A longitudinal dataset of physiological, hormonal, metabolic, and self-reported menstrual health data.

Female Reproductive Health and Contraception Use in CKD: An International Mixed-Methods Study

Research objectives: to evaluate the effectiveness of phytotherapy in the treatment of menstrual health disorders in women of early reproductive age after a moderate and severe form of the coronavirus disease.Material and methods. 104 women of early reproductive age with menstrual health disorders that occurred 3 months later after moderate or severe COVID-19 were under observation and 34 gynecologically and somatically healthy women of the control group who did not suffer from COVID-19. Female patients with COVID-19 were randomly divided into two groups: the main group (n=53) and the comparison group (n=51). The performed examination included: study of complaints, general and gynecological anamnesis, physical and gynecological examination, ultrasound examination of pelvic organs, determination of hormonal profile. All patients with COVID-19 received a comprehensive rehabilitation program, which included diet therapy, vitamin and mineral complexes, psychotherapy. In addition to the complex rehabilitation program patients of the main group received ayurvedic phytocompositions Femicycle or Femimens for 6 months.Results. It has been established that the moderate and severe course of the coronavirus infection affects the reproductive system of early reproductive aged women and leads to menstrual health disorders, among which irregular menstruation, premenstrual syndrome and dysmenorrhea dominate. Levels of pituitary, adrenal, ovarian and thyroid serum hormones were within the reference norm in most cases, but have statistically significant deviations from similar indicators of healthy control women who did not have COVID-19. One-third of women of early reproductive age after moderate to severe COVID-19 had elevated prolactin levels. Ayurvedic phytocompositions Femicycle and Femimens in a comprehensive rehabilitation program for post-COVID menstrual health disorders led to a faster recovery of menstrual health and a full hormonal recovery.Conclusions. Ayurvedic phytocompositions Femicycle and Femimens are effective and safe naturopathic drugs for restoring menstrual health in women of early reproductive age after experiencing moderate to severe COVID-19.

To analyse adolescents' self-reported experiences and behavioural outcomes of a person-centred, theory-based intervention in comparison with conventional information/instruction for improved oral hygiene. Data were derived from a prospective, multi-centred, two-arm, quasi-randomized field study focusing on the effectiveness of educational interventions for improved oral hygiene. Dental hygienists working within the Public Dental Service, Västra Götaland, Sweden, provided treatments, and adolescents with poor oral hygiene conditions were eligible for participation. The person-centred test intervention was based on social cognitive constructs, and motivational interviewing was used as an approach in communication. The control intervention included conventional information/instructions. Clinical examinations were performed, and questionnaires were distributed at baseline and at 6 months. Three-hundred and twelve patients were enrolled, and data from 276 patients, following treatment per protocol, were analysed. The test group was more satisfied with the education about gingivitis (very good: 61% vs. 37%) and communication during therapy (very good: 69% vs. 50%) and reported to a larger extent that they were much more careful regarding their oral hygiene after the treatment (30% vs. 15%) and had higher confidence about keeping up healthy gingival conditions, in comparison with the control group (all p < .01). The person-centred, theory-based intervention was superior in terms of adolescents' experiences of education and communication during therapy and self-reported oral hygiene behavioural outcomes at 6 months, in comparison with conventional information/instruction.

