Fetal size at the 32nd gestational week is associated with the risk of breech presentation at term birth.

OBJECTIVES: The association patterns between breech presentation at birth and fetal biometry at the first, second, and third trimesters, newborn size but also maternal age, body height, prepregnancy weight status as well as gestational weight gain, were analyzed using a dataset of 4501 singleton term birth in Vienna, Austria. METHODS: In this medical record-based study, fetal biometry was reconstructed based on the results of three ultrasound examinations conducted at the 11th/12th, 20th, and 32nd gestational weeks. Head dimensions, abdominal dimensions, and femur length were determined by sonography. Birth weight, birth length, and head circumference were measured immediately after birth. RESULTS: The total breech presentation rate at birth was 6.2%. Breech newborns were significantly (p < 0.001) shorter and lighter at the time of birth, their head circumferences, however, were significantly larger (p = 0.001). At the 32nd week, breech fetuses showed significantly smaller biparietal breadths, but highly significantly longer heads. Their abdominal dimensions were significantly smaller, and their femora were shorter. Higher maternal age, and a longer, but narrower fetal head as well as smaller abdominal dimensions at the 32nd gestational week were independently related to a higher risk of breech presentation at the time of birth. CONCLUSIONS: Fetuses who remain in a breech presentation until term birth (≥37 gestational weeks) differed significantly in head and abdominal dimensions from cephalic fetuses from the 32nd gestational week onwards.

An increase in the developmental tempo affects the secular trend in height in male Austrian conscripts birth cohorts 1951-2002.

OBJECTIVES: Using population-based data on height in Austria from birth cohort 1951 to 2002, we aim to evaluate the secular trends in height and developmental tempo among Austrian young men. METHODS: Data were obtained from the Austrian conscription medical examination. We included 1 205 112 conscripts (18-<20 years) who were born between 1951 and 2002 and 853 645 conscripts (17-<19 years) who were born between 1961 and 2002. Height was measured during the medical examination and was used to evaluate the secular trends of mean height over time. Furthermore, the mean difference in height between conscripts of 17- and 18 years old were compared across birth cohorts. RESULTS: The mean height of conscripts aged 17 years increased by 2.2 cm (p < .0001) in between 1961 and 2002. The mean height of conscripts aged 18 years increased by 4.3 cm (p < .0001) between 1951 and 2002. However, the increase in mean height has slowed down since the 1970 s. The difference in mean height between 17 and 18 years old widened from about 0.1 cm in 1961 to 0.3 cm around 1970 and then steadily narrowed again to 0.1 cm at the end of the study period. CONCLUSIONS: The increasing trend in height slows at the end of the 20th century, the developmental tempo at the population level, however, continued to increase. The difference in mean height between 17 and 18 years old narrowed, which may indicate that young men reached their final height earlier.

Lower educational level remains associated with lower body height among Austrian conscripts born from 1961 through 2002.

Growth patterns and final body height are influenced by genetic and socio-environmental factors. A major impact of education on growth has been documented. Body height increases with an increasing educational level.The present study focuses on the association patterns between body height and educational level among 1,734,569 Austrian male conscripts aged 17 to <19 born between 1961 and 2002. Four levels of education were classified to examine their association with body height. Over 42 years, the percentage of conscripts at the lowest educational level decreased dramatically from 37.5% to 1.7%. All educational classes showed increasing body heights over time. Despite a marked improvement in the living standard, body heights at different educational levels did not converge. In Austria, educational and social advancement was associated with higher population body heights. Young men at the lowest educational level, however, remain shorter and their body height gap to the highest educational level has widened.

The Handedness Index Practical Task (HI20): An economic behavioural measure for assessing manual preference.

ABSTRACTBecause self-report hand preference measures are limited to investigating cognitive aspects of manual laterality, valid, easy-to-administer and economic behavioural methods are needed for capturing the motoric component of handedness. Therefore, this study introduces the Handedness Index Practical Task (HI20) and tests it in a sample of 206 students (Mage = 23.79 years, SDage = 3.01 years), half of whom were self-specified left-handers. After confirming good reliabilities at the subscale and total scale levels, k-means cluster analysis allowed an empirically based partitioning of test subjects into left- (n = 72), mixed- (n = 23) and right-handers (n = 111). To validate this categorization and the HI20 index, data were compared with the Edinburgh Handedness Inventory (EHI), EHI-short, HI22 and hand grip strength. The congruency between the HI20 clusters and alternative categorizations ranged from 95.6% to 84.0%, while the clusters explained large portions of variance in grip strength differences. The HI20 sub- and total scores showed strong correlations with other measures of lateral preference. Altogether, the freely available HI20 emerges as a reliable and valid alternative for behavioural handedness assessment, whose power lies in explaining differential hand use patterns and enabling fine-grained examinations of handedness.

