained. We need to give special attention to adolescent population as they will be citizens and parents of tomorrow.

Athletes in weight-bearing sports may benefit from higher bone mineral density (BMD). However, some athletes are at risk for impaired BMD with female athlete triad (Triad). The purpose of this study is to understand the influence of sports participation and Triad on BMD. We hypothesize that athletes in high-impact and multidirectional loading sports will have highest BMD, whereas nonimpact and low-impact sports will have lowest BMD. Triad risk factors are expected to reduce BMD values independent of sports participation.Two hundred thirty-nine female athletes participating in 16 collegiate sports completed dual-energy x-ray absorptiometry (DXA) scans to measure BMD z-scores of the lumbar spine (LS) and total body (TB). Height and weight were measured to calculate body mass index (BMI). Triad risk assessment variables were obtained from preparticipation examination. Mean BMD z-scores were compared between sports and by sport category (high-impact, multidirectional, low-impact, and nonimpact). Multivariable regression analyses were performed to identify differences of BMD z-scores accounting for Triad and body size/composition.Athlete populations with lowest average BMD z-scores included synchronized swimming (LS, -0.34; TB, 0.21) swimming/diving (LS, 0.34; TB, -0.06), crew/rowing (LS, 0.27; TB, 0.62), and cross-country (LS, 0.29; TB, 0.91). Highest values were in gymnastics (LS, 1.96; TB, 1.37), volleyball (LS, 1.90; TB, 1.74), basketball (LS, 1.73; TB, 1.99), and softball (LS, 1.68; TB, 1.78). All Triad risk factors were associated with lower BMD z-scores in univariable analyses; only low BMI and oligomenorrhea/amenorrhea were associated in multivariable analyses (all P0.05). Accounting for Triad risk factors and body size/composition, high-impact sports were associated with higher LS and TB BMD z-scores and nonimpact sports with lower LS and TB BMD z-scores compared to low-impact sport (all P0.05).Both sport type and Triad risk factors influence BMD. Athletes in low-impact and nonimpact sports and athletes with low BMI and oligomenorrhea/amenorrhea are at highest risk for reduced BMD.

The knowledge of polycystic ovary syndrome (PCOS) natural history is limited. Our objective was to assess the effect of aging on clinical, hormonal and sonographic ovarian PCOS features and additionally to identify parameters that impact the course of PCOS. A secondary aim was to supply additional information on the reproductive outcome in women with previously diagnosed PCOS. A longitudinal cohort study with a median follow-up of 120.9 months was conducted, and 31 Caucasian women previously diagnosed with PCOS according to the Rotterdam criteria were re-examined at a median age of 35. Clinical examinations, transvaginal ultrasound scans, and lipid, E-selectin and sex hormone assessments were performed at the beginning and at the end of the follow-up. It was observed that menstrual cycles became regular and sonographic morphology of ovaries was normalized in 55% and 49% of the participants, respectively (all p &lt, 0.05). At the final assessment, 55% of the women no longer met the criteria for PCOS (p &lt, 0.05). The age, follicle-stimulating hormone (FSH) and E-selectin assessed at the baseline were the most important predictors of the PCOS persistence into later years (respectively, OR = 0.84, OR = 0.39, OR = 1.08, all p &lt, 0.05). Ninety-five percent of the patients who had ever been trying to conceive became pregnant a minimum of once. The women with persistent PCOS had worse metabolic and reproductive parameters compared to the women with resolved PCOS. Positive correlations were found between the number of miscarriages and ovarian volume, LH, androstenedione, 17-hydroxyprogesterone and an increase in E-selectin during the follow-up (R = 0.46, R = 0.59, R = 0.54, R = 0.49, R = 0.47, all p &lt, 0.05). In conclusion, progressing from the third to the fourth decade is connected with a reduction in PCOS features, which seems to have a great impact on fertility of women with a previous diagnosis of PCOS. FSH and E-selectin, as determined at the initial PCOS diagnosis, had an impact on the disappearance of the syndrome years after.

Leydig cell tumors are rare ovarian neoplasms. Affected individuals typically present with amenorrhea/oligomenorrhea and rapidly progressive features of virilization. Erythrocytosis can also occur as a result of high testosterone levels.

Health is a pre-requisite for optimal performance yet the parameters which govern health and performance of elite female athletes are little understood. The aim of this study was to quantify the health status of elite female athletes, and understand sociocultural factors influencing that status. The survey addressed demographic, health and athletic performance history, training load, contraceptive use, sport-specific appearance and performance pressures, and communication barriers. Three hundred and fifty-seven elite New Zealand female athletes were recruited to complete an on-line survey. Two hundred and nineteen athletes completed the survey. Oligomenorrhea/amenorrhea had been diagnosed in only 12% of athletes compared with 50% of athletes not on hormonal contraception who reported symptoms consistent with this diagnosis. Stress fractures and iron deficiency were common and associated with oligomenorrhoea/amenorrhea (P = 0.002), disordered eating (P = 0.009) or menorrhagia (P = 0.026). Athletes involved in individual sports (P = 0.047) and with higher training volumes (P < 0.001) were more likely to report a medical illness. Seventy-three percent of athletes felt pressured by their sport to alter their physical appearance to conform to gender ideals with 15% engaging in disordered eating practices. Barriers to communicating female health issues included male coaches and support staff, and lack of quality information pertaining to health. Elite female athletes may fail to reach peak performance due to specific health issues and undiagnosed pathology. Sociocultural factors influence the effectiveness of support of female's health and performance. Organizational and cultural change is required if elite female athletes are to combine optimal health with best performance.

Цель исследования – оценить влияние COVID-19 на репродуктивное здоровье женщин, а также выявить взаимосвязь ее степени тяжести и частоты нарушений менструального цикла. Материалы и методы. Дизайн исследования: одномоментное поперечное. Метод исследования: интервьюирование по телефону, выкопировка данных из медицинских карт стационарного больного Ф003/У. В исследование включены 83 женщины, которые получали стационарное лечение по поводу новой коронавирусной инфекции (НКИ) COVID-19. Статистическая обработка полученных данных проводилась с применением ППП «Мicrosoft Ехсеl 2007». Результаты. Частота нарушений менструального цикла через 3-6 месяцев после перенесенной НКИ COVID-19 была существенно выше, чем у этих пациенток до заболевания, как за счет олигоменореи и аменореи, так и за счет аномальных маточных кровотечений. Частота нарушений менструального цикла зависела от степени тяжести перенесенной инфекции. Заключение. НКИ COVID-19 оказывает негативное влияние на репродуктивное здоровье женщин. Необходимы дальнейшие углубленные исследования в этом направлении., The aim of the study – assess the impact of COVID-19 on women’s reproductive health and identify the relationship between its severity and the incidence of menstrual disorders. Materials and methods. Study design: single-point cross-section. Research method: interviewing by phone, copying data from medical records of an inpatient patient. F003/U. The research included 83 women who received hospital treatment concerning NCI COVID-19. Statistical processing of the obtained data was carried out using the application package "Microsoft Excel 2007". Conclusion. The NCI COVID-19 has a negative impact on women’s reproductive health. Further in-depth research is needed in this direction.

