Menstrual Disturbances in Premenopausal Women with End-Stage Renal Disease: A Cross-Sectional Study

Abstract

Objective: To evaluate menstrual disturbances and sex hormonal status in premenopausal women with end-stage renal disease (ESRD). Subjects and Methods: The study consisted of 184 patients with ESRD treated with one of four treatment modalities (46/modality): conventional hemodialysis (CHD), continuous ambulatory peritoneal dialysis (CAPD), nocturnal hemodialysis (NHD) and renal transplantation (RT). Blood samples were collected to determine sex hormone levels. Sociodemographic and clinical data were collected from medical records. A questionnaire was administered to analyze menstrual patterns, and the final analysis included 46, 43, 40 and 36 patients in the CHD, CAPD, NHD and RT groups, respectively. Results: The overall prevalence of menstrual disturbances was 64.2% for all four treatment modalities (RT: 50%; NHD: 55%; CAPD: 72.1%, and CHD: 76.1%). Serum prolactin levels were significantly lower (p < 0.01) in the NHD (25.1 ± 10.9 ng/ml) and RT (13.4 ± 5.1 ng/ml) groups than in the CHD group (55.2 ± 10.8 ng/ml). Serum progesterone levels were significantly higher (p < 0.01) in the NHD (25.7 ± 8.3 nmol/l) and RT (30.1 ± 5.9 nmol/l) groups than in the CHD group (17.7 ± 7.3 nmol/l). Moreover, the hormonal status (follicle-stimulating hormone, luteinizing hormone and testosterone) was much closer to normal in the NHD and RT groups compared to the other two groups. Conclusions: In this study, successful transplantation and NHD partially improved the symptoms of menstrual disturbances. Therefore, we recommend that further studies are necessary to confirm our finding in ESRD patients.

Pregnancy and End-Stage Renal Disease

“…Once reaching end-stage disease, most women are anovulatory, even if regular menstruation is present [2], as uremia leads to dysregulation of the hypothalamic-pituitary-gonadal axis. Follicular stimulating hormone levels are similar to non-uremic women, but luteinizing hormone (LH) levels are elevated.…”

Multifaceted Sexual Dysfunction in Dialyzing Men and Women: Pathophysiology, Diagnostics, and Therapeutics

“…To reference only a few studies, menstrual disturbances are reported to occur in the range of 64.2% (of 165) [ 51 ], 73% (of 63) [ 52 ], 74% (of 39) [ 53 ], and 80% (of 25) [ 54 ] of premenopausal patients after the initiation of dialysis. Of these, Lin et al [ 51 ] has documented the largest cohort of 165. The most common disturbance is secondary amenorrhea [ 51 , 52 , 53 , 54 ].…”

Radiofrequency endometrial ablation for treating heavy menstrual bleeding in women with chronic renal failure

“…Menstrual disorders have been shown to affect 64.2% of women with chronic renal disease [4]. The prevalence of HMB is 22.9%$38.9%.…”

“…The incidence of CRF is $200 cases per one million people in Western countries [3]. CRF in women is frequently accompanied by disturbances to endocrine function, leading to menstrual disorders that occur in 64.2% of women with CRF [4]. Uncontrolled HMB is a significant problem in subjects with chronic anemia due to renal disease as it leads to aggravation or worsening of the anemia.…”