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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↗
PubMed1976

Menstruation, reattribution, and competence.

Experiment 1 tested whether performance is influenced by the reattribution of task-relevant emotional arousal. Arousal was manipulated by level of anticipated shock and test anxiety. Tasks included the digit symbol substitution test, the Stroop Color-Word Interference Test, anagram solution, and unsolvable puzzles. Aroused subjects who were either given a pill attribution for their arousal or correctly warned that shock and test anxiety might upset them performed significantly better than aroused subjects who were given no manipulated attribution. Experiment 2 compared the performance of menstruating women complaining of moderate or severe symptoms with others not currently menstruating. It was expected that the latter two groups would not have a salient alternative attribution for task-relevant arousal and that women with stronger symptoms would. Experimentally aroused, high-symptom menstruating women performed significantly better than the other two aroused groups. The results suggest the beneficial effects of predictability and perceived normative standards upon performance, and the reattribution phenomenon was reconsidered within that context. The implications of these findings for competence during menstruction were also also discussed.

Arousal↗
PubMed2000

Iron stores and haemoglobin iron deficits in menstruating women. Calculations based on variations in iron requirements and bioavailability of dietary iron.

BACKGROUND: Iron stores and haemoglobin iron deficits in menstruating women can be calculated from body iron losses and absorption of dietary iron using recently developed methods. OBJECTIVE: To examine iron balance (iron status) expressed as body iron stores or haemoglobin iron deficits in menstruating women from amounts of iron lost (iron requirements) and amounts of dietary iron absorbed. Calculations are made both of stationary states and of the rate of changes in iron stores (iron status) when any of the two main factors determining iron balance are changed. DESIGN: The study is based on (1) previous and new equations describing relationships between iron absorption, iron requirements (losses), iron stores and/or haemoglobin deficits and (2) published data on iron requirements and their variation in menstruating adult women. RESULTS: Both iron stores and haemoglobin iron deficits are strongly related to iron requirements and absorption of dietary iron and follow the same equations during states of iron repletion and iron deficiency. When, for example, increasing or decreasing the bioavailability of the dietary iron, about 90% of the change in iron stores will occur within 1 y. CONCLUSIONS: There are strong relationships between iron requirements, bioavailability of dietary iron and amounts of stored iron. The observations that a reduction in iron stores and a calculated decrease of haemoglobin iron had the same increasing effect on iron absorption suggest that the control of iron absorption is mediated from a common cell, that may register both size of iron stores and hemoglobin iron deficit, eg the hepatocyte. European Journal of Clinical Nutrition (2000) 54, 650-657.

Absorption↗
PubMed2003

Consequences of iron depletion on health in menstruating women.

OBJECTIVE: To examine the consequences of single iron depletion on health in menstruating women, a common but rarely investigated situation in industrialized countries. DESIGN: We studied data issued from the SU.VI.MAX. cohort via a transversal and a longitudinal (2-y follow-up) approach. SUBJECTS AND METHODS: Iron-depleted menstruating women (ferritin &<15 micro g/l, n=472) were compared with iron-sufficient (ferritin 30-80 micro g/l, n=393) menstruating women (aged 35-51 y) in terms of health variables and quality of life (DUKE score) using logistic regression and analysis of variance. RESULTS: The risk of any infection or of specific types of infections was not increased by iron deficiency. Regarding the DUKE health profile, no specific score was significantly different between the two groups: only the scores reflecting 'physical health' (P=0.09) and 'perceived health' (P=0.12) showed a trend toward a lower level, while the best score for 'mental health' (P=0.11) was found in the group of iron-depleted women. The only significant difference between iron-depleted and iron-sufficient women concerned memory disorders, which were significantly less common in iron-depleted women, Odds ratio=0.7 (0.6-0.9; P=0.03). CONCLUSION: There is no conclusive evidence that an absence of iron stores has negative consequences; however, we must consider that in the case of a worsening of the iron balance, it may lead to a rapid decrease in the level of functional compounds. SPONSORSHIP: The laboratory Robapharm, Pierre Fabre, France.

Adult↗
PubMed1998

Quality of life during menstruation in patients with inherited bleeding disorders.

