During the rapid development of COVID-19 vaccines, concerns emerged about potential adverse effects on menstrual health. This study examines the association between COVID-19 vaccination-considering the number of doses and vaccine type-and menstrual disorders, specifically heavy menstrual bleeding (HMB) and amenorrhea (AM). Utilizing electronic health records from the Sistema d\'Informació per al Desenvolupament de la Investigació en Atenció Primària (SIDIAP) database in Catalonia, Spain, the retrospective cohort included 1,172,621 vaccinated women aged 12-55 with no prior menstrual disorders observed from 27 December 2020 to 30 June 2023. The incidence rate of HMB and AM increased with the second and third doses of the vaccine. Notably, the AstraZeneca® and Janssen® vaccines were associated with higher odds of HMB (OR: 1.765, CI: 1.527-2.033; OR: 2.155, CI: 1.873-2.476, respectively) and AM (OR: 1.623, CI: 1.416-1.854; OR: 1.989, CI: 1.740-2.269, respectively) from the first to the second dose compared to Pfizer/BioNTech®. Conversely, the Moderna® vaccine appeared to offer a protective effect against HMB (OR: 0.852, CI: 0.771-0.939) and AM (OR: 0.861, CI: 0.790-0.937) between the second and third doses. These results were adjusted for potential confounders, such as age, previous COVID-19 infection, and other relevant covariates.

UNASSIGNED: Four years after the start of the pandemic, there is limited evidence on the impact of COVID-19 on the women\'s health regardless of their reproductive status.
UNASSIGNED: The aim was to analyze the prevalence and associated factors of menstrual-related disturbances in formerly menstruating women following SARS-CoV-2 infection.
UNASSIGNED: A retrospective observational study of adult women in Spain was conducted during the month of December 2021 using an online survey (N = 17,512). The present analysis includes a subpopulation of SARS-CoV-2-infected and formerly menstruating women (n = 72). The collected data included general characteristics, medical history, and specific information on COVID-19. Chi-square and Mann-Whitney U-tests were performed. Bivariate logistic regression analysis was then performed to investigate possible associations between the occurrence of menstrual-related disturbances after SARS-CoV-2 infection.
UNASSIGNED: 38.8% of participants experienced menstrual-related disturbances following COVID-19. Among these, unexpected vaginal bleeding (20.8%) was the most common event, followed by spotting (11.1%) ( Table 1). Other reported changes were in the length (shorter = 12.5%) and flow (heavier = 30.3%) of menstrual bleeding in comparison to their previous experience. Regression analysis revealed that being a perimenopausal woman [adjusted odds ratio (AOR) 4.721, CI 95%, 1.022-21.796, p = 0.047] and having a previous diagnosis of menorrhagia (AOR 5.824 CI 95%, 1.521-22.310, p = 0.010) were factors associated with the event.
UNASSIGNED: These findings could help health professionals provide their patients with up-to-date scientific information to empower them to actively manage their reproductive health, especially in societies where menstrual health is still taboo.

BACKGROUND: The desire to conceive and become parents is a fundamental aspect of human life that carries immense personal, emotional, and societal significance. For many couples, achieving pregnancy represents a long-cherished dream, but the journey to parenthood is not always straightforward. The duration it takes to achieve the desired pregnancy can vary significantly among individuals and is influenced by many factors. This study explores the factors that influence the delayed time of pregnancy among women with naturally planned conception.
METHODS: An institutional-based cross-sectional study was conducted from May 1 to May 30, 2023, in public health facilities of Bale Zone administrative towns, Southeast Ethiopia. Using systematic random sampling, 388 women participated in the study and a pretested questionnaire was used to collect data. Bivariate logistic regression was done, and variables with p-values < 0.25 were exported to multivariable logistic regression, and a statistically significant association was declared at p-value < 0.05.
RESULTS: The study revealed delayed time to pregnancy was 18.6% with 95% (CI = 14.67-22.44%). Women\'s age ≥ 35, (AOR = 2.61; 95%, CI: 1.17-5.82), menstrual irregularity (AOR = 3.79; 95% CI: 1.98-7.25), and frequency of sexual intercourse/week (AOR = 2.15; 95% CI: 1.05-4.41) and women\'s sexual dysfunction before conception (AOR = 3.12, 95% CI: 1.62-6.01) were significantly associated factors with delayed time to pregnancy at p-value < 0.05.
CONCLUSIONS: The study revealed a substantial proportion of delayed time to pregnancy. This delayed time to pregnancy was associated with older maternal age, irregular menstrual cycles, coital activity per week, and the women\'s sexual dysfunction before pregnancy. Consequently, addressing delayed time to pregnancy requires a targeted approach, prioritizing initiatives such as raising awareness, fostering increased frequency of sexual activity per week, exploring interventions for women with irregular menstrual patterns, and challenges related to sexual dysfunction.

