• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.194-197
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• 2021

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m² for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2879-2886
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• 2012

In order to thoroughly analyze risk factors of breast cancer (BC) in premenopausal Uruguayan women, a case-control study was carried out at the Pereira Rossell Women's Hospital, Montevideo, where 253 incident BC cases and 497 frequency-matched healthy controls were interviewed on menstrual and reproductive story, were administered a short food frequency questionnaire and undertook a series of body measurements necessary to calculate body composition and somatotype. Odds ratio (OR) coefficients were taken as estimates of relative risk derived from unconditional logistic regression. Among the classical risk factors, only the family history of BC in first degree relatives was significantly associated with risk of premenopausal BC (OR=2.20, 95% CI 1.33-3.62). Interestingly, this risk factor was found to be stronger in women of ages >40 (OR=4.05, 95% CI 2.10-7.81), late menarche (OR= 2.39, 95% CI 1.18-4.85), early age for their first delivery (OR=3.02, 95% CI 1.26-7.22), short time between menarche and first delivery (OR=3.22, 95% CI 1.29-8.07), and with high parity (OR=4.10, 95% CI 1.79-9.36), although heterogeneity was detected only for age and parity. High consumption of red meat was positively associated with the disease risk (OR=2.20, 95% CI 1.35-3.60), in the same way as fried foods (OR=1.79, 95% CI 1.12-2.84). Conversely, a high intake of plant foods displayed a protective effect (OR=0.41, 95% CI 0.26-0.65). Except for hypertension (OR=1.55, 95% CI 1.03-2.35), none of the analyzed components of metabolic syndrome were associated to BC risk. Particular increases of risk for premenopausal BC were found for family history in first degree relatives in certain subsets derived from the menstrual-reproductive history. Preventive strategies could broaden their scope if new studies confirm the present results, in view of the limited prevention measures that premenopausal BC currently has.

• Journal of Korean Public Health Nursing
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• v.19 no.1
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• pp.53-63
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• 2005

The purpose of this study was to identify menstrual discomforts and coping m adult women. The subjects were 577 adult women. aged 20 years old and over. selected by convenient sampling. Data were collected through a questionnaire survey from December 2. 2004 to December 31. 2004. Two instruments were modified and used in this study. the Menstrual Discomfort Questionnaire by Park(1988) and the Menstrual Coping Questionnaire by Billings & Moos(198l). The data were analyzed by descriptive statistics. t-test. and ANOVA with SPSS 10.0 program. The results of this study were as follows. 1. The prevalence rate of dysmenorrhea was $85.6\%$. 2. The total mean score for menstrual discomforts was 2.82 of a possible total of 5. The mean score for each category was 3.10 for water retention. 2.93 for negative affect. 2.89 for pain. 2.74 for autonomic reactions. 2.73 for behavioral change. and 2.59 for concentration. 3. Statistical differences were found for menarche age(F=9.351. p<.00l), feeling to menstruation(F=12.376. p<.001). dysmenorrhea(t=7.3l7. p<.001). onset of dysmenorrhea (F= 12.766. p<.001). taking medication(t=6.289. p<.001). and degree of taking medication (F=12.924. p<.00l). 4. The coping modes with the highest scores were 'rest and go to the bed '$(83.3\%)$. 'regard menstruation as a physiological and temporary phenomenon' $(68.6\%)$, and 'take a warm shower' $(64.5\%)$. We conclude that there were many women with dysmenorrhea. that the first day was the onset of menstrual discomfort. and that it differed by menarche age. feeling to menstruation. dysmenorrhea. onset of dysmenorrhea. taking medication. and degree of taking medication. Nursing intervention has to be considered in programs to reduce menstrual discomfort.

• Journal of the Korean Society of School Health
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• v.24 no.1
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• pp.99-109
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• 2011