Polycystic Ovary Syndrome (PCOS), also known as Polycystic Ovarian Disease (PCOD), is a very common metabolic and endocrine disorder seen in premenopausal women. It is characterized by polycystic ovarian morphology on ultrasound, absence of ovulation, increased levels of male hormones, and hormonal imbalance. Such alterations in the normal physiology of a female of reproductive age have serious clinical consequences, including irregular menstrual cycles, oligomenorrhea (infrequent menstruation), amenorrhea (absence of menstruation), infertility, male-pattern hair growth (hirsutism), facial acne, insulin resistance and abnormal, weight gain (obesity). PCOS is thought to afflict 6–13% of women who are of reproductive age, and up to 70% of cases go untreated. Certain ethnic groups are more likely to experience it. Additionally, those populations frequently face greater issues, especially those pertaining to metabolic issues. Menstrual health is a direct indicator of a female's reproductive, endocrine and psychological health. A regular menstrual cycle indicates proper ovulation and hormonal balance. Irregular menstruation may serve as an early indication of PCOS. It is very important for female individuals of reproductive age to keep a check on their menstrual cycle, observe their vaginal discharge and maintain menstrual hygiene. Throughout the menstrual cycle, the hormonal fluctuations lead to various emotional changes suggesting that any abnormality in menstruation may also have psychological consequences. Despite increasing awareness of PCOS and its consequential physical manifestations, its psychosocial repercussions—including body image issues, emotional well-being, and social expression are less frequently discussed in clinical and research literature. Young females experiencing irregular menstruation may face socio-cultural stigma, leading to depression, anxiety, and a lack of confidence, which can hamper their academic and professional performance. Hence, there is a need for an in-depth understanding of how menstrual instability, as a consequence of PCOS, impacts the psychosocial responses of young women.

BackgroundThe onset of puberty and menarche is a specifically vulnerable time for girls, during which they begin to show interest in the opposite sex, while becoming exposed to a myriad of external pressures, including sexual coercion or harassment from boys and men, expectations to marry from their families, and the need to perform well in primary school in order to qualify for secondary school. According to several qualitative studies in Africa, such pressures are exacerbated by girls’ lack of knowledge of their bodies, their rights, and the implications of their decisions, and by their inability to manage puberty and adolescence safely and comfortably with appropriate menstrual health and hygiene management (MHM) products. The evaluation of the Nia Project is one of the first to analyze the individual and combined contributions of sanitary pads and provision of comprehensive reproductive health education on girls’ education and reproductive health outcomes.MethodsThe design for the evaluation of the Nia Project is a longitudinal, cluster-randomized controlled trial consisting of a baseline survey with a cohort of Class 7 girls, a school quality survey, qualitative data collection, school attendance tracking, and an endline survey at the completion of the 18-month intervention period with the same cohort. The study involves 140 public primary schools in three rural sub-counties (Magarini, Kaloleni and Ganze) of Kilifi County in the Coastal area of Kenya. The research sample includes 3489 girls, with about 25 girls per school on average. Before program implementation, the schools were stratified by sub-county and randomized to one of four study arms (35 schools per arm): 1) control, 2) disposable sanitary pads distribution, 2) reproductive health education, and 4) sanitary pad distribution and reproductive health education.DiscussionThe evidence provided will inform program investment and design, and contribute to the literature on the effect of menstrual health-based interventions on girls’ agency, safety and life outcomes.Trial registrationISRCTN10894523. Trial Registration Date: August 22, 2017.

To investigate the dynamics of serum anti-Müllerian hormone (AMH) levels during the luteal phase of controlled ovarian hyperstimulation (COH) and its possible association with follicle development. We prospectively studied 34 women undergoing COH with GnRH agonist and FSH. On the day of hCG (dhCG), serum AMH, estradiol (E2), progesterone and hCG levels were measured, and ovarian follicles were sorted into three size classes: <12, 12-15 and 16-22 mm. Hormonal measurements were repeated 4 days (hCG + 4) and 7 days (hCG + 7) after hCG. From dhCG to hCG + 4, we observed a decline in serum AMH levels (-64 +/- 3%; P < 0.0001), which paralleled that of E2 levels. From hCG + 4 to hCG + 7, an increase in AMH levels occurred (82 +/- 28%; P < 0.02), whose magnitude was correlated with the number of < 12 mm follicles (r = 0.68; P < 0.0001) but not with other follicle size classes nor with the remaining hormone levels. After hCG, AMH levels initially decline, presumably as an effect of follicle luteinization, then increase during the mid-luteal phase. Although the mechanisms implicated in the mid-luteal AMH increase are unclear, its positive association with small follicle count, but not with luteal progesterone and E2 levels, supports the hypothesis that AMH levels might reflect luteal follicle development.