The issue of preserving the reproductive health of women for many years does not lose its relevance. Fundamental studies of recent decades have made it possible to determine the basic mechanisms of functioning of the female reproductive system, but studies of the characteristics of pregnancy, complications in childbirth and the condition of newborn children in women with menstrual dysfunction in the puberty remain single.The objective: аccording to laboratory and instrumental methods of research, to study the characteristics of childbirth and the condition of newborns in women with menstrual dysfunction in the puberty.Materials and methods. According to the nature of the disorders, the main group of pregnant women (n=120) who had a menstrual pathology in the puberty were divided into 3 subgroups (n=40): the first – pregnant women with primary oligomenorrhea in the anamnesis, the second – with a late age menarche, the third – with puberty bleeding. The control group included pregnant women (n=40) with the correct rhythm of menstruation in puberty.Results. During the clinical study, significant differences in the biological readiness of the body for childbirth in all subgroups of the main group of pregnant women were noted compared with the control group. In 35(29,2%) pregnant women with menstrual dysfunction during the puberty, an «unripe» or insufficiently «mature» cervix was observed in the expected period of labor, which was important in the violation of labor activity during spontaneous labor in the occipital presentation and an increase in the frequency of delivery using cesarean section (CS) operation. Caesarean section was performed in 51(42,5%) pregnant women of the main group: planned CS in 39(32,5%), urgent delivery in 12(10,0%). In the group of pregnant women with the correct rhythm of menstruation, spontaneous delivery occurred in 37(92,5%) women, planned CS due to the narrowed pelvis and large fetus in 2(5,0%), emergency CS – 1(2,5%) case. The frequency of complications during childbirth (violation of labor, premature rupture of the membranes, bleeding) in the main group is 4 times higher than in the control group (p, Вопрос сохранения репродуктивного здоровья женщины в течение многих лет не теряет своей актуальности. Фундаментальные исследования последних десятилетий позволили определить основные механизмы функционирования женской репродуктивной системы, но единичными остаются исследования особенностей протекания беременности, осложнений в родах и состояния новорожденных у женщин с нарушениями менструальной функции в пубертатный период.Цель исследования: изучение особенностей родов и состояния новорожденных у женщин с нарушениями менструальной функции в пубертатный период по данным лабораторных и инструментальных методов исследования.Материалы и методы. По характеру нарушений основную группу беременных (n=120), имевших патологию менструальной функции в пубертатный период, разделили на три подгруппы: 1-я – беременные с первичной олигоменореей в анамнезе (n=40), 2-я – с поздним возрастом менархе (n=40), 3-я – с пубертатными кровотечениями (n=40). В контрольную группу вошли беременные (n=40) с правильным ритмом менструаций в пубертате.Результаты. В ходе клинического исследования отмечали достоверные отличия биологической неготовности организма к родам во всех подгруппах основной группы беременных по сравнению с контрольной группой. У 35(29,2%) беременных с нарушениями менструальной функции в пубертатный период в предполагаемый срок родов отмечали «незрелую» или недостаточно «зрелую» шейку матки, что нарушало родовую деятельность при самопроизвольных родах в затылочном предлежании и увеличивало частоту родоразрешения с применением кесарева сечения (КС). Кесарево сечение проведено у 51(42,5%) беременной основной группы: плановое КС – у 39(32,5%), срочное в родах – у 12(10,0%). В группе беременных с правильным ритмом менструаций самопроизвольные роды произошли у 37(92,5%) женщин, плановое КС из-за суженного таза и большого плода провели у 2(5,0%) женщин, экстренное КС – 1(2,5%) случай. Частота осложнений при родах (нарушение родовой деятельности, преждевременный разрыв плодных оболочек, кровотечения) в основной группе в 4 раза выше, чем в группе контроля (р, Питання збереження репродуктивного здоров’я жінки протягом багатьох років не втрачає своєї актуальності. Фундаментальні дослідження останніх десятиліть дозволили визначити основні механізми функціонування жіночої репродуктивної системи, але поодинокими залишаються дослідження щодо особливостей перебігу вагітності, ускладнень пологів і стану новонароджених у жінок із порушеннями менструальної функції у пубертатний період.Мета дослідження: вивчення особливостей пологів і стану новонароджених у жінок, які мали порушення менструальної функції у пубертатний період, за даними лабораторних та інструментальних методів дослідження.Матеріали та методи. За характером порушень основну групу вагітних (n=120), які мали розлади менструальної функції у пубертатний період, було розподілено на три підгрупи: 1-а – вагітні з первинною олігоменореєю в анамнезі (n=40), 2-а – з пізнім віком менархе (n=40), 3-я – з пубертатними кровотечами (n=40). До контрольної групи увійшли вагітні (n=40) з правильним ритмом менструацій у пубертаті.Результати. У ході клінічного дослідження відзначали достовірні розбіжності біологічної неготовності організму до пологів у всіх підгрупах основної групи вагітних порівняно з контрольною групою. У 35(29,2%) вагітних, які мали порушення менструальної функції у пубертатний період, у передбачуваний термін пологів відзначено «незрілу» або недостатньо «зрілу» шийку матки, що порушувало пологову діяльність при мимовільних пологах у потиличному передлежанні і підвищувало частоту розродження шляхом кесарева розтину (КР). Кесарів розтин проведено у 51(42,5%) вагітної основної групи: плановий КР – у 39(32,5%), терміновий під час пологів – у 12(10,0%). У групі вагітних із правильним ритмом менструацій мимовільні пологи відбулися у 37(92,5%) жінок, плановий КР через звужений таз і великий плід провели у 2(5,0%) жінок, екстрений КР – 1(2,5%) випадок. Частота ускладнень під час пологів (порушення пологової діяльності, передчасний розрив плодових оболонок, кровотечі) в основній групі у 4 рази вища, ніж у групі контролю (р

