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|Title:||Reproductive chances after persistent menstrual disorders in adolescence|
|Authors:||Dramusic, V. |
|Citation:||Dramusic, V., Yang, M., Ratnam, S.S., Rajan, U. (1995). Reproductive chances after persistent menstrual disorders in adolescence. Contemporary Reviews in Obstetrics and Gynaecology 7 (4) : 230-238. ScholarBank@NUS Repository.|
|Abstract:||Five years or more follow-up are described in relation to 700 adolescents who presented with various menstrual disorders: 288 (41.0 per cent) had secondary amenorrhoea; 128 (18.3 per cent) primary amenorrhoea; 167 (23.9 per cent) dysfunctional uterine bleeding; and 117 (16.8 per cent) oligomenorrhoea. Detailed breakdown of clinical, endocrine and ultrasound features amongst the various groups of menstrual disorders were analysed and presented. Also, modalities of treatment and their outcome were assessed. An important feature was that adolescent girls with polycystic ovary syndrome (PCOS) were found in all the four major groups of menstrual disorders, comprising 25.6 per cent of subjects, indicating that this syndrome occurs earlier than once thought. A. subgroup of PCOS-like patients (clinical and endocrine features almost identical to PCOS but not all the ultrasound findings) may give some answers regarding progression to PCOS. An additional follow-up related to 128 cases of dysfunctional uterine bleeding and 36 with primary amenorrhoea originally surveyed in the period of 1970-79. The impact of various menstrual disorders on fertility, bone metabolism and estrogen-dependent cancer risk is discussed. Metabolic disorders associated with PCOS need long-term consideration also because of impaired carbohydrate tolerance and lipid disturbance. We concluded that primary amenorrhoea is not a benign entity: the incidence of infertility goes up to 38 per cent; many may need hormone replacement treatment, surgical procedures or later some form of assisted reproduction. Most complex was the group with PCOS, with chronic anovulation and its implications which persist in up to 37%. Similarly, among cases of dysfunctional uterine bleeding, chronic anovulation was noted in up to 26 per cent of individuals, which could impair the reproductive function. Obesity, length of menstrual disorder, time of onset and length of treatment were variables influencing outcome considerably, as well as reproductive potential.|
|Source Title:||Contemporary Reviews in Obstetrics and Gynaecology|
|Appears in Collections:||Staff Publications|
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