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Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting approximately 5 to 18% of women of reproductive age and 3 to 11% of teenagers. The diagnostic criteria used in adult patients are not suitable for the diagnosis of adolescent patients, because some of the features may be physiological for puberty, so research is still ongoing to improve the criteria for diagnosing PCOS in teenagers. Polycystic ovary syndrome is associated with hormonal and metabolic changes and may predispose to the occurrence of many other diseases, such as obesity, metabolic syndrome, hypertension, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). Due to the high prevalence of PCOS and the various health problems it brings, it is necessary to select adolescent girls from the risk group, make an efficient diagnosis, start appropriate treatment, and lead the patient through a lifestyle change as soon as possible. Researchers' attention is increasingly focused on patients presenting with PCOS already in their teenage years. In our work, we want to look at the latest reports regarding the prevalence, pathophysiology and diagnosis of PCOS in adolescent girls. [ABSTRACT FROM AUTHOR]

Background: Growth hormone (GH) positive pituitary neuroendocrine tumors do not always cause acromegaly. Approximately one-third of GH-positive pituitary tumors are classified as non-functioning pituitary tumors in clinical practice. They typically have GH and serum insulin-like growth factor 1 (IGF-1) levels in the reference range and no acromegaly-like symptoms. However, normal hormone levels might not exclude the underlying hypersecretion of GH. This is a rare and paradoxical case of pituitary tumor causing acromegaly-associated symptoms despite normal GH and IGF-1 levels. Case presentation: We report a case of a 35-year-old woman with suspicious acromegaly-associated presentations, including facial changes, headache, oligomenorrhea, and new-onset diabetes mellitus and dyslipidemia. Imaging found a 19 × 12 × 8 mm pituitary tumor, but her serum IGF-1 was within the reference, and nadir GH was 0.7ng/ml after glucose load at diagnosis. A thickened skull base, increased uptake in cranial bones in bone scan, and elevated bone turnover markers indicated abnormal bone metabolism. We considered the pituitary tumor, possibly a rare subtype in subtle or clinically silent GH pituitary tumor, likely contributed to her discomforts. After the transsphenoidal surgery, the IGF-1 and nadir GH decreased immediately. A GH and prolactin-positive pituitary neuroendocrine tumor was confirmed in the histopathologic study. No tumor remnant was observed three months after the operation, and her discomforts, glucose, and bone metabolism were partially relieved. Conclusions: GH-positive pituitary neuroendocrine tumors with hormonal tests that do not meet the diagnostic criteria for acromegaly may also cause GH hypersecretion presentations. Patients with pituitary tumors and suspicious acromegaly symptoms may require more proactive treatment than non-functioning tumors of similar size and invasiveness. [ABSTRACT FROM AUTHOR]

The hormonal changes in women influence creatine dynamics, emphasizing its potential importance during menstruation, pregnancy, postpartum, menopause, and postmenopause. Yet, limited research explores creatine's impact on female reproductive health at the population level. Our study investigated the relationship between dietary creatine intake and reproductive health indices in US women using data from the 2017–2020 National Health and Nutrition Examination Survey (NHANES). We extracted a dataset containing females aged 12 years and above who provided details about their reproductive health and dietary habits. Daily creatine intake was quantified as a relative amount (mg per kg body mass) and did not include creatine from dietary supplements and pharmacological agents. A daily requirement for dietary creatine for healthy women was employed to classify respondents into two separate subpopulations: (1) suboptimal intake of creatine (<13 mg per kg body mass per day) or (2) recommended intake (dietary creatine ≥ 13 mg per kg body mass per day). A total of 4522 female participants from the NHANES study (age 44.5 ± 20.5 years) provided data on their reproductive health and dietary intake. The average daily creatine intake for the group was 10.5 ± 10.8 mg per kg body mass. The odds ratio for having irregular periods in women consuming ≥13 mg of creatine per kg body mass daily (recommended intake) compared to those with suboptimal intake was 0.75 (95% CI, from 0.66 to 0.86), indicating a significant association between higher intake of dietary creatine and lower risk of oligomenorrhea (p <.001). Moreover, women consuming less than 13 mg of creatine per kg body mass faced an increased risk of fetal macrosomia (OR 1.26; p =.04), pelvic infection (OR 1.68; p =.01), hysterectomy (OR 1.42; p <.001), oophorectomy (OR 1.54; p <.001), and receiving hormone replacement therapy (OR 1.26; p =.02). Consuming a creatine‐rich diet has been linked to lower risks of reproductive issues in US women aged 12 and above. Those consuming ≥13 mg of creatine per kg body mass daily showed notably lower risks of irregular menstrual periods, obstetric conditions, and pelvic pathology. Further studies are needed to confirm these potential benefits. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a disease affecting as many as about 10% of women of reproductive age, also 3-11% of teenage patients, and can lead to numerous complications and coexists with many diseases. Research is ongoing to establish an appropriate diagnostic and therapeutic path for adolescent girls with PCOS. It is also important to implement appropriate check-ups among teenagers with PCOS in order to prevent PCOS complications and initiate appropriate treatment as soon as possible and prevent the long-term consequences of these complications. The relationship between the co-occurrence of PCOS and diseases such as metabolic syndrome, hypertension, obesity, insulin resistance, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) is increasingly being investigated. A great attention is also being paid to the problem of mental health in this group of patients. In our study, we will review the latest reports on the treatment of PCOS and look at the complications that this syndrome can cause.

