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PubMed2003

[Luteal phase treatment with mifepristone and misoprostol for prevention of pregnancy].

OBJECTIVE: To assess the efficacy and side-effects after treatment of 100 mg mifepristone and misoprostol in the luteal phase of the cycle. METHODS: This study was carried out in seven family planning clinics in China, including 699 women who were exposed to unprotected intercourse more than five days earlier or having had more than one episode of unprotected intercourse in the same cycle. Mifepristone 100 mg was given on admission followed two days later by 400 micro g misoprostol orally in the luteal phase of the cycle. RESULTS: One woman was lost to follow-up after taking mifepristone. After treatment 25 women (3.6%) were pregnant and 673 women had return of menstruation, among whom, 381 (56.6%) had the return of menstruation +/- 3 days of the expected day, 57 women (8.5%) had a delay of menstruation > 7 days. Pregnancy rate was related to the number of acts of intercourse before treatment, the difference was statistically significant (P < 0.05). The main side effects within a week after treatment were diarrhoea and abdominal pain (31.1%) as well as nausea and vomiting (20.4%). CONCLUSION: The use of mifepristone with misoprostol during luteal phase provides an option for occasional use for preventing pregnancy.

Adult↗
PubMed2006

[Pituitary response to GnRH analogue testing in girls with a polycystic ovary syndrome].

UNLABELLED: THE AIM of our study was to estimate the gonadotropin level after GnRH analogue injection in girls with PCOS after suppression with dexamethasone. MATERIAL AND METHODS: 57 girls with hirsutism, mean age 15.9 years, were involved in the study. The research was performed in the early and middle follicular stage. Menstrual disorders were observed in 78% of them. The patients were divided into 3 groups: I -- with clinical and laboratory symptoms of PCOS (menstruation disorders, testosterone >65 ng/ml and/or LH/FSH >2; n=29), II -- with menstruation disorders and without elevated androgen level (n=15), III -- without menstruation disorders and without elevated androgen level (n=13). Basal blood samples were drawn at 8 a.m. GnRH analogue (Relefact LH-RH) 100 microg was then given subcutaneously and blood samples were drawn every 4 hours for 24 hours. RESULTS: Basal level of LH was the highest in group I (6,18+/-4,10 IU/l) in comparison with II (5.53+/-3.40 IU/l) and III (3.82+/-2.79 IU/l). After GnRH analogue administration mean LH concentration increased in all groups and peaked after 2 hours. Stimulated LH level was the highest in group I and differed statistically significantly from group III during the whole period of the test. The most significant difference occurred at 12 a.m. (p=0.003) and 10 a.m. (p=0.004). The FSH secretion in all tested groups was similar. It peaked, like LH, after 2 hours after GnRH analogue injection and decreased slightly during next 2 hours. A marked decrease was observed in the following period of time. CONCLUSIONS: 1. High and fast LH secretion responding to GnRH analogue indicates masculinization of the hypothalamo-pituitary axis in PCOS girls. 2. The hirsute girls without menstrual disturbances and hormonal abnormalities probably also have subtle masculinization of the pituitary response to stimulation by GnRH analogue.

Adolescent↗
PubMed1991

Leisure physical activity and age at menarche.

Early menarche has been associated with higher risk of breast cancer. A prospective study of 2487 girls, has been conducted in Quebec City, Canada, to evaluate the relationship of exercise to menarche, taking personal and family characteristics into account. Weight, height, body mass index, and abdominal and supra-iliac skinfolds were inversely associated with age of menstruation. Mother's age at menarche was positively associated with age of menstruation. Age, mother's age at menarche, and weight-adjusted incidence density ratios (IDR) showed no association between energy expenditure and onset of menstruation. Girls who participated in dance, gymnastic figure skating, synchronized swimming, or diving competitions had a lower risk of reaching menarche at an early age (IDR = 0.71 (0.51-0.97)).

