Search

Background: Menstruation is a physiological phenomenon that begins in females in adolescent age. Poor menstrual hygiene can result in significant reproductive disorders. However, improving the knowledge about menstruation even before menarche can improve menstrual hygiene. Objective: The aim of this study was to determine the knowledge and practice of adolescent girls towards menstrual hygiene, in Buraidah city. Materials and Methods: A cross-sectional study was conducted among 258 intermediate school girls in Buraidah city. A semi-structured, self-administered questionnaire was used to collect information on demographics, menstrual history, knowledge about menstruation, hygiene practices, and school absence during menstruation. The survey was conducted from December 2019 to Februry 2020. Results: Before menarche, 49.6% of the girls knew about menstruation. The mothers were the most common (94%) source of information about menstruation. Regarding menstruation, 68.2% had bleeding for four to six days, and 42.2% had an interval of 21 to 35 days between periods. Approximately 61.7% participants had 'acceptable' level of knowledge, 2.0% had a 'good' knowledge and 36.3% had 'poor' knowledge regarding menstruation. Most (60.5%) students were categorized as having unsatisfactory self-hygiene practice. During the last three months, 35.8% of the girls were absent for one day due to menstruation. 47.7% of the students omit some foods and drinks from their diet during menstruation; soft drinks were the most omitted. Mother's occupation (P = 0.022), family monthly income (P = 0.007), and prior knowledge on menstruation (P = 0.006) were significantly associated with knowledge regarding menstruation. Conclusion: Knowledge and practice toward menstrual hygiene is unsatisfactory. Creating awareness on self-hygiene during menstruation is recommended.

Background: Dysmenorrhea constitutes one of the most frequent disorders in women of a fertile age. The objective of this research was to Comparative Study between Different Acupressure Points on Relieving severity of primary dysmenorrhea. Research Design : Prospective experimental design was utilized, Setting: at Faculty of Nursing, Benha University Sampling: convenience sample 120 females aged 18–25 years old who met the study criteria. were randomly assigned to one of two groups and evaluated during three menstrual cycles. Tools: four tools were used for data collection, first tool, was An interview questionnaire (a) Socio-demographic data (b)Menstrual history Second tool, Pain responses sheet, (a) Physiological responses to pain, (b) Behavioral responses to pain, Third tool, a modified version of "Johansson pain-o-meter ,Fourth tool, a follow up chart. Results: main results of this study revealed that the severity of dysmenorrhea pain diminished significantly following treatment with acupressure at the SP6 and SP8 points (P < 0.001). Furthermore, Significant differences was observed between usage the SP6 and SP8 regarding the effect on physical condition and regarding the effective words (pain severity) which was reduced significantly further with SP6 point compared to SP8 point (*p

INTRODUCTION: To measure mammography-related pain in two groups of women undergoing regular surveillance as a baseline for future care.\ud METHODS: Following ethical approval, two hundred women aged 32 to 84 years (mean 54), were invited by written invitation to participate in the study. 100 women had a family history (FH) of breast cancer, 100 had undergone conservative surgery (FU) for breast cancer and were currently asymptomatic. A validated pain scale was used to score the participants’ perceived pain before compression based on memory, immediately after compression and one week later. A series of baseline parameters were also captured including compression force, breast size/density, menstrual history and any adverse events following mammography to allow the investigation of relationships.\ud RESULTS: There was a strong correlation (r=0.79, p

Introduction: Adolescence is a transition phase characterized by physical, physiological and psycho-social changes. The adolescents are a powerful human resource and they must be provided with the opportunity for holistic development in order to achieve their ambitions. In most rural areas, in India, the menstrual health of adolescent girls is often neglected. It is important to invest in the menstrual health of the adolescent girls, so as to ensure a healthy family in their adulthood. Most rural adolescent girls are silent sufferers of menstrual problems, owing to various socio-cultural taboos. This study was done to assess the risk factors of menstrual problems among rural school going adolescents in Tamil Nadu, India. Materials and Methods: A cross sectional study was done among 350 school going rural adolescent girls in Tamil Nadu. The participants were selected by simple random sampling and data regarding their menstrual history and nutritional status was assessed by BMI for age graphs for adolescents. Pallor was examined to assess the presence of anaemia. Results: The mean age of the participants was 14.7 years. Menstrual problems were present in 87.7% of the participants. Participants who attained menarche before 12 years of age were significantly at risk for dysmenorrhea and menorrhagia (p Conclusion: It is evident that early menarche is a significant risk factor for menstrual problems. This calls for several longitudinal studies to explore the genetic, socioeconomic and nutritional factors that may influence the menarche. Keywords: Adolescent girls, Menstrual problems, Reproductive health.

