Menstrual Irregularities

The ripple effect: impacts of climate change on menstrual health and paths to resilience

Girls and women face greater threats and severe ramifications from climate change, with studies consistently finding that women experience more health risks from climate change than men do. Climate change endangers girls and women's sexual and reproductive health and rights, including their menstrual health and hygiene practices. However, menstrual health and hygiene is rarely discussed in the context of climate change. We scoped the existing evidence to describe the interlinkages between climate change and menstrual health and hygiene, and outline services that anticipate, respond to, cope with, recover from, adapt to or transform in response to climate related events, trends and disturbances. Specifically, we describe how climate change disrupts access to essential menstrual health and hygiene information, products and services, impacts menstrual disorders and the menstrual cycle, and intensifies existing inequalities. Recommendations for improvement include climate resilient menstrual health and hygiene services encompassing access to menstrual products and materials, impartment of knowledge and skills, access to climate resilient facilities and services, social support, and policy actions.

Psychological and physical stress response and incidence of irregular menstruation in female university employees: a retrospective cohort study

Background This study aimed to assess a clinical relevance of three-dimensional occupational stress (job stressor score [A score], psychological and physical stress response score [B score], and social support for workers score [C score]) of the Brief Job Stress Questionnaire (BJSQ) in the national stress check program in Japan to irregular menstruation.Methods The present retrospective cohort study included 2,078 female employees aged 19-45 years who had both annual health checkups and the BJSQ between April 2019 and March 2022 in a national university in Japan. The outcome was self-reported irregular menstruation measured at annual health checkups until March 2023. A dose-dependent association between BJSQ scores and incidence of irregular menstruation was examined using Cox proportional hazards models to calculate multivariable-adjusted hazard ratios (HRs) of four quantile (0-49% [Q0-49], 50-74% [Q50-74], 75-89% [Q75-89], and 90-100% [Q90-100]) of the BJSQ scores.Results During 2.0 years of the median observational period, 257 (12.4%) women reported irregular menstruation. B score, not A or C scores, was identified as a significant predictor of irregular menstruation (adjusted HR [95% confidence interval] of A, B, and C scores per 1 standard deviation: 1.06 [0.89-1.27], 1.35 [1.15-1.57], and 0.93 [0.80-1.08], respectively). Women with higher B score had a significantly higher risk of irregular menstruation in a dose-dependent manner (adjusted HR [95% confidence interval] of Q0-49, Q50-74, Q75-89, and Q90-100: 1.00 [reference], 1.38 [1.00-1.90], 1.48 [1.00-2.18], and 2.18 [1.38-3.43], respectively).Conclusions Psychological and physical stress response predicted irregular menstruation.

Menstrual Dysfunction in Adolescent Female Athletes

Despite the benefits of exercise on mental and physical health, excessive training loads can lead to health problems in the long term, including a wide spectrum of menstrual dysfunction (MD). This narrative review aims to analyze the relationship between physical exercise and MD in adolescent female athletes to support regular menstrual health monitoring and promote educational programs on reproductive risks. When dealing with MD in young athletes, several factors entangled with maturation of the hypothalamus-pituitary-ovarian axis should be considered. Firstly, some disciplines seem to have a higher prevalence of MD due to the high loads of training regimes and the early introduction of athletes to a competitive career. Moreover, low energy intake and a low body mass index appear to exacerbate existing MD. Lastly, disordered eating behaviors and psychological stress can contribute to MD in female athletes. The type of sport, influencing the intensity and duration of exercise, as well as individual psycho-physiological and environmental factors, may influence the role of physical activity in the manifestation of MD. Early recognition and management of MD, along with collaboration between sports organizations and health professionals, are crucial to minimize risks, ensure proper nutrition, and balance training with recovery. Keeping an open discussion on the topic may prospectively improve awareness, early diagnosis, and treatment strategies, as well as reduce injury risk and enhance sports performance.

An update of polycystic ovary syndrome: causes and therapeutics options

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by menstrual irregularities, chronic anovulation, hirsutism, androgenic alopecia, and acne. At diagnosis, patients can with different manifestations according to the disease phenotype, patient's age, and lifestyle. However, most patients pursue medical care because of the clinical symptoms of PCOS, such as hyperandrogenism, menstrual irregularities and infertility. Recent studies have shown that PCOS is associated with 80% of anovulatory infertility; however, the precise mechanism of PCOS-induced anovulation is still undetermined. The treatment strategies of PCOS are symptomatic depending mainly on the desired goals and clinical benefits. Life style intervention is still the first line treatment option for overweight females seeking pregnancy. In addition, there are many pharmacological agents that could be added to induce ovulation such as metformin, and clomiphene citrate. Nowadays, many patients preferred to use some herbal medicine that was proved to have potential therapeutic benefits in many studies in the management of PCOS. The purpose of this review was to discuss PCOS-induced infertility and the available therapeutic options as well as the impact of COVID-19 infection on the success of fertility attempts. To address this purpose, Pubmed, Scopus, EMBASE and Google databases were searched for studies discussing PCOS-induced infertility. The literature search revealed the proper therapeutic plans to treat PCOS-induced infertility, and that treatment should be modified according to patient's complaints, reproductive desires, and disease phenotypes. In conclusion, the use of specific therapeutic agents and patients' adherence to lifestyle interventions could help patients recover their reproductive and metabolic health.

