OBJECTIVE: To examine the likelihood of self-reporting a diagnosis for PCOS with the presentation of menstrual irregularity in a diverse, multiethnic population, based on data collected between August 9th, 2017 and October 24th, 2017 for the pilot of the Ovulation and Menstruation (OM) Study at Boston University School of Medicine. BACKGROUND: Polycystic ovary syndrome, or PCOS, is the most common endocrine disorder among reproductive age women. It is typically diagnosed by variable combinations of menstrual irregularity, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound. An alternative is its diagnosis as one of exclusion due to similarities in presentation to other endocrine disorders. As a result, PCOS may often be misdiagnosed and mismanaged in the course of a patient’s care, further exacerbated by a poor understanding of the syndrome, a lack of easily available resources, and patient frustration with clinician interactions. The early identification of key hallmarks of the disorder, such as menstrual irregularity, and awareness of its linkage to PCOS, could lead to early diagnosis and intervention. METHODS: 248 participants enrolled and participated in the Ovulation and Menstruation (OM) Health Study’s as members of its pilot cohort. Inclusion criteria were women ages 18-45 currently experiencing menstrual periods without a history of chemotherapy, radiation, or surgical menopause. Participants completed the relevant sections of the OM Study survey related to demographics, menstrual cycle patterns, and history of PCOS. Demographic questions pertained to the age, race/ethnicity, country of birth, and education levels of the participants. The menstrual cycle questions provided information regarding the age of menarche, length and pattern of menses and the menstrual cycle overall. The questions regarding history of PCOS ascertained the presence of an official or self-diagnosis for PCOS for the participant, and the age at which this was determined. The descriptive measures were presented for comparison before determining the concurrence of the presence of menstrual irregularity and the diagnosis of PCOS across demographic categories and calculating an associated prevalence ratio. RESULTS: Among women reporting a history of menstrual irregularity for 3 months or greater, PCOS was the second-highest self-reported cause for menstrual irregularity, with 20.7% of participants endorsing it as the cause for their irregularity. The presence of menstrual irregularity for 3 or more months was also more likely to be present in concurrence with a clinician diagnosis, or to a lesser extent, a self-diagnosis, for PCOS. Participants were also far more likely to have a clinician diagnosis for PCOS if they were White, US-born, young, or educated. The same applied for the likelihood of a self-diagnosis with the exception of age. CONCLUSIONS: The association between menstrual cycle irregularities and likelihood of being diagnosed with PCOS is supported by the data and appears to be influenced by demographic factors such as race/ethnicity, age, and education.

Abstract Oligomenorrhea (menstrual disturbances) and hirsutism (excessive growth of body hair) are typical symptoms of polycystic ovary syndrome, a common endocrine disorder with long-term health risks among fertile-age women. Associations between body size development and polycystic ovary syndrome symptoms in a cohort design (528 symptomatic and 1479 asymptomatic women) and endocrine, metabolic and clinical characteristics of women with self-reported symptoms of oligomenorrhea or hirsutism in a nested case-control design (518 cases and 1036 controls) were investigated in this general population-based study. Gynecologic ultrasonographic examinations were performed in 196 cases and 67 controls to assess the morphology of the ovaries and its relationship to biochemical and clinical parameters. The study population was derived from the Northern Finland Birth Cohort 1966, which included all births with expected birth dates in 1966 in Northern Finland and is well representative of the general female population. Polycystic ovary syndrome symptoms in adulthood were associated with obesity, particularly abdominal obesity, in adolescence and in adulthood, but not with birth weight or being small for gestational age. Hormonal changes typical of polycystic ovary syndrome, i.e. higher circulating concentrations of testosterone, luteinizing hormone (LH) and insulin and lower levels of sex hormone-binding globulin (SHBG), were detected in women with self-reported symptoms of oligomenorrhea and/or hirsutism compared with the controls. Less favorable metabolic cardiovascular disease risk factor profiles, higher body mass index (BMI), waist-hip ratio (WHR), and triglyceride and C-reactive protein (CRP) concentrations and lower high density lipoprotein cholesterol (HDL-C) levels, were detected in women with symptoms, being the most severe among women who reported both hirsutism and oligomenorrhea. Unfavorable characteristics were pronounced in the presence of overweight or obesity. Women with symptoms more often had features characteristic of polycystic ovarian morphology associated with an endocrine and clinical profile reflecting polycystic ovary syndrome. This study shows that questioning in regard to symptoms of oligomenorrhea and hirsutism is useful in detecting women at risk of polycystic ovary syndrome and associated health risks. Avoidance of being overweight is important among young women to prevent the development of insulin resistance. Systematic follow-up of women with symptoms of oligomenorrhea and hirsutism is justified for prevention and early detection of long-term health risks.

