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PubMed1988

Evaluation of iron status in Chadian pregnant women: consequences of maternal iron deficiency on the haematopoietic status of newborns.

An assessment of iron status was performed on 112 pregnant women at delivery (and on their newborns in 70 cases) and on 114 menstruating women in N'Djamena, Chad. Anaemia (according to the haematocrit value) was observed in 25.0% of pregnant women and in 23.7% of menstruating women. Iron deficiency was defined as the combination of a low serum ferritin level (less than or equal to 12 micrograms/l), a low transferrin saturation (less than 16%) and/or a high erythrocyte protoporphyrin (greater than 3 micrograms/g Hb). A moderate increase in the serum ferritin level (between 13 and 50 micrograms/l) associated with a low transferrin saturation and/or a high erythrocyte protoporphyrin concentration indicated iron-deficiency in an inflammatory context. Iron deficiency was present in 66.9% of pregnant women and in 30.7% of menstruating women. Anaemia was associated with iron deficiency in 78.6% of cases in anaemic pregnant women and in 44.4% of cases in anaemic menstruating women. A correlation between maternal and newborn haematopoiesis was found, and some iron parameters in newborns were related to the iron status of mothers.

Adult↗

PubMed1980

Analysis of seizure dispersion during menstrual cycle in women with epilepsy.

The correlation between seizures and menstrual cycle was studied in 69 females with epilepsy, mean age 28.7 years. Between 1975-1978 the patients had registered in standard diaries data of menstruation and seizures. Altogether 1237 complete menstrual cycles were collected with 6900 registered seizures. The computer analysis showed a significant increase of seizures frequency in the second phase of cycle with the peak on the first day of menstruation. During 7 days before menstrual bleeding 2137 seizures were noted while during 7 days after menstruation 1476 fits were registered. In 58% of cases the frequency of seizures increased during premenstrual phase, in 9% during menstruation and in 33% the influence of menstrual cycle was not observed. In the group of women with seizures related to menstrual cycle the course of epilepsy was worse, the premenstrual tension syndrome was present more often and cycles were prolonged as compared with females without correlation between seizures and cycle. It may be suggested that in severe epilepsy the function of neuroendocrine system is altered. Following hormonal dysfunction, the risk of seizure incidence may be increased in the second phase of menstrual cycle.

Adult↗

PubMed1994

Cardiovascular risk factors by ethnic group and menstrual status among 13- and 14-year-old Israeli schoolchildren.

BACKGROUND: Ethnic differences in cardiovascular risk factors have been demonstrated previously among Israeli children and adolescents. This study examines the prevalence of selected risk factors and risk factor clusters among 13- and 14-year old Israeli schoolchildren according to ethnic origin and other demographic variables, and takes into account the unique contribution of menstrual status of the girls to risk factor differences. METHODS: Demographic and menstrual status (for the girls) data were obtained for 299 West Jerusalem eighth grade students. Height, weight, and blood pressure were measured, and blood was obtained for total cholesterol, high density cholesterol (HDL), and triglyceride measurements. Differences in mean Body Mass Index (BMI), blood pressure, and lipids, as well as in the percentage of children with specific risk factors or total number of risk factors were tested for among the various demographic and menstrual status groups. RESULTS: BMI was statistically significantly greater among females (20.2 kg/m2) than among males (19.46 kg/m2), (p = .04) and among menstruating females (21.1 kg/m2) compared with non-menstruating females (17.9 kg/m2), (p = .000). Mean systolic blood pressure was higher among menstruating (109.8 mmHg) than non-menstruating (105.9 mmHg) females (p = .09). Statistically nonsignificant differences in mean systolic blood pressure and total cholesterol were found according to paternal country of origin. According to defined cutoff points, 8.7% of the students had elevated BMI, 2.8% had elevated systolic or diastolic blood pressure, and 13.0% had elevated total cholesterol. 17.5% of the students had one cardiovascular risk factor and 3.1% had two risk factors. CONCLUSIONS: The data demonstrate a high prevalence of cardiovascular risk factors without statistically significant ethnic differences in this population. Menstrual status exerted a unique effect upon BMI and systolic blood pressure. Pubertal status should be considered in the assessment of risk factors in early adolescents. Total-community-oriented intervention is recommended for this population.

