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PubMed2003

Treatment of functional hypothalamic amenorrhea with hypnotherapy.

OBJECTIVE: To determine the effects of hypnotherapy on resumption of menstruation in patients with functional hypothalamic amenorrhea (FHA). DESIGN: Uncontrolled clinical study. SETTING: Academic clinical care center. PATIENT(S): Twelve consecutive women with FHA were selected. INTERVENTION(S): A single 45- to 70-minute session of hypnotherapy was administered, and patients were observed for 12 weeks. MAIN OUTCOME MEASURE(S): Patients were asked whether or not menstruation resumed and whether or not well-being and self-confidence changed. RESULT(S): Within 12 weeks, 9 out of 12 patients (75%) resumed menstruation. All of the patients, including those who did not menstruate, reported several beneficial side effects such as increased general well-being and increased self-confidence. CONCLUSION(S): Hypnotherapy could be an efficacious and time-saving treatment option that also avoids the pitfalls of pharmacological modalities for women with FHA.

Amenorrhea↗
PubMed1999

Exploring the bio-psycho--social approach to premenstrual experiences.

A bio-psycho-social approach to the premenstrual syndrome suggests that cyclical hormonal changes are acknowledged and interpreted in light of the expectations and the attitudes acquired in the process of socialization. In this study, attitudes toward menstruation and premenstrual experiences of 229 Israeli students of different ethnic groups and gender role orientations were explored. The findings were consistent with previous reports: attitudes toward menstruation and premenstrual experiences were associated with exposure to premenstrual symptoms in women family members and negative messages during adolescence; respondents of a more traditional background perceived menstruation as relatively debilitating and bothersome but also a natural event and reported more severe experiences. However, models aimed at estimating the causal relationship indicated that attitudes toward menstruation depend on premenstrual experiences rather than predict them. The difficulties of investigating such reciprocal relationships of menstrual attitudes and premenstrual experiences cross-culturally and longitudinally are discussed.

Adult↗
PubMed1999

Menstrual and premenstrual issues in female military cadets: a unique population with significant concerns.

CONTEXT: There is a strong need to determine what effect, if any, menstruation has on the performance of duty as a Cadet at the United States Military Academy (USMA) at West Point, and to determine what impact, if any, the USMA environment has on the menstrual cycle. STUDY OBJECTIVES: To study menstrual function and premenstrual symptoms in a structured, rigorous military environment; determine the perceived impact of menstrual and premenstrual symptoms on academic, physical, and military activities; and evaluate the difficulties inherent to menstruation in a military setting. DESIGN, SETTING, AND PARTICIPANTS: A survey about high school menstrual and premenstrual function, and the Premenstrual Assessment Form (PAF), were completed by all 158 freshman female Cadets in July 1991. In May 1992, 83 participants completed a survey assessing menstrual and premenstrual symptoms, including interference with activities during the year. MAIN OUTCOME MEASURES: Menstrual regularity, premenstrual symptoms, interference with activities. RESULTS: Participants reported menstrual patterns and premenstrual symptoms in high school similar to other females their age. Most (62%) predicted a change in menstruation at the USMA, half were worried that physical symptoms would interfere with activities, one-fourth were worried that premenstrual symptoms would interfere with activities, and one-fourth were worried that obtaining and changing menstrual materials would interfere with activities. Almost all respondents (91%) reported changes in menstruation during the year, most commonly less regular, less frequent, shorter, lighter, and less crampy periods. Menstrual and premenstrual symptoms interfered with physical activities (66.2%, 61.4% respectively) more so than academic (50.6%, 45.7% respectively) or military activities (39.8%, 47.0% respectively). Female Cadets described significant difficulties with changing (62.6%), obtaining (51.8%), and disposing of (38.5%) menstrual materials. CONCLUSIONS: The data demonstrate major changes in menstrual function in over 90% of female Cadets; a significant perceived impact of menstrual and premenstrual symptoms on academic, physical, and military activities; and difficulties in obtaining, changing, and disposing of menstrual materials in a military setting. These findings have implications for females in the military, as well as for young women generally.

