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Cited by 73Diabetes Management and ResearchMenstrual Health and DisordersHypothalamic control of reproductive hormones

Menstrual cycle irregularities and their relationship with HbA1c and insulin dose in adolescents with type 1 diabetes mellitus

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Gaete, Ximena, Vivanco, Maritza, Eyzaguirre, Francisca C., López, Patricia, Rhumie, Hana K., Unanue, Nancy, Codner, Ethel·2010·Fertility and Sterility
DOI 10.1016/j.fertnstert.2009.08.039
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Abstract

Objective To evaluate the prevalence and risk factors of menstrual cycle irregularities in adolescents with type 1 diabetes mellitus. Design Prospective diary of menstrual cycle. Setting Pediatric diabetes clinics and nearby schools. Patient(s) Adolescents with type 1 diabetes mellitus treated with multiple daily insulin doses (n = 56) and 56 healthy adolescents. Main outcome measure(s) Duration and variability of menstrual cycle. Result(s) Duration of the menstrual cycle was 48 ± 39 and 32 ± 7 days in girls with type 1 diabetes mellitus and controls, respectively. Oligomenorrhea (58.9% vs. 19.6%) and amenorrhea (10.7% vs. 1.8%) were more prevalent in girls with type 1 diabetes mellitus than in controls. Oligomenorrhea was observed in 53.3% of the girls with type 1 diabetes mellitus with optimal metabolic control. Girls with an HbA1c level of 7.6% to 8.9% exhibited increased cycle duration, menstrual cycle variability, and prevalence of oligomenorrhea compared with controls. Regression analysis showed that, for each point of increase in HbA1c, the menstrual cycle duration increased by 5.1 days. Cycle variability was associated with a higher daily insulin dose. Conclusion(s) Despite optimal metabolic control, a higher prevalence of oligomenorrhea was observed in girls with type 1 diabetes mellitus compared with controls. This is the first report to describe the high variability of the menstrual cycle in type 1 diabetes mellitus. HbA1c and insulin dose are important factors related to menstrual irregularities in type 1 diabetes mellitus.

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  • Fluctuations in insulin sensitivity associated with the female menstrual cycle occur due to changes in the balance between estrogen and progesterone.

    “Fluctuations in insulin sensitivity associated with the female menstrual cycle occur due to changes in the balance between estrogen and progesterone.”

    From A study of changes in insulin requirements related to the menstrual cycle in Japanese women with type 1 diabetes using the advanced hybrid closed‐loop system (2026) · cites this paper as [2]

    The discussion under TABLE 2 links insulin dose and HbA1c to menstrual-cycle irregularities in adolescents with type 1 diabetes, but does not address menstrual-cycle fluctuations in insulin sensitivity. Searches for insulin sensitivity and estrogen–progesterone balance found no passage establishing the claimed mechanism; page numbers were unavailable in our copy. (LLM, conf=0.74)

    Experimental — accuracy not yet measured

  • Reduced insulin sensitivity begins around ovulation and peaks during the progesterone-dominant luteal phase.

    “Reduced insulin sensitivity is known to begin around ovulation and to peak during the progesterone‐dominant luteal phase 1 , 2 .”

    From A study of changes in insulin requirements related to the menstrual cycle in Japanese women with type 1 diabetes using the advanced hybrid closed‐loop system (2026) · cites this paper as [2]

    The discussion accompanying Table 2 links insulin dose to menstrual-cycle variability and proposes effects of insulin on ovarian function. It does not describe insulin sensitivity beginning to fall around ovulation or reaching its lowest point in the luteal phase. Searches for ovulation, progesterone, luteal phase, and cyclic insulin resistance found no passage addressing that timing; page numbers were not available in our copy. (LLM, conf=0.76)

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Authors
Gaete, X., Vivanco, M., Eyzaguirre, F. C., López, P., Rhumie, H. K., Unanue, N., & Codner, E.
Affiliations
  • Hospital Roberto del Rio (CL)
  • University of Chile (CL)
  • Hospital San Borja Arriarán (CL)
  • Complejo Asistencial Sótero del Río (CL)
ORCID
López, Patricia
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2010-10
Volume
94
Issue
5
Pages
1822-1826
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2009.08.039
OpenAlex
W1981944612
Cited by
73
References
46
Citations by year
2026: 1 · 2025: 5 · 2024: 9 · 2023: 7 · 2022: 7 · 2021: 4 · 2020: 10 · 2019: 1 · 2018: 4 · 2017: 2 · 2016: 2 · 2015: 3 · 2013: 7 · 2012: 4
FWCI
2.67
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
  • Americanae (AECID Library) (submittedVersion, other-oa)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
  • Universidad de Chile (submittedVersion)
Funders
Fondo Nacional de Desarrollo Científico y Tecnológico (N 1050452)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
type 1 diabetes, menstrual irregularity, oligomenorrhea, amenorrhea, HbA1c, glycemic control, insulin dose, menstrual cycle variability, adolescents
MeSH terms
Adolescent, Amenorrhea, Diabetes Mellitus, Type 1, Dose-Response Relationship, Drug, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Menstrual Cycle, Menstruation Disturbances, Oligomenorrhea, Predictive Value of Tests, Prospective Studies, Risk Factors, Time Factors, Prevalence, Case-Control Studies

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