BACKGROUND: Immaturity of the endocrine system that controls the normal menstrual cycle frequently results in abnormal uterine bleeding (AUB) and elicits anemia in adolescent girls. This study was conducted to assess the predictive value of endometrial thickness (ET) for anemia in adolescent girls with AUB. METHODS: A retrospective chart review was performed for a cohort of adolescents (12–18 years old) with AUB who presented over a 10-year period. Complete blood count and ultrasonographic data of 115 adolescent girls with AUB were analyzed. Subjects were classified according to ET as group I (ET < 11 mm) and group II (≥11 mm), and the incidence of anemia was compared. Subjects were also classified according to age as group Y (12–15 years old of age) and group O (16–18 yr), and ET, hemoglobin (Hb), and incidence of anemia were compared. RESULTS: The incidence of anemia in all subjects was 67.8% and was significantly higher in group II than in group I (P < 0.001). The incidence of severe anemia was 56.9% in group II, which was higher than in group I (P=0.039). The incidence of anemia was not significantly different between groups Y and O. However, the incidence of severe anemia was significantly higher in group Y than in group O (P=0.001). CONCLUSION: AUB can result in severe anemia in adolescent girls particularly those who are close to menarche or have a thick endometrium. Early supervision of AUB is required in order to avoid anemia in adolescent girls with AUB.
Adolescent* ; Anemia* ; Blood Cell Count ; Cohort Studies ; Endocrine System ; Endometrium ; Female* ; Humans ; Incidence ; Menarche ; Menstrual Cycle ; Organization and Administration ; Retrospective Studies ; Uterine Hemorrhage*

To establish a fetal biparietal diameter (BPD)-gestational age formula based on the data of pregnant women from Xiaoshan District of Hangzhou, and to evaluate its application in prenatal screening.Data of 3500 pregnant women with gestational age between 15 weeks and 19 weeks+6 receiving prenatal screening in Xiaoshan Hospital during May 2014 and May 2015 were collected. BPDs were used to establish a localized BPD-gestational age formula. The localized formula was used to evaluate the prenatal screening risks in 1759 pregnant women with irregular menstrual cycles or uncertain last menstrual period (LMP) in Xiaoshan District, and the results were compared with those calculated using formula in LifeCycle 4.0.With localized formula, the total positive rate of Down syndrome, trisomy 18 syndrome and deformity of neural tube was decreased from 6.96% to 5.85% (<0.05), in which the positive rate of Down syndrome decreased (<0.05), that of deformity of neural tube increased (<0.05), and that of trisomy 18 syndrome remained the same (>0.05). The median MoMs of free-hCG β and α-fetoprotein calculated using localized formula were significantly different from those calculated using the formula in LifeCycle 4.0 (all<0.05), and the former ones were more closer to 1. For women of fetus diagnosed with the above diseases, the positive rate calculated using localized formula was almost the same as that calculated using the formula in LifeCycle 4.0.BPD-gestational age formula should be localized based on the statistical analysis of the local population, which will help to reduce the false positive rate, and make the results more accurate and reliable in prenatal screening.
Adult ; Body Weights and Measures ; standards ; Cephalometry ; standards ; statistics & numerical data ; Chorionic Gonadotropin, beta Subunit, Human ; blood ; standards ; Chromosomes, Human, Pair 18 ; Down Syndrome ; diagnosis ; embryology ; Epidemiologic Measurements ; Female ; Fetal Development ; Gestational Age ; Head ; embryology ; Humans ; Mass Screening ; methods ; standards ; statistics & numerical data ; Menstrual Cycle ; Neural Tube Defects ; diagnosis ; embryology ; Pregnancy ; Prenatal Diagnosis ; methods ; standards ; statistics & numerical data ; Reference Values ; Trisomy ; diagnosis ; Trisomy 18 Syndrome ; alpha-Fetoproteins ; analysis ; standards

BACKGROUNDGender is one of the risk factors accounting for the high prevalence of adolescent myopia. Considerable research results have shown that myopia incidence of female is higher than that of male. This study aimed to analyze the correlation between ocular parameters and serum estrogen level and to investigate the vision changes along with estrogen change in menstrual cycle of adolescent females.

METHODSA total of 120 young females aged between 15 and 16 years, diagnosed with myopia were recruited. Spherical lens, cylindrical lens, axis, interpupillary distance (IPD), and vision in each tested eye of the same subject were measured by automatic optometry and comprehensive optometry, with repetition of all measurements in the menstrual cycle of the 2 nd or 3 rd days, 14 th days, and 28 th days, respectively. Serum estradiol (E 2 ) levels were assayed by chemiluminescence immunoassay at the same three times points of the menstrual cycle mentioned above.