Adolescent↗
PubMed2000

Gynaecological and obstetrical morbidity in women with type I von Willebrand disease: results of a patient survey.

Type 1 von Willebrand disease (vWD) is generally regarded clinically as 'mild' and the obstetrical-gynaecological features have not been fully described. We administered a patient questionnaire and provider survey of the medical and quality of life aspects of childbirth and menstruation to 99 type 1 vWD patients and compared the patients presently menstruating (n=81) to a cohort of 150 menstruating females in the general population. The following measurements had a statistically higher proportion in the vWD group: number of tampons/towels used for a typical menstrual cycle (P=0. 002); percentage reporting that clothes are stained by menses (P = 0. 001); past or present history of anaemia (P = 0.001); childbirth-related bleeding (P=0.001); and childbirth-related bleeding necessitating RBC transfusion (P=0.002). Quality of life assessment of the impact of menses in both of the above cohorts was measured by a Likert scale using seven quality of life parameters. Compared to the control group, the vWD patients had a significantly higher score, with P-values of < 0.0001 for each parameter. Hormonal interventions for menorrhagia in the vWD patients were < or = 50% effective. Menorrhagia resulted in red blood cell transfusions in 6% of patients, dilatation and curettage in 17% and hysterectomy in 13%. Despite the common connotation of type 1 vWD as clinically 'mild', childbirth and the monthly challenge to haemostasis presented by menstruation result in a substantial degree of morbidity in females with type 1 vWD. These results support the rationale for ongoing international efforts to increase awareness of vWD as a cause for menorrhagia and to improve the quality of life in females with known vWD.

Adolescent↗
PubMed1998

Idealised versus tainted femininity: discourses of the menstrual experience in Australian magazines that target young women.

Information and messages concerning health-related issues are not confined to material provided by official figures or sources. Much information exists in the community and comes from a variety of sources. One such source is the media. This paper reports the findings of a study conducted over a 12-month period of advertisements for menstrual products in a selection of four monthly Australian magazines (n = 48) directed towards young women. The study examined the way in which menstruation and the menstrual experience were depicted in terms of page space, textual content and visual images. Findings revealed that advertisements for menstrual products provided confusing, conflicting and paradoxical messages. These included stressing the normality of menstruation while also emphasising the importance of keeping it hidden and secret. Menstruation was depicted as being a state of tainted (idealised) femininity because of the potential for the menstrual silence to be shattered by people finding out. Protection failure was depicted as being the ultimate in tainted femininity and a result of a woman's incorrect choice of product. Choosing menstrual-care products was depicted as simple but, paradoxically, complex and confusing. Women were depicted as liberated and sophisticated but images and language related to infancy were used. Freedom and liberation were conferred by the use of the advertised product. Overall, in common with previous studies, menstruation was depicted as a crisis of hygiene that is a risk to femininity. Advertisements for pantyliners suggest that femininity itself poses a threat to (idealised) femininity. This study demonstrates the crucial role of the media as a source of health information for young women.

Adolescent↗
PubMed2000

Role of persistent amenorrhea in bone mineral metabolism of young hemodialyzed women.

