فهیمه رمضانی تهرانی

Cardiovascular diseases are common health problems in women. Evidence shows that serum prolactin levels can be related to the development of cardiovascular diseases. This study aimed to determine the association between prolactin levels and cardiovascular diseases in women.

In this population-based study, eligible women were chosen from the participants of the Tehran Lipid and Glucose Study. Cox model was used to evaluate the relationship between prolactin levels and the risk of cardiovascular diseases.

A total of 1279 women participated in this study. There was no significant difference in the prolactin levels between the two groups with and without cardiovascular diseases (p=0.98). Age (affected group: 36.97±7.24 years Vs. non-affected group: 31.68±7.26 years; p<0.001) and body mass index (BMI) (affected group: 28.07±4.52 kg/m2 Vs. non-affected group: 26.01±4.46 kg/m2; p<0.001) was significantly higher in the affected group than the non-affected group. Prolactin was not associated with an increased risk of cardiovascular diseases in the whole population and in the menopausal and non-menopausal groups. There was no association in unadjusted model. However, in the adjusted model, the risk of cardiovascular diseases increased by 7% and 12% for each unit of increase in age and BMI, respectively. Moreover, in postmenopausal women, the risk increased by 10 and 11% for each unit of increase in age and BMI, respectively. Also, the number of births increased the risk of cardiovascular diseases by 25% in the whole population and by 79% in women of reproductive age.

The results of this study did not show a statistically significant association between the risk of cardiovascular diseases and the serum prolactin levels in women.

 Polycystic ovary morphology (PCOM) is an ultrasound finding and, according to the Rotterdam criteria, one of the diagnostic criteria for polycystic ovary syndrome (PCOS) in adult women. Given the hormonal changes, such as serum prolactin levels, associated with the number of ovarian follicles and ovulation, this study aimed to investigate the relationship between PCOM (based on ultrasound evidence) and different serum prolactin levels.

In this study, data from the PCOS prevalence study in Iran and the PCOS prevalence study in Khuzestan were used. In these studies, a multi-stage cluster random sampling method was employed for sample selection, and data collection involved completing a questionnaire, conducting face-to-face interviews, collecting fasting venous blood samples for laboratory evaluations, and performing ovarian ultrasounds. In the present study, based on the inclusion criteria, 750 women were enrolled in two groups: the PCOM group (120 individuals) and the control group (630 individuals). A quantile regression model was used to assess the relationship between PCOM and prolactin levels, with a significance level set at p<0.05.

The mean prolactin levels did not significantly differ between the PCOM group and the control group. Even after adjusting for potential confounding factors (such as age, body mass index, and number of pregnancies), the quantile regression model revealed no significant differences in prolactin levels across any quintile between women with PCOM and the control group (p>0.05).

Our population-based study showed that prolactin levels are not significantly different between the healthy group and those affected by PCOM.

Subclinical hypothyroidism is one of the common thyroid disorders in women with polycystic ovary syndrome, which can lead to adverse outcomes. This review explored the effects of subclinical hypothyroidism on the clinical and biochemical features and complications of polycystic ovary syndrome. In this review, the keywords of hypothyroidism, subclinical hypothyroidism, polycystic ovary syndrome, metabolic syndrome, and diabetes were searched in the PubMed, Web of Science, Google Scholar, Scientific Information Database, and Magiran database to gather relevant publications up until May 2023. According to available evidence, adipose tissue disorders, inflammation, glucose absorption and production disorders, and insulin secretion disorders may lead to insulin resistance. Insulin resistance, in turn, predisposes to the occurrence of cardiometabolic and fertility disorders. There is no evidence supporting the exacerbation of clinical symptoms, such as hirsutism, menstrual disorders, and biochemical manifestations, but several pieces of evidence have noted that the probability of lipid and glycemic disorders in individuals with polycystic ovary syndrome may increase in the presence of subclinical hypothyroidism. Also, some studies have pointed out a high risk of fertility complications when polycystic ovary syndrome coincides with subclinical hypothyroidism. When managing the symptoms and complications of polycystic ovary syndrome, more attention should be paid to the potential adverse effects of concurrent subclinical hypothyroidism and related metabolic complications.

Diabetes mellitus (DM) and polycystic ovary syndrome (PCOS) are rising health issues. Evidence highlighted the potential for an increased risk of PCOS among females with DM across various locations and ethnicities. This study aimed to investigate the prevalence of PCOS among Iranian females with and without DM.

In this population-based cross-sectional study, eligible females were selected from participants of the Tehran Lipid and Glucose Study (TLGS). For this study, females with complete data were selected from Phase VI (2016–2018) of TLGS. The logistic regression model was used.

At first, 4435 women with definite information about PCOS status were included, women with unclear diagnoses of DM and PCOS were excluded, and finally, 2867 were included in the study. Then, they were divided into two categories, Under 40 years and over 40 years. Among females without DM aged <40 years, 28.3%, and among those with DM aged <40 years, 53.7% had PCOS. Among participants with DM, PCOS patients were younger and had better fasting blood glucose levels. Using logistic regression for PCOS risk from a logistic regression model in participants, it was found that among patients with and without DM, increasing age decreased the odds of PCOS by 85% and 42%, respectively. On the contrary, among participants without DM, a family history of DM increased the risk of PCOS (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.006 to 1.49, p=0.04).

