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Introduction: Several studies described that COVID-19 vaccinations can cause menstrual disorders. Our study aimed to describe whether this also resulted in more general practitioner (GP) consultations for menstrual disorders after COVID-19 vaccination, based on a large cohort study., Methods: A retrospective self-controlled cohort study was performed including vaccinated women in 2021 aged 12-49 years from two large, representative GP databases in the Netherlands. Incidence rates and incidence rate ratio's (IRR) were calculated using Poisson regression, adjusting for SARS-CoV-2 infection as time-varying confounder. The exposed period was set at maximum six months after each COVID-19 vaccination and the non-exposed period was defined as all-time outside the exposed period., Results: The cohort included 631,802 women, of which 18,986 (3 %) consulted the GP for a menstrual disorder during 2021. Increased GP consultations were observed among 12-14 year olds for amenorrhea/hypomenorrhea/oligomenorrhea (IRR: 1.85, 95 % CI: 1.30-2.65) and irregular/frequent menstruation (IRR: 1.33, 95 % CI: 1.06-1.69) after COVID-19 vaccination in general, and after Pfizer/BioNTech vaccination (IRR: 1.87, 95 % CI: 1.31-2.67 for amenorrhea/hypomenorrhea/oligomenorrhea and IRR: 1.35, 95 % CI: 1.06-1.70 for irregular/frequent menstruation). Persons from this age group were in general also vaccinated with Pfizer/BioNTech. No increase in the frequency of GP consultations were observed for older age groups, other vaccine brands, and potential risk groups., Conclusion: For the majority of women, no increased GP consultations for menstrual disorders was found. Solely for the youngest age group (12-14 year olds) increased GP consultations for specific types of menstrual disorders was found after Pfizer/BioNTech vaccination., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Menstrual irregularities significantly distress women living with HIV (WLHIV), impacting their reproductive health and quality of life. Although the underlying mechanism remains inconclusive, studies have outlined possible contributory factors. This narrative review explores the burden of menstrual irregularities and associated hormonal dysregulation among women living with HIV in Nigeria. It synthesises data from studies to present an overview of the prevalence, patterns, potential etiology, and impacts of menstrual irregularities among WLHIV., Main Body: A literature search across electronic databases such as PubMed, Google Scholar, and Web of Science was conducted, and information was extracted and synthesized to delineate the burden of menstrual irregularities in WLHIV. Eligibility criteria included original studies assessing the prevalence, aetiology, and impact of menstrual abnormalities among WLHIV in Nigeria. A narrative data synthesis approach utilized common themes and key concept extraction, including identifying patterns in the literature to present specific trends such as prevalence, patterns, etiology, and determinants. Menstrual irregularities were found to be prevalent among Nigerian WLHIV, varying from 29 to 76% across different regions, exceeding reports of similar studies in developed nations. Similarly, menstrual disorders including amenorrhea, oligomenorrhea, and polymenorrhea, were attributed to factors like HIV acquisition, antiretroviral therapy, low body mass index, and hormonal imbalances. Low CD4 count and high viral load with associated complications have been identified as major contributing factors. Distortion of the hypogonadal-pituitary-ovarian axis by viral-induced pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), interleukin-6 (IL-6), and interferon-gamma (IFN-γ) may disrupt the hormonal balance necessary for regular menstrual cycles. Fluctuating levels of follicle-stimulating hormone (FSH), luteinising hormone (LH), estradiol, and prolactin have been reported among WLHIV. Although adherence to antiretroviral therapy has offered immense relief, its direct therapeutic effects on menstrual irregularities are inconclusive.., Conclusions: This study highlights the burden of menstrual disorders among WLHIV. It underscores the interplay between clinical, therapeutic, and client-associated factors as determinants of these abnormalities. Exploring associated complications like secondary infertility, reduced bone mineral density, and resultant osteoporosis, mirrors the significant impact of menstrual and hormonal irregularities on the reproductive health and quality of life of WLHIV., (© 2024. The Author(s).)

Objectives: Assessment of the relationship between dietary patterns and menstrual disorders among female medical and paramedical students at Beni-Suef University, Egypt., Methods: Beni-Suef University conducted a cross-sectional analytical questionnaire-based study. Three hundred fifty two female medical and paramedical students agreed to participate in the study. The collected data about demographics, physical activity, menstrual history, and dietary assessment were transferred to SPSS version 26 for statistical analysis. A p value ≤0.05 was considered statistically significant., Results: The prevalence of irregular cycles, heavy blood flow, severe dysmenorrhea, and premenstrual syndrome (PMS) was found to be (21.9 %), (13.1 %), (35.5 %), and (68.9 %), respectively. Poor adherence to the Mediterranean diet (40.1 %) and physical activity (69.9 %) was present. Females with irregular cycles (p=0.472), heavy menstrual blood flow (p=0.007), and severe dysmenorrhea (p=0.029) reported lower adherence to the Mediterranean diet. Mothers' educational level (p=0.034), family income (p=0.005), and family size (p=0.009) were significantly associated with dietary adherence., Conclusions: Poor adherence to regular physical activity and the Mediterranean diet is highly prevalent in our research and is highly associated with menstruation disorders. So, it is critical to support health education programs emphasizing healthy dietary habits and regular physical activity to improve menstrual health and women's quality of life., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Objective: To assess the prevalence of menstrual abnormalities among medical students, and to explore its association with stress levels., Methods: TThe cross-sectional study was conducted from May 18 to May 28, 2021, in Baghdad, Iraq, after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad, and comprised female medical students in Baghdad. Data was collected using simple random sampling technique and employed an online questionnaire that was distributed through e-mail. The questionnaire had 3 domains: demographic and anthropometric data, menstrual history, and psychological stress. The psychosocial stress levels was assessed using the Perceived Stress Scale-10. Data was analysed using SPSS 25., Results: There were 397 subjects with mean age 20.84±1.621 years (range: 17-24 years). Mean age of menarche was 12.65±1.399 years, mean body mass index was 22.71±6.369kg/m2 and the mean stress score was 22.71±6.016. Dysmenorrhoea was seen in 369(92.9%) cases, and premenstrual symptoms in 391(98.5%). Dysmenorrhoea, premenstrual syndrome and heavy bleeding were significantly associated with stress level (p<0.05)., Conclusions: Most students had heavy bleeding and dysmenorrhoea, which were severe enough to require analgesics. There was a significant association between high stress levels and the occurrence of menstrual abnormalities.

Background: Contraceptive methods are well-established in their ability to prevent pregnancy and increase individual agency in childbearing. Evidence suggests that contraceptives can also be used to treat adverse conditions associated with menstruation, including abnormal and prolonged uterine bleeding, heavy menstrual bleeding, painful menstruation, endometriosis, uterine fibroids, and premenstrual dysphoric disorders.This review investigates the effects of contraceptive techniques such as contraceptive pills, and long-acting reversible contraceptives (e.g. intrauterine devices, implants) on menstrual morbidity., Methods: Over ten databases with no geographical boundaries were searched from inception until October 2023. Study designs were one of the following types to be included: parallel or cluster randomised controlled trials, controlled clinical trials, controlled before and after studies, interrupted time series studies, cohort or longitudinal analyses, regression discontinuity designs, and case-control studies. Ten team members screened the papers in pairs with a Kappa score of more than 7, and Covidence was used. Conflicts were resolved by discussion, and the full papers were divided among the reviewers to extract the data from eligible studies., Results: Hormonal contraceptives are considered a well-tolerated, non-invasive, and clinically effective treatment for abnormal and prolonged uterine bleeding, heavy menstrual bleeding, painful menstruation, endometriosis, uterine fibroids, and premenstrual dysphoric disorders. Our studies investigating quality of life or well-being in women with heavy menstrual bleeding, endometriosis, or uterine fibroids have found improvements in all dimensions assessed., Conclusions: Hormonal contraceptives significantly reduce pain, symptom severity, and abnormal bleeding patterns associated with women who suffer from heavy menstrual bleeding, endometriosis, and uterine fibroids.