Background: Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine–metabolic disorder in women of reproductive age. Diagnosis is based on the evidence-based international guideline 2018 and the Rotterdam Consensus to classify PCOS phenotypes. This study aims to characterize the biodemographic, clinical, metabolic, and reproductive variables and their relationship with PCOS phenotypes in a population from the Ecuadorian Andes. Methodology: A cross-sectional study was conducted with a non-random consecutive sample of 92 women who attended the outpatient gynecology and endocrinology clinic at the Hospital of the Technical University of Loja (UTPL)—Santa Inés, Loja, Ecuador, between January 2022 and July 2023. Descriptive statistics, mean calculations, standard deviation, parametric and nonparametric tests, odds ratios (OR), confidence intervals (CI), and p-values were employed. Results: The average age was 22 ± 3.4 years, with a predominantly mestizo, urban, single, highly educated, and medium–high socioeconomic level population. It was identified that phenotypes A + B are at a higher risk of developing oligomenorrhea and hypertriglyceridemia compared to phenotypes C + D, with statistically significant differences (p < 0.05). Furthermore, in terms of reproductive variables, phenotypes A + B exhibit a significantly higher frequency of elevated anti-Müllerian hormone (AMH) compared to phenotypes C + D, also with statistical significance (p < 0.05). Conclusions: The classical phenotypes A and B of PCOS are the most common in Ecuadorian Andean women and carry a higher risk of insulin resistance, anovulation, metabolic disorders, and elevated triglyceride levels compared to phenotypes C and D. Ethnic diversity and sociocultural habits influence the prevalence and clinical manifestations of these phenotypes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Congenital adrenal hyperplasia is an autosomal recessive disorder caused by a defect in adrenal steroidogenesis. The non-classical variant begins at puberty and is manifested by menstrual irregularities, hirsutism, genital hyperpigmentation, clitoral hypertrophy, accelerated growth, and elevated levels of testosterone and other androgens. Individuals with these non-classical forms of the disease are born with normal-appearing genitalia and begin clinical manifestations with the steroidogenic stimulus characteristic of adolescence. CLINICAL CASE: A 16-year-old female patient seen at the endocrinology clinic for menstrual irregularities and hirsutism, menarche at 13 years of age with menstrual irregularities (oligomenorrhea) and recession of the frontal hairline, breast and pubic hair development grade 4 on the Tanner scale for both features. The diagnosis of late-onset 21-hydroxylase blockade (non-classical form) was established. Initial treatment consisted of metformin and cyproterone, with marked relieve of hyperandrogenism and correction of menstrual irregularities. CONCLUSIONS: Late-onset non-classical congenital adrenal hyperplasia is due to a homozygous point mutation of the CYP21A2 gene, which in turn is due to a coding error at position 281 of the 21-hydroxylase protein, consisting of a substitution of the amino acid valine for leucine and resulting in complete inactivation of both alleles of the enzyme. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome (PCOS) is a common disorder found in women of reproductive age in India. It has multigenic etiology, including genetic, lifestyle, stress, diet, exercise, and obesity. Methods: We have searched various databases such as PubMed and Google Scholar including the relevant literature on "PCOS." Results: Some of the most common clinical features observed are oligomenorrhea/amenorrhea, hyperandrogenemia, hyperinsulinemia, polycystic ovaries in ultrasonography, hirsutism, alopecia, acne, and acanthosis nigricans. Several studies have shown an association between PCOS and heart disease because of varied causes, including altered lipid/glucose metabolism, hypertension, systemic inflammatory conditions, vascular injuries, obesity, and hyperandrogenism. PCOS and hyperprolactinemia are the two most common etiologies of anovulation in women, although evidence linking them suggests independent origins of these conditions. Hence, PCOS influences the quality of life as its clinical manifestations may lead to fear of sexual unattractiveness, poor self-esteem, discontent with one's physical appearance, social anxiety, emotional changes, and mood swings, causing huge psychological distress. Conclusion: It is essential to focus on managing the patients' primary needs and reducing the impact of long-term risk factors when treating a patient with PCOS. The symptoms of a PCOS patient could be well managed when a variety of specialists work together, catering to a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome is one of the common diseases during the reproductive period that the common treatments are mostly symptomatic and their long-term use has many complications. According to previous studies that showed the effect of wet cupping on calf muscles on oligomenorrhea pattern, this study was performed with aim to investigate the effect of wet cupping on calf muscles on clinical and laboratory symptoms and quality of life in patients with this syndrome. Methods: In this randomized clinical trial study which was performed in 2019-2021, 60 PCOS women with minimum 60 days menstrual cycle entered the study and randomly divided to cupping and control groups (n=30 per group). At the 26th day menstrual cycle, after blood sampling for two groups, wet-cupping on calf muscles was done for intervention group. Menstrual period, insulin resistance and quality of life were measured using Cronin PCOS Questionnaire. Data analysis was done using SPSS statistical software (version 20) and student t and chi-square tests. P

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects women of child-bearing age, with a worldwide prevalence ranging from 6 to 20%. Considering the potential side effects of chemical medications and the need for long-term drug administration, complementary treatments such as acupuncture, auriculotherapy, and herbal medicine have been considered. Hence, this study was designed to compare the effects of auriculotherapy, a herbal component (Aslagh capsule), and metformin on the clinical symptoms of PCOS. Materials and Methods: This is a randomized controlled clinical trial study, which allocated 24 women, aged 18–43 years old, with oligomenorrhea in PCOs, in a 1:1:1 ratio, to three groups. Result: A decreasing pattern in the duration of the menstrual cycle was observed in all three groups, but this was significant only in the auriculotherapy group. There were no significant differences between the three groups in acne and hirsutism scores. However, there was a significant reduction in excess hair growth and density of hair in the auriculotherapy group compared to the other two groups (P < 0.05). Besides, in the auriculotherapy group, the reduction in thickness of excess hair at the end of the second and third months of treatment were marginally significant compared to the two other groups. Conclusions: Auriculotherapy and Aslagh capsule can be effective in reducing PCOS symptoms, similar to metformin. However, auriculotherapy is more effective than the other treatments in reducing the duration of the menstrual cycle, excess hair growth, and hair density.