Purpose: The purpose of this study was to investigate factors influencing dysmenorrhea in middle school girls and to analyze the differences in dysmenorrhea according to personal factors of the subjects. Methods: This study was conducted from March 22 to April 2, 2010. The subjects of the study were 572 girls who attended three middle schools in Seoul and experienced dysmenorrheal. All were surveyed using the same questionnaire. Data were analyzed by the SPSS/WIN 12.0 program and included descriptive statistics, ANOVA and multiple regression analysis. Results: 1) The mean age of the subjects was 13.53 years, and the mean age of first menstruation (menarche) was 11.94 years. The number of days between the onset of menstrual cycles was 30.01 days. Most of the respondents had irregular menstrual cycles and menstrual periods lasting 3 to 7 days long. 2) Chief menstrual pains were lower abdominal and back pain. Subjects reported experiencing severe lower abdominal and/or back pain, most commonly on the second day of menstruation. The average score of menstrual discomfort was over 60 points (63%). The average score per 6 points of dysmenorrhea was as follows: fatigue (3.48), sensitivity (3.27), disability of movement (3.27), napping or lying down (2.98), mood swings (2.95), interference with studies (2.87). 3) Individual subject characteristics influencing the onset of dysmenorrhea were as follows: high stress levels, being in poor health, having an irregular diet, being younger and having longer menstrual periods than most other subjects. Conclusion: During puberty, girls with earlier menarche complained of physical and emotional discomfort, and irregular menstrual periods. Therefore, we need to explain overall menstrual characteristics and individual differences in the occurrence of dysmenorrhea, in health education programs.

• Korea journal of population studies
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• v.14 no.1
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• pp.55-69
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• 1991

The objective of the study is to figure out the status of reproductive health and general characteristics related to maternal health for Korean-Americans living in Los Angeles. We collected data from the married women who wanted no more additional child birth and were attending the Family Planning Clinic of Koryo Health Foundation in Los Angeles during 1988. There were 494 women met the eligibility requirement for this study. The results are summarized below. 1. In the age distribution of the women who desired no more additional child birth, women 30-34 age group constituted the largest proportion at 36.6 percent ; the mean age of women was 35.1915.55. The mean number of child birth was 1.77, and the proportion of the women by number of child birth were 35.2 percent for one children, 50.1 percent for two children 10.5 percent for three children, and 2.6 percent for four children. All of the women experienced pregnancy at least once, and mean number of pregnancy was 3.42. The mean number of total experience of induced abortion was 1.56. and 76.7 percent of these women had experience with induced abortions. To prevent further pregnancies, 90.1 percent of the women were utilizing the contraceptive methods, and the highest proportion by the contraceptive methods was condoms(53.7%), 9.3 percent in spermicides, 8.7 percent in IUDs, 8.7 percent in rhythm method, and 6.9 percent in oral pills. 2. The mean age of women at each stage of reproductive life cycle were 14.74 years at time of menarche, 24.55 years at time of marriage, 26.60 years at time of the first child birth, and 28.75 years at time of the last child birth. In age distribution of the women by birth cohort (Group I : birth cohort 1940-1954, Group H : birth cohort 1955-1970), the mean menar-cheal age of the women was 14.96 years in group I , and 14.53 years in group H . Mean age at time of marriage was 25.01 years in group I and 24.08 years in group H . Mean child birth age of the women by birth cohort was 27.19 years In group I and 26.01 years in Group II for the first child birth and 30.07 years in group I and 27.45 years in group II for the last child birth. The total length of reproductive life cycle from menarche to menopause (presumed to be at 49 of age years) was 34.26 years. The len-gth of phase I (from menarche to marriage) was 9.81 years, while phase H (marriage to first birth) was 2.05 years, and phase Ill (first birth to last birth) was 2. 15 years, and the last phase of reproductive life cycle, phase IV (last birth to menopause) was 20.25 years. The proportion of each phase 10 total length of reproductive life cycle was 28.6 percent, 6.0 percent 6.3 percent, and 59.t percent respectively. In the tendency of each phase in reproductive life cycle by birth cohort (group I , U ), the length of phase I, II , III of birth cohort group II was diminished in comparison with those of birth cohort group I , but the length of phase IV was extended by 2.38 years. 3. Among the women, the mean number of total pregnancy by birth cohort group was 2.01 in group I and 1.10 in Group II, and mean number of child birth was 1.97 in group I and 1.58 in group II. In terms of pregnancy was-tage rate by birth cohort group, among the total pregnancy of birth cohort group I , 51.8 percent of the cases resulted in induced abortions or spontaneous abortions whils 48.2 percent resulted in live births, and 42.2 percent or total pregnancy in group II resulted in pregnancy wastage and 57.8 percent of the cases resulted in live births.