Background:Saliva could be an attractive alternative to blood for assessing thyroid hormonal function.Objectives:Our goal was to determine if the levels of thyroid hormones in saliva can accurately reflect a person’s thyroid status and if they consistently correlate with the levels of the same hormones in the blood.Design:We conducted a cross-sectional study.Methods:We enrolled a total of 109 participants with different thyroid conditions. We measured TSH (Thyroid-Stimulating Hormone), free T3 (fT3), and free T4 (fT4) in the blood using two different immunoassay methods: electrochemiluminescence immunoassay (ECLIA) and chemiluminescence immunoassay (CLIA). Saliva samples were collected using Salivette® tubes, and then we analyzed the levels of thyroid hormones in the saliva using liquid chromatography with tandem mass spectrometry (LC-MS/MS).Results:Comparing salivary and serum levels of thyroid hormones, we observed significantly lower fT4 and higher fT3 levels in saliva (p < 0.001), regardless of the measurement method. We also found that salivary fT3 and fT4 levels were positively correlated in the entire group of participants (p < 0.001, R 0.575), as well as in those with TSH values within the normal reference range (p < 0.001, R 0.570). We further divided participants based on their TSH reference intervals and assessed the correlations between serum and salivary thyroid hormones within these groups. We also discovered that taking exogenous levothyroxine influenced the correlations between serum and salivary thyroid hormones. Thyroid antibodies did not have a significant impact on the levels of thyroid hormones in both serum and saliva.Conclusion:This study demonstrates that salivary thyroid hormones can partially reflect the levels of these hormones in the blood. Saliva may be a useful tool in a clinical setting for patients with thyroid antibodies, but it may not be as effective for those who are taking levothyroxine as a treatment.

Background: Although plasma estrogen and androgen levels are significantly positively associated with risk of postmenopausal breast cancer, it is unknown how long a single blood hormone measure can predict subsequent breast cancer risk as most prior studies have included less than 10 years of follow-up. If including hormone levels into current breast cancer risk prediction models improves discriminative ability, evaluating how the hormone/breast cancer association varies by years since blood collection can help determine the most relevant time period for hormone measures. In addition, whether the associations vary by tumor hormone receptor status is unclear. Methods: We conducted a prospective nested case-control analysis within the Nurses' Health Study cohort. Blood samples were collected in 1989-1990 and then in 2000-2002. Among eligible postmenopausal women not using postmenopausal hormones (PMH) at blood collection, 796 cases were diagnosed through June, 2010. Two control subjects (n=1,583) were matched to cases on age and time of blood collection. We used unconditional logistic regression analyses to estimate the relative risks (RRs, 95%CIs) by controlling for breast cancer risk factors. Results: The intra-class correlation coefficients for the two blood measures collected 10 years apart were 0.69 for estradiol, 0.71 for testosterone, 0.54 for dehydroepiandrosterone sulfate (DHEAS), and 0.74 for sex hormone-binding globulin (SHBG). Overall, women in the top 25% of levels of estradiol, free estradiol, testosterone, free testosterone, and DHEAS (compared to the lowest 25% of levels) were at a 50-107% higher risk of breast cancer (all p-trends&amp;lt;0.004). Relative risks were similar when comparing cases diagnosed 1-10 vs. 11-20 years (and 16-20 years) after blood collection (all p-values for interaction by follow-up period&amp;gt;0.15). For example, comparing the highest with lowest (reference) quartile of hormones measured 10 year or less before breast cancer diagnosis, the multivariable RRs (95%CIs) for overall breast cancer were 2.0 (1.4-2.7; p-trend&amp;lt;0.001) for estradiol, 1.4 (1.1-1.9; p-trend=0.001) for testosterone, and 0.63 (0.47-0.85; p-trend=0.006) for SHBG. The comparable RRs (95%CIs) for blood samples collected 11-20 years before diagnosis were 2.0 (1.3-3.1; p-trend=0.002) for estradiol, 1.6 (1.0-2.4; p-trend=0.11) for testosterone, and 0.68 (0.44-1.04; p-trend=0.04) for SHBG. Importantly, with the exception of DHEAS, the associations varied significantly by hormone receptor status of the tumor. For example, the multivariable RRs (95%CIs) comparing the highest vs. lowest quartile were 2.8 (2.0-4.0; p-trend&amp;lt;0.001) for ER+/PR+ tumors (n=347) vs. 1.1 (0.6-2.1; p-trend=0.98) for ER-/PR- tumors (n=80) for estradiol (p-heterogeneity&amp;lt;0.01), 1.8 (1.3-2.5; p-trend&amp;lt;0.001) vs. 0.6 (0.3-1.2; p-trend=0.35) for testosterone (p-heterogeneity&amp;lt;0.01), and 0.46 (0.31-0.67; p-trend=0.01) vs. 1.07 (0.56-2.06; p-trend=0.67) for SHBG (p-heterogeneity=0.01). Conclusions: A single blood sex hormone measurement in postmenopausal women can predict risk of hormone receptor positive breast cancer for up to 20 years. Citation Format: Xuehong Zhang, Shelley S. Tworoger, A. Heather Eliassen, Susan E. Hankinson. Postmenopausal plasma sex hormone levels and subsequent risk of breast cancer over 20 years of follow up. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr B105.