RESULTSIn young females with myopia, the spherical lens showed a statistically significant difference among all different time in menstrual cycle (all P < 0.0001). The cylindrical lens, axis, and IPD were changed significantly during the menstrual cycle (P < 0.05). The vision of the three different time points in menstrual cycle had a significant difference (χ2 = 6.35, P = 0.042). The vision during the 14 th and 28 th day was higher compared to that on the 2 nd or 3 rd days (P = 0.021). Serum E 2 levels were significantly different at different time points in menstrual cycle (P < 0.05). E 2 levels reached its maximum value on the 14 th day and the minimum value on the 2 nd or 3 rd day.

CONCLUSIONSIn adolescent females, the spherical lens and other related ocular parameters vary sensitively with different levels of E 2 in menstrual cycle. Vision in late menstrual stage is significantly higher than that in premenstrual stage.

Adolescent ; Estradiol ; blood ; Estrogens ; blood ; Female ; Humans ; Menstrual Cycle ; blood ; Myopia ; blood ; Progesterone ; blood

OBJECTIVETo investigate the relationship between fetal growth restriction and decreased ovarian reserve (DOR) in adulthood to screen high-risk population for early interventions.

METHODSForty-four patients with FGR and 88 normal women aged 18-40 years were enrolled. All the subjects were examined for serum levels of follicle-stimulating hormone (FSH), inhibin B (INH-B), and anti-mullerian hormone (AMH) using enzyme-linked immunosorbent assay method in the first 3-5 days of the menstrual cycle, and the counts of antrum ovarian follicle were detected by transvaginal or transabdominal ultrasonography.

RESULTSThe serum levels FSH, INHB, AMH, and AFC in FGR group differed significantly from those in the control group (P<0.05).

CONCLUSIONFGR will affect reproductive endocrine function in adulthood to cause a decreased ovarian reserve.

Adolescent ; Adult ; Anti-Mullerian Hormone ; blood ; Case-Control Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Fetal Growth Retardation ; Follicle Stimulating Hormone ; blood ; Humans ; Inhibins ; blood ; Menstrual Cycle ; Ovarian Follicle ; physiology ; Ovarian Reserve ; Prospective Studies ; Young Adult

Allogenic peripheral blood stem cell transplantation (Allo-PBSCT) is being used to treat hematological malignancies with increasing frequency. Graft-versus-host disease (GvHD) is a complex complication of PBSCT. A 43-year-old woman came to the gynecology clinic for amenorrhea. She had been diagnosed with acute myeloid leukemia 2 years earlier and treated with induction and consolidation chemotherapy. After developing complete remission, she underwent Allo-PBSCT. When she started chemotherapy, her menstrual cycle completely disappeared. Fourteen months after menopausal hormone replacement therapy, it was discovered that her upper vaginal canal was completely obstructed. The lower vagina had an atrophic appearance. We report a rare case of partial vaginal obstruction as a complication of chronic GvHD and review the literature. We expect that this case report provides an opportunity to remind clinician of the gynecologic complications of GvHD.
Amenorrhea ; Consolidation Chemotherapy ; Female ; Graft vs Host Disease ; Gynecology ; Hematocolpos ; Hematologic Neoplasms ; Hormone Replacement Therapy ; Humans ; Leukemia, Myeloid, Acute ; Menstrual Cycle ; Peripheral Blood Stem Cell Transplantation ; Porphyrins ; Vagina

OBJECTIVE: To compare the blood glucose levels, insulin concentrations, and insulin resistance during the two phases of the menstrual cycle between healthy women and patients with premenstrual syndrome (PMS). METHODS: From January of 2011 to the August of 2012, a descriptive cross-sectional study was performed among students in the School of Medicine of Jahrom University of Medical Sciences. We included 30 students with the most severe symptoms of PMS and 30 age frequency-matched healthy controls. We analyzed the serum concentrations of glucose, insulin, and insulin resistance by using the glucose oxidase method, radioimmunometric assay, and homeostasis model assessment of insulin resistance equation, respectively. RESULTS: No significant differences between the demographic data of the control and PMS groups were observed. The mean concentrations of glucose of the two study groups were significantly different during the follicular and luteal phases (p=0.011 vs. p<0.0001, respectively). The amounts of homeostasis model assessment of insulin resistance of the two study groups were significantly different in the luteal phase (p=0.0005). CONCLUSION: The level of blood glucose and insulin resistance was lower during the two phases of the menstrual cycle of the PMS group than that of the controls.
Blood Glucose ; Cross-Sectional Studies ; Female ; Glucose ; Glucose Oxidase ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Luteal Phase ; Menstrual Cycle ; Premenstrual Syndrome

OBJECTIVETo explore the influence of water fluoride exposure on reproductive hormones in female.