The aim of the study was to investigate are there associations between common female sex-specific health conditions (oligo/amenorrhea, hyperandrogenism, menopause and polycystic ovary syndrome [PCOS]) and high-sensitivity troponin-T (hs-TnT) levels. Cross-sectional and longitudinal analyses of a general population-based prospective cohort study were performed. The hs-TnT levels of 3146 women aged 46 were measured using an Elecsys® Troponin T high-sensitivity assay. Median hs-TnT levels and 25 and 75 percentiles of the cases and controls were compared. Also, a logistic regression analysis using a binary outcome – undetectable hs-TnT (< 3.0 ng/L) versus detectable hs-TnT (≥ 3.0 ng/L) – was performed. Women with oligo/amenorrhea at age 31 had significantly higher hs-TnT levels at age 46 than women without oligo/amenorrhea (4.06 [3.59; 4.86] vs 3.98 [3.44; 4.71] ng/L, p =.042). Menopausal women had significantly higher hs-TnT levels than premenopausal women (4.15 [3.54; 4.91] vs 3.95 [3.45; 4.68] ng/L, p =.012) at age 46. Women with PCOS or hyperandrogenism had comparable hs-TnT levels with their controls. In the adjusted logistic regression analysis, oligo/amenorrhea (odds ratio [OR] = 1.52 [0.90–2.57]), hyperandrogenism (OR = 1.20 [0.75–1.92]), PCOS (OR = 1.51 [0.81–2.84]) and menopause (OR = 1.05 [0.63–1.74]) were not significantly associated with detectable hs-TnT. This study was the first to investigate how oligo/amenorrhea, hyperandrogenism, PCOS and menopause are associated with hs-TnT. Although women with oligo/amenorrhea and menopause had higher hs-TnT levels than women without these conditions, the difference was small. Larger studies are required to better understand the effects of oligo/amenorrhea on cardiovascular health. No previous studies have investigated the association between common female sex-specific health conditions, such as oligo/amenorrhea, hyperandrogenism and PCOS, and hs-TnT levels. Only one prior study has investigated the association between menopause and hs-TnT levels. Hs-TnT levels were significantly higher in women with oligo/amenorrhea and relatively early menopause at age 46 than women without these conditions, whereas women with hyperandrogenism or PCOS and their controls have comparable hs-TnT levels. The effect of oligo/amenorrhea on cardiovascular health should be further investigated. A simple question about the presence of oligo/amenorrhea might identify women at increased risk of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome is one of the common diseases during the reproductive period that the common treatments are mostly symptomatic and their long-term use has many complications. According to previous studies that showed the effect of wet cupping on calf muscles on oligomenorrhea pattern, this study was performed with aim to investigate the effect of wet cupping on calf muscles on clinical and laboratory symptoms and quality of life in patients with this syndrome. Methods: In this randomized clinical trial study which was performed in 2019-2021, 60 PCOS women with minimum 60 days menstrual cycle entered the study and randomly divided to cupping and control groups (n=30 per group). At the 26th day menstrual cycle, after blood sampling for two groups, wet-cupping on calf muscles was done for intervention group. Menstrual period, insulin resistance and quality of life were measured using Cronin PCOS Questionnaire. Data analysis was done using SPSS statistical software (version 20) and student t and chi-square tests. P<0.05 was considered significant. Results: In this study, 21 members of cupping group and 6 members of control group menstruated after the intervention, the difference was statistically significant (p<0.001). Insulin resistance changed significantly in the intervention group (p=0.03). Quality of life was significantly improved in the cupping group (p=0.01), but no significant statistical difference was observed in the control group. Conclusion: Calf muscles wet-cupping can be considered as one of the options for causing bleeding in people with PCOS. Obviously, more studies are necessary to compare different protocols and investigate its mechanism. [ABSTRACT FROM AUTHOR]

FSH, estrogen and progesterone testing are widely utilized in clinical practice. Lateral flow assays (LFAs) are cost-effective tools used for diagnosing infectious diseases, pregnancy, and substance testing. The focus of this narrative review is the potential for the wider utilization of listed hormone LFAs. A search was conducted with PubMed, Google Scholar and Wiley online libraries using keywords without any limitation on the publication date; animal studies were excluded. Clinical guidelines for the related conditions were included. According to published data, E3G and PdG are used to determine ovulatory cycles and can be utilized for research purposes to establish the normal range of menstrual cycles, as there is currently disagreement among guidelines. FSH measurement in blood samples is utilized to predict oocyte yield in assisted cycles and to differentiate women with premature ovarian insufficiency from hypothalamic amenorrhea, and can be replaced with more convenient urine testing. PdG was tested to assess the risk of pregnancy complications, specifically miscarriage and ectopic pregnancy, and might become a screening tool for miscarriage in the future. PMS, PMDD and ovarian carcinogenesis could be extensively studied using LFAs to gain a better understanding of the biology behind these conditions. Before implementing these LFAs into clinical practice, the reproducibility of progesterone assays should be evaluated. The results are critical for treatment decisions, and universally recognized standards for estradiol measurement should be developed. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is a chain of pathological, biochemical and endocrinal events which usually present with complaints like infertility, features of hyperandrogenemia (HA), amenorrhea and signs of metabolic disturbances like impaired glucose tolerance. Aim: To assess clinical, endocrinal and radiological profile of cases with polycystic ovary syndrome in tertiary care centre. Methodology: Descriptive cross-sectional study conducted in gynaecological OPD on 100 women having PCOS diagnosed by Rotterdam criteria. Results: Most of cases were belongs to age group of 20 to 24 years (47%) with mean age of patients was 23.69 ± 4.48 years. Half were obese (48%). Almost 50% women showed features of hyperandrogenism and 86% had oligomenorrhea. Serum testosterone levels were found to be increased among 54% women. Out of three Rotterdam criteria for diagnosis of PCOS, most cases had chronic anovulation (irregular cycles) followed by 83% had USG suggestive of PCOS and 46% had hyperandrogenism. Association between hyperandrogenism, acanthosis nigricans and obesity were statistically significant (p

Introduction: One of the common problems of women in reproductive age is abnormal cessation or reduction of menstrual bleeding, which causes many complications and reduces the quality of life. The present study was conducted with aim to provide a treatment protocol of oligoamenorrhea (secondary amenorrhea, oligomenorrhea) within the framework of the basics of evidence-based Persian medicine and conventional medicine.Methods: In this study, information was collected in the form of narrative review by searching the contents related to cessation or reduction of menstrual bleeding from various Persian medical sources and searching in databases of Pubmed, Web of science, Google scholar, Iranmedex, SID, Magiran with related keywords in order to find evidence and documents. In the next stage, 10 sessions of group discussions on the topic of explanation and interpretation of menstrual disorders in Persian medicine and conventional medicine were held with the presence of experts in the field of Persian medicine and obstetrics and gynecology. Finally, consolidated treatment was presented in the form of a treatment protocol with emphasis on clinical evidences.Results: The principles of oligoamenorrhea treatment in Persian medicine include lifestyle modification, specially nutrition, physical activity, mental and sleep health, use of herbal medicines, and manual operations (which can be integrated with the treatment steps of some causes of this disorder in conventional medicine.Conclusion: Considering the existence of some problems in olioamenorrhea treatment in conventional medicine, the use of Persian traditional medicine in the treatment of oligoamenorrhea along with the protocols of conventional medicine can be helpful in the control and management of this disorder.

AbstractObjective The aim of the study was to investigate are there associations between common female sex-specific health conditions (oligo/amenorrhea, hyperandrogenism, menopause and polycystic ovary syndrome [PCOS]) and high-sensitivity troponin-T (hs-TnT) levels.Methods Cross-sectional and longitudinal analyses of a general population-based prospective cohort study were performed. The hs-TnT levels of 3146 women aged 46 were measured using an Elecsys® Troponin T high-sensitivity assay. Median hs-TnT levels and 25 and 75 percentiles of the cases and controls were compared. Also, a logistic regression analysis using a binary outcome – undetectable hs-TnT (< 3.0 ng/L) versus detectable hs-TnT (≥ 3.0 ng/L) – was performed.Results Women with oligo/amenorrhea at age 31 had significantly higher hs-TnT levels at age 46 than women without oligo/amenorrhea (4.06 [3.59; 4.86] vs 3.98 [3.44; 4.71] ng/L, p = .042). Menopausal women had significantly higher hs-TnT levels than premenopausal women (4.15 [3.54; 4.91] vs 3.95 [3.45; 4.68] ng/L, p = .012) at age 46. Women with PCOS or hyperandrogenism had comparable hs-TnT levels with their controls. In the adjusted logistic regression analysis, oligo/amenorrhea (odds ratio [OR] = 1.52 [0.90–2.57]), hyperandrogenism (OR = 1.20 [0.75–1.92]), PCOS (OR = 1.51 [0.81–2.84]) and menopause (OR = 1.05 [0.63–1.74]) were not significantly associated with detectable hs-TnT.Conclusions This study was the first to investigate how oligo/amenorrhea, hyperandrogenism, PCOS and menopause are associated with hs-TnT. Although women with oligo/amenorrhea and menopause had higher hs-TnT levels than women without these conditions, the difference was small. Larger studies are required to better understand the effects of oligo/amenorrhea on cardiovascular health.

