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Purpose: The purpose of this study was to describe the implementation of menstrual-cycle (MC) and hormonal-contraceptive (HC) tracking among Gaelic Football players, including the characterization of MC status and symptomatology, and to examine the effect of MC and oral-contraceptive-pill phases on daily wellness. Methods: Fourteen highly trained players (age 24.2 [3.5] y), including non-HC (n = 6), oral contraceptive pill (n = 7), and intrauterine system (n = 1) users, prospectively tracked their MC or HC alongside daily self-reported wellness measures for 4 months. A combination of calendar-based counting, urinary ovulation prediction testing, and a midluteal serum progesterone measurement was used to assess MC status. Results: Only 2 non-HC players were eumenorrheic. Two players exhibited oligomenorrhea (cycle length, 39 [4] d), and ovulation was not detected in one of them. Luteal phase deficiency was indicated in 2 players (serum progesterone range <1.0–7.5 nmol·L−1). All players except 1 reported at least 1 negative MC-related symptom or HC side effect. Linear mixed-model analyses revealed that wellness measures were not affected by oral contraceptive pill phase (P >.05). Linear mixed-model analysis was not performed in non-HC users due to the small sample of eumenorrheic players (n = 2). Conclusions: Diverse reproductive profiles were observed, including HC use and subtle MC irregularities that would likely go undetected without prospective MC tracking using biochemical outcomes. This highlights the value of incorporating ovulation testing and blood sampling when establishing the MC status of athletes in applied research and practice where feasible. Applied researchers should anticipate practical challenges, including inconsistencies in ovulation testing timings and the time scale required to assess MC status among athletes. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Despite the increased popularity of female elite road cycling, research to inform the fueling requirements of these endurance athletes is lacking. In this case study, we report for the first time the energetics of a female world-tour cyclist competing in the 2023 Tour de France Femmes, an 8-day race of the Union Cycliste Internationale. The 29-year-old athlete presented with oligomenorrhea and low T3 before the race. Total daily energy expenditure assessed with the doubly labeled water technique was 7,572 kcal/day (∼4.3 physical activity levels), among the highest reported in the literature to date for a female. Crank-based mean maximal power was consistent with female world-tour cyclists (5 min, mean 342 W, 4.8 W/kg; 20 min 289 W, 4.1 W/kg). The average daily energy intake measured with the remote food photography method (Stage Days 1–7) was 5,246 kcal and carbohydrate intake was 13.7 g/kg (range 9.7–15.9 g/kg), and 84 g/hr during stages, and an average fat intake of 15% of daily energy intake. An estimated 2,326 kcal/day energy deficit was evidenced in a 2.2 kg decrease in body mass. Notwithstanding the high carbohydrate intake, the athlete was unable to match the energy requirements of the competition. Despite signs of energy deficiency preexisting (oligomenorrhea and low T3), and other further developing during the race (weight loss), performance was in line with that of other world-tour cyclists and a best personal performance was recorded for the last stage. This case study emphasizes the need for further research to inform energy requirements for female athletes' optimal performance and health. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What is the predictive value of oligomenorrhea and other PCOS diagnostic characteristics in adolescence (age 15–18 years) for future fertility and cardiovascular and metabolic health at adult age? SUMMARY ANSWER Adolescents with oligomenorrhea are more often treated to conceive but are as likely to have as much children as those with regular periods, while persisting oligomenorrhea may associate more often with cardiovascular or metabolic problems. WHAT IS KNOWN ALREADY Adolescents with oligomenorrhea have a high risk for adult PCOS associated with subfertility due to ovulatory disorders and long-term health risks. Longitudinal studies to estimate the extent of these risks with input starting at adolescence and covering the complete reproductive lifespan are lacking. STUDY DESIGN, SIZE, DURATION A 25-year prospective follow-up study based on a unique population-based adolescent study on menstrual irregularities performed between 1990 and 1997, the Pubertal Onset of Menstrual Cycle abnormalities, a Prospective study (POMP study). Of the 271 invited adults, 160 (59%) participated. PARTICIPANTS/MATERIALS, SETTING, METHODS We contacted stratified samples of the POMP study cohort two decades after the initial study for a questionnaire assessing PCOS features, fertility history, pregnancy outcome, metabolic, and cardiovascular health. One hundred and sixty subjects completed the questionnaire. The mean adolescent age was 15.3 years, and the women were 39.6 years at the time of follow-up. One hundred and eight subjects had a regular menstrual cycle as adolescents and 52 were oligomenorrheic. MAIN RESULTS AND THE ROLE OF CHANCE Of those with adolescent regular menstrual cycles 12 never tried to conceive, 4 tried but never conceived and 92 of 96 (96%) conceived, 89 of 96 (93%) delivering at least one living child. The median number of children was two. The mean time to pregnancy (TTP) was 8.4 months in the women with regular periods as adolescents and 13.2 months in case of oligomenorrhea (P  = 0.08) and subfertility was present in respectively 18% and 26%. 47 of 52 adolescents with oligomenorrhea tried to conceive and 45 succeeded to have at least one live birth. Twenty-eight per cent of the subjects reported a change over time of their menstruation pattern. Fifty per cent of the girls with adolescent oligomenorrhea developed a regular cycle and 16% of those with regular periods changed to oligomenorrhea with significantly more reported subfertility (40%, P  = 0.04). In case of persistent oligomenorrhea, a significant proportion (40%) underwent fertility treatment (P  = 0.04). Adult BMI did not differ between groups. The risk for pregnancy-induced hypertension or pre-eclampsia was comparable between the groups. Gestational diabetes developed in three subjects each with persistent oligo amenorrhea. Adult diabetes, hypertension, and hypercholesterolemia were also mostly reported in case of persistent oligomenorrhea. In this group, the prevalence of combined cardiovascular and metabolic problems was 14% compared to 7% in the case of regular menstrual cycles as adolescent. LIMITATIONS, REASONS FOR CAUTION The numbers in the study are small. However, the small difference between the percentage with a least one living child of those with adolescent oligomenorrhea versus those with adolescent regular menstrual cycles is reassuring. Time to pregnancy data may have been biased by early treatment of oligomenorrheic adults. WIDER IMPLICATIONS OF THE FINDINGS Oligomenorrheic adolescents may be reassured that their chance to have a live birth is comparable with those with a regular menstrual cycle. STUDY FUNDING/COMPETING INTEREST(S) This research received no external funding, J.S.E.L. received unrestricted research grants from the following companies (in alphabetical order): Ansh Labs, Ferring, Merck, and Roche Diagnostics. He received consultancy fees or royalties from Ansh Labs, Art pred, Ferring, Gedeon Richter, and Roche Diagnostics. He received presentation fees from Ferring and Roche Diagnostics as well as support for attending meetings and/or travel from Ferring and Roche Diagnostics and he participated in the advisory board of the LOCI Trial UK. TRIAL REGISTRATION NUMBER Dutch Trial Registry, NTR5871. [ABSTRACT FROM AUTHOR]

