Original StudyAge at Menarche and Menstrual Irregularities of Adolescents with Type 1 Diabetes
Introduction
The onset of menarche is a trademark of female pubertal growth, and menstrual irregularities are a common problem of early puberty. However, by late adolescence, 75% of girls report several problems related to menstruation, such as delayed or abnormal cycles or heavy menstrual bleeding, and they are the leading reasons for physician office visits by adolescents.1
Disorders in reproductive function have long been documented as a common problem for women of reproductive age with type 1 diabetes. Late menarche is commonly seen when type 1 diabetes develops in the peripubertal years, and some type of menstrual disorder is found in almost one third of all women of reproductive age with type 1 diabetes.2, 3, 4 Type 1 diabetes is considered to interrupt the regular hypothalamic-pituitary-gonadal function, particularly if the diabetes is inadequately controlled,2 so it influences menstrual cycles and other functions of the reproductive system.3, 4 Nevertheless, there is no adequate information regarding the natural history of menstruation in women with type 1 diabetes compared to women without diabetes across all ages in the reproductive lifespan. A small number of studies of menstrual irregularities and type 1 diabetes have incorporated comparison groups without diabetes, but the responsibility of potential familial factors relating to the menstrual characteristics of women with type 1 diabetes is not clear. In case-control studies of menstrual cycles, women with type 1 diabetes report a considerably greater frequency of menstrual irregularities,3, 4 such as oligomenorrhea and amenorrhea.3, 4 Additional menstrual cycle characteristics, such as duration and bleeding heaviness, have not been well investigated in young women who have type 1 diabetes. Furthermore, investigating menstrual irregularities might finally identify women at high risk for conditions such as osteoporosis and cardiovascular diseases,5 which are identified complications of type 1 diabetes.
The main purpose of this study was to investigate the age at menarche and the menstrual irregularities in adolescents with type 1 diabetes compared to those in healthy adolescents.
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Materials and Methods
This study was an aged-matched, controlled study that involved two groups—the study group and the control group. In all, 102 questionnaires were administered to the adolescents with type 1 diabetes, and 100 (response rate 98%) were completed and returned. Thus, the study group consisted of 100 adolescents aged 12 to 18 years with type 1 diabetes who attended the diabetes center of a children's hospital in Athens. The sample size was calculated by using power analysis, and it was found that the
Social and Demographic Characteristics of the Samples
Of the teens in the study group, 82% answered that they menstruated, and 92.9% of the adolescents in the control group said the same (P = 0.005).
A major criterion for the comparison of the two groups was the age distribution of the participants. The mean age of the participants in the study group was 15.0 years (95% CI, 14.6-15.4) as opposed to the mean age in the control group, which was 15.5 years (95% CI, 15.2-15.7), and no statistically significant difference was observed (P = 0.065).
Table 1
Discussion
The main purpose of this study was to investigate the age at menarche and the menstrual irregularities in adolescents with type 1 diabetes.
The 1-year delayed age at menarche in the adolescents with type 1 diabetes compared to healthy adolescents and to adolescents with onset of diabetes occurring prior to the age of 10 years had been previously confirmed by other researchers.3, 15, 16, 17, 18, 19
Our findings suggest that the age at menarche among adolescents having developed type 1 diabetes
Conclusion
Adolescents with type 1 diabetes are more likely to experience menstrual disturbances (oligomenorrhea) than are healthy adolescents. Among women with onset of diabetes prior to the age of 10 years, the age at menarche was delayed as compared to the age at menarche of those with onset of diabetes after the age of 10 years and to those who belonged to the group of healthy adolescents.
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Alterations in the Menstrual Cycle as a Peculiar Sign of Type 1 Diabetes Mellitus: A Meta-analytic Approach
2024, Canadian Journal of DiabetesMenstrual Dysfunction in Adolescents with Chronic Illness: A Systematic Review
2023, Journal of Pediatric and Adolescent GynecologyPrevalence of urinary system, pelvic organ, and genital tract disorders among women with type 1 diabetes in Germany
2021, Primary Care DiabetesCitation Excerpt :Although urogenital complications are common in individuals with T1D, data defining the expected prevalence, incidence, and risk factors is still limited. Studies published on this topic were performed outside of Europe [6,7], or on small patient samples [8], or more than 10 years ago [9–13]. It is important to identify and reduce the risk of developing these complications.
Puberty in type 1 diabetes mellitus: Advances in care are associated with changes in pubertal milestones and hormone profiles
2020, Current Opinion in Endocrine and Metabolic ResearchCitation Excerpt :Ovulation is not impaired in adolescents living with T1D [32]. However, menstrual irregularities are a frequent problem in this population [1,3,26,33] Oligomenorrhea is the most frequent abnormality of the menstrual cycle in adolescents with T1D, especially in those with poor metabolic control [34,35], with a prevalence of oligomenorrhea of 20–80% [33–36], compared with less than 10–20% in adolescents who are three years postmenarcheal [37]. Gaete et al. [33] reported a longer duration of the menstrual cycle by five days with each point of increase in the HbA1c level.
Diabetes: a metabolic and reproductive disorder in women
2020, The Lancet Diabetes and EndocrinologyCitation Excerpt :Oligomenorrhoea and increased cycle length are the most prevalent menstrual cycle abnormalities observed in contemporary type 1 diabetes groups. Menstrual dysfunction is especially prevalent in adolescents with type 1 diabetes, reported at 20–80%,17,19,20 compared with 20–40% in adult women with type 1 diabetes.21–23 A prospective study evaluating menstrual cycles in adolescents with and without type 1 diabetes showed that the risk of menstrual irregularities was six times greater in women with type 1 diabetes than in women without, and the risk became even greater with increasing HbA1c.24
Pubertal development in children diagnosed with diabetes mellitus type 1 before puberty
2015, Journal of Pediatric and Adolescent Gynecology