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Background: Coronavirus 2019 (COVID-19) has affected almost all communities throughout the world. It affects different systems in the body, which causes irreparable consequences. Objective: This study aimed to investigate the effect of the COVID-19 virus on menstrual disorders, anti-Mullerian hormone (AMH), thyroid peroxidase (TPO), thyroid stimulating hormone (TSH), and prolactin levels in women with COVID-19 disease. Materials and Methods: This prospective cohort study was conducted on 201 women (101 healthy, and 100 women with COVID-19) in Nomadic hospital, Khorramabad, Iran from February-October 2021. After recovery from COVID-19, participants were interviewed about their menstrual cycle in their 1st and 4th months. Blood samples were collected during 1st and 4th months, and AMH, TSH, TPO, and prolactin levels were assessed. Results: No significant differences were observed in the 1st and 4th months regarding menstrual disorders, TPO, and prolactin levels in the patient group (p > 0.05). The mean level of AMH in the healthy group was higher than the patient group in both times (p < 0.001). A relationship between TSH and COVID-19 was observed in the 1st month (p < 0.001); however, no significant relationship was observed in the 4th month, in this regard. Conclusion: Endocrine dysfunction in the form of low AMH and high TSH were common among COVID-19 patients. Due to the importance of menstrual and hormonal disorders, especially AMH and TSH, and their association with COVID-19, health policymakers should find appropriate solutions to reduce complications.  

Dysmenorrhea is a common symptom secondary to various gynecological disorders, but it is also represented in most women as a primary form of disease. Pain associated with dysmenorrhea is caused by hypersecretion of prostaglandins and an increased uterine contractility. The primary dysmenorrhea is quite frequent in young women and remains with a good prognosis, even though it is associated with low quality of life. The secondary forms of dysmenorrhea are associated with endometriosis and adenomyosis and may represent the key symptom. The diagnosis is suspected on the basis of the clinical history and the physical examination and can be confirmed by ultrasound, which is very useful to exclude some secondary causes of dysmenorrhea, such as endometriosis and adenomyosis. The treatment options include non-steroidal anti-inflammatory drugs alone or combined with oral contraceptives or progestins.

Premature ovarian failure (POF) is the term usually used to describe women aged younger than 40 years, who present with amenorrhoea, hypergonadotropic hypogonadism, and infertility. POF is a devastating diagnosis for reproductive-aged women. The clinical presentation is diverse, and several different disorders can lead to premature ovarian failure. POF has serious health consequences, including psychological distress, infertility, osteoporosis, autoimmune disorders, ischaemic heart disease, and increased risk of mortality. Hashimoto's disease is the most frequent autoimmune disorder associated with premature ovarian failure. Management should be initiated immediately to prevent long-term consequences. Oestrogen therapy is the mainstay of management. Hormone therapy should be provided to eliminate symptoms of oestrogen deficiency.

The aim of this study was to rapidly review the literature on the prevalence of menstrual disorders in female athletes from different sports modalities. Articles were searched in the Web of Science and PubMed database in May 2022. A total of 1309 records were identified, and 48 studies were included in the final stage. The menstrual disorders described in the included studies were primary (in 33% of included studies) and secondary amenorrhea (in 73% of included studies) and oligomenorrhea (in 69% of included studies). The prevalence of menstrual disorders among the studies ranged from 0 to 61%. When data were pooled according to discipline (mean calculation), the highest prevalence of primary amenorrhea was found in rhythmic gymnastics (25%), soccer (20%) and swimming (19%); for secondary amenorrhea in cycling (56%), triathlon (40%) and rhythmic gymnastics (31%); and oligomenorrhea in boxing (55%), rhythmic gymnastics (44%) and artistic gymnastics (32%). Based on the results of this review, the study supports the literature of the higher prevalence of menstrual disorders in gymnastics and endurance disciplines. However, team sports modalities such as volleyball and soccer also presented a considerable percentage of menstrual disorders compared to the general population. It reinforces the importance of coaches and physicians paying attention to athletes’ menstrual cycle as the occurrence of menstrual disorders can be associated with impairment on some health components.