Objective: Polycystic Ovary Syndrome (PCOS) is diagnosed by a combination of three features: hyperandrogenism (biochemical and/or clinical), ovulatory dysfunction, and polycystic ovarian morphology, usually detected by ultrasonography. Our study aimed to determine the need for androgen measurements by using hirsutism to establish hyperandrogenism for diagnosing PCOS in a medically unbiased population. Materials and Methods: We utilized a pre-existing cohort of unselected (medically unbiased) females aged 18–45 years. All underwent a history and physical, including a modified Ferriman-Gallwey (mFG) hirsutism score. Subjects were categorized clinically as eumenorrheic non-hirsute (CONTROLS), menstrual dysfunction only (OLIGO-ONLY), hirsutism only (HIRSUTE-ONLY), or menstrual dysfunction and hirsutism (OLIGO + HIRSUTE). All subjects underwent measurements of androgens using high-quality assays. CONTROLS established the upper normal limit for androgen levels. We defined PCOS using the NIH 1990 criteria. Results: Of 462 individuals with complete evaluations, 311 (67.3%) were CONTROLS, 71 (15.4%) were OLIGO-ONLY, 64 (13.9%) were HIRSUTE-ONLY, and 16 (3.5%) were OLIGO + HIRSUTE. Neither HIRSUTE-ONLY nor OLIGO-HIRSUTE women required androgen measures to demonstrate hyperandrogenism. Among OLIGO-ONLY, 19 (26.8%) demonstrated hyperandrogenemia without hirsutism, with White women significantly more likely than Black women to demonstrate this. Conclusions: In our study of medically unbiased reproductive-aged women using the NIH 1990 criteria for PCOS, only 15.4% of women evaluated (those with menstrual dysfunction only) required androgen measurements. In these women only one-quarter demonstrated hyperandrogenemia. These data provide a strategy to minimize the need for androgen assays, including firstly categorizing subjects by clinical presentation and then assessing circulating androgens in the subgroup with menstrual dysfunction only. [ABSTRACT FROM AUTHOR]

Background/Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of fertile age. Some studies suggest that a ketogenic diet (KD) may have a role in treating PCOS. We aimed to demonstrate the long-term effectiveness of a KD in PCOS. Methods: Eighteen patients with PCOS phenotype A were enrolled: 28% were of normal weight, 28% were overweight, and 44% had obesity. All participants followed a KD without meal replacements for 45 days. After this period, patients underwent gradual carbohydrate reintroduction over 45 days, and thereafter healthy eating indications were given. Twelve patients completed the study. The patients were assessed at baseline and after 6 months. Anthropometric data, body composition, pelvic ultrasound, blood chemistry, hirsutism, and menstrual cycles frequency were recorded; Results: Besides improvement in anthropometric parameters, menstrual cycles (p 0.012), ovarian volume (p 0.029), FSH (p 0.05), LH (p 0.037), and progesterone (p 0.017) improved independently of weight or fat loss. However, testosterone and hirsutism improvements were influenced by weight and fat mass reduction. Conclusions: Our study showed that a KD followed by gradual carbohydrate reintroduction in PCOS has beneficial effects medium term, mostly independent of body weight loss, even in normal-weight women, suggesting that nutritional ketosis exerts beneficial effects per se. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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