Objectives: This study aimed to investigate serum anti-Mullerian hormone (AMH) and prolactin levels in polycystic ovarian syndrome (PCOS) according to the presence of oligomenorrhea. Methods: Women with PCOS who were admitted to an endocrinology outpatient clinic consecutively between January and December 2020 were enrolled in this study retrospectively. The age of the patients included in this study was between 18 and 40 years. Patients diagnosed with PCOS according to Rotterdam revised criteria. Demographic and clinical characteristics of the patients were obtained from patients' files. Results: A total of 301 women with PCOS were enrolled in this study. The mean prolactin levels were 20.0±8.5 ng/mL and 22.2±5.5 ng/mL in PCOS patients with and without oligomenorrhea (p=0.091). No significant differences in AMH levels were also found between the two groups 5.3 (5.2-5.4) versus 5.3 3 (5.0-6.0) ng/mL, respectively (p=0.798). AMH levels were positively correlated with prolactin and negatively with follicular-stimulating hormone in PCOS subjects (r=0.512, p<0.001, r=-0.155, p=0.007, respectively). The oligomenorrhea group demonstrated increased serum glucose and Vitamin D levels and platelet distribution width value and decreased glycated hemoglobin, estradiol, free testosterone, hemoglobin, and red cell distribution width values (p<0.001, p=0.017, p=0.018, p=0.001, p=0.008, p=0.027, p=0.001, and p=0.010, respectively). In addition, serum prolactin had a relationship between free testosterone and vitamin D levels (r=0.210, p<0.001; r=-0.123, p=0.320, respectively). Conclusion: AMH and prolactin levels did not differ in PCOS patients with and without oligomenorrhea. [ABSTRACT FROM AUTHOR]

Background and Objectives: The Quantum Menstrual Health Monitoring Study will measure four key reproductive hormones in the urine (follicle-stimulating hormone, FSH; estrone-3-glucuronide, E13G; luteinizing hormone, LH; and pregnanediol glucuronide, PDG) to characterize patterns that predict and confirm ovulation, referenced to serum hormones and the gold standard of the ultrasound day of ovulation in participants with regular cycles. These normal cycles will provide a reference for comparison to irregular cycles in subjects with polycystic ovarian syndrome (PCOS) and athletes. Materials and Methods: Participants will track their menstrual cycles for 3 months and be provided with an at-home urine hormone monitor (Mira monitor) to predict ovulation. The day of ovulation will be confirmed with serial ultrasounds completed in a community clinic. Urine results will be compared to serum hormone values. Other markers of menstrual health, such as bleeding patterns and temperature changes, will be determined using a customized app. Three groups will be recruited. Group 1 will include those with consistent regular cycle lengths (between 24–38 days), and will be compared to two groups with irregular cycle lengths (with increased cycle length variability and longer cycles). Group 2 will include those with polycystic ovarian syndrome (PCOS) with irregular cycles and Group 3 will include individuals participating in high levels of exercise with irregular cycles. Hypothesis: The Mira monitor quantitative urine hormone pattern will accurately correlate with serum hormonal levels and will predict (with LH) and confirm (with PDG) the ultrasound day of ovulation in those with regular cycles as well as those with irregular cycles. Rationale: Once the ultrasound validation is complete, tools like the Mira monitor with a customized app may become a new standard for at-home and remote clinical monitoring of the menstrual cycle without having to use labor-intensive follicular-tracking ultrasound or follow serum hormone changes. Conclusions: Precision monitoring of the menstrual cycle is expected to impact individuals who want to increase their menstrual health literacy and guide decisions about fertility. [ABSTRACT FROM AUTHOR]

Background: Menstrual problems and infertility are best understood and treated with knowledge of gynecological endocrinology. Serum prolactin levels in infertile individuals with menstrual disorder are the focus of this study. Materials and Methods: Patients between the ages of 20 and 40 (the reproductive age range) were split into two groups for a year-long prospective case-control research. Fifty fertile women with normal periods served as the control group, while 150 infertile women with menstrual dysfunctions made up the research group. Serum prolactin levels were checked in addition to other relevant laboratory and radiographic tests to get a full picture of the obstetric history. Results: In this analysis, hyperprolactinemia was shown to occur in 24.6% of participants. Hyperprolactinemia was more common in those with polycystic ovary syndrome (33.3%), oligomenorrhea (27.27%), secondary amenorrhea (30.2%), primary amenorrhea (5.5%), irregular menstruation (9.09%), and 25% of those with regular ovulatory cycles and 40% of those with regular anovulatory cycles. Oligomenorrhea was the most common presenting symptom among hyperprolactinemic patients (48.7%), followed by secondary amenorrhea (35.1%). Patients with secondary amenorrhea had a substantially higher mean blood prolactin level (111.42 ng/mL) compared to those with oligomenorrhea (69.3 ng/mL). Seventy-five point six percent of hyperprolactinemic individuals experienced primary infertility, but only twenty-seven point zero seven percent experienced secondary infertility. (p0.01). Blood prolactin levels were significantly different (p 0.01) between cases with and without galactorrhea, and 66.6% of patients with galactorrhea had hyperprolactinemia. Although 13.5 percent of hyperprolactinemic individuals experienced galactorrhea, this symptom was not consistently present. Conclusion: Regular blood prolactin testing is required for the diagnosis of hyperprolactinemia, a major cause of infertility and menstrual disruption. [ABSTRACT FROM AUTHOR]

The purpose of the study was to evaluate the prevalence, co-morbidities, pharmacological therapy, and effectiveness of common lifestyle changes for metabolic dysfunction in women with the polycystic ovarian syndrome (PCOS) and related comorbidities in the gynaecology division. This 6-month prospective observational study of 120 PCOS patients who were gynaecology patients at a tertiary care hospital was conducted from September 2021 to February 2022. An interview with the patient was done using an assessment form. This study highlighted the supportive evidence among PCOS patients for the advantages of changing one's lifestyle. This study involved 90 PCOS individuals out of a total of 120 participants, many of them were in the 20–30 age group. This research analyses the high prevalence of cardiovascular disease co-morbidities and demonstrates that a high BMI is the most common risk factor for PCOS. The findings of our study indicate the necessity of evaluating the complications seen in individuals who are at risk, such as infertility. This line of research demonstrates the critical impact that medication and lifestyle modifications play in managing PCOS. Patients with the polycystic ovarian syndrome should get advice regarding lifestyle modifications from a clinical pharmacist.

