The influence of age at menarche, menstrual cycle length and bleeding duration on time to pregnancy: a large prospective cohort study among rural Chinese women

Zhang, Qingning; Yy, Wang; Zhang, Y; Hg, Zhang; Yang, Yuan; He, Yao; Jh, Xu; Zhao, Jun; Peng, ZQ; Ma, Xu

doi:10.1111/1471-0528.14469

Cited by 31 publications

(21 citation statements)

References 44 publications

(54 reference statements)

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“…Importantly, we show that a cycle length of 28 days is not common for many women, which is usually the reference length for a typical woman. Comparatively, previous analyses among women using fertility apps or cohort studies have reported that the mean or median cycle length for all women ranged between 28 and 30 days [ 8 , 11 , 33 , 34 ], and studies reporting on actual cycles reported means between 27.7 and 29.6 days [ 2 , 4 , 5 , 7 , 35 ]. These results cannot be extrapolated to an individual woman, and clinically, it is not helpful, as we have clearly demonstrated that the percentage of women with an average cycle length of 28 days is uncommon.…”

Section: Discussionmentioning

confidence: 97%

“…Data on aggregated cycles show mean cycle lengths of 28 to 29 days [ 2 , 3 ] and 29 to 30 days [ 4 - 7 ]. Other studies reporting on the number of women and their cycle length have demonstrated that 77% of women in the United States and Canada have a cycle length of 25 to 31 days [ 5 ]; 65% of rural Chinese women have a cycle length of 27 to 29 days [ 8 ]; and 84% of Australian women have a cycle length of 26 to 34 days [ 9 ]. Few studies also reported on the estimated day of ovulation, demonstrating an estimated day of ovulation at day 14 in only 3% to 10% of cycles [ 10 ] and at day 15 in 12% to 16% cycles [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Menstrual Cycle Length and Patterns in a Global Cohort of Women Using a Mobile Phone App: Retrospective Cohort Study

Grieger¹,

Norman²

2020

J Med Internet Res

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Background There is increasing information characterizing menstrual cycle length in women, but less information is available on the potential differences across lifestyle variables. Objective This study aimed to describe differences in menstrual cycle length, variability, and menstrual phase across women of different ages and BMI among a global cohort of Flo app users. We have also reported on demographic and lifestyle characteristics across median cycle lengths. Methods The analysis was run based on the aggregated anonymized dataset from a menstrual cycle tracker and ovulation calendar that covers all phases of the reproductive cycle. Self-reported information is documented, including demographics, menstrual flow and cycle length, ovulation information, and reproductive health and diseases. Data from women aged ≥18 years and who had logged at least three cycles (ie, 2 completed cycles and 1 current cycle) in the Flo app were included (1,579,819 women). Results Of the 1.5 million users, approximately half (638,683/1,579,819, 40.42%) were aged between 18 and 24 years. Just over half of those reporting BMIs were in the normal range (18.5-24.9 kg/m2; 202,420/356,598, 56.76%) and one-third were overweight or obese (>25 kg/m2; 120,983/356,598, 33.93%). A total of 16.32% (257,889/1,579,819) of women had a 28-day median cycle length. There was a higher percentage of women aged ≥40 years who had a 27-day median cycle length than those aged between 18 and 24 years (22,294/120,612, 18.48% vs 60,870/637,601, 9.55%), but a lower percentage with a 29-day median cycle length (10,572/120,612, 8.77% vs 79,626/637,601, 12.49%). There were a higher number of cycles with short luteal phases in younger women, whereas women aged ≥40 years had a higher number of cycles with longer luteal phases. Median menstrual cycle length and the length of the follicular and luteal phases were not remarkably different with increasing BMI, except for the heaviest women at a BMI of ≥50 kg/m2. Conclusions On a global scale, we have provided extensive evidence on the characteristics of women and their menstrual cycle length and patterns across different age and BMI groups. This information is necessary to support updates of current clinical guidelines around menstrual cycle length and patterns for clinical use in fertility programs.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Menstrual Cycle Length and Patterns in a Global Cohort of Women Using a Mobile Phone App: Retrospective Cohort Study

Grieger¹,

Norman²

2020

J Med Internet Res

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“…Menarche can be delayed by genetic factors, hypothalamus-pituitary-ovarian axis abnormalities, undernutrition, hard physical exercise, psychological factors, or chronic disease. These factors affect not only the menarche but also subsequent fertility of the women [17,18].…”

Section: International Journal Of Reproductive Medicinementioning

confidence: 99%

Determinants of Infertility among Married Women Attending Dessie Referral Hospital and Dr. Misganaw Gynecology and Obstetrics Clinic, Dessie, Ethiopia