The issue of preserving the reproductive health of women for many years does not lose its relevance. Fundamental studies of recent decades have made it possible to determine the basic mechanisms of functioning of the female reproductive system, but studies of the characteristics of pregnancy, complications in childbirth and the condition of newborn children in women with menstrual dysfunction in the puberty remain single. The objective:аccording to laboratory and instrumental methods of research, to study the characteristics of childbirth and the condition of newborns in women with menstrual dysfunction in the puberty. Materials and methods.According to the nature of the disorders, the main group of pregnant women (n=120) who had a menstrual pathology in the puberty were divided into 3 subgroups (n=40): the first – pregnant women with primary oligomenorrhea in the anamnesis, the second – with a late age menarche, the third – with puberty bleeding. The control group included pregnant women (n=40) with the correct rhythm of menstruation in puberty. Results.During the clinical study, significant differences in the biological readiness of the body for childbirth in all subgroups of the main group of pregnant women were noted compared with the control group. In 35(29,2%) pregnant women with menstrual dysfunction during the puberty, an «unripe» or insufficiently «mature» cervix was observed in the expected period of labor, which was important in the violation of labor activity during spontaneous labor in the occipital presentation and an increase in the frequency of delivery using cesarean section (CS) operation. Caesarean section was performed in 51(42,5%) pregnant women of the main group: planned CS in 39(32,5%), urgent delivery in 12(10,0%). In the group of pregnant women with the correct rhythm of menstruation, spontaneous delivery occurred in 37(92,5%) women, planned CS due to the narrowed pelvis and large fetus in 2(5,0%), emergency CS – 1(2,5%) case. The frequency of complications during childbirth (violation of labor, premature rupture of the membranes, bleeding) in the main group is 4 times higher than in the control group (p Conclusion.The results of the studies confirm the presence of the biological unpreparedness of the body for the normal course of labor in women with menstrual dysfunction in the puberty, as evidenced by violations of labor, the main predictor of which is placental dysfunction. The frequency of individual conditions that occur in the perinatal period is significantly higher than in newborns from mothers who had the correct rhythm of menstruation. It is possible to reduce the frequency of obstetric and perinatal complications in women with reduced reproductive potential by optimizing the pregravid preparation program and introducing a scientifically based complex of treatment and preventive measures.

