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PubMed1979

The timing of menstruation-related symptoms assessed by a daily symptom rating scale.

A daily symptom rating scale (DSRS) was constructed from items previously used in questionnaires and rating scales measuring menstrual symptoms. The DSRS was found to have adequate reliability and validity. The profiles of symptom intensity of 65 women, mainly hospital staff, median age 19, during one menstrual cycle, with particular emphasis on the premenstrual week and menstruation are reported. Significant differences in ratings during the cycle were found. Ratings increased during the premenstrual week and were maximal on the days immediately preceding and following the onset of menstruation. No abrupt decline in ratings was found when menstruation commenced. Results were compared with answers to a menstrual distress questionnaire, previously administered to the same women and the questionnaire results were in good agreement with DSRS results on the day of maximum symptom intensity (the day immediately before or the day immediately after the onset of menstruation.

Adolescent↗
PubMed1988

Serum CA 125 levels in patients with endometriosis: changes in CA 125 levels during menstruation.

We investigated serum CA 125 levels in 120 patients with benign gynecologic disease, and examined variations in CA 125 levels during the menstrual cycle in six normally cycling women. CA 125 levels were elevated transiently during menstruation, suggesting that blood samples taken during menstruation can give a false-positive result. Whereas the CA 125 values during the nonmenstrual part of the cycle were significantly higher in the patients with adenomyosis and advanced endometriosis (stages III and IV) than in those with a normal pelvis, there was no difference between the patients with mild endometriosis (stages I and II) and the normal-pelvis group. CA 125 levels during menstruation were significantly elevated, not only in women with adenomyosis and advanced endometriosis, but also in those with mild endometriosis, compared with those with a normal pelvis. These data suggest that the measurement of serum CA 125 during menstruation may increase the rate of detection of endometriosis over that in studies done during other phases of the cycle.

Antigens, Neoplasm↗
PubMed1982

Symptoms associated with menstruation.

Symptoms associated with menstruation during the teenage and young adult years may represent a spectrum of possibilities varying from a relatively benign deviation from normal to a serious life-threatening disease. Nevertheless, even for the young woman found to be without serious disease, menstrual problems have special meaning associated with the fear of being different from peers, concern about being less than complete or wholesome, and anxiety regarding future functioning as a normal woman. The physician must be aware of the adolescent's sensitivity in this area. Her apprehension should influence the manner in which the various abnormalities of menstruation are evaluated and managed. The physician must understand and appreciate the potential for profound emotional effects and psychological implications of menstrual conditions. The manner in which we care for the adolescent with menstrual symptoms will determine to a significant degree how successfully the patient will cope with abnormalities of menstruation.

Adolescent↗
PubMed2000

[The experience of menstruation and its disorders in 603 women using contraception in 1999].

AIM: An epidemiological survey completed during the first quarter of 1999 assesses the frequency of menstrual disorders as well as their effects on the lives of women using contraception. MATERIALS AND METHODS: The results presented involve a sample of 603 women, with 405 using the pill and 198 fitted with an IUD. The average age of onset of menstruation in the sampled population was 12.8 years. Although most women declared that they felt no anxiety at the time, over one-third of the women surveyed explained that they felt a certain hesitancy in discussing the topic. Even today, certain feelings, such as shame or pride, are still evoked in the interviews. Although over half believe that it is normal to menstruate, the process is nevertheless considered "somewhat bothersome" by certain women who also refer to "purification." Traditional cultural perspectives remain a strong influence. Menstrual disorders predating the initial use of contraception were reported in 150 women (occasional intermenstrual bleeding, 130 cases; other anomalies excluding metrorrhagia, 27 cases). Even if most of the women believe these problems to be inevitable, they also claim to be relatively troubled by these disorders, which often involve a considerable degree of discomfort. Such disorders are significantly more frequent in the "IUD" group, as well as in women who claim a very early onset of menstruation and those who consider explanations provided by the physician as "insufficient." CONCLUSION: The difference creates a certain fear with respect to any social or individual norm that may have been internalized. Thus the information presented in this study may provide ways and means to better understand women in general and our women patients in particular.

Adolescent↗
PubMedDate not supplied

Symptoms related to menstruation in adolescent Swiss girls: a longitudinal study.

