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A shocking, illuminating and moving account of how women around the world are shattering the taboos around menstruation.

Abstract Introduction Laboratory errors related to interfering substances can cause significant morbidity related to unnecessary investigations and interventions and patient anxiety. Estradiol (E2) is quantified mainly with competitive immunoassays. The prevalence of analytical interference can be up to 6% and is due to the impairment of the interaction between test antibody and analyte, causing falsely elevated levels. Nevertheless, interference due to heterophile antibody is extremely rare. Clinical Case A 51-year-old woman, normal weight, nulliparous, irrelevant previous medical history, menarche at 12 years old and regular menstrual cycles, was referred to the Endocrinology Department due to elevated E2 level. She was followed 4 years before in another institution with no formal diagnosis complaining of severe vasomotor symptoms, vaginal dryness and menometrorrhagias. She was on combined oral contraceptives for 10 years as a method of contraception, which she stopped two years ago. The first two E2 random values were 2362 and 3121 pmol/L, respectively when she had 47 and 49 years old. During our evaluation in January 2021, at the age of 51 years old, in the 4th day of her menstrual cycle, the laboratory evaluation revealed: FSH 9.56 mUI/mL (2.5-10.2), LH 5.43 mUI/mL (1.9-12.5), Prolactin 18.12 ng/mL (2.8-29.2), E2 3530.51 pmol/L (71.6-529.2), 17-Hydroxiprogesterone 0.52 ng/mL (0.32-1.47), DHEA-SO4 75.9 ug/dL (35-430), 4-Androstenedione 1 ng/mL (0.3-3.3) and SHBG 137 nmol/L (18-144). Transvaginal pelvic ultrasonography performed 15 days after menstrual period revealed 2 subserous leiomyomas, a 12 mm endometrial line and a right ovary with a pre-ovulatory follicle. CT scan of adrenal glands was unremarkable and a sellar MRI revealed a 4mm area of hypocaptation in the left region of the adenohypophysis. During this period the patient was treated with escitalopram 10 mg od, with vasomotor symptoms improvement. Two years later, after a 6-month period of amenorrhea, she repeated the analytical evaluation that revealed raised gonadotropins levels (FSH 102.12 mUI/mL, LH 25.37 mUI/mL), low progesterone 0.91 mUI/mL (< 4.45) but maintained a largely elevated estradiol level (1128.01 pmol/L) with undetectable free Estriol (< 0.10 ng/mL). This pattern motivated laboratorial review of blood samples by mass spectrometry and not by chemiluminescence as before. The value was substantially lower (447 pmol/L) hypothesizing the presence of heterophilic antibodies. Conclusion Although false E2 elevation due to analytical interference is rare, it must be suspected when results are discordant with the clinical picture and there is no evidence of neoplastic disease. Here, we report a case of falsely elevated E2 that led to prolonged investigation and major impact on a female's quality of life during the challenging period of perimenopause.

\"Your period. What is it, really? And why is it so embarrassing to walk to the bathroom hiding a tampon in your sleeve? Comedian and Scandinavian YouTube sensation Clara Henry has the answers to all your burning questions about bleeding. Have you always wondered what menstruation is, why it causes terrible cramps, or why it makes you want to do nothing but eat chocolate and watch cute cat videos? Have you been shocked that it's taboo to talk about something that half the world's population goes through every month? And above all, have you been looking for the best snarky response to the question \"Are you on your period, or what?\" Whether you're expecting your first period, have already gotten it, or know someone close to you who's just begun the torment, this funny and informative book will tell you everything you need to know. In a funny, powerful, and entertaining voice, this book covers important terms, types of sanitary protection, and the history of menstruation and women's fight for equal access to reproductive healthcare. And if you suddenly find yourself hankering for chocolate or cute animals? Well. Welcome to the period club\"-- Provided by publisher.

Objectives: To evaluate of the indications requiring surgical treatment after Levonorgestrel-Releasing Intrauterine System (LNG-IUS) (Mirena®) treatment due to heavy menstrual bleeding. Methods: This retrospectively designed study was created with 72 patients who applied to the university hospital gynecology outpatient clinics between January 2018 and April 2019 and were diagnosed with heavy menstrual bleeding and received LNG IUS (Mirena®) for treatment. Results: Surgery was not performed in 60 (83.33%) patients who had heavy menstrual bleeding and underlying organic pathology (FIGO-PALM group) These patients were treated with LNG-IUS. However, in 12 (16.67%) patients, LNG-IUS was removed and surgery was performed due to resistance to treatment within an average of 10.2 ± 8.0 months. There was no difference between the groups in terms of age, gravida, parity, body mass index and endometrial thickness p > 0.05 for all parameters), but the mean hemoglobin value in the surgical group was found to be significantly lower than the group without it (8.9 ± 1.2 g/dL vs 11 ± 1.6 g/dL, p = 0.03) In the surgical group, the median diameters of leiomyoma and myoma compressing the endometrium were found to be significantly higher (44 mm vs 34 mm, p = 0.03 and 42 mm vs 33 mm, p = 0.04; respectively). Conclusions: LNG-IUS (Mirena®) is a popular and effective treatment option for heavy menstrual bleeding. The necessity of surgical treatment due to resistance to LNG-IUS revealed that the underlying organic pathologies in these patients should be determined precisely and effective treatment options should be carefully selected before LNG-IUS is inserted.

Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. Menopause means permanent cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity. It is the point of time when last and final menstruation oocurs. Autogenic relaxation technique also known as relaxation training is any method, process, or activity that helps a person relax. The aim of the study to evaluate the effectiveness of autogenic relaxation technique on depression among menopausal women admitted to saveetha medical college and hospital. A quantitative approach with experimental research design was adopted for the present study. 60 samples were selected by using simple random sampling techniques. A self structured questionnaire method was used to collect the demographic data. Among 60 participants 30 in the experimental group and 30 in the control group of menopausal women.

\"In this collection, writers of various ages and across racial, cultural, and gender identities share stories about the period. Each of [the] twelve authors brings an individual perspective and sensibility. They write about homeless periods, nonexistent periods, male periods, political periods, and more\"--Front flap.

A guide for pre-adolescent girls to the changes that puberty brings to their bodies, including information about menstruation.