Abstract: Objective  To explore the clinical characteristics of the patients with follicular cysts and menstrual disorders. Methods  A total of 178 women with follicular cysts complicated by menstrual disorders were recruited, who were aged 23-53 (38.62±6.35) years and came to the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital between August 2022 and July 2024. The participants were divided into three groups according to the age, with 27 women in the age group of 21-30 years (Group 1), 77 in the age group of 31-40 years (Group 2), and 74 in the age group of>40 years (Group 3). The age and menstruation of these patients were collected, the body height, weight, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (Po), total testosterone (TT), prolactin (PRL), anti-müllerian hormone (AMH) and thyroid function ［blood routine and blood clotting for patients with abnormal uterine bleeding (AUB) ］were measured, and the diameter of ovarian cyst and the thickness of endometrium were examined. The clinical characteristics of the patients with follicular cysts complicated by menstrual disorders were described and compared with each other among the three age groups. Results  ① Among 178 patients, 61 (34.3%) patients presented with complaints of cessation of regular menstruation or amenorrhea and 117 (65.7%) with complaints of AUB. Out of 178 patients, 13 (7.3%) patients developed anemia due to AUB, and all the patients were treated with medication. ② Follicular cysts disappeared in 1 month for 124 (69.7%) patients, disappeared in 2 months for 176 (98.9%) patients, and disappeared in 3 months for 178 (100%) patients. A total of 177 (99.4%) patients had follicular cysts with a diameter less than 5 cm, and only 1 (0.6%) patient had follicular cysts with a diameter ≥ 5 cm. ③ The overall prevalence of diminished ovarian reserve (DOR) in patients with follicular cysts complicated by menstrual disorders was 82.0%, and the prevalence of DOR was 70.2% for the patients under 40 years old. The prevalence of DOR in three age groups was 37.0% (10/27), 81.8% (63/77), and 98.6% (73/74), respectively. The prevalence of DOR gradually increased with age. ④ The median AMH values for Group 1, Group 2, and Group 3 were 1.55, 0.51, and 0.15 ng/mL, respectively. The FSH level in Group 3 was significantly higher than that in Groups 1 and 2 (adjusted P<0.05), while the AMH level was significantly lower than that in Groups 1 and 2 (adjusted P<0.05). The AMH level in Group 2 was lower than that in Group 1 (adjusted P<0.05). Conclusion  Patients with follicular cysts complicated by menstrual disorders are recommended to receive medication treatment, rather than just expecting treatment. The prevalence of DOR in patients with follicular cysts complicated by menstrual disorders is significantly higher than that in normal women, even in women younger than 40 years old. Therefore, it is essential to evaluate the ovarian reserve of these patients while treating menstrual disorders, particularly for young women with fertility needs.

Key words: follicular cyst, functional ovarian cyst, menstrual disorders, diminished ovarian reserve, anti-Müllerian hormone, abnormal uterine bleeding, sex hormone