The prevalence of PCOS was not significantly different between subjects with and without DM in our population.

Impaired endometrial receptivity and implantation failure have been reported in women with polycystic ovary syndrome (PCOS). However, the molecular mechanisms underlying impaired implantation in women with PCOS remain unclear. In this study, the relative expression of the CYP19 gene in ovarian granulosa cells (GCs), as well as SOCS3, HOXA9, and HOXA11 genes in the uterine tissue (genes involved in the implantation process) were examined in the adult rat model of PCOS compared to controls.

Five milligrams of free testosterone was subcutaneously injected into pregnant rats on the 20th day of pregnancy, and pregnant rats in the other group only received solvent. Female offspring who were exposed to androgen during their fetal life were considered as a rat model of PCOS, and female offspring from the other group were considered as the control group (n=8 in each group). The relative expression of the CYP19 gene in ovarian GCs and SOCS3, HOXA9, and HOXA11 genes in the uterus were measured using SYBR-Green real-time PCR.

A significant decrease in the relative expression of the CYP19 gene was observed in the ovarian GCs of the rat model of PCOS compared to controls (p=0.02). In addition, the relative expression of SOCS3 (p<0/001), HOXA9 (p=0.018), and HOXA11 (p=0.007) genes significantly decreased in the uterine tissue of PCOS rats compared to the controls.

Reduced expression of the CYP19 gene in ovarian GCs, SOCS3, HOXA9, and HOXA11 in the uterine tissue may be one of the molecular mechanisms underlying implantation failure in PCOS subjects.

Evidence suggests that prolactin and metabolic disorders have a significant impact on the pathophysiology of reproductive disorders in both males and females. This study aimed to summarize the existing literature in this field. In this review, we followed the SANRA checklist to compile relevant studies, and a search was performed until January 2023 using relevant keywords in PubMed, Web of Science, SID, Magiran, and Google Scholar. All articles related to the purpose of the current study were extracted and evaluated by the authors. The available evidence indicates that relatively high prolactin levels within the physiological range appear to be beneficial for metabolism. Dysregulation of this hormone, such as in hyperprolactinemia, can lead to various adverse metabolic effects, including insulin resistance, glucose intolerance, anovulation, defects in gonadotropin secretion, and sexual dysfunction. On the other hand, suppressed levels of prolactin can also disrupt both the reproductive and metabolic systems. The complex interaction between prolactin and metabolic markers in the body is believed to play an important role in metabolic and reproductive health. However, the optimal level of prolactin that reflects metabolic health and fertility in both genders remains unknown. Further research is needed to determine the factors that determine the metabolic role of prolactin in the reproductive system.

Alzheimer's disease (AD), a progressive neurodegenerative disease, is the most common type of dementia. Polycystic ovary syndrome (PCOS) is associated with metabolic and hormonal disorders, obesity, inflammation, gut microbiota dysbiosis, and an elevated risk of mood disorders and depression. Therefore, patients with this syndrome may be exposed to cognitive and memory disorders, followed by AD. The aim of this review was to focus on the cognitive function, memory, and the risk of dementia and AD in women with PCOS and to identify the factors affecting the risk of progression to these complications in women with this syndrome. Reviewing the literature on the relationship between PCOS and the occurrence of cognitive and memory disorders showed that several disorders linked with PCOS and some drugs used to treat these patients could positively or negatively affect the risk of the development of cognitive and memory disorders. While some reports have declared positive effects for androgens and oral contraceptive drugs on cognitive function and memory, others have argued that insulin resistance, obesity, inflammation, oxidative stress, gut microbiota dysbiosis, and depression may negatively affect cognitive and memory function in women with PCOS, predisposing them to AD. More studies are needed to estimate the risk of cognitive disorders, memory deficits, and AD in women with PCOS and to identify the factors involved in the development of these disorders. The early identification of PCOS patients at risk of developing these cognitive disorders can help prevent the progression of these conditions and appropriately treat them.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age worldwide. Most of the affected women with PCOS have clinical and biochemical symptoms of metabolic disorders. In recent years, researchers have shown the association between the gut dysbiosis with many types of endocrine diseases. Evidence showed that an imbalance of gut microbiota, immune disorder and environmental changes can contribute to various diseases including polycystic ovary syndrome. This study aims to summarize the role of gut microbiota in the development of common metabolic disorders in PCOS.

A comprehensive search was conducted on PubMed, Scopus, and Google Scholar databases for articles published from the beginning to 2022. Only articles with English abstracts were reviewed.

The composition of gut microbiota and related secretions influence the biochemical pathways involved in ovarian metabolism and the increase of androgens. This make individuals with PCOS more susceptible to or worsen metabolic disorders such as obesity, dyslipidemia, liver dysfunction, diabetes and heart disease. Furthermore, studies have shown that interventions targeting the gut microbiota can lead to improvements in metabolic indices. This study provides a comprehensive roadmap for identifying factors that contribute to the progression of PCOS and potential treatment methods.

Reversing gut dysbiosis by affecting metabolic pathways may be effective in the prevention and treatment of PCOS.

