B-thalassaemia and normal menstrual cycle. Would we expect a better menstrual cycle if ferritin levels can be maintained at a lower level?

This paper contains the findings of a scientific research project pertaining to a population of women with β-thalassaemia and examining the frequency of their menstrual cycle. The evaluation of the menstrual cycle of the subjects (B- thalassaemia women) was based on the ferritin levels in hemoglobin before transfusion, the level of deironization and the response of the FSH-LH (Folic Stimulating Hormone-Luteinizing Hormone) after stimulation with GnRH. This study is retrospective and covers the period from 1981 to 1999. A sample of 122 B-thalassaemia women taken from the B-thaiassaemia patients referred to the "Nicosia Center for Thalassaemia" in Cyprus participated in the study. Subjects were divided into four groups according to their menstrual cycle. Women with a normal menstrual cycle were assigned to the first group, women with areomenorrhea to the second group, women with secondary amenorrhea to the third group and women with primary amenorrhea were put in the fourth group. The results obtained show that the age of the sample ranges from 15 to 48 years. The majority of the subjects (85%) were 20-40 years old. The largest group (34.1%) consisted of women with normal menstrual cycle. The results did not reveal any statistically important difference with reference to the frequency of deironization among the groups studied, while the hemoglobin levels ranged from 8.5-11 g/dL in all groups. An upward tendency in ferritin levels was found for every year (period studied=a total of 18 years) for the group with normal menstrual cycle in comparison to the group with primary amenorrhea. Statistically important differences were found for the minimum ferritin value between groups one and four (P<0.048). Finally, the average values of FSH and LH after stimulation with GnRH showed the minimum response in the secondary and primary amenorrhea groups. Statistically important differences (P<0.010) were reported for LH and (P<0.50) for FSH.

Keywords: β-thalassaemia, menstrual cycle, Ferritin, hemoglobin, cieironiza- tion, FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone)