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PubMed1991

The impact of spinal cord injury on female sexuality, menstruation and pregnancy: a review of the literature.

Spinal cord injury (SCI) results in alterations in sexual functioning. This area has been studied in depth in males; however, the literature pertaining to female sexual dysfunction after injury is sparse and focused primarily on menstruation and pregnancy. This report reviews the literature on female sexuality, menstruation and pregnancy after SCI and discusses the findings.

Breast Feeding↗
PubMedDate not supplied

Recalled characteristics of menstruation in relation to reproductive history among Caucasian, Japanese and Chinese women living in Hawaii.

Characteristics of menstruation and reproductive history were studied in 2331 Caucasian, 4097 Japanese and 1003 Chinese women living in Hawaii and born between 1900 and 1940. Irregular periods, heavy flow and menses lasting more than five days were reported significantly more often in Caucasians than in the other two groups. Canonical correlation and multiple-regression procedures revealed that parity, recalled age at menarche and year of birth were significantly associated to the menstrual descriptions reported, in complex ways, distinctive in each ethnic group. Some similarities in the relationship of reproductive history variables with particular menstruation characteristics were found in the Caucasian and Japanese groups. For example, increased parity was associated with increased menstrual bleeding in both Caucasians and Japanese, and later age at menarche was significantly correlated with irregular menses in these two groups.

Age Factors↗
PubMed2005

Endocrine regulation of menstruation.

In women, endometrial morphology and function undergo characteristic changes every menstrual cycle. These changes are crucial for perpetuation of the species and are orchestrated to prepare the endometrium for implantation of a conceptus. In the absence of pregnancy, the human endometrium is sloughed off at menstruation over a period of a few days. Tissue repair, growth, angiogenesis, differentiation, and receptivity ensue to prepare the endometrium for implantation in the next cycle. Ovarian sex steroids through interaction with different cognate nuclear receptors regulate the expression of a cascade of local factors within the endometrium that act in an autocrine/paracrine and even intracrine manner. Such interactions initiate complex events within the endometrium that are crucial for implantation and, in the absence thereof, normal menstruation. A clearer understanding of regulation of normal endometrial function will provide an insight into causes of menstrual dysfunction such as menorrhagia (heavy menstrual bleeding) and dysmenorrhea (painful periods). The molecular pathways that precipitate these pathologies remain largely undefined. Future research efforts to provide greater insight into these pathways will lead to the development of novel drugs that would target identified aberrations in expression and/or of local uterine factors that are crucial for normal endometrial function.

Adolescent↗
PubMed1982

Menstruation-related periodic hypersomnia: a case study with successful treatment.

A 16-year-old girl suffered from 1 to 2-week periods of hypersomnia associated with each menstruation. Serum hormone levels were normal. CSF concentrations of homovanillic acid and 5-hydroxyindolacetic acid were lower in hypersomniac than in symptom-free phases. 3-methoxy-4-hydroxyphenylethylene glycol was not affected. The sleep periods occurred only in connection with ovulatory menstrual cycles. When ovulation was inhibited by a combination of ethinylestradiol and lynestrenol, an oral contraceptive pill, the hypersomnia ceased. Thus, the hypersomnia seemed to be linked to the occurrence of ovulatory menstruations.

Adolescent↗
PubMed2005

[Role of matrix metalloproteinases in the endometrium in normal and pathologic menstruation].

Menstruation was thought to be the consequence of ischemic necrosis of the endometrium, resulting from vasoconstriction of the spiral arterioles. However, a new paradigm recently emerged when it was shown that human endometrium produces a lot of matrix metalloproteinases (MMPS) at menstruation. These MMPS are active and degrade almost all constituents of the extracellular matrix at neutral pH, allowing for tissue fragmentation and shedding. The tight control of their expression by progesterone and the close relationship in time and space between their expression and the lysis of the mucosa suggest their involvement in triggering menses as well as abnormal bleeding. A proof of their involvement was provided by culturing explants in conditions that mimic ex vivo the menstrual degradation of the endometrium, because specific inhibitors of MMPS prevent lysis of the extracellular matrix. Several cytokines have been shown to focally modulate the inhibition of MMPs expression by progesterone in a paracrine way.

Arterioles↗
PubMed1983

Effect of breast-feeding status on prolactin secretion and resumption of menstruation.

