Endocrine Abstracts

Background: Women with diabetes mellitus type 1 (DMt1) are known to have a higher prevalence of reproductive disorders, including delayed menarche, menstrual cycle abnormalities and рolycystic ovary syndrome (PCOS)-like phenotype.

Objective: To evaluate the menstrual cycle characteristics of women with type 1 diabetes mellitus as well as to compare them with healthy women of reproductive age.

Methods and patients: The study included 37 women with DMt1 and 38 clinically healthy women serving as a control group. A detailed gynecological anamnesis was obtained: age at menarche, menstrual cycle interval (MC), menstruation lenght, dysmenorrhea, pregnancies, births, miscarriages. Oligomenorrhoea was defined as having a menstrual cycle longer than 35 days throughout at least the past year. Primary dysmenorrhea wad defined as painfull menstruation unrelated to a secondary pelvic disease. The metabolic control was evaluated by the glycated haemoglobin (HbA1C). Anthropometric measurements, basal levels of testosterone (T), thyroid-stimulating hormone (TSH) and serum prolactin were studied in all participants. Body mass index (BMI) was calculated.

Results: There was no statistically significant difference in terms of age (P = 0.26) and BMI (P = 0.57) in the studied population. Euthyroid function and normoprolactinaemia were reported in all participants. Women in the DMt1 group had statistically significantly higher T and HbA1C levels than healthy controls (P =0.000). There was no significant difference in the age at menarche or menstruation lenght in women with DMt1 compared to the control group. The mean duration of MC in DMt1 group was (32.73±5.9), comapred to the control group (30.29±2.53), without reaching statistical significance (P = 0.07). 14 women (37.8%) with DMt1 reported oligomennorhea. A statistically significant difference between the relative proportion of diabetic women with dysmenorrhea (51.4%) compared to healthy controls with dysmenorrhea (23.7%) (z-test, P < 0.05) was observed. Women with DMt1 had a higher number of pregnancies (P = 0.005), births (P = 0.03) and miscarriages (P = 0.03) compared to healthy controls. A significant correlation was found between T and dysmenorrhea (r =0.508, P = 0.001) and with oligomennorhea (r =0.664, P = 0.000). There was also a positive significant relationship between dysmenorrhea and oligomennorhea (r =0.648, P = 0.000).

Conclusion: Despite satisfactory metabolic control, women with DMt1 have higher frequency of menstrual cycle irregularities. Early and precise examination of menstrual cycle characteristics of women with DMt1 is essential for developing a better approcah towards the reproductive dissorders observed in diabetic women.Key words type 1 diabetes mellitus, oligomennorhea, dysmenorrhea, menstrual cycle, testosterone.