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PubMed1990

Cyclic changes in conjunctival smears from menstruating females.

Cytohormonal evaluation has become an accurate procedure for the assessment of estrogenic effect on the vaginal and buccal mucosa. Both show a cyclical variation in the maturation index (an "estrogenic value" based on epithelial maturation). Conjunctival smears were taken from the temporal conjunctiva of 11 premenopausal and 7 postmenopausal females on a near-daily basis. No females had evidence of ocular surface disease, including keratoconjunctivitis sicca. After fixation and Papanicolaou staining, maturation indices for each specimen based on the differential morphology were red in a single blind fashion by a Papanicolaou cytologist. Cyclical variations paralleling the menstrual cycle in eight of nine premenopausal women were noted with maturation index values ranging from 30 (low estrogen effect) to 82 (high estrogen effect), peaking on day 11 or 21 of the menstrual cycle. No cyclical change was found in postmenopausal smears and smears of subjects with endocrine abnormalities. Maturation index values ranged from 30 to 38. Conjunctiva appears to be an estrogen-sensitive epithelium.

Cell Division↗
PubMed1996

FSH isoforms: bio and immuno-activities in post-menopausal and normal menstruating women.

OBJECTIVE: The full expression of gonadotrophin biological activity depends on the gonadotrophin carbohydrate component. Our aim was to study serum FSH isoforms present in the follicular phase (FPS) and in the menopause (PMS) since the endocrine status may influence the structure of incorporated oligosaccharides. SUBJECTS: Ten healthy post-menopausal women (age range 53-68) not receiving any hormonal treatment and 10 healthy women (age range 20-28) in the follicular phase of their menstrual cycle were studied. MEASUREMENTS: Bio and immuno FSH-activities (Sertoli cell aromatase induction assay and RIA, respectively) were determined in separated isoforms after concanavalin A chromatography. Isolated isoforms were: UB, unbound; WB, weakly bound and FB, firmly bound to the lectin. RESULTS: PMS showed two groups of immuno and bio-active FSH isoforms: WB, bearing biantennary galactosylated type and FB, bearing high mannose or hybrid type oligosaccharides. Immuno and bio-active FSH were not detected in the UB fractions. WB isoforms represented 82 +/- 6% of the total bioactivity recovered in samples analysed individually; their B/I ratio was 0.85 +/- 0.20. FB isoforms were 18 +/- 6%; their B/I ratio was 3.27 +/- 0.60. Whole serum B/I ratio was 1.20 +/- 0.30. Similar results were obtained when pooled sera was analysed: WB: 77%, B/I: 0.82; FB: 23%, B/I: 3.75. Whole serum B/I in pooled samples was 1.10. FPS showed a different pattern. UB isoforms, bearing triantennary or bisecting oligosaccharides, were 41 +/- 3% of the total bioactivity recovered in samples analysed individually. Their B/I ratio was 0.61 +/- 0.23. WB isoforms were 59 +/- 3% and their B/I 0.76 +/- 0.14. FB FSH isoforms were not detected. The whole serum B/I ratio was 0.60 +/- 0.30. Similar results were obtained when pooled sera was analysed: WB 43%, B/I 0.42; FB 57%, B/I 0.62. Whole serum B/I in pooled samples was 0.70. CONCLUSIONS: These results show that, in normal women, circulating FSH bioactivity is associated with isoforms with different oligosaccharide [correction of oligosacharide] structures according to hormonal status. FSH in the follicular phase has a higher degree of branching and a more complete carbohydrate chain than the FSH secreted during the menopause.

Adult↗
PubMed2003

Impact of patient information booklet on treatment decision--a randomized trial among women with heavy menstruation.

OBJECTIVE: Does a patient information booklet influence treatment for menorrhagia? DESIGN: Randomized trial and a pre-trial prospective cohort study. SETTING: Gynaecology outpatient clinics in 14 Finnish hospitals. PARTICIPANTS: A total of 363 (randomized trial) plus 206 (cohort study) patients with menorrhagia. INTERVENTION: An information booklet about menorrhagia and treatment options, mailed before the first visit to the outpatient clinic. MAIN OUTCOME MEASURES: Distribution of treatment modalities, knowledge about treatment options, satisfaction with communication with personnel and anxiety. RESULTS: Treatment decision within 3 months was made more often in the intervention group than in the control group (96% and 89% respectively, P = 0.02). Oral medication was more frequently chosen, and newly introduced treatments (minor surgery, hormonal intrauterine system) were less frequently used in the intervention group (at 3-month follow-up 21% and 29%, respectively). The differences persisted at the 12-month follow-up. In the pre-trial group, new treatment methods were less frequently chosen and used than in the control group. Additional information did not increase the number of surgical procedures used, improve knowledge, or influence satisfaction or anxiety. CONCLUSIONS: Additional information led to an increase in specific treatment decisions and changed the distribution of used treatments without increasing the number of surgical procedures. The study suggests that well-informed women adopting an active role may counteract physicians' emphasis on newly introduced treatments.

