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At least 127 records · Page 7Linked to original sources
PubMed1980

Toxic-shock syndrome in menstruating women: association with tampon use and Staphylococcus aureus and clinical features in 52 cases.

To determine the risk factors associated with toxic-shock syndrome (TSS) in menstruating women, we conducted a retrospective telephone study of 52 cases and 52 age-matched and sex-matched controls. Fifty-two cases and 44 controls used tampons (P < 0.02). Moreover, in case-control pairs in which both women used tampons, cases were more likely than controls to use tampons throughout menstruation (42 of 44 vs. 34 of 44, respectively; P < 0.05). There were no significant differences in brand of tampon used, degree of absorbency specified on label, frequency of tampon change, type of contraceptive used, frequency of sexual intercourse, or sexual intercourse during menstruation. Fourteen of 44 cases had one or more definite or probable recurrences during a subsequent menstrual period. In a separate study, Staphylococcus aureus was isolated from 62 of 64 women with TSS and from seven of 71 vaginal cultures obtained from healthy controls (P < 0.001).

Adolescent↗
PubMed2000

Menstruation, the oral contraceptive pill, and acute appendicitis.

OBJECTIVE: To find out if there was any association between histologically confirmed acute appendicitis, menstruation, and the use of the oral contraceptive pill. DESIGN: Retrospective study. SETTING: District general hospital, Scotland. SUBJECTS: 366 consecutive patients (median age 21, range 10-51) with histologically confirmed acute appendicitis during the period 1981-1990 were studied, 314 of whom were having menstrual cycles. 208 patients with physiological menstrual cycle were included in the study, and 82 patients were taking the oral contraceptive pill. INTERVENTIONS: Prospectively collected standardised data using computer assisted diagnosis of acute abdominal pain was used to review patients with histologically confirmed acute appendicitis. RESULTS: Acute appendicitis was confirmed in 17/208 of patients (8%) who were menstruating, which is significantly less than might be expected (p < 0.003). 5/82 (6%) of those taking oral contraception had withdrawal bleeding and acute appendicitis (p = 0.2). CONCLUSIONS: Acute appendicitis is less common among women during physiological menstruation, but no differences are noted during the withdrawal bleeding phase when taking oral contraception.

Acute Disease↗
PubMed1996

The evolution of endometrial cycles and menstruation.

According to a recent hypothesis, menstruation evolved to protect the uterus and oviducts from sperm-borne pathogens by dislodging infected endometrial tissue and delivering immune cells to the uterine cavity. This hypothesis predicts the following: (1) uterine pathogens should be more prevalent before menses than after menses, (2) in the life histories of females, the timing of menstruation should track pathogen burden, and (3) in primates, the copiousness of menstruation should increase with the promiscuity of the breeding system. I tested these predictions and they were not upheld by the evidence. I propose the alternative hypothesis that the uterine endometrium is shed/resorbed whenever implantation fails because cyclical regression and renewal is energetically less costly than maintaining the endometrium in the metabolically active state required for implantation. In the regressed state, oxygen consumption (per mg protein/h) in human endometria declines nearly sevenfold. The cyclicity in endometrial oxygen consumption is one component of the whole body cyclicity in metabolic rate caused by the action of the ovarian steroids on both endometrial and nonendometrial tissue. Metabolic rate is at least 7% lower, on average, during the follicular phase than during the luteal phase in women, which signifies an estimated energy savings of 53 MJ over four cycles, or nearly six days worth of food. Thus the menstrual cycle revs up and revs down, economizing on the energy costs of reproduction. This economy is greatest during the nonbreeding season and other periods of amenorrhea when the endometrium remains in a regressed state and ovarian cycling is absent for a prolonged period of time. Twelve months of amenorrhea save an estimated 130 MJ, or the energy required by one woman for nearly half a month. By helping females to maintain body mass, energy economy will promote female fitness in any environment in which fecundity and survivorship is constrained by the food supply. Endometrial economy may be of ancient evolutionary origin because similar reproductive structures, such as the oviducts of lizards, also regress when a fertilized egg is unlikely to be present. Regression of the endometrium is usually accompanied by reabsorption, but in some species as much as one third of the endometrial and vascular tissue is shed as the menses. Rather than having an adaptive basis in ecology or behavior, variation in the degree of menstrual bleeding in primates shows a striking correlation with phylogeny. The endometrial microvasculature is designed to provide the blood supply to the endometrium and the placenta, and external bleeding appears to be a side effect of endometerial regression that arises when there is too much blood and other tissue for complete reabsorption. The copious bleeding of humans and chimps can be attributed to the large size of the uterus relative to adult female body size and to the design of the microvasculature in catarrhines.