BACKGROUND: Chronic renal failure in women is frequently associated with endocrine disturbances leading to menstrual disorders. However, most studies on renal osteodystrophy have not taken into account the possible role of these hormonal disturbances on the pathogenesis of bone alterations seen in these patients. In the present study, we evaluated bone mineral metabolism in a group of young hemodialyzed women with persistent amenorrhea and compared them with similar women with regular menstruation. METHODS: We studied 74 women who were further subdivided into 43 women with regular menstrual periods and 31 women with persistent amenorrhea, defined as the absence of menstrual bleeding for more than six months. In all patients, we performed a bone mineral density (BMD) analysis and simultaneously evaluated different biochemical parameters, intact parathyroid hormone (iPTH), sexual hormone determinations that included total estradiol, follicle-stimulating (FSH), and luteinizing hormone and markers of bone resorption such as the procollagen type 1 cross-linked carboxy-terminal telopeptide (ICTP). RESULTS: Serum calcium, phosphorus, and iPTH were similar in both groups. Serum alkaline phosphatase was higher in amenorrheic women. Although the total serum estradiol concentration was normal in the amenorrheic women when compared with nonuremic women, the values were significantly lower than those in regularly menstruating women. Serum FSH and ICTP values were significantly higher in the amenorrheic women. Trabecular BMD in the lumbar spine was also significantly lower in the amenorrheic women compared with regularly menstruating dialysis patients. Lumbar spine BMD and total estradiol levels correlated significantly in the amenorrheic group. CONCLUSIONS: These studies show that persistent amenorrheic young women on dialysis have lower trabecular BMD and evidence of increased bone resorption when compared with normal menstruating women on dialysis. The possible impact of these results in the natural history of the uremic osteodystrophy remains to be determined.

Adult↗
PubMed2005

[Menstrual bleeding -- must that be? Extended use of oral hormonal contraceptives].

More and more women request less menstruation and would refuse temporarily or completely gladly onto the menstruation and the accompanying symptoms. Through the continuous conquest of the oral hormonal contraceptive pills in the long-cycle treatment can the loss of blood reduced, breakthrough bleeding and spotting can be decreased or prevented and the complaints occurring with menstruation as well as menstruation conditional provocations for cycle dependent illnesses can be reduced or prevented. The long cycle is a genuine alternative for these women to the improvement in living quality and hygiene even if for this purpose extensive great studies are not yet available.

Contraceptives, Oral, Hormonal↗
PubMed2001

The assault on ignorance: teaching menstrual etiquette in England, c. 1920s to 1960s.

At the end of the nineteenth century, medical paradigms of menstruation were located in a language of pathology and disability. Women were, therefore, perceived as incapable of competing with men in the world of education, work, and economics on account of their erratic and debilitating biology. This essay examines the challenge posed to this vision of menstrual disability by female medical practitioners in the early decades of the twentieth century. The new narratives of menstruation authored by these women not only re-cast normative menstrual experience as non-disabling, but were also formulated on the basis of canvassing the opinions of healthy schoolgirls rather than developing theories based on clinical contact with a minority of women defined as 'ill'. Yet female practitioners remained tied to a culture of 'menstrual discretion', thus perpetuating the secrecy and taboo associated with menstruation in the nineteenth century. This essay explores the tensions inherent in striving to overturn an oppressive medical model of menstruation whilst promoting menstrual discretion, and aims to place such apparent contradictions within the context of cultural notions of gendered identity and feminine sexuality.

Adolescent↗
PubMed1998

Matrix metalloproteinase expression in Macaca mulatta endometrium: evidence for zone-specific regulatory tissue gradients.

Matrix metalloproteinases (MMPs) are highly expressed in the human endometrium during menstruation, and these enzymes participate in the cyclic destruction and regeneration characteristic of the primate endometrium. To examine hormonal regulation of MMPs in vivo, we evaluated MMP expression and localization in the endometrium of ovariectomized rhesus macaques under various hormonal conditions. Although all MMPs were up-regulated by progesterone (P4) withdrawal, their expression declined spontaneously after menstruation in the absence of P4. Of 7 MMPs examined, only matrilysin and stromelysin-3 were suppressed any further when P4 levels were experimentally re-elevated. MMP expression was confined to the upper functionalis zone during menstruation, but after menstrual breakdown was complete, matrilysin and the tissue inhibitor of MMPs, TIMP-1, shifted expression from the functionalis to the basalis zone in the absence of both estradiol and P4. The spiral arteries in the functionalis, but not the basalis, were intense foci of MMP and TIMP-1 expression. Menstruation and MMP expression after P4 withdrawal were similar in both the presence and absence of estradiol. In sum, endometrial MMPs in vivo are strongly up-regulated by P4 withdrawal, but zone-specific tissue gradients greatly influence the pattern and degree of MMP expression.

