the flow properties of blood during menstrual cycle in female undergraduate students in rivers state

Description

ABSTRACT

Menstrual flow properties are considered relevant indicators of reproductive health, though few studies have evaluated patterns among regularly menstruating premenopausal women. The authors evaluated self-reported flow properties, incidence of spotting, and associations with reproductive hormones among 201 women in the BioCycle Study (2020–2022) with 2 consecutive cycles. Flowing patterns were assessed by using daily questionnaires and pictograms. Marginal structural models were used to evaluate associations between endogenous hormone concentrations and subsequent total reported blood loss and flowing length by weighted linear mixed-effects models and weighted parametric survival analysis models. Women bled for a median of 5 days (standard deviation: 1.5) during menstruation, with heavier bleeding during the first 3 days. Only 4.8% of women experienced midcycle bleeding. Increased levels of follicle-stimulating hormone (β = 0.20, 95% confidence interval: 0.13, 0.27) and progesterone (β = 0.06, 95% confidence interval: 0.03, 0.09) throughout the cycle were associated with heavier menstrual bleeding, and higher follicle-stimulating hormone levels were associated with longer menses. Bleeding duration and volume were reduced after anovulatory compared with ovulatory cycles (geometric mean blood loss: 29.6 vs. 47.2 mL; P = 0.07). Study findings suggest that detailed characterizations of bleeding patterns may provide more insight than previously thought as noninvasive markers for endocrine status in a given cycle.

TABLE OF CONTENTS

COVER PAGE

TITLE PAGE

APPROVAL PAGE

DEDICATION

ACKNOWLEDGEMENT

ABSTRACT

CHAPTER ONE

1.0      INTRODUCTION

• BACKGROUND OF THE STUDY
• PROBLEM STATEMENT
• AIM AND OBJECTIVES OF THE STUDY
• RESEARCH QUESTION
• SIGNIFICANCE OF THE STUDY
• SCOPE OF THE STUDY

CHAPTER TWO

LITERATURE REVIEW

• REVIEW OF THE STUDY
• MENSTRUAL CYCLE
• ABNORMAL MENSTRUATION
• CAUSES ABNORMAL MENSTRUATION
• ABNORMAL MENSTRUATION DIAGNOSIS
• MANAGEMENT AND TREATMENT
• PREVENTION OF ABNORMAL MENSTRUATION

CHAPTER THREE

3.0      MATERIALS AND  METHODO

• STUDY DESIGN
• DATA COLLECTION
• POPULATION OF THE STUDY
• EXCLUSION CRITERIA
• SAMPLE AND SAMPLING METHOD
• BLOOD FLOW ASSESSMENT
• HORMONE AND OVULATION ASSESSMENT
• COVARIATE ASSESSMENT
• STATISTICAL ANALYSIS
• ETHICAL APPROVAL

 

CHAPTER FOUR

4.0      RESULT AND DISCUSSION

4.1      RESULT

4.2      DISCUSSION

4.3      LIMITATION OF THE STUDY

CHAPTER FIVE

• CONCLUSION

REFERENCES

 

CHAPTER ONE

1.0                                                      INTRODUCTION

1.1                                       BACKGROUND OF THE STUDY

Menstrual flow properties are considered relevant indicators of reproductive health, and changes in flow patterns may impact the quality of life for pre- and perimenopausal women (1). Menstruation is often irregular among women of early and late reproductive ages, but its variability among women of mid-reproductive age remains unclear (2, 3). Further, irregular bleeding patterns and midcycle bleeding may be indicative of endocrine dysfunction and uterine abnormalities, and such patterns have been associated with infertility, breast and ovarian cancers, type 2 diabetes, and cardiovascular disease (4). Studies of menstrual bleeding have typically been done among women taking hormonal birth control, suffering from bleeding disorders, trying to conceive, or who are perimenopausal (10).

Variations in sex hormone levels are hypothesized to be associated with bleeding patterns, as hormones throughout the menstrual cycle influence the proliferation and shedding of the endometrial lining of the uterus (3). During the follicular phase, endometrial cells proliferate under the influence of estrogen, but following ovulation, progesterone secretion stimulates additional morphologic changes in the endometrium. After an ovulatory cycle, menstruation is most often a result of progesterone withdrawal, which induces a series of events involving vasoconstriction, cytokine changes in the endometrium, and programmed cell death (23). Despite these known biologic relations, few studies to our knowledge have evaluated the association between hormonal changes and bleeding patterns among healthy young women who report regular menstrual cycles and are not trying to become pregnant.

Our goal was to analyze properties of menstrual flow, incidence of spotting, and associations with sex hormones among healthy premenopausal women with self-reported regular menstrual cycles. Evaluation of bleeding patterns is important for our understanding of expected flowing properties for identification of potentially abnormal cycles or underlying endocrine dysfunction.

The work is organized as follows: chapter one discuses the introductory part of the work,   chapter two presents the literature review of the study,  chapter three describes the methods applied, chapter four discusses the results of the work, chapter five summarizes the research outcomes and the recommendations.

1.2                                               PROBLEM STATEMENT

The menstrual cycle is the monthly series of changes a woman’s body goes through in preparation for the possibility of pregnancy. Tracking your menstrual cycles can help you understand what’s normal for you, time ovulation and identify important changes — such as a missed period or unpredictable menstrual bleeding. Menstrual flow might occur every 21 to 35 days and last two to seven days. For the first few years after menstruation begins, long cycles are common. However, menstrual cycles tend to shorten and become more regular as you age. The menstrual cycle, which is counted from the first day of one period to the first day of the next, isn’t the same for every woman, and this led to the study of the flow properties of blood during menstrual cycle in women.

1.3                              AIM AND OBJECTIVES OF THE STUDY

The main aim of this study is to observe the differences in the flow properties of blood during menstrual cycle in female undergraduate students in rivers state. The objectives of the study are:

1. To determine the differences in pattern of menstruation among undergraduate students.
2. To investigate and compare the menarcheal age, menstrual cycle regularity, menstrual flow duration, prevalence of premenstrual syndrome (PMS), and symptoms during menstruation (SDM), in

• To ascertain difference menstrual cycle flow experience of undergraduate students

1.4                                       Research questions

1. What are undergraduate students’ experiences of menstruation?
2. What are the antecedents of university students’ positive and negative experiences of menstruation?
3. How do undergraduate students’ menstrual experiences impact their education?
4. How do the menstrual experiences of undergraduate students from culturally diverse backgrounds, and non-binary and transgender menstruators differ from students in other groups?

1.5                                                   SCOPE OF THE STUDY

This study covers studying the menstrual age, menstrual cycle regularity, menstrual flow duration, prevalence of premenstrual syndrome (PMS), and symptoms during menstruation (SDM) among female undergraduate students in rivers state. The flow properties were assessed by using daily questionnaires and pictograms. Marginal structural models were used to evaluate associations between endogenous hormone concentrations and subsequent total reported blood loss and bleeding length by weighted linear mixed-effects models and weighted parametric survival analysis models.

1.6                                           SIGNIFICANCE OF THE STUDY

This study will serve as an avenue for having a deep knowledge about menstrual cycle, which will include the knowing when the flow is normal or abnormal, causes abnormal menstruation, abnormal menstruation diagnosis and , abnormal menstruation.