The objective: to study the features of the pathological state of the mammary glands, depending on the nature of the menstrual cycle, the characteristics of the hormonal and immunological status in women with menstrual disorders of endocrine genesis.Materials and methods. For the study, a group of 130 patients (n=130) of reproductive age (mean age 27±2,3 years) was selected, who were divided into 2 subgroups by the nature of menstrual dysfunction: 1 subgroup (n=73) – women with secondary amenorrhea and oligomenorrhea background of chronic anovulation, 2 subgroup (n=57) – women with a regular rhythm of the menstrual cycle and insufficiency of the luteal phase (ILP). All patients complained about the absence of pregnancy for an average of 4±1,2 years.To assess the state of the reproductive system and hormone-dependent organs, women underwent complex clinical-hormonal, ultrasound, radiothermometric, X-ray and immunological examinations.Results. Menstrual irregularities in all patients are caused by endocrine pathology: secondary amenorrhea and oligomenorrhea against the background of chronic anovulation – 56,2%, regular rhythm in combination with ILP – 43,8%. When examining the mammary glands, 88,9% of patients were diagnosed with various variants of fibrocystic disease (FCD), underdevelopment of structural elements, involutive changes that do not correspond to age, focal formations.Thus, the frequency of FCD with anovulation is 1,3 times higher than with ILP (43,9% and 35,1%, respectively), while focal formations in the mammary glands of the type of fibroadenoma are 4 times more likely to be detected in patients with ILP than with amenorrhea (5,3% and 1,4%, respectively). With radiothermometry, in 13,4% of cases FCD was additionally diagnosed, which was not detected by ultrasound, while the coincidence of the results of both diagnostics was noted in 49,2%.In 1 subgroup, every 2nd patient (52,0%) was diagnosed with hyperprolactinemia. The hormonal parameters were characterized by a decrease in the level of FSH, LH, estradiol, and the degree of inhibition of the secretion of these hormones increased depending on the increase in the level of prolactin. In patients with hyperprolactinemia, different forms of FCD were detected 2,4 times more often. Hormonal and immunological examination revealed a decrease in the activity of T-helpers, immunoregulatory index, circulating immune complexes in both groups, while no significant differences were found between the groups.Conclusion. When studying the characteristics of the nature of the menstrual function of the patients, it was found that the majority of the subjects had latent disorders of the hypothalamic-pituitary-ovarian system, which were compensated until a certain point and manifested themselves under the influence of unfavorable factors. With ILP more often than with anovulation, mixed forms of FCD and diffuse forms with a predominance of the cystic component were diagnosed.Probably, these changes in the mammary glands can be explained by the insufficient effect of progesterone and a relative increase in the level of estrogens, which support the proliferation of the connective tissue and epithelial components of the mammary gland. As a result, obstruction of the ducts develops, which in some patients leads to an increase in alveoli and the formation of cystic cavities. Progesterone deficiency is also largely associated with changes in the immune status in patients with endocrine infertility, but immune disorders develop secondarily and are not specific for a particular pathology., Цель исследования: изучение особенностей патологического состояния грудных желез в зависимости от характера менструального цикла, особенностей гормонального и иммунологического статуса у женщин с нарушениями менструальной функции эндокринного генеза.Материалы и методы. Для исследования отобрана группа из 130 больных репродуктивного возраста (средний возраст – 27±2,3 года), которых по характеру нарушений менструальной функции распределили на две подгруппы: 1-я подгруппа (n=73) – женщины с вторичной аменореей и олигоменореей на фоне хронической ановуляции; 2-я подгруппа (n=57) – женщины с регулярным ритмом менструального цикла и недостаточностью лютеиновой фазы (НЛФ). Все больные предъявляли жалобы на отсутствие беременности в среднем в течение 4±1,2 года.Для оценки состояния репродуктивной системы и гормонально зависимых органов женщинам проводили комплексное клинико-гормональное, ультразвуковое, радиотермометрическое, рентгенологическое и иммунологическое обследования.Результаты. Нарушения менструального цикла у всех больных обусловлены эндокринной патологией: вторичная аменорея и олигоменорея на фоне хронической ановуляции – 56,2%, регулярный ритм в сочетании с НЛФ – 43,8%. При обследовании грудных желез у 88,9% пациенток диагностированы различные варианты фиброзно-кистозной болезни (ФКБ), недоразвитие структурных элементов, инволютивные изменения, не соответствующие возрасту, очаговые образования.Так, частота ФКБ при ановуляции в 1,3 раза выше, чем при НЛФ (43,9% и 35,1% соответственно), в то же время очаговые образования в грудных железах по типу фиброаденомы в 4 раза чаще выявлены у пациенток с НЛФ, чем с аменореей (5,3% и 1,4% соответственно). При радиотермометрии в 13,4% случаев дополнительно диагностирована ФКБ, не выявленная при УЗИ, при этом совпадение результатов обеих диагностик отмечено в 49,2%.В 1-й подгруппе каждой второй пациентке (52,0%) установлен диагноз «Гиперпролактинемия». Гормональные параметры характеризовались снижением уровней ФСГ, ЛГ, эстрадиола, причем степень угнетения секреции этих гормонов увеличивалась в зависимости от повышения уровня пролактина. У пациенток с гиперпролактинемией в 2,4 раза чаще выявляли разные формы ФКБ. Гормонально-иммунологическое обследование выявило снижение активности Т-хелперов, иммунорегуляторного индекса, циркулирующих иммунных комплексов в обеих группах, при этом достоверных отличий между группами не зафиксировано.Заключение. При изучении особенностей характера менструальной функции пациенток было установлено, что у большинства обследуемых имели место скрытые нарушения гипоталамо-гипофизарно-яичниковой системы, которые компенсировались до опреде­ленного момента и проявились под воздействием неблагоприятных факторов. При НЛФ чаще, чем при ановуляции, диагностировали смешанные формы ФКБ и диффузные формы с преобладанием кистозного компонента.Вероятно, описанные изменения в грудных железах можно объяснить недостаточным влиянием прогестерона и относительным повышением уровня эстрогенов, которые поддерживают пролиферацию соединительнотканного и эпителиального компонентов грудной железы. Вследствие этого развивается обструкция протоков, что у ряда больных приводит к увеличению альвеол и формированию кистозных полостей. С дефицитом прогестерона в значительной степени связаны и изменения иммунного статуса у пациенток с эндокринными формами бесплодия, но иммунные нарушения развиваются вторично и не являются специфическими для той или иной патологии., Мета дослідження: вивчення особливостей патологічного стану грудних залоз залежно від характеру менструального циклу, особливостей гормонального й імунологічного статусу у жінок із порушеннями менструальної функції ендокринного генезу.Матеріали та методи. Для дослідження відібрано групу із 130 хворих репродуктивного віку (середній вік – 27±2,3 року), яких за характером порушень менструальної функції розподілено на дві підгрупи: 1-а підгрупа (n=73) – жінки з вторинною аменореєю і олігоменореєю на фоні хронічної ановуляції; 2-а підгрупа (n=57) – жінки з регулярним ритмом менструального циклу і недостатністю лютеїнової фази (НЛФ). Усі хворі скаржились на відсутність вагітності у середньому протягом 4±1,2 року.Для оцінювання стану репродуктивної системи і гормонально залежних органів жінкам проводили комплексне клініко-гормональне, ультразвукове, радіотермометричне, рентгенологічне та імунологічне дослідження.Результати. Порушення менструального циклу у всіх хворих були зумовлені ендокринною патологією: вторинна аменорея і олігоменорея на фоні хронічної ановуляції – 56,2%, регулярний ритм у поєднанні з НЛФ – 43,8%. Під час обстеження грудних залоз у 66,9% пацієнток діагностовано різні варіанти фіброзно-кістозної хвороби (ФКХ), недорозвиток структурних елементів, інволютивні зміни, які не відповідають віку, вогнищеві утворення.Так, частота ФКХ при ановуляції в 1,3 разу вище, ніж при НЛФ (43,9% і 35,1% відповідно), у той самий час вогнищеві утворення грудних залоз за типом фіброаденоми у 4 рази частіше виявлено у пацієнток з НЛФ, ніж з аменореєю (5,3% і 1,4% відповідно). При радіотермометрії у 13,4% випадків було додатково діагностовано ФКХ, не виявлену при УЗД, при цьому співпадіння результатів обох діагностик відзначено у 49,2%.У 1-й підгрупі кожній другій пацієнтці (52,0%) був встановлений діагноз «Гіперпролактинемія». Гормональні параметри характеризувались зниженням рівнів ФСГ, ЛГ, естрадіолу, причому ступінь пригнічення секреції цих гормонів збільшувався залежно від підвищення рівня пролактину. У пацієнток з гіперпролактинемією у 2,4 разу частіше виявляли різні форми ФКХ. Гормонально-імунологічне дослідження виявило зниження активності Т-хелперів, імунорегуляторного індексу, циркулюючих імунних комплексів в обох групах, при цьому достовірних розбіжностей між групами не зафіксовано.Заключення. Під час вивчення особливостей характеру менструальної функції пацієнток було встановлено, що у більшості обстежуваних реєстрували приховані порушення гіпоталамо-гіпофізарно-яєчникової системи, які компенсувались до певного моменту і проявилися під впливом несприятливих факторів. При НЛФ частіше, ніж при ановуляції, було діагностовано змішані форми ФКХ і дифузні форми з превалюванням кістозного компонента.Імовірно, наведені зміни у грудних залозах можна пояснити недостатнім впливом прогестерону і відносним підвищенням рівня естрогенів, які підтримують проліферацію сполучнотканинного та епітеліального компонентів грудної залози. Унаслідок розвивається обструкція проток, що у низки хворих призводить до збільшення альвеол і формування кістозних порожнин. Із дефіцитом прогестерону значною мірою пов’язані і зміни імунного статусу у пацієнток з ендокринними формами безпліддя, але імунні порушення розвиваються вторинно і не є специфічними для тієї чи іншої патології.

