Prospective follow‐up of menstrual disorders in adolescence and prognostic factors

Wiksten-Almströmer, Marianne; Hirschberg, Angelica Lindén; Hagenfeldt, Kerstin

doi:10.1080/00016340802478166

Cited by 66 publications

(35 citation statements)

References 14 publications

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“…In fact, the same criteria (anovulation, hyperandrogenism and polycystic ovaries) that in adults are used for diagnosis, in adolescents may be transitory or in evolution 21-23 . According to previous suggestions 15 , to overcome errors in diagnosis only subjects after at least 2 years from the menarche were considered.…”

Section: Discussionmentioning

confidence: 99%

Adolescents with Classical Polycystic Ovary Syndrome Have Alterations in the Surrogate Markers of Cardiovascular Disease but Not in the Endothelial Function. The Possible Benefits of Metformin

Fruzzetti

Ghiadoni

Virdis

et al. 2016

Journal of Pediatric and Adolescent Gynecology

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Study Objective To study whether adolescents with the classical form of polycystic ovary syndrome have alterations in metabolic and vascular structure and function. The effect of metformin was evaluated. Design Controlled study Setting University outpatient clinic Participants Eighteen PCOS non obese adolescents were enrolled. Seventeen healthy age-matched adolescents were recruited as controls. Interventions The metabolic profile and the endothelial structure and function were evaluated. Main Outcome Measure(s) Hormonal and lipid profile, blood pressure (BP) measurement, fasting glucose and insulin levels, C-reactive protein (CRP), homocysteine, tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and plasmin-antiplasmin complexes (PAP) were measured. Flow mediated dilation (FMD), central pulse wave velocity (PWV), radial artery pulse wave (AIx) and common carotid intima-media thickness (IMT) were also assessed. PCOS girls were also studied 6 months after treatment with metformin (850 mg bid). Results PCOS adolescents were insulin resistant and/or hyperinsulinemic and they had higher BP values and levels of CRP and PAI-1 than the controls. The levels of t-PA and PAP were similar in both groups. FMD, PWV and IMT were also similar. Metformin significantly (p<0.05) reduced insulin, BP, CRP and PAI-1 levels. The PAP levels significantly (p<0.05) increased. Radial AIx was significantly reduced after metformin. No modifications in FMD, PWV and IMT were observed. Conclusions Adolescents with classical PCOS have alterations in some surrogate markers of cardiovascular risk and they are ameliorated by metformin. No deterioration of vascular structure and function has been detected, probably due to the short duration of exposure to the disease.

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Section: Discussionmentioning

confidence: 99%

Adolescents with Classical Polycystic Ovary Syndrome Have Alterations in the Surrogate Markers of Cardiovascular Disease but Not in the Endothelial Function. The Possible Benefits of Metformin

Fruzzetti

Ghiadoni

Virdis

et al. 2016

Journal of Pediatric and Adolescent Gynecology

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“…These data, like earlier studies on variation in menstrual cycle length, indicate that complete maturation of the hypothalamic-pituitary-ovarian axis can take up to 5 years after menarche [64][65][66][67] . Despite the view that irregular menstrual cycles in the first 5 years are not a reason for clinical concern, more recent studies report that regular menstrual patterns can in fact be established within 6-12 months of menarche [68][69][70] . Indeed, after 6 years of follow-up, 59% of the adolescents who had presented with oligomenorrhea at the beginning of the study remained oligomenorrheic and fulfilled the criteria for PCOS [70] .…”

Section: Question 3: What Are the Criteria For Evidence Of Oligo-anovmentioning

confidence: 99%

“…The challenge for the clinician is the differentiation of adolescents with 'physiological adolescent anovulation' from those with true ovulatory dysfunction, particularly because evidence suggests that symptoms of PCOS can appear in the first years after menarche [70,78] . Thus, the persistence of menstrual irregularities appears to be a good indicator of the possible underlying pathology with acknowledgement that the definition of persistence differs among experts.…”