Background: Menstrual disorders, influenced by dietary habits like high fat intake and low fruit and vegetable consumption, are a global public health issue. This study assessed the prevalence of dysmenorrhea, premenstrual syndrome (PMS), and irregular menstrual cycle (IMC) among female university students in Bangladesh, focusing on food cravings and low vitamin A intake as risk factors., Methods: In this comprehensive study, data from randomly selected female university students were collected using a structured questionnaire. The associations were analyzed through chi-square tests and multivariable logistic regression, reported as adjusted odds ratios (AOR)., Results: The most prevalent menstrual disorder was dysmenorrhea (68.3%) followed by PMS (33.8%), and IMC (24.3%). Food cravers for high-fat and sweet foods were likely to experience dysmenorrhea (AOR: 2.4, 95% CI: 1.5-3.9, P<0.001), suffer from PMS (AOR: 3.9, 95% CI: 2.3-6.6, P<0.001), and have IMC (AOR: 3.0, 95% CI: 1.6-5.3, P<0.001) vs. subjects who didn't. Subjects consuming vitamin A-rich plant foods had 40% (AOR: 0.6, 95% CI: 0.4-0.9, P < 0.01) and 60% (AOR: 0.4, 95% CI: 0.2-0.6, P<0.001) less likely suffering from dysmenorrhea and IMC vs. who didn't. Both underweight and overweight/obese subjects experienced more than 2-fold dysmenorrhea vs. normal-weight peers. The chance of IMC was nearly 3-fold among overweight/obese subjects. However, lower physical activity was associated with PMS and IMC whereas family history was associated with dysmenorrhea and PMS. Among the socio-demographic factors, maternal education, place of residence, and earlier menarche (≤12 years) were associated with dysmenorrhea while marital status was associated with IMC., Conclusion: This study indicates that increasing the intake of vitamin A-rich plant foods and reducing high-fat, sweet foods can lower the risk of dysmenorrhea and IMC. Additionally, it highlights the need for regular exercise to mitigate the increased risk of PMS and IMC., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Background: COVID-19 vaccines can lead to diverse local and systemic side effects, but there is limited evidence concerning their association with menstrual cycle changes. This study aimed to assess the prevalence of menstrual cycle alterations after COVID-19 vaccination among adult women., Methods: We systematically searched the PubMed, Web of Science and Science Direct databases for observational studies that included adult women and investigated the range of menstrual alterations. The quality of the studies was evaluated via the Newcastle-Ottawa scale. All the data were analyzed via Comprehensive Meta-Analysis Software Version 4.0. Forest plots were created to calculate the individual and pooled prevalence rates of different types of menstrual changes and 95% confidence intervals (CI) via fixed-effects and random-effects models, as appropriate. Heterogeneity was assessed with Q statistics and the I 2 test., Results: Eleven studies, encompassing 26,283 adult women, met our eligibility criteria. Among the selected studies, five were cohort studies, five were cross-sectional studies, and one employed a case‒control design. The menstrual changes included abnormal cycle duration, dysmenorrhea, irregular cycles, and abnormal cycle flow (heavy and light flow), with pooled percentages of 27.3% (CI: 7.2-64.6%), 22% (CI: 5.2-59.4%), 16% (CI: 5.8-37.2%), 11.7% (CI: 5.8-22%), and 5.5% (CI: 2.3-12.5%), respectively., Conclusions: This review highlights the prevalence of menstrual changes after COVID-19 vaccination and emphasizes the importance of considering menstrual health as an integral part of postvaccination monitoring and health care interventions. However, longitudinal studies are essential for establishing a definitive causal relationship between COVID-19 vaccination and menstrual alterations., (© 2024. The Author(s).)

Aim: In the aftermath of natural disasters, understanding the intricate links between mental health and physiological responses, such as menstrual cycle patterns, becomes crucial. This study explores the relationship between post-traumatic stress and menstrual irregularities among women of reproductive age residing in regions affected by the 2023 earthquake in Turkey., Methods: 309 women of reproductive age living in 11 provinces affected by the earthquake centered in Kahramanmaraş on February 6, 2023 and declared as disaster areas constituted the study sample. Data were collected online using Google forms nine months after the earthquake. The collected data were obtained using the Participant Information Form, Impact of Events Scale and Post-traumatic Stress Disorder-Short Form. In the data analysis, descriptive statistics such as count, percentage, median, minimum, and maximum were used, along with statistical tests including the Mann-Whitney U test, chi-squared test, multiple logistic regression analysis, and ROC analysis., Results: In the study, an increase in menstrual irregularities among women was observed following the earthquake (%14.3 to %44.8, p < .001). Risk factors for menstrual irregularities included post-traumatic stress symptoms, comorbid chronic diseases, and smoking. The prevalence of PTSD was found to be 22.7% and this was associated with women with menstrual irregularities. Setting the cut-off score of the IES-R scale at 45.50 resulted in higher sensitivity for detecting irregular menstrual cycles., Conclusions: Women's menstrual cycles are affected after an earthquake. Therefore, post-earthquake mental health recovery programs should specifically address the protection of women's physical and mental health. This comprehensive approach can reduce the effects of earthquake-induced stress and trauma., (© 2024 The Author(s). Brain and Behavior published by Wiley Periodicals LLC.)

Objective: To determine the frequency of phenotypes of polycystic ovarian syndrome (PCOS) in patients presenting with sub-fertility, and to compare the clinical and hormonal characteristics among them., Study Design: Descriptive cross-sectional study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Forest View Specialist Clinic, Peshawar, Pakistan, from August 2022 to January 2023., Methodology: The study included 662 female patients presenting with menstrual irregularities, hyperandrogenism, and infertility to the clinic. PCOS was diagnosed on the basis of the Rotterdam criterion and clinical features and classified into different phenotypes on the basis of the National Institute of Health (NIH) panel criteria. Data were entered and analysed by IBM SPSS VERSION 23.0. The frequency of four phenotypes was calculated and phenotypes were compared for age, weight, hormonal profiles, and history of miscarriages. A p <0.05 was considered statistically significant., Results: Frequency of PCOS in patients with infertility was 59.76%. Phenotype A was seen in 58.2%, phenotype D in 23.3%, phenotype C in 16.9%, and phenotype B in 1.7% of cases. The LH/FSH ratio was statistically significant in phenotype A as compared to other phenotypes, while other parameters were non-significant., Conclusion: The frequency of PCOS is high in patients with infertility. Phenotype A is the most common variant and is associated with significant impairment of the LH/FSH ratio., Key Words: Polycystic ovarian syndrome, Subfertility, Phenotypes of PCOS, Hyperandrogenism, Anovulation, R-C1.

Objectives: This systematic review aimed to assess the association between psychosocial factors in the workplace and menstrual abnormalities or fertility, focusing on literature implementing a prospective cohort design., Methods: We searched MEDLINE, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society electronic databases for studies published from inception to February 26, 2020, and updated the search in PubMed on May 29, 2024. Inclusion criteria were (P) adult female workers (over 18 years old), (E) presence of adverse psychosocial factors at work, (C) absence of adverse psychosocial factors at work, and (O) any menstrual cycle disorders, menstrual-related symptoms, or fertility issues. Prospective cohort studies were included. The included studies were summarized descriptively., Results: Database searching yielded 14,238 abstracts, with nine studies meeting the inclusion criteria. Outcomes included fertility (n = 5), irregular menstrual cycle (n = 1), early menopause (n = 1), endometriosis (n = 1), and serum hormones (n = 1). Study findings included that women with high job demands and low job control were less likely to conceive, and working over 40 h per week and frequent heavy lifting, and rotating night shift work increased the risk of earlier menopause. Studies on night shift/rotating work and fertility outcomes showed no significant differences., Conclusion: This review underscores the insufficient high-level evidence regarding the association of psychosocial factors at work with fertility and menstrual disorders, emphasizing the necessity for future well-designed studies., (© 2024 The Author(s). Japan Journal of Nursing Science published by John Wiley & Sons Australia, Ltd on behalf of Japan Academy of Nursing Science.)

Purpose: To elucidate the impact of long COVID on menstruation and mental health, medical records of patients with long COVID were evaluated., Methods: Symptoms of long COVID, QOL, mental health, and related endocrine data were compared between two groups with and without menstrual disturbances., Results: Of 349 female patients who visited our clinic between February 2021 and March 2023, 223 patients with long COVID (aged 18-50 years) were included. Forty-four (19.7%) of the patients had menstrual symptoms associated with long COVID. The patients with menstrual symptoms were older than those without menstrual symptoms (42.5 vs. 38 years). The percentage of patients with menstrual symptoms was higher during the Omicron phase (24%) than during the Preceding (13%) and Delta (12%) phases. Cycle irregularity was the most frequent (in 63.6% of the patients), followed by severe pain (25%), heavy bleeding (20.5%), perimenopausal symptoms (18.2%), and premenstrual syndrome (15.9%). Fatigue and depression were the most frequent complications. Scores for fatigue and for QOL were significantly worse in long COVID patients with menstrual symptoms. Results of endocrine examinations showed significantly increased cortisol levels in patients with menstrual complaints., Conclusion: Long COVID has an impact on menstrual conditions and on QOL related to menstrual conditions.

Study Objective: Premenstrual syndrome (PMS), dysmenorrhea, and abnormal uterine bleeding are frequent gynecological problems in adolescent girls. Studies show that sleep disorders and menstrual cycle irregularities are common conditions and indicate that they may occur together. Studies on the relationship between sleep quality and menstruation are mostly available for late adolescents (17 years and older) and young adult age groups. Our study aims to evaluate this relationship in adolescents aged 12-18., Methods: A survey study was structured and consisted of 4 sections. The first section includes anthropometric measurements and medical history of the participants; the second section includes "menstruation and menstruation symptoms history"; the third section includes "The Sleep Quality Scale and Sleep Variable Questionnaire"; and the fourth section includes the "Premenstrual Syndrome Assessment Scale" (PMSAS). Our survey was applied to those who visited the adolescent medicine outpatient clinic., Results: The Sleep Quality Scale score was significantly lower in those with high PMSAS scores (P < .001). The participants who had dysmenorrhea and experienced other symptoms during menstruation had significantly lower SQS scores and sleep efficiency (SE) (P < .001). There was no significant difference between heavy menstrual bleeding, defined as lasting more than 7 days, requiring more than 5-6 pads/tampons per day, and SE/quality (P > .05)., Conclusion: According to our study, dysmenorrhea and the presence of PMS may negatively affect the sleep quality of adolescents. Health professionals dealing with young people should take into account the effects of menstrual problems on sleep quality and offer appropriate support/treatment options., Competing Interests: Conflicts of Interest None of the authors have any conflicts of interest to disclose., (Copyright © 2024. Published by Elsevier Inc.)

During the rapid development of COVID-19 vaccines, concerns emerged about potential adverse effects on menstrual health. This study examines the association between COVID-19 vaccination-considering the number of doses and vaccine type-and menstrual disorders, specifically heavy menstrual bleeding (HMB) and amenorrhea (AM). Utilizing electronic health records from the Sistema d'Informació per al Desenvolupament de la Investigació en Atenció Primària (SIDIAP) database in Catalonia, Spain, the retrospective cohort included 1,172,621 vaccinated women aged 12-55 with no prior menstrual disorders observed from 27 December 2020 to 30 June 2023. The incidence rate of HMB and AM increased with the second and third doses of the vaccine. Notably, the AstraZeneca ® and Janssen ® vaccines were associated with higher odds of HMB (OR: 1.765, CI: 1.527-2.033; OR: 2.155, CI: 1.873-2.476, respectively) and AM (OR: 1.623, CI: 1.416-1.854; OR: 1.989, CI: 1.740-2.269, respectively) from the first to the second dose compared to Pfizer/BioNTech ® . Conversely, the Moderna ® vaccine appeared to offer a protective effect against HMB (OR: 0.852, CI: 0.771-0.939) and AM (OR: 0.861, CI: 0.790-0.937) between the second and third doses. These results were adjusted for potential confounders, such as age, previous COVID-19 infection, and other relevant covariates.

