with the decrease in estrogen levels, results in relative androgen excess as the menopausal transition progresses (Torr ens JI et al 2009). However, little is known about the trend of these hormonal changes in young women with primary ovarian insufficiency (POI). Here we investigate whether after the onset of menstrual irregularity the hormonal changes of these young women follow the same trend as in the natural menopausal transition.DESIGN: Cross-sectional study. MATERIALS AND METHODS: We evaluated women aged 18 to 42 with spontaneous 46, XX POI (n¼145) after they had been off hormone replacement therapy for at least two weeks. Serum free testosterone was measured by equilibrium dialysis and estradiol by competitive chemiluminescence immunoassay. We examined the relationship between reported time since onset of menstrual irregularity and serum estradiol and testosterone levels by using ANOVA after adjusting for age.RESULTS: At mean (SD) age of 31.6 AE 5.5 years, patients had experienced 88.5 AE 69.7 (range 3.3-299.8) months of menstrual irregularity. Mean estradiol and free testosterone level was 38.0 AE 41.6 (range 5.0-340.0) pg/ml and 2.4 AE 1.1 (range 0.2-6.3) pg/ml, respectively. Neither serum estradiol nor free testosterone level was significantly correlated with the duration of menstrual irregularity (r¼0.01, p¼0.9; and r¼0.10, p¼0.24, respectively).CONCLUSION: Unlike the natural menopausal transition, mean serum free testosterone and estradiol levels in women with 46, XX POI remain relatively stable as the time since onset of menstrual irregularity lengthens. This, combined with the findings of a broad range of serum values, characterizes this disorder as one in which intermittent and unpredictable ovarian function may extend for many years. . OBJECTIVE: Obstetrics and Gynecology resident scores on the REI section of the annual in-training exam are declining. Resident exposure to REI varies by program. The objective of this study was to determine if duration and quality of REI rotations are associated with resident satisfaction and perceived REI knowledge.DESIGN: Retrospective analysis of anonymous survey. MATERIALS AND METHODS: An anonymous, multiple-choice survey was provided to 4744 examinees during the 2008 Council on Resident Education in Obstetrics and Gynecology (CREOG) In-Training Examination. The survey queried residents' experiences on their REI rotation, satisfaction with the quality and duration of the REI rotation, and knowledge of REI. Logistic regression was used to assess the relationship between components of the REI rotation and self-reported knowledge of REI.RESULTS: In total 4670 residents (98%) completed the survey. Forty percent of residents described their knowledge of REI as poor. Fewer weeks dedicated to REI increased the risk of self-reported poor knowledge (P<0.001). Required vacation during the REI rotation and non-REI coverage more than two times a week was associated with more than a 60% increase in risk of poor knowledge (Odds Ratio (OR) 1.67, 95% Confidence Interval (CI): 1...
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