Background: Primary dysmenorrhea is considered the most common gynaecologic disorder amongyoung females. Primary dysmenorrhea is defined as painful and difficult menstrual flow in the absenceof any pelvic disorders.Objective: The study was carried out to examine the effect of Heat application on relieving pain ofprimary dysmenorrhea, examine the effect of core strengthening exercises on relieving pain of primarydysmenorrhea, compare between heat application and core strengthening exercises on relieving pain ofprimary dysmenorrhea among young femalesMethodology: Subjects Included in the study were between 25_35 years with primary dysmenorrheaselected from female. Three tools were used in this study, tool one: interviewing questionnaire whichinclude; socio demographic data, menstrual history. Tool two; assessment of dysmenorrheal symptoms.Tool three; WALLID SCORE Scale. random sample was used to select the participants of the study,total sample was 50 females.Results: P-value of group 2 is less than P-value of group 1 , we conclude that dataset of group 2 is moresignificant, and it means that Core Strengthening exercises is more statistically significant to reducedegree of pain in dysmenorrhea.Conclusion: core strengthening exercises (Group 2) was effective in reducing pain of dysmenorrhea ascompared with moist pack application (Group 1) this clearly observed in reduction in the mean of painscoring in group 1 after 4 weeks, and reduction the mean of pain scoring in group 2 after 8 weeks butthe great improvement in pain scoring was observed in group 2 at the end of 12 weeks.

Purpose: To determine the changes in central corneal thickness (CCT) during the menstrual cycle in Indian women. Methods: A prospective observational clinical study at a tertiary care center between December 2015 and December 2018. One hundred and twenty sixty women between 18 and 45 years were included. The CCT was measured using an ultrasound pachymeter at three specific timelines of the menstrual cycle: at the beginning (1st to 3rd day), during ovulation time (14th to 16th day), and at the end of the cycle (28th to 33rd day). Phases of the cycle were confirmed by the urine luteinizing hormone level. Results: The mean CCT of both eyes was 541.76 ± 4.21 μm, 559.21 ± 4.50 μm, and 544.52 ± 8.06 μm at the beginning, mid, and end of cycle, respectively. The mean CCT of the right eye was 541.68 ± 4.15 μm, 559.08 ± 4.50 μm, and 544.44 ± 8.06 μm and of the left eye was 541.84 ± 4.27 μm, 559.35 ± 4.50 μm, and 544.61 ± 8.06 μm at the beginning, mid, and end of cycle, respectively. Conclusion: The CCT value was significantly (P < 0.001) higher during ovulation compared to the beginning and end of the menstrual cycle. Our study recommends adding menstrual history in the workup of women undergoing refractive surgery as physiological variations in the CCT may result in unexpected surgical outcomes.

espanolLa etapa fertil de la mujer comprende gran parte de su vida. El padecimiento de desordenes menstruales, como dismenorrea, endometriosis y sindrome premenstrual (SPM), puede suponer graves implicaciones en la vida de las que lo sufren, por lo que es importante diagnosticar y tratarlos del modo mas adecuado. En la diagnosis es importante realizar una rigurosa historia clinica donde se recoja una anamnesis menstrual completa. Dentro del abordaje de estas afecciones pueden incluirse el tratamiento farmacologico analgesico y hormonal, la dietoterapia, cirugia o practicas alternativas. Aunque la alimentacion parece ser un factor modulador importante, no se ha estudiado con suficiente rigurosidad cientifica el efecto real que provoca en mujeres con alteraciones menstruales. Se aconseja estudiar cada caso de manera individual y adaptar la pauta dietetica-nutricional. En endometriosis, por ejemplo, debera considerarse de manera adicional si existen problemas de fertilidad o enfermedades de indole inmunitario. En lineas generales, se recomienda seguir un patron de alimentacion saludable, en el que predominen los alimentos frescos no procesados, y evitar los ricos en hidratos de carbono refinados o grasas, sal, alcohol y bebidas estimulantes. La eficacia de los suplementos alimentarios requiere mayor investigacion, aunque el efecto positivo del aceite de onagra en el SPM parece ser un hecho probado. EnglishThe reproductive age of a woman comprises a large part of her life. Suffering from menstrual disorders, such as dysmenorrhea, endometriosis and premenstrual syndrome (PMS), can have serious implications in the lives of those suffering them, so it is important to diagnose these problems and treat them in the most appropriate way. In the diagnosis of these problems it is important to carry out a rigorous medical history, in which a complete menstrual history is collected. Analgesic and hormonal pharmacological treatment, dietary therapy, surgery or alternative therapies may be included within the approach of these conditions. Regarding diet, this seems to be an important modulating factor, without having studied with sufficient scientific rigor the real effect it causes in women suffering from menstrual disorders. It is advisable to study each case individually and adapt the dietary-nutritional therapy. In endometriosis, for example, any additional problems such as fertility problems or immune diseases must be considered. In general, it is recommended to follow a healthy eating pattern, in which fresh unprocessed foods predominate, and avoid those rich in refined carbohydrates or fats, salt, alcohol and stimulating beverages. The efficacy of food supplements requires further research, although the positive effect of evening primrose oil on PMS appears to be a proven fact.

