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Introduction: 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. Materials and methods: The cohort consisted of 91 elite-level track and field athletes. Body compositions, including bone parameters and bone turnover markers (BTMs), were measured. Results: 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 < 0.01). There were no significant differences in BTMs between the two groups, but oligomenorrheic athletes had significantly lower percent body fat. Conclusion: More than 40% of the elite-level female track and field athletes in this study reported menstrual disorders with oligomenorrhea as the most common. However, none sought medical attention. As compared to the eumenorrheic athletes, the oligomenorrheic athletes had lower BMC and BMD. Hence, if an athlete is oligomenorrheic, bone parameter measurements are considerably important. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS), the most prevalent hormonal disorder in females, is characterized by low levels of progesterone, which causes increased estrogen levels leading to production of various anti and auto-antibodies. This study aimed to estimate and compare levels of anti-nuclear antibodies (ANA), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG), and anti-islet cell antibodies (anti-ICAb) in patients with PCOS and healthy controls. Methods: The present comparative study included 82 subjects divided into two groups with 41 individuals in each group. Group I included healthy subjects, while Group II included patients diagnosed with PCOS. Blood samples were collected to determine serum levels of ANA, anti-TPO, anti-TG, and anti-ICAb using commercially available ELISA kits. Data were analyzed by using SPSS 20.0. Results: Two (4.8%) subjects in Group II had ANA, but none of the other healthy individuals had these auto-antibodies. Levels of anti-TPO were higher in Group II (6.01 IU/ml) than in Group I (5.98 IU/ml). Levels of anti-TG and anti-ICAb were higher in Group I (19.86 and 32.49 IU/ml, respectively) than in Group II (19.78 and 26.07 IU/ml, respectively). Conclusion: Levels of ANA and anti-TPO were higher in patients with PCOS than in controls. By contrast, levels of anti-TG and anti-ICAb were higher in controls than in patients with PCOS.

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.

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Of late, the disease is on its rise due to environmental changes as well as lifestyle disorders, affecting 4%–26% of adolescent and young women all over the globe. Initially, this condition is asymptomatic in young girls, progressing toward menstrual irregularities, obesity, hyperandrogenism in late puberty and eventually developing insulin resistance, hypertension, type 2 diabetes, cardiovascular diseases, and infertility around middle age. Aims: Early diagnosis is necessary for early intervention, including lifestyle modifications to prevent the immediate and chronic consequences of PCOS. Materials and Methods: Our study design was of a cross-sectional questionnaire-based survey, conducted from September 2017 to March 2018 to investigate the prevalence of PCOS and its association with body composition variables. The study population comprised randomly chosen students (age group 18–20 years) of all discipline. The data were collected from the students using structured questionnaire with Rotterdam's criteria, and anthropometric measurements were taken using standard techniques. Results: Approximately 28% of the college students were found to be at high risk of developing PCOS. More than 85% of the PCOS cases had oligomenorrhea, 19% were hirsute, 41% had acne, 63% had emotional disturbance, and 22% with a positive family history. Furthermore, the body mass index of the PCOS students demonstrated a trend of Grade 1 obesity than the normal females of the same age group. Conclusion: The present study is an attempt to create increased awareness among the students for early and accurate diagnosis, which is the primary step in managing PCOS.