Adolescent↗

PubMed1994

A study on menstrual hygiene among rural adolescent girls.

Menstruation is a phenomenon unique to the females. It is clear from the study findings that majority of the girls were having correct knowledge about menstruation. Regarding the practices, only 10 girls were using boiled, and dried cloth as menstrual absorbent. Though almost all 64 girls received advice regarding menstrual hygiene from different sources, some of their practices were unhygienic. This shows that the mothers of these girls were lacking of right knowledge and the same thing was transferred to their off springs. Before bringing any change in menstrual practices they should be educated about the facts of menstruation and its physiological implications. The girls should be educated about the significance of menstruation and development of secondary sexual characteristics, selection of a sanitary menstrual absorbent and its proper disposal. This can be achieved through educational television programmes, school nurses/Health personnel, compulsory sex education in school curriculum and knowledgeable parents, so that she does not develop psychological upset and the received education would indirectly wipe away the age old wrong ideas and make her to feel free to discuss menstrual matters without any inhibitions.

Activities of Daily Living↗

PubMed1996

[A case of catamenial hemoptysis (pulmonary endometriosis) cured by VATS lobectomy].

We report here a case in which for hemoptysis during menstruation (catamenial hemoptysis) right middle lobectomy was performed thoracoscopically under a preoperative diagnosis of pulmonary endometriosis with a successful outcome. The patient was a 27-year-old housewife who from the age of 24 years experienced hemoptysis during menstruation, and was diagnosed as having pulmonary endometriosis on the basis of detailed examinations including bronchoscopy and chest CT. From the age of 26 years hormone therapy was administered, but the hemoptysis recurred with the menstruation following its cessation. After admission to this department bronchoscopy performed at the time of menstruation revealed bleeding from right B4 while chest CT showed an abnormal shadow in right S4 b. Right middle lobectomy was then performed thoracoscopically under a diagnosis of right middle lobe endometriosis. In the resected specimen findings of pulmonary hemosiderosis, granulomatous phlebitis and micrometastases from a thyroid cancer were noted. The postoperative course was favorable with no further episodes of hemoptysis occurring. In this case histological proof of endometriosis could not be obtained, but the diagnosis of pulmonary endometriosis was strongly suggested by the clinical course and objective findings such as pulmonary hemosiderosis.

Adult↗

PubMed1984

Sex hormone profiles in oligomenorrheic adolescent girls and the effect of oral contraceptives.

The hormonal profiles and the effect of oral contraceptives (OCs) on 16 oligomenorrheic and 10 regularly menstruating adolescent girls were studied. Testosterone, androstenedione, dehydroepiandrosterone, estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, prolactin, and sex-hormone-binding globulin were determined on blood samples obtained during a control cycle, during OC treatment, and during the follow-up cycle after discontinuation of OC use. The oligomenorrheic girls had significantly higher concentrations of androstenedione and total and free testosterone than regularly menstruating girls during the control cycle. Sex-hormone-binding globulin concentrations were significantly lower in the oligomenorrheic group. Both in oligomenorrheic and regularly menstruating girls OC treatment caused a decrease in the mean concentrations of all hormones, except prolactin, to similar levels. For 2 to 4 weeks after treatment the oligomenorrheic girls had significantly lower levels of androstenedione, total and free testosterone, and luteinizing hormone than before treatment. In the control group there were no significant differences between pretreatment and posttreatment hormone concentrations. The risks and benefits of prescribing OCs for oligomenorrheic adolescent girls are discussed.

Adolescent↗

PubMed2003

Lactational amenorrhea for family planning.