Background: The influence of menstrual cycle phases (MCPs), menstrual irregularities (MI) and hormonal contraceptive (HC) use on injury among female athletes has been scrutinised. Existing systematic reviews investigating the effect of exposures affecting the endogenous reproductive hormone status on sporting injuries are limited in terms of the types of studies included and injuries investigated. Objective: This scoping review aims to summarise the coverage of the literature related to the extent, nature and characteristics of the influence of MCP, MI and HC use on musculoskeletal injuries among athletes. It also aims to summarise key concepts and definitions in the relevant literature. Observational and experimental studies investigating the effect of MCP, MI, and HC on musculoskeletal injuries among female individuals of reproductive age were included. Studies specifically stating pregnant women, perimenopausal/postmenopausal athletes, or those using medication (other than HC) that affects reproductive hormone profiles or the musculoskeletal system were excluded. Methods: This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping reviews and JBI scoping review guidelines. Published and unpublished studies were sourced from several databases and resources. Initial keywords used included terms related to "menstrual cycle", "hormonal contraception" and "injury." Titles and abstracts of identified citations were screened independently and assessed for eligibility by two independent reviewers. Data from the included studies were extracted using a standard data extraction form. Results: The search yielded 10,696 articles, of which 96 met the eligibility criteria. Most studies investigated MI (77%), and 49% included MCP as a contributing injury risk factor. Publications have increased over the last two decades. Collectively, only 16% of research has been conducted in Africa, Asia and Oceania. There were no studies from South America. Seventy-five percent of the studies investigated individual versus team (25%) sport athletes. Most studies only investigated elite or professional (n = 24; 25%) level athletes. The definitions of injury, eumenorrhea and MI differ vastly among studies. Regarding MI, most studies (69%) investigated secondary amenorrhea, followed by oligomenorrhea (51%) and primary amenorrhea (43%). Concerning HC, the influence of oral contraceptive pills was mainly investigated. Conclusions: Research related to MCP, MI and HC as contributing musculoskeletal injury risk factors is increasing; however, several gaps have been identified, including research from countries other than North America and Europe, the study population being non-professional/elite level athletes, athletes participating in team sports and specific injuries related to MCP, MI and HC, respectively. Differences in methodology and terminology of injury, MCP and MI hinder comparative summative research, and future research should consider current published guidelines during the study design. Identifying barriers to following standard guidelines or research investigating the most practical yet accurate methods to investigate the influence of MCP on musculoskeletal health might yield valuable insights for future research designs. Clinical Trial Registration: Scoping review registration number: Open Science Framework (https://doi.org/10.17605/OSF.IO/5GWBV). [ABSTRACT FROM AUTHOR]

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Objective of the study: to find out the characteristics of the content of gonadotropins (luteinizing (LH) and follicle-stimulating (FSH) hormones)and prolactin (PRL) at different duration of oligomenorrhea (OM) in adolescent girls. Materials and methods. A general clinical examination, laboratory study of gonadotropins, PRL, carbohydrate metabolism was conducted in 194 adolescent girls aged 12–18 years with OM. The control group included 30 adolescent girls without OM. Results. The average content of gonadotropins had significant differences with the control group and in comparing the groups with each other. The mean LH values were significantly higher compared to the control group. The duration of OM had a negative effect on the LH level. LH value was increased by almost 3 times during the OM prolongation. PRL value significantly increased in girls with the existence of OM for more than 2 years. Almost 23% of patients had deviations in the content of PRL, both in the direction of increase and decrease. FSH, on the contrary, mostly fluctuated within physiological values. An increase LH/FSH ratio was registered in every fourth girl with OM at the beginning of the disease. Number of girls with high values of this ratio increased by 1.5–1.6 times. OM is characterized by dysgonadotropinemia. It was found in more than half of the patients (53.5%). Normogonadotropinemia was registered in a less than a third of patients (26.3%). Every fifth to sixth girl had hypergonadotropinemia (both gonadotropin hormones are elevated). Hypogonadrtropinemia (both gonadotropin hormones are decreased) was noted in isolated cases. The most frequent variants of dysgonadotropinemia were a combination of high LH and normative FSH, or normative LH and reduced FSH. That is, a relative deficiency of FSH is formed. Conclusions. The most important cause of OM is a violation of hormonal relationships. An increase in the levels of LH and PRL with the extension of the OM duration increases the risk of polycystic ovary syndrome. Regardless of FSH fluctuations, mainly within reference values, a relative FSH insufficiency is formed. Even reduced PRL leads to the metabolic disorders. [ABSTRACT FROM AUTHOR]