Basic contents of history taking include: General data, chief complaint, history of present illness, past medical history, review of systems, personal history, menstrual history, marital history, childbearing history and family history.

Adrenal oncocytomas are rare neoplasms that are usually benign and nonfunctional, and often detected incidentally. Very few cases have been reported of functioning adrenal oncocytomas. We report a rare case of adrenocortical oncocytoma in a 29-year-old female presenting with hirsutism and irregular menstrual history. The tumor was functional and was successfully managed by laparoscopic adrenalectomy. Detailed radiological, histological, and immunohistochemical workup was done to come to a definitive diagnosis of adrenal oncocytoma.

Objective: The objective of the study was to quantify the effect of surgically induced menopause (SIM) on quality of life as assessed by religion, body mass index (BMI), sexual problem, menstrual history, blood spotting after intercourse, menopausal symptoms, and psychological disorder in the age group of 40–55 years of women. Materials and Methods: In this cross-sectional study, 712 rural women, comprising of 40 women (aged 40–55 years) with SIM, were surveyed, by inverse cluster sampling with proportional to population size. The aim was to study SIM and its determinants; menopause anthropometric data, menopause symptoms, and associated psychosocial symptoms. The data was analyzed using bivariate and multivariate techniques. Results: Around 6.4% of Hindu women had SIM, followed by Muslim (6.2%) and others (1.1%). SIM was significantly high in BMI group

A dearth of research exists examining provider adherence to preventative health care guidelines at adolescent well-care visits. We examined adherence in 3 domains: documentation of sexual activity, documentation of menstrual characteristics, and administration of the human papillomavirus vaccine. We identified electronic health records of a random sample of 124 adolescent girls seen within the hospital-affiliated pediatric primary care clinics from July 1, 2014, to June 30, 2015. Approximately one quarter of the records examined had no documentation of sexual activity. Documentation occurred more frequently in English speakers ( P = .003). Asian girls had the least documentation of sexual activity ( P = .003). Clinicians documented menses characteristics in only 27% of adolescent girls with no documentation noted for Asian adolescents. Over 40% of eligible adolescents did not receive the human papillomavirus vaccine. Only 19.4% of adolescents received all the 3 recommended services. This study demonstrates that adolescent girls are not receiving recommended assessments or care to protect their reproductive health.

To determine the rates at which primary care providers elicit menstrual histories from adolescent girls at well visits.Retrospective chart review.The departments of Pediatrics, Adolescent Medicine, and Family Medicine of Cooper University Healthcare from January 1, 2010 to June 1, 2016.Women aged 12-21 years who were seen for a well visit in the described setting.None.We searched physician well visit notes for documentation of the following aspects of menstrual history: menarche, last menstrual period, usual length of cycle, and the presence or absence of associated symptoms (such as pain and cramps). The presence or absence of each aspect was recorded in a binary fashion in a deidentified data set.A total of 954 unique charts were analyzed: 415 from Adolescent Medicine, 289 from Family Medicine, and 250 from General Pediatrics at Cooper University Healthcare. Adolescent Medicine was 6.44 times more likely to take a complete menstrual history than Family Medicine (P .0001) and 5.80 times more likely than Pediatrics (P .0001). There was no statistical difference between Pediatrics and Family Medicine (odds ratio, 0.55; P = .3150).Menstrual history-taking is often incomplete and can vary between departments, even within the same institution. These results indicate opportunities to raise awareness about the importance of a complete menstrual history and to develop quality improvement initiatives to increase documentation of the complete menstrual history.

