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The current research aimed to explore the association of ultra-processed food consumption among college students with body composition, bowel movements, and menstrual irregularities with a focus on females. A cross-sectional study was conducted in Pune, India among 110 university students of both genders aged 18-25 years. A developed and validated Food Frequency Questionnaire (FFQ) based on the NOVA classification was used to evaluate UPF consumption, while the Constipation Scoring System (CSS) and the Premenstrual Symptoms Screening Tool assessed bowel habits and menstrual health, respectively. Anthropometric measurements, including BMI, body fat percentage,and visceral fat were recorded using an Omron Karada Analyzer. A higher percentage of participants were female (74.8%). Most participants (52.3%) consumed more than three meals daily, while 42.1% ate outside food 2-3 times per week. Higher UPF consumption showed a trend toward increased body fat (p = 0.053) and was significantly associated with greater visceral fat accumulation (p < 0.05). No significant associations were found between UPF intake and bowel movement, gastrointestinal symptoms, or menstrual cycle irregularities (p > 0.05). Higher UPF consumption showed a trend toward increased body fat percentage, though not statistically significant. These findings highlight the need to reduce UPF intake to mitigate potential risks of increased adiposity and metabolic disturbances.

Females with irregular or unpredictable cycles, including those with polycystic ovary syndrome (PCOS), have limited options for validated at-home ovulation prediction. The majority of over-the-counter ovulation prediction kits use urinary luteinizing hormone (LH) indicators that were optimized for those with regular menstrual cycles exhibiting a predictable mid-cycle LH surge. Artificial intelligence (AI) holds potential to address this health deficit via a smartphone-based salivary ferning ovulation test. Research on populations with irregular menstruation and PCOS can be challenging due to the duration and frequency of menstrual cycles. The objective of this study was to evaluate the feasibility for participants with diverse menstrual cycle lengths to complete study tasks designed to train and develop a potential future AI model for salivary ferning-based ovulation prediction. Participants were recruited for 2 menstrual cycles where retention, engagement, and adherence were evaluated. Participation entailed remotely collecting and uploading daily data (saliva, LH values), attending lab visits, and returning biological saliva samples. Of the 133 females recruited from February to October 2023 via targeted patient messages and a public research website, 69 (51.9%) were eligible (age 19-35 years at enrollment, currently menstruating, able to read and comprehend English, weigh more than 110 lb, have an active primary care or gynecological provider, and able to commute to the Massachusetts General Hospital (MGH) main campus within 10 days of their ovulatory event). Of the 43 (62.3%) eligible participants who consented and completed the baseline survey, the majority were White (n=24, 55.8%), employed (n=33, 76.7%), and highly educated (college or more; n=32, 74.4%) and had a mean BMI of 28.9 (SD 7.8) kg/m . Of those who received a study kit (n=29, 42%), 17 (58.6%) participants began data collection, 9 (31%) provided data for completed study tasks for 1 menstrual cycle, and 7 (24.1%) completed the study. Furthermore, 19 (44.2%) eligible participants who completed the baseline survey withdrew from the study, citing menstrual cycles being too irregular for the study timeline (n=5, 26.3%), becoming pregnant (n=4, 21.1%), moving outside the study area (n=4, 21.1%), no time to dedicate to the study (n=2, 10.5%), ineligibility (n=2, 10.5%), and stress related to observing anovulation (n=2, 10.5%). To optimize future scaled participant completion, the study design would include a more targeted recruitment message to address the high ineligibility status, streamline study procedures to ease the participant burden, and incorporate health education to equip participants with ovulatory health information to ameliorate the potential stress impacts of observing anovulation. After optimization, when scaled, this study design could provide an AI model with sufficient data to develop a smartphone-based ovulation predictor specifically tested on females with irregular or unpredictable cycles, including those with PCOS. A well-informed study design is the foundation to AI advancement and femtech (the technology sector focused on enhancing female health) growth, particularity for ovulatory and fertility digital health.