This study investigated prospectively the effect of supplementary breast feeding on the duration of lactational amenorrhoea and serum prolactin levels during prolonged breast feeding in a group of 34 Australian mothers. Although supplementary feeding correlated statistically with the decline in mean serum prolactin levels and the subsequent resumption of menstruation, critical analysis of the data revealed that serum prolactin levels were declining with time before the introduction of supplementary feeding. It was concluded that the resumption of menstruation during prolonged lactational amenorrhoea is associated with the introduction of supplementary infant feeding, but other factors may be more important in this process. The good correlation between the decline in serum prolactin levels and the return of cyclic ovarian activity in individual mothers suggests that measurement of serum prolactin level may be a useful predictive index for returning fertility during breast feeding.

Amenorrhea↗
PubMed2001

Complement factor I deficiency associated with recurrent meningitis coinciding with menstruation.

BACKGROUND: Complement (C) factor I deficiency is a rare immunodeficiency state frequently associated with recurrent pyogenic infections in early infancy. This deficiency causes a permanent uncontrolled activation of the alternative pathway resulting in massive consumption of C3. PATIENT: A 23-year-old woman with monthly recurrent meningitis episodes, mostly in the perimenstrual period, since August 1999. Previously, at age 16 years, she had meningococcal sepsis, also coinciding with menstruation. OBJECTIVES: To study the patient and her family to elucidate the molecular defects in the pedigree and to evaluate her clinical evolution. RESULTS: We describe clinical, immunological, and treatment follow-up during this period. First, we characterized the existence of a total complement factor I deficiency defined by undetectable levels by enzyme immunosorbent assay. This total deficiency was also found in her sister. Her parents and brother had approximately half of the normal levels. In addition, the patient had very low levels of C3; factor B; and an important reduction of factor H, properdin, C5, C7, and C8 complement components. Additional studies in the patient's sera evidenced high levels of immune complexes containing C1q and immunoglobulin (Ig) G, as well as C3b/factor H, C3b/properdin, C3b/IgG, and properdin/IgG complexes. Treatment with prophylactic antibiotics, antiestrogen medication, plasma infusions, or intravenous immunoglobulin has been unsuccessful in avoiding consecutive meningitis episodes. CONCLUSION: For the first time to our knowledge, these data present an unusual relationship between meningitis episodes and menstruation in factor I immunodeficiency.

Adolescent↗
PubMed1991

Spontaneous decidual reactions and menstruation in the black mastiff bat, Molossus ater.

Uterine function was assessed histologically in nonpregnant Molossus ater removed from a laboratory breeding colony. During the luteal phase of the cycle, bilateral decidual reactions were found to develop spontaneously in the absence of either embryos or experimental manipulation of the uterus. These included the formation of early decidual giant cells, closure of the uterine lumina, and morphological changes in the endometrial blood vessels. Some endothelial cell hypertrophy was noted in much of the decidua, but this was most pronounced in vessels associated with an unusual vascular tuft that formed in the endometrium surrounding the cranial end of the uterine lumen. These latter vessels also developed very prominent basal laminae. In pregnant bats, this tuft played a central role in the morphogenesis of the definitive discoidal chorioallantoic placenta. At the end of nonpregnant cycles, the decidua became necrotic and was sloughed off with associated bleeding. As in menstruating catarrhine primates, the endometrium of M. ater is vascularized by spiral arterioles and populated by distinctive granulocytes containing large, acidophilic granules. Increased coiling of these arterioles did not appear to be an essential element in the mechanism of mensturation in this species. M. ater is a monotocous, seasonal breeder, with a relatively long gestation period. Although it has a bicornuate uterus, ovulation and implantation appear to occur only on the right side of the tract. The ability to menstruate probably affords this bat an efficient mechanism for eliminating a highly differentiated endometrium from the usual implantation site in the event of a reproductive failure. In the wild, this may provide M. ater with another chance to establish a pregnancy at a still opportune time during the same breeding season.

Animals↗
PubMed1977

Effect of menstruation on academic performance among college women.