Menorrhagia is a common and major problem for patients with inherited bleeding disorders, especially vWD. Quality of life during menstruation was assessed in 99 patients with inherited bleeding disorders including vWD (n = 57), carriers of haemophilia A (n = 17), carriers of haemophilia B (n = 7) and FXI deficiency (n = 18), and comparison was performed with an age-matched control group (n = 69). A questionnaire was used that included four main sections: (i) general health, (ii) health and daily activities, (iii) dysmenorrhea and (iv) quality of life during the menstrual period. Although patients with inherited bleeding disorders felt that their health (in general) was very good, they had significantly poorer quality of life on all the scales used than controls. Thirty-nine per cent reported having cut down on the amount of time spent on work and other activities as a result of their menstruation; 47% felt that they accomplished less than they would like during this period, 38% felt that they were limited in the kind of work and other activities that they could do, and 40% found that it took extra effort to perform their work. Fifty-one per cent experienced moderate, severe or very severe dysmenorrhoea. Quality of life was statistically poorer in patients with vWD, menstrual scores > 100 according to the pictorial blood assessment chart (PBAC), those who had periods > or = 8 days and those who experienced flooding or passage of clots. In conclusion, menstruation has a negative effect on the quality of life in patients with inherited bleeding disorders especially in those with objectively confirmed menorrhagia.

Adolescent↗
PubMedDate not supplied

Iron supplementation for menstruating female blood donors.

Depletion of body iron stores is a major factor limiting regular blood donations by menstruating females. To determine if regular iron supplementation would solve this problem, we conducted a double-blind study in which menstruating female donors were randomly placed into one of three groups: one taking 39 mg elemental iron, a second taking 39 mg of iron plus 75 mg vitamin C, and a third taking 100 mg vitamin C daily. The women were requested to donate every 8 weeks for at least 1 year. Blood samples were taken on each donation for measurements of hemoglobin, total iron binding capacity (TIBC), and ferritin. In the two groups taking iron supplements hemoglobin and ferritin increased from baseline values and the TIBC decreased. The vitamin C control group showed decreases from baseline for hemoglobin and ferritin and increases in TIBC. Differences between groups taking iron supplements and the group not taking supplements were highly significant. Drop-out from the study was due to various causes; however, iron intolerance was uncommon. Minimal daily iron supplementation was beneficial in maintaining body iron stores and hemoglobin levels in menstruating females on a schedule of blood donation as often as every 8 weeks.

Adolescent↗
PubMed1999

Current concepts of the mechanisms of menstruation.

Menstruation is the process whereby the superficial or functionalis layer of the endometrium lining the uterine cavity disintegrates and is removed from the uterine lumen towards the end of the luteal phase of a non-pregnant cycle. Within a period of 5-6 days the old lining is removed and a new lining regenerated without scarring occurring, a remarkable example of controlled tissue remodelling unparalleled in other organs. This chapter describes the phenomenon of menstruation and tissue repair and reviews the vasoconstrictor and inflammatory hypotheses for the initiation of menstruation. Particular emphasis is placed on the roles of steroids, prostaglandins, endothelin, lysosomal enzymes and matrix metalloproteinases, and the involvement of the fibrinolytic system and apoptosis. Repair of the endometrium is compared to the processes and mechanisms of wound healing.

Adolescent↗
PubMed2005

[Matrix metalloproteinases and their role in menstruation and endometriosis].

Endometriosis is one of the most common benign proliferative disorders of the female genital tract and occurs in up to 20 % of women, leading to symptoms such as chronic pelvic pain, dyspareunia, dysmenorrhea but also sterility. Although retrograde menstruation represents a plausible explanation for the development of endometriosis, several additional factors have to contribute to the establishment, invasion and growth of endometriotic lesions since endometrial cells spilled into the peritoneal cavity can also be detected in the majority of women without evidence of disease. Within this, the ability of endometrial tissue to implant and invade the peritoneal surfaces and underlying tissues appears to be a pathogenic key mechanism for the growth of endometrium outside the uterine cavity. Matrix metalloproteinases (MMPs) constitute a group of enzymes that not only mediate physiologic tissue turnover such as endometrial breakdown at menstruation, but also have been shown to play important roles in the development of invasive and destructive diseases. The altered regulation of endometrial MMPs has therefore also been associated with the pathogenesis of endometriosis, linking the invasive potential of refluxed endometrium to the adhaesion and growth of endometriotic cells. The aim of present work is to review the role of MMPs in processes of menstruation and development of endometriosis.

Endometriosis↗