Gestational diabetes (GDM) is one of the serious complications of pregnancy which can lead to adverse outcomes for mother and offspring in the short and long-term. This systematic review study was performed to investigate the relationship between GDM and neurodevelopmental disorders in the offspring.

In this review study, to find the related articles, databases of PubMed, Scopus, Web of Science, and Google Scholar were searched using the keywords of gestational diabetes, offspring, cognitive disorder and behavioral disorder up to March 2022. The Newcastle-Ottawa scale was used to assess the quality of the studies. The findings of this study were reported qualitatively.

This study reviewed 14 observational studies with 728140 participants. The findings of included studies on the incident of neurodevelopmental complications in the offspring of mothers with GDM, who were diagnosed using different diagnostic criteria, show the possibility of neurodevelopmental complications in the offspring of mothers with GDM. The most common diagnosing criterion of GDM was the Carpenter-Coustan criterion; after that, the World Health Organization diagnostic criterion was the most common.

The available evidence mainly indicated the association between GDM and neurodevelopmental disorders in the offspring, while due to limited studies, it was not possible to compare the outcomes of different diagnostic and therapeutic approaches.

  Unwanted pregnancy can affect the sweet experience of motherhood and put a person at the crossroads of abortion or childbirth unaware of how each choice can affect a person's mental health, especially anxiety and depression. This study aimed to compare the rates of anxiety and depression between two groups of women with the experience of induced abortion and unwanted delivery.

  This research was conducted among 420 women with experience of unwanted pregnancy, including 210 women with a history of induced abortion and 210 women with a history of unwanted delivery. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were the main tools for gathering the related information. We collected demographic information, including marital status, age, number of children, occupation, and level of education. The associated data was analyzed based on an independent t-test using the Statistical Package for the Social Sciences (SPSS) software 19.

  The results showed that the rate of anxiety among women with a history of unwanted delivery was higher than those with induced abortion. Although there was no significant difference in depression between the two groups, most subscales of depression such as feelings of failure, dissatisfaction, guilt, self-blame, suicidal ideation, crying, apathy, indecision, feelings of worthlessness, impotence, changes in sleep patterns, irritability, changes in appetite, difficulty in concentration, fatigue, and sexual apathy in the group with a history of abortion were higher than the group of women with a history of unwanted delivery. In addition, the rate of anxiety and depression was higher among single women with experience of induced abortion than married ones (P<0.05).

  According to the results, different levels of depression are more likely to occur among women who experience induced abortion under the influence of cultural, social, and religious factors. On the other hand, the level of anxiety among mothers who choose the path of childbirth in the situation of unwanted pregnancy is higher due to the responsibilities of parenthood. Furthermore, the relationships out of the formal marriage in traditional societies like Iran are taboos and do not meet social acceptance; so single mothers have to abort secretly without having the right to choose. This coercion can explain the higher rate of anxiety and depression among single women with a history of induced abortion than married ones.

Practical Implications:

  The results of the present study can be used in the field of applied research and the development of preventive and therapeutic protocols and cover a large number of mothers and infants affected by anxiety disorders and depression due to unwanted pregnancies.

Polycystic ovary syndrome and primary headaches are common health problems in women around the world. Some evidence indicates that these two disorders may share some risk factors. This narrative review study was performed aimed to investigate the common pathways involved in the simultaneous occurrence of these two disorders.

In this narrative review study, the relevant keywords such as polycystic ovary syndrome and primary headache (migraine, cluster headache and tension headache) were searched in databases of PubMed, Scopus, Web of Science, and Google Scholar with English language limitation and no time limit until Nov 2019. Inclusion criteria were observational, experimental, and review studies, and the articles which presented findings appropriate to the objectives of this review study. Findings of this study were presented qualitatively.

In this study, 60 extracted articles were assessed. Polycystic ovary syndrome and primary headaches like migraine have some common risk factors and clinical consequences, but the possible overlap between these two disorders has not yet been identified. Numerous evidences have suggested that lifestyle and psychological factors are important factors that contribute in the development and progression of both disorders. In addition, other possible common pathological pathways include hormonal disorders (sex hormones, thyroid hormone, and prolactin), risk factors for metabolic abnormalities (insulin resistance, hypertension, and lipid disorder), obesity, and inflammatory factors.

The available evidence mainly indicates common pathways including hormonal, metabolic, and inflammatory abnormality in the development of polycystic ovary syndrome and primary headaches including migraine.

Employees in power plants are exposed to noise due to working with booster pumps, condensers, fans, boilers, steam valves, and other equipment. Noise, as a common detrimental factor, has devastating effects on human health. Today, infertility is one of the problems observed in different societies, and it is possible that noise, as a job stressor, affects fertility factors. The aim of this study is to investigate the relationship between occupational exposure to noise and the levels of some reproductive hormones in men working in power plants.

A descriptive-analytical study was conducted among the employees of different sections of the selected power plant around Tehran, in 2019. One hundred and twenty-two men working in the power plant were selected based on the age of 20-50 years, no history of infertility, and no use of bodybuilding supplements and steroids. They completed the Smoking and Petersburg Sleep Quality Index (PSQI) questionnaires, and their height and weight were measured to calculate Body Mass Index (BMI). Noise exposure was measured using the sound meter (SLM). Regarding the duration of each job task, the equivalent sound pressure level for individuals was calculated. Serum levels were determined for free testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH). The data were analyzed using SPSS version 25 statistical software.