Bayu

Egata

Kefale

et al. 2020

International Journal of Reproductive Medicine

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Background. Infertility is the inability to become pregnant after one year of sexual intercourse without the use of contraception. Epidemiological data suggest that 10 to 15% of couples around the world are suffering from infertility. The exact meaning of marriage is mainly fulfilled if the couple conceives and bears children. Failure of this often leads to unhappy married lives, divorces, and high levels of psychiatric morbidity. There is scarcity of data about determinants of infertility in Ethiopia. Therefore, the aim of this study is to identify the determinants of infertility among married women attending Dessie Referral Hospital and Dr. Misganaw gynecology and obstetrics specialty clinic, Dessie, Ethiopia, 2019. Methods. An institution-based case-control study was conducted on 281 participants. The participants were selected by a systematic random sampling technique. Data were collected using a structured interviewer-administered questionnaire. Data were entered into EpiData version 3.1 and exported to SPSS version 23 for analyses. Variables with p<0.25 in bivariable logistic regression were entered into multivariable logistic regression. Odds ratio with its 95% confidence interval was estimated to measure the direction and strength of the association. The level of statistical significance was set at p<0.05. Results. The determinants of women’s infertility were age at the first pregnancy (AOR=2.89; 95% CI: 1.105, 7.564), age at menarche (AOR=3.2; 95% CI: 1.278, 7.975), menstruation flow in days (AOR=4.17; 95% CI: 0.062, 0.929), multiple sexual partners (AOR=5.33; 95% CI: 2.124, 13.397), and history of STI (AOR=2.79; 95% CI: 1.088, 7.159). Conclusion. Age at the first pregnancy, age at menarche, multiple sexual partners, number of days of menstruation flow, and history of STI were determinants of women’s infertility. Infertility may bring about unhappy married lives, divorces, and high levels of psychiatric morbidity. Therefore, couples need to have heath education about risk factors for infertility.

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“…Menstrual abnormalities include painful cramps (dysmenorrhea), heavy bleeding (menorrhagia), absence of menstruation (amenorrhea), light or infrequent menstruation (oligomenorrhea) and premenstrual syndrome (PMS)[2–8]. These can be caused by a range of factors, including hormonal imbalances, genetic factors, infection, stress, and clotting disorders [9, 10], and are associated with complications such as anemia, osteoporosis, and in severe cases, infertility [11]. Abnormal menstrual patterns caused by altered hormonal balance may mediate the risk of hypertension.…”

Section: Introductionmentioning

confidence: 99%

Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: Results from Project ELEFANT

Barrow

et al. 2018

PLoS ONE

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BackgroundThe menstrual cycle is regulated by reproductive hormones such as estrogen which has been implicated in the pathogenesis of hypertension and is associated with obesity. However, to date there has scant study of hypertension in relation to menstrual characteristics and abnormalities. We hypothesize that adverse menstrual characteristics are associated with an increase the prevalence of hypertension and that this relationship is exacerbated by obesity.MethodsOur study leverages 178,205 healthy female participants (mean age = 29) in a population-based cross-sectional study in Tianjin, China. Menstrual characteristics including menstrual cycle length and regularity, menstrual bleeding length, menstrual blood loss and dysmenorrhea were assessed by self-reported questionnaires, and hypertension was diagnosed by physician. Multiple logistic regression models were used to assess the relationships between menstrual characteristics and hypertension.ResultsNormal length menstrual cycle (OR = 1.21, 95% CI: 1.03–1.41), oligomenorrhea (OR = 1.54, 95% CI: 1.12–2.07), irregular cycle (OR = 1.54, 95% CI: 1.22–1.93), and light menstrual blood loss (OR = 1.36, 95% CI: 1.06–1.72) were associated with hypertension among women who are overweight or obese, but not among women who are normal weight. Longer menstrual bleeding duration (OR = 1.44, 95% CI: 1.24–1.67) and dysmenorrhea were associated with increased prevalence of hypertension (OR = 1.20, 95% CI: 1.14–1.41) in all young women.ConclusionsThe prevalence of hypertension is higher among women with menstrual abnormalities, and this association is modified by overweight and obesity.

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The influence of age at menarche, menstrual cycle length and bleeding duration on time to pregnancy: a large prospective cohort study among rural Chinese women

Abstract: A later menarche, longer cycle, shorter or longer bleeding duration were associated with lower fecundity.

Cited by 31 publications

References 44 publications

Menstrual Cycle Length and Patterns in a Global Cohort of Women Using a Mobile Phone App: Retrospective Cohort Study

Menstrual Cycle Length and Patterns in a Global Cohort of Women Using a Mobile Phone App: Retrospective Cohort Study

Determinants of Infertility among Married Women Attending Dessie Referral Hospital and Dr. Misganaw Gynecology and Obstetrics Clinic, Dessie, Ethiopia

Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: Results from Project ELEFANT

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