Menstrual irregularities affect more than 30% of women with Type 1 Diabetes Mellitus (T1DM). These abnormalities probably lead to reduced fertility and earlier menopause. T1DM management has changed over time, with even more emphasis on stringent levels of glycaemic control. Thus, we investigated whether therapeutic T1DM change affected the menstrual disorders proportion in women with T1DM.
A meta-analysis was performed considering clinical trials in which menstrual abnormalities in women with T1DM have been studied. The literature was checked for those studies in which T1DM women were compared to healthy age-matched subjects. Both case-control, cohort and cross-section studies were included. The primary endpoint was the menstrual dysfunction rate.
Menstrual dysfunction proportion was higher in women with T1DM compared to controls (odds ratio: 2.08; 95% CI: 1.43, 3.03, p<0.001), even when sensitivity analysis was performed considering only studies published after 2000. The age at menarche was higher for women with T1DM compared to controls (mean difference: 0.53; 95% CI: 0.32, 0.74 years, p<0.001). Menstrual abnormalities proportion in T1DM was inversely related to diabetes duration, but they were not related to both body mass index and to glycated hemoglobin.
Meta-analytic approach confirmed the correlation between T1DM and menstrual irregularities. In T1DM menstrual dysfunction seemed to be related neither to the therapeutic management change across years, nor to the glycemic control, nor to body weight. The pathogenetic mechanisms underlying are not fully understood.
Copyright © 2023 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.