Background: The desire to conceive and become parents is a fundamental aspect of human life that carries immense personal, emotional, and societal significance. For many couples, achieving pregnancy represents a long-cherished dream, but the journey to parenthood is not always straightforward. The duration it takes to achieve the desired pregnancy can vary significantly among individuals and is influenced by many factors. This study explores the factors that influence the delayed time of pregnancy among women with naturally planned conception., Methods: An institutional-based cross-sectional study was conducted from May 1 to May 30, 2023, in public health facilities of Bale Zone administrative towns, Southeast Ethiopia. Using systematic random sampling, 388 women participated in the study and a pretested questionnaire was used to collect data. Bivariate logistic regression was done, and variables with p-values < 0.25 were exported to multivariable logistic regression, and a statistically significant association was declared at p-value < 0.05., Results: The study revealed delayed time to pregnancy was 18.6% with 95% (CI = 14.67-22.44%). Women's age ≥ 35, (AOR = 2.61; 95%, CI: 1.17-5.82), menstrual irregularity (AOR = 3.79; 95% CI: 1.98-7.25), and frequency of sexual intercourse/week (AOR = 2.15; 95% CI: 1.05-4.41) and women's sexual dysfunction before conception (AOR = 3.12, 95% CI: 1.62-6.01) were significantly associated factors with delayed time to pregnancy at p-value < 0.05., Conclusion: The study revealed a substantial proportion of delayed time to pregnancy. This delayed time to pregnancy was associated with older maternal age, irregular menstrual cycles, coital activity per week, and the women's sexual dysfunction before pregnancy. Consequently, addressing delayed time to pregnancy requires a targeted approach, prioritizing initiatives such as raising awareness, fostering increased frequency of sexual activity per week, exploring interventions for women with irregular menstrual patterns, and challenges related to sexual dysfunction., (© 2024. The Author(s).)

Purpose: To describe the self-reported menstrual health, symptomatology, and perceived effects of the menstrual cycle on athletic performance for national and international Australian football (soccer) players., Methods: Players from national and domestic teams were invited to complete an online questionnaire regarding menstrual health, use of hormonal contraceptives (HCs), negative symptomatology, and perceived disruption of the menstrual cycle to performance. Descriptive statistics and binomial regressions with odds ratios (OR) were used to report the relationship of menstrual-related variables with perceived performance disruption., Results: A total of 199 players (20.9 [5.1] y) completed the questionnaire, with 18% of players reporting using HCs. One primary amenorrhea case was detected, and 26% of players reported menarche at age ≥15 years. For non-HC users, the prevalence of secondary amenorrhea was 2%, oligomenorrhea was 19%, and heavy menstrual bleeding was 11%. Ninety-seven percent of players reported experiencing physical or affective menstrual symptoms (5 [1.3] per player), and 40% of all players reported that menstrual symptoms impacted their ability to work, study, train, or compete. Furthermore, 40% of players perceived their training or performance to be disrupted by the menstrual cycle. Increasing number of menstrual symptoms (OR = 1.43; 95% CI, 1.28-1.62; P < .001), heavy menstrual bleeding (OR = 12.73; 95% CI, 3.4-82.8; P < .001), and pelvic pain (OR = 3.40; 95% CI, 1.7-7.2; P < .001) increased the likelihood of perceiving the menstrual cycle to disrupt performance., Conclusion: Heavy menstrual bleeding and HC use were low among this cohort of national and international footballers, whereas amenorrhea and oligomenorrhoea were comparable with other football populations. Nearly all players reported menstrual symptoms, and increased symptomatology was associated with greater perceived effects on performance.

Introduction: Polycystic ovary syndrome (PCOS) is associated with a wide range of unfavorable cardiometabolic risk factors, including obesity, hypertension, insulin resistance, impaired glucose metabolism, dyslipidemia, and metabolic syndrome. Compared with women with regular menstrual cycles, women with a history of irregular menstrual periods have an increased unfavorable cardiometabolic risk. Recently, the association between the severity of oligomenorrhea and hyperinsulinemia and insulin resistance has been demonstrated. However, evidence linking the severity of menstrual cyclicity with cardiometabolic risk in PCOS women is scarce., Material and Methods: This work was a prospective cross-sectional study. A total of 154 women diagnosed with PCOS by the Rotterdam criteria were recruited from July 2021 to September 2022. PCOS women with eumenorrheic (eumeno group), oligomenorrhea (oligo group), and amenorrhea (ameno group) underwent history and physical examination, gonadal steroid hormone measurement, lipid profile, oral glucose tolerance test, and homeostasis model assessment of insulin resistance., Results: A trend toward an increase in unfavorable cardiometabolic risk markers including obesity, hypertension, prevalence of insulin resistance, prediabetes, dyslipidemia, and metabolic syndrome was observed in the ameno group (n = 57) as compared with the eumeno (n = 24) or oligo group (n = 73). A higher prevalence of insulin resistance (odds ratio [OR]: 3.02; 95% confidence interval [CI]: 1.03-8.81) and prediabetes (OR: 3.94; 95% CI: 1.01-15.40) was observed in the ameno group than in the eumeno group, and a higher proportion of dyslipidemia (OR: 2.44; 95% CI: 1.16-5.15) was observed in the ameno group than in the oligo group in the binary logistic regression analysis after adjusting for confounding factors., Conclusions: PCOS women with amenorrhea show a higher prevalence of insulin resistance, prediabetes, and dyslipidemia compared with those with oligomenorrhea or eumenorrhea. The severity of menstrual dysfunction could be used as a readily obtainable marker for the identification of PCOS women at greatest risk of cardiometabolic diseases., (© 2024 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)

Cross-sectional studies indicate that menstrual problems are related to poorer mental health; however, longitudinal studies are limited. This longitudinal study aimed to determine whether baseline menstrual characteristics were risk factors for incident and persistent mental health problems. The study was conducted among Chinese adolescent girls. Menstrual characteristics including menarche, menstrual cycle and menstrual pain were assessed at baseline, whereas mental health problems including PTSD, depression, anxiety, ADHD, insomnia, psychotic-like experiences, non-suicidal self-injury, suicide ideation, suicide plan, and suicide attempt were assessed at baseline (n = 1039) and at the 1-year follow-up (n = 946) by self-administered, structured questionnaires. Multiple logistic regressions were performed to examine whether menstrual characteristics were associated with incident (e.g., PTSD at follow-up but not baseline) and persistent (e.g., PTSD at both time points) mental health problems. The results demonstrated that early menarche was related to persistence of psychotic-like experiences; irregular menstruation was associated with higher rates of incident anxiety and insomnia, and persistent depression, anxiety, ADHD, insomnia, non-suicidal self-injury, suicide ideation, and suicide plan; menstrual pain was associated with elevated rates of incident PTSD and depression, and persistent depression, insomnia, psychotic-like experiences, non-suicidal self-injury, suicidal ideation, suicide plan, and suicide attempt. In conclusion, irregular menstruation and menstrual pain specifically contributed to the development of emotional problems and insomnia, and were associated with maintenance of the most mental health problems in early adolescence. The long-term effects of menstrual problems on mental health need further study., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Study Objective: To characterize typical menstrual cycle characteristics in adolescents and determine how these differ with age at menarche or years since menarche (gynecologic age)., Methods: We surveyed 13 to 18-year-old U.S. users of the Clue app (N = 6,486) and linked their responses to app-recorded cycle data (N=38,916 cycles). We analyzed cycle characteristics including cycle length, cycle variability, period length, experience of heavy flow, and dysmenorrhea in relation to gynecologic age and menarcheal age using mixed effects models., Results: With increasing gynecologic age, we observed dose-dependent associations of lower odds of cycle irregularity (defined as cycles that were highly variable, short, or long) and higher odds of reporting ≥1 day of heavy flow. Individuals <1 year post-menarche had lower odds of heavy flow (Odds Ratio (OR) = 0.3; 95% confidence interval (CI): 0.1, 0.6), and increased odds of having a highly variable cycle (OR = 2.6; 95% CI: 1.3, 5.2) or short cycles (OR = 5.0; 95% CI: 2.3, 11.0) compared to those who were 6+ years post-menarche. We also found associations with early and late age at menarche. Compared to menarcheal age of 14+ years, menarcheal age ≤10 years was associated with shorter cycle length (β = -1.63 days; 95% CI: -2.51, -0.75), increased odds of dysmenorrhea (OR = 3.2; 95% CI: 2.3, 4.6), and decreased odds of high cycle variability (OR = 0.8; 95% CI: 0.6, 1.0)., Conclusion: Cycle characteristics in adolescence are associated with menarcheal age and gynecologic age. Notably, highly variable cycles are common, especially among those with younger gynecologic age or older menarcheal age., Competing Interests: Conflict of Interest Authors Kim G. Harley, Annalisa Watson, Samantha Robertson have no conflicts of interest relevant to this article to disclose. Author Virginia J. Vitzthum is a paid consultant for and Author Amanda Shea is a salaried employee of Clue by BioWink, GmbH, the app that provided the data for this study., (Copyright © 2024. Published by Elsevier Inc.)