Low digit ratio (2D:4D) is associated with early natural menopause.

OBJECTIVES: Intrauterine environmental conditions may affect the number of primordial follicles and in this way the timing of menopause. The aim of the present study was to investigate association patterns between right hand digit ratio, that is, 2D:4D - as an indicator of prenatal androgen and estrogen exposure, and age at menopause. METHODS: One hundred sixty-nine women, who had experienced natural menopause, were enrolled in the study. Length of second and fourth finger were measured directly from the palmar side and digit ratios of both hands were calculated. For further analyses the digit ratio of the right hand was used only. Additionally, smoking habits, body weight and body height, body mass index and the number of children were determined. Multiple regression analyses were used to test association patterns between digit ratio and age at menopause, body height, BMI, nicotine consumption as well as number of births and age at menopause. RESULTS: Age at menopause correlated significantly positively with the digit ratio. A more feminine digit ratio is associated with a higher age at menopause, while a low digit ratio, interpreted as a hint of a higher androgen exposure during prenatal phase was associated with a lower age at menopause. CONCLUSIONS: Low digit ratio is associated with an earlier onset of natural menopause.

Meeting Report: Growth and Social Environment. Proceedings of the 25th Aschauer Soiree, held at Krobielowice, Poland, November 18th 2017.

Twenty-two scientists met at Krobielowice, Poland, to discuss the impact of the social environment, spatial proximity, migration, poverty, but also psychological factors such as body perception and satisfaction, and social stressors such as elite sports, and teenage pregnancies, on child and adolescent growth. The data analysis included linear mixed effects models with different random effects, Monte Carlo analyses, and network simulations. The work stressed the importance of the peer group, but also included historic material, some considerations about body proportions, and growth in chronic liver, and congenital heart disease.

Directional and fluctuating asymmetry among !Kung San and Kavango people of Northern Namibia: The impact of sex and subsistence patterns.

OBJECTIVES: The impact of sex and subsistence on fluctuating and directional asymmetry patterns was tested among !Kung San and Kavango people from northern Namibia. METHODS: Fluctuating and directional asymmetry from 6 paired traits were measured in a sample of 236 !Kung San and 248 Kavango people aged 18 to 65 years in the Kavango district and the Nyae-Nyae area of northern Namibia. Signed asymmetry, absolute and relative asymmetry, as well as composite fluctuating and directional asymmetry, were calculated. RESULTS: Males of both ethnic groups exhibited higher fluctuating asymmetry in comparison to their female counterparts. Marked differences in directional asymmetry of the upper extremities were found between !Kung San and Kavango people. The !Kung San people showed a significantly higher directional asymmetry than the Kavango people. CONCLUSIONS: Foraging subsistence increased directional asymmetry of the upper extremities among males as well as females. In contrast, higher fluctuating asymmetry-indicating a higher degree of developmental instability-was found among males independent of subsistence group.

MATERNAL HEIGHT AND PRE-PREGNANCY WEIGHT STATUS ARE ASSOCIATED WITH FETAL GROWTH PATTERNS AND NEWBORN SIZE.

The impact of maternal height, pre-pregnancy weight status and gestational weight gain on fetal growth patterns and newborn size was analysed using a dataset of 4261 singleton term births taking place at the Viennese Danube Hospital between 2005 and 2013. Fetal growth patterns were reconstructed from three ultrasound examinations carried out at the 11th/12th, 20th/21th and 32th/33th weeks of gestation. Crown-rump length, biparietal diameter, fronto-occipital diameter, head circumference, abdominal transverse diameter, abdominal anterior-posterior diameter, abdominal circumference and femur length were determined. Birth weight, birth length and head circumference were measured immediately after birth. The vast majority of newborns were of normal weight, i.e. between 2500 and 4000 g. Maternal height showed a just-significant but weak positive association (r=0.03: p=0.039) with crown-rump length at the first trimester and with the majority of fetal parameters at the second trimester (r>0.06; p0.09; p0.08; p0.17; p0.13; p0.13; p<0.001), were significantly positively associated with newborn size. Some of these associations were quite weak and the statistical significance was mainly due to the large sample size. The association patterns between maternal height and pre-pregnancy weight status with fetal growth patterns (p<0.001), as well as newborn size (p<0.001), were independent of maternal age, nicotine consumption and fetal sex. In general, taller and heavier women gave birth to larger infants. This association between maternal size and fetal growth patterns was detectable from the first trimester onwards.