There was no statistically significant relationship between demographic factors (marital status, work shift, education, sleep quality, and smoking) with serum levels of free testosterone, LH, and FSH. With increasing age (r=-0.25, P=0.005) and work experience, serum levels of LH decreased significantly (r=-0.203, P=0.025). In the study of the relationship between BMI and hormone levels, despite a decrease in the level of reproductive hormones with weight gain, no significant relationship was observed (P>0.05). There was no significant relationship between noise exposure and serum levels of free testosterone, LH, and FSH (P>0/05).

There was no relationship between noise exposure and demographic factors with the levels of free reproductive hormones, testosterone, LH, and FSH. However, it is not possible to make a definite statement in this regard without using more accurate methods to estimate male fertility performance and using a stronger study method.

Osteoporosis is humans' most common bone tissue disease that causes bone fractures. Based on the evidence, a combination of genetic and environmental factors, hormonal disorders such as estrogen deficiency, malnutrition, inflammatory factors, drugs, and physical inactivity are related to the pathogenesis of this disease. The present study aimed to review the effects of androgens and some endocrine diseases associated with androgen excess on bone health. PubMed and Scopus databases were searched to retrieve related articles, using the following keywords (“polycystic ovary syndrome” OR PCOS OR “cushing syndrome” OR “congenital adrenal hyperplasia” OR CAH) AND (Bone OR fracture OR osteoporosis OR osteopenia). Androgens are essential for the growth and maintenance of bone mass. Despite the positive effects of androgens on bone, a decrease in bone mineral density, osteoporosis, and an increased risk of fractures have been reported in patients with endocrine diseases exposed to androgen excess, including polycystic ovary syndrome, congenital adrenal hyperplasia, and cushing's syndrome. Decreased bone quality in these patients can be due to other associated factors, such as insulin resistance, obesity, increased inflammatory factors, gut microbiota dysbiosis, glucocorticoid therapy, and increased cortisol levels. In addition, long-term exposure to supraphysiologic doses of androgens may adversely affect bone health in these patients. Therefore, bone health in these patients should be carefully monitored, and preventive or therapeutic interventions should be taken for osteoporosis and fractures.

Gestational diabetes mellitus (GDM) is one of the most common complications occurring during pregnancy. This disorder is associated with adverse outcomes for mothers and their infants. Air pollution is one of the environmental stimuli that may predispose pregnant women to GDM. This systematic review examined studies on the relationship between air pollution and GDM incidence.

In this systematic review, the PubMed, Web of Science, and Scopus databases, as well as Persian databases of SID, Irandoc, and Magiran, were searched for related English and Persian articles using appropriate keywords until September 11, 2021. Out of 36175 related articles in the initial search, 31 eligible studies were evaluated. The quality of the articles was assessed using the Newcastle-Ottawa scale.

The review included 29 cohort studies, a case-control study, and a cross-sectional study. The quality assessment results showed that of the 31 studies selected, 29 (93.5%) were high quality studies, and only two (6.5%) were moderate quality studies. PM2.5 pollutants followed by NO2 pollutants were the most examined in the studies.

The results showed a direct relationship between air pollutants and GDM. The systematic review of the studies revealed that inflammation, oxidative stress, β-cell dysfunction, neurological, hormonal imbalance, intestinal microbiota imbalance, and insulin resistance may be involved in the association between air pollution and GDM.

Chronic kidney disease (CKD) is one of the most debilitating non-communicable diseases (NCDs). Since the incidence of NCDs increases after menopause, this study aimed to investigate the relationship between menopausal age and CKD incidence among menopausal women.

This study was performed longitudinally, and the subjects were selected from among 3697 postmenopausal women participating in the Tehran Lipid and Glucose Study. Among the subjects, those whose menopausal age and chronic kidney disease information were not recorded and who had chronic kidney disease before the study were excluded. Finally, 2,080 postmenopausal women remained in the study. The Cox regression model was used for data analysis.

By the end of the study, CKD occurred in 1351 menopausal women. The overall mean age of menopause was reported at 49.9±5.0. The mean age of menopause was 50±0.5 years in the patients and 49.7±5.0 years in others. After modifying the extraneous variables, the results showed that every year increase of age at menopause increased the incidence of CKD by 10% after menopause, with the hazard ratio of 1.10 and the confidence interval of 95% (1.07-1.13).

Menopausal age is directly related to the incidence of chronic kidney disease after menopause. Given the importance of CKD in reducing the quality of life and increasing mortality in patients, special attention should be paid to women of higher menopausal age in screening programs related to CKD.

The association between subclinical hypothyroidism (SCH) and gestational diabetes (GDM) is controversial. This study was performed with aim to compare the incidence of GDM in women with SCH and euthyroid women.