Background Irregular menstrual cycles including the length of cycles and menses, and heavy menstrual blood loss are linked to many gynaecological diseases. Obesity has been reported to be associated with irregular menstrual cycles. However, to date, most studies investigating this association are focused on adolescence or university students. Whether this association is also seen in adult women, especially women who had a history of birth has not been fully investigated. Methods Questionnaire data were collected from 1012 women aged 17 to 53 years. Data on age, weight and height, gravida, the length of menstrual cycles and menses, and the number of pads used during menses were collected. Factors associated with menstrual cycle according to BMI categories were analysed. Results There were no differences in the length of menstrual cycles and menses in women of different body mass index (BMI) groups. However, there was a significant difference in menstrual blood loss in women of different BMI categories. The odds ratio of having heavy menstrual blood loss in obese women was 2.28 (95% CL: 1.244, 4.193), compared to women with normal weight, while there was no difference in the odds ratio of having heavy menstrual blood loss in overweight, compared to normal weight, women. In contrast, the odds ratio of having heavy menstrual blood loss in underweight women was 0.4034 (95% CL: 0.224, 0.725), compared to women with normal weight. Conclusion Although BMI was not correlated with the length of menstrual cycle and menses, BMI is positively associated with menstrual blood loss. Our data suggest that BMI influences menstrual blood loss in women of reproductive age and weight control is important in women’s reproductive years.

Objectives In Japan, the prevalence of irregular menstrual cycles and its association with the frequency of night shifts have scarcely assessed. The present study aimed to evaluate the relationship between irregular menstrual cycles and the frequency of night shifts in Japanese female nurses. Methods We conducted a cross‐sectional web‐based self‐administered questionnaire survey in 2019. An irregular menstrual cycle was defined as a cycle length of ≤21 days or ≥39 days at least a few times over the past year or amenorrhea for at least 3 months. We used Poison regression analysis with a robust error variance to calculate the prevalence ratios adjusted for age, body mass index, hospital size, and the department in which they worked. Results A total of 1249 women were included, and 679 (54.4%) and 195 (15.6%) of them worked under two and three rotating shifts. The prevalence of irregular menstrual cycles was 24.8%, 37.4%, and 35.9% in the no night, two rotating, and three rotating shifts groups, respectively. While the frequency of night shifts had a dose‐responsive relationship with irregular menstrual cycles in the two rotating shifts group, it was not observed in the three rotating shifts group. However, the risk of work getting affected by dysmenorrhea or premenstrual symptoms increased in the three rotating shifts group. Conclusions Over 30% of Japanese female nurses working under night shifts had irregular menstrual cycles. The high frequency of night shifts increased the risk of irregular menstrual cycles and secondary amenorrhea in the two rotating shifts group.

Objectives: The study was aimed at evaluating the association between junk food consumption and BMI of adolescent girls along with the menstrual abnormalities and to compare it with controls. Methods: A cross-sectional study was conducted among 200 girls between 13 – 19 years of age at Bahria International Hospital, Lahore based on self-administered questionnaire from July 2021 to September 2021. The total subjects were divided in two groups Viz; Group-A which comprised of 100 girls with menstrual abnormalities and Group-B included 100 girls without menstrual problem (control group). The data recorded on the questionnaire about the demographic profile, anthropometric measurements, menstrual cycle characteristics, and dietary habits was subjected to statistical analysis using SPSS version 20 and Chi-Square was used to test quantitative significance between the two groups. Results: The mean age of participants was 17.02±1.76 years. It was observed that 40% girls had irregular menstrual cycle, 56% girls were suffering from dysmenorrhea and almost all girls of Group-I were suffering from premenstrual dysfunctions. The current study found a non-significant difference between two groups with regard to body mass index (P≥0.05). Significant difference was observed between two groups (P ≤ 0.05) as junk food consumption was high in Group-A as compared to Group-B. However, no significant difference was found between Group-A and B in relation to the consumption of salty snacks and frozen meat items (P≥0.05). Conclusion: The results suggested that junk food consumption affects menstrual cycle negatively however more studies are needed to confirm the association of BMI, consumption of salty snacks and frozen meat items with menstrual abnormalities. doi: https://doi.org/10.12669/pjms.38.8.6177 How to cite this:Latif S, Naz S, Ashraf S, Jafri SA. Junk food consumption in relation to menstrual abnormalities among adolescent girls: A comparative cross sectional study. Pak J Med Sci. 2022;38(8):---. doi: https://doi.org/10.12669/pjms.38.8.6177 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This cross-sectional survey aimed to determine the prevalence and characteristics of polycystic ovary syndrome (PCOS) and its isolated diagnostic features among Bangladeshi women aged 10-45 years, utilizing the 2023 International Evidence-Based Guidelines, incorporating anti-Mullerian hormone (AMH). From April-September 2024, 1201 females were sampled across eight divisions of Bangladesh using history, physical examinations, and blood collection. Total testosterone (TT) and AMH levels were assessed, with specific cut-offs established from a healthy control group. Thyroid dysfunction and hyperprolactinemia were excluded. Of 1201 participants, 403 were excluded. Among 798 eligible women, 38 (4.8%) had both irregular cycles and significant hirsutism, 75 (9.4%) had only significant hirsutism, 141 (17.7%) had only irregular cycles, and 544 (68.2%) had neither. After TT and AMH evaluation and excluding two hyperprolactinemia cases, a 6.9% (55/798) prevalence was found among 57 women with probable PCOS. Familial predisposition, unhealthy sleep behavior, and higher androgenic and metabolic features were observed in women with PCOS versus controls. Metabolic syndrome frequency was higher among adult PCOS (33.3% vs. 4.0%) than adolescent PCOS. The prevalence of PCOS among Bangladeshi women was 6.9%, with distinctive features compared to controls. Women with isolated diagnostic criteria require further evaluation and long-term follow-up.