Background Heavy menstrual bleeding (HMB) affects 27% of the general female population and may ultimately result in iron deficiency and anaemia. Given that systemic lupus erythematosus (SLE) predominantly affects women of childbearing age it is important to consider the burden of HMB in these patients. Purpose To identify the prevalence of HMB in pre-menopausal women with SLE. Methods From May 2017, female patients fulfilling revised ACR criteria diagnosis of SLE were asked to complete a health questionnaire including sections on anaemia and menstrual history based upon a similar validated questionnaire that has previously been used in other previous large studies to assess for HMB prevalence. Patients were considered to have HMB if two or more of the following criteria were met; passing of large blood clots, need for double sanitary protection, need for frequent changes of tampons or towels (every 2 hours or less), flooding to clothes/bedding. Patients were also asked how many menstrual periods they had in the previous 12 months and whether they had sought medical help for HMB before. Results A total of 107 patients completed the questionnaire (Age range 17–82; median 42; IQR 32–52). For the purpose of this study we included only the 68 patients who reported having at least one menstrual period in the last 12 months (Age range 17–51; median 35; IQR 29–40). The majority (31/68; 46%) had 12 periods in the previous year and only 9/68 (13%) had less than 6 periods in that time. Over a third (24/68; 35%) reported they had sought help for symptoms of HMB in the past. Of the 68 patients who had atlas one menstrual period in the last year; 41% (28/68) reported two or more of the features that would fit with a diagnosis of HMB; see figure 1. The prevalence of each of the four risk factors is summarised in figure 2. Conclusions The prevalence of HMB in women with lupus (41%) is higher than in previous studies of the general population (27%) thus increasing the risk of iron deficiency.

A Study on the Response Differences to the Sasang Constitution Questionnaire by Sasang Constitutions in High School Girls with Menstrual Disorders Soo-Hyung Jeon, Kyu-Kon Kim * , In-Seon Lee ** Dept. of Sasang Constitutional Medicine, College of Korean Medicine, Dongeui Univ. * Dept. of Data Information Science, Dongeui Univ. ** Dept. of OB & GY, College of Korean Medicine, Dongeui Univ.ObjectivesThe purpose of this study was to investigate whether the menstrual disorders affect the Sasang constitutions questionnaireresponse in high school girls.Methods Using a structured menstrual history questionnaire, we evaluated the degree of menstrual disorders of 795 high school girls who participated in this clinical trial. Based on the survey we classified them into menstrual disorders group and control group. They filled out SSCQ-P (Sasang Constitution Questionnaire for Patients) and we had compared the difference in response by Sasang constitutions. Each group included 97 girls respectively.From 68 girls in menstrual disorders group and 81 girls in control group, 149 questionnaire was analyzed statisticallyby their constitutions.Results Four questions in Soyangin, twenty one questions in Taeeumin, ten questions in Soeumin were statistically significant in response between menstrual disorders group and control group.ConclusionsSoyangin's menstrual disorders don't have a significant impact on SSCQ-P survey. Water retention of PMS may be affect divergence of lung and cause various symptoms in Taeeumin. Soeumin's menstrual disorders may be more affect negative emotions and activity decrease than other constitutions.Key Words: Menstruation, Constitution, Questionnaires, Response, Differences

Background: Adolescent runners may be at risk for low bone mineral density (BMD) associated with sports participation. Few prior investigations have evaluated bone health in young runners, particularly males. Purpose: To characterize sex-specific risk factors for low BMD in adolescent runners. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Training characteristics, fracture history, eating behaviors and attitudes, and menstrual history were measured using online questionnaires. A food frequency questionnaire was used to identify dietary patterns and measure calcium intake. Runners (female: n = 94, male: n = 42) completed dual-energy x-ray absorptiometry (DXA) to measure lumbar spine (LS) and total body less head (TBLH) BMD and body composition values, including android-to-gynoid (A:G) fat mass ratio. The BMD was standardized to Z-scores using age, sex, and race/ethnicity reference values. Questionnaire values were combined with DXA values to determine risk factors associated with differences in BMD Z-scores in LS and TBLH and low bone mass (defined as BMD Z-score ≤–1). Results: In multivariable analyses, risk factors for lower LS BMD Z-scores in girls included lower A:G ratio, being shorter, and the combination of (interaction between) current menstrual irregularity and a history of fracture (all P < .01). Later age of menarche, lower A:G ratio, lower lean mass, and drinking less milk were associated with lower TBLH BMD Z-scores ( P < .01). In boys, lower body mass index (BMI) Z-scores and the belief that being thinner improves performance were associated with lower LS and TBLH BMD Z-scores (all P < .05); lower A:G ratio was additionally associated with lower TBLH Z-scores ( P < .01). Thirteen girls (14%) and 9 boys (21%) had low bone mass. Girls with a BMI ≤17.5 kg/m2 or both menstrual irregularity and a history of fracture were significantly more likely to have low bone mass. Boys with a BMI ≤17.5 kg/m2 and belief that thinness improves performance were significantly more likely to have low bone mass. Conclusion: This study identified sex-specific risk factors for impaired bone mass in adolescent runners. These risk factors can be helpful to guide sports medicine professionals in evaluation and management of young runners at risk for impaired bone health.