Estimates of intraindividual variation in hormone levels provide the basis for interpreting hormone measurements clinically and for developing eligibility criteria for trials of hormone replacement therapy. However, reliable systematic estimates of such variation are lacking. To estimate intraindividual variation of serum total, free and bioavailable testosterone (T), dihydrotestosterone (DHT), SHBG, LH, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), oestrone, oestradiol and cortisol, and the contributions of biological and assay variation to the total. Paired blood samples were obtained 1-3 days apart at entry and again 3 months and 6 months later (maximum six samples per subject). Each sample consisted of a pool of equal aliquots of two blood draws 20 min apart. Men aged 30-79 years were randomly selected from the respondents to the Boston Area Community Health Survey, a study of the health of the general population of Boston, MA, USA. Analysis was based on 132 men, including 121 who completed all six visits, 8 who completed the first two visits and 3 who completed the first four visits. Day-to-day and 3-month (long-term) intraindividual standard deviations, after transforming measurements to logarithms to eliminate the contribution of hormone level to intraindividual variation. Biological variation generally accounted for more of total intraindividual variation than did assay variation. Day-to-day biological variation accounted for more of the total than did long-term biological variation. Short-term variability was greater in hormones with pulsatile secretion (e.g. LH) than those that exhibit less ultradian variation. Depending on the hormone, the intraindividual standard deviations imply that a clinician can expect to see a difference exceeding 18-28% about half the time when two measurements are made on a subject. The difference will exceed 27-54% about a quarter of the time. Given the level of intraindividual variability in hormone levels found in this study, one sample is generally not sufficient to characterize an individual's hormone levels but collecting more than three is probably not warranted. This is true for clinical measurements and for hormone measurements used to determine eligibility for a clinical trial of hormone replacement therapy.

Insights into PM10 sources in Houston, Texas: Role of petroleum refineries in enriching lanthanoid metals during episodic emission events