Menstrual cycles during COVID-19 lockdowns: A systematic review and meta-analysis

Coronavirus disease 2019 lockdowns produced psychological and lifestyle consequences for women of reproductive age and changes in their menstrual cycles. To our knowledge, this is the first systematic review to characterize changes in menstrual cycle length associated with lockdowns compared to non-lockdown periods. A search on 5 May 2022 retrieved articles published between 1 December 2019, and 1 May 2022, from Medline, Embase, and Web of Science. The included articles were peer-reviewed observational studies with full texts in English, that reported menstrual cycle lengths during lockdowns and non-lockdowns. Cross-sectional and cohort studies were appraised using the Appraisal tool for Cross-Sectional Studies and the Cochrane Risk of Bias Tool for Cohort Studies, respectively. Review Manager was used to generate a forest plot with odds ratios (OR) at the 95% confidence interval (CI), finding a significant association between lockdown and menstrual cycle length changes for 21,729 women of reproductive age (OR = 9.14, CI: 3.16-26.50) with a significant overall effect of the mean (Z = 4.08, p < 0.0001). High heterogeneity with significant dispersion of values was observed (I 2 = 99%, τ = 1.40, χ2 = 583.78, p < 0.0001). This review was limited by the availability of published articles that favored high-income countries. The results have implications for adequately preparing women and assisting them with menstrual concerns during lockdown periods.

Menstrual Symptoms After COVID-19 Vaccine: A Cross-Sectional Investigation in the MENA Region

Background

Since the emergence of COVID-19 vaccinations, many women around the world are reporting abnormalities in their menstrual periods post-vaccination. The aim of this study is to investigate the prevalence and impact of menstrual abnormalities after the COVID-19 vaccine among females residing within the Middle East and North Africa (MENA).

Methods

The study utilized a cross-sectional online self-administered survey from July 2021 to August 2021 targeting females living in the MENA region above the age of menarche who had received vaccine and were not pregnant or lactating, and do not have a history of primary ovarian insufficiency, hypothalamic menopause, or have undergone a hysterectomy. The survey was distributed regionally via social media.

Results

A total of 2269 females were included in our study, with a mean age of 34.3 ± 8.5 years. About 66.3% of participants reported menstrual symptoms post-vaccination, of which 46.7% experienced them after their first dose. However, in 93.6% of participants, the symptoms resolved within 2 months. Vaccine type did not significantly influence the incidence of abnormalities (p > 0.05). Participants who had confirmed previous COVID-19 infection had a very similar percentage of menstrual abnormalities compared to people who did not have COVID-19 infection or symptoms suspected of COVID-19 infection and did not test (67.5%, 66.8%, respectively); nevertheless, those who had experienced the COVID-19 vaccine general side effects had significantly more abnormalities (p < 0.001). Compared to their pandemic status, females reported significantly more abnormalities post-vaccination.

Conclusion

The study showed a possible link between the COVID-19 vaccine and menstrual abnormalities that have impacted their quality of life.

Efficacy and safety of moxibustion for menstrual irregularities: A protocol for systematic review and meta-analysis

BACKGROUND

Menstrual irregularities (MI) is 1 of the most common clinical gynaecological diseases, with abnormal menstrual cycles, abnormal bleeding, and abdominal pain before or during menstruation as the main clinical manifestations. In modern medicine, abnormalities in the function of the pituitary gland, hypothalamus, and ovaries can affect menstruation. Currently, hormone levels in the body are mostly regulated by hormonal drugs, but these drugs can lead to hormonal imbalance, which can lead to adverse reactions. Many clinical studies have reported that moxibustion has a good effect on MI treatment, but there is no relevant systematic review. So the purpose of this study is to evaluate the effectiveness and safety of moxibustion in treating MI.

METHODS

The following 8 electronic databases will be searched, including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Web of Science, Chinese Scientific Journal Database, Wanfang Database, and Chinese Biomedical Literatures Database from their inception to 1 December 2020 without any restrictions. Researchers retrieve the literature and extracted the data, evaluation of research methods, quality of literature. The outcomes will include total effective rate, incidence of any adverse events. We use the Cochrane Risk of a bias assessment tool to evaluate methodological qualities. Data synthesis will be completed by RevMan 5.3.0.

RESULTS

We will show the results of this study in a peer-reviewed journal.

CONCLUSIONS

This meta-analysis will provide reliable evidence for treatment of menstrual irregularities.

INPLASY REGISTRATION NUMBER

INPLASY2020120042.

Menstrual Problems and Lifestyle among Spanish University Women

Menstrual problems affect many young women worldwide, conditioning both their academic performance and quality of life. This study sought to analyse the prevalence of menstrual problems and their possible relationship with lifestyle among Spanish university women, as part of a research project (UniHcos Project) involving a cohort of 11 Spanish universities with 7208 university students. A descriptive analysis was performed using the bivariate chi-square test and the Student’s t-test together with a binary logistic regression, in which the dependent variable was ‘suffering from menstrual problems’. Menstrual problems were identified in 23.8% of the students, representing women who paid more visits to the doctor and to emergency rooms, and who consumed more painkillers and contraceptives. In relation to dietary preferences, menstrual problems were 1.39 (CI 95% 1.22–1.61; p = 0.000) times more likely among women classified as high-risk alcohol users according to the AUDIT questionnaire, and 1.187 (CI 95% 1.029–1.370; p = 0.019) times greater among those who consumed sweets daily, 1.592 (CI 95% 1.113–2.276; p = 0.011) times more frequent among those who eat fish daily, and 1.199 (CI 95% 1.004–1.432; p = 0.045) times greater among those who were dieting. Menstrual problems affect many college students and potentially modifiable lifestyle variables exist which may influence their prevalence. It would be interesting to develop programmes to promote women’s health in the university context.