Adult↗
PubMed2001

Long-term fluctuations of pressure pain thresholds in healthy men, normally menstruating women and oral contraceptive users.

The aim of this investigation was to evaluate whether the pressure pain threshold (PPT) in masticatory muscles of symptom-free subjects was influenced by fluctuations of the sex hormones. The PPT was measured with an electronic algometer for at least 10 consecutive menstrual cycles in 10 women using oral contraceptives and 10 women not using oral contraceptives, with a regular menstrual cycle (26-31 days). In addition, 10 men were measured in a regular pattern over a period of 1 year. All subjects were symptom-free with an age range between 18 and 39 years. Measurement sessions were held during three different cycle phases (follicular, luteal, perimenstrual) and each session consisted of four consecutive PPT measurements. By means of a linear mixed model (SAS), the PPTs of the masster, temporalis and thumb muscles were compared between: (1) groups, (2) sex-hormonal phases, (3) the four consecutive measurements of each muscle per session and (4) time. The PPTs of the masseter (p = 0.8419) and temporalis muscles (p = 0.2786) did not change significantly over time. There was no significant difference in variance for the masseter (p = 0.6250), temporalis (p = 0.9705) and thumb (p = 0.7446) between the three groups. The PPTs of all muscles were significantly lower during the perimenstrual phases in the two female groups. The present data showed similar patterns of PPTs for the three muscle groups. Moreover, the results have shown a very good consistency of the PPTs over a long time period, both in males and females.

Adult↗
PubMed2000

[The effect of the menstruation cycle on manifestations of pychiatric diseases].

In the present study we investigated whether a correlation exists between menstrual cycle phase on the day of an acute psychiatric admission and diagnostic entities. Therefore we assessed the menstrual cycle phase in 155 women at the time of acute admission for any non-organic psychiatric disorder. A specific diagnosis according to ICD-10-criteria and to Leonhard's nosology was established without knowledge of the menstrual cycle phase. Independent of diagnosis and classification, the majority of patients (57%) was admitted during the pre-menstrual/menstrual period. Comparing the frequencies of admission before (increasing blood-estrogen-level) and after ovulation (decreasing blood-estrogen-level) we found using ICD-10 criteria there were no significant differences between affective psychoses (F3), acute polymorphous psychotic disorder (F23), schizophrenia/schizoaffective psychoses (F20 and F25) and patients suffering from neuroses or personality disorders (F4-F6). Applying Leonhard's criteria we found no significant differences between endogeneous psychoses and personality disorders and no significant differences between cycloid psychoses and affective psychoses or affective psychoses and schizophrenias as well. However, patients with cycloid psychoses were significantly more frequently admitted to hospital during the luteal-/menstrual phase than patients with schizophrenia (chi 2-Test, p = 0.02). These findings do not confirm a specificity of a pre-menstrual exacerbation of psychotic symptoms for schizophrenia. Rather we found cycloid psychoses to be significantly more frequently associated with premenstrual exacerbation of symptoms.

Adolescent↗
PubMed1996

[Circadian blood serotonin and melatonin level in anorexia nervosa patients in comparison with normally menstruating women].

Day and night rhythms of melatonin and serotonin were measured in four female anorexia nervosa patients and for comparison in a control group with normal 28-day menstrual cycle. In the anorexia nervosa group the levels of gonadotropins and sexual steroids were distinctly lowered. In the LHRH test the hormonal profile showed pubertal to prepubertal patterns of secretion with an only moderate increase of LH and distinct shifting of the LH/FSH ratio in direction of FSH. For both groups the 24-hour profiles of melatonin and serotonin showed a normal cycle, i.e. melatonin had its maximum by night, whereas serotonin in contrast displayed its highest values by day. However, in the group of patients with anorexia nervosa the maximum of melatonin was on the average 2.1 fold higher than that found in the control group, whereas that of serotonin was 1.4 fold higher. A close functional coherence between the neurotransmitters melatonin and serotonin and the hypothalamic secretion of LHRH is being discussed.