Intergenerational Contacts Influence Health Related Quality of Life (HRQL) and Subjective Well Being among Austrian Elderly.

Over the last century population ageing is a well described phenomenon all over the world. The dramatic absolute and relative increase in the population component of the elderly and the very old has influenced not only population structure but also the relationships within families, in particular between older parents and their adult children. The aim of the present study was to examine the impact of intergenerational contact frequency on health related quality of life among 62 men and 98 women ranging in age between 60 and 94 years. All participants of the study were healthy and lived independently in their private homes. Data concerning subjective well being and health related quality of life were collected by personal interviews based on structured questionnaires. Health related quality of life was tested by means of the WHOQOL-BREF. The main finding of this study is that the frequency of intergenerational contacts has a significant impact on health related quality of life. Contact frequency with grandchildren per month correlated significantly (p<0. 01) with all five domains of the WHOQOL-BREF. Contact frequency with sons and daughters per month correlated significantly (p<0.05) with the social and the global domain. According to Kruskall-Wallis tests and regression analyses with increasing intergenerational contacts health related quality of life increased significantly (p<0.01). According to these results a close and frequent contact to offspring is an important source for quality of life during old age.

Menopause in a globalized world - A systematic literature review focussing on the challenge of health problems associated with menopausal transition among women with a migration background.

Globalization and international migration movements have massively changed the population structure of most industrial nations in recent decades. The ever-increasing proportion of people with a migration background also poses a challenge for the medical sector. A particular problem is the stressful phase of the menopausal transition, which - although not a pathological phenomenon but part of the female life history - can lead to psychological and physical symptoms due to hormonal changes, which significantly impair the quality of life of the women affected. However, treatment concepts, as well as access to medical facilities and information, are geared towards Western women from high-income countries. Women with a history of voluntary or forced migration originating from non-Western countries represent a particularly vulnerable group. To enable personalized treatment, studies on menopausal transition in women with a migration background are required. The present review shows that studies on menopausal women with a migration background have been conducted primarily in classic immigration countries such as the USA, Australia, or the UK, but that there is a lack of such studies in countries with no long tradition as an immigration country, such as Austria or Germany. This is becoming a growing problem, as the number of menopausal women with a migration background is increasing.

Changes in weight status among "Ju/'hoansi" San hunter-gatherers between 1968/69 and 1987-The effects of nutritional transition, sex and age.

BACKGROUND: Changes in lifestyle and dietary habits that hunter-gatherer populations have undergone in recent decades have often led to rising obesity rates with disastrous consequences for their health. OBJECTIVES: The associations between dietary habits and weight status were studied in 238 "Ju/'hoansi" San (93 women and 145 men) aged between 18 and 65 years in northern Namibia in 1987. Weight status was estimated based on the World Health Organization body mass index (BMI) categories, and dietary habits were recorded using food recall methods. Anthropometrics and weight status were compared with those of a sex- and age-matched sample of "Ju/'hoansi" San people collected by Nancy Howell in 1968/69. RESULTS: Body weight had increased significantly among "Ju/'hoansi" San people from 1968/69 to 1987. The number of underweight people decreased from 1968/69 to 1987. In 1987, most participants (60.9%) were of normal weight. Overweight was found in 1.3% of the women, but not among men. No participants were obese. Less than 4% of the women and less than 2% of the men consumed exclusively traditional hunter-gatherer food. Westernized food products were significantly (p < 0.001) more common among men and younger people. Dietary patterns were significantly associated with weight status. The less traditional the diet, the higher the BMI (p < 0.001). CONCLUSION: The transition to domestic agricultural and westernized foods was positively associated with increasing BMI. Overweight, however, was still an extremely rare condition in this population in 1987.

Secular trends and regional pattern in body height of Austrian conscripts born between 1961 and 2002.