Adolescent↗
PubMed1991

[A case of juvenile vesical endometriosis with unilateral renal agenesis and bicornate uterus].

A case of vesical endometriosis with unilateral renal agenesis is reported. A 13-year-old girl complained of difficulty in urination and lower abdominal pain during the menstruation. Detail urological examinations revealed left renal agenesis and intravesical cystic mass. The mass was located in the left vesical lateral wall, obstructing the vesical outlet and containing dark-brown-coloured fluid in it. She finally suffered from urinary retention following the menstruation and underwent a resection of the mass together with a part of the vesical wall. During the operation, the uterus was found to be a bicornate one. The resected mass was diagnosed as an endometriosis based on the histological findings. Eighteen months after the operation she is free from any symptoms during the menstruation and recurrence of endometriosis.

Adolescent↗
PubMed1990

Naltrexone in functional hypothalamic amenorrhea and in the normal luteal phase.

Fifteen young women with a diagnosis of secondary hypothalamic amenorrhea of at least 2 years' duration were given either 50 mg naltrexone daily or placebo, following a randomized double-blind crossover scheme. Seven patients did not menstruate with either therapy. In the other eight, the following results were recorded (mean +/- SD and range): a cycle length of 28.7 +/- 7.6 (12-45) days for naltrexone compared with 30.8 +/- 5.9 (16-43) days for placebo, a follicular phase length of 20.8 +/- 5.4 (14-34) days for naltrexone and 23.2 +/- 4.3 (19-32) days for naltrexone and 8.3 +/- 1.6 (5-10) days for placebo. The number of ovulatory cycles was 18 of 24 (75%) with naltrexone and eight of 24 (33%) with placebo (P less than .05). Most luteal phases were short. In five normally menstruating women, we gave either naltrexone or placebo in the luteal phase using a crossover blinded scheme. Steroidogenesis in the normal luteal phase was not impaired by naltrexone therapy. In functional hypothalamic amenorrheic patients with normal weight, menstruation might be restored by either placebo or naltrexone, but naltrexone provides a clinical and therapeutic advantage by increasing the ovulation rate.

Adult↗
PubMed1990

[Determination of gestational age by ultrasound].

The authors elaborated a procedure for correction of the gestation age by ultrasonic examination in pregnant women in the second and third trimester of gestation. The method was tested in a group of 500 pregnant women who were examined within the framework of a special ultrasound screening. In 5% of the group the gestation age calculated according to the last menstrual bleeding was not consistent with the results of the ultrasound examination. In these instances a correction was made in case the difference between the ultrasonic finding and the gestation age according to menstruation was two weeks or more, in the first as well as second trimester. In these instances the correction was made with regard to the difference in the first trimester. In the group of women where the correction was made there was in 44% a case-history of irregular menstrual cycles, as compared with 13% in the group where the ultrasonic finding was consistent with the gestation age according to the date of menstruation. In the majority of women (73%) with a shift of the conceiving ovulation the difference of the ultrasonic finding, as compared with the gestation age according to the last menstruation was three weeks or more.

Embryonic and Fetal Development↗
PubMed1990

Ovarian function studies in active ankylosing spondylitis in women. Clinical response to estrogen therapy.

Ovarian function was studied in 17 women with active ankylosing spondylitis (AS). Levels of FSH, LH, prolactin and androstenedione were normal in menstruating patients and FSH and LH were elevated in menopausal patients. In menstruating patients with active AS the estradiol levels were lower than in patients with inactive AS and significantly (p less than 0.05) lower than controls. Progesterone levels in menstruating patients were lower (P = NS) than controls. In menopausal patients estrogen levels were lower than their controls (P = NS). There was a significant (p less than 0.05) inverse correlation between the sedimentation rate and the estrogen level. Seven patients accepted oral estrogen therapy (average duration 4 months) and peripheral arthritis subsided within one month, all variables of clinical activity of AS improved and at the end of the study all patients were in functional class I.