Symptoms related to menstruation are reported in 140 Swiss girls according to postmenarcheal and chronological age. Premenstrual abdominal pains were present in 9-28% of the girls, depending on postmenarcheal age (i.e. years after menarche) (2-30% depending on chronological age). Dysmenorrhoea occurred in 44-64% of the girls according to postmenarcheal age (51-67% according to chronological age). Occasional severe dysmenorrhoea was the type most often reported, by 20-35% of the girls. Large intra-individual and inter-individual variabilities in the occurrence and severity of dysmenorrhoea were observed. The frequency of dysmenorrhoea increased in the first three postmenarcheal years and decreased thereafter. The prevalence of premenstrual headache was low, 0-5%. The frequency of headache during menstruation was 2-11% according to postmenarcheal age (2-19% by chronological age) which was low in comparison with other studies. Severe menstrual headache was more often reported than mild headache. Frequency of severe headache decreased in higher age groups. Other reported symptoms related to menstruation were general discomfort in 1-10% of the girls and premenstrual vaginal discharge in 10-22% according to postmenarcheal age (3-17% according to chronological age). Severe vaginal discharge was more frequent than mild discharge, 8-20% versus 0-3%. The frequency of vaginal discharge increased from the first to the fourth year after menarche.

Abdomen↗
PubMed1996

Coitus and menstruation in perimenopausal women.

The objective of the study was to determine whether coitus during menstruation in perimenopausal women is associated with increased menstrual flow defined as either heavier flow, more days of flow, or both. Initial interviews for the Stanford Menopause Study were conducted locally with 160 perimenopausal women. Six weeks later, additional data were gathered from 121 women. At a third interview, 6-10 weeks later at Stanford University, 56 of 57 subjects (mean age 48.8 +/- 3.9 SD) provided data on menstrual flow and coital behavior. At both the first and third interview, more than half of the women reported a pattern of increased menstrual flow. At the third interview, 83% of those reporting increased menstrual flow also reported a behavioral pattern of coitus during menses. Only 10% with diminished flow acknowledged such a pattern. Women who abstained from sex during menses were not less regular in coital activity at other times nor did the data reveal them to be less orgasmic than women who did not abstain. Our data reveal an association between coitus during menstruation and longer and/or heavier menstrual flow. The etiology of such increased flow is usually believed to be hormonal, but coitus during menstruation may be another important variable.

Coitus↗
PubMed2000

Menstruation in schoolgirls--1: The normal menarche.

The mean age for onset of menstruation (menarche) is 12.8 years. Many schools teach girls about puberty and menstruation and prepare them for the menarche. The school nurse has a valuable part to play in all aspects of menstruation in schoolgirls, psychological as well as physical. The early periods may be irregular and vary markedly in the amount of blood loss. It can take up a year or more for a steady pattern to develop. Dysmenhorrhoea may occur, which may be mild or of the severe spasmodic type. Premenstrual tension syndrome is less common in schoolgirls. Girls should be taught about the importance of hygiene, especially if tampons are used.

Adolescent↗
PubMed1975

Attitudes toward menstruation. International Committee on Applied Research in Population.

Historically, various interpretations of the menstrual process have been reflected in a wide, and usually negative, range of social attitudes toward menstruation. Recent clinical experience with continuation of the modern hormonal and mechanical methods of contraception that induce changes in the normal menstrual pattern suggests the need to understand current variations in attitudes and practices related to menstruation. This paper briefly outlines historical Western, Orthodox Jewish and Muslim, and contemporary US women's attitudes toward menstruation and begins to explore their relationship to contraceptive continuation.

Amenorrhea↗
PubMed1985

Menstruation, menstrual protection and menstrual cycle problems. The knowledge, attitudes and practices of young Australian women.

The results of a survey of 1377 young Australian women aged 14 to 19 years, conducted to determine their attitudes, state of knowledge and practices with regard to menstruation, are presented. The young women, as a group, lacked sufficient information about menstruation, about the time of ovulation, about menstrual discharge, and about the use of tampons. A high proportion (80%) considered menstruation to be inconvenient or embarrassing. Certain measures aimed at remedial action are suggested.

Adolescent↗
PubMed1986

Increased incidence of menstruation-associated bactericidal defects in neutrophils from women who have recovered from toxic shock syndrome.

There is a growing suspicion that a host abnormality may contribute to the pathogenesis of toxic shock syndrome (TSS). We found that females (5 of 5) who had recovered from TSS had transient, menstruation-associated decreases (greater than or equal to 9%) in the ability of their neutrophils to kill Staphylococcus aureus. 502A in vitro more often (P = 0.040 by Fisher's exact test) than non-TSS-affected control subjects (5 of 12). In addition, the average decrease in bactericidal activity in neutrophils obtained during menstruation from recovered TSS patients was 30 +/- 9% compared to 7 +/- 7% for neutrophils from non-TSS-affected control subjects. The results are consistent with the possibility that transient menstruation-associated decreases in neutrophil bactericidal function may indicate susceptibility and/or contribute to the development of TSS.