Data on gonadotoxicity of chemotherapies are essential to better counsel young females and males about the risk of infertility and to better indicate fertility preservation measures before cancer therapies. However, such data have not recently been reviewed for bone cancer. Therefore, a systematic literature search was conducted considering papers published since 2000. This study is part of the FertiTOX® project, which aims to improve the lack of data regarding gonadotoxicity of cancer therapies to enable more accurate counseling regarding fertility preservation. Only relapse-free women and men were included. Gonadotoxic therapy-induced suspected infertility was defined as very low anti-mullerian hormone, high gonadotropin concentration, amenorrhea, oligomenorrhea, azoospermia, or oligozoospermia. The quality of the individual studies was assessed using the Newcastle–Ottawa Scale (NOS). In total, 11 out of 831 studies were included in the review. Suspected infertility was found in 10/190 (5.1%, range 0%–66%) of female patients with osteosarcoma (six studies), in 24/46 (52.2%, range 46%–100%) of male patients with osteosarcoma (three studies), in 18/138 (13.0%, range 3%–18%) of female patients with Ewing's sarcoma (three studies), and in 34/38 (89.5%) of male patients with Ewing's sarcoma (one study). A risk calculation in relation to specific chemotherapies was not possible. Risk of suspected infertility tends to be higher in Ewing's sarcoma in which all patients received chemotherapies with alkylating agents. Two of the 11 included studies received a high NOS quality score, whereas the remaining nine studies received a low quality score, mainly because of the lack of a comparator group. Published data are too limited for precise estimation of the gonadotoxicity. However, data indicate clinically relevant risk for infertility, supporting counseling patients before chemotherapy about fertility preservation measures. [ABSTRACT FROM AUTHOR]

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

Progesterone is a natural steroid hormone, while progestins are synthetic molecules. In the female reproductive system, progesterone contributes to the control of luteinizing hormone and follicle-stimulating hormone secretion and their pulsatility, via its receptors on the kisspeptin, neurokinin B, and dynorphin neurons in the hypothalamus. Progesterone together with estradiol controls the cyclic changes of proliferation and decidualization of the endometrium; exerts anti-mitogenic actions on endometrial epithelial cells; regulates normal menstrual bleeding; contributes to fertilization and pregnancy maintenance; participates in the onset of labor. In addition, it exerts numerous effects on other endocrine systems. Micronized progesterone (MP) is natural progesterone with increased bioavailability, due to its pharmacotechnical micronized structure, which makes it an attractive diagnostic and therapeutic tool. This critical literature review aims to summarize and put forward the potential diagnostic and therapeutic uses of MP in the field of endocrinology. During reproductive life, MP is used for diagnostic purposes in the evaluation of primary or secondary amenorrhea as a challenge test. Moreover, it can be prescribed to women presenting with amenorrhea or oligomenorrhea for induction of withdrawal bleeding, in order to time blood-sampling for diagnostic purposes in early follicular phase. Therapeutically, MP, alone or combined with estrogens, is a useful tool in various endocrine disorders including primary amenorrhea, abnormal uterine bleeding due to disordered ovulation, luteal phase deficiency, premenstrual syndrome, polycystic ovary syndrome, secondary amenorrhea [functional hypothalamic amenorrhea, premature ovarian insufficiency], perimenopause and menopause. When administrated per os, acting as a neurosteroid directly or through its metabolites, it exerts beneficial effects on brain function such as alleviation of symptoms of anxiety and depression, asw well as of sleep problems, while it improves working memory in peri- and menopausal women. Micronized progesterone preserves full potential of progesterone activity, without presenting many of the side-effects of progestins. Although it has been associated with more frequent drowsiness and dizziness, it can be well tolerated with nocturnal administration. Because of its better safety profile, especially with regard to metabolic ailments, breast cancer risk and veno-thromboembolism risk, MP is the preferred option for individuals with an increased risk of cardiovascular and metabolic diseases and of all-cause mortality. [ABSTRACT FROM AUTHOR]