The human growth process is influenced not only by genetic factors but also by environmental factors. Therefore, regional differences in mean body heights may exist within a population or a state. In the present study, we described and evaluated the regional trends in mean body heights in the nine Austrian provinces over a period spanning more than four decades. Body height data of 1734569 male conscripts born in Austria with Austrian citizenship between 1961 and 2002 were anonymized and analyzed. From 1961 to 2002 birth cohorts, an overall increase in the mean body height of Austrian recruits was observed, although regional differences were evident. Regions with shorter body heights in the 1961-1963 birth cohorts showed a particularly pronounced increase in mean body heights. Meanwhile, the course of body height growth in the capital city, Vienna, was striking, where the highest body heights were documented for the 1961-1963 birth cohorts. In Vienna, mean body heights continued to decline until the 1984 birth cohort and increased again from the 1988 birth cohorts. In addition to economic factors, increased stress factors in an urban environment and a form of urban penalty are discussed as causes.

Evidence of non-adult vitamin C deficiency in three early medieval sites in the Jaun/Podjuna Valley, Carinthia, Austria.

OBJECTIVE: This study aims to determine and discuss the prevalence of non-adult scurvy cases from the early medieval Jaun/Podjuna Valley in southern Austria. MATERIALS: 86 non-adult individuals were assessed from three early medieval sites. METHODS: Morphological characteristics associated with suggestive and probable scurvy were observed macroscopically and under 20-40x magnification. RESULTS: A significant relationship between the prevalence of scurvy and age group was observed. Perinates (46%, 6/13) and children (27.5%, 8/28) showed a high prevalence of skeletal features indicating a diagnosis of scurvy, while no cases of scurvy were observed in adolescents and adults. CONCLUSIONS: In this Alpine region, scurvy occurred frequently in infants and children. Seasonal fluctuations of diet are discussed as factors triggering scurvy. SIGNIFICANCE: This study sheds new light on the prevalence of scurvy in the Alpine region and how the region developed after the fall of the Roman Noricum. It also models ways in which multiple lines of evidence can contribute to the diagnostic process. LIMITATIONS: Poor preservation posed a challenge to identifying probable cases of scurvy. Likewise, non-adult remains are difficult to diagnose due to their developing nature and it is not always possible to distinguish between normal bone growth and pathological growth. SUGGESTIONS FOR FURTHER RESEARCH: Future applications of biomolecular studies will help illustrate changes in diet that may have contributed to vitamin deficiencies.

The Impact of Higher Than Recommended Gestational Weight Gain on Fetal Growth and Perinatal Risk Factors-The IOM Criteria Reconsidered.

A too-high gestational weight gain, in combination with steadily increasing obesity rates among women of reproductive age, represents an enormous obstetrical problem, as obesity and high gestational weight gain are associated with enhanced fetal growth, low vital parameters, and increased cesarean section rates. This medical record-based study investigates the association patterns between too-low as well as too-high gestational weight gain, according to the 2009 Institute of Medicine (IOM) guidelines, and fetal growth, as well as birth mode and pregnancy outcome. The data of 11,755 singleton births that had taken place between 2010 and 2020 at the Public Clinic Donaustadt in Vienna, Austria, were analyzed. Birth weight, birth length, head circumference, APGAR scores, and pH values of the arterial umbilical cord blood described fetal growth as well as the vital parameters after birth. Gestational weight gain was classified as too low, recommended, or too high according to the different weight status categories of the IOM guidelines. Birth weight, birth length, and head circumference of the newborn were significantly increased (p < 0.001) among underweight, normal-weight, and overweight women who gained more weight than recommended. Among obese women, only birthweight was significantly (p < 0.001) higher among women who gained more weight than recommended. Furthermore, a too-high gestational weight gain was significantly associated with an increased risk of macrosomia and emergency cesarean sections among underweight, normal-weight, and overweight women, but not among obese ones. Obese and morbidly obese women experiencing excessive gestational weight gain showed no significantly increased risk of macrosomia or emergency cesarean section. However, among obese mothers, a too-low gestational weight gain reduced the risk of emergency cesarean sections significantly (p = 0.010). Consequently, the IOM recommendations for gestational weight gain fit only partly for pregnant women in Austria. In the case of obese and morbidly obese women, new guidelines for optimal pregnancy weight gain should be considered.

Stable population structure in Europe since the Iron Age, despite high mobility.

