Effect of COVID-19 vaccination on the menstrual cycle

BackgroundThe liver plays an important role in gonadal steroid hormone metabolism, which can affect reproductive health, including the menstrual cycle. However, evidence from large population-based studies is limited. Therefore, this study aimed to investigate the association between liver function markers and menstrual cycle irregularities in premenopausal Korean women using nationwide data.MethodsThis study analyzed Data from the Korea National Health and Nutrition Examination Survey 2010–2011. We investigated 3,045 premenopausal women aged 19–59 years. Liver function markers including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase, and fatty liver index were analyzed. Multivariable logistic regression analysis was performed to investigate the association between liver function markers and menstrual cycle irregularity while adjusting for confounding factors. Values were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analysis was also performed.ResultsBaseline characteristic analysis showed that approximately 14.4% of the study population experienced menstrual cycle irregularity. The mean age was 34.5±0.7 years. The highest quartile of serum ALT and AST levels showed significantly higher ORs for menstrual cycle irregularity (adjusted OR, 1.83; 95% CI, 1.26–2.64 and adjusted OR, 1.67; 95% CI, 1.17–2.39, respectively). A similar result was observed in the subgroup analysis.ConclusionLiver function markers were positively associated with menstrual cycle irregularities. In clinical settings, women of reproductive age with relatively decreased liver function should be considered for regular follow-up of their reproductive health status.

Smokeless tobacco (SLT) poses many negative health impacts. Despite its longstanding presence in societies across the world, the health implications of SLT have only been rigorously studied in recent decades. This systematic review and meta-analysis aimed to consolidate existing research to provide a comprehensive understanding of the global prevalence of SLT use among women of reproductive age. Relevant articles were extracted from databases such as PubMed, EMBASE, Web of Science, and Scopus from their inception until November 11, 2023. Observational studies reporting the number of SLT users among women of reproductive age were included. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) tool. The meta-analysis used a random-effects model to determine SLT prevalence, supported by statistical tools like forest plots, I2 statistics, and sensitivity analyses to ensure the accuracy and comprehensiveness of the results. All statistical analyses were performed in R version 4.3. From 10 studies involving 2,053,667 participants, a pooled prevalence for SLT use among women of reproductive age was found to be 9.3% (95% CI: 0.038 to 0.21), with significant heterogeneity among studies (I2 = 100%). Publication bias was suspected among the studies. Sensitivity analysis and subgroup analysis couldn’t resolve the heterogeneity. Our analysis shows a significant prevalence of SLT use in women of reproductive age, especially in low socioeconomic and developing countries like India, Pakistan, and Nepal. For women of reproductive age, the use of smokeless tobacco (SLT) can lead to infertility, pregnancy complications, and adverse fetal outcomes, including low birth weight and preterm birth. The results highlight the necessity for specific public health measures and policy changes to decrease SLT consumption among reproductive-age women. Further studies are needed to investigate the reasons behind SLT usage in this group and to assess the impact of intervention strategies, to guide more effective public health initiatives and policies.

Background: There are many factors that influence menstrual patterns to become irre­gular, including stress and obesity. Menstrual cycle irregularities can have a serious impact on women's health, which will affect the metabolic, fertility, sexual and reproductive systems. This study aims to analyze the influence of obesity and stress on menstrual cycle disorders with a meta-analysis study. Subjects and Method: This study is a syste­matic study and meta-analysis, with the follow­ing PICO, Population= women of childbearing age. Intervention= obesity and stress. Compa­rison = not obese and not stressed. Outcome = disruption of the menstrual cycle. The articles used in this study were obtained from several databases, including PubMed, ScienceDirect and Google Scholar. The keywords used are "menstrual disorder and obesity and stress", "obesity and menstrual irregularity", "obesity OR stress AND menstrual irregularity OR cross sectional study". The articles included in this study are full text articles with a cross sectional study design. Articles were collected using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application. Results: Meta-analysis of 8 observational studies showed that obese women were 4 times more likely to have menstrual cycle disorders than normal weight (aOR= 4.19; 95% CI= 1.99 to 8.84; p= 0.002). Meta-analysis of 6 observa­tional studies showed that women with stress had a risk of experiencing menstrual cycle dis­orders 1.28 times compared to women who did not experience stress (aOR= 1.28; 95% CI= 1.13 to 1.45; p = 0.001). Conclusion: Obesity and stress affect menstrual cycle disorders.