In this prospective study, data obtained from 1026 pregnant women (including 683 cases of euthyroid and 343 women with SCH) participating in the cohort study of Tehran thyroid and pregnancy (TTP) was used. Serum levels of thyrotropin (TSH), thyroxine (T4), T3-uptake, and thyroid peroxidase antibody (TPOAb) were measured at first visit of the first trimester of pregnancy; based on this, euthyroid and SCH women were identified. These two groups were evaluated for gestational diabetes. Data were analyzed using STATA software (version 13). The continuous variables were compared between the two groups using independent t-test and Mann-Whitney test, and categorical variables using chi-square test or Fisher's exact test. Log-binomial model was used to identify the effect of SCH and levothyroxine on GDM. P< 0.05 was considered statistically significant

There was no significant difference in the incidence of GDM in SCH women compared to the control group either in the unadjusted model or after adjusting for the effective risk factors. Also, there was no significant difference in the incidence of GDM between SCH with TPOAb+, SCH with TPOAb-, and euthyroid groups. The risk of GDM in the TPOAb positive group was not significantly different from TPOAb negative group. Serum TSH (p=0.9), T4 (p=0.8), T3-uptake (p=0.7), and TPOAb (p=0.4) levels were not significantly different between the GDM and non-GDM groups.

Although no significant association was found between GDM and SCH in this study, however, it seems that due to various factors affecting the incidence of SCH and GDM, such as different diagnostic criteria and reference values, proving this issue requires further studies.

Obesity and overweight and especially visceral fat accumulation are common findings in people with polycystic ovary syndrome and it has been shown that increasing body fat has a direct role in determining insulin resistance (4) Research shows that weight loss alone in women with polycystic ovary syndrome reduces insulin and androgen levels and resumes ovulation cycles (5) Research has also shown that in people with polycystic ovary syndrome, some cardiovascular risk factors such as fat profile (CHOL, TG, HDL, LDL) (7) are also affected due to The mechanisms of this disease are formed by this change in balance.Today, restrictions on diet and physical activity are recommended by experts as a priority for these patients (3). This has led to the use of different training methods, which have also yielded different results. Among these is a type of intense periodic Tabata exercise (13). Numerous clinical studies have reported significant aerobic, metabolic, musculoskeletal, and psychological benefits for water sports programs and intermittent swimming exercises (14).
However, in view of the above, it should be noted that due to the complications of polycystic ovary syndrome, which include infertility, cardiovascular disease and insulin resistance; Reducing the symptoms and treating this disease is very important. Therefore, according to the various results that have shown the role of exercise in controlling the symptoms and complications of this disease, and since no research has been done on the effect of Tabata exercises in water on these patients. The effect of Tabata exercises on cardiovascular risk factors in patients with polycystic ovary syndrome can be of particular importance.

The present research is a quantitative and applied study that was conducted with a two-group design (experimental and control) with pre-test and post-test. The statistical population of the present study consisted of all women with a body mass index of more than 29.9 in Isfahan with polycystic ovary syndrome. 30 people were selected as a sample from the community and provided they met the inclusion criteria, which were randomly assigned to the experimental group of Tabata + metformin exercise control. Subjects then completed a personal information questionnaire and blood samples were taken after 12 hours of night fasting to determine the level of research variables. In the continuation of the experimental group, the training program consisted of 12 weeks, 3 sessions per week and each session lasted 40 minutes of Tabata training in water with a special training song for 20 minutes and 10 minutes of stretching and cooling exercises. The dose of metformin prescribed in the experimental group was 500 mgr twice a day after breakfast and dinner. 48 hours after the last training session, blood samples were taken again from all subjects. Descriptive statistics and Shapiro-Wilk tests, one-way analysis of variance and Tukey's post hoc test were used to analyze the data using SPSS / 21 software at the significance level of 0.05.

The results of two-way analysis of variance test showed exercise (F = 47.708, P = 0.001, µ = 0.536), time (F = 26.049, P = 0.001, µ = 0.317) and exercise-time interaction (F = 69.105, P = 0.001 (5 = 0.552) had a significant effect on adiponectin in obese women with polycystic ovary syndrome. Regarding leptin, it was found that exercise, time and interaction of exercise and time had a significant effect on leptin and cholesterol in obese women with polycystic ovary syndrome. Also, the results of Ben Foroni test showed that leptin and cholesterol at the end of the period were significantly lower in the exercise group than the control group.The results also showed that exercise had a significant effect on triglyceride and LDL levels in obese women with polycystic ovary syndrome, but exercise time and interaction and time had no significant effect.Based on the results of two-way analysis of variance, it was found that exercise and interaction between exercise and time have a significant effect on HDL in obese women with polycystic ovary syndrome, but time has a significant effect on HDL in obese women with ovarian syndrome. It did not have polycystic.

