title: The influence of stress on the menstrual cycle among newly incarcerated women.
abstract: OBJECTIVE
  We sought to estimate the association of stressful life events on menstrual function in incarcerated women.
  
  
  METHODS
  Project CONNECT is a study of reproductive health needs of incarcerated women conducted between June 2002 and December 2003. This analysis examines menstrual function in 446 women from this cohort who were under the age of 45. Regularity was defined as menses between 26 and 35 days long. Amenorrhea was defined as > or =90 days since last menstruation. Measures included stressful experiences and deprivation (e.g., physical or sexual abuse, stressful living conditions, exchanging sex for drugs or money, or having had an incarcerated parent).
  
  
  RESULTS
  Menstrual dysfunction was common in this population. Nine percent reported amenorrhea, and 33% reported menstrual irregularity. A number of stressors were associated with menstrual irregularity, including having a parent with history of alcohol or drug problems (relative risk [RR] = 1.34; 95% confidence interval [CI], 1.00-1.80), childhood physical or sexual abuse (RR = 1.48; 95% CI, 1.03-2.13), or any sexual abuse (RR = 1.49; 95% CI, 1.03-2.14) after adjusting for age, race/ethnicity, smoking status, and recent drug use. These effects were attenuated somewhat when excluding women who had reported any hormonal contraceptive use in the past 3 months.
  
  
  CONCLUSIONS
  Incarcerated women have high rates of amenorrhea and menstrual irregularity and the prevalence may be associated with certain stresses. Further research on the causes and consequences of menstrual dysfunction in this underserved population is needed.
authors.affiliation: Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO 63110, USA. allsworthj@wudosis.wustl.edu
authors.forename: Jenifer E
authors.initials: JE
authors.lastname: Allsworth
authors.forename: Jennifer
authors.initials: J
authors.lastname: Clarke
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
authors.forename: Megan R
authors.initials: MR
authors.lastname: Hebert
authors.forename: Amy
authors.initials: A
authors.lastname: Cooper
authors.forename: Lori A
authors.initials: LA
authors.lastname: Boardman
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000453:epidemiology; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008599:Menstruation Disturbances / Q000453:epidemiology*; D016017:Odds Ratio; D011293:Premenstrual Syndrome / Q000453:epidemiology; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D012237:Rhode Island / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D016387:Women's Health