The objective:to study the features of the pathological state of the mammary glands, depending on the nature of the menstrual cycle, the characteristics of the hormonal and immunological status in women with menstrual disorders of endocrine genesis. Materials and methods.For the study, a group of 130 patients (n=130) of reproductive age (mean age 27±2,3 years) was selected, who were divided into 2 subgroups by the nature of menstrual dysfunction: 1 subgroup (n=73) – women with secondary amenorrhea and oligomenorrhea background of chronic anovulation, 2 subgroup (n=57) – women with a regular rhythm of the menstrual cycle and insufficiency of the luteal phase (ILP). All patients complained about the absence of pregnancy for an average of 4±1,2 years. To assess the state of the reproductive system and hormone-dependent organs, women underwent complex clinical-hormonal, ultrasound, radiothermometric, X-ray and immunological examinations. Results.Menstrual irregularities in all patients are caused by endocrine pathology: secondary amenorrhea and oligomenorrhea against the background of chronic anovulation – 56,2%, regular rhythm in combination with ILP – 43,8%. When examining the mammary glands, 88,9% of patients were diagnosed with various variants of fibrocystic disease (FCD), underdevelopment of structural elements, involutive changes that do not correspond to age, focal formations. Thus, the frequency of FCD with anovulation is 1,3 times higher than with ILP (43,9% and 35,1%, respectively), while focal formations in the mammary glands of the type of fibroadenoma are 4 times more likely to be detected in patients with ILP than with amenorrhea (5,3% and 1,4%, respectively). With radiothermometry, in 13,4% of cases FCD was additionally diagnosed, which was not detected by ultrasound, while the coincidence of the results of both diagnostics was noted in 49,2%. In 1 subgroup, every 2nd patient (52,0%) was diagnosed with hyperprolactinemia. The hormonal parameters were characterized by a decrease in the level of FSH, LH, estradiol, and the degree of inhibition of the secretion of these hormones increased depending on the increase in the level of prolactin. In patients with hyperprolactinemia, different forms of FCD were detected 2,4 times more often. Hormonal and immunological examination revealed a decrease in the activity of T-helpers, immunoregulatory index, circulating immune complexes in both groups, while no significant differences were found between the groups. Conclusion.When studying the characteristics of the nature of the menstrual function of the patients, it was found that the majority of the subjects had latent disorders of the hypothalamic-pituitary-ovarian system, which were compensated until a certain point and manifested themselves under the influence of unfavorable factors. With ILP more often than with anovulation, mixed forms of FCD and diffuse forms with a predominance of the cystic component were diagnosed. Probably, these changes in the mammary glands can be explained by the insufficient effect of progesterone and a relative increase in the level of estrogens, which support the proliferation of the connective tissue and epithelial components of the mammary gland. As a result, obstruction of the ducts develops, which in some patients leads to an increase in alveoli and the formation of cystic cavities. Progesterone deficiency is also largely associated with changes in the immune status in patients with endocrine infertility, but immune disorders develop secondarily and are not specific for a particular pathology.

The main function of a woman’s reproductive system is pregnancy and the birth of healthy offspring. In women with menstrual dysfunction in the pubertal period, more than 70% of pregnancy complications are observed, the most common of which are menacing miscarriage and placental insufficiency. Despite the medical and social significance, today there is not enough information about the reproductive potential of women with menstrual dysfunction in the puberty period, and their pregnancy and childbirth.The objective: аccording to laboratory and instrumental methods of research, to study the features of the course of pregnancy in women with menstrual dysfunction in the puberty.Materials and methods. According to the nature of the disorders, the main group of pregnant women (n=120) who had a menstrual pathology in the puberty were divided into 3 subgroups (n=40): the first – pregnant women with primary oligomenorrhea in the anamnesis, the second – with a late age menarche, the third - with puberty bleeding. The control group included pregnant women (n=40) with the correct rhythm of menstruation in puberty.Results. A clinical study found that women with menstrual irregularities in the puberty were significantly more likely than women with the right rhythm of menstruation, pregnancy was complicated by a threatening miscarriage in the early stages, threatening premature birth and chronic placental insufficiency.During the dynamic observation of pregnant women using modern diagnostic examination methods, placental dysfunction in the period of 11–14 weeks was detected in 15,0% of women, chronic placental insufficiency (compensated form) in 30–40 weeks – in 6,7%. At 36–40 weeks, chronic placental insufficiency was diagnosed in 59,2% of women, of which a subcompensated form with growth retardation of the first degree in 8,5% was diagnosed. A histological examination of the placenta revealed chronic placental insufficiency in 62,0% of women, of which 6,5% were in subcompensated form.Conclusion. In the course of a scientific search, an attempt was made to find a confirmation of the assumption that the basis of the genesis of placental dysfunction and related gestational complications in patients with disorders of the formation of menstrual function has a history of hormonal and metabolic imbalance, implantation endometrial insufficiency and vasculogenesis dysfunction, the premises of which are laid on stage of the pathological puberty.The results of the studies indicate the need to improve prognostic and diagnostic methods for the prevention of pregnancy complications in women with menstrual dysfunction in the puberty, based on new knowledge about the mechanisms of their development, and in the current demographic crisis are the requirement of the time., Основная функция репродуктивной системы женщины – наступление беременности и рождение здорового потомства. У женщин с нарушениями менструальной функции в пубертатный период наблюдается более 70% осложнений беременности, наиболее распространенными из которых являются угрожающий выкидыш и плацентарная недостаточность. Несмотря на медико-социальную значимость, на сегодня недостаточно информации о репродуктивном потенциале женщин с нарушениями менструальной функции в пубертатный период, об особенностях протекания у них беременности и родов.Цель исследования: изучение особенностей течения беременности у женщин с нарушениями менструальной функции в пубертатный период по данным лабораторных и инструментальных исследований.Материалы и методы. По характеру нарушений основную группу беременных (n=120), имевших патологию менструальной функции в пубертатный период, распределили на три подгруппы: 1-я – беременные с первичной олигоменореей в анамнезе (n=40), 2-я – с поздним возрастом менархе (n=40), 3-я – с пубертатными кровотечениями (n=40). В контрольную группу вошли беременные (n=40) с правильным ритмом менструаций в пубертате.Результаты. В ходе клинического исследования установлено, что у женщин с нарушениями менструальной функции в пубертатный период достоверно чаще, чем у женщин с правильным ритмом менструаций, беременность осложнялась угрожающим выкидышем в ранних сроках, угрожающими преждевременными родами и хронической плацентарной недостаточностью.При динамическом наблюдении беременных с применением современных диагностических методов обследования дисфункция плаценты в сроке 11–14 нед выявлена у 15,0% женщин, хроническая плацентарная недостаточность (компенсированная форма) в 30–40 нед – у 6,7%. В 36–40 нед хроническая плацентарная недостаточность была диагностирована у 59,2% женщин, из них – субкомпенсированная форма с задержкой роста плода 1-й степени – у 8,5%. При гистологическом исследовании плацент хроническая плацентарная недостаточность выявлена у 62,0% женщин, из которых у 6,5% – в субкомпенсированной форме.Заключение. В ходе научного поиска сделана попытка найти подтверждение предположению, согласно которому в основе генеза плацентарной дисфункции и связанных с ней гестационных осложнений у пациенток с нарушениями становления менструальной функции в анамнезе лежит гормональный и метаболический дисбаланс, имплантационная недостаточность эндометрия и дисфункция васкулогенеза, предпосылки для возникновения которых заложены на этапе патологического пубертатного периода.Результаты проведенных исследований свидетельствуют о необходимости усовершенствования прогностических и диагностических методов профилактики осложнений беременности у женщин с нарушениями менструальной функции в пубертатный период, основанных на новых знаниях о механизмах их развития и в условиях современного демографического кризиса являющихся требованием времени., Основна функція репродуктивної системи жінки – настання вагітності і народження здорового потомства. У жінок, які мали порушення менструальної функції у пубертатний період, спостерігається понад 70% ускладнень вагітності, найпоширенішими з яких є загрозливий викидень і плацентарна недостатність. Незважаючи на медико-соціальну значущість, на сьогодні бракує інформації щодо репродуктивного потенціалу жінок із порушеннями менструальної функції у пубертатний період, особливостей перебігу у них вагітності і пологів.Мета дослідження: вивчення особливостей перебігу вагітності у жінок, які мали порушення менструальної функції у пубертатний період, за даними лабораторних та інструментальних досліджень.Матеріали та методи. За характером порушень основну групу вагітних (n=120), які мали розлади менструальної функції у пубертатний період, було розподілено на три підгрупи: 1-а – вагітні з первинною олігоменореєю в анамнезі (n=40), 2-а – з пізнім віком менархе (n=40), 3-я – з пубертатними кровотечами (n=40). До контрольної групи увійшли вагітні (n=40) з правильним ритмом менструацій у пубертаті.Результати. У ході клінічного дослідження встановлено, що у жінок, які мали порушення менструальної функції у пубертатний період, достовірно частіше, ніж у жінок із правильним ритмом менструацій, вагітність ускладнювалась загрозливим викиднем у ранніх термінах, загрозливими передчасними пологами і хронічною плацентарною недостатністю.Під час динамічного спостереження вагітних із застосуванням сучасних діагностичних методів обстеження дисфункція плаценти у терміні 11–14 тиж виявлена у 15,0% жінок, хронічна плацентарна недостатність (компенсована форма) у 30–40 тиж – у 6,7%. У 36–40 тиж хронічну плацентарну недостатність діагностовано у 59,2% жінок, з них – субкомпенсовану форму із затримкою росту плода 1-го ступеня – у 8,5%. При гістологічному дослідженні плацент хронічна плацентарна недостатність виявлена у 62,0% жінок, з яких у 6,5% – у субкомпенсованій формі.Заключення. У ході наукового пошуку зроблена спроба знайти підтвердження припущенню, згідно з яким в основі генезу плацентарної дисфункції та пов’язаних з нею гестаційних ускладнень у пацієнток із порушенням становлення менструальної функції в анамнезі лежить гормональний та метаболічний дисбаланс, імплантаційна недостатність ендометрія та дисфункція васкулогенезу, передумови для виникнення яких закладено на етапі патологічного пубертатного періоду.Результати проведених досліджень свідчать про необхідність удосконалення прогностичних і діагностичних методів профілактики ускладнень вагітності у жінок, які мали порушення менструальної функції у пубертатний період, заснованих на нових знаннях щодо механізмів їхнього розвитку і в умовах сучасної демографічної кризи є вимогою часу.