Adult↗
PubMed1991

Iron requirements in menstruating women.

Total-absorbed-iron requirements in adult and teen-age menstruating women were calculated from previously published data on menstrual blood losses; hemoglobin distribution in healthy, nonanemic women; basal iron losses; and growth requirements in teen-agers. Because present calculations included the effect of the variation of all indices, the new requirements for iron were increased to 2.84 mg/d in adult women and 3.21 mg/d in teen-agers (95th percentiles). Six independent estimations of whole-diet iron bioavailability were made to translate absorbed iron requirements into dietary requirements. In subjects with no iron stores, estimated dietary iron bioavailability amounted to 14% (Swedish diet), 16% (French diet), and 16.6% (US diet). When 15% was used as a single figure to represent the optimal, long-term bioavailability of iron in a general Western-type diet, the 95th percentiles of dietary iron requirements were 18.9 mg in adult menstruating women and 21.4 mg in menstruating teenagers.

Absorption↗
PubMed1998

Prevention of postoperative nausea and vomiting in female patients during menstruation: comparison of droperidol, metoclopramide and granisetron.

The incidence of postoperative nausea and vomiting (PONV) is high in women during menstruation. We have compared the efficacy of droperidol, metoclopramide and granisetron in the prevention of PONV in female patients during menstruation undergoing major gynaecological surgery. In a randomized, double-blind study, 120 patients received droperidol 25 micrograms kg-1, metoclopramide 0.2 mg kg-1 or granisetron 40 micrograms kg-1 (n = 40 in each group) i.v. immediately before induction of anaesthesia. A standard general anaesthetic technique and postoperative analgesia were used throughout. There was a complete response, defined as no PONV and no administration of rescue medication, during the 24-h observation period in 45% of patients in the droperidol group, 38% in the metoclopramide group and 70% in the granisetron group (P = 0.021 vs droperidol, P = 0.003 vs metoclopramide). There was no difference in the incidence of adverse events between groups. We conclude that the prophylactic antiemetic efficacy of granisetron was superior to that of droperidol or metoclopramide for prevention of PONV in women during menstruation.

Adult↗
PubMed2000

Role of nitric oxide in implantation and menstruation.

Nitric oxide (NO) is a major paracrine mediator of various biological processes, including vascular functions and inflammation. In blood vessels, NO is produced by the low-input constitutive endothelial NO synthase (eNOS) and is a potent vasodilator and platelet aggregation inhibitor. The inducible NOS isoform (iNOS) is capable of producing NO at high concentrations which have pro-inflammatory properties. Immunohistochemical and molecular studies of endometrial NOS expression, as well as animal experiments with NOS inhibitors, indicate that NO plays an important role in endometrial functions such as endometrial receptivity, implantation and menstruation. In rodents, both iNOS and eNOS are highly up-regulated in the implantation sites, and NOS inhibitors show synergistic effects with antiprogestins in inhibiting the establishment of pregnancy. In the human endometrium, eNOS have been localized in the glandular epithelium and in endometrial microvascular endothelium, primarily during the luteal phase. iNOS has been found in the endometrial epithelium during menstruation, in immunocompetent endometrial cells, and in decidualized stromal cells. In primates, NO may be involved in the initiation and maintenance of menstrual bleeding by inducing tissue breakdown and vascular relaxation as well as by inhibiting platelet aggregation. Endometrium-derived NO may also play a role in myometrial relaxation during menstruation. These studies open up new applications for NO-donating and -inhibiting agents in uterine disorders. NO donors may be useful in the treatment of dysmenorrhoea and for promoting fertility. Antiprogestins, progesterone receptor modulators and iNOS inhibitors may find applications in the treatment and prevention of abnormal uterine bleeding.

Animals↗
PubMedDate not supplied

Endometrial leukocytes and menstruation.

This review examines evidence supporting the concept that menstruation occurs as a result of an inflammatory process. In the endometrium, leukocyte numbers rise in the late secretory phase following the fall in serum progesterone concentrations. It is postulated that products released following activation of these leukocytes are critically important for menstruation. Mast cells, eosinophils, neutrophils and macrophages in particular are involved. Endometrial granular lymphocytes may also play a role, although their increase in numbers is somewhat earlier during the menstrual cycle than that of the others, suggesting perhaps a primary role in embryo implantation. Leukocyte products include a range of proteases, chemokines and cytokines which in concert result in focal production and activation of matrix metalloproteinases by endometrial cells and the subsequent breakdown of tissue that characterizes menstruation. Regulation of leukocyte entry, proliferation, differentiation and activation within the endometrium is not yet well understood, although both chemokines and cytokines produced locally by endometrial cells are clearly implicated. The role of progesterone in regulating these events is still not understood although the lack of progesterone receptors on endometrial leukocytes suggests indirect actions.