Objective In this study, we aimed to investigate the relationship between body mass index (BMI), waist circumference (WC) or waist-to-hip ratio (WHR) and oligomenorrhea or irregular menstruation in Chinese women of childbearing age. Methods A total of 1,423 Han women aged 19–39 years who were routinely examined at the Physical Examination Center of Peking University People's Hospital were enrolled by convenience sampling method. All participants were asked to fill up menstrual questionnaires. Binary logistic regression models were used to assess the odds ratio (OR) of different BMI, WC and WHR groups for the prevalence of oligomenorrhea and irregular menstruation. Moreover, we used the ROC curves to compare the predictive effects of BMI, WC and WHR on oligomenorrhea and irregular menstruation. Results Among the 1,423 participants, 93 women (6.5%) had BMI ≥ 30 kg/m2, 6.5% of the participants had oligomenorrhea, and 22.6% had irregular menstrual menstruation. Overall, those with BMI ≥30 kg/m2 (OR = 2.543; 95%CI 1.332–4.856; p = .005) or WC ≥ 90 cm (OR = 2.023; 95%CI 1.198–3.416; p = .008) were more likely to have long menstrual cycle. The prevalence of irregular menstruation was higher in the BMI ≥30 kg/m2 (OR = 2.509; 95%CI 1.591–3.958; p < .001), WC ≥ 90 cm (OR = 2.299; 95%CI 1.619–3.265; p < .001) and WHR ≥ 0.86 (OR = 1.739; 95%CI 1.293–2.339; p < .001) groups. The ROC curve showed that all three anthropometric indices had predictive effect, while there was no significant difference in predicting oligomenorrhea. WC was a better predictor for irregular menstruation compared with BMI. Conclusions Obesity, oligomenorrhea and irregular menstruation were common in Chinese women of childbearing age, and obesity was associated with oligomenorrhea and irregular menstruation. Abdominal obesity might have a stronger predictive effect on irregular menstruation.

The Impact of Bariatric Surgery Compared to Metformin Therapy on Pregnancy Outcomes in Patients with Polycystic Ovarian Syndrome: a Systematic Review and Meta-analysis

Context: Toxoplasma gondii remains a global concern, especially in developing countries. This parasite is particularly important in women of childbearing age due to its increased risk of miscarriage and serious complications in the newborn. Objectives: This systematic review and meta-analysis was conducted to determinet the serum prevalence of acute and chronic T. gondii infection in women of reproductive age in Iran. Methods: The systematic search process was carried out from January 2010 to July 2024 through four English databases (PubMed, Scopus, Web of Science, and Science Direct) and two Persian databases (Magiran and SID) as well as Google Scholar as a specialized search engine for the article. Meta-analysis analysis was performed using a random effects model. Prevalence estimates and 95% confidence intervals were calculated for each study. Heterogeneity was evaluated using the I2 statistic. Egger and Begg's test was also used to assess the publication bias. Results: A total of 869 records were retrieved, resulting in 28 studies including 13,177 individuals of reproductive age included in the meta-analysis for T. gondii-specific IgG and/or IgM antibodies. The seroprevalence of IgG and IgM antibody serum in women is 29% (95% CI: 23% - 34%) and 4% (95% CI:3% - 5%) respectively. Egger's test results (P = 0.001) showed publication bias. Conclusions: The prevalence of chronic (IgG) and acute infection (IgM) T. gondii in women of reproductive age in Iran is relatively high. Therefore, there is an urgent need for education to increase women's awareness.