Animals↗
PubMedDate not supplied

College women's attitudes and expectations concerning menstrual-related changes.

The present study examined college women's expectations, attitudes, and knowledge about menstrual-related changes in order to provide a more complete picture of how women perceive the experience of menstruation and to explore the interrelationships of these variables. The women responded to the Moos Menstrual Distress Questionnaire as if they were premenstrual and as if they were intermenstrual in order to examine expectations about symptom changes for themselves. They also responded to a series of agree/disagree items, which yielded five dimensions of attitudes or styles of coping with menstruation. In general, the results suggested that these college women accepted menstruation rather routinely and did not perceive it as overly disruptive. Furthermore, it appears that beliefs about menstruation are more complex than previously thought, involving differential perceptions of physical versus psychological symptoms and a variety of dimensions of menstrual-related attitudes.

Adaptation, Psychological↗
PubMedDate not supplied

The association between somatization and perceived ability: roles in dysmenorrhea among Israeli Arab adolescents.

OBJECTIVE: The aim of this study was to investigate whether somatization and attitudes toward menstruation predict the incidence of pain intensity and dysmenorrhea among Israeli Arab adolescent females. METHODS: Participants were 160 Israeli Arab adolescents, including 50 Muslims, 50 Christians, and 60 Druze. A 20-item questionnaire was used to assess attitudes regarding menstruation. The short version of the Brief Symptom Inventory was used to measure the level of somatization. RESULTS: Factor analysis of the Attitudes Toward Menstruation Instrument revealed two significant composites: perceived ability and impurity during menstruation. High levels of somatization predicted pain intensity and low levels of perceived ability predicted the prevalence of dysmenorrhea. Although the Israeli Muslim adolescents revealed higher levels of somatization as compared with their Christian and Druze counterparts and the Druze revealed the lowest levels of perceived ability compared with the other subgroups, no significant role for ethnicity and impurity was found. No differences were found between groups in scores of menstrual pain and prevalence of dysmenorrhea. Higher levels of somatization and lower levels of perceived ability, as well as a greater portion of Muslim and Druze and higher levels of religiosity, were found among rural residents. CONCLUSIONS: The role of cultural variables and personality traits in the complexity of dysmenorrhea as a socio-bio-psychological phenomenon is proposed in light of contemporary interactive models. It is suggested that within the Israeli Arab minorities the impact of cultural background on health affects more the perceptual and cognitive levels and are not generalized to overt behavior and morbidity such as dysmenorrhea.

Adolescent↗
PubMed1983

Involvement of prostaglandins in vasopressin stimulation of the human uterus.

The involvement of prostaglandins (PG) in the vasopressin (VP) action on the human uterus was investigated in healthy women during three menstruations. Intrauterine pressure was recorded and total pressure area measured. Repeated plasma samples were taken for estimations of arginine(A)- and lysine(L)-VP, 15-keto-13,14-dihydro-PGF2 alpha and 11-ketotetranor PGF metabolites. During the first menstruation LVP was infused in a dose of 0.08 micrograms/min. During the second menstruation the infusion of LVP was repeated with the same dose, but 70 min before infusion the women received an oral dose of 500 mg of naproxen. During the third menstruation PGF2 alpha was administered intravenously in a dose of 25 micrograms/min. LVP infusion per se caused a significant increase in uterine activity and plasma levels of LVP and PG metabolites. When the women were pretreated with naproxen practically the same uterine activity was induced and closely similar plasma levels of LVP were obtained, but the levels of PG metabolites decreased significantly in comparison with the first series of experiments. Infusion of PGF2 alpha caused an increase in uterine activity but no change in the plasma levels of AVP. The results indicate that uterine stimulation with VP is possible without an obligatory last step of PG synthesis and release. The results also support the concept that an elevated VP level in primary dysmenorrhoea may be of aetiological importance and is not just released as a 'stress'-hormone because of the dysmenorrhoeic pain.