Adult↗
PubMed1986

Early complications of first trimester interruption of pregnancies with rivanol predilatation.

The early complications of the non-invasive interruption of 1361 first trimester pregnancies induced by Rivanol predilatation were studied. For this purpose the patients were called back for follow-up examination 6 weeks after the operation. The number of patients reporting at the control examination was 769. The number of febrile complications of genital origin was low. Slight postoperative bleeding exceeded the amount of normal menstruation only in 4.9% of the patients and, in general, it did not last longer than 7 days. The same applied to abdominal and lumbar complaints. The proportion of early complications was lower than after interruptions with the D + VA and D + C methods. The first menstruation after the operation did not differ from the earlier menstruation pattern of the particular patient in 75.9% of the cases. This also showed that the use of Rivanol did not involve lasting and severe damage to the endometrium.

Abortion, Induced↗
PubMed1988

Menarche: prior knowledge and experience.

The purpose of this study was to determine the details of first menstruation and the differences between those who had knowledge of menstruation prior to menarche and those who did not. Information from 305 young women in India was collected regarding menarcheal bleeding pattern, disturbances in normal menstruation, and menarcheal age. Those who had knowledge prior to menarche considered it to be a normal physiological function, while those who did not were "appalled" and "horrified." Those having prior knowledge had a high rate of regularity, lower rate of dysmenorrhea, and earlier onset of menarche. The subjects were unanimous in their desire for more information to be provided prior to menarche.

Adolescent↗
PubMed1984

Iron and blood donation.

Regular blood donors undergo a progressive decline in iron reserves, while some develop frank iron-deficient erythropoiesis. The prevalence of iron depletion is significantly higher in menstruating women and increases progressively as the rate of donation increases. While conventional screening programmes based on the haemoglobin are adequate to prevent the development of progressive iron deficiency anaemia, they provide no indication of the development of tissue iron depletion. Recent studies indicate an impairment in a number of physiological processes associated with iron depletion but the liabilities of mild iron deficiency have not been fully defined. While it would be desirable to avoid iron depletion in regular blood donors only a minority of the eligible population have been willing to provide the blood resources of the USA in the past, and many individuals who can maintain high rates of donation without developing iron deficiency anaemia would be eliminated. However, there is little doubt that continued efforts should be made to encourage a broader base of volunteer donors. Improved public awareness of the need for blood has made it possible to obtain 88 per cent of the total supply from donors who gave blood three or less times during the year, and only 13.4 per cent of men and 11 per cent of women made three of more donations (Table 6). Further, women under 46 years of age constitute only 1 per cent of all donors who give four or more times during the year. Until clear-cut evidence is obtained of the deleterious effects of a lack of iron, the low prevalence of depleted iron reserves in men and non-menstruating women donors seems acceptable. However, current blood banking practices place a disproportionate iron demand on menstruating women. Because of the additional burden of pregnancy in this donor group, efforts to reduce the prevalence of a lack of iron in the child-bearing female should be encouraged. The simplest approach would be to limit the rate of blood donation to a maximum of three per year. This also is a subgroup among whom the application of more specific screening procedures for iron deficiency can clearly be justified. Iron supplementation programmes are also an attractive approach in these people who are likely to be highly motivated. Neither of these approaches have been adequately evaluated at the present time.

Administration, Oral↗
PubMedDate not supplied

Ovarian function after therapy for Hodgkin's disease.

Ovarian function has been evaluated in 10 women in fertile age, free of disease, who underwent therapy for Hodgkin's disease. Women were divided into groups according to their age at the time of the diagnosis and therapy used. In the group of 6 women treated with chemotherapy alone or associated with sovradiaphragmatic roentgentherapy, 4 (66%) are regularly menstruating and 2 (33%) have become amenorrheic; while among the 4 women treated with TNI or inverted Y, 3 (75%) have become amenorrheic and 1 (25%) is regularly menstruating. 7 women were younger than 30 at the time of the diagnosis: 5 (72%) are regularly menstruating and 2 (28%) have become amenorrheic; while in the group older than 30 at the time of the diagnosis all 3 (100%) have become amenorrheic. These results show that, at present, it is not possible to predict the preservation or the renewal of the ovarian function after therapy for Hodgkin's disease; only taking in account all elements such as age, ovarian function prior to therapy and kind of treatment is it possible to propose a prognostic hypothesis.

