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At least 289 records · Page 16Linked to original sources
PubMed1999

Implications of decidualization-associated protease expression in implantation and menstruation.

During progesterone-induced decidualization of estradiol (E2)-primed human endometrial stromal cells (HESCs), the interstitial-type extracellular matrix (ECM) of the follicular phase endometrium is transformed in the luteal phase to a mixture of residual interstitial- and new basal laminar-type components. This transformation is accelerated by reduced proteolytic activity of HESCs undergoing decidualization (DZ). In cultured HESCs, progestins, but not E2, induce the expression of several DZ markers, and E2 enhances these effects despite the lack of response to E2 alone. Using this well-characterized in vitro DZ model we evaluated the expression of plasminogen activators (PAs), which degrade ECM components that undergo rapid turnover, and matrix metalloproteinases (MMPs), which degrade the bulk of ECM components. Medroxyprogesterone acetate (MPA) inhibited the catalytic activity of urokinase-type PA (uPA) and tissue-type PA (tPA) as well as the expression of such MMPs as interstitial collagenase (MMP-1) and stromelysin-1 (MMP-3). Moreover, E2 + MPA elicited greater inhibitory effects on the expression of all of these proteases. Progestin inhibition of PA activities reflected reciprocal upregulation in the output of the PA inhibitor PAI-1, which produced large molar excesses of PAI-1 compared with the PAs in HESC-conditioned medium. By contrast, the tissue inhibitor of the MMPs, TIMP1, as well as gelatinase A (MMP-2), was constitutively expressed by the HESCs. In the absence of implantation, menstruation-associated degradation of the functional endometrial ECM is triggered by withdrawal of circulating ovarian steroids. This process was evaluated in cultured HESCs that were first decidualized during 10 days of exposure to E2 + MPA, and then withdrawn to steroid-free medium with and without the antiprogestin RU 486. As expected, steroid withdrawal reversed progestin-inhibited PA activity as well as the expression of MMP-1 and MMP-3 and progestin-enhanced PAI-1; much greater reversal was observed in medium supplemented with RU 486. Unlike the changes in PAI-1, neither TIMP1, nor MMP-2 expression was affected by withdrawal to steroid-free or to RU 486-medium. By altering the composition of the ECM of the luteal phase endometrium, progestin-elicited inhibition of the PAs, uPA and tPA, as well as that of the MMPs, MMP-1 and MMP-3, modulates trophoblast adhesion, migration and differentiation. Conversely, steroid withdrawal elicited increases in uPA, MMP-1 and MMP-3 activities would promote endometrial sloughing by degrading the mixture of decidual cell-derived basement membrane-like proteins and interstitial components that comprise the stromal ECM of the perimenstrual endometrium.

Decidua↗
PubMed2003

Porphyria cutanea tarda with menopausal exacerbation: the possible role of menstruation as natural phlebotomy.

We describe a 48-year-old woman with a 12-year history of porphyria cutanea tarda who showed a remarkable exacerbation of her eruptions accompanied by high serum levels of iron and ferritin at menopause. As iron storage is known to be a triggering factor of porphyria cutanea tarda, the possible role of menstruation as natural phlebotomy to prevent porphyria cutanea tarda exacerbation is discussed.

Female↗
PubMed2002

Soy isoflavones: no effects on bone mineral content and bone mineral density in healthy, menstruating young adult women after one year.