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

Background: PCOS is a complex genetic condition that is heterogeneous and multifactorial. It primarily affects females who are of reproductive age. One of the most common illnesses in the world, neglected treatment for this one can lead to infertility and possibly uterine cancer. Objectives: This study aimed to determine the prevalence and phenotypes of PCOS among women attending a teaching hospital of eastern India. Methods: The present cross sectional observation study of 50 PCOS patients was carried out from April 2023 to December 2023 in gynecology out-patient department of Gynae and Obstetrics, Calcutta National Medical College, Kolkata, West Bengal, India. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results: The prevalence of PCOS was 5.42% in the gynecology out-patient visits and 38.46% among infertile women. The mean age group of the patients was 24.3±5.16 SD. The mean BMI was 23.2±5.32 SD. The mean duration of infertility was 5.68 years. In present study among 50 PCOS patients, hirsutism was present in 28 (56%). Androgenic features like acne were present in 20 (40%) of the patients, acanthosis nigricans in 10 (20%) of the patients and androgenic alopecia was present in 26 (52%) of patients. The prevalence of metabolic syndrome in our study was 18.0%. In this study menstrual irregularity was the most common complaint. Conclusions: According to the study, oligomenorrhea was evident in the majority of our participants with polycystic ovarian syndrome. Central obesity and hirsutism were also frequent presentations. Because of their more severe ovulatory dysfunction, obese women with PCOS require additional care to ensure proper management. [ABSTRACT FROM AUTHOR]

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

• Polycystic ovary syndrome (PCOS) is common worldwide. The syndrome refers to a group of disorders with multiple reproductive, metabolic, and endocrine elements. • PCOS affects women from fetal life throughout their lifespan, often decreasing reproductive ability and quality of life, and increasing other types of morbidity and mortality. It is often undiagnosed and untreated. • Management traditionally focuses on the treatment of hyperandrogenism and oligomenorrhea. Women with PCOS often have dyslipidemia, hypertension, obesity, and metabolic syndrome. Management plans should incorporate diagnosis and management of these factors, if present, because of the strong contribution to risk for atherosclerotic cardiovascular disease. • Understanding that the disease extends throughout life emphasizes the importance of continued screening for and treatment of risk factors to prevent cardiovascular disease throughout a woman's lifespan. • Given the complexities of the syndrome and heterogeneous manifestations, optimal management often requires a multi-disciplinary approach to provide counseling and support for lifestyle modification and addressing the full range of any reproductive, endocrine, and cardiometabolic abnormalities. Polycystic ovary syndrome (PCOS) is a common endocrinopathy worldwide with a heterogeneous clinical presentation including reproductive, metabolic, and endocrine elements. However, the assessment and management of PCOS remains inconsistent, with many women undiagnosed and untreated. We now also understand that the management of PCOS should extend throughout a woman's lifespan as many elements of the syndrome persist after menopause. Management has traditionally focused on the treatment of hyperandrogenism and oligomenorrhea. Women with PCOS often have dyslipidemia, hypertension, obesity, and metabolic syndrome, which may be worsened by the hormonal abnormalities, and are therefore at higher risk for cardiovascular disease morbidity and mortality, a risk that increases after menopause. While treatment with hormonal therapy, in particular combined oral contraceptives, may improve cardiovascular risk factors, management plans should incorporate specific diagnosis and management of these factors, if present, because of the strong contribution to the risk for atherosclerotic cardiovascular disease. Given the complexities of the syndrome, optimal management often requires a multi-disciplinary approach including the lipid and cardiometabolic specialist to provide counseling and support for lifestyle modification along with pharmacologic therapy as indicated to address the full range of any reproductive, endocrine, and cardiometabolic abnormalities. [ABSTRACT FROM AUTHOR]

Background Menstrual cycle irregularities and anovulation have been found to occur with increased frequency in women who deviate considerably from normal weight. Ovulation abnormalities may also be caused by fluctuations in weight, such as being overweight, obese, or underweight, which are hypothesized to disrupt the energy balance. Objectives The aim of this study was to find out the association between menstrual patterns and body mass index (BMI) among students of selected health science university. Materials and Methods A descriptive research study was conducted among 222 university students at a selected health science university in Mangalore. The samples were selected by using simple random sampling techniques. A demographic proforma, self-reported menstrual pattern questionnaire, and anthropometric measurements like height and weight were measured. BMI was calculated by using the standardized formula, BMI= (weight [kg]/height [m 2 ]) by the World Health Organization for the Asian population based on the revised consensus guidelines for India. Students who are aged between 17 and 25 years, unmarried female students who are studying under Yenepoya (deemed to be university), attained menarche, and who are willing to participate in the study were included in the study. Results From this study, it can be considered that the mean age of menarche was 12.49 ± 0.51years. Most 68.5% students reported dysmenorrhea. It is the most common menstrual disorder among our study subjects. Of the total subjects, 38.3% cases had oligomenorrhea, which was the next most common menstrual disorder. The majority of the subjects has a normal BMI, with a mean of 21.02 kg/m 2. There is a significant association between dysmenorrhea, oligomenorrhea, and polymenorrhagia with BMI status of university students at 0.05 level significance. Conclusion Lifestyle modification and nutritional counselling for female students could alleviate menstrual problems. It will not only improve the girls' current health, sense of well-being, and overall quality of life but may also lower her risks for future disease and ill health after proper advice about diet and exercise. Menstrual irregularities are mostly neglected by the society due to unawareness regarding the irregular menstrual pattern and their problems. [ABSTRACT FROM AUTHOR]

