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Fulltext The female athlete triad among elite Malaysian athletes: prevalence and associated factors

Quah YV, Poh BK, Ng LO, Noor MI

Asia Pac J Clin Nutr, 2009;18(2):200-8.
PMID: 19713179

Women participating in a wide range of competitive sports are at higher risk of developing eating disorders, menstrual irregularities and osteoporosis, which are generally referred to as the 'female athlete triad'. The objective of this study was to determine the prevalence of female athlete triad and factors associated with this condition among athletes participating in different sports. A total of 67 elite female athletes aged between 13-30 years participated in the study and were subdivided into the 'leanness' and 'non-leanness' groups. Eating disorders were assessed using a body image figure rating and the Eating Disorder Inventory (EDI) with body dissatisfaction (BD), drive for thinness (DT), bulimia (B) and perfectionism (P) subscales. Menstrual irregularity was assessed with a self-reported menstrual history questionnaire. Bone quality was measured using a quantitative ultrasound device at one-third distal radius. Prevalence of the female athlete triad was low (1.9%), but the prevalence for individual triad component was high, especially in the leanness group. The prevalence of subjects who were at risk of menstrual irregularity, poor bone quality and eating disorders were 47.6%, 13.3% and 89.2%, respectively, in the leanness group; and 14.3%, 8.3% and 89.2%, respectively, in the non-leanness group. Since the components of the triad are interrelated, identification of athletes at risk of having any one component of the triad, especially those participating in sports that emphasise a lean physique, is an important aid for further diagnosis.

Matched MeSH terms: Amenorrhea/epidemiology
Ovarian failure in oral cyclophosphamide treatment for systemic lupus erythematosus

Wang CL, Wang F, Bosco JJ

Lupus, 1995 Feb;4(1):11-4.
PMID: 7767332 DOI: 10.1177/096120339500400103

Ninety-two women with systemic lupus erythematosus treated with oral cyclophosphamide were studied to ascertain the prevalence and the factors associated with ovarian dysfunction. Menstrual disturbance during treatment occurred in 55% of patients: 36% had amenorrhoea and 19% had oligomenorrhoea. Sustained oligomenorrhoea occurred in 12% patients. Permanent amenorrhoea (> 12 months) after cessation of oral cyclophosphamide occurred in 27% of patients. Hormonal studies in these patients were consistent with ovarian failure. Older age at initiation of treatment and high cumulative dose of cyclophosphamide were found to be associated with this outcome. There was a trend towards linear relationship between the age of initiation of cyclophosphamide therapy and frequency of amenorrhoea. A statistically significant association between amenorrhoea and cumulative dose of cyclophosphamide after adjustment for age was found whereas no such association was linked to the duration of treatment. Fourteen of the 23 women who wished to become pregnant after cessation of treatment conceived resulting in 20 live births and two abortions.

Matched MeSH terms: Amenorrhea/epidemiology
Women With Amenorrhea and Men With Menstruation: The Qualitative Experiences of People With Disorders of Sex Development in Nigeria

Sani AM, Arif II, Arshad MM, Mungadi IA, Soh KG, Soh KL

J Nurs Res, 2020 Feb;28(1):e67.
PMID: 30855517 DOI: 10.1097/jnr.0000000000000313

BACKGROUND: Disorders of sex development (DSD) affect the quality of life of people who live with this condition. In developing countries, diagnoses of DSD are associated with a delay in presentation until the patients developed ambiguous physical traits and features.
PURPOSE: This study explores the menstrual experiences of people with DSD and sex reassignment in Nigeria.
METHODS: A qualitative approach with a phenomenological study design was employed in this study to explore and describe the experiences of people with DSD at the Usmanu Danfodiyo University Teaching Hospital in Sokoto, Nigeria. The data were collected using face-to-face interviews, transcribed verbatim, and analyzed using NVivo software.
RESULTS: The findings show that the participants experienced menstrual problems: men with menstruation and women with amenorrhea. The female participants generally described amenorrhea as a disappointment and linked menstruation with womanhood. Amenorrhea evinced both emotional and psychological effects. However, some of the female participants considered amenorrhea in a positive light and were happy with their lives without menstruation. The menstrual experiences of male participants included menarche, lower abdominal pain, regular monthly bleeding, and ovulation. The male participants described menstruation as a disaster in their lives and a source of anxiety, suicidal ideation, and depression. Menstruation negatively affected their psychosocial well-being.
CONCLUSIONS: The menstrual experience of individuals with DSD negatively affects their quality of life. The women with DSD in this study showed a generally poor knowledge of menarche, menstruation, and puberty, indicating that their parents had ignored the initial symptoms of DSD. DSD were only recognized at puberty because of the development of ambiguous physical traits and of the onset of menstruation in men and the confirmation of amenorrhea in women.

Matched MeSH terms: Amenorrhea/epidemiology
Cytogenetic profile of patients with clinical spectrum of ambiguous genitalia, amenorrhea, and Turner phenotype: A 21-year single-center experience

Elkarhat Z, Belkady B, Charoute H, Zarouf L, Razoki L, Aboulfaraj J, et al.

Am J Med Genet A, 2019 08;179(8):1516-1524.
PMID: 31207162 DOI: 10.1002/ajmg.a.61257

The aim of the present study was to determine the frequency and nature of chromosomal abnormalities involved in patients with the clinical spectrum of ambiguous genitalia (AG), amenorrhea, and Turner phenotype, in order to compare them with those reported elsewhere. The study was conducted in the Cytogenetic Department of Pasteur Institute of Morocco, and it reports on the patients who were recruited between 1996 and 2016. Cytogenetic analysis was performed according to the standard method. Among 1,415 patients, chromosomal abnormalities were identified in 7.13% (48/673) of patients with AG, 17.39% (28/161) of patients with primary amenorrhea (PA), 4% (1/25) of patients with secondary amenorrhea, and 23.20% (129/556) of patients with Turner phenotype. However, Turner syndrome was diagnosed in 0.89% (6/673) of patients with AG, 10.56% (17/161) of patients with PA, and 19.78% (110/556) of patients with Turner phenotype. In addition, Klinefelter syndrome and mixed gonadal dysgenesis were confirmed in 2.97% and 1.93% of patients, respectively, with AG, while, chimerism, trisomy 8, and trisomy 13 were confirmed only in 0.15% each. Trisomy 21 was confirmed in patients with AG and Turner phenotype (0.15% and 0.36%, respectively). Moreover, 5.60% (9/161) of patients with PA have been diagnosed as having sex reversal. Thus, the frequency of chromosomal abnormalities observed in Moroccan patients with PA is comparable to that reported in Tunisia, Turkey, Iran, and Hong Kong. However, the frequency is significantly less than that identified in India, Malaysia, Italy, and Romania.

Matched MeSH terms: Amenorrhea/epidemiology