Background: Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. Obesity exacerbates the reproductive complications of PCOS; however, the management of obesity in women with PCOS remains a large unmet clinical need. Observational studies have indicated that bariatric surgery could improve the rates of ovulatory cycles and prospects of fertility; however, the efficacy of surgery on ovulation rates has not yet been compared with behavioural modifications and medical therapy in a randomised trial. The aim of this study was to compare the safety and efficacy of bariatric surgery versus medical care on ovulation rates in women with PCOS, obesity, and oligomenorrhoea or amenorrhoea., Methods: In this multicentre, open-label, randomised controlled trial, 80 women older than 18 years, with a diagnosis of PCOS based on the 2018 international evidence-based guidelines for assessing and managing PCOS, and a BMI of 35 kg/m 2 or higher, were recruited from two specialist obesity management centres and via social media. Participants were randomly assigned at a 1:1 ratio to either vertical sleeve gastrectomy or behavioural interventions and medical therapy using a computer-generated random sequence (PLAN procedure in SAS) by an independent researcher not involved with any other aspect of the clinical trial. The median age of the entire cohort was 31 years and 79% of participants were White. The primary outcome was the number of biochemically confirmed ovulatory events over 52 weeks, and was assessed using weekly serum progesterone measurements. The primary endpoint included the intention-to-treat population and safety analyses were per-protocol population. This study is registered with the ISRCTN registry (ISRCTN16668711)., Findings: Participants were recruited from Feb 20, 2020 to Feb 1, 2021. 40 participants were assigned to each group and there were seven dropouts in the medical group and ten dropouts in the surgical group. The median number of ovulations was 6 (IQR 3·5-10·0) in the surgical group and 2 (0·0-4·0) in the medical group. Women in the surgical group had 2.5 times more spontaneous ovulations compared with the medical group (incidence rate ratio 2·5 [95% CI 1·5-4·2], p<0·0007). There were more complications in the surgical group than the medical group, although without long-term sequelae. There were 24 (66·7%) adverse events in the surgical group and 12 (30·0%) in the medical group. There were no treatment-related deaths., Interpretation: Bariatric surgery was more effective than medical care for the induction of spontaneous ovulation in women with PCOS, obesity, and oligomenorrhoea or amenorrhoea. Bariatric surgery could, therefore, enhance the prospects of spontaneous fertility in this group of women., Funding: The Jon Moulton Charity Trust., Competing Interests: Declaration of interests ADM has received research funding from the Medical Research Council (MRC), National Institute for Health and Care Research (NIHR), Jon Moulton Charitable Foundation, Anabio, Fractyl, Boehringer Ingelheim, Gila, Randox, and Novo Nordisk. ADM has received honoraria for lectures and presentations from Novo Nordisk, AstraZeneca, Currax Pharmaceuticals, Boehringer Ingelheim, Screen Health, GI Dynamics, Algorithm, Eli Lilly, Ethicon, and Medtronic. ADM and CWlR are shareholders in the Beyond BMI clinic, which provides clinical obesity care. SA was supported by Princess Nourah bint Abdulrahman University Researchers Supporting Project (PNURSP2024R530), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. CWlR reported grants from the Irish Research Council, Science Foundation Ireland, Anabio, and the Health Research Board. CWlR has received honoraria for lectures and presentations from Novo Nordisk, Herbalife, Eli Lilly, Johnson & Johnson, Rhythm Pharmaceuticals, Currax Pharmaceuticals, and Boehringer Ingelheim. CWlR serves on advisory boards of Novo Nordisk, Herbalife, GI Dynamics, Eli Lilly, Johnson & Johnson, Altimmune, Irish Life Health, and Boehringer Ingelheim. CWlR plays a leadership role in the Irish Society for Nutrition and Metabolism. CWlR was the Chief Medical Officer and Director of the Medical Device Division of Keyron in 2021—both of these were unremunerated positions. CWlR was a previous investor in Keyron, which developed endoscopically implantable medical devices that mimic the surgical procedures of sleeve gastrectomy and gastric bypass. CWlR does not have any contracts with other companies to put their products into clinical practice. CWlR continues to provide scientific advice to Keyron for no remuneration. AA was supported by the NIHR Clinician Scientist Award and MRC project grant. AA has received consulting fees from Myovant Sciences and honoraria for a lecture from Merck. AA serves on the public engagement committee of the Society for Endocrinology. FS has received a grant from the Deutsche Forschungsgemeinschaft (2027/5–1). BL, AD, and PT received a grant from the Jon Moulton Charitable Foundation. GKD has received research grants from the NIHR, Novo Nordisk, and Diabetes Digital Media, as well as payment or honoraria for lectures and presentations from Novo Nordisk, Rhythm Pharmaceuticals, Eli Lilly, Ethicon, and Medtronic. GKD is a co-founder and shareholder in the Heracles Project clinic, which provides clinical care for men's health. GKD plays a leadership role in The Association for the Study of Obesity and is a member of the Society for Endocrinology–British Endocrine Society. RM has received a grant from the Waterloo Foundation, as well as payment and support from Roche Diagnostics and the Androgen Excess and Polycystic Ovary Syndrome Society. HR has received a grant from the Jon Moulton Charitable Foundation, as well as payment or honoraria from Novo Nordisk and support from Ipsen. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

