Division of Pediatric-Adolescent Gynecology and Reconstructive Surgery, 2nd Department of Obstetrics and Gynecology, University of Athens, Medical School, 'Aretaieion' Hospital, Athens, Greece. Endocrine development
07/2012; 22:160-70. DOI: 10.1159/000331697
Menstrual disorders are very common in adolescence, and can be the cause of a significant amount of stress to both the patients and their parents. Variations of the menstrual cycle in this age are very broad and are mainly caused by the immaturity of the hypothalamic-pituitary-ovarian (HPO) axis. Amenorrhea (either primary or secondary), abnormal uterine bleeding and dysmenorrhea are conditions that require careful evaluation through a stepwise and logical manner. The term primary amenorrhea refers to the condition when menarche fails to occur, while secondary amenorrhea refers to the cessation of menses once they have begun. The occurrence of irregular, prolonged or heavy abnormal uterine bleeding is one of the most urgent gynecological problems in adolescence and the diagnosis of dysfunctional uterine bleeding should be used only when all other organic and structural causes of abnormal vaginal bleeding have been ruled out. Dysmenorrhea refers to painful menstruation and is the most common reason for which a young girl may refer to a gynecologist. It is characterized as primary in the absence of an underlying organic disease, and as secondary when there is evidence of pelvic pathology. Appropriate and early management of the patient is necessary in order to minimize the possibility of future complications regarding woman's reproductive ability.
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- "Dysmenorrhea and menstrual pain are often experienced by women in their ovulatory phase and
may start soon after their first menstrual cycle and persist into their late 40s5, 6). Women experience pain due to consistent and repeated dysmenorrhea. "
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ABSTRACT: [Purpose] This study aimed to examine the factors influencing dysmenorrhea among Korean middle school adolescents. [Subjects] The subjects included 572 female students in three different middle schools located in Seoul, South Korea. [Methods] A cross-sectional design was adopted. The measurement tools used included a demographic form and revised Menstrual distress Questionnaire (MDQ). [Results] The analyses showed that the prediction model was significant. The value of the adjusted R(2) was 0.282, which corresponds to an explanatory power of 28.2%. The factor found to have the most influence on dysmenorrhea among Korean middle school adolescents was stress, followed by health status, onset of dysmenorrhea, consecutive days of menstruation, and dietary habits. [Conclusion] Nursing intervention programs for alleviating dysmenorrhea in Korean middle school adolescents are essential in order to reduce their level of stress, improve their perceived health status, and help them to maintain regular dietary habits. Reflecting on the recent trend of female students menstruating at a younger age, public health education courses and counseling programs should offer customized methods for alleviating dysmenorrhea.
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ABSTRACT: The effect of the inflammatory bowel diseases (IBD) on menstrual function is largely unknown. The aims of this study were to determine whether changes in menstrual function occur in the year before IBD diagnosis or in the initial years after diagnosis.
Women aged 18 years and older in the Ocean State Crohn's and Colitis Area Registry with at least 2 years of follow-up were eligible for this study. All patients were enrolled within 6 months of IBD diagnosis and followed prospectively. Menstrual cycle characteristics were retrospectively assessed. To assess for changes over time, general linear models for correlated data were used for continuous outcomes, and generalized estimating equations were used for discrete outcomes.
One hundred twenty-one patients were studied. Twenty-five percent of patients experienced a change in cycle interval in the year before IBD diagnosis and 21% experienced a change in the duration of flow. Among women with dysmenorrhea, 40% experienced a change in the intensity of their menstrual pain and 31% experienced a change in its duration. Overall cycle regularity increased over time. Quality of life was significantly lower in women without regular cycles across all time points.
Changes in menstrual function occur frequently in the year before IBD diagnosis; therefore, screening for menstrual irregularities should be considered in women with newly diagnosed IBD. Patients can be reassured that cycles typically become more regular over time.
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Menstrual-cycle irregularity may have an important influence on the subsequent development of chronic diseases. Several risk factors for irregular menstrual cycles have been detected, including stress. Our aim was to extend research on the link between chronic stress and menstrual-cycle irregularity and to assess potential protective factors, such as dispositional resilience, which we hypothesize to be associated with the maintenance or promotion of a healthy menstrual cycle.
For this cross-sectional study, data on 696 healthy women aged 20-40 years were obtained. The women completed measures of chronic stress, dispositional resilience and menstrual-cycle irregularity. Furthermore, potential confounds were assessed.
Of the participants, 383 (55%) reported no current use of hormonal contraceptives; 313 (45%) reported current use hormonal contraception and were included as a control group. The results suggest that in women not using hormonal contraception, chronic stress (OR = 1.05, 95%CI = 1.02-1.08, p = 0.001) and dispositional resilience (OR = 0.43, 95%CI = 0.31-0.59, p < 0.001) have a main effect on menstrual cycle regularity. In addition, women with greater dispositional resilience have reduced risk for irregular menstrual cycles in the face of low to moderate chronic stress; however, this association is changed at the highest level of chronic stress.
These findings suggest that dispositional resilience may be a protective psychological trait that modulates reproductive functioning.
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