In the United States, adolescents suffer from inadequate menstrual health, meaning that adolescents are unprepared for menarche, lack the practical resources they need to comfortably and confidently manage menstruation, and receive inadequate health education and care for menstrual pain and disorders. In this article, we provide a historical analysis of the role of school nurses in addressing menstruation from the early 20th century up to the present day. We contextualize the current realities of school nursing and menstrual health education and clinical support. We argue that the decentralized US school system, a cultural aversion to open discussion about menstruation, and the outsized influence of commercial menstrual product manufacturers have hampered the ability of school nurses to deliver menstrual health education along with menstrual health support. Finally, we discuss implications for today's schooling experiences as well as recommendations for how to support school nurses in aligning our national approach to menstrual health toward the public health perspective of menstrual equity.

A growing number of women of reproductive age experience menstrual disorders. The menstrual cycle is considerably influenced by dietary habits, physical activity, and the use of stimulants. The main aim of this study was to assess women’s knowledge about the menstrual cycle and the influence of diet and lifestyle factors on menstrual symptoms, and to identify dietary models that may alleviate or exacerbate menstrual distress. A total of 505 young women participated in the study. Nearly 90% of the respondents reported at least one menstrual disorder, mostly dysmenorrhea (70.7%), whereas secondary amenorrhea was least frequently reported (13.8%) (p = 0.002). In the study population, dysmenorrhea/menstrual distress was linked with higher consumption frequency of certain food groups. Women with severe dysmenorrhea consumed refined cereal products, processed meat, sugar, and water significantly more frequently than women with moderate menstrual pain. In turn, sweetened dairy products, animal fats, and fruit were consumed more frequently by women with low intensity of menstrual pain (mild pain). Significant differences in knowledge about the menstrual cycle and physiological changes in the body were observed between the compared dietary models.

Abstract Background In public health, disease prevention targets are often decided based on expert opinion and short-term needs, rather than systematic, data-driven criteria. Few studies have proposed how to set disease prevention targets. Therefore, we propose the Flow Disruption Model to identify prevention target diseases using the disease progression network. Methods We first developed the statistically significant disease progression network using South Korea's National Health Insurance (NHIS) claims data (∼50M patients), where disease transitions are represented as directed edges weighted by attributable risk (AR). Using this network, we developed the Flow Disruption Model (FDM) to select prevention priority target diseases. The FDM quantifies how preventive interventions at specific disease-focused on primary and secondary/tertiary prevention by reducing in-/out-transitions-can reduce subsequent risk across the disease network. Priorities were assigned to diseases that most reduced cumulative subsequent risk. The model was applied as an example to identify priority prevention targets for reducing dementia incidence in women in their 70s. Results We identified prevention targets based on 208,869 disease pathways leading to dementia in women in their 70s. In the first round, secondary/tertiary prevention targeted degenerative nervous system diseases, menstrual disorders, and symptomatic mental disorders (50s). In the second round, cerebral palsy (70s) was targeted by secondary/tertiary prevention, and mood disorders (60s) by both. In the final round, polyneuropathies (70s) were targeted by both, and oedema (60s) by primary prevention. Conclusions The FDM identifies high-impact prevention targets for reducing the incidence of a specific disease. By quantifying the impact of prevention strategies, it provides insights to guide early prevention, optimize resource allocation and support evidence-based public health planning. Key messages • We developed the Flow Disruption Model to identify prevention targets where intervention can most effectively reduce the incidence of specific diseases within the population-level disease network. • Our model quantifies the impact of prevention strategies for reducing specific disease incidence, supporting data-driven selection of priority targets for early intervention/public health planning.