Adult↗
PubMed1984

Toxic shock syndrome: clinical and laboratory findings in 30 patients.

Thirty patients with toxic shock syndrome (TSS) that developed between May 1980 and March 1983 in Vancouver were studied prospectively. In the 15 cases related to menstruation the illness followed a uniform and predictable clinical course. In the 15 other cases (3 in males) the disease was not related to menstruation, and the sources of the Staphylococcus aureus infections were diverse; 67% were hospital-acquired. Profound but transient lymphocytopenia associated with marked leukocytosis was the most striking laboratory finding and one not previously emphasized in the literature. S. aureus was isolated from sites of soft-tissue infection, the vagina or the endocervix in all except one case. Two patients had bacteremia. Phage types 29 and 29 + predominated among the isolates tested. All the genital S. aureus isolates tested produced the TSS marker protein, while the bacteria from wounds, throat, nose and blood were sometimes positive. Two patients (7%) died from refractory shock and multiple organ failure. All patients with a febrile, exanthematous, multisystem illness, particularly if it is associated with menstruation or a staphylococcal infection, should be evaluated promptly and treated empirically for TSS.

Adolescent↗
PubMedDate not supplied

[The endocrine status in anorexia nervosa (author's transl)].

Alterations in the secretion of iodothyronines, cortisol, testosterone and growth hormone have previously been described in anorexia nervosa. We have studied prolactin and gonadotropins secretion in 23 cases of anorexia nervosa. Prolactin secretion was normal. Modifications in gonadotropins release were observed. However they could not be always related to weight loss since amenorrhea could either precede weight loss or still be present after return of the weight to normal. In all cases, FSH release after LHRH stimulation was normal. No increase in LH levels was observed after LHRH injection when the weight was 70% below the ideal weight. With increasing weight, LH release progressively recovered and normal LHRH-induced LH release was obtained when the weight was above 90% of the ideal weight. At normal weight, the ratio of LH/FSH was normal in patients menstruating less than 3 months after the test, while the ratio was low in non-menstruating females. In conclusion, when the weight was insufficient basal levels of FSH and LH and responses after LHRH stimulation corresponded to a prepuberal stage. An increase in the LH/FSH ratio and a normal LH/FSH ratio preceeded the recovery of menstruations. In about 1/3 of the cases, such an evolution was not observed without any satisfactory explanation. Other factors than weight may be involved, especially when the amenorrhea persists after weight recovery.

Anorexia Nervosa↗
PubMed1981

[The influence of the menarche on the extent of selected somatic characteristics of Warsaw girls].

The objective of this work was to establish whether the higher level of physical development observed in 13-year old girls as compared with their coevals of 15 years earlier, was due to the earlier maturing of the former, hence to a greater share of menstruating girls in that group. A comparison of the levels of development of selected somatic characteristics and the distribution of frequency of body height in the menstruating and non-menstruating groups, indicates that the secular trend is independent of menarche.

Adolescent↗
PubMed1995

[Pulmonary endometriosis with recurrent catamenial hemoptysis].