Background Ovarian steroid cell tumors represent a rare category of sex cord-stromal tumors that constitute less than 0.1% of all ovarian tumors. These neoplasms are classified into three main subtypes according to the cell of origin: Leidyg cell tumors, stromal luteomas, and steroid cell tumors not otherwise specified (SCTs-NOS). The latter subtype is defined as a neoplasm of an uncertain lineage that mostly affects middle-aged women, whereas it’s rare in younger ages. Case presentation We report a case of a 21-year-old virgin female who presented to our hospital with complaints of mild abdominal pain, hirsutism, and oligomenorrhea for more than a year. Before her current admission, the patient had attended an external gynecologic clinic where she had been prescribed oral contraceptives to regulate her periods. Nevertheless, on presentation to our institution, physical examination revealed abdominal tenderness with a palpable pelvic mass and mild hirsutism in the thigh. Ultrasonography demonstrated a large left ovarian mass measuring 154 × 104 mm, and compressing the uterus. Therefore, a unilateral salpingo-oophorectomy was performed, and interestingly, pathologic examination of the large aforementioned mass alongside with immunohistochemical correlation revealed the diagnosis of a large ovarian steroid cell tumor-not otherwise specified with a unique combination of benign and malignant features. Conclusions Although ovarian steroid cell tumors represent a rare category, they must be considered in the differential diagnosis for mild virilization symptoms in young females due to the importance of early diagnosis and management. In this manuscript, we aimed to present the first case report from Syria that highlights the crucial role of detailed morphological examination for challenging cases despite the difficulties in differential diagnosis, and the absence of ancillary techniques. Furthermore, we managed to discuss a brief review of diagnostic methods, histological characteristics, and treatment recommendations.

PCOS is one of the most common endocrine disorders and NAFLD is one of its most dangerous metabolic consequences. The diagnosis of NAFLD is not a practical task and the condition is at risk of being overlooked. The use of simpler but still reliable surrogate markers is necessary to identify women with a high likelihood of NAFLD. The aim of this study was to evaluate the clinical correlates of NAFLD Liver Fat Score (NAFLD-LFS) in women with oligomenorrhea and/or hirsutism. Furthermore, the study aimed to evaluate whether, among the hormonal parameters evaluated in such women, possible hallmarks of NAFLD may be identified. To this purpose, 66 women who attended our Outpatient Clinic for oligomenorrhea and/or hyperandrogenism were included in the study. In order to validate the results obtained in the first cohort, a second independent sample of 233 women evaluated for female sexual dysfunction (FSD) was analyzed. In cohort 1, NAFLD-LFS positively correlated with metabolic and inflammatory parameters. Among the hormone parameters, NAFLD-LFS showed no significant relationships with androgens but a significant negative correlation with SHBG (p

The reproductive system is exposed to various adverse factors and harmful effects at all stages of functioning of an organism. Against the background of declining levels of women's reproductive health in recent years, there has been a clear tendency towards an increase in the number of patients with pathology of puberty. The low level of somatic and reproductive health before pregnancy causes a high incidence of complicated labors, which leads to a deterioration in the development of subsequent generations.The purpose of the study. To provide clinical characteristics of women who had menstrual dysfunction in puberty, which were based on the study of clinical and anamnestic data, laboratory and instrumental research methods, analysis of risk factors, clinical course, treatment effectiveness and dispensary observation.Materials and methods. According to the nature of the disfunctions, the main group of women (n = 210) who had menstrual disorders in puberty was divided into 3 subgroups (n = 70): the first - women with primary oligomenorrhea and timely average menarche, the second - with late menarche, the third - with pubertal bleeding. The control group included women (n = 70) with the correct rhythm of menstruation in puberty.Results. The clinical prospective study analyzed the social status of women with reproductive dysfunction in puberty, the frequency and structure of existing concomitant somatic diseases, the duration of the menstrual cycle, the nature of diseases of the female genital organs; the assessment of the comprehensive treatment of revealed disorders, which allowed to obtain a favorable reproductive prognosis. The majority of surveyed women (53.3%) planned a pregnancy, which occurred in 75.9% from among of planning ones.Conclusions. The conduction of clinical and anamnestic analysis of the reproductive function of women with menstrual dysfunction in puberty will increase the effectiveness of the treatment of identified disorders and will allow developing algorithms for management of such women during planning and during pregnancy.