Adult↗
PubMed2002

Sexual activity, orgasm and tampon use are associated with a decreased risk for endometriosis.

OBJECTIVE: The purpose of the study was to determine if sexual behaviors, orgasm, tampon use, and douching during menstruation modify the risk of endometriosis. METHODS: A case-control study was conducted. Subjects (n = 2,012) consisted of members of the Endometriosis Association and friends not affiliated with the organization who completed mailed surveys. Data were analyzed using chi(2), Fisher's exact test, t test, and regression analyses. RESULTS: There was no difference between study groups concerning douching practices. However, cases were less likely than controls to report sometimes or often engaging in sexual behaviors during menstruation (p = 0.002, OR = 1.5), and sexual behaviors during menstruation that included orgasm (p = 0.001, OR = 1.5). Cases were also less likely than controls to report using only tampons (p < 0.0001, OR = 2.6). CONCLUSION: Sexual activity, orgasm, and tampon use during menstruation may confer protection against endometriosis.

Adult↗
PubMed1987

Airway responsiveness to methacholine during the natural menstrual cycle and the effect of oral contraceptives.

Exacerbations of symptoms have been reported in some women with asthma just prior to and during menstruation. We examined changes in airway responsiveness to methacholine during 2 consecutive menstrual cycles in 17 well-controlled asthmatics with a wide range of airway responsiveness. In 10 women with regular natural cycles, measurements were made 1 wk before and 1 wk after the start of menstruation to coincide with the highest and lowest progesterone levels. The mean concentration of methacholine to cause a fall in FEV1 of 20% (PC20) premenstruation was 1.49 mg/ml, which was not significantly different from the mean postmenstruation PC20 of 1.34 mg/ml (p = 0.45). Although there were only 10 subjects, the power was 96%, indicating little likelihood of any difference between the 2 phases. In 7 women taking oral contraceptives, the mean PC20, measured within 1 wk of completing a 21-day course, was 1.19 mg/ml, which was not different from the mean PC20 of 0.97 mg/ml measured after the start of menstruation but before restarting medication (p = 0.17). The power was 98%. In both groups, there was no difference in FEV1 or medication use during the cycle, but symptoms were worse during menstruation. The results suggest that the fluctuations in serum progesterone levels that occur during natural menstrual cycles are insufficient to alter airway responsiveness in an unselected sample of asthmatic women. They also demonstrate that changes in symptoms occur during the cycle both in women with natural cycles and those using contraceptives and that these changes are not related to serum progesterone levels or airway responsiveness.

Adult↗
PubMed1996

Effect of surgery on gonadal function of premenopausal women with pituitary adenomas other than prolactinomas.

The effects of surgery on pituitary-gonadal function were investigated in women with pituitary adenomas other than prolactinomas. The subjects were 46 women of premenopausal age with a pituitary adenoma. Twenty tumors were GH producing, 19 were nonfunctioning, and 7 were adrenocorticotropin producing adenomas. The surgery was performed mainly via the transsphenoidal route, with the aim of eradicating the tumor and preserving pituitary function. The menstrual cycle was preserved postoperatively in 9 out of 10 (90%) patients with regular preoperative menstruation. Menstrual disturbance was seen in 36 (78.3%) cases preoperatively. The causative factors for menstrual disturbance were gonadotropin impairment and hyperprolactinemia in GH producing and nonfunctioning adenoma. Excessive hormonal secretion itself is a major causative factor for menstrual disturbance in GH and ACTH producing adenoma. Regular menstruation was restored following surgery in 20 out of 36 (55.6%) patients with menstrual problems. The predicting factors for postoperative recovery of menstruation are: size of adenoma less than 40 mm, period of amenorrhea less than 5 years, and preoperatively preserved gonadotropin secretion. In addition, preoperative hyperprolactinemia was also a predicting factor in women with nonfunctioning adenoma. Thus, even in patients with pituitary adenomas other than prolactinoma, the restoration of menstruation is highly achievable when surgery is performed with attention to preserving pituitary function.