No description available.

Introduktion: Många kvinnor påverkas negativt av fysiska och psykiska besvär under sin menstruationscykel. Det råder idag stor kunskapsbrist om hur subkliniska menstruella besvär som kraftig menstruationssmärta, riklig menstruationsblödning, premenstruellt syndrom, premenstruellt dysforiskt syndrom, oregelbunden menstruation och menstruationsbortfall kan lindras utan att använda läkemedel. Fysisk aktivitet och kost har visats ge stora hälsoeffekter vid många sjukdomar och besvär och därför var syftet att undersöka om det även ger positiva hälsoeffekter vid menstruella besvär. Syfte: Syftet med litteraturstudien var att studera om fysisk aktivitet och kost kan minska fysiska och psykiska subkliniska menstruella besvär och därigenom ge ökat välmående. Metod: Sökt i Pubmed med sökorden subkliniska besvär i relation till fysisk aktivitet respektive kost hos fertila tränade och otränade kvinnor utan inverkan av hormonella preventivmedel. Resultat: Studien har visat vissa belägg för att fysisk aktivitet och kost kan lindra några subkliniska menstruella besvär. Premenstruellt syndrom (PMS) kan främst lindras genom lugna, meditativa aktiviteter. Vidare sågs god effekt på PMS av mindre men fler måltider med komplexa kolhydrater, samt intag av vitaminer och mineraler. Yoga har även visats minska menstruationssmärta, och allmän fysisk aktivitet har visat antydan till att förbättra menstruationens regelbundenhet. För att undvika oregelbunden menstruation eller menstruationsuppehåll behövs adekvat energiintag. Övriga subkliniska menstruella besvär saknade tydliga rekommendationer. Konklusion: Studien har visat att fysisk aktivitet och kost kan ha positiva effekter på vissa menstruella subkliniska besvär. För kvinnor med PMS verkar lugna, meditativa former av fysisk aktivitet kunna lindra syndromet. Yoga och fysisk aktivitet har även visats minska dysmenorré. Tillräckligt energiintag är essentiellt för att undvika oregelbunden och utebliven menstruation. Ytterligare studier behövs inom området för att säkerställa resultat och ge generella rekommendationer. / Background: Many women experience physical and psychological symptoms during their menstrual cycle. Research is scarce about how to ease subclinical menstrual disorders like dysmenorrhea, menorrhagia, premenstrual syndrome, premenstrual dysphoric syndrome, oligomenorrhea and amenorrhea without using medicines. Physical activity and diet is proved to have positive effects on several diseases and we therefore wanted to see if positive effects also could be seen on subclinical menstrual disorders. Aim: The aim of this study was to investigate if physical activity and diet could reduce physical and psychological subclinical menstrual disorders and lead to a better wellbeing. Method: Searching for subclinical menstrual disorders in relation to physical activity and diet in fertile, active and inactive women without the use of hormonal contraceptives was done using Pubmed. Results: The study has shown that physical activity and diet could reduce some of the problems associated with subclinical menstrual disorders. Premenstrual syndrome (PMS) could be eased through calm, meditative activities. Positive effects could be seen when eating more often but smaller meals containing complex carbohydrates and by taking additional vitamins and minerals. Yoga has been proved to reduce menstrual pain and there’s also an indication that physical activity could improve the regularity of the menstrual cycle. Adequate energy intake is needed to avoid oligomenorrhea and amenorrhea. No clear recommendations were found for the remaining subclinical menstrual disorders. Conclusion: The study has shown that physical activity and diet have positive effects on some subclinical menstrual disorders. Symptoms of PMS could be eased by calm, meditative activities. Yoga and physical activity have been shown to reduce dysmenorrhea. Adequate energy intake is essential to avoid oligomenorrhea and amenorrhea. Further research is needed to give general recommendations.