Background: Nutrition is important to the management and relief of the symptoms in menstrual disorders. This study aims to investigate the relationship between menstrual disorders and specific foods and nutrient intake in women., Methods: Five-hundred-nine menstruating women participated in the study. The questionnaire form was created by the researchers via Google Forms and distributed in online applications (WhatsApp, Instagram etc.). The questionnaire consists of 5 sections, including demographic data, declared anthropometric measurements (height (m or cm), weight (g or kg)), questions about eating habits, menstruation status, and 24-hour food consumption. Statistical analysis was made with SPSS 23; nutrient analysis of food consumption was made using BeBiS 9.0., Results: It was found that the body mass index (BMI) of healthy participants was higher than women with menstrual disorders. Women with menstrual disorders have lower intake of protein, vitamin K, vitamin B 3 , vitamin B 5 and sodium compared with healthy women. All participants have a higher intake of vitamin B 3 , sodium, phosphorus, and manganese, and have a lower intake of other nutrients compared with the national adequate intake., Conclusion: Our findings showed that women with menstrual disorders consume more high-sugar food/beverages and have inadequate nutrients intake., (© 2024. The Author(s).)

Affiliated athletes are frequently subject to higher levels of anxiety due to the intensity of training, competition and many other factors. This anxiety can cause alterations in their health, both physically and mentally, such as menstrual irregularities, eating disorders, etc. In this work we have analysed the anxiety levels of a population of female affiliated paddlers and the possible consequences for their health. The results showed that a third of the female paddlers analysed have a moderate/high risk of suffering from anxiety; and within this group, the less sporting experience the athlete has, the greater the probability is of suffering from anxiety. Moreover, almost half the total of the female paddlers suffers from menstrual dysfunction before an important competition, with this number rising among high performance athletes, even though three out of every four adjust their training schedule to their menstrual cycle. Less-experienced female athletes, who show higher anxiety levels, also present a greater risk of suffering from eating disorders., (© 2024. The Author(s).)

Background: In 1992 the American College of Sports Medicine first described the Female Athlete Triad. The Triad is a metabolic injury involving three distinct clinical traits: low energy availability, with possible eating disorder, low bone mineral density and menstrual dysfunction (MD). Although the estimated prevalence of the Triad is low (1.2 %), single factors are common in female athletes, at all competitive levels and ages. Even though the Triad was described over two decades ago, the interrelation of the three diagnostics components is still debated: additional evidence is required to improve the multidisciplinary treatment approach for this complex condition. MD is one of the first signs of energy impairment. The present study aims at investigating MD determinants and predictors in female athletes, to allow an early diagnosis of the Triad and to implement adequate preventive strategies., Materials and Methods: An original structured questionnaire was composed to detect the presence of MD risk factors. Included participants were active female athletes within reproductive age range (15-40 years old). Anthropometric parameters and training-related factors, possibly affecting the regularity of the menstrual cycle, were investigated., Results: Respondents were 288 female athletes. Among them, 73.3 % were under 25 years of age; 6.6 % resulted underweight; 30.6 % reported to follow a meal plan/diet and 13.9 % declared to be a smoker. Lean sports were practiced by 30.6 % of responders. Body-weight congruence was detected in in 79.9 % of participants, whereas overestimation of body image was found in 16.3 % of athletes. Irregular menstrual cycle, a possible MD predictor, was present in 33.0 % of athletes, with 41.1 % practicing some lean sport (p = 0.007). Also, overestimation of body image suggested an increased risk of menstrual irregularity (p = 0.001). BMI <18.5 or BMI >30 could also act as risk factor, although significance was not fully obtained (p = 0.053). Overall, practice of lean sports and overestimation of body image appeared good determinants of increased menstrual irregularity (AOR 2.02 and 3.83, respectively)., Conclusions: Menstrual irregularity in female athletes can be considered an early predictor of MD: risk is further increased in athletes of lean sports and reporting an overestimation of self-perceived body image. Screenings and awareness programs should specifically address female athletes, because of their vulnerable-group profile. In order to define a standardized at-risk profile for Triad onset and sequelae likelihood, evaluation of menstrual regularity should especially be considered, in conjunction with the assessment of other indicators of energy availability (e.g. TEE, lean and fat mass, BMC). Testing for sport-derived stress and disordered eating attitudes is also recommended. Preventive strategy should involve the proactive engagement of sport clubs and periodic competitive sport medical assessment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

There has been significant interest in the changes in menstrual cycles following coronavirus disease 2019 (COVID-19) infection or vaccination. This study aimed to investigate the evidence for such changes and their potential risk factors. We used a descriptive study design and gathered data by sharing an online survey questionnaire on social media platforms. The questionnaire included questions regarding sociodemographic factors, menstrual cycle changes, and COVID-19 anxiety. The study population comprised women aged 18 to 49 years from Izmir. All data analyses were performed using Statistical Package for the Social Sciences 21.0. The risk factors influencing menstrual irregularities were determined after the COVID binary logistic regression analysis, including univariate and multivariate models. Among the 465 participants, those with an associate's degree had a significantly higher risk of menstrual irregularities than those with a high school diploma (P = .012). Anxiety scores emerged as a significant risk factor for menstrual cycle irregularities (P = .026). However, neither COVID-19 infection nor vaccination resulted in significant changes in the menstrual cycle characteristics (P > .05). Other sociodemographic variables, such as age, body mass index, and smoking, were not significantly associated with menstrual cycle changes(P > .05). The study findings suggest that educational level and anxiety may play a role in menstrual irregularities, whereas COVID-19 infection or vaccination itself may not directly affect menstrual cycle., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The association between covid-19 vaccine and menstrual disturbance is unclear., Methods: An in-person cross-sectional survey among female members ≥ 18 years enrolled in an ongoing Zero TB prospective cohort in Northern India who had received one or two doses of covid-19 vaccine was conducted to study the characteristics and association of menstrual disturbance within six months of receiving Covishield., Results: Between June 29 and September 5, 2021, 339 females ≥ 18 years of age were administered the survey. Median age was 30 (IQR: 22-39) years; 84 % were between 18 and 49 and 16 % were ≥ 50 years old. There were 152 college students, 27 healthcare workers, and 160 nuns. Forty-two women (12 %) had received one dose and 297 (88 %) had received two doses of Covishield. Overall, 66 (20 %) women reported experiencing menstrual disturbance after receiving Covishield vaccine. The problems included early menstruation: 6 % (n = 19/339); late menstruation: 4 % (n = 14/339); and heavier bleeding: 5 % (n = 17/339). Disturbances lasted for less than seven days and cycles normalized in 1-3 months. There was no post-menopausal bleeding. There was no significant difference in menstrual disturbance based on receiving one vs. two doses of Covishield (OR: 1.58; 95 % CI: 0.55-4.57; p = 0.381). History of SARS-CoV-2 infection was not associated with the development of menstrual disturbance among the vaccinees (OR: 0.63; 95 % CI: 0.24-1.73; p = 0.379). Presence of emotional disturbance at baseline (OR: 31; 95 % CI: 3.52-267; p = 0.002) or previous history of dysmenorrhea (OR: 41; 95 % CI: 8.7-196; p < 0.001) was associated with menstrual disturbance in the vaccinees, indicating their potential to confound or bias study results., Conclusion: Menstrual problems were reported by Covishield vaccinees, but they were minor and reversible within three months and do not constitute a ground for vaccine hesitancy. Studies designed to assess causal link taking care to avoid selection bias or confounding are needed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background and Objectives : New investigations have detected an enhanced probability for women to develop menstrual cycle alterations after anti-COVID-19 vaccination. Moreover, given that the protective immunity provided by anti-COVID-19 vaccination appears to wane quickly, booster vaccination has been recommended. Nonetheless, whether adverse events arise from such repeated immunization has not been studied. Materials and Methods : We studied the incidence of menstrual cycle alterations, the quantity of menstrual cycle alterations per subject, and of altered menstrual cycles in nonpregnant women of fertile age after anti-COVID-19 vaccination in a cohort of vaccinated female subjects by the means of a standardized questionary that was applied via telephone calls each month. Subjects that received up to four doses were studied for 6 months after each dose. We calculated the odds ratio for enhanced incidence, as well as quadratic functions for the tendencies. A sensitivity analysis excluding subjects taking hormonal birth control and those with polycystic ovary syndrome was performed. Results : Anti-COVID-19 vaccination enhanced the probability to develop menstrual cycle alterations (OR 1.52, CI at 95% 1.2-1.8, p < 0.0001) and, interestingly, such a tendency was enhanced when subjects received more doses (R 2 = 0.91). Furthermore, the same trends repeated for the quantity of alterations per subject, and of altered cycles. Such an effect was further demonstrated to be independent upon the vaccine brand being applied, the birth control status, and the diagnosis of polycystic ovary syndrome. Conclusions : Vaccination is the most cost-effective measure for primary prevention and is considered to be safe. Nonetheless, in this article, we show data that suggest that repeated vaccination of adult female subjects may lead to an enhanced incidence of menstrual cycle-related adverse events, quantity of alterations per subject, and altered cycles. We therefore think that the development of new vaccine formulations that produce longer-lasting immunity is of paramount importance to reduce the potential for dose accumulation-dependent enhanced risk.