Adult↗
PubMed1990

Menstruation phobia treated by cognitive correction: a case report.

The management of a case of cessation of menstruation in which differing beliefs and expectations between the patient and psychiatrist led to a diagnosis of phobia of menstruation is described. The treatment was purely cognitive. The problems were acknowledged and clarified. A reorientation was achieved that increased self-efficacy and made the return of menstruation acceptable.

Adolescent↗
PubMed1995

Oral administration of methylergometrine shows a late and unpredictable effect on the non-pregnant human menstruating uterus.

OBJECTIVE: To study the pharmacodynamic and pharmacokinetic properties of oral and intravenous methylergometrine upon uterine motility during menstruation. STUDY-DESIGN: Intra-uterine pressure was measured in six volunteers with a fluid-filled sponge-tipped catheter during menstruation. Methylergometrine was given orally (0.5 mg) or intravenously (0.2 mg) in a cross-over design. RESULTS: After intravenous administration, a fast increase of the frequency of uterine contractions and basal tone occurred with a decrease of amplitude, lasting at least 30 min. Oral administration had a late and less marked effect on uterine motility. An intravenous dose administered 24 h after an oral dose had no effect on uterine motility. Pharmacokinetic data, such as the maximum plasma concentration (Cmax), the time at which Cmax is reached (tmax) and the half-life of absorption (t1/2abs) also demonstrated large individual variations after oral administration. CONCLUSIONS: Oral administration of methylergometrine had an unpredictable and late effect on uterine motility on the menstruating uterus, probably due to an unpredictable bioavailability, in contrast with the fast and predictable effect after intravenous administration.

Administration, Oral↗
PubMed1985

Menstruation as medicine.

Traditional healing rituals in many parts of the world seem to derive from a model of cyclical renewal provided in the first instance by menstruation. Health is seen as dependent upon a correct balance between polar opposite states such as 'heat' and 'cold','dryness' and 'wetness' etc. Nature seems to achieve such balance by alternating regularly between opposites such as night and day, wet season and dry. In this way, periodic 'death' (night, winter etc.) alternates with 'life'. The logic of healing rites is that humans, too, should be able to move through 'death' to 'new life' by keeping closely in tune with wider rhythms of renewal. It is argued here that ideally, women should achieve this by menstruating in synchrony with the moon, which periodically 'dies' and is 'reborn'. Failing this--runs the traditional logic--men themselves must learn to 'menstruate' in some symbolic sense in order to safeguard the rhythms of renewal.

Attitude to Death↗
PubMedDate not supplied

Is thrombolytic therapy safe during active menstruation?

A 39-year-old female presented to the Emergency Department during the fourth day of menstruation and within 2 hours of the onset of chest pain associated with dyspnea, diaphoresis, and emesis. An electrocardiogram showed acute inferior myocardial infarction and serial CPK enzyme levels peaked at 958 IU/L with 9% MB fraction. Along with aspirin and intravenous nitroglycerin, the patient was given thrombolytic therapy consisting of tPA with an initial bolus of 35 units, followed by 65 units infused within 60 minutes together with heparin 5000 units intravenous bolus, and 1000 units/hour maintenance infusion for 5 days. The menses were prolonged 1 day longer than her usual 5 days; however, there was no increase in the amount of bleeding during any day. The hemoglobin dropped from 12.5 G/dl to 11.3 G/dl in the first 6 hours, but remained stable thereafter. This initial drop in hemoglobin was considered a dilutional effect of 1.5 L of normal saline the patient received intravenously during that period. Although no available guidelines exist regarding the safety of thrombolytic agents during active menstruation, this case report and a few others reported in the literature suggest that normal menstruation is not a contraindication to thrombolytic therapy during acute myocardial infarction.

Adult↗
PubMed2002

Menstrual status and serum leptin levels in anorectic and in menstruating women with low body mass indexes.