Animals↗
PubMed1996

The signals and molecular pathways involved in human menstruation, a unique process of tissue destruction and remodelling.

Human endometrium is a specialized tissue that undergoes sequential phases of proliferation and secretory changes in order to support the implantation and growth of an embryo. If implantation does not occur, this tissue rapidly undergoes dissolution during the menstrual period. Tissue shedding during menstruation is associated with significant apoptosis, disordered expression of adhesion molecules, loss of filamentous (F) actin from cell borders and fragmentation of endometrial glands. On the other hand, compromise of integrity of vessels and dissolution of the extracellular matrix leads to bleeding and tissue dissolution. The processes of bleeding and tissue shedding during menstruation are precisely controlled by a number of systemic and local factors. The systemic signal that leads to menstruation is the withdrawal of the steroid hormones. The available evidence suggests but does not yet prove that tumour necrosis factor (TNF)-alpha may serve as the local signal contributing to the processes of menstrual shedding and bleeding. Secretion of metalloproteinases and their subsequent activation induced by plasmin facilitates degradation of extracellular matrices and bleeding. The menstrual process ceases by secretion of steroid hormones directly or through regulation of production or activation of signals that lead to tissue shedding and bleeding.

Actins↗
PubMed2000

Early pregnancy predictors of preterm birth: the role of a prolonged menstruation-conception interval.

OBJECTIVE: To study early pregnancy characteristics as possible risk factors associated with preterm birth. DESIGN: Retrospective analysis of prospectively collected maternity data. POPULATION: 21,069 singleton deliveries with record of a specified last menstrual period and a midtrimester dating scan. SETTING: Catchment area of tertiary centre serving a general maternity population. METHODS: Univariate and multivariate analysis. Variables included: maternal age; height; weight at first visit; parity; ethnic group; cigarette smoking and alcohol consumption recorded in early pregnancy; history of abortion; history of preterm birth; and discrepancy between menstrual dates and ultrasound dates. MAIN OUTCOME MEASURES: Adjusted odds ratios for factors associated with preterm birth, stratified according to parity (nulliparae vs multiparae) and gestational age (early preterm, 24-33 weeks; late preterm, 34-36 weeks; all preterm, < 37 weeks). Population attributable risk (aetiologic fraction) of the significant variables for preterm birth. RESULTS: The overall preterm (< 37 weeks) delivery rate according to scan dates was 7 x 0%. Preterm birth was associated with young (< 20 years), short (< or = 155 cm) and underweight (< or = 52 kg) mothers, non-Europeans, cigarette smokers, previous abortion or previous preterm delivery, and a prolonged menstruation-conception interval. Preterm births which followed the spontaneous onset of labour (72%) had results which were similar to the overall group, while there were too few iatrogenic preterm deliveries for separate analysis. Logistic regression showed that associations varied in different parity and gestational age groups. For nulliparae, smoking was not associated with preterm birth, but it was strongly associated with multiparous women (adjusted OR 1 x 8, 95% CI 1 x 6-2 x 1). A past history of premature delivery had the highest risk for birth before 34 weeks in the index pregnancy (adjusted OR 5 x 1, 95% CI 3 x 4-7 x 6). A discrepancy between menstrual and scan dates of greater than +7 days, suggestive of a prolonged interval between last menstruation and conception, was present in 23 x 3% of all pregnancies, and was associated with an increased risk of preterm delivery in all gestational age categories for nulliparae (adjusted OR 1 x 5, 95% CI 1 x 3-1 x 8) and multiparae (adjusted OR 1 x 9, 95% CI 1 x 6-2 x 2). Because of its high prevalence, this variable constituted a relatively high population-attributable risk for premature birth for both nulliparae (10 x 7%) and multiparae (16 x 6%). CONCLUSIONS: A discrepancy of more than +7 days between menstrual and scan dates, indicating a prolonged interval between last menstruation and conception, is a significant predictor of preterm birth. This effect is independent of other factors such as maternal age, height, weight and smoking which are also associated with prematurity. In a maternity population with ultrasound scan dates and recorded last menstrual period, this variable can be easily calculated and used as a marker for increased surveillance.

Analysis of Variance↗
PubMed1993

Bowel habit and dietary fibre intake before and during menstruation.

