Effects of valproate and cardbamazepine on reproductive function in adolescent girls with epilepsy

This study was conducted on 40 epileptic adolescent girls aged from 12-18 years old suffering from idiopathic generalized or partial epilepsy to evaluate the effect of vaiproate [VPA] and carbamazepine [CBZ] on their reproductive function. They were compared with 20 healthy control girls of the same age range. Anthropometric indexes, body mass index [BMI], and transabdominal ultrasonography were evaluated. Serum concentrations of follicle-stimulating hormone [FSH], luteinizing hormone [LH], testosterone, and insulin were measured. The results showed that VPA-treated girls had more menstrual disturbances, acne, obesity, and polycystic ovaries than CBZ-treated and control groups. No hisutism was found. Serum concentrations of testosterone and insulin were significantly higher in VPA-teated group than in the other two groups. We concluded that VPA might induce hyperandrogenism in epileptic girls. This emphasizes the importance of careful endocrine observation of girls taking VPA for epilepsy

Effect of depo-provera on serum cortisol and the reserve capacity of suprarenal cortex

Depot-medroxy progesterone acetate [DMPA][Depo-provera] is a long acting [three months] contraceptive for intramuscular injection. The present study evaluates the effects of Depo-provera on the blood cortisol [morning samples] among twenty [20] multiparous users of Depo-provera injection prior to and after 7 days, one and 3 months of injection. The effect of this drug on blood corticosterone was, also, investigated in female albino rats prior to and after one, seven [7], and fifteen [15] days of its injection. The intra-peritoneal [IP] injection of the Depo-provera to female rats caused a significant gradual decrease of blood corti-costerone level after one, seven, and fifteen days of injection. Same results were obtained in women who were injected intramuscularly with the drug. The 5-h Synacthen [ACTH stimulation test] showed a significant gradual decrease in adrenal response in rats. These data show impairment of the response of pro gestin users to powerful or prolonged stress, such as long operative time, or any other life stressors

Menstruation among adolescent school girls

This work was carried out to study the characteristics and problems of the menstrual cycle among adolescent schoolgirls, the knowledge of girls about different aspects of menstruation and to assess the practicing of menstrual hygienic measures in relation to their knowledge. The study was carried out on 210 postmenarcheal schoolgirls aged 13-16 years [104 preparatory school girls and 106 secondary school girls] as a random sample from one preparatory and one secondary school at El-Mahalla El-Kobra City, Gharbia Governorate during the scholastic year 1999-2000. The average menarcheal age was 12.63. +/- 0.99 years. The mean duration of menstrual blood flow was 4.74 +/- 1 .60 days. Most of the studied girls [60%] had menstrual cycle of normal length [28-32 days]. Only 36.67% of the studied girls menstruating blood in average amount. Most of the studied girls menstruating regularly [87.14%]. Nearly two thirds of the studied girls suffered from premenstrual symptoms [66.24%], with significant higher percent among secondary school girls than preparatory ones [72.64% and 57.69% respectively]. Vulvitis was detected among 15.24% of the studied girls during the period of the study with no significant difference between preparatory and secondary schoolgirls. The most frequent premenstrual symptoms among the studied girls were abdominal cramps, impaired concentration, headache, mood changes and low work performance with significant difference between them. Abdominal cramps and low work performance were more frequent among preparatory school girls than secondary school girls. Some premenstrual symptoms, were more frequent among secondary school girls than preparatory ones as headache, mastalgia, backache, fatigue and behavioral changes. The menstrual gynecological problems were detected among 88.10% of the studied girls, with no significant difference between preparatory and secondary schoolgirls. The most frequent menstrual problem was dysmenorrhea [75.71%], with higher percent among preparatory than secondary schoolgirls [81 .73% and 69.8 1% respectively]. Heavy menstrual bleeding represented 47.62%. followed by hypomenorrhea [14.29%] and polymenorrhea [7.62%]. Menstruation was a leading cause to other non-gynecological problems including: decreased daily activities, impaired school performance and school absentism, with no significant difference between preparatory and secondary school girls. 37.03% of the studied girls had correct knowledge, 30.11% had false knowledge and 32.86% had no information about menstruation. The pattern of distribution of' knowledge as being good or unsatisfactory was significantly different between preparatory and secondary schoolgirls regarding good knowledge about; premenstrual symptoms, changes that occur differences regarding their knowledge about menstrual hygiene, Statistically, there were significant differences between correct and bad practice of hygienic measures among the studied girls on the light of their knowledge regarding; perineal hygiene, use of chemicals during perineal wash, frequency of changing pads during menstruation, sanitary disposal of pads, and bathing during menstruation [with higher percents of good knowledge and correct practice among secondary schoolgirls than preparatory ones]. 84.29% of the studied girls depended on a single source of information about menstruation. The highest percent of the studied girls depended on their mothers as a source of information [51.43%]. The level of education among parents of the studied girls denoted that their reproductive knowledge was not sufficient as a source of information and they must be indulged in the programs of reproductive health education for the benefit of their daughters. The occupation of parents and their economic standard may have a role as a barrier for good practice of hygienic measures inspite of the good knowledge among their girls. The findings of the present study point to the need for early school-based reproductive health education programs, incorporating correct information on reproductive biology and the subsequent prevention of reproductive ill health. The reproductive education programs designed for schoolgirls must be based upon their true knowledge at different education grades, putting in consideration the role of their curriculum