A phenolic compound in Foeniculum vulgare can improve human health. Foeniculum vulgar contains flavonoids, glycosides, and other constituents that are used for medicinal ailments. Trans-anethole, fenchone, and estragole essential oils are the main ingredients in F. vulgare seeds. The principle component of fennel oil, anethole, has structural similarity with the synthetic oestrogen diethylstilbestrol, making it an active estrogenic agent. Women with PCOS may exhibit obesity, amenorrhea, oligomenorrhea, infertility, or androgenic features, which are characterized by the absence of ovulation and hyperandrogenism. Oligomenorrhea is a kind of irregular menstruation period. Treatment of oligomenorrhea depends on the causes; the main cause of oligomenorrhea is the presence of polycystic ovarian syndrome (PCOS), with 75–85%experiencing infrequent periods. This mini-review focuses on F. vulgare seeds as an advantageous addition to treat PCOS. Women with PCOS also have a lower level of the hormone progesterone due to the absence or reduction in ovulation. Numerous phytoestrogens can be found in F.vulgare seeds; with less insulin resistance and lower blood sugar level, fennel phytoestrogen content is beneficial. It is also thought to aid in reducing the cellularim balance that causes PCOS’s metabolic abnormalities.

Copyright of Reproductive Health of Woman is the property of Professional-Event Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reproductive Health of Woman is the property of Professional-Event Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To examine the outcomes of prenatally diagnosed lower urinary tract obstruction (LUTO) with current management using vesicoamniotic shunting (VAS). Methods: A retrospective study of prenatally diagnosed LUTO before 26 weeks of gestation at two tertiary centers in Japan between March 2002 and September 2017. LUTO was diagnosed by ultrasound demonstration of an enlarged fetal bladder associated with hydronephrosis and/or hydroureters. VAS was offered for fetuses with LUTO at ≤26 weeks of gestational age, in the presence of oligohydramnios or decreasing amniotic fluid and a favorable fetal urinary analysis. Results: Among 87 fetuses with LUTO, 46 (53%) were terminated before 22 weeks of gestation. Eight cases (9%) underwent VAS and one underwent fetoscopic urethrotomy. The live birth rates in the VAS and expectant groups were 100% (8/8) and 56% (18/32), respectively (p = 0.034), and the survival rates at 6 months old with a normal renal function were 38% (3/8) and 16% (5/32), respectively (p = 0.608). The etiology varied with six cases of associated anomalies among 23 diagnosed cases. Among the nine cases of posterior urethral valve (PUV), only one fetus underwent VAS at 25 weeks of gestation, ultimately surviving with mild renal dysfunction. Among the other eight cases of PUV that were managed expectantly, two died, and only one of the six survivors showed a normal renal function. Conclusions: More than half of the prenatally diagnosed LUTO cases were terminated. VAS seemed effective for achieving a perinatal survival, regardless of etiology. The outcomes were poor in cases of expectantly managed PUV. [ABSTRACT FROM AUTHOR]

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 < 0.05). In a subgroup analysis where n = 22 participants were excluded (ambiguous baseline menstrual cycle, insufficient time in intervention for menstrual recovery classification), 64% of the Oligo/Amen + Cal group exhibited improved menstrual function compared with 19% in the Oligo/Amen Control group (χ2, P = 0.001).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. [ABSTRACT FROM AUTHOR]

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.

Purpose: This study investigated the satisfaction of elite female cyclists with their body weight (BW) in the context of race performance, the magnitude of BW manipulation, and the association of these variables with menstrual function. Methods: Female competitors in the Australian National Road Cycling Championships (n = 32) and the Oceania Championships (n = 5) completed a questionnaire to identify current BW, BW fluctuations, perceived ideal BW for performance, frequency of weight consciousness, weight-loss techniques used, and menstrual regularity. Results: All but 1 cyclist reported that female cyclists are “a weight-conscious population,” and 54% reported having a desire to change BW at least once weekly; 62% reported that their current BW was not ideal for performance. Their perceived ideal BW was (mean ± SD) 1.6 ± 1.6 kg (2.5% ± 2.5%) less than their current weight (P < .01), and 73% reported that their career-lowest BW was either “beneficial” or “extremely beneficial” for performance. 65% reported successfully reducing BW in the previous 12 months with a mean loss of 2.4 ± 1.0 kg (4.1% ± 1.9%). The most common weight-loss technique was reduced energy intake (76%). Five cyclists (14%) had been previously diagnosed as having an eating disorder by a physician. Of the 18 athletes not using a hormonal contraceptive, 11 reported menstrual dysfunction (oligomenorrhea or amenorrhea). Conclusion: Elite Australian female cyclists are a weight-conscious population who may not be satisfied with their BW leading into a major competition and in some cases are frequently weight conscious. [ABSTRACT FROM AUTHOR]