OBJECTIVE: To evaluate serum leptin levels in anorectic women, menstruating women with low body mass indexes (BMI) and normally menstruating women with normal BMI. DESIGN: Prospective study. SETTING: University clinics. PATIENT(S): Fourteen amenorrheic patients with anorexia nervosa (group A), 11 menstruating women with a BMI <18 kg/m(2) (group B), and 20 normal controls. MAIN OUTCOME MEASURE(S): Determination of BMI, caloric intake, total fat mass, ovarian volume, and serum leptin, insulin-like growth factor I, FSH, LH, E(2), PRL, and TSH levels. INTERVENTION(S): None. RESULT(S): Mean BMI and fat mass were similar in groups A and B and significantly higher in controls. Mean caloric intake was significantly lower in group A than in group B and controls. Median serum leptin levels were significantly lower in group A than in group B and controls, and significantly lower in group B than in controls. Median serum insulin-like growth factor I levels were significantly lower in group A than in group B and controls. Binary segmentation analysis of groups A and B showed that LH was the most relevant variable in differentiating the two groups, followed by leptin. CONCLUSION(S): A threshold of leptin levels exist above which, even in the presence of low body mass indexes, the menstrual function is preserved.

Adult↗
PubMed1991

Comparative morphometric study of the endometrium, the fallopian tube, and the corpus luteum during the postovulatory phase in normally menstruating women.

OBJECTIVE: To compare function and histologic structure of the corpus luteum (CL) to the morphology of the endometrium and the fallopian tube in normally menstruating women. DESIGN: Circulating steroid and luteinizing hormone (LH) levels were compared with CL steroid production in vitro and the histology of CL, endometrium, and the fallopian tube at four stages of the postovulatory phase (days LH +/- 0/LH+3, LH+4/LH+7, LH+8/LH+11, LH+12/onset of menstruation). SETTING OF PATIENTS: The study included 28 volunteers with proven fertility undergoing surgical sterilization timed in relation to the LH surge. INTERVENTIONS: Blood and urine samples for LH, progesterone (P), and estradiol assessment were obtained before (simultaneously with ultrasound examinations), during, and after operation. Biopsy specimens from CL, endometrium, and fallopian tube were taken at the surgical sterilization and subjected to morphometric analyses. MAIN OUTCOME MEASURES AND RESULTS: Significant correlation was found between the endometrial dating and the LH surge (r = 0.923) and between the dating of the endometrial and CL biopsies (r = 0.918). A significant correlation (P less than 0.01) existed between circulating P levels and two endometrial indices; the number of vacuolated cells (LH+4/LH+7) and the glandular diameter (LH+8/LH+11). CONCLUSION: In normally menstruating women, the endometrial biopsy is likely to closely gauge the CL activity provided the biopsy is timed in relation to the LH surge.

Adult↗
PubMed1979

Treatment with a single vaginal suppository containing 15-methyl PGF2 alpha methyl ester at expected time of menstruation.

Termination of early pregnancy, by vaginal administration of prostaglandin analogues, one to three weeks after the first missed menstrual period, has advantages and disadvantages in comparison with vacuum aspiration. Some of these may be reduced if the patient is treated earlier. In the present study the effect and safety of one vaginal administration of 2.5 to 3 mg 15-methyl-PGF2 alpha methyl ester around the expected time of menstruation was evaluated in 16 women exposed to the risk of pregnancy. The overall number of treatment cycles was 35 and pregnancy was confirmed by plasma beta-HCG in eight. The treatment resulted in bleeding in all the pregnant cycles while in the nonpregnant ones it only provoked spotting and bleeding did not begin until the expected time of menstruation. Treatment with 2.5 mg 15-methyl-PGF2 alpha methyl ester resulted in complete abortion in one of three women. If the dose was increased to 3 mg all five treated women aborted. In nonpregnant patients no changes in the levels of estradiol-17 beta or progesterone at any time during the 24-hour observation period were found. Serum cortisol and prolactin but not TSH levels started to increase two hours after the start of treatment and reached a maximum after five hours. The increase coincided with the onset of uterine pain. Ovulatory cycles as judged from basal body temperature occurred in the first menstrual cycle following treatment in all nonpregnant patients. Although possible to use as a "once a month treatment" it seems preferable since the dose is the same, to postpone treatment until menstruation is delayed for a week or more.

Abortion, Induced↗
PubMed1993

Menstruation as the pelvic aggressor.

Cumulative evidence supports the concept of retrograde menstruation being a pelvic aggressor as it contributes to both the development of endometriosis and related symptoms such as dysmenorrhoea and infertility. A major problem in studying the association between these entities (retrograde menstruation, endometriosis, dysmenorrhoea and infertility) is the lack of an accurate method to quantify the amount of retrograde menstruation.

Ascitic Fluid↗