Ancient DNA research in the past decade has revealed that European population structure changed dramatically in the prehistoric period (14,000-3000 years before present, YBP), reflecting the widespread introduction of Neolithic farmer and Bronze Age Steppe ancestries. However, little is known about how population structure changed from the historical period onward (3000 YBP - present). To address this, we collected whole genomes from 204 individuals from Europe and the Mediterranean, many of which are the first historical period genomes from their region (e.g. Armenia and France). We found that most regions show remarkable inter-individual heterogeneity. At least 7% of historical individuals carry ancestry uncommon in the region where they were sampled, some indicating cross-Mediterranean contacts. Despite this high level of mobility, overall population structure across western Eurasia is relatively stable through the historical period up to the present, mirroring geography. We show that, under standard population genetics models with local panmixia, the observed level of dispersal would lead to a collapse of population structure. Persistent population structure thus suggests a lower effective migration rate than indicated by the observed dispersal. We hypothesize that this phenomenon can be explained by extensive transient dispersal arising from drastically improved transportation networks and the Roman Empire's mobilization of people for trade, labor, and military. This work highlights the utility of ancient DNA in elucidating finer scale human population dynamics in recent history.

Evolutionary medicine and its implications for endocrinological issues (e.g. menopause).

Evolutionary medicine, which was formalized in the early 1990s, investigates evolutionary causes of recent human disease, disorders and malfunctions but also the influence of changing living conditions and modernization on health and disease. Evolutionary medicine can also provide insights into endocrinological disorders and in particular in the process of female reproductive senescence. Female reproductive senescence, i.e. menopausal transition is physiologically caused by the decline of estrogen secretion, which is associated with various somatic and psychic discomforts making this stage of life extremely uncomfortable. From the viewpoint of evolutionary medicine, these menopausal symptoms are the result from the sudden decrease of very high lifetime estrogen levels to zero during postmenopause, a situation which is quite new in our evolution and history. While women in recent developed countries experience menarche early, menopause late, few pregnancies, short periods of lactation and consequently low life time estrogen levels. The opposite is true of women living in traditional societies, whose living conditions may be interpreted as a mirror of the situation in our history. From this viewpoint we can conclude that menopausal symptoms may are the result of a mismatch between female reproductive physiology and recent living conditions.

Maternal obesity affects newborn somatometrics and vital parameters in a gender typical manner--evidence for the male disadvantage hypothesis?

According to the male disadvantage hypothesis male foetuses react more sensitive to maternal stress factors during gestation. In the present study the gender typical impact of maternal prepregnancy overweight and obesity as well as gestational weight gain on newborn somatometrics was tested on basis of births records of 7565 births, which took place in Vienna Austria. Maternal weight status was determined at the beginning of pregnancy according to the WHO recommendations. Newborns were measured immediately after birth. With increasing maternal prepregnancy weight status and increasing gestational weight gain birth weight, birth length and head circumference increased too. Among male newborns however the increase was lower than among female ones. With increasing maternal weight status the prevalence of macrosome newborns increased significantly. Among girls however this increase was significantly higher. Male foetuses seem to react more sensitive to a higher maternal weight status in comparison to girls. These results can be interpreted in sense of the so called male disadvantage hypothesis.

Maternal Prepregnancy Obesity Affects Foetal Growth, Birth Outcome, Mode of Delivery, and Miscarriage Rate in Austrian Women.

The increasing obesity rates among women of reproductive age create a major obstetrical problem as obesity during pregnancy is associated with many complications, such as a higher rate of caesarean sections. This medical record-based study investigates the effects of maternal prepregnancy obesity on newborn parameters, birth mode, and miscarriage rate. The data of 15,404 singleton births that had taken place between 2009 and 2019 at the public Danube Hospital in Vienna were enrolled in the study. Newborn parameters are birth weight, birth length, head circumference, APGAR scores, as well as pH values of the arterial and venous umbilical cord blood. In addition, maternal age, height, body weight at the beginning and the end of pregnancy, and prepregnancy body mass index (BMI) (kg/m2) have been documented. The gestational week of birth, the mode of delivery, as well as the number of previous pregnancies and births, are included in the analyses. Birth length, birth weight, and head circumference of the newborn increase with increasing maternal BMI. Furthermore, with increasing maternal weight class, there tends to be a decrease in the pH value of the umbilical cord blood. Additionally, obese women have a history of more miscarriages, a higher rate of preterm birth, and a higher rate of emergency caesarean section than their normal-weight counterparts. Consequently, maternal obesity before and during pregnancy has far-reaching consequences for the mother, the child, and thus for the health care system.