The prolactin receptor gene (PRLR) may contribute to polycystic ovarian syndrome (PCOS) since it plays important roles in physiological ovarian functions. PRLR-knockout mice have irregular cycles and subfertility and variants in or around the PRLR gene were associated in humans with female testosterone levels and recurrent miscarriage. We tested 40 variants in the PRLR gene in 212 Italian families phenotyped by type 2 diabetes (T2D) and PCOS and found two intronic PRLR-variants (rs13436213 and rs1604428) significantly linked to and/or associated with the risk of PCOS. This is the first study to report PRLR as a novel risk gene in PCOS. Functional studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate associations between menstrual function, eating disorders, and risk of low energy availability with musculoskeletal injuries in British servicewomen. Methods: All women younger than 45 yr in the UK Armed Forces were invited to complete a survey about menstrual function, eating behaviors, exercise behaviors, and injury history. Results: A total of 3022 women participated; 2% had a bone stress injury in the last 12 months, 20% had ever had a bone stress injury, 40% had a time-loss musculoskeletal injury in the last 12 months, and 11% were medically downgraded for a musculoskeletal injury. Menstrual disturbances (oligomenorrhea/amenorrhea, history of amenorrhea, and delayed menarche) were not associated with injury. Women at high risk of disordered eating (Female Athlete Screening Tool score >94) were at higher risk of history of a bone stress injury (odds ratio (OR; 95% confidence interval (CI)), 2.29 (1.67–3.14); P < 0.001) and time-loss injury in the last 12 months (OR (95% CI), 1.56 (1.21–2.03); P < 0.001) than women at low risk of disordered eating. Women at high risk of low energy availability (Low Energy Availability in Females Questionnaire score ≥8) were at higher risk of bone stress injury in the last 12 months (OR (95% CI), 3.62 (2.07–6.49); P < 0.001), history of a bone stress injury (OR (95% CI), 2.08 (1.66–2.59); P < 0.001), a time-loss injury in the last 12 months (OR (95% CI), 9.69 (7.90–11.9); P < 0.001), and being medically downgraded with an injury (OR (95% CI), 3.78 (2.84–5.04); P < 0.001) than women at low risk of low energy availability. Conclusions: Eating disorders and risk of low energy availability provide targets for protecting against musculoskeletal injuries in servicewomen. [ABSTRACT FROM AUTHOR]

Hereditary angioedema (HAE) is characterized by recurrent angioedema attacks with no urticaria. This disease has a high mortality due to asphyxia. Level of complement component 4 (C4), C1 esterase inhibitor (C1-INH) level and function, and genetic mutations determine different endotypes of HAE. Clinical presentation and the triggers of vasogenic edema may change according to the endotypes. An adolescent girl with oligomenorrhea, obesity, hirsutism, and acanthosis nigricans was diagnosed with polycystic ovary syndrome and prescribed ethinyl estradiol and cyproterone acetate containing oral contraceptive (OC). On the sixteenth day of treatment, she developed angioedema of the face, neck, and chest leading to dyspnea. Adrenaline, antihistamine, and corticosteroid treatments were ineffective. In the family history, the patient’s mother and two cousins had a history of angioedema. C1-INH concentrate was administered with a diagnosis of HAE. C4 and C1-INH level and activity were normal. Genetic analysis identified a mutation in the factor 12 (F12) gene, and the diagnosis of F12-related HAE was made. OC treatment was discontinued. She has had no additional angioedema attacks in the follow-up period of two years. OC containing estrogen may induce the life-threatening first attack of F12-related HAE even in children. Recurring angioedema attacks in the family should be asked before prescribing estrogen-containing OC pills. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a hyperandrogenic endocrinological disorder associated with chronic oligo-anovulation and polycystic ovarian morphology. Compared to women without PCOS, women with PCOS have a risk of sexual dysfunction that is more than 30% higher. Although alterations in sex hormones and psychosocial wellbeing have been proposed, the precise mechanisms of FSD in PCOS remain unclear. The aim of our study was to analyze how the hormonal, clinical and psychometric parameters of PCOS patients are involved in the development of sexual dysfunction. The study group consisted of 54 women, aged between 21 and 32 years, diagnosed with PCOS. We collected the following parameters: age, body mass index (BMI), the Ferriman–Gallwey score (FG), maximum duration of oligomenorrhea, abdominal circumference (AC), free testosterone value (FT), luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio value, serum cortisol value and ovarian ultrasound appearance. At the time of the examination, patients were asked to fill in the Female Sexual Function Index (FSFI) and the Body Exposure during Sexual Activities Questionnaire (BESAQ). Statistically significant differences were observed between normal weight and overweight women regarding BESAQ (p-value = 0.02) and FSFI total (p-value <0.001). Elevated BMI, AC or BESAQ scores correlated with a lower FSFI score. The most involved domains of the scale were orgasm, arousal, and desire. Elevated BESAQ scores increase the risk of female sexual dysfunction (FSD) by 4.24 times. FT, BESAQ score, BMI, and LH/FSH ratio were found to independently predict FSD. The cutoff point for the BESAQ score in detecting FSD was found to be 1.97. Weight, body image and anxiety related to sexual activities seem to be significant components in the development of sexual dysfunction in PCOS patients, beyond the effect due to hyperandrogenism. FT value has a U-shape effect in sexual dysfunction, because both in the case of deficit and in the case of excess, sexual function is impaired. BESAQ is a strong predictor for sexual dysfunction in women with PCOS, along with FT value, LH/FSH ratio and BMI. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. It is linked to genetic and environmental factors such as nutrition. Insulin resistance (IR) is one of the major pathological changes in PCOS. This study aimed to determine the relationship between IR and macronutrient intake in PCOS subgroups. Methods: This case-control study was performed on 151 women with PCOS and were divided into four groups according to the Rotterdam diagnostic criteria: A=41, B=33, C=40, and D=37, and 31 women were also in the control group and did not have this syndrome. All macronutrients were assessed with a 168-item food frequency questionnaire (FFQ). Results: There was a significant relationship between HOMA-IR and some dietary components (Increased calorie in group A, increased total fat intake in group C, lower intake of unsaturated fats (PUFA and MUFA) in group D and higher intake of saturated fat (SFA) and protein intake in the control group). There was no correlation in subgroup B (ovulatory phenotype). Conclusion: Due to the significant relationship between IR and some dietary components in PCOS subtypes, it is recommended to maintain a balance in carbohydrate and fatty acids intake, and increase dietary fiber to improve health parameters in PCOS subjects. [ABSTRACT FROM AUTHOR]