The objective: to assess the impact of chronic stress caused by war and displacement on the hormonal balance of refugee women. Materials and methods. 60 women were examined, who were divided into groups: the 1st group included women who were affected by hostilities (20 persons), and the 2nd group included displaced women (20 individuals). In these 40 women the hormonal studies were conducted in the conditions of military aggression in Ukraine. The control group (3rd group) included healthy women who were examined in the pre-war period. All examined women were 20–25 years old with an average body weight of 55–60 kg. Concentrations of progesterone, estradiol, follicle-stimulating hormone (FSH) and luteinizing hormone, prolactin in the I and II phases of the menstrual cycle (MC), cortisol in the I phase of the MC were determined in blood serum using the enzyme immunoassay method. An analysis of the results of research on the role of the hypothalamic-pituitary-adrenal system in the regulation of the stress response was carried out. Results. In the examined women, various disorders of MC were observed, such as: menometrorrhagia, hypermenorrhea, acyclic uterine bleeding, oligomenorrhea, and amenorrhea. The most pronounced changes in menstrual function were observed in women who were affected by hostilities. Such significant disorders of MC in women of this group coincided with changes in indicators of gonadotropic hormones of the pituitary gland and sex hormones in the blood. A study of the psycho-emotional state of women who suffered from hostilities established that these women have a significant stressful effect of various risk factors on the body. Changes in the levels of cortisol, prolactin and other hormones were detected. Conclusions. Studies have shown that chronic stress affects the hormonal status of women affected by hostilities and of displaced women, including FSH, estradiol, and prolactin levels. A significant increase in the level of FSH in the follicular phase of the menstrual cycle and an increase in the level of estradiol in the luteal phase were determined, which may indicate a compensatory reaction of the body to stress. A significant increase in the level of prolactin was also found, which can cause disorders of menstrual function and affect the psycho-emotional state. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovarian syndrome is the most common endocrine and metabolic disorder in women of childbearing age, affecting 3–15% of women worldwide, leading to reproductive, metabolic, and psychological issues. Patients with polycystic ovarian syndrome require rigorous thyroid function detection, monitoring, and correction over time. In this study, we aimed to evaluate the clinical presentations and thyroid dysfunction in patients with polycystic ovarian syndrome. Methods: An observational study was done in patients with polycystic ovarian disease presenting to a tertiary care centre over six months, from December 2023 to May 2024 Total population sampling was done. All the women during the study period diagnosed with polycystic ovarian disease based on Rotterdam criteria were included in the study after getting ethical approval from the institutional review board. (Reference number: 20102023/03). Results: The mean age of women in the study was 24.74±5.01 years. A total of 28 (31.46%) patients of polycystic ovarian disease had hyperthyriodism, hypothyroidism was found in 13 (14.60%) and subclinical hypothyroidism was found in 6 (6.74%) patients. All the women had menstrual irregularities. Regarding androgenic characteristics, 53 (59.55%) of patients presented with hirsutism, 43 (48.51%) presented with acne, 13 (14.61%) women had alopecia, and 4 (4.49%) women had acanthosis. Conclusions: Hyperthyroidism, hypothyroidism and subclinical hypothyroidism were prevalent in polycystic ovarian disease patients, emphasizing the need for thorough thyroid evaluation in polycystic ovarian disease patients due to its impact on metabolic and reproductive health. High rates of menstrual irregularities, androgenic symptoms like hirsutism and acne, and fertility challenges were also prevalent, aligning with findings from similar studies.

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

Background PCOS is most common endocrine disorders among women of reproductive age group. This syndrome has varied manifestations affecting the females of all age groups. Rotterdam criteria are the most used for the diagnosis of PCOS. AMH is a newer marker which is secreted much more by the polycystic ovaries compared to normal ovaries and is not affected by day of menstrual cycle and even use of OCPs. Due to persistent controversies regarding diagnosis of PCOS due to its complex presentation and to evaluate ovarian morphology, AMH can be used as a new quantitative and biologic marker for PCOS. Methods This was a case–control study performed on women attending Gynaecology OPD at a tertiary care hospital. The study consisted of 100 women with PCOS, diagnosed using Rotterdam criteria and 173 women as controls. Clinical profile, clinical examination, BMI, blood investigations like FSH, LH, TSH, prolactin and AMH levels were assessed. Sonography of the pelvis to see the ovarian morphology was done for all women. Results AMH levels in PCOS cases were on average 8.16 ng/ml, which was significantly higher than controls’ levels of 3.05 ng/ml (p = 0.001). AMH produced sensitivity of 83% when employed as a supplement to the current Rotterdam criteria as the fourth criterion. However, when AMH was used in place of PCOM in the Rotterdam criterion, AMH produced a sensitivity of 89%. Conclusion To conclude AMH levels were considerably greater in PCOS. AMH values offer good diagnostic potential when used in conjunction with the current Rotterdam criteria for the diagnosis of PCOS