It is generally viewed that contraception is safer than undergoing a full term pregnancy. However, health professionals should still exercise caution when prescribing. A comprehensive history should be taken from all clients including medical history, family history, obstetric history, menstrual history and sexual history. This history should be used alongside the UK medical eligibility criteria (UKMEC) guidelines to guide prescribing. The article also includes some guidance on prescribing contraception for women with some common medical conditions. Health professionals should always consider contraception when assessing women's health needs.

Aims: To evaluate the prevalence of primary dysmenorrhea and its severity among female university students in Iran; its associated symptoms; its impact on academic performance and social activities. Study Design: This is a cross ‐ sectional descriptive study. Place and Duration of Study: This study carried out from May to July 2012 in the Islamic Azad university, branch of Rasht in Iran. Methodology: A cross ‐ sectional survey of 600 students conducted by questionnaire. The questionnaire consisted of three parts that included demographic characteristics; menstrual history; and impact of dysmenorrhea on academic performance and social activities. A visual analogue scale (VAS) was used to assess the severity of dysmenorrhea. Data were analyzed using the chi-squire test by SPSS. Results: The results showed that the prevalence of dysmenorrhea was 73.2% and there were significant differences between pain intensity and associated symptoms (P

Background: Menarche marks the beginning of a multitude of physical, physiological, and psychological changes in the lives of the adolescent girls. The reaction to menstruation depends on awareness and knowledge about the subject. Menstruation and menstrual practices are still clouded by taboos and sociocultural restrictions, resulting in adolescent girls remaining ignorant of scientific facts and hygienic health practices which sometimes result in adverse health issues. Aims and Objectives: The aims and objectives of this study were to understand the knowledge of menstruation and menstrual hygiene among 1st year female medical students. Materials and Methods: The study was conducted on 66 female medical students, after inclusion and exclusion criteria. They are given a questionnaire containing questions related to relevant personal history, menstrual history, practices, etc., for filling. Results: Of 66 students, 74.24% had knowledge about menstruation before they attained menarche, and in 68.18%, mother is the main source of information. 15% has used cloth at some point of time, most of them being from rural areas. At present, 98% are using sanitary napkins. 15% of them are uncomfortable to go to shops alone to buy sanitary napkins. Conclusion: Menstrual hygiene is a vital aspect of health education for adolescent girls as it related with health consequences. Since mothers form a major source of menstrual information, educating the mothers can lead to more hygienic practices. Since the practice of using cloth is seen more in the rural areas, increasing the availability of sanitary napkins at an affordable price in the rural settings can result in more hygienic practices in rural areas.

Background: The menarche is known to assess the integrity of a woman’s circuitry from brain to ovary to the uterus and its timing is determined by multiple factors, one of which is attainment of a particular waist-to-hip (W/H) ratio, suggesting that leptin conveys information about the fat distribution to hypothalamus to initiate the process of menarche. Aims and Objectives: This study aims to assess the mean age of menarche in this region (AOM) and to find if there is any difference between the AOM of government and private school-going girls and to find the relationship between AOM and various anthropometric measurements. Materials and Methods: A total of 250 randomly selected adolescent girls were asked to fill a pretested pre-structured questionnaire regarding anthropometric measurements, sociodemographic profile, and menstrual history. Results: The mean AOM was found to be 12.94 ± 0.74 years and the difference between the AOM of government and private schools is highly significant (P < 0.001) and W/H ratio is the single best predictor of the AOM. Conclusion: As childhood obesity and mental stress are on a rise worldwide, both these puberty accelerators are producing a new generation of girls who are sexually mature at a very tender age and this pubertal maturity should be matched by social maturity.

Study Objective To determine the SCUBE1 levels in adolescents with primary dysmenorrhea. Design A prospective cross-sectional study. Setting A university hospital outpatient clinic, Rize, Turkey. Participants A total of 40 adolescent girls, 15 on menses and 25 not on menses. Interventions and Main Outcome Measures Demographic features and menstrual history of the participants were assessed and blood samples were obtained for detecting the platelet volume, platelet counts, and SCUBE1 levels of the participants. Results No difference was detected between the 2 groups in mean platelet volume, platelet count, and SCUBE1 levels. Conclusion Future trials are required to investigate the relation between SCUBE1 levels and primary dysmenorrhea.