OBJECTIVE: Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder that affects the endocrine glands and reproductive processes in adolescent girls, potentially impacting their quality of life. This study aims to compare the quality of life between adolescent girls with PCOS and those without PCOS.
METHODS: The present study is an analytical cross-sectional study. It involved 12-18-year-old girls who were diagnosed with PCOS based on the Rotterdam criteria for the case group. An ordinal logistic regression model was employed to assess the impact of the studied variables on different levels of quality of life, and Odds Ratio (OR) values were determined for predictor variables.
RESULTS: The findings of the study revealed that the control group had a significantly higher percentage of individuals with excellent quality of life (score 209-260) compared to the group with polycystic ovary syndrome (p<0.05). The results of the ordinal logistic regression analysis indicated that age variables (OR=0.64, CI 95 %; 0.44-0.93), menstrual disorders (OR=0.07, CI 95 %; 0.01-0.38), and micromastia (OR=0.03, CI 95 %; 0.004-0.34) were identified as factors influencing the quality of life of girls with polycystic ovary syndrome.
CONCLUSIONS: It was concluded that patients with PCOS had a lower quality of life score. The variables of age, menstrual disorders, and micromastia were determined as influencing factors the quality of life. The results of this study are significant and warrant further research in this area, particularly with regard to the financial resources of patients in the challenging economic circumstances facing the nation - the majority of which are brought on by economic sanctions.

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This article is a summary of normal menstrual bleeding and how to recognize abnormalities based on patient\'s symptoms as well as identify possible causes in order to direct treatment. This article discusses abnormal uterine bleeding including the definition, etiology, evaluation, and treatment. It also discusses primary ovarian insufficiency, transgender medicine, and menopause.

Recent methodological recommendations suggest the use of the \"3-step method,\" consisting of calendar-based counting, urinary ovulation testing, and serum blood sampling, for the identification of subtle menstrual disturbances (SMDs). However, the use of the 3-step method is not always feasible, so a less demanding combination of calendar-based counting and urinary ovulation testing, that is, the 2-step method, may be a viable alternative.
OBJECTIVE: To investigate the agreement between the 2- and 3-step methods for the detection of SMDs.
METHODS: Menstrual cycles (MCs, 98) of 59 athletes were assessed using the 2- and 3-step methods. Regular-length MCs (ie, ≥21 and ≤35 d) were classified as either having no SMD (luteal phase length ≥10 d, midluteal progesterone concentration ≥16 nmol·L-1, and being ovulatory) or having an SMD (eg, short luteal phase [<10 d], inadequate luteal phase [midluteal progesterone concentration <16 nmol·L-1], or being anovulatory). Method agreement was assessed using the McNemar test and Cohen kappa (κ).
RESULTS: Substantial agreement was observed between methods (κ = .72; 95% CI, .53-.91), but the 2-step method did not detect all MCs with an SMD, resulting in evidence of systematic bias (χ2 = 5.14; P = .023). The 2-step method detected 61.1% of MCs that had an SMD ([51.4, 70.8]), as verified using the 3-step method, and correctly identified 100% of MCs without an SMD.
CONCLUSIONS: MCs classified as being disturbed using the 2-step method could be considered valid evidence of SMDs. However, MCs classified without SMDs do not definitively confirm their absence, due to the proven underdetection via the 2-step method.