Background/Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of fertile age. Some studies suggest that a ketogenic diet (KD) may have a role in treating PCOS. We aimed to demonstrate the long-term effectiveness of a KD in PCOS. Methods: Eighteen patients with PCOS phenotype A were enrolled: 28% were of normal weight, 28% were overweight, and 44% had obesity. All participants followed a KD without meal replacements for 45 days. After this period, patients underwent gradual carbohydrate reintroduction over 45 days, and thereafter healthy eating indications were given. Twelve patients completed the study. The patients were assessed at baseline and after 6 months. Anthropometric data, body composition, pelvic ultrasound, blood chemistry, hirsutism, and menstrual cycles frequency were recorded; Results: Besides improvement in anthropometric parameters, menstrual cycles (p 0.012), ovarian volume (p 0.029), FSH (p 0.05), LH (p 0.037), and progesterone (p 0.017) improved independently of weight or fat loss. However, testosterone and hirsutism improvements were influenced by weight and fat mass reduction. Conclusions: Our study showed that a KD followed by gradual carbohydrate reintroduction in PCOS has beneficial effects medium term, mostly independent of body weight loss, even in normal-weight women, suggesting that nutritional ketosis exerts beneficial effects per se.

Background & Objective: Endometrial hyperplasia is the primary precursor of endometrial cancer in the female reproductive system, with abnormal uterine bleeding (AUB) being the predominant manifestation of this condition. The purpose of this study was to determine the prevalence of endometrial hyperplasia and its correlation with various factors among patients presenting with abnormal uterine bleeding. Materials & Methods: This cross-sectional descriptive-analytical study reviewed the hospital records of all patients with abnormal uterine bleeding admitted to Ali Ebn-e Abi Taleb Hospital in Zahedan from April 2015 to April 2018. Data were analyzed using the SPSS. Results: The prevalence of endometrial hyperplasia was estimated to be 20.3%. The average age of the study subjects was about 45 years. The highest number of patients (37, 52.9%) belonged to the age group of 36-50 years. Among the different types of endometrial hyperplasia observed, the most common was "simple non-atypical hyperplasia" found in 45 patients (64.3%), while the least common was "simple atypical hyperplasia" observed in three patients (4.3%). Overall, "non-atypical hyperplasia" (including both simple and complex types) was present in 58 patients (82.85%). The prevalence of infertility, obesity, hypertension, diabetes, premature menarche, late menopause, family history, oligomenorrhea, and polycystic ovary syndrome (PCOS) was reported in 7.1%, 32.9%, 24.3%, 22.9%, 8.5%, 13.6%, 7.1%, 5.7%, and 3.4% of cases, respectively. Conclusion: women with a history of diabetes, hypertension, and obesity are at an increased risk of developing endometrial hyperplasia. Therefore, it is crucial to evaluate these patients for the presence of endometrial hyperplasia. [ABSTRACT FROM AUTHOR]

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

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

Objective: The primary aim of this study was to investigate the effects of autologous intrauterine platelet-rich plasma (IU-PRP) infusion during ovulation induction with clomiphene citrate (CC) on endometrial thickness (EMT) and clinical pregnancy in patients with polycystic ovary syndrome (PCOS) and thin endometrium. The secondary outcome was to detect possible transformations in oligomenorrheic cycles after PRP. Methods: This study was conducted on 35 anovulatory PCOS patients aged between 22 and 29 years who applied for infertility treatment. The patients had a thin endometrium in their past history. EMT 7 mm was considered thin endometrium. The diagnosis of PCOS was made according to the revised Rotterdam criteria. A total of 35 patients were divided into two groups according to whether they received PRP or not. Twenty patients received CC plus PRP treatment, whereas 15 patients received CC treatment alone. Patients in both groups were administered CC at a dose of 100 mg/day for 5 days, starting from the 3rd day of progesterone-related withdrawal bleeding. Follicular development and EMT were recorded using transvaginal ultrasonography. In cases with EMT <7 mm, approximately 0.5-1 mL of autologous PRP was infused with the IUI catheter, four days after CC treatment, i.e., on the ninth day of the cycle. EMT was measured and recorded again 3 and 6 days after PRP. Timed intercourse was recommended for cases with a follicle with a mean diameter of at least 16-18 mm. The biochemical and clinical pregnancy rates of both groups were recorded. Results: Both groups were similar in terms of participant age and body mass index. All participants in the CC plus PRP group were successfully infused with autologous PRP on the ninth day of the cycle. The serum estradiol, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and LH/FSH ratios of both groups were similar. Biochemical pregnancy and clinical pregnancy rates of the CC plus PRP group were significantly higher than those of the CC alone group (p<0.03 and p<0.02, respectively). Although clinical pregnancy was detected in 5 individuals in the PRP group (25%), clinical pregnancy was recorded in 2 individuals in the CC alone group (13.3%). There was no significant change in the oligo/anovulatory cycle patterns of patients with and without PRP. EMT values on the sixth (4.96±2.11 mm vs. 4.68±2.47 mm, p<0.37) and eighth days were similar between the two groups (5.11±3.10 mm vs. 5.29±3.01 mm, p<0.51). Compared with the CC alone group, the EMT values measured both at day 12 (6.34±1.09 mm vs. 5.47±3.90 mm, p<0.02) and at day 15 (7.44±2.60 mm vs. 6.23±2.70 mm, p<0.01) in the PRP group were found to be significantly higher. Conclusion: IU-PRP infusion in PCOS patients with thin endometrium who underwent ovulation stimulation with CC significantly increased both EMT and clinical pregnancy rates. [ABSTRACT FROM AUTHOR]