Objectives: Menstrual cycle symptoms are very common in female athletes. However, more evidence about the association between menstrual cycle characteristics and symptoms with sleep and mental health in athletes needs to be gathered. This study aimed to examine this association in German exercising women and athletes., Design: 322 women (mean age: 23.13 ± 4.36) participated in a cross-sectional study. The survey included the Menstrual Symptom index (MSi), the Depression Anxiety Stress Scales (DASS-21), the Pittsburgh Sleep Quality Index (PSQI), and the Athletes Sleep Behavior Questionnaire (ASBQ). Additionally, demographic, sport-specific data and further menstrual cycle characteristics were examined. Multiple regression models were used for the statistical analyses., Results: The MSi score demonstrated a highly significant (p < 0.001) positive association with Depression, Anxiety, Stress, PSQI, and ASBQ. The most prevalent menstrual cycle symptoms were cravings/increased appetite, mood changes/anxiety, and tiredness/fatigue. A difference between individual and team sport athletes could not be found. Moreover, there was no association between the constructs and menses length, irregularity, or heaviness of bleeding., Conclusions: Menstrual cycle symptoms occur very frequently in female athletes. In this study, they were related to mental health, sleep quality, and sleep behavior, regardless of the cycle phase. This evidence demonstrates the relevance of considering the menstrual cycle and menstrual symptoms in future studies with female athletes and in sport practice., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Our study aims to evaluate clinical predictors of menstrual cycle disorders in female athletes who compete in running disciplines. This is a prospective observational study. Women were recruited between January and May 2022. Fifty-three patients were enrolled and completed a questionnaire about menstrual cycle, physical activity, and food habit characteristics. Of the women in our population, 39.6% had menstrual irregularities and reported a significantly higher number of kilometers run per week (67 vs. 35, p:0.02). The number of kilometers run per week was associated with menstrual irregularities (for 10 km, OR 1.35; IC95% 1.05-1.73; p: 0.02) after adjusting for BMI, age, level of sport and caloric intake. The variable of "km run per week" appeared as a diagnostic indicator of irregular menstrual cycle with statistical significance (AUC ROC curve 0.71, IC95% 0.54-0.86, p-value=0.01) and the cut-off of 65 km run per week is a good indicator of the presence of irregular menstrual cycle (sensitivity (SE) and specificity (SP) of 55% and 81.48%). Menstrual cycle disorders are very frequent in female athletes, and the variable of km run per week may play a role in screening endurance athletes at high risk for these disorders., Competing Interests: The authors declare that they have no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Introduction: The menstrual cycle is an important indicator of health in female athletes. Female elite adolescent dancers are expected to control their weight while also training intensely, which can lead to menstrual disorders. This study aimed to investigate the relationship between body composition and menstrual status in female elite adolescent dancers. Methods : In total, 131 female elite adolescent dancers (age: 15.9 ± 1.5 years) were enrolled in this study. We measured the height, weight, and body fat percentage (BFP) for each participant and calculated their body mass index (BMI). We gathered information on individual menstruation patterns and the participants' menstrual cycles over the previous year using recall methods. We then compared the differences between dancers with menstrual cycle disorders and those without. Primary amenorrhea was defined as menarche occurring after the age of 15, while secondary amenorrhe was defined as experiencing fewer than 5 or no menstrual periods for at least 3 of the previous 12 months. We conducted a reliability test using the same questionnaire 2 weeks later. Statistical significance was defined as P  < .05, and we calculated the effect sizes (d) and 95% confidence intervals (95% CI). Results : The average BMI and BFP were 22.6 ± 3.0% and 19.4 ± 2.2 kg/m 2 , respectively. Low BFP and low BMI were observed in 51 (38.6%) and 47 (35.6%) participants, respectively. Primary amenorrhea in 3 participants (2.3%) and 29 (22.1%) reported experiencing secondary amenorrhea; they had lower BFP than the dancers who did not experience amenorrhea ( P  = .041, 95% CI, -2.51 to -0.05). Conclusion : Female elite adolescent dancers in China may have lower BFP and menstrual problems. Given that lower BFP may contribute to the occurrence of menstruation disorders, it is essential to pay an attention to both BFP and the menstruation status in female elite adolescent dancers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: This scoping review aimed to summarize the findings of studies regarding the perceived impact of the menstrual cycle on athletic performance, as well as the prevalence of negative menstrual cycle symptoms., Design: Scoping review., Methods: Three databases were searched and the Preferred Reporting Items for Systematic reviews and Meta Analyses extension for Scoping Reviews (PRISMA-ScR) was used as guidance., Results: A total of 39 studies were included in the final analysis. Between 2.8 and 100 % of athletes reported their performance being negatively impacted by their menstrual cycle, and the main reason was the occurrence of menstrual cycle symptoms. Additionally, a large variability in the prevalence of menstrual cycle symptoms was reported in the different studies mainly due to methodological differences and recall biases., Conclusions: Similarly, as to what has been reported in reviews summarizing performance outcomes during different menstrual cycle phases, this review highlights the high degree of variability between how athletes perceive to be impacted by their menstrual/hormonal contraceptive cycle., Registration: The protocol of this scoping review was registered at the Open Science Framework on 14 September 2023 (osf.io/efu9x)., Competing Interests: Declaration of interest statement Two of the authors (CP and GB) are consultants with Orreco, creators of the free FitsWoman menstrual cycling tracking app for athletes., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Purpose: This study aimed to investigate the association between psychological distress (PD) at age 16 and menstrual symptoms experienced across women's life., Methods: Up to 2584 females from the 1970 British Cohort Study, a study of individuals born within one week in 1970, were included. PD at age 16 was measured with the 12-item General Health Questionnaire. Three categories were derived: low PD (<11), moderate PD (11-15), and severe PD (>15). Five menstrual health symptoms were self-reported at each age (16, 30 and 42 years). Binomial logistic regressions examined associations between PD at age 16 and each individual symptom, adjusted for age of menarche, sleep and appetite problems, physical activity levels and socioeconomic position., Results: The most prevalent symptoms were "pain" (61 %), "painful period" (10 %) and "heavy period" (33 %) at ages 16, 30 and 42, respectively. At age 16, those with severe PD were more likely to experience depression (OR: 2.92; 95% CI: 2.31, 3.70)), irritability (1.67; 1.33, 2.11), menstrual pain (1.34; 1.01, 1.80), and headaches (1.29; 1.02, 1.63). A weak association was found between severe PD at age 16 and pre-menstrual tension at age 30 (1.72; 1.01, 2.83). At age 42, those with severe PD at age 16 were more likely to experience pre-menstrual tension (1.89; 1.46, 2.44), painful periods (1.64; 1.27, 2.11), and heavy periods (1.28; 1.00, 1.62)., Discussion: Menstruating females with higher levels of PD in adolescence have an increased risk of menstrual symptoms across adolescence, early and mid-adulthood. Our findings suggest the need to consider early-life psychological interventions to improve women's menstrual experiences across their reproductive years., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any competing or conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: The purpose of this paper is to call for a nationwide study to assess the prevalence and incidence of women health problems related to menstrual disorders and severe pelvic pain., Rationale: The exact prevalence and incidence of endometriosis, adenomyosis, severe painful menstrual disorders, and of severe chronic pelvic pain are unknown. These issues severely impact women's quality of life and represent huge costs for our societies. Using adapted questionnaires, recent progresses in diagnosis and increased fundings announced by politicians, we can and should change this situation by performing a nationwide study to assess prevalence and incidence of these women problems in the French general population. The huge, anticipated costs of this study do appear quite reasonable when accounting for the enormous costs and societal consequences of endometriosis, menstrual disorders and severe pelvic pain., Conclusion: These long-awaited data will improve our understanding of the causes, consequences, and natural history of endometriosis. These data will allow women to better understand that pain is not always related to endometriosis, thus preventing unjustified fears. Physicians will be able to adapt and improve medical managements, particularly the diagnosis. Politicians will have the tools to improve women's health and gender equality., Competing Interests: Declaration of competing interest The author has no conflict of interest to declare., (Copyright © 2024 The Author. Published by Elsevier Masson SAS.. All rights reserved.)

Background: Regularity of menstrual cycles is an important indicator of women's health and fertility, and female workers are exposed to several factors, such as sleep disorders, stress, and shift work, that affect their menstrual regularity. This makes it necessary to comprehensively identify the determinants of menstrual regularity. Therefore, this study identified the factors affecting menstrual regularity among female workers from physiological, psychological, and situational dimensions based on the theory of unpleasant symptoms., Methods: This was a secondary analysis of the 2010-2012 Korea National Health and Nutrition Examination Survey and utilized the data of 2418 female workers. Based on the theory of unpleasant symptoms, physiological factors included age, age at menarche, childbirth experience, body mass index, and sleep duration. Psychological factors included stress level, depressive mood, and suicidal ideation. Situational factors included education level, household income, consumption of alcohol, engagement in smoking, and work schedule. The χ²-test and hierarchical logistic regression analysis were performed, reflecting the complex sample design., Results: Age at menarche, childbirth experience, and body mass index among physiological factors and education level and work schedule among situational factors were found to be related to menstrual regularity. A higher risk of menstrual irregularities was found among those who had given birth (versus those who had not), had a high age at menarche (versus those with a low age at menarche), were obese (versus those who had a normal body mass index), had elementary school-level or lesser educational achievements (versus those with college graduate-level or higher educational achievements), and who had a shift work schedule (versus those with a fixed schedule)., Conclusions: Intervention is needed for female workers who have these risk factors, and special attention must be paid to female workers who have a shift work schedule. Additionally, since body mass index can be controlled, intervention concerning body mass index is necessary to reduce menstrual irregularity., (© 2024. The Author(s).)