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Polycystic ovary syndrome (PCOS) is a common endocrinological disorder in women with significant reproductive, metabolic, and psychological health implications. The lack of a specific diagnostic test poses challenges in making the diagnosis of PCOS, resulting in underdiagnosis and undertreatment. Anti-Mullerian hormone (AMH) synthesized by the pre-antral and small antral ovarian follicles appears to play an important role in the pathophysiology of PCOS, and serum AMH levels are often elevated in women with PCOS. The aim of this review is to inform the possibility of utilizing anti-Mullerian hormone either as a diagnostic test for PCOS or as an alternative diagnostic criterion in place of polycystic ovarian morphology, hyperandrogenism, and oligo-anovulation. Increased levels of serum AMH correlate highly with PCOS, polycystic ovarian morphology, hyperandrogenism, and oligo/amenorrhea. Additionally, serum AMH has high diagnostic accuracy as an isolated marker for PCOS or as a replacement for polycystic ovarian morphology. [ABSTRACT FROM AUTHOR]

Background: Considering the high prevalence of polycystic ovary syndrome (PCOS) in women of reproductive age and the metabolic disorders associated with it, this study was conducted to determine the effects of curcumin on metabolic indices and androgen level (primary outcomes), and menstruation characteristics, and hirsutism (secondary outcomes) in women with PCOS. Methods: This triple-blind randomized controlled trial was conducted on women with PCOS who visited the health centers at Eslamshahr County (Tehran Province-Iran) from 2020 to 2022. The participants were allocated into two groups (curcumin and placebo) using block randomization method. The treatment group received two 500 mg edible curcumin tablets together at the same time per day for twelve weeks while the control group received placebo tablets similar to curcumin. Biochemical parameters such as Fasting Blood Insulin (FBI), Fasting Blood Sugar (FBS), triglyceride, total cholesterol, Low Density Lipoprotein- cholesterol (LDL-C), High Density Lipoprotein- cholesterol (HDL-C) were measured before intervention and then 3 months after the intervention. Sex Hormone Binding Globulin (SHBG) and testosterone serum levels were measured 3 months after the intervention. Questionnaires regarding the menstrual cycle characteristics and the Ferriman–Gallwey score were also filled for evaluating hirsutism before the intervention as well as 3 months after the intervention. The independent t-test, Mann-Whitney U test, and ANCOVA were used to analyze the data. Results: There was no statistically significant difference between the two groups in terms of socio-demographic and the baseline levels of measured outcomes. After 12 weeks of intervention, the mean serum FBS levels in the curcumin group were significantly lower than in the placebo group (mean difference: 6.24; 95%confidence interval: -11.73 to -0.76; P = 0.027) but there was no significant difference between the two groups in terms of triglyceride (P = 0.351), cholesterol (P = 0.528), LDL (P = 0.064), HDL (P = 0.306), FBI (p = 0.929), SHBG (p = 0.682), and testosterone (p = 0.133) serum levels. After the intervention, amenorrhea and oligomenorrhea frequency in the curcumin group was significantly lower than in the placebo group (13% vs. 22%, P = 0.038). There was no significant difference in terms of duration of menstruation (P = 0.286) and hirsutism (P = 0.630) between the two groups. Conclusion: Curcumin decreased FBS levels and improved menstruation characteristics (amenorrhea, oligomenorrhea, and menstrual irregularities) in women with PCOS but did not affect other metabolic, hormonal, and hirsutism indices. More studies using a larger sample size are required for a definitive conclusion. Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N51 Date of registration: 30/11/2019. URL: https://en.irct.ir/user/trial/40597/view; Date of first registration: 30/11/2020. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder adversely affecting fertility and reproductive health with diverse clinical manifestations in women. Aim: The objectives of the present study are to determine and compare the prevalence of PCOS between rural and urban Assamese women in Guwahati, Assam. Methods: A total of 150 (75 rural; 75 urban) Assamese women aged 18-35 years have been collected at Pratiksha Hospital, Guwahati, Assam. The relevant data were collected through self-administered pre-structured and interview methods. Results: Higher prevalence of PCOS was found in the urban areas living in nuclear families in comparison to rural areas. Recent weight gain and obesity with a higher prevalence of oligomenorrhea were found to be higher among the urban participants. An excess androgen activity evidenced by increased hirsutism was higher in the urban areas as compared to rural areas in association with increased levels of serum insulin. Conclusion: A long-term personalized management program is required for effectively treating individuals with PCOS which may help in regulating the symptoms and various other metabolic complications.

Introduction: Thyroid disorders are very common in females and are known to prevent ovulation. Thyroid disorders can impact menstrual cycles and causes menstrual irregularities and infertility in females. Aim: To determine effects of hypothyroidism on menstrual cycle pattern and prevalence of subfertility among women having thyroid dysfunction. Materials and Methods: This cross-sectional study was conducted in Department of Obstetrics and Gynaecology in collaboration with Department of Endocrinology in Government Medical College, Datia Madhya Pradesh, India from July 2019 to June 2021. A total of 205 patients aged 18-45 years were taken. Among them, 116 and 89 patients were of hypothyroid and euthyroid respectively. After properly selecting patients, detailed history of their menstrual cycles was taken and effect of thyroid dysfunction on menstrual irregularities was assessed. The collected data were evaluated and analyzed using Statistical Package of the Social Sciences (SPSS). Results: A total of 205 patients participated in present study. Mean age was 35+/-5 years. Among 205 subjects, 116 were hypothyroid and 89 were euthyroid. Among the hypothyroid subjects, 72 (62.1%) had normal menstrual cycles, 23 (19.8%) had history of oligomenorrhea, 12 (10.3%) had polymenorrhea, and 9 (7.7%) had amenorrhea, while among the thyroid subjects, 76 (85.4%) had normal menstrual cycle, 6 (6.7%) had oligomenorrhea, 5 (5.6%) had polymenorrhea, and 2 (2.2%) had amenorrhea, with statistically significant differences (p