Introduction: Irregular menstrual cycle has negative health and psychosocial repercussions for women of reproductive age worldwide. However, there is no national data for policymakers and health planners in Ethiopia. Therefore, this review aimed to determine the overall burden of irregular menstrual cycle and predictors among reproductive-age women in Ethiopia. Methods: International databases (SCOPUS, CINAHL, CAB Abstract, EMBASE, PubMed, Web of Science, Google, and Google Scholar) and lists of references were employed to search literature in Ethiopia. The random-effects model was used to calculate the odds ratios of the outcome variable using STATA version 18. The heterogeneity of the studies was measured by computing I2 and p-values. In addition, sensitivity analysis and funnel plots were performed to test the stability of pooled data in the presence of outliers and publication bias. Results: The review includes 21 studies and 9109 populations. The overall burden of irregular menstrual cycles among reproductive-age women was 35% (95% CI: 30–41) with I2 = 96.96%. Sleeping for <5 h a day (AOR: 2.49; 95% CI: 1.49–3.49) and a stressful life (AOR: 3.15; 95% CI: 1.44–4.85) were predictors of irregular menstrual cycles. Conclusion: More than one in every three reproductive-age women in Ethiopia experience irregular menstrual cycles. Sleeping for <5 h a day and stress increase the likelihood of an irregular menstrual cycle, which can be modified by improving sleeping hours and decreasing stress stimulators through psychotherapy.

Ovarian steroid cell tumors are a rare subtype of sex‐cord stromal cell tumors. Overall, these tumors make <0.1% of all ovarian tumors. These neoplasms can be divided according to the cell of origin into stromal luteomas, Leydig cell tumors, and steroid cell tumors not otherwise specified. These tumors can be benign, malignant, or borderline, with variable presentation. We report a case of 24‐year‐old virgin female who was referred to our hospital after being diagnosed with steroid cell tumor‐not otherwise specified. Prior to her admission, the patient had been treated unsuccessfully with oral contraceptive pills due to male‐pattern facial hair growth, abdominal cramps, and irregular menstrual cycle. Lack of improvement warranted further investigations. Hormonal studies showed an elevated total testosterone, dehydroepiandrosterone sulfate, and morning fasting cortisol. Ultrasonography and computed tomography confirmed the presence of a large pelvic mass with mixed solid and cystic component. Therefore, unilateral salpingo‐oophorectomy was performed. Pathological and immunohistochemical examination suggested the presence of a large ovarian steroid cell tumor‐not otherwise specified with malignant behavior. The patient did not receive adjuvant therapy and developed metastatic disease. She received four cycles of BEP protocol with no improvement, so she was referred to our center to continue oncological management. Case revision confirmed the presence of steroid cell tumor, but of a different subtype: Leydig cell. She received six cycles of carboplatin‐paclitaxel, but her assessment showed disease progression. We report this case with review of literature regarding the appropriate approach to these rare tumors. Although rare, ovarian steroid cell tumors should be included in the differential diagnosis of virilization in young females, especially those refractory to hormonal therapy. In our study, we aimed to present the first reported Palestinian case, which highlights the importance of detailed morphological examination in addition to the difficulties encountered to reach a proper diagnosis. We also provided a review of the existing literature regarding chemotherapeutic lines used in such cases and the response to each. Although rare; ovarian steroid cell tumors should be included in the differential diagnosis of virilization in young females, especially those refractory to hormonal therapy.