It seems that the increasing nature of exercise in water, which with a gradual increase in the intensity of exercise and the use of intense exercise movements that were followed in the present study, has led to an increase in energy consumption and a significant increase in adiponectin concentrations. In addition, the involvement of larger muscle masses in this method of exercise has helped to intensify this process in obese women with polycystic ovary syndrome. Findings have shown that when working in water, more muscle groups are used to overcome water resistance, and this can be useful in increasing the dynamic pressure on bones and muscles and increase energy consumption(23). It seems that this mechanism is the main cause of changes in serum adiponectin in the present study.Intensity and duration of activity, nutritional status of individuals, blood sampling hours, calorie imbalance, rhythm of leptin wheels, etc. are affected by exercise (30). People who are more obese are more resistant to leptin, so they need more exercise to affect leptin levels (30).Modifying the leptin response to exercise can lead to insulin sensitivity and improve energy expenditure. In general, physical activity lowers leptin levels not only by reducing fat mass but also by increasing leptin sensitivity.The results of the present study showed that eight weeks of Tabata training in water had no significant effect on cholesterol levels in obese women with polycystic ovary syndrome. Cholesterol levels are affected by the balance between endogenous cholesterol and cholesterol from food. In the present study, nutrition and stress could not be controlled. Perhaps due to the pressure and duration of the protocol, cholesterol levels in obese women with polycystic ovary syndrome did not change significantly. Because the mechanism of action of exercise in improving lipid profile is related to the enzymatic processes involved in lipid metabolism, so if exercise was done with proper nutrition, it would allow for greater enzymatic and hormonal adaptation and changes in cholesterol.Regarding the possible mechanism of the effect of physical activity on blood lipoproteins, the findings of previous research have shown that physical activity reduces triglycerides by increasing the activity of two enzymes, lipoprotein lipase and lecithin cholesterol acyl transferase (32). It seems that longer training can be more effective on the lipid profile, while exercise affects most of the lipid profile of women with higher basal triglyceride levels (33). Also, one of the mechanisms of effect of regular physical activity is that it increases the transport and use of triglycerides by muscle (34).

Premenstrual syndrome is one of the most common menstrual disorders in women at reproductive age. This syndrome affects women’s quality of life and reduces their efficiency. On the other hand, the main cause is not known, various factors such as lifestyle, type of nutrition, and hormones affect it. Since vitamins and minerals have been suggested as possible factors affecting the severity of symptoms of this syndrome, so this study was conducted with aim to investigate the effect of vitamins and minerals on the symptoms of the syndrome.

In this narrative review study, to find the related studies, databases of SID, PubMed, and Google Scholar were searched according to the keywords including premenstrual syndrome, premenstrual syndrome symptoms, minerals, and vitamins from 1980 to 2020. The clinical trial and review studies which were published and the language of them was English or Persian were selected.

Some vitamins such as vitamin E, B6, D and some minerals such as magnesium, zinc, and calcium have a positive effect on the symptoms of premenstrual syndrome.

Since the optimal consumption of vitamins and minerals promotes general health, the results of this narrative review by identifying the challenges in this area, leads to the recognition and use of effective minerals and vitamins to reduce the symptoms of premenstrual syndrome.

The expression of adiponectin hormone and its receptors in the ovary suggests a regulatory role for this hormone in the female reproductive system. To identify the pathogenic mechanism of polycystic ovary syndrome (PCOS) and explain the effects of prenatal hyperandrogenization, the expression of the adiponectin gene (AdipoQ), and its receptors (R1 and R2) were assessed in the ovaries and granulosa cells (GCs) of PCOS rats.

Five pregnant Wistar rats in the experimental group received 5mg of free testosterone dissolved in 0.5ml of sesame oil and benzyl benzoate on the 20th day of pregnancy, and five mice in the control group received 0.5ml of solvent. AdipoQ, R1, and R2 expression were examined in female offspring ovaries at birth, 10 and 100 days (puberty), and in GCs of adult offspring. Relative gene expression was measured by TaqMan real-time polymerase chain reaction.

The expression of AdipoQ and its receptors in the ovaries of experimental mice at birth did not show a statistically significant difference from the control group. AdipoQ expression in the ovaries of the experimental group showed a decrease ten days after birth (P=0.001), after puberty (P=0.008), and in GCs (P=0.001) compared to the expression level at birth. There was a decreased expression of R1 and R2 at ten days of age compared to birth (P=0.046 and 0.001, respectively). AdipoQ and R2 expression were reduced in 10-day-old ovaries and GCs of adult offspring compared to the control group (P<0.05).

Prenatal hyperandrogenization could dysregulate the reproductive system by affecting AdipoQ, R1, and R2 ovarian expression after birth and puberty and play a role in the pathogenesis of PCOS.

Based on available evidence, exposure of the female fetus to androgens during the prenatal period, by affecting the expression of some genes, can cause polycystic ovary syndrome (PCOS) in adulthood. On the other hand, changes in luteinizing hormone (LH) levels and its receptor are associated with the risk of reproductive disorders, including PCOS. The present study aimed to evaluate the expression of the LH receptor gene in the ovaries of a rat model of PCOS induced by androgen exposure in the prenatal period.

In adult rats with PCOS and controls (eight animals in each group), different phases of the sexual cycle (estrous cycle) were determined using vaginal smears, and the anogenital distance (AGD) was measured using a vernier caliper. Ovarian granulosa cells were isolated, and RNA was extracted. The LH receptor gene expression levels in these cells were determined using the real-time polymerase chain reaction (PCR). Data were analyzed by GraphPad Prism software.