The study of hemodynamic features of the pelvic organs in women is of great clinical importance, since it allows assessing the degree of recovery of endometrial regeneration after menstruation, the possibility of implantating a fertilized egg and placental development. Women who have had menstrual dysfunction in puberty, the determination of qualitative and quantitative parameters of uterine hemodynamics can be useful while choosing treatment tactics, evaluating its effectiveness, and will also provide significant assistance in predicting the prospects for their reproductive health. The purpose of the study. To examine the hemodynamics of uterus and assess the ability of endometrium to implant in women with menstrual dysfunction in puberty with the help of ultrasound and dopplerometry.Materials and methods. To achieve the set goals, 120 women of reproductive age from 19 to 32 years old were examined. By the nature of the disorders, the main group of women (n = 90) with menstrual dysfunction in puberty were divided into 3 subgroups (n = 30): the first group - women with primary oligomenorrhea, the second one - with late menarche, the third one - with pubertal bleeding. The control group consisted of women (n = 30) with the correct rhythm of menstruation in puberty. Results. On the basis of a comparative analysis of the echographic parameters of the size of the uterus in women with menstrual dysfunctions in puberty (main group) and women with the correct rhythm of menstruation (control group), it was found that, on the average stage of endometrial secretion, the volume of the uterus is 1, 2 times smaller in women of the main group (p˂0.05) due to the width of the body of the uterus (p˂0.001). The ratio between the length of the body and cervix in the examined groups did not differ significantly. The thickness of the anterior wall of the uterus is less than the control values in women with late menarche (p˂0.05) and pubertal bleeding (p˂0.01), which was a predictor of the absence of combined uterine pathology. Echographic examination of the thickness of the endometrium at a late stage of the proliferation phase in the examined women did not reveal significant differences with the control group. In the middle stage of the secretion phase, the thickness of the endometrium was less in women, who had menstrual dysfunction in puberty - 9.50 ± 0.27 mm versus 11.38 ± 0.48 mm in the group with the correct menstruation rhythm (p

Polycystic ovarian syndrome is the most common endocrinological disorder in women of reproductive age and has a considerable metabolic, reproductive, and cardiovascular consequences. This study was designed to provide an overview of the presentation of he clinical profile and hormonal presentation of the patients with polycystic ovarian syndrome attending a tertiary care hospital.A descriptive cross-sectional study was conducted between September 14, 2019 to October 16, 2019 on patients presenting to a tertiary care hospital, after obtaining ethical clearance from Institutional Review Committee (Dated 03/09/2019) and informed consent from the patient or patient relatives. Data entry and analysis were done in Microsoft Excel 10. The data was statistically analysed using Statistical Package for the Social Sciences (SPSS) version 20.0.The study included 100 PCOS patients. The mean age of the patients was 24.9±4.52 years and the most common group was 26-34 years. The most common presenting symptom was menstrual irregularity which was seen in 86 (86%) of the patients, followed by weight gain in 55 (55%) of the patients. Thirty percent (30 in number) of the patients were overweight, while eleven (11%) of the patients had grade I obesity. LH/FSH ratio was more than or equal to 2 in eighty-three percent 83 (83%) of the patients.Polycystic ovarian syndrome has varying clinical manifestations, most commonly affecting the young women of reproductive age group. The commonest presenting complaint in the current study was menstrual abnormality. Majority of the patients had deranged hormonal profile which can lead to an increased risk of cardiovascular disease and type 2 DM. Thus, awareness regarding PCOS is important for early diagnosis and to prevent its sequalae to various complications.

Eating Disorders (ED) are associated with multiple physical complications that strongly affect the physical health of these young and fragile patients and can also cause significant mortality, the highest among psychiatric pathologies. Among the various organic complications, albeit still little known, the gynecological implications, up to infertility, are very widespread. Both among adolescent and adult patients, gynecological symptoms can be very widespread and range from menstrual irregularities to amenorrhea, from vaginitis to ovarian polycystosis, up to complications during the gestational phase and in postpartum, in addition to the possible consequences on the unborn child. Among the most frequent and significant gynecological disorders in women with ED, there are menstrual irregularities that may occur with oligomenorrhea or even amenorrhea. This symptom, although no longer part of the DSM-5 diagnostic criteria for defining Anorexia Nervosa (AN), must be considered a very relevant event in the overall evaluation of young women and adolescents with eating disorders. Functional Hypothalamic Amenorrhea in ED patients is related to psychological distress, excessive exercise, disordered eating, or a combination of these factors which results in suppression of the hypothalamic- pituitary-ovarian axis, resulting in hypoestrogenism. The objective of this paper is to summarize the causes and the mechanism underlying the menstrual disorders and to provide a better understanding of the correlation between the reproductive system and the mechanisms that regulate food intake and eating habits. In addition, early recognition of risk factors for eating disorders for gynecological implications can help put more accurate assessments of patients to prevent potentially fatal complications. The importance of the involvement of specialist gynecologists in the multidisciplinary team that has to follow patients with eating disorders is also discussed.