Importance: Polycystic ovary syndrome (PCOS), characterized by irregular menstrual cycles and hyperandrogenism, is a common ovulatory disorder. Having an irregular cycle is a potential marker for cardiometabolic conditions, but data are limited on whether the associations differ by PCOS status or potential interventions., Objective: To evaluate the association of PCOS, time to regularity since menarche (adolescence), and irregular cycles (adulthood) with cardiometabolic conditions., Design, Setting, and Participants: This cross-sectional study used a large, US-based digital cohort of users of the Apple Research application on their iPhone. Eligibility criteria were having ever menstruated, living in the US, being at age of consent of at least 18 years (or 19 years in Alabama and Nebraska or 21 years in Puerto Rico), and being able to communicate in English. Participants were enrolled between November 14, 2019, and December 13, 2022, and completed relevant surveys., Exposures: Self-reported PCOS diagnosis, prolonged time to regularity (not spontaneously establishing regularity within 5 years of menarche), and irregular cycles., Main Outcomes and Measures: The primary outcome was self-reported cardiometabolic conditions, including obesity, prediabetes, type 1 and 2 diabetes, high cholesterol, hypertension, metabolic syndrome, arrhythmia, congestive heart failure, coronary artery disease, heart attack, heart valve disease, stroke, transient ischemic attack (TIA), deep vein thrombosis, and pulmonary embolism measured using descriptive statistics and logistic regression to estimate prevalence odds ratios (PORs) and 95% CIs. Effect modification by lifestyle factors was also estimated., Results: The study sample (N = 60 789) had a mean (SD) age of 34.5 (11.1) years, with 12.3% having PCOS and 26.3% having prolonged time to regularity. Among a subset of 25 399 participants who completed the hormonal symptoms survey, 25.6% reported irregular cycles. In covariate-adjusted logistic regression models, PCOS was associated with a higher prevalence of all metabolic and several cardiovascular conditions, eg, arrhythmia (POR, 1.37; 95% CI, 1.20-1.55), coronary artery disease (POR, 2.92; 95% CI, 1.95-4.29), heart attack (POR, 1.79; 95% CI, 1.23-2.54), and stroke (POR, 1.66; 95% CI, 1.21-2.24). Among participants without PCOS, prolonged time to regularity was associated with type 2 diabetes (POR, 1.24; 95% CI, 1.05-1.46), hypertension (POR, 1.09; 95% CI, 1.01-1.19), arrhythmia (POR, 1.20; 95% CI, 1.06-1.35), and TIA (POR, 1.33; 95% CI, 1.01-1.73), and having irregular cycles was associated with type 2 diabetes (POR, 1.36; 95% CI, 1.08-1.69), high cholesterol (POR, 1.17; 95% CI, 1.05-1.30), arrhythmia (POR, 1.21; 95% CI, 1.02-1.43), and TIA (POR, 1.56; 95% CI, 1.06-2.26). Some of these associations were modified by high vs low body mass index or low vs high physical activity., Conclusions and Relevance: These findings suggest that PCOS and irregular cycles may be independent markers for cardiometabolic conditions. Early screening and intervention among individuals with irregular menstrual cycles may be beneficial.

Background: Adults with developmental disabilities often have less access to reproductive health services than adults without these disabilities. However, little is known about how adolescents with developmental disabilities, including autism, access reproductive healthcare., Objective: We aimed to characterize the use of reproductive healthcare services among adolescents with autism and those with other developmental disabilities in comparison with adolescents with typical development., Study Design: We conducted a cohort study of a sample of adolescents who were continuously enrolled members of Kaiser Permanente Northern California, an integrated healthcare system, from ages 14 to 18 years. The final analytical sample included 700 adolescents with autism, 836 adolescents with other developmental disabilities, and 2187 typically developing adolescents who sought care between 2000 and 2017. Using the electronic health record, we obtained information on menstrual conditions, the use of obstetrical-gynecologic care, and prescriptions of hormonal contraception. We compared healthcare use between the groups using chi-square tests and covariate-adjusted risk ratios estimated using modified Poisson regression., Results: Adolescents with autism and those with other developmental disabilities were significantly more likely to have diagnoses of menstrual disorders, polycystic ovary syndrome, and premenstrual syndrome than typically developing adolescents. These 2 groups also were less likely than typically developing peers to visit the obstetrician-gynecologist or to use any form of hormonal contraception, including oral contraception, hormonal implants, and intrauterine devices. Adolescents in all 3 groups accessed hormonal contraception most frequently through their primary care provider, followed by an obstetrician-gynecologist., Conclusion: Adolescents with autism and those with other developmental disabilities are less likely than their typically developing peers to visit the obstetrician-gynecologist and to use hormonal contraception, suggesting possible care disparities that may persist into adulthood. Efforts to improve access to reproductive healthcare in these populations should target care delivered in both the pediatric and obstetrics-gynecology settings., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Although it has been shown that amenorrhea associated with low energy availability or relative energy deficiency in sport affects body physiology in female athletes, the association between menstrual dysfunction during active sports careers and reproductive function after retirement is not clear., Objective: To investigate the association between menstrual dysfunction during their active sports career and post-retirement infertility in female athletes., Methods: A voluntary web-based survey was aimed at former female athletes who had become pregnant and gave birth to their first child after retirement. Nine multiple-choice questions were included, on maternal age, competition levels and menstrual cycles during active sports careers, time from retirement to pregnancy, the time of resumption of spontaneous menstruation after retirement, conception method, and mode of delivery, etc. Regarding cases of primary and secondary amenorrhea among the abnormal menstrual cycle group, only those whose spontaneous menstruation had not recovered from retirement to the time of pregnancy were included in the study. The association between the presence of abnormal menstrual cycles from active sports careers to post-retirement pregnancy and the implementation of infertility treatment was evaluated., Results: The study population included 613 female athletes who became pregnant and gave birth to their first child after retiring from competitive sports. Of the 613 former athletes, the infertility treatment rate was 11.9%. The rate of infertility treatment was significantly higher in athletes with abnormal than normal menstrual cycles (17.1% vs. 10.2%, p  = 0.0225). Multivariable logistic regression analysis showed that maternal age (adjusted odds ratio [OR] 1.194; 95% confidence interval [CI] 1.129, 1.262) and abnormal menstrual cycles (OR and 1.903; adjusted OR 1.105, 3.278) were the relevant factors for infertility treatment., Conclusion: It was suggested that menstrual dysfunction that persist from active sports careers to post-retirement may be a factor in infertility when trying to conceive after retirement.

Objectives: Menstrual disorders are among the most prevalent health issues among young female students studying in health science faculties. This study aimed to provide insights into the menstrual patterns among medical faculty students and determine whether stress can be a risk factor for its various disorders., Methods: This cross-sectional study was conducted in the Faculties of Medicine, Dentistry, and Pharmacy at the Syrian Private University, Damascus, Syria, between October and November 2022. A total of 980 female students anonymously completed the identification of menstrual problems and the perceived stress scale (PSS) questionnaire. The data were analyzed using SPSS-25., Results: The mean age of students was 21.52 ± 2.06 years. The most common menstrual disorders in this study were dysmenorrhea (88%), and premenstrual syndrome (87%). A total of 82% had mild to moderate stress, 10% had high stress, and 8% had low stress. Moderate to high perceived stress was associated with an increased risk of PMS (OR = 1.79, P = 0.0037)., Conclusion: These findings stress the importance of universities, especially health science faculties, establishing protocols for early detection and intervention in students with stress and menstrual disorders. Implementing stress reduction education and timely counseling, along with preventive measures, is crucial for students' well-being. Further research is needed to refine interventions for this group., (© 2023 International Federation of Gynecology and Obstetrics.)

Background: Menstrual irregularities are present in >30% of women with type 1 diabetes mellitus (T1DM). These abnormalities will likely lead to reduced fertility and earlier menopause. T1DM management has changed over time, with even more emphasis on stringent levels of glycemic management. Thus, we investigated whether therapeutic T1DM changes have an influence on the proportion of menstrual disorders in women with T1DM., Methods: A meta-analysis was performed that included clinical trials in which menstrual abnormalities in women with T1DM were studied. The literature was checked for studies in which women with T1DM were compared with healthy, age-matched controls. Case-control, cohort, and cross-sectional studies were included. The primary endpoint was rate of menstrual dysfunction., Results: Menstrual dysfunction was higher in women with T1DM compared with controls (odds ratio 2.08, 95% confidence interval [CI] 1.43 to 3.03, p<0.001), even when sensitivity analysis was performed, considering only studies published after 2000. The age at menarche was higher for women with T1DM compared with controls (mean difference 0.53, 95% CI 0.32 to 0.74 years, p<0.001). The proportion of menstrual abnormalities in T1DM was inversely related to diabetes duration, but was unrelated to both body mass index and glycated hemoglobin., Conclusions: The meta-analytic approach used confirmed the correlation between T1DM and menstrual irregularities. T1DM menstrual dysfunction seemed unrelated to change in therapeutic management across years, as well as to glycemic management and body weight. The underlying pathogenetic mechanisms are not fully understood., (Copyright © 2023 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

Background: This study aimed to investigate the relationship between the prevalence of menstrual irregularities, energy intake, and sleep deprivation among female athletes., Methods: A total of 128 female athletes, with an average age of 19.2 ± 1.2 years, participated in the study and tracked their food intake over a three-day period. Menstrual status and sleep duration were assessed using a questionnaire, and psychological anxiety was evaluated using the State and Trait Anxiety Inventory (STAI). These were measured once during the investigation. The impact of sleep status on state anxiety and daily energy intake was examined using the T-test. A generalized linear model (GLM) with a log link function was employed to investigate the effects of sleep deprivation on the presence of menstrual irregularities., Results: As the results of the present study, sleep deprivation significant increased both state and trait anxiety ( p < 0.05), as well as affecting energy intake ( p < 0.05), particularly protein and carbohydrate intakes ( p < 0.05). However, GLM analysis indicated that while sleep deprivation did not directly influence the prevalence of menstrual irregularities ( p > 0.05), state anxiety emerged as a significant factor impacting the prevalence of menstrual irregularities ( p < 0.05)., Conclusions: The results of the present study suggest a potential pathway wherein sleep deprivation might elevate state anxiety levels, consequently indirectly contributing to an increase the probability of menstrual irregularities. In conclusion, the results of the presents study provide novels insights suggesting that sleep deprivation might directly increase state anxiety and indirectly affect the prevalence of menstrual irregularities. Hence, decreased sleep duration might be related to mental health issues and the prevalence of menstrual irregularities both significant concerns among female athletes. Future studies will play a crucial role in further elucidating how sleep patterns impact the health and well-being of female athletes., Competing Interests: Kenichi Shibuya is an Academic Editor for PeerJ. Kenichi Shibuya and Mana Miyamoto are the Special Issue Editors., (© 2024 Miyamoto and Shibuya.)