Menstrual irregularity is a common health concern among female adolescents, with potential impacts on their family life, social participation, academic performance, and overall well-being. Therefore, this study aims to assess the prevalence of menstrual irregularity and identify its associated factors among female high school students in the region. A multicenter, facility-based cross-sectional study was conducted among 714 female students from 11 high schools, selected using a multistage sampling technique. Data were collected through a pre-tested, self-administered questionnaire, entered into EpiData version 4.6, and analyzed using statistical package for the social sciences version 26. Descriptive statistics were used to summarize participant characteristics. Binary logistic regression was performed to assess the association between independent variables and menstrual irregularity, with crude odds ratios and 95% confidence intervals. Variables with a p value < 0.25 in the bivariable analysis were included in a multivariable logistic regression model. Model fitness was assessed using the Hosmer-Lemeshow goodness-of-fit test, and multicollinearity was evaluated using variance inflation factor (VIF) and tolerance tests. Statistical significance was determined at p  < 0.05. The prevalence of menstrual irregularity was 29.10% (95% CI 25.90%–32.50%). Significant factors associated with menstrual irregularity included: age 18–19 years [AOR 3.08, 95% CI 1.15–8.28], early menarche (≤ 12 years) [AOR 2.60, 95% CI 1.45–4.67], sleeping ≤ 5 h per night [AOR 3.65, 95% CI 1.02–13.09], perceived moderate stress [AOR 2.04, 95% CI 1.05–3.98], and perceived high stress [AOR 3.52, 95% CI 1.60–7.76]. The prevalence of menstrual irregularity in this study was lower than that observed in previous studies. Significant factors associated with menstrual irregularity included age, early menarche, insufficient sleep, and high stress levels. It is recommended that school-based health education and stress management programs be strengthened to help reduce menstrual irregularities among female students

Menstrual problems are usually taboo; and often, some, such as dysmenorrhea, are presumed normal. This study seeks to compare the menstrual characteristics and symptoms of female university students reporting self-perceived normality concerning their cycles and menstruation with those who perceive their menstruation as being abnormal. A cross-sectional descriptive study was conducted among 270 nursing students using a self-report questionnaire that included sociodemographic and gynecological issues, together with Visual Analog Scale, the Andersch and Milsom Scale, and the Spanish version of the EuroQol-5 Dimension (EuroQol-5D) to measure self-perceived health status. A bivariate analysis was performed using the chi-square test, linear trend chi-square, and Student’s t-test, and a multivariate analysis of stepwise binary logistic regression was performed to predict the perception of cycle abnormality. In total, 77.4% of participants displayed normality; however, in self-reporting of menstrual characteristics, 67.4% identified alterations. Young women suffering from menstrual dizziness were 1.997 (CI95% = 1.010–3.950; p = 0.047) more likely to manifest abnormal menstruation, 4.518 (CI95% = 1.239–16.477; p = 0.022) more likely if they suffered from Grade 3 menstrual pain, and 2.851 (CI95% = 1.399–5.809; p = 0.004) more likely if they perceived that menstruation interfered with their daily lives. Many menstrual changes and symptoms are still considered normal, making it difficult to identify and address these issues. Therefore, it is necessary to develop health policies and strategies to improve menstrual health literacy for increased knowledge and earlier diagnosis.

The female athlete triad (TRIAD) is a spectrum of disorders involving low energy availability (LEA), low bone mineral density, and menstrual disorders. It is increasingly common to use the term ‘relative energy deficiency in sport’ (RED), emphasising the extensive impact of LEA on the body. The aim of this narrative review was to gather original research encompassing female athletes across various sports as well as to collect findings on the potential of a nutrition-focused approach to prevent or treat the aforementioned disorders. A comprehensive search was conducted in PubMed and Scopus. Several challenges were identified regarding the adequacy of the energy availability, protein, and carbohydrate requirements in the diets of female athletes. Moreover, insufficient intake of vitamin D has been observed across all athlete groups studied. This insufficiency also extends to the average requirement for Ca, Mg, the Ca/P ratio, Zn, and Fe. To address those concerns, a nutritional approach is proposed in the latter part of this review. The factors that can improve the absorption of micronutrients have also been discussed. The TRIAD/REDs affect an ever-growing number of women and require appropriate therapeutic management, particularly through nutritional care. Therefore, cooperation within an interdisciplinary team comprising a physician, nutritionist, physiotherapist, and psychologist is crucial.