Adenoma↗
PubMed1982

[Menstrual cycle lengths and the estimated time of ovulation in the cynomolgus monkey (Macaca fascicularis)].

Establishing of an efficient system for the judgement of an optimal mating time is an important prerequisite for the successful development of a large scale breeding of macaques as laboratory animals. In general, an optimal mating time has been judged on the basis of individual records of menstruation. The length of the previous menstrual cycle has usually been used for the prediction of the next cycle length. In the present study, the lengths of 240 menstrual cycles of 60 cynomolgus monkeys of our breeding colony were statistically analysed. The mean and the standard deviation of those cycle-lengths were 29.4 and 4.3 days, respectively. Correlationship between the length of a menstrual cycle and the length of its previous cycle was statistically significant (p less than 0.05). However, practically the correlation was not meaningful because the correlation coefficient (r) was very small even if the length of the second one of two successive cycles (r = 0.26) or the average length of three successive cycles (r = 0.36) is selected as a reference length. In other words, a cycle length can not be predicted on the basis of the length of the previous menstrual cycle. However, a marked increase of serum follicle stimulating hormone (FSH) concentration was observed from 8 to 15 days after menstruation. In 60 per cent of the animals observed, FSH increased 10 to 11 days after menstruation. Ovulation was observed one or two days later than the day of FSH increase. Therefore, the optimal mating time is judged to be between 11 and 14 days after menstruation regardless of the menstrual cycle length.

Animals↗
PubMed1986

The regulation of menstrual cycle and its relationship to the moon.

UNLABELLED: A synchronous relationship between the menstrual cycle and lunar rhythm was confirmed by: Investigative data: Among the 826 female volunteers with a normal menstrual cycle, aged between 16 and 25 years, a large proportion of menstruations occurred around the new moon (28.3%), while at other times during the lunar month the proportion of menstruations occurring ranged between 8.5-12.6%; the difference was significant (p less than 0.01). LABORATORY FINDINGS: The 6-hydroxymelatonin levels in the urina sanguinis of 3 female volunteers reached their zenith prior to and during menstruation, gradually declining to their nadir during ovulation. The difference in 6-hydroxymelatonin between menstruation and ovulation was significant (p less than 0.01). Two of these three volunteers had their zenith in the period of the new moon and nadir 3-4 days prior to the full moon respectively. Clinical experience: The lunar-menses-regulatory therapy in treatment of Nephropenic secondary amenorrhea revealed 4 clinical cure, 5 marked effect, 8 menogogue and 3 ineffect out of 20 cases.

Adolescent↗
PubMedDate not supplied

Women's reproductive health: recent advances in therapies.

Normal cyclic menstruation involves a delicate concert of hormonal events, characterized by midcycle ovulation and, if no pregnancy is achieved, menstrual flow. Women's health--and especially their reproductive health and fertility--may be affected by abnormalities in cyclicity or in menstruation. A number of valuable modes of therapy have recently become available. Abnormal cyclicity may be caused by decreased estrogen levels (from exercise, smoking, or eating disorders). Small ovulation induction pumps, which deliver minute physiologic concentrations of gonadotropin-releasing hormone (GnRH) around the clock, can be used for safe and successful treatment. Increased estrogen levels may also affect cyclicity, and may be suppressed with new GnRH antagonists or stimulated to cyclicity with pure follicle-stimulating hormone. Abnormal menstruation may be caused by intrauterine scarring or fibroids. Outpatient hysteroscopic surgery may successfully and conservatively be used to treat these problems. Today, even women who have been born without a uterus or who have undergone hysterectomy may have a child through a host uterus program. This combines in vitro fertilization of the husband's sperm with his wife's egg with transfer of the embryo into a host who is capable of carrying the pregnancy. Our potential to improve women's reproductive health continues to expand, as some of the recent developments described above for treating abnormalities of cyclicity or menstruation attest.

Female↗