Adolescent↗
PubMed1999

In-vitro maturation of human oocytes from regularly menstruating women may be successful without follicle stimulating hormone priming.

This prospective randomized study investigated whether the developmental potential of in-vitro matured (IVM) human oocytes is improved by follicle stimulating hormone (FSH) priming before aspiration. Normally cycling women were recruited among couples referred for in-vitro fertilization or intracytoplasmic sperm injection because of male factor and/or tubal disease. In the first experiment, 20 women were randomly allocated to either no stimulation (n = 10) or stimulation for 3 days with rec-FSH (Gonal-F, Serono) at a fixed dose of 150 IU/day from day 3 (n = 10). The oocytes were aspirated when the follicle(s) was observed to be 10 mm and matured in vitro for 36 h. In experiment 2, 12 women received rec-FSH (150 IU/daily) from day 3. In five patients stimulation was given for 3 days and aspiration performed as in the first experiment; the remaining seven patients continued stimulation until follicles were 10 mm in diameter and aspiration was performed 72 h later. All the oocytes were cultured for 48 h. FSH priming did not increase the number of oocytes obtained per aspiration and did not improve on maturation to metaphase II, cleavage rate or embryo development. The implantation potential of IVM embryos may be improved by maturation for 36 h compared to 48 h. In the first experiment, five out of 20 patients (25%) obtained a clinical pregnancy with an implantation rate of 15% (5/33). One has delivered a healthy boy and three pregnancies are ongoing beyond 32 gestational weeks. In the second experiment, an implantation rate of 7% and a single pregnancy (8%) was obtained, with delivery of a healthy girl.

Cytoplasm↗
PubMed1980

Personality and menstruation.

An attempt was made to relate personality to premenstrual tension (PMT), using two groups of 40 parous and 40 mulliparous women, respectively composed of 20 single and 20 married subjects with an age range of 21 to 30 years. The menstrual instruction group had identical age range and means with the nonmenstrual group. Control for pregnancy, use of contraceptives, and irregularity of periods was by exclusion. The influence of civil status and parity was also examined. Standard measures of personality and anxiety were utilized. It was found that: 1) The menstrual instruction group had higher scores in state anxiety than the nonmenstrual group. 2) State anxiety scores were positively and significantly correlated with trait anxiety scores. 3) The differences in state anxiety between the menstrual and nonmenstrual groups manifested in the form of exaggeration of symptomm reporting. 4) The Maudsley Personality Inventory did not discriminate between our menstrual and nonmenstrual groups. 5) The global scores of the premenstrual sympto checklist did not discriminate between our menstrual and nonmenstrual groups but the sections on breast, urinary, and pelvic symptoms did. 6) Neither marital status nor parity by itself had any significant effect on the performance of our menstrual and nonmenstrual groups.

Adult↗
PubMed2004

A randomized trial among women with heavy menstruation -- impact of a decision aid on treatment outcomes and costs.

OBJECTIVE: To evaluate the effects of a decision aid for menorrhagia on treatment outcomes and costs over a 12-month follow-up. DESIGN: Randomized trial and pre-trial prospective cohort study. SETTING AND PARTICIPANTS: Gynaecology outpatient clinics in 14 Finnish hospitals, 363 (randomized trial) plus 206 (cohort study) patients with menorrhagia. INTERVENTION: A decision aid booklet explaining menorrhagia and treatment options, mailed to patients before their first clinic appointment. MAIN OUTCOME MEASURES: Health related quality of life, psychological well-being, menstrual symptoms, satisfaction with treatment outcome, use and cost of health care services. RESULTS: All study groups experienced overall improvement in health-related quality of life, anxiety, and psychosomatic and menstrual symptoms, but not in sexual life. Treatment in the intervention group was more active than in the control group, with more frequent course of medication and less undecided treatments. However, there were no marked disparities in health outcomes, satisfaction with treatment outcome and costs. Total costs (including productivity loss) per woman because of menorrhagia over the 12-month follow-up were 2760 and 3094 in the intervention and control group, respectively (P = 0.1). The pre-trial group also had a significantly lower rate of uterus saving surgery compared with the control group, but no difference in costs because of menorrhagia treatment. CONCLUSION: Despite some differences in treatment courses, a decision aid for menorrhagia in booklet form did not increase the use of health services or treatment costs, nor had it impact on health outcomes or satisfaction with outcome of treatment.

Adult↗