Menstrual irregularity is a common reproductive endocrine disorder among women of reproductive age, serving both as an early indicator of various gynecological diseases and a potential marker of underlying metabolic disturbances. Low-density lipoprotein cholesterol (LDL-C), a key indicator of lipid metabolism, lacks robust epidemiological evidence regarding its association with menstrual irregularity. This study utilized data from the 2013 to 2014 cycle of the National Health and Nutrition Examination Survey, which included (n = 623) women aged 15 to 49 years, to train a logistic regression model for assessing the association between LDL-C levels and menstrual irregularity. The model was externally validated using data from the 2009 to 2010 cycle (n = 799). Model performance was evaluated using the area under the receiver operating characteristic curve (area under the curve [AUC]), calibration plots, and confusion matrices. A nomogram was constructed to enhance clinical interpretability. The analysis indicated that LDL-C levels and age were significant predictors of menstrual irregularity. The AUCs of the model were 0.754 in the training set and 0.765 in the validation set, demonstrating good predictive performance and robustness. Residual analysis and collinearity diagnostics further supported the good fit of the model. The nomogram based on the final model enables visualized assessment of individual risk, aiding clinical risk stratification and decision-making. Elevated LDL-C levels are significantly associated with menstrual irregularity in women of reproductive age, suggesting its potential role as a metabolic biomarker of reproductive health. Longitudinal studies are recommended to clarify the causal relationship and to explore the potential of lipid-lowering interventions in menstrual regulation.

Introduction: Cupping therapy or Hijamah is a traditional practice after spiritual healings and herbal medicine in Islamic Arabic culture. Wet cupping is by far the most common type of cupping therapy. No previous study in Palestine about this topic and nurses are not in isolation of this topic. So, the purpose of the study is to investigate the use of cupping therapy among women in reproductive age. Methods: A cross-sectional study from September 2018 through December 2018, to evaluate the use of cupping therapy among women in reproductive age in three centers at 48 lands/ Palestine. The sample size was included 100 Palestinian women from 48 lands were selected from three centers taken from their files. Developed questionnaires were used based on previous study and researchers’ experience. SPSS version 20 was used for analysis. Results: Show there is a significant relationship between using cupping therapy and improvement in the Menstrual cycle with a significant P-value (0.0377). The study showed that (34%, n=34) of women answered that they have used therapy to treat back pain; (67%, n=23) of them reported improvement and pain decreased. The study (24%, n=24) of women answered that they have used therapy to treat infertility; (75%, n=18) of them become pregnant after 2-3 sessions of cupping therapy. The study showed that (13%, n=13) of women answered that they have used therapy to treat migraines; (46%, n=6) of them reported relieved headache after Hijama. While, (11%, n=11) of women answered that they have used therapy to treat menopausal signs and symptoms; (18%, n=2) of them reported improvement. About (8%, n=8) of women have used therapy for irregular menses; (62%, n=5) of them reported improvement. Finally, (7%, n=7) of women have used in just because of “Sunnah” or religious issues, and (3%, n=3) have used for dysmenorrhea with good outcomes. Lab tests for these patients were the same before and after Hijama except for the infertility group. For this group the mean of test for 24 participants was: FSH before cupping was 7 IU/L and after 9 IU/L, TSH was 0.6 IU/L and after 1.2 IU/L, LH was 5 IU/L and after 7.5 IU/L, progesterone was 6 IU/L after cupping becomes 7.5 IU/L, with high satisfaction level (77%, n=77) of participants. Discussion and Conclusion: In general these results support and reinforce our hypothesis that cupping therapy has a positive effect on women in reproductive age in treating menstrual disorders, migraine, infertility, back pain and findings recommended several conditions. The nurses should have knowledge regards to this complementary treatment to provide culturally competent care.