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

Management of hemoperitoneum due to ruptured ovarian cyst in patients on anticoagulation is a dilemma. Low threshold of surgery intervention may increase the risk of some events operatively. There is a trend for less invasive treatment in highly selected patients. We present two cases of massive hemoperitoneum due to ruptured ovarian cyst that were on anticoagulation. Successful conservative management was done in both of them and one patient, due to refractory abdominal pain, required interventional radiologic drainage, instead of surgery approach with good outcome. Ovulation suppression was started in both of them with regular uneventful follow up heretofore. Less invasive management is preferred in carefully selected patients of hemoperitoneum in women on anticoagulation. Ovulation suppression to avoid recurrence must be emphasized. [ABSTRACT FROM AUTHOR]

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

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

Background and Objective: Polycystic ovary syndrome is one of the most common endocrine disorders, whose symptoms usually begin immediately after the first menstrual period. Previous studies found a significant relationship between dysmenorrhea, premenstrual syndrome and polycystic ovary syndrome. The aim of this study is to investigate the effect of chamomile on dysmenorrhea and premenstrual syndrome in patients with polycystic ovary syndrome. Methods: This clinical trial was conducted on 70 patients diagnosed with polycystic ovary syndrome based on Rotterdam criteria referring to a clinic in Mashhad. Patients were randomly assigned to two groups. The first group received two 500 mg chamomile capsules per day and the second group received two placebo capsules per day for three months. The response to treatment in premenstrual syndrome, dysmenorrhea and oligomenorrhea was evaluated using the Visual Analogue Scale and DSM-IV premenstrual syndrome diagnosis questionnaire. Findings: The mean age of the patients in the intervention group was 25.43±5.58 and in the placebo group was 28.06±5.71 years. The rate of improvement in women with premenstrual syndrome (16.6%), dysmenorrhea (50%) and oligomenorrhea (26.7%) was higher in chamomile group compared to placebo. There was no statistically significant difference in body mass index between the chamomile group (25.17±4.95) and the control group (25.57±6.7). Conclusion: Based on the results of this study, chamomile improved the symptoms of oligomenorrhea in patients with polycystic ovary syndrome and showed positive effects on dysmenorrhea and premenstrual syndrome. Therefore, chamomile can be used as a simple, low-cost therapy in the treatment of polycystic ovary syndrome patients. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

The female athlete triad is a condition where low energy availability is typically observed together with menstrual dysfunction and/or low bone mineral density. How this condition affects maximal work capacity in endurance athletes is not clear, and the recovery time course of menses with increased energy availability with concomitant high training load is unknown. This case study of an amenorrheic elite road cyclist reports resumption of normal menstrual function after weight gain during a 5-year period (2014-2019), while engaged in high training load and competition. The athlete (...O2max 3.54 L/min, 64ml⋅min-1⋅kg-1, aerobic peak power output 300 W, 5.4 W/kg) reported amenorrhea (2013-2015) and oligomenorrhea (2015-2018). Training load increased from 2014 to 2019 (584-818 hr/year and 26,707-41,945 training stress score/year). Regular menses (every 23-35 days) resumed in June 2018, ~5-6 months after a weight gain episode. During the period of menstrual dysfunction, body mass was 51.3 ± 2.25 kg (mean ± 95% confidence limit) and fat percentage was 19% (dual-energy X-ray absorptiometry, 2016), and after weight gain, body mass was 56.8 ± 2.63 kg and fat percentage was 25% (dual-energy X-ray absorptiometry, 2019). Crank-based power meter data showed absolute mean maximal power (in watts) improvement over the 5 s to 4 hr range through the 2014--2019 period, while relative mean maximal power (in watts per kilogram) likely peaked in the 2015--2016 season for 5 min, 20 min, and 30 min, but remained mostly unchanged across seasons. Results suggest that (a) the best relative power output associated with aerobic capacity (5 min to 1 hr) can be achieved during menstrual dysfunction, (b) high performance achieved despite an increase in body mass, and (c) resumption of menses is achievable while maintaining high training loads when coupled with high energy availability. [ABSTRACT FROM AUTHOR]