BACKGROUND: 50 % of pregnancies are unwanted. For several reasons including difficulty in obtaining contraceptives, no or ineffective contraception is used to prevent these unwanted pregnancies. The Lactational Amenorrhoea Method(LAM) however is a contraceptive method available and accessible for many women. OBJECTIVES: To assess in fully breastfeeding women, staying amenorrheic, the efficacy of the Lactational Amenorrhoea Method as a contraceptive method. The efficacy of LAM, as defined in 1988 in Bellagio, was compared with alternative definitions of LAM; the outcomes were measured using pregnancy and menstruation life tables. SEARCH STRATEGY DATA SOURCES: MEDLINE searches from 1966 until 2002 and EMBASE from 1988 until 2002; reference lists of studies and review articles; books related to LAM; published abstracts from breastfeeding, reproductive health, contraceptive conferences; and e-mail communication with coordinators of such studies. SELECTION CRITERIA: From 454 potentially relevant studies 154 investigated the risk of pregnancy during LAM or lactational amenorrhea. Two reviewers applied the following inclusion criteria: prospective study, cases and -if available- controls had to be sexually active, pregnancy had to be confirmed by physical examination or a pregnancy test. Life table menstruation rates and life table pregnancy rates were taken as endpoints. Thirteen publications, reporting on 9 intervention groups and 2 control groups, met the inclusion criteria and were included in this systematic review. Their quality was assessed. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data, disagreements were resolved through discussion. Because of the heterogeneity of the included studies, the studies were analyzed using narrative methods. MAIN RESULTS: For the outcome two controlled studies of LAM users reported life table pregnancy rates at 6 months of 0.45 and 2.45 percent and 5 uncontrolled studies of LAM users reported 0-7.5 percent. Life table pregnancy rates of women fully breastfeeding and amenorrheic but not using any contraceptive method were 0.88 in one study and 0.9-1.2 percent (95% CI 0. 0-2.4 ) in a second study, depending on the definition of menstruation used. The life table menstruation rate at 6 months in all studies varied between 11.1-39.4 percent. REVIEWER'S CONCLUSIONS: No clear difference in life table pregnancy rates was found between women using LAM and supported in doing so, and fully breastfeeding, amenorroic women not using any method. Because the length of lactation amenorrhoea of women using LAM is too different between populations studied, and population specific, it is uncertain whether LAM extends lactational amenorrhoea.

Amenorrhea↗

PubMed2005

Cohort study of depressive moods in Thai women during late pregnancy and 6-8 weeks of postpartum using the Edinburgh Postnatal Depression Scale (EPDS).

OBJECTIVE: To identify depressive moods as measured by the Edinburgh Postnatal Depression Scale in late pregnancy and postpartum, explore associated factors and assess changes in depressive moods. METHODS: A cohort study of 610 pregnant Thai women was conducted. The self-reporting EPDS was completed at 36-40 weeks and at 6-8 weeks postpartum. RESULT: The prevalence of depressive moods (scores of 10 or more on the EPDS) was 20.5% during pregnancy and 16.8% at postpartum. Factors related to depressive moods in late pregnancy included marital status, evidence of irritable moods before menstruation, and attitudes towards this pregnancy. Unmarried women, women having irritable moods before menstruation or women having negative attitudes towards this pregnancy had double risk. Related factors during the postpartum period included religion, evidence of irritable moods before menstruation, perception of pregnancy complications and attitudes towards this pregnancy (p < 0.01). Women who perceived of having complications during this pregnancy, those who had irritable moods before menstruation or had negative attitudes towards this pregnancy had also double risk. The depressive moods were significantly reduced postnatally. CONCLUSION: One-fifth of pregnant and postpartum women experienced depressive moods but the severity declined at postpartum.

Adult↗

PubMed1995

Variations in plasma volume affect total and low-density lipoprotein cholesterol concentrations during the menstrual cycle.

Serum lipids are known to vary during the menstrual cycle. To determine if changes in plasma volume contribute to this effect, we determined serum lipids, lipoproteins, and estimated changes in plasma volume in 18 premenopausal women at the start of and at 5-day intervals after menstruation. Eleven men served as a comparison group. Changes in plasma volume were estimated from changes in hemoglobin and hematocrit. Total and low-density lipoprotein (LDL) cholesterol (mean +/- SD) increased 15 +/- 14 mg/dL (9% +/- 10%) and 11 +/- 13 (11% +/- 14%) within 10 days after the start of menstruation (P < .05) and then decreased toward baseline during the rest of the cycle. High-density lipoprotein (HDL) cholesterol increased 3 mg/dL, or 5%, (P < .05) on days 10 and 15 after menstruation. Plasma volume decreased 4% +/- 9% (P < .06) 10 days after the start of menstruation, and this maximum decrease in plasma volume coincided with peak increases in total, LDL, and HDL cholesterol. Except for an 8-mg/dL increase in LDL cholesterol at day 5, lipid changes were no longer significant after adjusting for changes in plasma volume. We conclude that alterations in plasma volume account for approximately half of the increase in total and LDL cholesterol during the menstrual cycle.