Purpose: To explore associations between food insecurity (FI), gestational diabetes mellitus (GDM), and polyhydramnios in North Louisiana (LA) mothers, specifically in racially diverse and economically disadvantaged populations. Methods: A cross-sectional study was conducted from 2018 to 2023 among pregnant women receiving care at multiple obstetric units in a large, academic tertiary care health system providing services to patients across North LA. The study included patients from both urban and rural regions, permitting for the sample to be generalizable to North LA. Data was extracted from the electronic medical records (Epic) and categorized based on diagnoses of interest as determined by ICD-10 codes and FI status, as determined by the validated, two-question Hunger Vital Sign questionnaire. Diagnoses of interest included GDM (ICD-O24) and polyhydramnios (ICD-O40). Analyses were performed in jamovi using Chi-squared (X2) tests and Odds Ratios (ORs) within a 95% confidence interval (CI) for maternal FI and diagnoses, with additional stratification by race and age. Age categories were defined as optimal reproductive age (18-34), advanced maternal age (AMA, 35-39), very AMA (40-44), and extreme AMA (45-50). Results: The patient population (n=2,642) consisted of 58% African American (AA) women and 42% other, non-Black women.72% of patients were of optimal reproductive age, 19% of AMA, 7% of very AMA, and 2% of extreme AMA. Analysis revealed statistically significant associations in food-insecure mothers experiencing both GDM and polyhydramnios concurrently (OR=3.47, 95% CI, 1.46–8.21, p=0.003), with a diagnosis of polyhydramnios without GDM (OR=1.75, 95% CI, 1.05–2.90, p=0.027), and with a diagnosis of GDM without polyhydramnios (OR=1.29, 95% CI, 1.05–1.83, p=0.020). Stratifying by race and age, significant associations for food-insecure Black women with concurrent GDM and polyhydramnios were observed in those of optimal reproductive age (OR=4.39, 95% CI, 1.09–17.6, p=0.023). This association was not statistically significant in other races. No significant associations for GDM and polyhydramnios concurrently were observed in any race of AMA, very AMA, or extreme AMA. There were no cases of GDM and polyhydramnios in non-Black, extreme AMA women; thus, associations in this group could not be evaluated. Statistically significant associations were observed in food-insecure Black women with a diagnosis of polyhydramnios without concurrent GDM in those of optimal reproductive age (OR=0.377, 95% CI, 0.163–0.869, p=0.017); this association was not significant in other races. No significant associations were observed in Black women with polyhydramnios alone in those of AMA, very AMA, or extreme AMA. A significant association was observed in non-Black women of AMA with polyhydramnios alone (OR=6.38, 95% CI, 1.71–23.9, p=0.002), but not in non-Black, very AMA women. There were no cases in non-Black, extreme AMA women; as such, associations could not be evaluated. Statistically significant associations were observed in food-insecure Black women with GDM without concurrent polyhydramnios in those of optimal reproductive age (OR=0.469, 95% CI, 0.309–0.710, p&lt;0.001); this association was not significant in other races. Similarly, no statistically significant associations were observed in Black women with GDM alone in those of AMA, very AMA, or extreme AMA. However, significant associations were observed in non-Black women with GDM alone in those of AMA (OR=13.8, 95% CI, 4.75–40.2, p&lt;0.001) and very AMA (OR=9.27, 95% CI, 1.15–74.5, p=0.011). No significant association was observed in non-Black, extreme AMA women. Conclusion: Associations between FI, GDM, and polyhydramnios highlight a complex interplay influenced by race and age. The statistically significant association between FI and both GDM and polyhydramnios is reasonable, as GDM is a known risk factor for polyhydramnios. However, this association was only significant in Black women of optimal reproductive age, underscoring a need for further investigation. Findings of GDM and FI without concurrent polyhydramnios, stratified by race and age, further aligned with literature, as food-insecure Black women of optimal reproductive age were less likely to experience GDM alone, and food-insecure non-Black women of AMA or very AMA were more likely to experience GDM alone. The data also suggests that maternal FI could be a risk factor for polyhydramnios independent of GDM, with ORs implying that mothers experiencing FI are more likely to be diagnosed with polyhydramnios alone than GDM alone, independent of race and age. Considering race and age, significant associations persisted between FI and polyhydramnios without concurrent GDM in only Black women of optimal reproductive age and non-Black women of AMA. This suggests food-insecure Black women of optimal reproductive age are less likely to develop polyhydramnios alone, while food-insecure non-Black women of AMA are more likely. Differences in prevalence of GDM and polyhydramnios by race and age emphasize the importance of screening in appropriate patient populations and pique interest regarding topics for future study.

