Saei Ghare Naz, M., Rostami Dovom, M., & Ramezani Tehrani, F. (2020). The Menstrual Disturbances in Endocrine Disorders: A Narrative Review. International Journal of Endocrinology and Metabolism, 18(4), e106694. https://doi.org/10.5812/ijem.106694
Saei Ghare Naz M, Rostami Dovom M, Ramezani Tehrani F. The Menstrual Disturbances in Endocrine Disorders: A Narrative Review. Int J Endocrinol Metab. 2020;18(4):e106694. doi:10.5812/ijem.106694
Saei Ghare Naz, Marzieh, et al. "The Menstrual Disturbances in Endocrine Disorders: A Narrative Review." International Journal of Endocrinology and Metabolism, vol. 18, no. 4, 2020, pp. e106694.
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Research Institute for Endocrine Sciences01kpm1136
Shahid Beheshti University of Medical Sciences034m2b326
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RRM Academy Synopsis
Infrequent Periods Top Menstrual Changes in Endocrine Disorders
A 2020 review found that infrequent periods, cycles longer than 35 days, are the most common menstrual change linked to endocrine disorders. It covered studies on PCOS, diabetes, high prolactin, thyroid disease and Cushing syndrome. The search ran through December 2019.
Key Findings
In a study of 1,741 women with polycystic ovary syndrome, about 30% had regular menstrual cycles, nearly 50% had infrequent periods, and nearly 20% had no periods at all.
About 25% to 30% of women of childbearing age with diabetes had menstrual abnormalities, according to one cited report.
In a European registry of 390 women with Cushing syndrome, 56% had menstrual irregularity. In a separate 45-patient study, the figure reached 80%, tracking cortisol level more closely than androgen level.
A first-line drug treatment (cabergoline or bromocriptine) restored a normal, ovulatory menstrual cycle in about 80% of patients treated for high prolactin levels.
Among women with acromegaly, 62% had no periods at all, 15% had infrequent periods, and 4% had frequent periods, per the cited study.
Interpretation
This is a narrative review. The authors searched four databases for studies through December 2019. They grouped the findings by condition: PCOS, diabetes, high prolactin, thyroid disease, Cushing syndrome and acromegaly. Each percentage traces back to one cited study, so a reader can follow any figure to its own source group. The findings support larger, pooled studies of menstrual pattern as a marker across these conditions.
RRM Context
The menstrual cycle is widely regarded as a vital sign. This review supports that view. Several endocrine disorders, including thyroid disease and Cushing syndrome, leave a clear mark on the cycle. Doctors can find each mark with standard hormone tests. Restorative reproductive medicine uses cycle charting to catch that mark early and trace its cause.
Our editorial summary of this paper, not the article's abstract.
Abstract
Context
Menstrual cycle is considered the fifth vital sign among women. This study aimed to summarize the menstrual disturbances in different endocrine disorders.
Evidence Acquisition
In this narrative review, relevant studies (up to December 2019) were searched based on the MeSH keywords diabetes, polycystic ovary syndrome, Cushing's syndrome, thyroid dysfunction, hyperprolactinemia, menstrual cycle, uterine bleeding, and menstruation. Databases used for searching articles included Google Scholar, Scopus, PubMed, and Web of science for observational, experimental, and review studies.
Results
Endocrine disorders trigger the onset of menstrual disturbance across the reproductive lifespan of women. Endocrine glands (pituitary, thyroid, pancreas, adrenal, and ovaries) have a functional role in endocrine regulation of the menstrual cycle. According to available evidence, oligomenorrhea (cycles longer than 35 days) is the most common menstrual disturbance among endocrine disorders (thyrotoxicosis, hypothyroidism, polycystic ovary syndrome, Cushing's syndrome, and diabetes). Complex endocrine pathways play an essential role in a women's menstrual calendar.
Conclusions
The menstrual cycle length and amount of bleeding can be indicative of endocrine disorders. Further studies are needed to identify the unknowns about the association between endocrine disorders and the menstrual cycle.