BACKGROUND: The effects of isoflavone-enriched soy protein on human bone mineral content (mass) and density in healthy, menstruating young adult females have not been examined in a comparative prospective investigation. Peri- and post-menopausal women have been reported to show beneficial effects of isoflavones on bone measurements. Therefore, young women may also be able to improve their accrual of peak bone mineral content (BMC) and bone mineral density (BMD) during the early adult years of bone consolidation with an isoflavone-enriched diet. OBJECTIVES: In this controlled, double-blind intervention, we tested the hypothesis that an isoflavone-rich soy protein diet increases BMC and BMD in young adult females over a period of one year in comparison to a control group receiving soy protein that has isoflavones removed. DESIGN: Young healthy women of any ethnic background, 21 to 25 years of age, were divided into two groups, placebo (n = 13) and supplement (n = 15). The soy protein supplement was enriched with isoflavones ( approximately 90 mg of total isoflavones/day), whereas the control protein diet was isoflavone-deficient, even though it contained the same amount of soy protein and other ingredients as the isoflavone-rich diet. Dual-energy x-ray absorptiometric (DXA) measurements of BMC and BMD were made at baseline and at 6 and 12 months. DXA estimates of body composition, including fat mass and lean body mass, were generated from whole-body BMC measurements. BMI was calculated as weight (kg) over height (m) squared. Physical activity was assessed, and three-day dietary records were taken at entry (baseline) and at 6 and 12 months. RESULTS: No changes in BMD after 12 months were found in either the isoflavone-treated (treatment) group or the isoflavone-deficient (control) group. Other variables also remained essentially constant over the 12-month period, including normal menstrual patterns in both the treatment and control groups. CONCLUSIONS: The isoflavone-rich soy preparation had no effects on BMC and BMD over a 12-month period in young healthy adult females with normal menses. An isoflavone-rich supplement appears to have little or no effect on bone in young adult women with normal ovarian function, at least over this 12-month study period.

Absorptiometry, Photon↗
PubMed2006

Development of a new scale to measure Beliefs about and Attitudes Toward Menstruation (BATM): data from Mexico and the United States.

This article introduces the Beliefs about and Attitudes toward Menstruation Questionnaire (BATM). It is a 5-point Likert scale that was normed on 1,090 Mexican people of different ages and educational levels. In a second study data from 274 undergraduate students from Mexico and the United States were compared. Four factors emerged in both samples: secrecy, annoyance, proscriptions and prescriptions, and pleasant. Mexican students scored significantly higher than U.S. students on the Proscriptions and Prescriptions subscale. Men scored significantly higher on this subscale than women. Implications of these findings are discussed, as is the possible utility of the questionnaire for future research.

Analysis of Variance↗
PubMed1997

Menstruation and pediatric spinal cord injury.

Menstrual characteristics were studied in young women who sustained spinal cord injuries (SCI) prior to puberty or in early adolescence. Subjects were 37 females who were injured prior to age 16 years and who were at least 10 years old at the time of interview; 22 were injured prior to menarche and 15 after menarche. Average age of menarche for females injured before puberty was 12.3 years which is similar to their mothers (mean 12.6 years) and to patients injured after menarche (mean 12.0 years). Of 15 females injured after menarche, seven reported no interruption in menses while eight had interruptions ranging from one to seven months. No significant menstrual problems were noted in either group. This information about menstruation should be included in sexuality teaching of parents and patients when an SCI occurs to a child or adolescent.

Adolescent↗
PubMed1996

Endothelin and menstruation.

Endothelin (ET) and its mRNA are present in human endometrium. Its expression varies across the menstrual cycle, reaching maximal levels in the pre-menstrual phase. Human endometrial epithelial cells are the major in-vitro source of ET, and its release is affected by the stage of the menstrual cycle from which the endometrium is taken and by the cytokines transforming growth factor-beta 1 and interleukin-1 alpha. The cyclical variation in both ET mRNA and protein expression across the normal menstrual cycle, and the differences observed in abnormal uterine bleeding (specifically reduced immuno-reactivity in luminal and glandular epithelium in the endometrium of Norplant users), are consistent with a role for ET in the control of menstrual bleeding. The role of epithelial cell ET is not yet understood. Whether this source of ET is important in endometrial regeneration and repair following menstruation or in vaso-constriction to cease menstrual bleeding remains to be determined.

Animals↗
PubMed2000

Different patterns of structural luteolysis in the human corpus luteum of menstruation.