Background and objectives Polycystic ovary syndrome (PCOS) is a common endocrine disorder with heterogeneous aetiology. It is characterized by irregular menses and or oligo/anovulation, hyper-androgenism, and polycystic ovaries. The prevalence and diagnosis of PCOS changes depending on which clinical criteria are utilized to confirm the diagnosis. The prevalence can be high as 8–13% when the Rotterdam criteria are used. However, there is significant inter-individual variation in presentation. We have studied the socio-demographic and clinical characteristics of PCOS patients attending the Endocrinology clinic in a tertiary care institute in Sri Lanka. Methods A descriptive cross sectional study was conducted from September 2019 to September 2020 at the Endocrinology Unit of the National Hospital of Sri Lanka. All the patients who met the inclusion and exclusion criteria and who has a diagnosis of PCOS made according to Rotterdam criteria were recruited in to the study. After obtaining informed written consent, the data was collected using an interviewer administered questionnaire. HOMA-IR was calculated using the fasting insulin and blood glucose level. Results The study enrolled sixty females. The mean age was 26.7 years (range 18–44). The mean weight was 64.8 (SD = 11.9) kg and BMI was 27.1 (SD = 4.8) kg/m −2 . According to Asian BMI cut-offs, 1 (1.7%) patient was underweight and 13 (21.7%) had normal weight. Forty six (76.7%) had their weight in the overweight or obese category. Fifty four (90.0%) patients had clinical or biochemical evidence of hyperandrogenism while 24 (40%) had polycystic ovaries on trans-abdominal ultrasound scan and 50 (83.3%) had irregular menstrual cycles. According to the body fat percentage assessed by the whole body DEXA scan 4.1% normal body fat, while 50.0% and 45.8% had overweight and obesity respectively. HOMA-IR detected 61.1% to have high insulin resistance. Out of the patients who had USS of the abdomen 27.5% had co-existent non-alcoholic fatty liver. Fifty four percent of the patients had sub/infertility. Conclusions The majority of the population were overweight or obese and had higher prevalence of insulin resistance and non-alcoholic fatty liver. Out of the clinical characteristics used to make the diagnosis of PCOS, the presence of clinical or biochemical evidence of hyperandrogenism and irregular menstrual cycles are more common than the detection of polycystic ovaries on trans-vaginal USS. The higher prevalence of overweight, obesity, insulin resistance and NAFLD associated with PCOS makes the diagnosis and management of the disease crucial to prevent long term consequences of the disease.

Background Acromegaly is a disease of growth hormone excess that results in enlargement of extremities, abnormal glucose and lipid metabolism, and gonadal disruption. Manifestations of the disease are insidious and typically lead to a diagnostic delay of 7–10 years. Classically the polycystic ovary syndrome (PCOS) phenotype is described in women with irregular menses, clinical or biochemical evidence of androgen excess, and/or multiple ovarian follicles on pelvic ultrasonography. Women with acromegaly may present with some or all of these symptoms. Our objective was to evaluate the prevalence of PCOS in patients with acromegaly and to determine if diagnosis of PCOS results in a delay in diagnosing acromegaly. Methods Using patient databases at two academic health centers, we identified 97 premenopausal women aged 18–49 years old presenting with acromegaly. Data were collected regarding pelvic sonography and reproductive history, including the diagnosis of PCOS. Patients carrying the diagnosis of PCOS before their diagnosis of acromegaly were identified and the remaining patients were screened using the Rotterdam criteria to identify additional patients meeting the criteria for PCOS prior to their diagnosis of acromegaly. Results Mean age of the population ( n  = 97) at the time of diagnosis of acromegaly was 33.4 ± 7.5 years (SD). Thirty-three percent of patients ( n  = 32) either carried a diagnosis of PCOS or met diagnostic criteria for PCOS before their diagnosis of acromegaly. In the subset of patients in whom data on symptom onset were available, those who met criteria for PCOS were diagnosed with acromegaly a median of 5 years [4, 9] after the onset of symptoms compared to 2 years [0.92, 3] ( p  =  0.006) in the patients who did not meet criteria for PCOS. Conclusions Our data demonstrate a high prevalence of signs and symptoms of PCOS in reproductive-aged women with acromegaly and a longer time to diagnosis in women who meet the clinical criteria for PCOS. As screening for acromegaly is relatively simple and done with measurement of a random, non-fasting IGF-1 level that can be drawn at any time during the menstrual cycle, screening patients with PCOS for acromegaly may lessen the delay in diagnosis for reproductive-aged women with this disease.