Irregular and longer sexual cycles, an increase in AGD (17.32 17 0.3 vs. 11.73 ± 0.26 mm (P=0.0001)), and a decrease in LH receptor gene expression (42. ± 0.12) 0 vs. 0.88 (0.13 (P=0.02)) were observed in the adult rat model of PCOS compared to controls.

A decrease in LH receptor gene expression in the ovarian granulosa cells may be one of the mechanisms involved in the pathophysiology of PCOS following prenatal exposure of the female fetus to androgens.

Despite the theoretical superiority of oral contraceptives (OCs) containing antiandrogenic progestins, to the products with androgenic activity, the clinical benefits of these compounds remain unknown. This study aimed to compare the efficacy of OCs containing desogestrel (DSG) or drospirenone (DRSP) on the hormonal, clinical and metabolic parameters of the patients with polycystic ovary syndrome (PCOS).

This study was a randomized clinical trial and included 126 patients with PCOS. Patients were randomly assigned to one of the intervention groups using OCs containing DSG or DRSP. Outcomes of interest, including serum androgens, Ferriman-Gallwey score, and anthropometric and metabolic parameters were measured at the baseline, third, and sixth months of treatment.

After 3 to 6 months of treatment with OCs, we found no significant difference between the two groups in regard to serum androgen levels. There were also no significant differences between the two treatment groups, in terms of Ferriman-Gallwey score and anthropometric parameters, except for waist circumference in the sixth month of treatment (P = 0.011). After 3 months of the intervention, patients treated with OCs containing DSG had higher levels of low-density lipoprotein cholesterol (LDL) (P = 0.017), higher systolic (P = 0.013) and diastolic blood pressures (P = 0.008) than those treated with OCs containing DRSP.

Although use of OCs containing antiandrogenic and androgenic progestins had the same effects on hormonal profiles, anthropometric and hirsutism parameters, compounds containing DSG were associated with more negative effects on serum lipids and blood pressure.

Cardiac function and resistance to ischemia/reperfusion (I/R) injury are affected by various factors including sex hormones, especially androgens and estrogens. The aim of this study was to examine the effects of prenatal testosterone exposure on cardiac tolerance to I/R injury in male rats during adulthood.

The hearts of male rats exposed to testosterone during the critical period of fetal development (experimental group) and also rats in the control group were isolated and perfused in a Langendorff apparatus. Values of hemodynamic parameters, including left ventricular systolic pressure (LVSP), left ventricular developed pressure (LVDP), rate pressure product (RPP) and peak rates of positive and negative changes in left ventricular pressure (±dp/dt) were recorded using a power lab system. Generalized linear regression model and generalized estimation equation model were used for data analysis.

At baseline (before ischemia), adult male rats in the experimental group demonstrated significantly higher values of LVSP, LVDP, RPP and ± dp/dt, compared to the rats in the control group (P < 0.05).
After reperfusion, the values of LVSP, LVDP, RPP and ±dp/dt significantly decreased in the experimental rats compared to the rats in the control group (P < 0.05).

The present study showed that fetal hyperexposure to testosterone led to lower cardiac tolerance to I/R injury in male rats, in adulthood.

Factors associated with menstrual irregularities are highly important. This study aimed to determine the association between age at menarche and menstrual irregularities in reproductive period.

This prospective longitudinal study, was done in women participating in Tehran Lipid and Glucose Study who did not reach menarche at the time of enrollment, but their age of menarche was recorded later during follow-up visits. The subjects were divided into three groups based on the age of menarche: 1- menarcheal age< 11 years; 2- menarcheal age 11-15 years, and 3-menarcheal age>15 years. The odds of menstrual irregularities were compared between these groups considering group 2 as reference. Statistical analyses were performed in STATA V13.

The odds of menstrual irregularities in women of group 1 was two times higher than those in group 2 (OR = 2.0, 95% CI: 1.1-3.8) that was 2.2 times higher (OR = 2.2, 95% CI: 1.1-4.2) after adjusting for age and body mass index.

Menarcheal age <11 years increases the risk of menstrual irregularities in reproductive women and should be considered as an influential factor in assessment of women with menstrual irregularities.

One of the most important factors affecting the stability of marital life is sexual health, which affects the human's quality of life. Therefore, it is important to take appropriate measures to maintain sexual health and prevent and treat the sexual disorders. This study was performed with aim to review the effect of medicinal plants in the treatment of sexual disorders.

To find the related articles in this narrative review study, the related keywords were searched in the databases of PubMed, Scopus, Web of Science, SID, Magiran, Embaseand Google Scholar until March 2020 without time limitation. For each plant, the selected clinical trials and reviews with full text and published in English or Persian were used.

In the present review study, after an initial review of 717 articles, finally 75 articles were reviewed.According to the findings of this study, the effects of plants on sexual disorders are different. Some plants like as Rose reduce dyspareunia, create orgasm and increase libido and some plants such as Ginger improve erectile dysfunction and sexual satisfaction. Some plants like as Tribulus are effective in reducing sexual dysfunction by increasing the number and quality of sperm as well as the increasing testosterone hormone.

The findings of this study showed that the use of appropriate plants can be effective in treating sexual disorders; however, more studies in this field are needed.