Adult↗

PubMed1987

The effect of sodium meclofenamate in premenstrual asthma: a controlled clinical trial.

We speculated that changes in endogenous prostaglandin synthesis might be responsible for the syndrome of premenstrual asthma (worsening of asthma in relation to menstruation). To test our hypothesis, we compared the effects of sodium meclofenamate, a prostaglandin synthesis inhibitor, and placebo on premenstrual asthma in a 4-month, double-blind, crossover study of 17 women with asthma. Day-by-day evaluation revealed that peak expiratory flow reached a nadir during menstruation on both meclofenamate and placebo therapy and varied inversely with menstrual symptoms and asthma symptoms. Meclofenamate therapy resulted in significant improvement in peak expiratory flow during the early premenstrual period but had no treatment effect on the exacerbation of asthma during the late premenstrual period and early menstruation. The overall improvement in pulmonary function caused by meclofenamate therapy was correlated with the treatment effect on menstrual symptoms. Meclofenamate caused a small, nonsignificant decrease in use of theophylline and oral beta-agonist agents, whereas corticosteroid use increased slightly but not significantly. This study demonstrates the temporal relationship between menstrual symptoms and asthma. The study also demonstrates that inhibition of prostaglandin synthesis does not prevent exacerbation of asthma in relation to menstruation.

Adolescent↗

PubMed1988

Influence of the menstrual cycle on neuroendocrine and behavioral responses to an opiate agonist in humans: preliminary results.

Growth hormone (GH), prolactin (PRL), cortisol, noradrenaline (NA) and euphoric responses to the mu opiate receptor agonist Fentanyl (FE) (0.2 mg/70 kg intravenously) were investigated in five healthy, drug-free, female volunteers at menstruation and at ovulation. The plasma GH response to FE was blunted at menstruation relative to the GH response at ovulation. Basal and maximal PRL concentrations were about 1.5 times higher at ovulation than at menstruation. Cortisol and NA concentrations as well as mood and behavioral responses were not influenced by the menstrual cycle. These results confirm earlier reports of a reduced GH response at menstruation to other pharmacological agents. They also demonstrate that the menstrual cycle is an important influence on neuroendocrine responses to opiate challenge.

Adult↗

PubMed2006

Polymorphisms of the CYP1B1 gene may be associated with the onset of natural menopause in Chinese women.

The Cytochrome P450 1B1 (CYP1B1) is one of the major CYP450 enzymes catalyzing 4-hydroxylation, an important elimination step for estrogens. Relatively little is known, however, about the impact of this gene on the onset and cessation of menstruation, which are significant milestones in a woman's life and predictors of many hormone related diseases. In this report, we described the association of four SNPs in the CYP1B1 gene, Arg48Gly, Ala119Ser, Leu432Val, and Asp449Asp, with the ages of menarche and menopause, years of menstruation and total number of menstrual cycles. Included in the study were 1958 community controls from two recently completed population-based case-control studies of breast cancer and endometrial cancer. No association was observed between the CYP1B1 polymorphisms and the age of menarche among either pre- or post-menopausal women. Among the women who experienced natural menopause, the three non-synonymous SNPs were significantly associated with menopausal age, years of menstruation, and total number of menstrual cycles. The Gly and Ser alleles of Arg48Gly and Ala119Ser were associated with later menopause, more years of menstruation and more menstrual cycles, while women with allele Val at Leu432Val had a 0.9 year earlier menopause, 1.0 year shorter reproductive span, and 12.6 fewer menstrual cycles than those women without this allele. In conclusion, the results from this study suggested that CYP1B1 genetic polymorphisms may be associated with the natural onset of menopause.

Adult↗

PubMed2001

Emergency contraception with Multiload Cu-375 SL IUD: a multicenter clinical trial.