A 32-year-old woman with a history of dilation and curettage for missed abortion at 31 years old had sudden hemoptysis during menstruation on May 25, 1993. She had catamenial hemoptysis again, and was admitted to our hospital on July 21, 1993. After admission, catamenial hemoptysis occurred, and a nodular shadow was noted in the right S4 area on chest roentgenogram and computed tomogram. A few days after menstruation, hemoptysis and the abnormal shadow on chest roentgenogram disappeared. Pulmonary endometriosis was diagnosed by clinical course, past history, and chest roentgenographic findings. During the next menstruation, hemoptysis and a nodular shadow in the right S4 area on chest roentgenogram recurred, so transbronchial lung biopsy and laparoscopy were done. TBLB specimens revealed macrophages with phagocytosed hemosiderin, and laparoscopy revealed pelvic endometriosis. She was treated with buserelin acetate. Catamenial hemoptysis and the nodular shadow on the chest roentgenogram disappeared after treatment.

Adult↗
PubMedDate not supplied

Canadian National Breast Screening Study: first screen results as predictors of future breast cancer risk.

Characteristics of women aged 40-59, recorded at an initial breast screen, were compared with the outcome of incident, invasive breast cancer occurring up to 3 years after the initial screen. The study design was case-control, nested within the study population of the Canadian National Breast Screening Study. Screening consisted of a two-view mammographic examination and physical examination of the breasts; additional risk factor information was obtained from self-administered questionnaires. Of the etiological risk factors considered only age at entry or years menstruating were significant risk factors for breast cancer (P < 0.0025). Years menstruating accounted for much of the age effect and all of the menopausal status effect. Risk factors obtainable from mammography and physical examination were more significant than self-reported risk factors, other than age or years menstruating. In spite of possible misclassification of the variable parenchymal pattern, women with a mammographic film classified as either P2 or DY had a 2-fold risk of breast cancer (odds ratio = 2.1; 95% confidence interval = 1.5-2.9, P = 2.9E-05). An abnormality reported by either the radiologist [odds ratio = 1.7 (1.3-2.3)] or nurse examiner [odds ratio = 1.9 (1.4-2.6)] was also associated with an independent significant risk.

Adult↗
PubMed1997

Does endometrial resection help dysmenorrhea?

BACKGROUND: Menorrhagia is a common symptom and is often associated with dysmenorrhea. METHODS: The effect of transcervical resection of the endometrium (TCRE) on dysmenorrhea associated with menorrhagia was investigated in a prospective study. Ninety consecutive women were monitored before surgery and for a period of up to 12 months after resection. The amount of pelvic pain experienced was scored daily on a scale of 0-3, and was timed in relation to menstruation. RESULTS: There was a significant decrease in the level of pain experienced during menstruation and overall during the menstrual cycle (p < 0.001), but not in the premenstruum. The effect on pain was immediate and was maintained throughout the follow-up period of the study. The presence of adenomyosis or leiomyomata in the surgical specimen did not influence the beneficial effect on pain. CONCLUSIONS: Based on these findings, dysmenorrhea during menstruation should not be a contraindication to transcervical endometrial resection in women with menorrhagia.

Adult↗
PubMed1997

[Sex education in 6th and 7th grade girls].

OBJECTIVES: To help the students to know the basic knowledge on sexual health of adolescent, to have a positive attitude toward the phenomenon occurred during the adolescence; and to promote the health behaviors of girls. METHODS: Three hundred and sixty-three 6th and 7th grade girls from Fuxin city were involved. These girls were divided into experimental group and control by class. Pretest, post-test one month after education, and follow-up test four months after education were conducted respectively. RESULTS: After education, the score of basic knowledge on sexual health of the girls in the experimental group increased from 4.86 to 17.20. The score of positive attitude toward menstruation increased from 31.8 to 42.3. The percentage of the girls who had healthful and optimistic emotion during the menstruation increased from 43.5% to 82.9%. The percentage of the girls who visited hospital if they had reproductive diseases increased from 54.3% to 87.6%. The percentage of the girls who often wash the external genitals during menstruation increased from 50.9% to 79.0%. The ability of avoiding sexual harassment and abuse was enhanced. The follow-up test showed that the effects of sex education lasted. During the whole experimental process, no student who had sexual intercourse was discovered. CONCLUSION: Sex education in 6th and 7th grade girls is essential, feasible and effective in China.

Child↗

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