This study aimed to explore the potential application value of acupuncture in alleviating the impact of long COVID on women's menstrual cycles, by investigating the occurrence of long COVID among female college students, its effects on menstruation, and the intervention of acupuncture. This cross-sectional study surveyed female college students with a history of coronavirus disease 2019 (COVID-19) before April 10, 2023. A questionnaire was used to analyze demographic characteristics, post-COVID sequelaes, duration of symptoms, and treatments received during that period. Among the 731 participants enrolled in the survey, 468 were female undergraduate students who met the analysis criteria. Among them, 85 individuals fit the definition of "Long COVID" (18.16%). Within the group of patients with long COVID, 69 individuals experienced changes in their overall menstrual patterns compared to the 6 months prior to contracting the novel coronavirus (81.18%). Additionally, 17 individuals opted for acupuncture treatment following the onset of COVID-19 (20.00%), which resulted in less impact on their menstrual cycle (41.18% vs 64.71% without receiving acupuncture, OR = 2.62), menstrual period duration (41.18% vs 64.71%, OR = 2.62), menstrual flow (47.06% vs 69.18%, OR = 2.52), and the color of menstrual blood (41.18% vs 63.24%, OR = 2.46) among these patients. Long COVID had a certain impact on menstruation. Acupuncture potentially alleviates the clinical symptoms of long COVID and reduces its impact on women's menstrual cycle, thus having potential therapeutic value in the treatment of long COVID., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Evidence on how menstrual characteristics may differ based on socioeconomic factors and self-rated health is significantly scarce. The main aim of this study was to investigate the associations between menstrual characteristics, sociodemographic factors and self-rated health among women and people who menstruate (PWM) aged 18-55 in Spain., Methods: This cross-sectional study includes data from an online survey collected in March-July 2021 across Spain. Descriptive statistical analyses and multivariate logistic regression models were performed., Results: The analyses included a total of 19,358 women and PWM. Mean age at menarche was 12.4 (SD = 1.5). While 20.3% of our participants experienced a menstrual abundance over 80 ml, 64.1% reported having menstrual blood clots; 6.4% menstruated for longer than 7 days. 17.0% had menstrual cycles that were shorter than 21 days or longer than 35 days. Reports of moderate (46.3%) and high (22.7%) intensity menstrual pain were common. 68.2% of our participants experienced premenstrual symptoms in all or most cycles. The odds for lighter menstrual flow, shorter bleeding days and menstrual cycles were higher as age increased, and amongst participants with less educational attainment. Caregivers presented higher odds for abundant menstrual flow and longer menstruations. Reporting financial constraints and a poorer self-rated health were risk factors for abundant menstrual flow, menstrual blood clots, shorter/longer menstruations and menstrual cycles, premenstrual symptoms, moderate and intense menstrual pain., Conclusions: This study suggests that age, educational attainment, caregiving, experiencing financial hardship and a poorer self-rated health may shape or mediate menstrual characteristics. It thus highlights the need to investigate and address social inequities of health in menstrual research., (© 2024. The Author(s).)

This study was aimed to assess the type and severity of COVID vaccine-induced menstrual disorders and also to investigate the risk factors for menstrual changes following COVID-19 vaccination in Pakistani females. A cross-sectional survey-based study was conducted in females between 12 -70 years of age from February to July 2022. The survey was conducted via in-person interviews as well as via social media. The data was analyzed using standard descriptive statistical parameters, the sociodemographic and clinical features were evaluated and reported as frequencies (percentages). The study comprised a total of 1023 female subjects. Approximately 36.9% of women reported menstrual abnormalities following immunization, with 30.5% experiencing them following their second dose. However, in majority of these women (21%) the symptoms were resolved after 3 months of irregularity. Vaccine type significantly influenced the incidence of menstrual disorders (p <0.001) which were linked to Pfizer-Biontech, Sinopahrm, Sinovac, Moderna at rates of 14.9%, 9.5%, 4.7% and 2.7%, respectively. Both AstraZeneca and Moderna were implicated in postmenopausal bleeding (1.6% and 0.8%, respectively). The study showed that females receiving COVID-19 vaccines experienced menstrual irregularities such as short duration of periods, decreased volume of bleeding, and frequent menstrual cycles. However, the symptoms were temporary and self-limiting.

The purpose of this study was to examine the menstrual cycle (MC) characteristics, explore the impact on performance, and identify barriers to and facilitators of MC-related communication among high-performance female adolescent athletes in Singapore. Ninety athletes (15.4 ± 1.8 years) from multiple sports completed an online questionnaire. Eighty-four athletes were postmenarcheal (menarcheal age 11.9 ± 1.3 years), including two who were using an oral contraceptive pill (OCP). Secondary amenorrhea, current or history of, was self-reported in 16% of athletes. Sixty-two percent and 67% of non-OCP athletes perceived that the MC affected their ability to train and compete, respectively. Athletes preferred speaking to a parent (85%) and a female figure (67%) about MC-related concerns. Through thematic analysis, three barriers to communication were constructed: (1) pervasive menstrual stigma, (2) constraints of the training environment, and (3) the low value placed on MC-related conversations. Two facilitators of communication were constructed: (1) respect athletes' individual experiences as menstruating girls and (2) foster a safe space for MC-related conversations. Findings demonstrated that menstrual irregularities are common in adolescent athletes and screening for MC disorders, particularly primary amenorrhea should be undertaken in this population, with clear support pathways for management including symptom mitigation. To support athletes in raising MC-related concerns when needed, structured communication pathways that consider individual preferences and involve a (female) point of contact should be established within the training environment. Improving menstrual health literacy among adolescent athletes before any misinformation or negative perceptions are firmly established may contribute to longevity in their athletic careers., (© 2023 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Background: Recent study has demonstrated that the GnRH system in patients with post-COVID syndrome may be influenced by SARS-CoV-2. However, the impact of COVID-19 infection on women's menstruation is still unknown., Objective: We aimed to investigate the the relationship between coronavirus disease 2019 (COVID-19) and menstruation in premenopausal women., Methods: This was a retrospective cohort study. Pre-menopausal women were invited to participate in the online questionnaire on wechat. Participants were divided into four groups according to whether they were infected with severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) and whether they had menstrual changes during the pandemic. Sociodemographic characteristics, history of COVID-19, menstruation and menstrual changes of the participants were collected. Statistical analyses were performed using SPSS, version 25.0 (SPSS Inc., Chicago, IL, USA)., Results: A total of 1946 women were included in the study. 1800 participants had been or were currently infected with SARS-COV-2, and 146 people had not been infected. Among 1800 patients with COVID-19, 666 (37.0%) had changes in menstruation, and 1134 (63.0%) did not, which was significantly higher than the uninfected participants (c 2  = 12.161, P = 0.000). The proportion of participants with menstrual cycle changes (450/67.6%) is larger than that of uninfected participants (c 2  = 6.904, P = 0.009). COVID-19 vaccination was associated with lower odds of menstrual cycle change (OR, 0.855; 95% CI, 0.750-0.976). Participants who reported chest pain (OR, 1.750, 95% CI, 1.209-2.533) and dyspnea (OR, 1.446; 95% CI, 1.052-1.988) during infection had greater odds of changes to their menstrual cycle compared with the participants who did not., Conclusions: The association between the COVID-19 and increased prevalence of menstrual cycle irregularity. COVID-19 vaccination is a protective factor in the long term, and participants with chest pain and dyspnea are more likely to develop AUB., (© 2023. The Author(s).)

Background Menstrual cycle irregularities are associated with cardiovascular and cardiometabolic disease. We tested associations between age at menarche and cycle irregularity in adolescence and cardiometabolic health in early adulthood in a subsample from the Pittsburgh Girls Study. Methods and Results Data from annual interviews were used to assess age at menarche and cycle irregularity (ie, greater or less than every 27-29 days) at age 15 years. At ages 22 to 25 years, cardiometabolic health was measured in a subsample of the Pittsburgh Girls Study (n=352; 68.2% Black), including blood pressure, waist circumference, and fasting serum insulin, glucose, and lipids. T tests were used for continuous data and odds ratios for dichotomous data to compare differences in cardiometabolic health as a function of onset and regularity of menses. Early menarche (ie, before age 11 years; n=52) was associated with waist circumference ( P =0.043). Participants reporting irregular cycles (n=50) in adolescence had significantly higher levels of insulin, glucose, and triglycerides, and higher systolic and diastolic blood pressure ( P values range from 0.035 to 0.005) and were more likely to have clinical indicators of cardiometabolic predisease in early adulthood compared with women who reported regular cycles (odds ratios ranged from 1.89 to 2.56). Conclusions Increasing rates and earlier onset of cardiovascular and metabolic disease among women, especially among Black women, highlights the need for identifying early and reliable risk indices. Menstrual cycle irregularity may serve this purpose and help elucidate the role of women's reproductive health in protecting and conferring risk for later cardiovascular and cardiometabolic diseases.