• Journal of the Korean Dietetic Association
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• v.11 no.1
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• pp.86-94
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• 2005

This study was conducted to examine bone mineral density and factors which effect on bone mineral density such as daily nutrients intake, age, menarch age and physical condition among healthy female college students in Daegu area from April 20, to May 20, 2004. 1. Average age was 20.5$\pm$0.96 years old, average height was 160.9$\pm$4.30㎝, and average weight was 55.9$\pm$7.67㎏. Body mass index was 21.6$\pm$2.91㎏/㎡, body fat was 25.6$\pm$5.79％, menarche age was average 12.5$\pm$1.1 years old and WHR(waist/hip circumference ratio) was 0.8$\pm$0.01㎝/㎝. 2. Average level of bone mineral density(T-score -0.56$\pm$0.91) was in normal range. But, 11 persons(24.4％) are over T-score -1.0, 33 persons(73.4％) were within -1.0 - -2.5 and one person(2.2％) was under -2.5. It is very anxious level for Osteopenia-low bone mass, as research result shows 73.4% of the subject of examine on the level of Osteopenia. 3. Daily calorie intake was 2,550㎉ and each nutrient intake, compared to the seventh recommended dietary allowances for korean, was as follows ; Calorie 112％, protein 123％, calcium 78％, phosphorus 137％, iron 68％, vitamin A 101％, vitamin $B_1$ 141％, vitamin $B_2$ 95％, niacin 107％, vitamin C 128％ and zinc 120％. The ratio of calcium to phosphorus(Ca/P) is 0.66, low compared to RDA, but phosphorus intake is so high compared to RDA that precautions should be taken. The ratio of calcium to protein(Ca/Protein) is 8.55. 4. Menarche age and bone mineral density of calcaneus showed positive correlation and body mass index(BMI) indicated positive correlation. Age, height, weight. WHR and physical activity coefficient all do not indicate any significant correlation with bone mineral density. 5. Intake of Calorie, Ca, Ca/p ratio, carbohydrate and fat intake were positively correlated and, protein was negatively correlated, and Fe, Na, P and cholesterol were negatively correlated with BMD. These results indicate that average bone mineral density of subjects was in normal range, but subjects in the stage of osteopenia-low bone mass are many and bad effects are expected to have on their bone mineral density after menopause. Therefore, in order reach maximal bone mineral density, they should improve the balance between calcium and phosphorus and reduce salt intake. And it is thought that education and profound studies on relevant factors affecting the genesis of bone mineral density should be made.

• Journal of the Korean Society of School Health
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• v.20 no.1
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• pp.91-101
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• 2007

Purpose: The present study intended to reveal the association between the physique of adolescent women and dysmenorrhea, and the factors related to the frequency of dysmenorrhea. Methods: The study subjects included 511 girls of a women's high school in Daejeon city and they were, during the period of March 1st through April 30th, 2005, given self-administered questionnaires about frequency of menstruation, age, physique, exercise, and such menstruation-related items as age of menarche, menstrual period and days, and amount. Results: As with the frequency of dysmenorrhea, 38.4% experienced it 「always」, 44.6% 「occasionally」, and 17.0% 「almost scarcely」, and those with dysmenorrhea accounted for 83.0% of the subjects. The frequency of dysmenorrhea was not significant difference according to the BMI and HPI. However, the lower the age of menarche and the greater the amount of menstrual flow, the more frequent dysmenorrhea. The symptoms of dysmenorrhea included the highest frequency of low back pain(68.5%) and it was followed by abdominal pain(65.9%), sensibility(54.0%), fatigue(51.7%), and nervousness(49.5%). These accompanied symptoms tended to be worse as the frequency of dysmenorrhea increased. The multiple logistic regression analysis revealed that the relative risk of frequency of dysmenorrhea is 2.2 times in age of 14, by a standard age of 15 as menarchial age, 2.2 in 13, and 3.1 in below 12. The menstrual days was 3.0 times in both below 2 days and over 8 days with the standard days of 3-7 days. The menstrual amount was 1.9 times in the group with a greater amount of menstrual bleeding and 1.5 times in the group with a less amount than the normal group, respectively. Conclusion: The above results suggest that the rate of experiencing dysmenorrhea was up to 83.0% and 38.4% from these had dysmenorrhea upon every menstruation. It is thought that dysmenorrhea could be a great disadvantage sufficient to impair optimal health to a larger body of school girls. Further, for quality of life, it is required that more fundamental strategies instead of pain killers or others for palliation of dysmenorrhea would be established among adolescents.