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.

Abstract 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.

Background: PCOS is among the most common endocrinopathy in women of reproductive age group with increasing prevalence worldwide either due to dietary or lifestyle changes or due to the involvement of genetic background. It is diagnosed in a woman with 1. Oligomenorrhoea/amenorrhea 2. Clinical/Biomedical signs of Hyperandrogenism, Hirsutism, Acne, Alopecia, elevated androgen levels (testosterone) 3. Presence of polycystic ovaries on ultrasound scans. This study is planned to assess the biochemical parameters, fasting glucose, fasting insulin, uric acid and lipid profile in women with PCOD. The parameters will be reported to see the risk of development of CVDs. Method: The study was conducted at Krishna hospital, Krishna Institute of Medical Sciences, Karad- a tertiary care teaching institute. A total of 39 samples were studied of ultrasound diagnosed cases of PCOD and analysed in biochemistry laboratory, Krishna hospital. The statistical software SPSS versions were used for the analysis of collected data from PCOS patients and control group and Pearson correlation between the study variable was performed to find out the relationships. Result: The present study showed increased fasting blood glucose in 23% cases and hyperinsulinemia in 28% cases suggestive of increased risk of developing diabetes in PCOS patients. A significant deviation of serum uric acid towards the higher range of reference value and an increase in the Cholesterol, LDL, VLDL, TGL and a slight deviation of HDL towards the lower range of the reference value indicate dyslipidemia. The above result may predict CVD risk in PCOS patients. Conclusion: The study revealed hyperinsulinemia and an increase in FBS along with dyslipidemia to be a risk factor for developing CVD and diabetes among PCOS patients. [ABSTRACT FROM AUTHOR]

Capsule: Oligo/amenorrhea is an independent risk factor of low ovarian response but not high ovarian response, particularly in women with low AMH levels. Objective: To investigate the association of menstrual cycle length (MCL) with anti-Müllerian hormone (AMH) and ovarian response. Methods: This 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 Results: A 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]. Conclusion: AMH 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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.

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.

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. [ABSTRACT FROM AUTHOR]

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 < 0.001). Women with PCOS in adulthood had a higher median adolescent AMH of 6.0 compared with 2.5 μg/L in the non-PCOS group (P < 0.001). AMH at adolescence showed an area under the receiver operating characteristic curve for PCOS in adulthood of 0.78. In adolescent girls with oligomenorrhea the proportion developing PCOS in adulthood was 22.5% (95% CI, 12.4-37.4) against 5.1% (95% CI, 2.1-12.0) in girls with a regular cycle (P = 0.005). Given adolescent oligomenorrhea, adding high AMH as factor to predict adult PCOS or adult oligomenorrhea was of no value.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. [ABSTRACT FROM AUTHOR]