The objectives of the present study were to evaluate the efficacy and side effects and the benefits and limitations of inserting Multiload intrauterine device (IUD) for emergency contraception. A total of 1013 women requesting emergency contraception was recruited, among whom 843 were parous women and 170 nulliparous women. Multiload Cu-375 SL IUD was inserted within 120 h after unprotected intercourse. A urine test for pregnancy was performed before IUD insertion to rule out pregnancy. Participants were followed-up until 1 week after the expected day of the next menstruation. Pregnancy test or ultrasound scanning were performed if menstruation did not return. Efficacy of preventing unplanned pregnancy was calculated. Efficacy and side effects were compared between the parous and nulliparous groups. The results showed that there were two pregnancies, one in each group. The pregnancy rate was 0.2 per 100 women. The efficacy rate of preventing unwanted pregnancy in the parous group was 98.1% and in the nulliparous group 92.4%. The difference was not significant. Removal of IUD because of pain and bleeding was 2.5% in parous women, but was more in the nulliparous group (10.6%). After the return of menstruation, 95.7% of parous women and 80% of nulliparous women maintained the IUD for contraception. There were two complete expulsions and three partial expulsions of the IUD, but there was no significant changes in menstruation and bleeding pattern, nor was infection or trauma observed. It was concluded that IUD insertion is a safe and effective method for emergency contraception for both parous and nulliparous women. One of the advantages of using an IUD is its long-term contraceptive effect, if the women prefer to continue its use.

Contraceptives, Postcoital↗

PubMed1998

Relationship of gender and menstrual status to symptoms and medication side effects in patients with schizophrenia.

Schizophrenic outpatients (62 females, 59 males) were evaluated to examine the relationships between menstrual status, gender, clinical measures of psychopathology and drug side effects. Menstrual status was determined for 55 female patients. Blood from 44 female subjects, drawn before the AM dose of neuroleptic, was assayed for prolactin concentrations. In 27 premenopausal women (age < 45 years), six (22%) reported irregular menses and one (4%) reported amenorrhea. Women with irregular menses did not differ in their prolactin levels or neuroleptic dose, from women with regular menses. Amenorrheic women (n = 22) were significantly older than men (n = 59) and menstruating women (n = 33). After controlling for age, menstruating women did not differ in clinical measures of psychopathology, drug side effects, or neuroleptic dose compared to amenorrheic women or men. Comparison of 15 age-matched pairs of menstruating females and amenorrheic females revealed significantly lower levels of akathisia and depression in the menstruating group and a trend towards lower serum prolactin concentrations (P = 0.08). In female subjects, prolactin levels correlated significantly with neuroleptic dose (r = 0.36, P < 0.005). Our results only partially support hypothesized relationships between menstrual status, prolactin levels and neuroleptic effects and serve to emphasize the importance of controlling for age when comparing these clinical variables.

Adult↗

PubMed2000

Ultrasonic assessment of variations in thickness of subcutaneous fat during the normal menstrual cycle.

OBJECTIVE: To verify the occurrence of natural variations in thigh and abdominal subcutaneous fat thickness related to the phases of the menstrual cycle, to assess the value of ultrasonography as a reliable method for monitoring subcutaneous fat thickness changes and to evaluate their amplitudes. METHODS: This study included 10 women (19-39 years) who menstruated regularly. None had used oral contraceptives or slimming products during the 3 months prior to the study. At cycle day 2 (CD2), CD6, CD14, CD22, CD27 and CD30 days (CD0: beginning of menstruation), the subjects were submitted to: (1) measurement of weight and thigh perimeters, (2) measurements of thigh and abdomen subcutaneous fatty tissue thickness on B-mode images acquired at 10 MHz. A protocol was designed to guarantee a reproducible repositioning during the whole time course of the study and ultrasound examinations (US) were always performed by the same trained person to avoid inter-examiner variability. RESULTS: Subcutaneous fat thicknesses decreased during the first half of the cycle and reached their lowest values at day 22 (-2.0% for the thighs; -3.3% for the abdominal region). Both thigh and abdomen subcutaneous fat reached their maximum thicknesses during menstruation with respective increases of +2.2 and +4.0%. The observed cyclic amplitude variations in the subcutaneous adipose tissue thickness accounted for 7.3% for the abdominal region and 4.1% for the thighs. CONCLUSION: Variations in adipose tissue thickness during the menstrual cycle could be quantified and monitored by US. The thickness of the thigh and abdominal hypodermis was more important during menstruation and decreased in mid-cycle with a minimum occurring 1 week after ovulation.