BACKGROUND: This study was designed to evaluate the frequency and type of menstrual disorders in thyroid dysfunction. The relationship between thyroid dysfunction and menstrual disorders has been known for a long time. The menstrual cycle should be checked in women with thyroid dysfunction. On the contrary, women with menstrual irregularities should be investigated for thyroid dysfunction.
METHODS: Women who presented to our hospital\'s internal medicine and endocrinology clinics that recently diagnosed thyroid dysfunction were included. The patients were divided into five groups (subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, overt hyperthyroidism, and euthyroid) according to thyroid functions. They were questioned regarding the amount, frequency, and duration of menstrual bleeding. The prevalence of menstrual disturbances, including secondary amenorrhea, hypomenorrhea, oligomenorrhea, hypermenorrhea, polymenorrhea, menorrhagia, metrorrhagia, and menometrorrhagia, was examined in 485 patients and 108 healthy controls.
RESULTS: Hypermenorrhea was significantly more common in patients with overt hypothyroidism (33%) than in controls (6%) (p<0.05). The types and frequencies of menstrual disorders in patients with hyperthyroidism and those with normal thyroid function were not significantly different from those in controls.
CONCLUSIONS: Menstrual abnormalities frequently occur in women with thyroid dysfunction. Therefore, menstrual dysfunction should be considered when treating patients with thyroid abnormalities.

YOUNG FEMALE ATHLETES AND HIGH LEVEL SPORT. The impact of intensive sport on the menstrual cycle varies according to the individual and the nutritional balance in relation to energy expenditure; impaired reproductive function with menstrual disturbances is an indicator of the syndrome of relative energy deficiency in sport (REDs). Raising the awareness of the female elite athlete, her sport environment, her family and the health professionals in charge of medical care enables better prevention and avoids harmful consequences on bone metabolism, reduced immunity and cardiovascular risk, among others, and the impact on endurance and resistance performance. The absence of a menstrual cycle, apart from hormonal contraception, is incompatible with the research of sport performance. Similarly, moderate to severe dysmenorrhea, heavy menstrual periods which are a source of iron-deficiency anemia, and premenstrual syndrome which interferes with training, should not be treated as a fatality or taboo subject, but should be managed by appropriate treatment and explained to the athlete to ensure care compliance.
JEUNES FEMMES ET SPORT DE HAUT NIVEAU. L’impact du sport intensif sur le cycle menstruel varie en fonction de chacune, de l’équilibre nutritionnel par rapport à la dépense énergétique ; les perturbations du cycle menstruel constituent un indicateur du syndrome de déficit énergétique relatif dans le sport (REDs). La sensibilisation de la sportive, de son environnement sportif, familial et des professionnels de santé en charge du suivi médical permet une meilleure prévention et évite notamment les conséquences néfastes sur le métabolisme osseux, la diminution de l’immunité, le risque cardiovasculaire et l’impact sur la performance en endurance et en résistance. L’absence de cycle menstruel, hors contraception hormonale, est antinomique avec la recherche de la performance. De la même façon, la dysménorrhée modérée à sévère, des règles abondantes, sources d’anémie ferriprive ou un syndrome prémenstruel gênant l’entraînement ne doivent pas être vécus comme une fatalité ou un sujet tabou, mais être pris en charge par un traitement adapté et expliqué à la sportive pour soutenir l’adhésion à la prise en charge.

BACKGROUND: Nutrition is important to the management and relief of the symptoms in menstrual disorders. This study aims to investigate the relationship between menstrual disorders and specific foods and nutrient intake in women.
METHODS: Five-hundred-nine menstruating women participated in the study. The questionnaire form was created by the researchers via Google Forms and distributed in online applications (WhatsApp, Instagram etc.). The questionnaire consists of 5 sections, including demographic data, declared anthropometric measurements (height (m or cm), weight (g or kg)), questions about eating habits, menstruation status, and 24-hour food consumption. Statistical analysis was made with SPSS 23; nutrient analysis of food consumption was made using BeBiS 9.0.
RESULTS: It was found that the body mass index (BMI) of healthy participants was higher than women with menstrual disorders. Women with menstrual disorders have lower intake of protein, vitamin K, vitamin B3, vitamin B5 and sodium compared with healthy women. All participants have a higher intake of vitamin B3, sodium, phosphorus, and manganese, and have a lower intake of other nutrients compared with the national adequate intake.
CONCLUSIONS: Our findings showed that women with menstrual disorders consume more high-sugar food/beverages and have inadequate nutrients intake.