Structural luteolysis is a complex process responsible for the elimination of the corpus luteum (CL). The aim of this study was to analyse the luteolytic process of the CL of menstruation. For this, we have morphologically studied 654 ovaries from 340 cycling women. Apoptotic cells were observed almost exclusively during the perimenstrual period and were extremely scarce at advanced stages of involution. Steroidogenic luteal cells surviving to the perimenstrual apoptotic wave underwent characteristic degenerative changes, consisting of intense cytoplasmic vacuolation, expression of macrophage markers and accumulation of lipofuscin pigment, and they persisted for long periods of time. Accumulation of corpora albicantia (CA) was observed in only 25% of a subset of 168 women, whereas 28% showed involuting CL without hyalinization, consisting of clusters of pigment-filled cells, and 46.4% showed ovaries with a mixture of CA and involuting CL without hyalinization or involuting CL with intermediate features. Evolution of the CL towards CA seemed to be related to the presence of a large, blood-filled cavity. The data from this study suggested that different patterns of structural luteolysis exist during CL involution, and that the final fate of the involuting CL is dependent on the presence of a large, central, blood-filled cavity.

Adult↗
PubMed1988

Evaluation of the frequency of anaemia and iron-deficiency anaemia in a group of Algerian menstruating women by a mixed distribution analysis: contribution of folate deficiency and inflammatory processes in the determination of anaemia.

Frequency of anaemia was estimated by two methods for 254 menstruating women living in South-eastern Algeria. One method defines the frequency of anaemia as the percentage of women with haemoglobin concentrations below the cut-off point defined by WHO (12 g/dl). The second method defines the frequency of anaemia as the percentage of women whose haemoglobin values are shifted downwards relative to a Gaussian distribution of haemoglobin of nonanaemic women. The conventional cut-off point probably tends to overestimate the true frequency of anaemia: 7% of women with haemoglobin concentration less than 12 g/dl were not found as anaemic using the cumulative frequency method. The contribution of iron deficiency folate deficiency and inflammatory process was estimated using the cumulative frequency distribution after excluding respectively women with biological evidence of iron deficiency (serum ferritin of 12 micrograms/l or less, transferrin saturation less than 15% and/or MCV less than 80 fl), of folate deficiency (red blood cell folates less than 100 micrograms/l) and of inflammatory process (C. Reactive Protein more than 12 mg/l, orosomucoid more than 1.4 g/l or white cell counts of more than 10,000/mm3). According to this method iron deficiency represented the most important cause of anaemia in the context of our sample: iron deficiency contributed to 77% of anaemia. Folate deficiency and inflammatory processes do not in themselves appear to contribute to anaemia.

Adult↗
PubMed2002

Endometrial nuclear receptor co-factors SRC-1 and N-CoR are increased in human endometrium during menstruation.

Steroid hormone receptor co-factors are abundantly expressed in the uterus in order to modify steroid hormone receptor action, either leading to activation or repression of transcription in the endometrium. However, the role of co-factors in remodelling of the human endometrium has not been established. We therefore endeavoured to evaluate the presence of the co-activator SRC (steroid receptor co-activator)-1 and the co-repressors N-CoR (nuclear receptor co-repressor) and steroid co-repressor SMRT (silencing mediator of retinod and thyroid) receptors in the human endometrium during the different phases of the menstrual cycle. By using a real-time RT-PCR assay, we showed that SRC-1, N-CoR and SMRT mRNA are expressed in human endometrium during all phases of the menstrual cycle, as well as in inactive endometrium. Moreover, endometrial expression of SRC-1 and N-CoR mRNA increased during menstruation when compared with the other phases of the menstrual cycle (P < 0.001). Immunohistochemistry demonstrated that SRC-1 and N-CoR stain positive in the glandular epithelium and stroma in menstrual phase endometrium. The staining was weak in proliferative and secretory endometrium and absent in inactive endometrium. Our results suggest that differential expression of endometrial steroid receptor co-factors probably play a role in the regulation of human endometrium remodelling.

DNA-Binding Proteins↗
PubMed2006

Expression and regulation of vascular endothelial growth factor ligands and receptors during menstruation and post-menstrual repair of human endometrium.