• Journal of Korean Public Health Nursing
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• v.5 no.2
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• pp.45-51
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• 1991

The purpose of this study is to investigate the stress and coping level as a result of dysmenorrhea which was experienced by girls. For the collection of data, the girls from the 1st to the 3rd grade in middle school in Seoul were selected through a random sampling technique. The survey was conducted from the 1st. to the 14th of June, 1991 by the use of questionnaires made after a pilot study. The final subjects for analysis were restricted to only those who had experienced me~arche, the number of which totaled 1,131. The stress, coping level, and other variables, were tested and analysed by descriptive statistics (eg, frequency, percentage, mean and standard deviation), t-test, ANOVA and Pearson's correlation coefficients. The obtained results are summarized as follows. 1. The chronological start for menarche was at a mean age of 13.1 The respondents who had experienced menarche numbered $70.9\%$ of the 1st grades and $96.2\%$ of the 2nd grades in middle school, otherwise the starting age for menarche was in the 4th grade in primary school. 2. Their menstrual cycle and period were longer than adult's one. The number of students studied who had experienced dysmenorrhea during their menstrual cycle were 860, and 650 of those revealed that their mothers or sisters had experienced similar problems. 3. The subjects who were late or head left early rather than being absent from school every menstruation cycle were more stressful. The results are thought to show that the girl's perception of dysmenorrhea seems to be more sensitive than adult's one. 4, A significant negative correlation was found between the perception of menstrual flow and strees level. It means that an increase in the stress of dysmenorrhea was associated with decreased menstrual bleeding. The degree of hypochondrical concern assessed by the girls was significantly correlated to stress and coping level. When the girls perceived high stress as a result of dysmenorrhea, they worried about their physical health more. The above results lead us to the suggestion that the starting point of early education with a school program is appropriate for the 4th grade in primary school. Especially if the girls in middle school should be required to give the information about correct knowledge and sufficient self -care management of menstruation monthly, if this could be implemented the loss in school days among the students due to dysmenorrhea would be minimized with more ease.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3741-3745
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• 2016

Background: This study was carried out to examine breast cancer risk and its fertility predictors in women aged ${\geq}35$. Materials and Methods: This cross-sectional study was conducted on 560 healthy women referred to health centers of Tabriz-Iran, 2013-2014. Five-year and lifetime risk of developing breast cancer were determined using the Gail model. General linear modeling was applied to determine breast cancer predictors. Results: The mean age of the subjects was 42.7 (SD: 7.7) years. Mean 5-year and lifetime risks of developing breast cancer were determined to be 0.6% (SD: 0.2%) and 8.9% (SD: 2.5%), respectively. Variables of family history of breast cancer, age, age at menarche, parity, age at first childbirth, breastfeeding history, frequency of breastfeeding, method of contraception, marital status and education were all found to be predictors of breast cancer risk. Conclusions: According to the results of this study, screening programs based on the Gail model should be implemented for Iranian people who have a high risk for breast cancer in order to facilitate early detection and better plan for possible malignancies.

• Korean Journal of Health Education and Promotion
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• v.19 no.1
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• pp.171-184
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• 2002

The purpose of this study was to investigate the relationship between self concept and depression of middle-aged women. The Subjects were 102 middle-aged women whose age range were 40-59 years old living in urban area. The instruments used in this study were self concept scale developed by Rosenberg and the depression scale developed by Zung. Data were collected done from July 1 to July 31, 2001 by a structured questionnaire. The Data were analyzed by the SPSS/PC+ program using t-test, ANOV A and Pearson Correlation Coefficient. The results of the study were as followed : 1. Mean score of self concept was 2.35. 2. Mean score of depression scale was 2.43 3. The relationship between self concept and depression was statistically negative correlation(r=-0.3769, P〈0.001). 4. There were statistically significant differences in the score of middle-aged women's self concept to the age(F=3.41, P〈0.05), education(F=2.97, P〈0.05), Occupation(t=1.84, P〈0.05). 5. General characteristics variables were significantly related to the level of depression were the age(F=3.12, P〈0.05), numbers of children(t=3.59,P〈0.05). Obstetrical characteristics variables were significantly related to the level of depression were age of menarche(F=4.03, P〈0.05), times of abortion(t=10.09, P〈0.001). In conclusion, this study revealed that self esteem was an important factor related to depression. I suggest that to decrease depression, it should be encouraged self esteem.