The FIGO systems defining the nomenclature and symptoms of abnormal uterine bleeding (AUB) in the reproductive years (System 1) and the PALM-COEIN classification of causes of AUB (System 2) are designed to facilitate research, education, and the provision of optimum clinical care for affected women. Development of these systems has been the result of a collaborative effort of experts in bench and translational and clinical research from six continents aided by a spectrum of representatives from relevant medical societies, journals, and regulatory bodies. Integral to this development has been a decision to cease the use of poorly defined and inconsistently used terms such as menorrhagia, metrorrhagia, and dysfunctional uterine bleeding, to name a few, and replace them with a set of terms and definitions that are relatively easily understood and translated into the spectrum of languages used by medical providers and patients globally. The utilization of these systems requires a disciplined approach to obtaining a menstrual history, relatively simple laboratory investigations, and the appropriate use of imaging techniques accessible to most clinicians worldwide. This section describes the two systems, their crucial role in guiding investigation, and an approach to implementation, all designed to facilitate the creation of a menu of therapeutic options, considering the identified factors contributing to the problem of nongestational AUB.

Background: Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) characterized by mood changes, anxiety, and somatic symptoms experienced during the specific time of menstrual cycle. Prevalence data of PMS and PMDD is sparse among college girls in India. Aims: The aim of this study is to study the prevalence of PMS and PMDD among college students of Bhavnagar (Gujarat), its associated demographic and menstrual factors, to rank common symptoms and compare premenstrual symptom screening tool (PSST) with Structured Clinical Interview for DSM-IV-TR defined PMDD (SCID-PMDD) for sensitivity and specificity. Materials and Methods: A cross-sectional survey was done in five colleges of Bhavnagar. Of 529 subjects approached, 489 college girls were finally analyzed for sociodemographic data, menstrual history, and PSST. SCID-PMDD was applied among those who were positive on PSST and 20% of those who were negative. The data were analyzed using OpenEpi Version 2. Chi-square test was done for qualitative variables and analysis of variance for quantitative variables. Sensitivity, specificity, and predictive values were calculated for PSST. Results: The prevalence of PMS was 18.4%. Moderate to severe PMS was 14.7% and PMDD was 3.7% according to DSM IV-TR and 91% according to International Classification of Diseases, 10th edition criteria. The symptoms commonly reported were “fatigue/lack of energy,” “decrease interest in work,” and “anger/irritability.” The most common functional impairment item was “school/work efficiency and productivity.” PSST has 90.9% sensitivity, 57.01% specificity, and 97.01% predictive value of negative test. Conclusion: Prevalence of PMS among college students is similar to other studies from Asia. PSST is a useful screening tool for PMS, and it should be confirmed by more specific tool as by SCID-PMDD. Routine screening with PSST can identify college girls who can improve with treatment.

To investigate menstruation as a stereotype threat that could have the effect of diminishing cognitive performance, 92 undergraduate women from a small, urban university in the Mid-Atlantic region of the United States (US) completed two cognitive tasks, a Stroop test, and an SAT-based mathematics test, as well as a Menstrual History Questionnaire (MH) and the Menstrual Attitudes Questionnaire (Brooks-Gunn and Ruble 1980). The MH served as the menstruation stereotype threat. Some women were also presented with positive information about menstruation, which served as the positive prime. The order of materials varied to yield four conditions: Menstruation Threat/No Positive Prime—MH first, then cognitive tasks; Menstruation Threat/Positive Prime—MH first, then positive information, then cognitive tests; Positive Prime/No Menstruation Threat—positive information first, then cognitive tasks, then MH; and No Positive Prime/No Menstruation Threat—cognitive tests first, then MH. In all four conditions, participants completed the Menstrual Attitudes Questionnaire last. Results indicated that participants receiving the Menstruation Threat completed significantly fewer items on the Stroop test. In addition, subjects in the No Positive Prime/Menstruation Threat condition performed more poorly on the Stroop the closer they were to their next period. This effect was absent for the Positive Prime/Menstruation Threat condition and reversed for participants in the Positive Prime/No Menstruation Threat. This suggests that positive priming moderates the relationship between closeness to menstruation and cognitive performance. Implications of the results for addressing stigma associated with menstruation are discussed.

Summary. There are currently limited data on the use of endometrial ablation in the treatment of heavy menstrual bleeding (HMB) in women with inherited bleeding disorders (IBDs). A retrospective review of prospectively collected data was performed. Twelve women with IBDs who had received endometrial ablation for the treatment of HMB were identified and their records reviewed. Details of their menstrual history; quality of life (QOL) and amount of menstrual blood loss [as assessed by pictorial blood-loss assessment chart (PBAC) and haemoglobin (Hb) concentration] pre and post-ablation were collected. Twelve women were included. The median duration of follow-up post-ablation was 32 months (range, 6–76). The median duration of menstruation decreased from 11 to 0 days after treatment (P = 0.004). Median PBAC scores decreased from 1208 preop to 0 post-ablation (P = 0.002).The median Hb concentrations (10.5–13.1 g dL−1) and QOL scores (median, 17–54) improved significantly after endometrial ablation (P