The concept of «ovarian reserve» in recent years has been widely discussed in the literature. This is a functional reserve of the ovaries, reflecting the size of the follicular pool of the ovaries and the quality of the oocytes in them, that is, it characterizes the ability of the ovaries to develop a healthy follicle with a full egg. Determination of ovarian reserve allows you to more accurately assess the reproductive potential of women and prevent pathological conditions and diseases that reduce fertility.The objective: аccording to laboratory and instrumental methods of research, to give a comprehensive assessment of the condition of the ovarian reserve in women with menstrual dysfunction in the puberty.Materials and methods. The main group of women (n=90) with a pathology of menstrual function in the puberty, according to the nature of the violations, was divided into 3 subgroups (n=30): the first – women with primary oligomenorrhea in the anamnesis, the second – with late age menarche, the third – with puberty bleeding. The control group consisted of women (n=30) with the correct rhythm of menstruation in puberty. The age range of the subjects is from 19 to 32 years. The biochemical and echographic markers of the ovarian reserve were studied.Results. In a clinical study, it was found that in women with menstrual dysfunction in the puberty, the concentration of antimuller hormone (AMH) in the blood serum and the size of the ovaries (total volume) are greater due to the greater number of small follicles compared to women in the control group. A direct correlation between the parameters of AMH and the number of follicles and the inverse between AMH and the diameter of the follicles indicate normal ovarian reserve. This pattern was observed in women with a primary history of oligomenorrhea and late menarche. In women with pubertal hemorrhages, the concentration of AMH in the blood did not significantly differ from the control group, the total volume of both ovaries was greater than in women with a normal rhythm of menstruation (p, Понятие «овариальный резерв» в последние годы довольно широко обсуждается в литературе. Это функциональный резерв яичников, отображающий величину фолликулярного пула яичников и качество ооцитов в них, то есть характеризует способность яичников к развитию здорового фолликула с полноценной яйцеклеткой. Определение овариального резерва позволяет более точно оценить репродуктивный потенциал женщины и предупредить патологические состояния и заболевания, снижающие фертильность.Цель исследования: по данным лабораторных и инструментальных методов исследования дать комплексную оценку состояния овариального резерва у женщин с нарушениями менструальной функции в пубертатном периоде.Материалы и методы. Основную группу женщин (n=90) с патологией менструальной функции в пубертатном периоде по характеру нарушений разделили на три подгруппы (n=30): первая – женщины с первичной олигоменореей в анамнезе, вторая – с поздним возрастом менархе, третья – с пубертатными кровотечениями. В контрольную группу вошли женщины (n=30) с правильным ритмом менструаций в пубертате. Возрастной диапазон обследуемых – от 19 до 32 лет. Исследовались биохимические и эхографические маркеры овариального резерва.Результаты. В ходе клинического исследования установлено, что у женщин с нарушениями менструальной функции в пубертатном периоде концентрация антимюллерового гормона (АМГ) в сыворотке крови и размеры яичников (суммарный объем) больше за счет большего количества мелких фолликулов по сравнению с женщинами контрольной группы. Прямая корреляционная зависимость между показателями АМГ и количеством фолликулов и обратная между АМГ и диаметром фолликулов свидетельствуют о нормальном овариальном резерве. Эта закономерность прослеживалась у женщин с первичной олигоменореей в анамнезе и поздним возрастом менархе. У женщин с пубертатными кровотечениями концентрация АМГ в крови достоверно не отличалась от группы контроля, суммарный объем обоих яичников был больше, чем у женщин с нормальным ритмом менструаций (р, Поняття «оваріальний резерв» останніми роками досить широко обговорюється в літературі. Це функціональний резерв яєчників, який відображає величину фолікулярного пулу яєчників і якість ооцитів в них, тобто визначає здатність яєчників до розвитку здорового фолікула з повноцінною яйцеклітиною. Визначення оваріального резерву дозволяє більш точно оцінити репродуктивний потенціал жінки і попередити патологічні стани і хвороби, що знижують фертильність.Мета дослідження: за даними лабораторних та інструментальних методів дослідження надати комплексну оцінку стану оваріального резерву в жінок, які мали порушення менструальної функції в пубертатному періоді.Матеріали та методи. Основну групу жінок (n=90), які мали розлади менструальної функції в пубертатному періоді, за характером порушень було розподілено на три підгрупи (n=30): перша – жінки з первинною олігоменореєю в анамнезі, друга – з пізнім віком менархе, третя – з пубертатними кровотечами. До контрольної групи увійшли жінки (n=30) з правильним ритмом менструацій у пубертаті. Віковий діапазон обстежуваних – від 19 до 32 років. Досліджувались біохімічні й ехографічні маркери оваріального резерву.Результати. У ході клінічного дослідження встановлено, що в жінок, які мали порушення менструальної функції в пубертатному періоді, концентрація антимюллерового гормону (АМГ) у сироватці крові і розміри яєчників (сумарний обсяг) більше за рахунок більшої кількості мілких фолікулів порівняно з жінками контрольної групи. Пряма кореляційна залежність між показниками АМГ і кількості фолікулів та зворотна між АМГ і діаметром фолікулів свідчать про нормальний оваріальний резерв. Ця закономірність простежувалась у жінок з первинною олігоменореєю в анамнезі і пізнім віком менархе. У жінок з пубертатними кровотечами концентрація АМГ у крові достовірно не відрізнялась від групи контролю, сумарний обсяг обох яєчників був більшим, ніж у жінок з нормальним ритмом менструацій (р

CapsuleOligo/amenorrhea is an independent risk factor of low ovarian response but not high ovarian response, particularly in women with low AMH levels.ObjectiveTo investigate the association of menstrual cycle length (MCL) with anti-Müllerian hormone (AMH) and ovarian response.MethodsThis was a retrospective cohort study. A total of 7471 women who underwent ovarian stimulation and oocyte retrieval were enrolled. The main outcome was the number of oocytes retrieved.Main ResultsA total of 5734 patients were eligible for analysis. In women without polycystic ovary syndrome (PCOS), serum AMH levels and antral follicle count were significantly lower in women with short cycles and higher in women with oligo/amenorrhea than those with a normal menstrual cycle. In women with PCOS, compared to women with a normal menstrual cycle, women with short cycles and women with oligo/amenorrhea showed higher antral follicle count and higher serum AMH levels. Compared with the 0-25th range group of AMH levels, 75-100th percentile groups showed a significantly increased rate of oligo/amenorrhea in women with and without PCOS [adjusted odds ratio (OR) =1.9 (1.04, 3.46), 2.4 (1.70, 3.35)]. In women without PCOS, the low ovarian response was more common in women with short cycles and less common in women with oligo/amenorrhea compared to women with normal cycles [OR=3.0 (2.38, 3.78), 0.7 (0.55, 0.96), respectively]. When adjusted for AMH levels, both short cycles and oligo/amenorrhea were associated with an increased risk of low response [adjusted OR=1.3 (1.02, 1.75), 1.3 (0.93, 1.86), respectively]. In women without PCOS and with low AMH levels, the low ovarian response was more common in women with short cycles as well as in women with oligo/amenorrhea [OR=1.5 (1.08, 1.98), 1.7 (1.08, 2.69), adjusted OR=1.2 (0.86, 1.74), 2.2 (1.31, 3.82), respectively].ConclusionAMH levels are significantly associated with increased risk of oligo/amenorrhea in women with and without PCOS. AMH is an indispensable confounder in the association between MCL and ovarian response in women without PCOS. Oligo/amenorrhea is an independent risk factor associated with a low ovarian response in women without PCOS, particularly those with low AMH levels.