Validity of biobank studies on hormone associated cancers depend on the extent the sample preservation is affecting the hormone measurements. We investigated the effect of long-term storage (up to 22 years) on immunoassay measurements of three groups of hormones and associated proteins: sex-steroids [estradiol, progesterone, testosterone, dihydroepiandrosterone sulphate (DHEAS), sex hormone-binding globulin (SHBG)], pregnancy-specific hormones [human chorionic gonadotropin (hCG), placental growth hormone (pGH), alpha-fetoprotein (AFP)], and insulin-like growth factor (IGF) family hormones exploiting the world largest serum bank, the Finnish Maternity Cohort (FMC). Hormones of interest were analyzed in a random sample of 154 Finnish women in the median age (29.5 years, range 25 to 34 years) of their first pregnancy with serum samples drawn during the first trimester. All hormone measurements were performed using commercial enzyme-linked- or radio-immunoassays. Storage time did not correlate with serum levels of testosterone, DHEAS, hCG, pGH and total IGFBP-1. It had a weak or moderate negative correlation with serum levels of progesterone (Spearman's ranked correlation coefficient (rs)=− 0.36), IGF-I (rs=−0.23) and IGF binding protein (BP)-3 (rs=−0.38), and weak positive correlation with estradiol (rs=0.23), SHBG (rs=0.16), AFP (rs=0.20) and non-phosphorylated IGF binding protein (BP)-1 (rs=0.27). The variation of all hormone levels studied followed the kinetics reported for early pregnancy. Bench-lag time (the time between sample collection and freezing for storage) did not materially affect the serum hormone levels. In conclusion, the stored FMC serum samples can be used to study hormone-disease associations, but close matching for storage time and gestational day are necessary design components of all related biobank studies.

AimTo examine individual variability between perceived physical features and hormones of pubertal maturation in 9–10-year-old children as a function of sociodemographic characteristics.MethodsCross-sectional metrics of puberty were utilized from the baseline assessment of the Adolescent Brain Cognitive Development (ABCD) Study—a multi-site sample of 9–10 year-olds (n = 11,875)—and included perceived physical features via the pubertal development scale (PDS) and child salivary hormone levels (dehydroepiandrosterone and testosterone in all, and estradiol in females). Multi-level models examined the relationships among sociodemographic measures, physical features, and hormone levels. A group factor analysis (GFA) was implemented to extract latent variables of pubertal maturation that integrated both measures of perceived physical features and hormone levels.ResultsPDS summary scores indicated more males (70%) than females (31%) were prepubertal. Perceived physical features and hormone levels were significantly associated with child’s weight status and income, such that more mature scores were observed among children that were overweight/obese or from households with low-income. Results from the GFA identified two latent factors that described individual differences in pubertal maturation among both females and males, with factor 1 driven by higher hormone levels, and factor 2 driven by perceived physical maturation. The correspondence between latent factor 1 scores (hormones) and latent factor 2 scores (perceived physical maturation) revealed synchronous and asynchronous relationships between hormones and concomitant physical features in this large young adolescent sample.ConclusionsSociodemographic measures were associated with both objective hormone and self-report physical measures of pubertal maturation in a large, diverse sample of 9–10 year-olds. The latent variables of pubertal maturation described a complex interplay between perceived physical changes and hormone levels that hallmark sexual maturation, which future studies can examine in relation to trajectories of brain maturation, risk/resilience to substance use, and other mental health outcomes.

Unraveling Genes, Hormones, and Breast Cancer

The early diagnosis of acromegaly may be difficult when serum levels of growth hormone are minimally elevated and imaging of the pituitary gland fails to show an adenoma. However, transsphenoidal surgery has the greatest chance of cure at this stage. We therefore investigated the value of sampling petrosal sinuses for measurement of growth hormone in this group of patients. Simultaneous bilateral sampling of the inferior petrosal sinuses to measure serum concentrations of growth hormone was performed in five patients suspected of having acromegaly but with nondiagnostic CT scans (n = 5) and MR images (n = 3) of the pituitary gland. Levels of growth hormone from the petrosal sinuses were five to 36 times greater than levels in the peripheral veins in all five patients, and three of four showed a marked response to growth hormone-releasing hormone. During transsphenoidal surgery, growth hormone-producing microadenomas were resected completely in four patients. In the fifth patient, a left-sided microadenoma had invaded the cavernous sinus and could not be resected completely. Lateralization of the adenomas within the pituitary gland on the basis of differences in levels of growth hormone between the two petrosal sinuses was not completely reliable. Elevated levels of growth hormone in selective samples from the inferior petrosal sinuses can help support an early diagnosis of acromegaly when peripheral growth hormone levels and imaging are not diagnostic.

Lanthanum Carbonate Delays Progression of Coronary Artery Calcification Compared With Calcium-Based Phosphate Binders in Patients on Hemodialysis