The stool frequency, faecal form and dietary fibre intakes of 25 menstruating women were recorded during the 4 days just before menstruation and the first 4 days of menstruation. At the time of the bleed there was a significant increase (P < 0.01) in stool frequency, a significant decrease (P < 0.001) in faecal form and a significant increase (P < 0.01) in dietary fibre intake. There are indications that cyclical changes in fibre intake may have some bearing on differences in bowel function between the luteal phase and menses although other factors would appear to play a dominant role.

Adult↗
PubMed1997

Production of endometrial matrix metalloproteinases, but not their tissue inhibitors, is modulated by progesterone withdrawal in an in vitro model for menstruation.

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are implicated in normal menstruation, but the mechanism of their regulation is not yet clear. Human endometrial stromal cell cultures were established to mimic the events of the late luteal phase of the menstrual cycle: after 6 days of culture with estradiol 17beta (10 nmol/L) and progestin (P, 100 nmol/L), half the cells were subjected to P withdrawal, and medium was harvested on day 10. Decidualization of the cells was verified by PRL immunohistochemistry. Latent MMP-1, -2, -3, and -9 were detected by zymography and quantitated by densitometry, and production of all enzymes was increased on withdrawal of P. This increase was confirmed by enzyme-linked immunosorbent assay for MMP-1. TIMP-1, -2, and -3 also were produced by the cells, with a mean ratio of 3.9:1:1.2, respectively. There was no effect of P withdrawal on either the amount of each TIMP or their relative concentrations. Expression of the messenger RNA for TIMP-1 or TIMP-2 also was not changed by P withdrawal. Thus, withdrawal of P alters the ratio of MMPs to TIMPs in this model in favor of MMPs and, hence, of tissue degradation. However, the focal nature of menstruation-associated MMP activity suggests that P withdrawal is unlikely to be the only factor responsible for in vivo induction of MMPs at menstruation.

Cells, Cultured↗
PubMed1992

Menstruation in short-tailed fruit bats (Carollia spp.).

Uterine function was assessed histologically in Carollia spp. removed from a laboratory breeding colony. The uteri of periovulatory bats examined on days 1-3 post coitum varied considerably depending upon whether regressing corpora lutea were present. In females lacking such corpora lutea, the endometrium was shallow and proliferative. In most of the bats having regressing corpora lutea, the endometrium was thicker and necrotic portions of the superficial lamina functionalis were being sloughed off with associated bleeding (i.e. in the form of a true menstrual process). The presence of regressing corpora lutea and well-developed endometria in these animals indicated that short-tailed fruit bats are spontaneous ovulators with a functional luteal phase to their cycles. Menstruation was also observed in some females that were not periovulatory, or that lacked regressing corpora lutea. The endometrium was not vascularized by spiral arterioles, but it did contain distinctive granulocytes similar to those observed in catarrhine primates and other menstruating bats. Most endometrial growth occurred after ovulation and, in pregnant animals, was associated with retention of the embryos in the oviducts for approximately 13-16 days. Carollia perspicillata normally produces one young at a time, after a gestation period of about 4 months, and is a seasonal breeder in the wild. Menstruation probably provides this bat with an efficient mechanism for eliminating a well-developed endometrium from its simplex uterus in the event of fertilization failure or early embryonic loss. This may give the female another chance to establish a pregnancy and produce an infant at a reasonably opportune time during the same breeding season.

Animals↗
PubMed1986

Menstruation span--a time-limited risk factor for endometrial carcinoma.

A case-control study was undertaken to investigate the influence of reproductive factors on the risk of developing endometrial carcinoma. The study comprised 254 women with newly diagnosed endometrial carcinoma, resident in a defined geographical area, and 254 age-matched population controls. Nulliparity and late menopause were positively associated with endometrial carcinoma. Each additional full-term pregnancy resulted in a decrease in the risk by 16%. The importance of parity and menopausal age decreased with increasing life span, and in women older than 69 years these two variables did not discriminate significantly between cases and controls. The calculated number of years of menstruation (the "menstruation span") was used as a combined measure of the impact of parity, age at menarche and age at menopause on the risk of developing endometrial carcinoma. The patients had a significantly longer mean menstruation span than the controls (33.6 versus 31.2 years; p less than 0.001) and a longer span than 39 years gave a 4.2 times higher risk than one shorter than 25 years. It is suggested that the total length of time for which a woman is exposed to unopposed estrogen is important and that the effect of this hormonal influence is time-limited.

Adolescent↗
PubMed2006

Do all regularly menstruating women ovulate in each cycle?