Asymmetry in body composition parameters of the upper and lower extremity among healthy Austrian women.

Humans typically have bilateral symmetry, however, deviations from perfect symmetry can be observed. In the case of the upper extremities, mostly a right-biased asymmetry in the length or strength of the bones, but also lean body mass was reported. Regarding the lower extremities, the asymmetry patterns are weaker. The aim of this study is to analyze directional and cross-asymmetry in body composition parameters among healthy non-athletic women. In particular, it is hypothesized that body composition asymmetry patterns of the limbs change with increasing age. 584 Austrian women aged between 16 and 83 years were enrolled in the study. Data collection took place between 1995 and 2000 at the Menox outpatient department for the treatment of climacteric symptoms in Vienna. Bone mineral density (BMD), bone mineral content (BMC), lean mass, and fat mass was determined using dual-energy-x-ray absorptiometry (DEXA). Signed asymmetry was calculated for each body composition parameter of the upper and lower limbs. Right-sided symmetry dominated for lean mass, BMC, and BMD in the upper extremity. Asymmetry in the lower limbs was not as strong as in the arms, but a right-sided asymmetry was still observable. Fat mass showed the strong right-sided asymmetry of all measurements for the lower extremities in the whole sample. Contra lateral asymmetry of the extremities could be found in 37-45% of the sample for lean mass, BMD, and BMC. For fat mass, almost half of the sample displayed cross asymmetry. Significant associations between asymmetry patterns and age were observable for the fat mass of the upper extremities only. Participants younger than 30 years showed a significant left-sided asymmetry for fat mass in the upper extremities. However, this pattern changed around the age of 30 and shifted to a slight right-sided asymmetry. In general, the body composition of the upper and lower limbs showed distinct asymmetry patterns.

Amenorrhea and BMI as independent determinants of patient satisfaction in LNG-IUD users: cross-sectional study in a Central European district.

OBJECTIVE: This study investigated the satisfaction of women carrying the LNG-IUD and determined influencing factors, especially considering bleeding patterns and body mass index (BMI). DESIGN: Cross sectional study. SETTING: Gynecological offices in a Central European district. PARTICIPANTS: 1825 women aged between 18 and 60 years. MEASUREMENT: While sitting in the waiting room, voluntary patients had to answer a questionnaire about their experiences with the levonorgestrel intrauterine device. One question was used to determine whether the women were current, former or not users of the intrauterine coil. RESULTS: 415 women who had some experiences with Mirena were found. Overall, 266 (65.7%) were "very satisfied," 83 (20.5%) "quite satisfied," 18 (4.4%) "moderate satisfied," 19 (4.7%) "less satisfied," and the same amount "really not satisfied" with the hormonal coil. Women with amenorrhea were more often "very satisfied" in general, than women with hypermenorrhea (178 (67.9%) vs. 3 (1.1%) p < 0.001). Concerning bleeding patterns, 295 (74.1%) were "very satisfied" and 23 (5.8%) "really not satisfied". 203 (91.0%) of all amenorrhoeic women were "very satisfied" with their bleeding patterns, but only 2 (9.5%) of all women with hypermenorrhea (p < 0.001 for α = 0.05). Amenorrhea particularly occurred in women who had a significantly lower body mass index (24.4 ± 4.4 kg/m(2) vs. 27.6 ± 6.5 kg/m(2) in women with hypermenorrhea, p = 0.018 for α = 0.05). After allocating women to the widely used BMI-categories (underweight, normal weight, overweight, obese class I and II) it was evident, that normally weighted women tend toward amenorrhea as well at the beginning of LNG-IUD use as well after 4-5 years of use. In contrast to this, overweighed and obese women tend more often to amenorrhea at the end of use, but not at the beginning (72.7% and 55.6% vs. 25.0% and 0%). Women with a lower BMI were more often "very satisfied" concerning bleeding patterns, but not concerning the general satisfaction. CONCLUSION: Our study showed much evidence, that amenorrhea occurs more often in women with lower BMI contrary to women with a higher one-especially at the beginning of LNG- IUD use. Furthermore amenorrhea was mostly considered to be a positive menstrual change.