METHODSCross-sectional study was conducted in seven villages of a county in Henan province by using simple random sampling including high fluoride area, defluoridation project area and control area on April, 2011 based on the preliminary study results of fluoride concentration in drinking water. Women who were born and growth or lived in the village at least 5 years and aged 18-48 years old were recruited using cluster sampling. They were divided into high fluoride group (HFG, 116 subjects), defluoridation project group (DFPG, 132 subjects) and control group (CG, 227 subjects) in accordance with the above areas. All subjects accepted questionnaire and physical checkup. Fasting blood and morning urine samples were collected. The concentration of fluoride in urine was determined by fluoride ion selective electrode method. The serum level of GnRH was detected using enzyme linked immunosorbent assay (ELISA). The serum level of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), estradiol (E2) were determined by chemiluminesence immunoassay (CLIA).

RESULTSThe average age was (39.44 ± 7.34), (38.84 ± 8.03), (37.45 ± 7.70) years old in female from DFPG, HFG and CG respectively, there were no significant differences among the three groups (F = 3.02, P = 0.05). The urine fluoride levels were (1.34 ± 1.07), (2.59 ± 1.57), (0.92 ± 0.46) mg/ml in female from DFPG, HFG and CG respectively, there was a significant difference among three groups (F = 105.38, P < 0.01). No significant differences were observed of serum GnRH, LH, T, FSH and E2 among three groups in follicular phase (P > 0.05). The serum levels of E2 in Ovulatory period were 67.73, 58.09, 84.96 pg/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in CG (H = 4.00, P < 0.05). The serum levels of T in Ovulatory period were 0.55, 0.45, 0.55 ng/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in DFPG (H = 6.47, P < 0.05), but no significant difference was observed between HFG and CG (H = 2.41, P > 0.05). The serum levels of GnRH in Luteal phase were 24.09, 20.16, 23.50 ng/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in DFPG (H = 14.14, P < 0.05) and CG (H = 12.53, P < 0.05). The serum level of E2 in luteal phase were 81.47, 64.60, 74.55 pg/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in DFPG (H = 5.69, P < 0.05). As for LH, FSH and T, no significant differences were observed among the three groups (P > 0.05 respectively). The abnormal rates of E2 level were 22.73 (30/102), 37.93 (44/72), 20.26 (46/181) in female from DFPG, HFG and CG respectively. The E2 abnormal rate in female from HFG was higher that from DFPG (χ(2) = 6.82, P < 0.05) and CG (χ(2) = 12.38, P < 0.05).

CONCLUSIONFluoride exposure may influence reproductive hormones in female, especially in ovulatory and luteal phase of menstrual cycle.

Adult ; Cross-Sectional Studies ; Drinking Water ; chemistry ; Environmental Exposure ; adverse effects ; Estradiol ; blood ; Female ; Fluorides ; adverse effects ; urine ; Follicle Stimulating Hormone ; blood ; Gonadotropin-Releasing Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Menstrual Cycle ; drug effects ; Middle Aged ; Progesterone ; blood ; Testosterone ; blood

OBJECTIVETo study the changes in sexual function in premenopausal women after renal transplantation.

METHODSForty-two married premenopausal women receiving dialysis therapy for at least 6 months with normal renal function for 6 months after renal transplantation were examined for hormonal profiles and menstrual cycles. The sexual functions of the patients were evaluated using Female Sexual Function Index (FSFI) before and 6 months after the transplantation.

RESULTSBefore renal transplantation, amenorrhea, oligomenorrhea, polymenorrhea, and eumenorrhea were found in 18 cases (42.9%), 10 cases (23.8%), 5 cases (11.9%) and 9 cases (21.4%), as compared to 7 cases (16.7%), 5 cases (11.9%), 6 cases (14.3%) and 24 cases (57.1%) after the transplantation, respectively. Prolactin (PRL), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels significantly decreased and estradiol (E2) and progesterone (P) significantly increased after renal transplantation (P<0.001). Nineteen patients (45.2%) before and 36 patients (85.7%) after the surgery reported to have an active sexual life (P<0.001). The total incidences of female sexual dysfunction before and after kidney transplantation were 90.5% and 40.5% (P<0.001), respectively. The scores for sexual desire, arousal, lubrication, satisfaction, orgasm, and pain in FSFI were significantly increased after kidney transplantation (P<0.001).