Section: Question 3: What Are the Criteria For Evidence Of Oligo-anovmentioning

confidence: 99%

The Diagnosis of Polycystic Ovary Syndrome during Adolescence

et al. 2015

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dress a series of questions regarding the diagnosis of PCOS during adolescence including the following: clinical and biochemical evidence of hyperandrogenism, criteria for oligoanovulation and polycystic ovary morphology, diagnostic criteria to exclude other causes of hyperandrogenism and amenorrhea, role of insulin resistance, and intervention. Results and Conclusion: Features of PCOS overlap normal pubertal development. Hence, caution should be taken before diagnosing PCOS without longitudinal evaluation. However, treatment may be indicated even in the absence of a definitive diagnosis. While obesity, insulin resistance, and hyperinsulinemia are common findings in adolescents with hyperandrogenism, these features should not be used to diagnose PCOS among adolescent girls. © 2015 S. Karger AG, Basel Key WordsHyperandrogenism · Ovarian hyperandrogenism · Ovary · Polycystic ovary syndrome · Puberty Abstract Background/Aims: The diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescence are controversial, primarily because the diagnostic pathological features used in adult women may be normal pubertal physiological events. Hence, international pediatric and adolescent specialty societies have defined criteria that have sufficient evidence to be used for the diagnosis of PCOS in adolescents. Methods: The literature has been reviewed and evidence graded to ad-

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“…If an adolescent experienced menstrual bleeding in equal intervals between 21 and 35 days, it was evaluated as regular menstruation (normal); if the menstruation interval was less than 21 days, it was considered to be short; if the menstruation interval was more than 35 days, it was considered to be long. Menstruation of less than 2 days was accepted as short, between 2 and 7 days as normal, and more than 8 days as long [26,27]. …”

Section: Methodsmentioning

confidence: 99%

Review of Frequency of Dysmenorrhea and Some Associated Factors and Evaluation of the Relationship between Dysmenorrhea and Sleep Quality in University Students

Şahin

Özdemir²,

Ünsal³

et al. 2014

Gynecol Obstet Invest

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Objective: To determine the frequency of dysmenorrhea in university students, review some associated factors and evaluate the relationship between dysmenorrhea and sleep quality. Material and Methods: The study group included 520 students. Survey forms prepared previously in line with the study objective were completed by the students under supervision. The severity of dysmenorrhea was rated with Visual Analogue Scale. Pittsburgh Sleep Quality Index was used to evaluate the sleep quality. The χ² test, Mann-Whitney U test and Kruskal-Wallis test were used for the analyses. Statistical significance level was accepted at p < 0.05. Results: Mean age of the students was 20.23 ± 1.59 years (range 17-25). Frequency of dysmenorrhea was determined to be 69.0% (n = 359). Frequency of dysmenorrhea was higher in smokers, those with menstrual irregularity, those who use drugs for menstrual regulation and those having a family history (p < 0.05 for each). The most frequent symptoms in those having dysmenorrhea history were weakness (59.6%), fatigue (58.5%) and breast tenderness (45.4%), respectively. Sleep quality was found to be poorer in the students having a history of dysmenorrhea (p < 0.05). Conclusions: Dysmenorrhea is an important health problem in young women. Dysmenorrhea affects the sleep quality negatively.

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Prospective follow‐up of menstrual disorders in adolescence and prognostic factors

Cited by 66 publications

References 14 publications

Adolescents with Classical Polycystic Ovary Syndrome Have Alterations in the Surrogate Markers of Cardiovascular Disease but Not in the Endothelial Function. The Possible Benefits of Metformin

Adolescents with Classical Polycystic Ovary Syndrome Have Alterations in the Surrogate Markers of Cardiovascular Disease but Not in the Endothelial Function. The Possible Benefits of Metformin

The Diagnosis of Polycystic Ovary Syndrome during Adolescence

Review of Frequency of Dysmenorrhea and Some Associated Factors and Evaluation of the Relationship between Dysmenorrhea and Sleep Quality in University Students

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