Women may experience anovular menstruation due to some pathophysiological causes which can be detected either by invasive histological examination as well as noninvasive serial ultrasound test. The women who are regularly menstruating without ovulation in each cycle were identified in this study. In a tertiary level infertility care centre of Bangladesh in Dhaka infertile population was the subject of the study. The serial ultrasound noninvasive procedure is used for diagnosis of anovular menstruation and found very much helpful.

Adult↗
PubMed2000

[Menstruation disturbances in a 17-year-old girl with coeliac disease].

The case of 17 year old girl with coeliac disease and menstruation disturbances was described. The patient began to menstruate regularly at the age of 15 during gluten-free diet. After the change to gluten diet bleedings occurred every 10 days. When she again went on free-gluten diet regular menstruations came back. These disturbances may be connected with introducing gluten to the diet.

Adolescent↗
PubMed2000

[Resumption of menstruation during lactation after delivery].

Twenty-three women in the menstruation resumption during lactation were evaluated. Average period of lactational amenorrhoea was 7 months after delivery. Ovulation before the first menstruation has occurred in 7 breastfeeding women (39%), but only in one case it took place earlier than 6 months after labour. The correlation was established between the resumption of menstruation and entirely period of breastfeeding per day. The Lactational Amenorrhoea Method (LAM) as the family planning procedure was discussed.

Adult↗
PubMed2000

Migraine associated with menstruation.

Many women report increased frequency of migraine in association with menstruation. The term 'menstrual' migraine is often used despite lack of an agreed definition. The International Headache Society has classified most headaches but not 'menstrual' migraine. A proposed definition is based on the finding that the prevalence of migraine increases on day 1 +/- 2 of the menstrual cycle. Attacks occurring at this time of the cycle are typically without aura. Effective acute therapy is the mainstay of management for menstrual and non-menstrual attacks although there is some evidence that attacks linked to menstruation are less responsive to treatment compared with migraine at other times of the cycle. If several attacks occur throughout the cycle, standard prophylactic agents should be used. Women with exclusive 'menstrual' migraine may benefit from perimenstrual prophylaxis but this should only be instigated once the association between migraine and menstruation has been confirmed with prospective records kept for a minimum of three cycles. NSAIDs are the treatment of choice in reducing migraine associated with menorrhagia and/or dysmenorrhoea, otherwise perimenstrual oestrogen supplements using percutaneous or transdermal oestrogens are recommended. Combined oral contraceptives are useful for women requiring contraception although there is a tendency for attacks to occur during the pill-free interval. If these are contraindicated, depot progestogen is an alternative as it also inhibits ovulation and can improve migraine, provided amenorrhoea is achieved. Oral progestogen-only contraception has little place in the management of 'menstrual' migraine as it does not inhibit ovulation and is often associated with a disrupted menstrual cycle. Some women consulting with menstrual migraine are menopausal and may be considering hormone replacement therapy. Studies suggest that non-oral routes of delivery of oestrogen, which provide stable levels, are more likely to improve migraine than oral oestrogens, which produce variable day-to-day levels. Too low a dose of oestrogen is ineffective at controlling symptoms but too high a dose, particularly if coupled with surges of endogenous oestrogen, can trigger migraine aura. Once the route and dose has been optimised, continuous oestrogens can control migraine as well as menopausal symptoms. Additional progestogen, necessary for unhysterectomised women, can exacerbate migraine. To minimise this, progesterone derivatives or non-oral routes of delivery are recommended, with continuous regimens used where possible.

Female↗
PubMed2003

[Clinical study on treatment of 405 cases of irregular menstruation by tiaojing zhixue granules].

OBJECTIVE: To provide scientific and objective basis for Tiaojing zhixue granules treating irregular menstruation of clinical effect. METHOD: Choose 405 cases suffering from irregular menstruation and make a systematic study 304 patients were treated with Tiaojing Zhixue granules, 101 patients received Fuxuening treatment. RESULT: After treatment, the obvious effective rate of Tiaojing Zhixue granules was 78.3% and the total effective rate 97.4%, granule cure rate of Fuxuening was 38.6% and the total effective rate 87.1%. Comparison showed significant difference (P < 0.001). Safety spithetical observation did not discover harmful effects and toxicity and side effects antagonize common symptoms 26 entries of clinical studying, the 7 entry are: weary and tired, short breaths, sore loins, weak knees, insomnia and eccessive dreaming, rapid and thready pulse, colliquative, distending pain in the lower abdomen and hypochondria. Among them, the comparison showed significant difference about treatments(P < 0.01-0.001). CONCLUSION: Tiaojing Zhixue granules treatment irregular menstruation are scientific and effective.

Adolescent↗