Oral tranexamic acid (TXA) 250 mg twice daily has been used effectively for 4 weeks to 6 months to treat melasma. As relapses are frequent on discontinuation, a minimum effective dose of TXA that can be used safely for long time remains unknown. We compared the efficacy of oral TXA 250 mg once daily and 500 mg twice daily given for 16 weeks in 132 (m:f 23:109) adults with melasma. 42 patients in Group-A (TXA 250 mg/d) and 46 patients in Group-B (TXA 500 mg twice/d) completed the study. They were followed up at 4-week interval for percentage reduction in baseline Melasma Area Severity Index (MASI) and at 24 and 28 weeks for relapse. Therapeutic response, for both as per-protocol and intention-to-treat analysis, was scored as very good (> 75% reduction), good (51–75% reduction), moderate (25–50% reduction), mild (< 25% reduction) or no improvement. Reduction in mean MASI score at 4 weeks was not statistically significant in Group-A but it decreased significantly 8 weeks onwards and was comparable with that in Group-B. The relapse rate was higher in Group-B (10.8%) than Group-A (4.7%) at the end of 28 weeks. Oligomenorrhoea and abdominal discomfort in few patients did not necessitate treatment discontinuation. TXA 500 mg twice daily showed early reduction in mean MASI score compared to 250 mg given once daily with comparable safety and therapeutic efficacy at 16 weeks. Open-label cross-sectional design, no control arm, small number of patients in each group, MASI score being subjective assessment tool, short duration of treatment and follow-up are study limitations. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovarian syndrome (PCOS) 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 PCOS in the Nepalese population attending a tertiary care hospital, specifically the clinical presentation and hormonal profile. Methods: 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. Results: 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. Conclusions: PCOS 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.

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.

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 < 0.05.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. [ABSTRACT FROM AUTHOR]

Background and Aim: Obesity is one of the risk factors for polycystic ovarian syndrome (PCOS), and weight loss is the mainstay of treatment. This study investigates the effects of sleeve gastrectomy on clinical and paraclinical signs and symptoms of PCOS patients referred to a tertiary hospital., Methods: Female patients with a definite diagnosis of PCOS and body mass index (BMI) > 40 kg/m 2 who were candidates for sleeve gastrectomy were enrolled in this cohort study and followed for 1 year postoperatively. Clinical signs and symptoms of PCOS, sonographic examination, and laboratory hormonal assessments were assessed preoperatively and 1 year following surgery., Results: Fifty patients enrolled in the study. The mean age of patients was 31.69 ± 9.54 years. The mean BMI before and after the surgery was 44.28 ± 3.03 and 29.37 ± 2.41 kg/m 2 , respectively. Oligomenorrhea was improved in 66% of patients. According to the sonographic criteria, PCOS was improved in 74% of patients. After a year post-operation, while the mean serum levels of the follicular stimulating hormone (FSH), testosterone, and dehydroepiandrostenedione have improved significantly in all patients (p < 0.001 in all), the significant decrease in serum luteinizing hormone (LH), LH/ FSH ratio, and estrogen was only noted in patients with improved clinical response (p < 0.05, p < 0.001, and p < 0.001 respectively)., Conclusion: Weight loss and improvements in hyperandrogenism following sleeve gastrectomy result in clinical and paraclinical improvement of PCOS signs and symptoms, including oligomenorrhea and ovulation induction., (© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Competing Interests: Competing interests: None declared.

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. [ABSTRACT FROM AUTHOR]

Menstrual disorders are widespread in the population, a significant part of them is associated with stress. However, stress is not identical simply to nervous tension, it is a nonspecific reaction to changes in conditions that require adaptation. Stress factors should be divided into physical, metabolic and psychological factors. Of particular importance are violations of the biological rhythms of the body, as well as psychological features of the relationship of patients with the mother. In general, with expressed stress, the reproductive function is inhibited. This effect is realized in several ways, in particular through transient hyperprolactinemia. Treatment of functional, stress-dependent hyperprolactinemia is carried out by plant dopaminomimetics. The use of Vitex agnus-castus drugs in such patients normalizes the secretion of prolactin and regulates the menstrual cycle