OBJECTIVE To evaluate bone mineral density (BMD) by age in premenopausal elite long-distance runners at 2 time points, 5.02 ± 0.5 years apart. DESIGN Follow-up study. SETTING University Research Institute. PARTICIPANTS Twenty-three elite-level distance runners (baseline age, 24.9 ± 3.9 years; body mass index, 18.7 ± 1.1; running distance, 89.3 ± 19.4 km/wk) participated in the study. MAIN OUTCOME MEASURES Dual-energy x-ray absorptiometry (iDXA; GE Healthcare)-derived BMD z-scores for the total body (TB), lumbar spine (LS) (L2-L4), and proximal femur. A z-score of

Abnormal uterine bleeding (AUB) is a prevalent symptom that encompasses abnormalities in menstrual regularity, duration, frequency and/or volume, and it is encountered frequently by both primary care physicians and obstetrician-gynecologists. Research on AUB has used numerous methods to measure bleeding and assess symptoms, but the lack of universally accepted outcome measures hinder the quality of research and the ability of clinical investigators to collaborate in multicenter trials. Similarly, clinical care for women reporting heavy, prolonged, or irregular menstrual bleeding is not optimized because standard ways of evaluating symptoms and change in symptoms over time do not exist. This article describes (1) the current methods of evaluating women with AUB, both in research and clinical care; and (2) offers suggestions for the development of a standardized structured menstrual history for use in both research and clinical care.

Dating measurements are used to confirm the postmenstrual dates (if known) or to estimate the gestational age (GA) of the fetus when the menstrual history is unknown or unreliable. Normally the earliest technically satisfactory measurement will be the most accurate for dating purposes. Once the gestational age has been assigned, later measurements should be used to assess fetal size and should not normally be used to reassign gestational age.

To investigate factors associated with menstrual dysfunction, self-reported bone stress injuries and energy balance in women runners.613 runners were randomly sampled during the registration period for an endurance event. Demographic information, including self-reported height and weight, training and injury history and menstrual history, was collected by questionnaire.Ultra-marathon (ULTRA) participants (n = 276) were significantly older (mean (SD) 39 (8.2) vs 34 (10.5) years; p0.001), lighter (58.2 (6.6) vs 59.6 (8.3) kg; p0.05) and reported a higher training volume (p0.001) than half-marathon (HALF) participants (n = 337). Significantly more ULTRA subjects than HALF subjects reported a previous bone stress injury (21% vs 14%; p0.05). There was no difference between the groups for menstrual status, but age at menarche was later (p0.01) in the ULTRA group. Data were combined according to the absence (REG; n = 368/602 (61%)) or presence (IRREG; n = 234/602 (39%)) of a history of menstrual irregularity. Subject morphology was similar between groups, but the IRREG group had a higher self-reported measure on the self-loathing subscale (SLSS; p0.01). The whole group was then classified according to current menstrual status, with 165 women being classified as currently irregular. (OLIGO/AMEN; 11.6%) and 445 women as currently regular (EUMEN; 88.4%). There were no morphological differences between the groups, however the OLIGO/AMEN group had a later age of menarche (p0.01) than the EUMEN group. Further, women who reported a previous bone stress injury had higher SLSS scores than those who did not (2.91 (0.98) vs 2.68 (0.84); p0.05).There may be two independent mechanisms associated with energy balance, which are related to bone stress injuries, but may not necessarily be related to menstrual dysfunction.

The objective was to study the effect of a short period of war on the menstrual cycles of exposed women. Six months after a 16-day war women in exposed villages aged 15-45 years were asked to complete a questionnaire relating to their menstrual history at the beginning 3 months after and 6 months after the war. A control group not exposed to war was also interviewed. The data collected were analyzed to estimate the effect of war on three groups of women: those who stayed in the war zone for 3-16 days (Group A) those who were displaced within 2 days to safer areas (Group B) and women not exposed to war or displacement (Group C-control). More than 35% of women in Group A and 10.5% in Group B had menstrual aberrations 3 months after the cessation of the war. These percentages were significantly different from each other and from that in Group C (2.6%). Six months after the war most women regained their regular menstrual cycles with the exception of 18.6% in Group A. We found a short period of war acting like an acute stressful condition resulted in menstrual abnormalities in 10-35% of women and is probably related to the duration of exposure to war. This might last beyond the war time and for more than one or two cycles. In most women the irregular cycles reversed without any medical intervention. (authors)