Abstract Background Tripterygium Wilfordii Hook F (TwHF) preparation has been widely used in the treatments of IgA nephropathy (IgAN) in China. However, the effectiveness and safety of the new generation of TwHF preparation, KuxXian capsule, on the treatment of IgAN remains unknown. Methods Here, we retrospectively describe our experience treating 55 consecutive IgAN patients with KunXian. We defined complete remission as proteinuria 50% reduction in proteinuria from baseline. Results At first follow-up after KunXian treatment (5.7 weeks, IQR 4.7–7.9), all but two patients (96%) showed a reduction in proteinuria. The overall median proteinuria decreased from 2.23 g/day at baseline to 0.94 g/day (P

Background: Polycystic ovary syndrome (PCOS) is currently considered to have a peri-adolescence onset and continuously influence the reproductive and metabolic health of the patients, while the diagnostic criteria among adolescent population haven't been universally unified till now. This survey seeks to preliminarily evaluate the prevalence of PCOS in the tenth grade schoolgirls in Guangzhou area under NIH criteria and analyze the clinical features of adolescents with PCOS. Methods: The cross-sectional epidemiological survey was carried out among the tenth grade schoolgirls in Guangzhou area by the method of cluster sampling. The contents of this survey included the questionnaire, physical exams and serum measurements. Until now, totally 1294 girls underwent this survey and 1095 serum samples were restored. 235 non-hirsute (mFG < 6), postmenarcheally 2-year girls were randomly selected as the control group, among which the cut-off value of biochemical hyperandrogenemia was set accordingly. The prevalence of PCOS among this population was preliminarily evaluated according to the NIH criteria. Results: Along with the increase of gynecological age, the menstruations of girls was becoming more regular and the incidence of oligomenorrhea or amenorrhea was declining. Even among those who were less than 2 years after menarche, those whose menstrual cycle were longer than 90 days accounted for lower than 5%. The 95th percentile of mFG score was 6 among the girls who were < 2 years after menarche, and 5 among the girls who were > 2 years after menarche. Among the 235 healthy girls, the 95th percentile values of Testosterone (T), Free androgen index (FAI) and Androstenedione (A2) were 2.28 nmol/mL, 4.37, and 5.20 nmol/mL respectively. Based on the NIH criteria, the prevalence of PCOS in this survey was 3.86%. The prevalence of adolescent PCOS tend to slightly increase with age and gynecological age, but the difference was not statistically significant. The prevalence of PCOS among obese girls was markedly higher than that in lean girls. Conclusion: Based on the NIH criteria, the prevalence of PCOS among the tenth grade schoolgirls in Guangzhou area was 3.86%. The diagnosis of hyperandrogenism among adolescents should also be based on both clinical and biochemical parameters. [ABSTRACT FROM AUTHOR]

Periodic bleeding is the visible manifestation of ovarian cycling. An average woman in developed countries can expect to experience more than 400 menstrual cycles during her reproductive lifetime. It is important to have a thorough understanding of the endometrial pathways that regulate implantation and menstrual cycles. Menstrual cycles usually last around 28 days, although they can vary from person to person. Menarche depend on the nutrition and heredity. Menstrual cycle irregularities may also be linked to endocrine instability, low body weight, intense exercise, and psychological stress. Among adolescent girls, dysmenorrhea is one of the most common gynecologic conditions. It is defined as pain in the pelvis that is directly related to menstruation. Other symptoms include headache, back pain, nausea, vomiting, and diarrhoea. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Menstrual irregularities are one of the main clinical symptoms caused by polycystic ovary syndrome (PCOS). Pharmacological treatment options for non-fertility indications to restore menstrual frequency play an important role in the management of PCOS. Oral contraceptive pills are commonly prescribed for adolescents with menstrual irregularities, however, when contraindicated or poorly tolerated, further pharmacological therapy is required. This systematic literature research aims to provide an overview concerning the effects of non-hormonal pharmacological treatment options on menstrual irregularities in adolescents suffering from PCOS. A systematic literature search in PubMed, Cochrane, Embase, Bio-SISS and Web of Science was performed, including literature from January 1998 to September 2022, using specific keywords in order to find related studies. n = 265 studies were identified of which n = 164 were eligible for further evaluation. Only four placebo-controlled studies were identified, with diverging inclusion and exclusion criteria. Available data on specific non-hormonal off-label use medication primarily consisted of metformin, Glucagon-like peptide 1 receptor agonists, thiazolidinediones, anti-androgen agents (spironolactone, finasteride, flutamide) and supplements (chromium picolinate, myo-inositol). However, only a few have partly pointed out beneficial effects on improving menstrual frequency in patients diagnosed with PCOS. In summary, metformin in dosages of 1500–2550 g/day, GLP-1—analogues and supplements were effective in regulation of menstrual cycles in adolescents diagnosed with PCOS. Menstrual frequency in adolescents with PCOS is essential to prevent hypoestrogenism with long-term consequences. In this context, MET is the most effective and cost- efficient in overweight adolescent girls, also showing beneficial effects in the regulation of insulin sensitivity, especially if COCs are contraindicated or not well-tolerated. Further studies are needed to evaluate therapies in lean and normal-weight girls with PCOS. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder adversely affecting fertility and reproductive health with diverse clinical manifestations in women. Aim: The objectives of the present study are to determine and compare the prevalence of PCOS between rural and urban Assamese women in Guwahati, Assam. Methods: A total of 150 (75 rural; 75 urban) Assamese women aged 18-35 years have been collected at Pratiksha Hospital, Guwahati, Assam. The relevant data were collected through selfadministered pre-structured and interview methods. Results: Higher prevalence of PCOS was found in the urban areas living in nuclear families in comparison to rural areas. Recent weight gain and obesity with a higher prevalence of oligomenorrhea were found to be higher among the urban participants. An excess androgen activity evidenced by increased hirsutism was higher in the urban areas as compared to rural areas in association with increased levels of serum insulin. Conclusion: A long-term personalized management program is required for effectively treating individuals with PCOS which may help in regulating the symptoms and various other metabolic complications. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) represents an endocrine condition affecting 5–18% of adolescents, frequently in association with obesity, metabolic alterations, and liver dysfunction. In this study, we aimed to evaluate the prevalence and risk factors for developing non-alcoholic fatty liver disease (NAFLD) in a cohort of PCOS adolescents. Thirty-two girls were assessed for anthropometric and biochemical markers: total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), glucose, insulin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (γGT). In addition, LH, FSH, 17β-Estradiol (E2), prolactin, testosterone (T), free testosterone, delta 4-androstenedione (D4 A), dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding protein (SHBG) were also evaluated. All subjects underwent liver ultrasound to detect NAFLD. Our data demonstrated that PCOS adolescents complicated with NAFLD accounted for 37.5%, and those with obesity and lower SHBG were more predisposed to developing NAFLD. Moreover, SHBG showed a negative correlation with several parameters such as blood pressure, body mass index, waist circumference, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR). Our results demonstrated that the assessment of SHBG may allow the identification of PCOS adolescents at risk for developing NAFLD and metabolic alterations. [ABSTRACT FROM AUTHOR]