Regeneration and growth of the human endometrium after shedding of the functional layer during menstruation depends on an adequate angiogenic response. We analysed the mRNA expression levels of all known vascular endothelial growth factor (VEGF) ligands and receptors in human endometrium collected in the menstrual and proliferative phases of the menstrual cycle. In addition, we evaluated the expression of VEGF-A, VEGF-R2 and NRP-1 at the protein level. Two periods of elevated mRNA expression of ligands and receptors were observed, separated by a distinct drop at cycle days (CDs) 9 and 10. Immunohistochemical staining showed that VEGF and VEGF-R2 were expressed in epithelial, stromal and endothelial cells. NRP-1 was mainly confined to stroma and blood vessels; only in late-proliferative endometrium, epithelial staining was also observed. Except for endothelial VEGF-R2 expression in CDs 6-8, there were no significant differences in the expression of VEGF, VEGF-R2 or NRP-1 in any of the cell compartments. In contrast, VEGF release by cultured human endometrium explants decreased during the proliferative phase. This output was significantly reduced in menstrual and early-proliferative endometrium by estradiol (E2) treatment. Western blot analysis indicated that part of the VEGF-A was trapped in the extracellular matrix (ECM). Changes in VEGF ligands and receptors were associated with elevated expression of the hypoxia markers HIF1alpha and CA-IX in the menstrual and early proliferative phases. HIF1alpha was also detected in late-proliferative phase endometrium. Our findings indicate that VEGF-A exerts its actions mostly during the first half of the proliferative phase. Furthermore, VEGF-A production appears to be triggered by hypoxia in the menstrual phase and subsequently suppressed by estrogen during the late proliferative phase.

Adult↗
PubMed1993

Menstruation increases the risk of nausea and vomiting after laparoscopy. A prospective randomized study.

BACKGROUND: Several factors may influence the incidences of postoperative nausea and vomiting. In women, one of these factors may be the timing of their surgery in relation to their menstrual cycle. The purpose of this study was to assess the effect of menstruation and efficacy of the antiemetic droperidol on postoperative nausea and vomiting. METHODS: In a prospective randomized double-blind clinical trial, 100 female patients who were scheduled for laparoscopic tubal sterilization were stratified on the basis of the date of their last menses into menstrual (days 1-8) and nonmenstrual (days 9-28) groups. Patients in both groups were then randomized to receive placebo or 10, 20, or 30 micrograms/kg droperidol before induction of anesthesia, and data were obtained for 24 h after completion of their surgery. RESULTS: Nausea and vomiting were reported in 55 patients, and the risk was 2.92 times greater in the menstrual group (71.4%) than in the nonmenstrual group (46.2%; (P = .013). Droperidol (30 micrograms/kg) reduced the incidence of vomiting from 47.1% (placebo) to 13.3% in the nonmenstrual group (P = .045) but had no effect in the menstrual group. Five prognostic variables (menstrual stratum, droperidol, age 30 yr or younger, weight 65 kg or less, and history of nausea and vomiting) for postoperative nausea and vomiting were tested by stepwise logistic regression. Menstrual stratum was the only variable identified as a significant (P = .017) predictor, having a percent probability equal to 2.21. CONCLUSIONS: The risk of postoperative nausea and vomiting is increased in women undergoing laparoscopic tubal sterilization during the first 8 days of their menstrual cycle, and droperidol up to 30 micrograms/kg is not as effective in these patients.

Adult↗
PubMed2003

On the correlation between local fibrinolytic activity in menstrual fluid and total blood loss during menstruation and effects of desmopressin.

The primary objective of this study was to investigate the correlation between fibrinolytic activity in menstrual fluid and total menstrual blood loss during menstruation. We also wanted to evaluate the influence of desmopressin nasal inhalation on the local fibrinolytic activity in menstrual fluid. Six women with objectively verified menorrhagia and six women with normal menstrual blood loss were examined. With a slender catheter introduced through the cervical canal, menstrual fluid was collected on the day in the cycle when the most intense bleeding occurred. The fibrinolytic activity in menstrual fluid was measured both as plasmin content using an amidolytic method with chromogenic substrate and with a fibrin plate method. A significant correlation between the amount of menstrual blood loss and fibrinolytic activity was found in menstrual fluid of both groups and with both methods. We could not find an increased fibrinolytic activity in menstrual fluid when the women with menorrhagia were treated with desmopressin nasal inhalation. Knowledge of the local factors influencing monthly blood loss can be valuable when searching for more effective medical treatment of menorrhagia. Apprehension that desmopressin should increase local fibrinolytic activity in menstrual fluid could not be confirmed.