Objective To determine the prevalence, predictors and outcome of dysmenorrhea among female medical students in King Abdulaziz University (KAU), Jeddah, Saudi Arabia. Methods A cross-sectional study was conducted among 435 medical students at KAU, Jeddah selected through stratified random sample method. A pre-constructed, validated, self-administered questionnaire was used to collect personal and socio-demographic information. Data about menstrual history, stress, smoking were also collected. The severity of dysmenorrhea was scored by the "Visual Analogue Scale (VAS)". Descriptive and analytical statistics were conducted. Results The prevalence of dysmenorrhea was 60.9%. Logistic regression showed that heavy period was the first predictor of dysmenorrhea (aOR=1.94; 95% CI: 1.29- 2.91), followed by stress (aOR=1.90; 95% C.I.: 1.19-3.07). The prevalence of severe dysmenorrhea among the sufferers was 38.6%. Depressed mood was the commonest (80.8%) symptom accompanying dysmenorrhea. Regarding the outcome of dysmenorrhea, 67.5% of the sufferes reported emotional instability, while 28.3% reported absenteeism from the university. Conclusions A high prevalence of dysmenorrhea was prevalent among medical students in King Abdulaziz University (KAU), Health promotion, screening programs, and stress management courses are recommended.

Many young women are unsure of what constitutes normal menses. By asking focused questions, pediatric providers can quickly and accurately assess menstrual function and dispel anxiety and myths. In this article, we review signs and symptoms of normal versus pathologic menstrual functioning and provide suggestions to improve menstrual history taking. [ Pediatr Ann . 2015;44(9):e213–e217.]

Background: Dysmenorrhea is a common gynecological condition with painful menstrual cramps of uterine origin. Prevalence of primary dysmenorrhea is not yet clearly studied in central India. Objective: To study prevalence of primary dysmenorrhea in young girls and to evaluate associated clinical markers of dysmenorrhea. Materials and Methods: In a cross-sectional study, data was collected among 310 girls (18-25 years) on age at menarche, presence and absence of dysmenorrhea, dysmenorrhea duration, pre-menstrual symptoms (PMS), family history, menses irregularities, menstrual history, severity grading using visual analogue scale (VAS) using a semi-structured questionnaire. Results: Dysmenorrhea was reported in 84.2% (261) girls and 15.8% (49) reported no dysmenorrhea. Using VAS, 34.2% of girls experienced severe pain, 36.6% moderate and 29.2% had mild pain. Bleeding duration was found to be significantly associated with dysmenorrhea (χ2 = 10.5; P < 0.05), girls with bleeding duration more than 5 days had 1.9 times more chance of getting dysmenorrhea (OR: 1.9; 95% CI: 1.7-3). Moreover, girls with the presence of clots had 2.07 times higher chance of having dysmenorrhea (OR: 2.07; 95% CI: 1.04-4.1) (P < 0.05). Almost 53.7% girls who had some family history of dysmenorrhea, 90.9% experience the condition themselves (χ2 = 11.5; P < 0.001). Girls with family history of dysmenorrhea had three times greater chance of having the same problem (OR: 3.0; 95% CI: 1.5-5.8; P = 0.001). Conclusion: Dysmenorrhea is found to be highly prevalent among college going girls. Family history, bleeding duration and presence of clots were significant risk factors for dysmenorrhea.

The requirement that every woman desiring medical abortion must come in person to a clinical facility to obtain the drugs is a substantial barrier for many women. To eliminate this requirement in the United States, two key components of the standard initial visit would need to be restructured. First, alternatives to ultrasound and pelvic exam would need to be identified for ensuring that gestational age is within the limit for safe and effective treatment. This is probably feasible: for example, data from a large study suggest that in selected patients menstrual history is highly sensitive for this purpose. Second, the Food and Drug Administration would need to remove the medically unwarranted restriction on distribution of mifepristone. These two changes could allow provision of the service by a broader range of providers in nontraditional venues or even by telemedicine. Such options could have profound benefits in reducing cost and expanding access to abortion.

A 39-year-old manager presented with a 2-year history of secondary subfertility. She had previously had an uncomplicated termination of pregnancy at the age of 24. Her menstrual history reported heavy but regular periods with occasional mid-cycle bleeding. Her cervical smear tests had been normal.

The menopause should be diagnosed based on age, menstrual history and clinical symptoms, and as such, follicle stimulating hormone testing may be considered inappropriate when diagnosing the menopause or peri-menopause in women aged 45 and over. As part of a demand optimisation programme, the number of follicle stimulating hormone tests requested to diagnose the menopause in this age group was quantified and educational interventions were implemented to reduce inappropriate testing. The number of follicle stimulating hormone tests requested to diagnose the menopause in women aged 45 and over was successfully and sustainably reduced.