Human growth hormone (HGH), thyroid stimulating hormone (TSH) and cortisol levels in the serum of menstruating Thai women.
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Menstrual length was analysed in 2,342 women attending the Shepherd Foundation. Prolonged menses were more common in Australian and New Zealand born, in women with irregular, short or long menstrual cycles, menstrual pain, high parity, and an intrauterine device. In contrast to women with premenstrual tension and menstrual pain, psychological factors, smoking and drinking were not more common in women with increased menstrual length. It is concluded that somatic factors alone control menstrual length, and results in the present study support the hypotheses that both the hypothalamic-pituitary system and prostaglandins may be involved in this control. Evidence was found that the use of the contraceptive pill reduces the incidence of premenstrual tension when menstrual length is also reduced.
The effect of high and low doses of norethisterone on seizure frequency was studied in nine epileptic patients, aged 20-30 years. All patients satisfied the defined criteria of having catamenial exacerbation. The study was double blind, placebo controlled, and randomised. Each patient was followed through four menstrual cycles with each drug dose and also with placebo. The results of this study suggest that norethisterone is not effective in the control of seizures associated with the menstrual period.
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The physiologic mechanisms whereby the human endometrium maintains hemostasis during endovascular trophoblast invasion, yet permits menstrual hemorrhage, are unknown. This paradoxical relationship was investigated by evaluating endometrial expression of tissue factor (TF), the primary initiator of hemostasis, and plasminogen activator inhibitor-1 (PAI-1), the primary inhibitor of fibrinolysis. We observed increased immunostaining for TF and PAI-1 in sections of decidualized stromal cells from luteal phase and gestational endometrium. To determine whether TF and PAI-1 expression are directly linked to decidualization, both endpoints were monitored in a well described in vitro model of decidualization. Thus, confluent stromal cell cultures were exposed to vehicle control, 10(-8) M estradiol (E2), 10(-8) to 10(-6) M medroxyprogesterone acetate (MPA) or both E2 + MPA for 2-24 days in serum-containing or defined media. The progestin enhanced the content of stromal cell-associated immunoreactive and functionally active TF and PAI-1 released into the medium and elevated levels of stromal cell TF and PAI-1 mRNA. While E2 alone was ineffective, it greatly augmented MPA-enhanced TF and PAI-1 protein and mRNA content. Dose-dependent effects on TF and PAI-1 content were observed between 10(-8) to 10(-6) M MPA +/- E2. Similar results were observed for decidual cells derived from first trimester endometrium and cultured in type 1 collagen gels. Following optimal induction of TF and PAI-1 expression by E2 + MPA in stromal cell cultures, removal of these steroids greatly reduced levels of both TF and PAI-1 protein and mRNA within 4 days. These studies suggest a mechanism whereby endometrial hemostasis is maintained during trophoblast invasion yet reduced at the end of nonfertile cycles to permit menses.
Both hyper- and hypothyroidism may result in menstrual disturbances. In hyperthyroidism, amenorrhea was described as early as 1840 by von Basedow. The most common manifestation is simple oligomenorrhea (decreased menstrual flow). Anovulatory cycles are very common. Increased bleeding may occur, but is rare in hyperthyroidism. Nowadays hyperthyroidism is diagnosed earlier than it once was, and so the clinical picture is generally milder. So, menstrual disorders are less common than in previous series. In a recent paper, 21.5% of 214 patients had disturbances in their cycle, compared to 50% in some older series. In hypothyroidism, on the contrary, polymenorrhea (increased menstrual bleeding) is more common. Defects in hemostasis may contribute to this. Anovulation may be represent. Fertility is reduced in both hyper- and hypothyroidism, and the outcome of pregnancy is more often abnormal than in euthyroid women. It is of interest that in juvenile hypothyroidism precocious puberty has been described. This is probably due to a "spillover" effect of the glucoprotein hormones: TSH, which is markedly increased in hypothyroidism, has a small FSH- and LH-like effect. Galactorrhea may also be present in hypothyroidism, possibly because TSH, the hypophyseal TSH-releasing hormone, increases the secretion of both TSH and PRL.
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Electroencephalographic driving reponses to photic stimulation vary with the menstrual cycle and with manipulations of ovarian hormones thought to control the menstrual cycle. Estrogens reduce driving responses to photic stimulation, and estrogen plus progesterone enhance these responses. The electroencephalographic changes may reflect the effects of gonadal steroid hormones upon central adrenergic processes.
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