Background: Sexual problems are common among women with pelvic floor disorders (PFD). Few studies have explored the relationship between obesity and sexual function in women with PFD. This study aimed to prove that obesity was a risk factor for worse sexual function in women with PFD, and to investigate the mediating role of menstrual irregularity., Methods: This was a cross-sectional study involving 783 women with PFD from Shandong Province, China between June 2020 and February 2021. Female sexual function was assessed using the Pelvic Organ Prolapse/UI Sexual Questionnaire-12 (PISQ-12). Obesity was defined as BMI ≥ 28.0. Menstrual irregularity was defined as menstrual cycles ≥ 35 or menstrual cycles < 25 days. Logistic regression and multiple linear regression were employed to explore the association among obesity, menstrual irregularity and sexual function., Results: Obesity was associated with worse PISQ-12 scores compared with normal- weight women (mean score 28.14 ± 7.03 versus 32.75 ± 5.66, p < 0.001). After adjusting for controlling variables, women with obesity (β= -3.74, p < 0.001) and menstrual irregularity (β= -3.41, p < 0.001) had a worse sexual function. Menstrual irregularity had a mediation effect on the association between obesity and sexual function., Conclusions: This study provided evidence that obesity was associated with worse sexual function in women with PFDs, and the effect of obesity on sexual function was partially mediated by menstrual irregularity. Weight control may have potential benefits for improving sexual function and preventing female sexual dysfunction. It's also important to pay attention to the menstrual cycle., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objectives: To assess the prevalence of diminished ovarian reserve (DOR) in Chinese women with follicular cysts and menstrual disorders and relationship to hormonal markers., Methods: 117 women with follicular cysts and menstrual disorders, aged 24 ∼ 53 (39.19 ± 6.61) years; measurements of height, weight, follicle-stimulating hormone (FSH), luteinizing hormone (LH), E2, progesterone (Po), prolactin (PRL), total testosterone, AMH, follicular cyst diameter, endometrial thickness. Three age groups were compared: 1) 21 ∼ 30 years, 2) 30 ∼ 40 years, 3) > 40 years., Results: Total prevalence of DOR 86.3%, in the groups 50%, 81.6%, and 98.4%, in group-3 significantly higher than in group-1 and 2. 34.2% of the 117 patients complained of cessation of regular menstruations or amenorrhea, 65.8% of abnormal uterine bleeding. Follicular cysts disappeard in cycle-1 for 98 (83.8%) and in cycle-2 for 117 (100%) patients. AMH decreased with age, significantly different between the three groups. Total testosterone in group-1 and 2 was significantly higher than in group-3. In total AMH had a negative correlation with age and E2 ( p  < 0.01) and positive correlation with total testosterone ( p  < 0.05)., Conclusions: Assessing ovarian reserve with follicular cysts and menstrual disorders is important because often pointing to DOR. The overall prevalence of DOR was high; even young women (<40 years) with follicular cysts and menstrual disorders had a low level of AMH. So AMH can be used as a marker to define DOR with higher sensitivity than other markers like FSH and E2. Primarily, these results only apply to Chinese women and should be confirmed in further studies.

Background: Many signals of menstrual disturbances as possible side effects of vaccination against COVID-19 have been reported. Our objective was to compare the risk of menstrual disturbances before and after vaccination among women aged 18-30 years in Oslo, Norway., Methods: We used electronic questionnaires to collect reports of menstrual disturbances from 3972 women aged 18-30 years, participating in the population-based Norwegian Young Adult Cohort. We examined the occurrence of menstrual disturbances (heavier bleeding than usual, prolonged bleeding, shorter interval between menstruations, longer interval between menstruations, spot bleedings, stronger pain during menstruation, period pain without bleeding) before and after the first and second dose of COVID-19 vaccine. Relative risks (RR) according to vaccination were estimated using a self-controlled case-series design. We performed additional analyses stratified by vaccine brand, contraception/hormone use, and presence of gynecological condition(s)., Results: The prevalence of any menstrual disturbance was 36.7 % in the last menstrual cycle prior the first vaccine dose. The RR for heavier bleeding than usual was 1.90 (95 % CI: 1.69-2.13) after the first vaccine dose and 1.84 (95 % CI 1.66-2.03) after the second dose. Increased risks of prolonged bleeding, shorter interval between menstruations, and stronger pain during menstruation were also observed after both doses. The RRs did not differ with vaccine brand, contraception/hormone use, or presence of gynecological condition(s) for any of the menstrual disturbances., Conclusion: Menstrual disturbances were common regardless of vaccination. We found increased risk of menstrual disturbances after vaccination, particularly for heavier bleeding than usual, prolonged bleeding, shorter interval between menstruations, and stronger period pain. In the future, menstrual characteristics should be included in vaccine trials., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Menstruation is a natural phenomenon for every female, starting from adolescents to menopausal age. Any disturbances in menstrual patterns can eventually affect one's physical as well as psychological health which in turn hamper the quality of life of women. Several factors including genetic predisposition as well as lifestyle modifications adversely affect normal menstrual patterns. Hence, this study aims to evaluate the prevalence of menstrual disorders among adolescents and young women as well as the associated risk factors. A cross-sectional random survey was conducted from January 2020 to January 2022 in various schools and colleges. A structured questionnaire was prepared which include anthropometric details, demographic information, and lifestyle patterns. The data were extracted for further statistical analysis. In the overall study population, the prevalence of PCOS, Dysmenorrhea, Menorrhagia, Polymenorrhea, Hypomenorrhea and the irregular menstrual cycle was found at 14.14%, 15.14%, 6.29%, 3.70%, 5.16% and 44.83% respectively. The mean BMI of the study population was 19.949 ± 4.801 kg/m 2 and the mean WHr was 0.872 ± 0.101, indicating a moderate to high risk of metabolic disorder among the study population. Increased BMI, short sleep, and sedentary and vigorous physical activity can contribute to the risk of developing menstrual disorders. Unhealthy food habits are a major risk factor for menstrual disorders. Lifestyle modifications like healthy food habits, sleeping patterns, physical activity, etc. can effectively reduce the risk of menstrual disorders and also cut down the severity of more complex health problems. In-depth biochemical and molecular analysis is required to identify specific biomarkers., (© 2023. The Author(s).)

Context: Fertility represents a major concern in patients with acromegaly., Objective: The current retrospective study aimed to investigate gonadal function and fertility rates in acromegalic women., Methods: In this referral-center study, 50 acromegalic women with disease onset within reproductive age were evaluated for prevalence of gonadal dysfunction and infertility. Anthropometric, metabolic, hormonal parameters, and gynecological ultrasound were evaluated at diagnosis and after disease control. Data about menstrual disturbances, pregnancy, and polycystic ovarian morphology (PCOM) were investigated at disease onset, at diagnosis, and after disease control., Results: At presumed disease onset, menstrual disturbances were reported in 32% of patients. Uterine leiomyoma, ovarian cysts, and PCOM were diagnosed in 18%, 12%, and 8%, respectively; 36.8% of patients were infertile. At diagnosis, menstrual disturbances were found in 58.1% (P = .02), being significantly more prevalent in patients with higher insulin-like growth factor-I quartiles (Q) (P = .03, Q1 vs Q4). Gynecological ultrasound revealed uterine leiomyoma, ovarian cysts, and PCOM in 39.1% (P = .04), 28.2% (P = .09), and 13% (P = .55), respectively. The infertility rate was 100% (P = .02). At disease control, menstrual disturbances were slightly decreased as compared to diagnosis (P = .09). Noteworthy, menstrual disturbances (P = .05) and particularly amenorrhea (P = .03) were significantly more frequent in patients with active disease duration greater than 5 years (median) as compared to those achieving disease control in less than 5 years. Among patients with pregnancy desire, 73.3% conceived at least once, with resulting infertility significantly decreased compared to diagnosis (26.7%; P = .01). At-term deliveries, preterm deliveries, and spontaneous abortions were recorded in 86.7%, 6.6%, and 6.6%, respectively, of the 15 pregnancies reported by the patients. No neonatal malformations and/or abnormalities were recorded., Conclusion: Gonadal dysfunction and infertility are common in acromegalic women within reproductive age, being directly influenced by disease status and/or duration., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: COVID - 19 vaccine can lead to various local and systemic side effects, including menstrual irregularities in women. There is no robust quantitative evidence of the association between the COVID - 19 vaccine and menstrual irregularities. A meta-analysis was performed to estimate the pooled prevalence of a range of menstrual disorders that may occur in women following COVID - 19 vaccination., Methods: After searching for epidemiological studies, we systematically performed a meta-analysis on PubMed/Medline, EMBASE, and Science Direct. Sixteen studies were finally included in the study. We estimated the pooled prevalence and corresponding 95 % confidence intervals (CIs) for a group of menstrual disorders, including menorrhagia, polymenorrhea, abnormal cycle length, and oligomenorrhea. Heterogeneity was assessed using the I 2 statistic and the Q test., Results: Overall, the pooled prevalence of menorrhagia was 24.24 % (pooled prevalence 24.24 %; 95 % CI: 12.8-35.6 %). The pooled prevalence of polymenorrhea was 16.2 % (pooled prevalence: 16.2 %; 95 % CI: 10.7-21.6 %). The pooled prevalence of abnormal cycle length was relatively lower than that of the other disorders (pooled prevalence: 6.6 %; 95 % CI: 5.0-8.2 %). The pooled prevalence of oligomenorrhea was 22.7 % (95 % CI: 13.5-32.0 %)., Conclusion: The findings indicate that menorrhagia, oligomenorrhea, and polymenorrhea were the most common menstrual irregularities after vaccination. The findings also suggest that a relatively high proportion of women suffer from menstrual irregularities. Further longitudinal studies are needed to confirm the causal relationship between COVID-19 vaccination and menstrual irregularities., Competing Interests: Conflict of Interest The authors declare that they have no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)