Introduction: Oligomenorrhea is one of the most common menstrual disorders defined as the prolongation of menstrual intervals. This growing disorder reduce the quality of life for women of reproductive age due to complications, such as abnormal uterine bleeding, infertility, hirsutism and psycho-social consequences. Due to the complications of hormonal medications which are the common treatment of this disorder, the necessity of using complementary therapies is suggested; therefore, the present review study was conducted to investigate the therapeutic strategies of Persian medicine. Methods: In this review study, the main sources of Persian Medicine were investigated using the synonyms of oligomenorrhea such as “Ehtebās-e-tams”, “Habs-e- heiz”, reduction and discontinuation of menstruation. Then, to find new studies, the databases such as Google scholar, PubMed and ISI were searched with the keywords of Oligomenorrhea, Amenorrhea, PCOS, Persian Medicine and Traditional Medicine and the results were compared. Results: In texts of Persian Medicine, oligomenorrhea is referred as the "Ehtebas Tams". Therapeutic approaches to "Ehtebas Tams", like other treatments in Persian Medicine, in the first step include lifestyle modification, dietary modification, sleep and wake adjustment, exercise and bathing. The second step includes the use of emmenagogue herbal medicine which are mostly considered as phytoestrogen. These herbs are prescribed in various forms (Pill, Decoction, Herbal Tea, Vaginal Suppository, Vaginal Douche, ointment and sitz-bath). In the third step, manipulations such as wet cupping and phlebotomy are recommended as a therapeutic approach. Conclusion: Considering the effectiveness of some of these treatments in new studies such as Vitex agnus-castus, Mentha longifolia and Foeniculum vulgare, it is recommended to conduct more clinical studies based on Persian medicine therapies in addition to conventional medicine for treatment of oligomenorrhea.

Background Adolescents often experience menstrual irregularity in the first few years after menarche. Abnormal menstrual cycles may increase the risk of polycystic ovary syndrome. Objective To determine the menstrual cycle patterns of adolescent females in Indonesia and associated factors. Methods This cross-sectional study was conducted at two senior high schools in Surakarta, Central Java, from September to October 2016. Subjects were healthy female students whose parents have given written informed consent. Girls taking hormonal drugs or with chronic diseases were excluded. Subjects filled questionnaires on menstrual cycle, diet, ethnicity, and physical activity. All subjects underwent anthropometric measurements (height and weight). Kruskal-Wallis test was used for data analysis. Results Four hundred and forty-four subjects met the inclusion criteria. Mean age at menarche was 12.27 (SD 1.08) years. Mean menstrual cycle length was 31.1 (SD 6.5) days. Abnormal menstrual cycle occurred in 30.6% of subjects (24.5% oligomenorrhea, 5.9% polymenorrhea, and 0.2% amenorrhea). Ethnicity (Javanese, Chinese, or Arab) was significantly associated with menstrual cycle category (P

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. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence and the related characteristics of oligomenorrhea among women within childbearing age in China. Study design: A large-scale community-based investigation was conducted from 2013 to 2015. A total of 12,964 women aged 18–49 years from 9 provinces/municipalities in China were recruited for healthcare screening in local community health centers. Outcome measures include clinical history, ultrasonographic exam, and hormonal and metabolic parameters. Results: Among women within childbearing age in China, the prevalence of oligomenorrhea was 12.2% (1,579/12,964). Both sociodemographic factors and medical history were significantly associated with oligomenorrhea (P < 0.05). In such women, the prevalence of obesity, acne, seborrhea, acanthosis, larger ovarian size, and polycystic ovarian morphology was higher when compared with normal women; the prevalence of anti-Mullerian hormone, total testosterone, and androstenedione (P < 0.05) was higher as well. The infertility rates of all women were higher in the oligomenorrhea group (17.2%, 272⁄1,579) than in the non-oligomenorrhea group (9.0%, 1,024⁄11,385), and among women without contraception, for the oligomenorrhea group, the infertility rate was 32.5% (128⁄394), and for the non-oligomenorrhea group, 17.9% (400⁄2,240). In the oligomenorrhea group, 57.4% (156/272) of the women underwent treatments for infertility, which was higher than the non-oligomenorrhea group 36.1% (370/1,024). Conclusions: Obesity, acne, seborrhea, acanthosis, larger ovarian size, and polycystic ovarian morphology were significantly associated with oligomenorrhea. The increase of anti-Mullerian hormone, total testosterone, and androstenedione level was also demonstrated in the oligomenorrhea group. Higher prevalence of infertility and medical treatment rate was observed in women with oligomenorrhea. [ABSTRACT FROM AUTHOR]