Administration, Inhalation↗
PubMed2006

ACOG Committee Opinion No. 349, November 2006: Menstruation in girls and adolescents: using the menstrual cycle as a vital sign.

Young patients and their parents often are unsure about what represents normal menstrual patterns, and clinicians also may be unsure about normal ranges for menstrual cycle length and amount and duration of flow through adolescence. It is important to be able to educate young patients and their parents regarding what to expect of a first period and about the range for normal cycle length of subsequent menses. It is equally important for clinicians to have an understanding of bleeding patterns in girls and adolescents, the ability to differentiate between normal and abnormal menstruation, and the skill to know how to evaluate patients' conditions appropriately. Using the menstrual cycle as an additional vital sign adds a powerful tool to the assessment of normal development and the exclusion of serious pathologic conditions.

Adolescent↗
PubMed1976

Menstruation per urethram. A case report.

The case history is presented of a 24-year-old woman who had a uterus duplex, grossly underdeveloped cervices, absent vagina and who menstruated regularly through a communication between one cervical canal and the urethra.

Cervix Uteri↗
PubMed1977

Intercellular spaces and cell junctions in endometrial glands: their possible role in menstruation.

Intercellular spaces and cell junctions in human endometrial glands were studied by elctron microscopy following different methods of fixation. The size of the spaces, known to alter during the cycle, was found to depend also on the method of fixation. Various intrusive cells and different types of cell debris were seen in these spaces. The three most widely recognized cell junctions (desmosomes, tight junctions and gap junctions), were all most abundant near the cell apices. The possible significance of these findings in elucidating the cellular mechanism of menstruation is discussed.

Endometrium↗
PubMed1986

Endometriosis: its association with retrograde menstruation, dysmenorrhoea and tubal pathology.

Seventy-five women admitted for sterilization were laparoscoped during menstruation. Retrograde spillage of menstrual blood was observed in 76%. The occurrence of dysmenorrhoea was not associated with spillage of menstrual blood, observed endometriosis or tubal pathology. Mild or stage I endometriosis was detected in 43% of all the women but in only 54% of those who had retrograde spill. Retrograde spill was seen in 97% of those with endometriosis. A significant association (P less than 0.001) was found between endometriosis and tubal damage not due to endometriosis. The implication of these findings are discussed.

Adult↗
PubMed1988

Uterine blood flow and myometrial activity at menstruation, and the action of vasopressin and a synthetic antagonist.

Local endometrial blood flow was measured by a thermistor technique and myometrial activity by intrauterine pressure recording in 10 women before and during menstruation. The effect of lysine vasopressin infusion (1 pmol/kg body-weight per min) and of bolus injection of a synthetic oxytocin analogue, 1-deamino-2-D-Tyr(OEt)-4-Thr-8-Orn-oxytocin (10 nmol/kg body-weight), were studied. Spontaneous variations in blood flow were seen synchronous with clearly demarcated uterine contractions, the myometrial activity being significantly increased in early (day -1 to day +2) compared with late (day +3 to day +5) menstrual phase. The vasopressin infusion decreased blood flow, stimulated uterine activity and caused slight to moderate dysmenorrhoea-like pain. These effects were completely inhibited by the injection of the oxytocin analogue. In-vitro studies on uterine arteries confirmed that the analogue also inhibited the vasopressin-induced constriction of the uterine arteries. This antagonist was more effective than two other analogues, 1-deamino-2-D-Tyr(OEt)-4-Val-8-Orn-oxytocin and 1-deamino-2-Tyr(OEt)-oxytocin. The counteracting effect of 1-deamino-2-D-Tyr(OEt)-4-Thr-8-Orn-oxytocin on the vasopressin-induced decrease of blood flow and increase of contractions supports the therapeutic value of the drug in primary dysmenorrhoea and preterm labour.

Adult↗