Background and Objectives: The Quantum Menstrual Health Monitoring Study will measure four key reproductive hormones in the urine (follicle-stimulating hormone, FSH; estrone-3-glucuronide, E13G; luteinizing hormone, LH; and pregnanediol glucuronide, PDG) to characterize patterns that predict and confirm ovulation, referenced to serum hormones and the gold standard of the ultrasound day of ovulation in participants with regular cycles. These normal cycles will provide a reference for comparison to irregular cycles in subjects with polycystic ovarian syndrome (PCOS) and athletes. Materials and Methods: Participants will track their menstrual cycles for 3 months and be provided with an at-home urine hormone monitor (Mira monitor) to predict ovulation. The day of ovulation will be confirmed with serial ultrasounds completed in a community clinic. Urine results will be compared to serum hormone values. Other markers of menstrual health, such as bleeding patterns and temperature changes, will be determined using a customized app. Three groups will be recruited. Group 1 will include those with consistent regular cycle lengths (between 24–38 days), and will be compared to two groups with irregular cycle lengths (with increased cycle length variability and longer cycles). Group 2 will include those with polycystic ovarian syndrome (PCOS) with irregular cycles and Group 3 will include individuals participating in high levels of exercise with irregular cycles. Hypothesis: The Mira monitor quantitative urine hormone pattern will accurately correlate with serum hormonal levels and will predict (with LH) and confirm (with PDG) the ultrasound day of ovulation in those with regular cycles as well as those with irregular cycles. Rationale: Once the ultrasound validation is complete, tools like the Mira monitor with a customized app may become a new standard for at-home and remote clinical monitoring of the menstrual cycle without having to use labor-intensive follicular-tracking ultrasound or follow serum hormone changes. Conclusions: Precision monitoring of the menstrual cycle is expected to impact individuals who want to increase their menstrual health literacy and guide decisions about fertility.

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.

Background: Polycystic ovary syndrome (PCOS), and one of its distinguishing characteristics, oligomenorrhea, have both been associated with ovarian cancer risk in some but not all studies. However, these associations have been rarely examined by ovarian cancer histotypes, which may explain the lack of clear associations reported in previous studies.Methods: We analyzed data from 14 case-control studies including 16,594 women with invasive ovarian cancer (n = 13,719) or borderline ovarian disease (n = 2,875) and 17,718 controls. Adjusted study-specific ORs were calculated using logistic regression and combined using random-effects meta-analysis. Pooled histotype-specific ORs were calculated using polytomous logistic regression.Results: Women reporting menstrual cycle length >35 days had decreased risk of invasive ovarian cancer compared with women reporting cycle length ≤35 days [OR = 0.70; 95% confidence interval (CI) = 0.58-0.84]. Decreased risk of invasive ovarian cancer was also observed among women who reported irregular menstrual cycles compared with women with regular cycles (OR = 0.83; 95% CI = 0.76-0.89). No significant association was observed between self-reported PCOS and invasive ovarian cancer risk (OR = 0.87; 95% CI = 0.65-1.15). There was a decreased risk of all individual invasive histotypes for women with menstrual cycle length >35 days, but no association with serous borderline tumors (Pheterogeneity = 0.006). Similarly, we observed decreased risks of most invasive histotypes among women with irregular cycles, but an increased risk of borderline serous and mucinous tumors (Pheterogeneity < 0.0001).Conclusions: Our results suggest that menstrual cycle characteristics influence ovarian cancer risk differentially based on histotype.Impact: These results highlight the importance of examining ovarian cancer risk factors associations by histologic subtype. Cancer Epidemiol Biomarkers Prev; 27(2); 174-82. ©2017 AACR.

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.

The objective: to study the structure of gynecological pathology and the hormonal background in women with infertility and various types of thyroid pathology. Materials and methods. The anamnesis of infertile patients was studied. The women, depending on the pathology of the thyroid gland and the method of fertilization were divided into the following groups: the 1st group included 119 women with infertility without thyroid pathology who became pregnant after the use of assisted reproductive technologies (ART); the 2nd group-47 patients who became pregnant with the help of ART and in whom antibodies to thyroid peroxidase (anti-TPO antibodies) were detected; the 3rd group-30 women with compensated hypothyroidism, whose pregnancy occurred with ART; the 4th group-39 women without thyroid pathology and with spontaneous pregnancy; the 5th group-128 patients with compensated hypothyroidism and spontaneous pregnancy. The concentrations of the following hormones in the blood plasma in the early follicular phase were determined in all the patients: luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, testosterone, cortisol, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate. Results. There were no significant differences between the women with infertility and thyroid pathology and the patients with spontaneous pregnancy without thyroid pathology regarding the age of menarche onset, the period of regularity onset of the menstrual cycle after menarche. The most frequent disorder of the menstrual cycle in patients of the 1st (26.9 %), 2nd (25.5 %) and 3rd (26.6 %) groups was dysmenorrhea. Oligomenorrhea was more often detected in women with infertility and thyroid pathology who became pregnant with the help of ART (25.5 % of patients in the 2nd group and 23.3%-in the 3rd group), compared to women with spontaneous pregnancy. The endocrine factor of infertility was most often determined in women with infertility who became pregnant after ART and had thyroid pathology: in the presence of anti-TPO antibodies, this factor was found in 29.8 % of women, hypothyroidism-23.3 %. External genital endometriosis as a cause of infertility prevailed among patients with infertility without thyroid pathology, who became pregnant after ART (34.4 %), and women with compensated hypothyroidism, whose pregnancy occurred with the help of ART (26.6 %). In patients with infertility and anti-TPO antibodies, who became pregnant after ART, a significant increase of LH concentration was found compared to the patients with spontaneous pregnancy without thyroid diseases. A significant increase of FSH level was also determined in women of the 1st group compared to healthy patients with spontaneous pregnancy. Conclusions. In women with infertility and various types of thyroid pathology the disorders of the ovarian-menstrual cycle such as dysmenorrhea and oligomenorrhea are typical. The main factor of infertility in patients without thyroid diseases is external genital endometriosis, in persons with thyroid pathology-an endocrine factor. In women with infertility and various types of thyroid pathology, a significant increase of luteinizing hormone concentration in the blood plasma in the follicular phase of the menstrual cycle was established. [ABSTRACT FROM AUTHOR]