Abdominal Muscles↗

PubMed1998

Bone mineral changes during pregnancy and lactation: a longitudinal cohort study.

1. The influence of pregnancy, lactation and weaning on bone mineral density in healthy women was investigated during a 2 year prospective study of 59 pregnant and lactating women from the 18th week of gestation. 2. Bone mineral density was measured by dual energy X-ray absorptiometry at the non-dominant radius ultra distally and more proximally in the 18th and 37th weeks of gestation, and 0, 3, 6, 12 and 18 months after delivery. Measurements of bone mineral density of the lumbar spine, the proximal femur and the whole body were performed at all dates after delivery. 3. Reappearance of menstruation after delivery averaged 6.1 months; mean lactating period was 8.7 months. During pregnancy and lactation bone mineral density tended to decrease, but different measuring sites showed different patterns of bone mineral density changes. The reduction in the ultra distal radius during pregnancy amounted to 2%, and no further changes were observed here during lactation. After delivery, reduction in mean bone mineral density was most pronounced in the spine (5.2% in 3 months), but the fall in bone mass tended to revert after resumption of menstruation. Bone mineral density was still reduced by 3.3% after 12 months in women with menstruation resumption later than 8 months after delivery. No significant reduction was observed 18 months after delivery. No association with calcium intake, weight changes or initial bone mineral density was observed. High calcium intake did not protect against bone mineral loss in the spine and the femur. 4. Thus it can be concluded that bone loss during pregnancy and lactation took place mainly from the trabecular skeleton. Resumption of menstruation tended to result in a regain of bone mass towards baseline.

Absorptiometry, Photon↗

PubMedDate not supplied

[Psychosomatic aspects of endometriosis].

Endometriosis is a varied and unspecific disorder, which can be detected by way of subtle diagnostics in almost every woman. In one case it is a minor accidental finding, in another case it is a cancer-like, mostly incurable, chronic painful a disease, which often has sterility and aggressive therapies as subsequence. For the origin of endometriosis many causes are discussed. The theory of retrograde menstruation through an hyperperistaltic-dystocic uterus presents on one hand an organic explanation-concept. From the psychosomatic point of view this unphysiological menstruation could also be seen as the result of an unsolved conflict, which might be connected with the gender-role or personal, familiar and social attitudes about menstruation. The exo- and endogenic supply with hormones in a time with less pregnancies and therefore more menstruation is also a contributing factor to the origin and development of this disturbance. Beside the theory of endometriosis as an autoimmune disease also implicates psychosomatic thoughts. Though there is always a repeatedly talk the "cancer of the career-woman", there are however very few psychosomatic research projects regarding endometriosis. Therefore it is a characteristic of this disease, that finding and feeling are very often controversial. This emphasizes the importance of psychosomatic, psychosexual, social and biographical aspects in connection with endometriosis. This point of view makes a relative plausible and comfortable explanation for the CPPS and sterility uncertain. Without question diagnosis and therapy of endometriosis followed on one hand by stigmatization and on the other hand by often restriction of quality of life leads to a lot of subsequent psychosocial problems.

Endometriosis↗

PubMed2006

Secular trends in menarcheal age among Ghanaian women in Accra.

The Women's Health Study of Accra is a population-based cross-sectional survey that was conducted between March and September 2003 to assess the burden of disease in women in Accra. In addition to data relating to general health and living conditions, data on age at first menstruation was collected during the survey. A retrospective cohort analysis of the reported age at menarche was conducted using data from 2,644 women aged between 18 and 100 years. The median age of first menstruation of the entire cohort was 15.5 years and the median age of first menstruation among those aged <20 was 14.5 years. There was a statistically significant difference in median age at menstruation among the different age and socioeconomic groups. Multiple linear regression showed a significant decline of 0.2 years per decade in the mean age at menarche among Ghanaian women.

Adolescent↗