CONCLUSIONSA successful renal transplantation can significantly improve sexual functions in premenopausal women.

Adult ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Kidney Transplantation ; adverse effects ; Menstrual Cycle ; Middle Aged ; Premenopause ; Progesterone ; blood ; Prolactin ; blood ; Sexual Behavior ; Sexual Dysfunction, Physiological ; epidemiology

This study tested the hypothesis that effects of the menstrual cycle on resting blood pressure carry over to dynamic exercise. Eleven healthy females were studied during the early (EP; low estrogen, low progesterone) and late follicular (LP; high estrogen, low progesterone) menstrual phases. Stroke volume (SV), heart rate (HR), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), and total vascular conductance (TVC) were assessed at rest and in response to mild and moderate cycling exercise during EP and LP. During EP, compared to LP, baseline SBP (111+/-1 vs. 103+/-2 mmHg), DBP (71+/-2 vs. 65+/-2 mmHg) and mean arterial pressure (MAP) (84+/-2 vs. 78+/-1 mmHg) were higher and TVC (47.0+/-1.5 vs. 54.9+/-4.2 ml/min/mmHg) was lower (p<0.05). During exercise, absolute values of SBP (Mild: 142+/-4 vs. 127+/-5 mmHg; Moderate: 157+/-4 vs. 144+/-5 mmHg) and MAP (Mild: 100+/-3 vs. 91+/-3 mmHg; Moderate: 110+/-3 vs. 101+/-3 mmHg) were also higher, while TVC was lower (Mild: 90.9+/-5.1 vs. 105.4+/-5.2 ml/min/mmHg; Moderate: 105.4+/-5.3 vs. 123.9+/-8.1 ml/min/mmHg) during EP (p<0.05). However, exercise-induced increases in SBP, MAP and TVC at both work intensities were similar between the two menstrual phases, even though norepinephrine concentrations were higher during LP. Results indicate that blood pressure during dynamic exercise fluctuates during the menstrual cycle. It is higher during EP than LP and appears to be due to additive effects of simultaneous increases in baseline blood pressure and reductions in baseline TVC.
Arterial Pressure ; Blood Pressure ; Cardiac Output ; Estrogens ; Female ; Heart Rate ; Hemodynamics* ; Humans ; Menstrual Cycle* ; Norepinephrine ; Stroke Volume

Primary aldosteronism (PA) is characterized by inappropriately high production of aldosterone relatively autonomous from the renin-angiotensin system and no suppression by sodium loading. The prevalence of PA is estimated more than 10% among nonseleted hypertensive patients. PA is clinically very important since patients with PA have higher cardiovascular morbidity and mortality than age- and sex-matched patients with essential hypertension and the same degree of blood pressure elevation. The ratio of plasma aldosterone concentration to plasma renin activity (ARR) has been generally accepted as a first-line screening test. ARR might be affected by patient age, anti-hypertensive drugs, posture and menstrual cycles. Once the ARR is measured, confirmative test should be performed. Although a gold standard confirmative test for PA is not yet identified, intravenous saline loading test is widely used. Adrenal venous sampling (AVS) is a gold standard for differentiation of unilateral from bilateral forms of PA. Since adrenal CT imaging has limitations to accurate diagnosis of PA, AVS is recommended for all patients who wish to pursue surgical treatment. Although unilateral laparoscopic adernalectomy is the optimal treatment for patients with aldosterone producing adenoma or unilateral hyperplasia, strong evidence linking adernalectomy with improved quality of life, morbidity or mortality is not available. Mneralocorticoid receptor antagonists, spironolactone or eplerenone, are recommended for pharmacologic therapy of PA.
Adenoma ; Aldosterone ; Antihypertensive Agents ; Blood Pressure ; Female ; Humans ; Hyperaldosteronism ; Hyperplasia ; Hypertension ; Mass Screening ; Menstrual Cycle ; Plasma ; Posture ; Prevalence ; Quality of Life ; Renin ; Renin-Angiotensin System ; Sodium ; Spironolactone