Background: While increased risk of psychiatric burden in patients with polycystic ovarian syndrome (PCOS) is reported in the literature, there is dearth of reports from Saudi Arabia on occurrence of psychological burden in women with PCOS. This study aimed to compare the sociodemographic and clinical features of PCOS cases with non-PCOS control and explore the prevalence of depression, anxiety and stress in PCOS and non-PCOS women.Materials and Methods: This is a case-control study carried out in PSMMC, Riyadh, Saudi Arabia from March 2019 to June 2019. Samples were recruited by convenience sampling and simple random method in PCOS cases (82) and control group (85), respectively. Depression, Anxiety and Stress Scale-21 (DASS-21) was used to measure the presence of psychological burden.Results: High percentage of participants were in an age group of 26-35 years (51%) and university educated (64%). Significantly (P = 0.001) high proportion of PCOS cases found with irregular menses, hirsutism, infertility and presence of acne (P = 0.001) when compared to control group. The odds of developing depression (P = 0.006), anxiety (P = 0.028) and stress (P = 0.000) was significantly higher in PCOS cases compared to control participants. Further, among the three parameters, the occurrence of stress (odds ratio, OR=10.45) in women with PCOS was more common than depression (OR=2.675) and anxiety (OR=2.056).Limitations: Recall bias and inclusion of only one hospital.Conclusion: In conclusion, most of the PCOS cases had stress, depression and anxiety compared to control group. Meeting the psychological need of the PCOS women will help in improving their quality of life. [ABSTRACT FROM AUTHOR]

The diagnosis of polycystic ovary syndrome (PCOS) in adolescents is complicated by the overlap of normal puberty with features of PCOS. To address this difficulty, recent diagnostic guidelines have worked to modify adult diagnostic criteria for use in adolescents. These guidelines stress that a definitive diagnosis of PCOS is not needed to initiate treatment. Deferring diagnosis, while providing symptom treatment and regular follow-up, is one recommended option. Treatment options for PCOS should be individualized to the presentation, needs, and preferences of each patient. The goals of treatment are to improve the quality of life and long-term health outcomes. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS), the most prevalent hormonal disorder in females, is characterized by low levels of progesterone, which causes increased estrogen levels leading to production of various anti and autoantibodies. This study aimed to estimate and compare levels of anti-nuclear antibodies (ANA), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG), and anti-islet cell antibodies (anti-ICAb) in patients with PCOS and healthy controls. Methods: The present comparative study included 82 subjects divided into two groups with 41 individuals in each group. Group I included healthy subjects, while Group II included patients diagnosed with PCOS. Blood samples were collected to determine serum levels of ANA, anti-TPO, anti-TG, and anti-ICAb using commercially available ELISA kits. Data were analyzed by using SPSS 20.0. Results: Two (4.8%) subjects in Group II had ANA, but none of the other healthy individuals had these auto-antibodies. Levels of anti-TPO were higher in Group II (6.01 IU/ml) than in Group I (5.98 IU/ml). Levels of anti-TG and anti-ICAb were higher in Group I (19.86 and 32.49 IU/ml, respectively) than in Group II (19.78 and 26.07 IU/ml, respectively). Conclusion: Levels of ANA and anti-TPO were higher in patients with PCOS than in controls. By contrast, levels of anti-TG and anti-ICAb were higher in controls than in patients with PCOS. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to evaluate the effects of a long-term treatment with α-lipoic acid (ALA) combined with myo-inositol (MI) on clinical and metabolic features of women with polycystic ovary syndrome (PCOS). Fifty-seven women with PCOS and a history of oligoamenorrhea were treated with MI and ALA (800 mg + 2000 mg per day). Forty-four of them had complete clinical charts and were considered eligible for the study. Information about cycle length and body mass index (BMI) was checked after 6, 12, and 24 months. After 12 months ovarian volume, total testosterone plasma levels and changes in hirsutism were also evaluated. The metabolic parameters were evaluated in 16 women after 6 and 18 months of the treatment. Cycle length was significantly reduced at 6 (p <.001), 12, and 24 months of treatment (p <.01). BMI showed a reduction only at 6 months (p <.05), thereafter returning similar to the basal values. No changes of testosterone and ovarian volume were observed. HOMA-IR and fasting insulin were unchanged, but the insulin response to a 3 h OGTT was improved after 6 (p <.01) and 18 months (p <.05) of treatment. No individual suffered from any adverse event. In conclusion, the combination of ALA and MI showed to be useful as long-term therapy in PCOS women, providing a normalization of the menstrual cycle and an amelioration of insulin levels with a high tolerability. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]