Globally, approximately 30% of women of reproductive age are affected by anaemia. Anaemia is of major public health concern due to its strong association with increased morbidity and mortality among women of reproductive age. This study aimed to examine the trends and factors influencing anaemia among women of childbearing age in Tanzania. An analytical cross-sectional study was conducted using data from the Tanzania Demographic and Health Surveys collected between 2004/05, 2010, 2015/16, and 2022. The study included 40,632 women of reproductive age who were selected for haemoglobin measurements. Two stage sampling was used to select survey participants. A modified Poisson regression model was used to identify factors associated with anaemia. Adjusted prevalence ratios (APR) with 95% Confidence Intervals (CI) were calculated to estimate the strength of the association. The overall pooled prevalence of anaemia was 44.0% (95% CI: 43.0-44.9) among women of reproductive age. Among these women, 29.2% (95% CI: 28.4-29.9) had mild anaemia, 13.4% (95% CI: 12.9-13.9) had moderate anaemia, and 1.4% (95% CI: 1.3-1.6) had severe anaemia. Looking at the trend over time, the prevalence of anaemia was 48.4% in 2004/05 (95% CI: 46.2-50.5), 40.1% in 2010 (95% CI: 38.4-41.9), 44.8% in 2015/16 (95% CI: 43.4-46.4), and 41.5% in 2022 (95% CI: 39.8-43.3). The findings demonstrate anaemia as both a clinical and public health challenge, requiring multi-sectoral approaches. The persistent associations across demographic, socioeconomic, and reproductive domains suggest that singular interventions are unlikely to address this prevalence sufficiently. Reducing the burden of anaemia will require coordinated efforts across clinical care, public health programming, and social policy to address both immediate nutritional needs and underlying determinants.

BackgroundWorldwide, sexual and reproductive health remains a prominent public health concern for women of reproductive age. Modern contraceptive methods play a crucial role in enabling individuals and families to regulate fertility, thereby reducing unintended pregnancies, abortions, pregnancy-related complications, and mortality. Due to the scarcity of reliable and current data regarding the factors affecting the adoption of modern contraceptives among women of reproductive age at the national level in Ghana, this research aimed to explore the determinants of modern contraceptive usage among reproductive age women.MethodsThe study analyzed data from the 2022 Ghana Demographic and Health Survey, including a weighted sample of 6,839 reproductive-age women. By employing a multilevel logistic regression model, the study sought to determine factors associated with the utilization of modern contraceptives. Associations between explanatory variables and the outcome were evaluated using adjusted odds ratios (AORs) along with 95% confidence intervals (CIs). Statistical significance was established using a p-value threshold of less than 0.05. All statistical analyses were conducted using STATA version 17 software.ResultsThe study found that 26.36% (95% CI: 25.33-27.34%) of women of reproductive age in Ghana used modern contraceptives. Secondary education (AOR = 1.26, 95% CI = 1.03–1.53), poorer household (AOR = 1.30, 95% CI = 1.05–1.61), women’s marital status, i.e. married (AOR = 1.46, 95% CI = 1.16–1.83), living with a partner (AOR = 1.65, 95% CI = 1.32–2.06), divorced (AOR = 2.53, 95% CI = 1.48–4.31), and separated (AOR = 1.70, 95% CI = 1.21–2.37), multipara (AOR = 1.39, 95% CI = 1.04–1.87), were the factors that promote modern contraceptive utilization. Women’s age in years, i.e. 35–39 (AOR = 0.71, 95% CI = 0.52–0.97), 40–44 (AOR = 0.63, 95% CI = 0.44–0.90), and 45–49 (AOR = 0.45, 95% CI = 0.25–0.79), history of pregnancy loss (AOR = 0.86, 95% CI = 0.76–0.98), region, i.e. Greater Accra (95% CI = 0.42–0.92), Bono East (95% CI = 0.32–0.81), Northern (95% CI = 0.28–0.67), Savannah (95% CI = 0.28–0.81), and North East (95% CI = 0.20–0.63), were all associated with a lower use of modern contraceptives.ConclusionsModern contraceptive utilization was low in this study. Factors such as women’s education, socioeconomic status, and marital status were associated with increased modern contraceptive utilization, whereas women’s age and regional disparities were linked to lower usage rates. These findings emphasize the need for targeted interventions to address socioeconomic barriers and regional disparities in access to family planning services across Ghana.

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.