Polycystic ovary syndrome is the most common endocrine disorder of the reproductive system in women. It is associated with some diseases such as insulin resistance, type 2 diabetes, endometrial hyperplasia, increased risk of cardiovascular disease, depression and sometimes mental disorders (2). Insulin resistance is currently a common feature of polycystic ovary syndrome, which puts women at risk for type 2 diabetes, coronary artery disease, high blood pressure and obesity. According to research, 70% of women with this complication have insulin resistance (4). Insulin resistance leads to an increase in insulin levels, which stimulates androgen production in the ovarian stroma and impairs follicular development (5). In addition, research has shown that in people with polycystic ovary syndrome, some cardiovascular risk factors such as apolipoproteins (6) are also affected, which due to the mechanisms of this disease, this change in balance is formed. Research suggests that the most important way to prevent and treat infertility disorders in people with polycystic ovary syndrome is to control their diabetes and weight (16). Although the benefits of aerobic exercise have been proven in many studies, little research has been done on intense intermittent exercise. One type of intense intermittent exercise is the Tabata exercise (5). Numerous clinical studies have reported significant aerobic, metabolic, musculoskeletal, and psychological benefits for water sports programs and intermittent swimming exercises (22). Considering the above and the importance of treating polycystic ovary syndrome on the one hand and the importance of angiogenesis on the other hand, the researcher intends to investigate the effect of Tabata exercise in water and metformin on endostatin and in obese women with polycystic ovary syndrome.

The present research is a quantitative and applied study that was conducted with a two-group design (experimental and control) with pre-test and post-test. The statistical population of the present study consisted of all women with a body mass index of more than 29.9 in Isfahan with polycystic ovary syndrome. 30 people were selected as a sample from the community and provided they met the inclusion criteria, which were randomly assigned to the experimental group of Tabata + metformin exercise control. Subjects then completed a personal information questionnaire and blood samples were taken after 12 hours of night fasting to determine the level of research variables. In the continuation of the experimental group, the training program consisted of 12 weeks, 3 sessions per week and each session lasted 40 minutes of Tabata training in water with a special training song for 20 minutes and 10 minutes of stretching and cooling exercises. The dose of metformin prescribed in the experimental group was 500 mgr twice a day after breakfast and dinner. 48 hours after the last training session, blood samples were taken again from all subjects. Descriptive statistics and Shapiro-Wilk tests, one-way analysis of variance and Tukey's post hoc test were used to analyze the data using SPSS / 21 software at the significance level of 0.05.

The results showed that exercise (F = 27.424, P = 0.001, µ = 0.329) and the interaction of exercise and time (F = 5.865, P = 0.019, µ = 0.095) had a significant effect on adiponectin in obese women with polycystic ovary syndrome. But time had no significant effect on adiponectin in obese women with polycystic ovary syndrome (F = 0.001, P = 0.972, µ = 0.001). It was also found that insulin resistance at the end of the period was significantly lower in the exercise group than the control group (P = 0.0001). In relation to apolipoprotein A, exercise (F = 0.099, P = 0.754, µ = 0.002), time (F = 1.645, P = 0.205, µ 0.029) and exercise-time interaction (F = 1.213, P = 0.275) were determined. µ = 0.021) had no significant effect on the amount of apolipoprotein A in obese women with polycystic ovary syndrome. Other findings showed exercise (F = 1.138, P = 0.291, µ = 0.020), time (F = 0.585, P = 0.448, µ = 0.010) and exercise-time interaction (F = 0.713, P = 0.402, µ = 0.013 ) Have no significant effect on the amount of apolipoprotein B in obese women with polycystic ovary syndrome.

The results of the present study showed that 12 weeks of Tabata exercise program in water led to a significant reduction in insulin resistance in obese women with polycystic ovary syndrome. This finding of the present study is consistent with the results of research by Harrison et al. (2012) and Esmailzadeh Tolouei et al. (2015) (20-21). Probably the reason for the decrease in insulin resistance in the present study is a decrease in factors such as weight, body mass index and fat percentage in these people after exercise. Regarding apolipoprotein A, it can be said that apolipoprotein A catalyzes low-density lipoprotein in the blood vessel wall of the body, especially the vascular wall of adipose tissue, by activating the enzyme lipoprotein lipase. In sports activities, low-density lipoprotein catabolism develops. Therefore, it is necessary to increase apolipoprotein A, but since the increase in low-density lipoprotein was not significant in this study, the lack of increase in lipopathological catabolism can be considered a reason for not increasing apolipo protein A. On the other hand, it has been suggested that the increase threshold of apolipo protein A is to exercise more than one hour per session and more than twelve weeks (26). However, the training protocol was followed in the study for 12 weeks, which could be one of the reasons why apolipo protein A did not change. Finally, the fact that apolipoprotein B levels do not decrease following Tabata exercises in the present study may be justified by the fact that LDL levels do not decrease. It seems that controlling the diet by consuming less foods with high or high glycemic index and instead consuming foods with low or medium glycemic index can have a positive effect on the amount of apolipoprotein B (29). Therefore, by controlling this nutritional factor, positive changes of apolipoprotein B can be achieved after exercise. However, in the present study, subjects did not follow a specific diet. A period of Tabata training did not cause a significant change in apolipoprotein B levels in obese women with polycystic ovary syndrome.