BackgroundDue to the increased magnitude of overweight/obesity in many countries, the World Health Organization (WHO) has identified it as a significant public health crisis, particularly affecting women of reproductive age in developing nations. Despite obesity/overweight among women of reproductive age being widely acknowledged as a pressing public health issue, there has been limited investigation into its pooled prevalence and various associated factors in low and middle-income countries (LMICs) with high maternal mortality. Thus, the objective of our study was to assess the pooled prevalence and associated factors of overweight/obesity among reproductive-age women in low and middle-income countries with high maternal mortality.MethodsWe analyzed secondary data using recent Demographic and Health Survey datasets from 21 low and middle-income countries with high maternal mortality. A weighted sample of 64,076 women of reproductive age was included in the analysis. The variables were extracted from the IR file, and the data were cleaned, recoded, and analyzed using STATA version 14.2 software. A multilevel binary logistic regression model was applied, and adjusted odds ratios (AOR) with 95% confidence intervals and a p-value of ≤ 0.05 were used to identify statistically significant associated factors. Model fitness and comparison were assessed using the ICC, MOR, PCV, and deviance (−2LLR).ResultIn this study, the pooled prevalence of overweight/obesity among women of reproductive age was 32% (95% CI: 27% − 37%), with a significant variation between countries, ranging from 10% in Burundi to 53% in Mauritania. Women of reproductive age with overweight/obesity showed a significant positive association with various factors compared to those with a normal BMI. Accordingly, women’s age, women’s educational status, women’s occupation, women’s marital status, households’ income levels, number of living children, frequency of watching television, using the internet, sex of household head, and sources of drinking water were identified as individual-level factors. On the other hand, residence, community poverty, and community-level media usage were found to be significantly associated with community-level variables.Conclusions and recommendationsMore than three out of ten women of reproductive age were overweight/obese in low and middle-income countries with high maternal mortality. Individual-level and community-level factors were associated with overweight/obesity. Special attention is recommended to older women, those with formal education, non-working women, individuals who spend time watching television and using the internet, urban residents, and female household heads. Furthermore, since higher household income is associated with an increased likelihood of weight gain, it is important to provide appropriate health interventions for women from the wealthiest households.

Dysmenorrhea, or menstrual pain, is one of the most common gynecological complaints among women of reproductive age, particularly among female students. Its impact extends beyond physical discomfort, affecting academic performance, psychological well-being, and overall quality of life. Despite its high prevalence, few studies have examined the determinants of menstrual pain severity among female medical students in Indonesia. This study aimed to identify the determinants of menstrual pain severity among female medical students at the Faculty of Medicine, Universitas Negeri Surabaya. A cross-sectional, descriptive quantitative study was conducted in November 2024, involving 112 participants selected through simple random sampling. Data were collected using a structured online questionnaire and analyzed with Spearman’s rho correlation and ordinal regression to assess associations between menstrual pain severity and independent variables, including body mass index (BMI), age at menarche, menstrual cycle characteristics, and exercise habits. Bivariate analysis indicated significant associations between menstrual pain severity and BMI (p = 0.004), age at menarche (p = 0.032), and exercise frequency (p = 0.038). However, in the adjusted multivariate regression model, only menstrual cycle length greater than 35 days remained significantly associated with increased pain severity (B = 1.143; p = 0.017). Other hypothesized predictors, including BMI, age at menarche, and exercise, did not retain independent effects after adjustment. In conclusion, irregular menstrual cycles—particularly very long cycles—were identified as the only independent determinant of increased menstrual pain severity among female students. These findings underscore the importance of considering menstrual cycle patterns when exploring risk factors for dysmenorrhea, while suggesting that commonly presumed predictors may not directly influence pain severity in this population.

Obesity is a public health problem and it is necessary to identify if non-symptomatic obese women must be submitted to endometrial evaluation. To determine the prevalence of endometrial hyperplasia and cancer in non-symptomatic overweight or obese women. A cross-sectional study was carried out in 193 women submitted to an endometrial biopsy using a Pipelle de Cornier. The findings were classified as normal, hyperplasia or cancer, and the results were compared to body mass index (BMI; kg/m(2)). For the purpose of statistical analysis, women were divided into two groups: women of reproductive age and postmenopausal women, and according to BMI as overweight or obese. The prevalence of endometrial cancer and hyperplasia was 1.0% and 5.8% in women of reproductive age and 3.0% and 12.1% in postmenopausal women, respectively. According to logistic regression, being in the postmenopause increased the risk of endometrial hyperplasia and cancer to 1.19 (95% confidence interval (CI): 0.36-3.90), while being postmenopausal and severely obese increased the odds ratio (OR) to 1.58 (95%CI: 0.30-8.23) and being postmenopausal and morbidly obese increased the OR to 2.72 (95%CI: 0.65-11.5). No increase in risk was found in women of reproductive age who were either overweight or obese. Our results show that non-symptomatic, severe or morbidly obese postmenopausal women have a high risk of developing endometrial hyperplasia or cancer; however, no such risk was found for women of reproductive age.