Many studies report that women's performance and affective patterns fluctuate with their menstrual cycle. Poor mental performance is generally more common during menstruation and for several days prior to onset. Research on academically advanced women, however, has shown that their scholastic performance is less likely to exhibit the usual menstrual decline. Presumably, they are motivated enough to exert a compensatory effort on "off-days." Thus the current research was designed to test whether, among college women, academic performance fluctuates with the menstrual cycle. The academic performance of volunteers in and introductory college psychology course was followed. Biweekly course tests were used to measure performance. The subjects filled out menstrual calendars, indicated their SAT scores, and answered questions from a standardized test of academic motivation. Following the convention of past research, the "paramenstruum" (the time of menstrual stress) was defined to be the 4 days prior to onset and the first 4 days of menstruation. The other days in the cycle comprise the "intermenstruum." On all eight tests, the difference between paramenstrual and intermenstrual performance (adjusted for aptitude and motivation) was insignificant.

Achievement↗
PubMed2005

Regular abdominal pain and fever in each menstruation onset: an unusual menses-associated familial Mediterrenean fever attacks and a favor result on colchicine treatment.

We present a 38-year-old woman suffering from regular abdominal pain and fever only in each menstruation onset for 7 years. The clinical symptoms, along with inflammatory findings during painful attacks, the beneficial effect of colchicine and genetic mutation (M694 V and M680I) supported the diagnosis of familial Mediterranean fever (FMF). A literature review indicated that FMF attacks occurring only during menstruation are rarely seen. This clinical picture may be confused with gynecological disorders especially in the people of Mediterranean origin.

Abdominal Pain↗
PubMed1976

Induction of menstruation with bromocryptine in patients with euprolactinemic amenorrhea.

Three nulliparous women presented with secondary amenorrhea with no evidence of endocrinopathy and normal skull x-ray. Pulsatile gonadotropin secretion was reduced, but an adequate pituitary gonadotropin reserve was demonstrable with luteinizing hormone-release factor provocation. The administration of bromocryptine was associated with amplification of pulsatile secretion of gonadotropins and was followed, in two of the three, by ovulatory menstruation. It is suggested that bromocryptine should be considered for induction of menstruation in euprolactinemic secondary amenorrhea.

Adult↗
PubMed1988

Why does RU486 fail to prevent implantation despite success in inducing menstruation?

The administration of RU38486 (RU486) in the luteal phase may induce menstruation, but it may not be associated with shedding of the functional layer of the endometrium. This provides an explanation why, in some cases of successful menstrual induction by RU486, pregnancy continues undisturbed. The ability of RU486 to interrupt a very early pregnancy is more likely to be related to its ability to cause shedding of the endometrium than its ability to induce menstruation.

Adult↗
PubMed2006

What is the desired menstrual frequency of women without menstruation-related symptoms?

INTRODUCTION: This study aimed to investigate the desired menstrual frequency of subjects without menstruation-related symptoms. MATERIALS AND METHODS: The study included 270 women of reproductive age. Women with menstrual headache, dysmenorrhea, hypermenorrhea and/or premenstrual syndrome were excluded. The study subjects completed a standardized questionnaire. RESULTS: Of the women, 75.6% declared that menstrual periods interfere with their sexual life, 28.8% preferred not having their menstrual period when at work and 48.4% reported that menstrual periods interfere with practicing sports. Given the choice, 28.5% of the women would desire amenorrhea and 27.8% would prefer a reduction in the frequency of menstrual periods. Of the 152 women desiring to reduce menstrual frequency, 73.0% declared that they would accept to use a drug to reduce menstrual frequency. CONCLUSIONS: Over 50% of women without menstruation-related symptoms would like to lessen the frequency of menstrual periods and about 50% of them would desire amenorrhea.

Adult↗
PubMed2006

Levels of polybrominated diphenyl ethers (PBDEs) in breast milk from central Taiwan and their relation to infant birth outcome and maternal menstruation effects.

In utero exposure to polybrominated diphenyl ethers (PBDEs) reduces the number of ovarian follicles in rat females and causes permanent effects on rat males. Little data have been gathered on the associations between PBDEs exposure and birth outcome and female menstruation characteristics in both epidemiological and animal studies. The aim of this study was to examine how PBDEs in breast milk are associated with infant birth outcome and maternal menstruation characteristics. Study participants were healthy women recruited from central Taiwan between December 2000 and November 2001. Twelve congener levels of PBDEs (BDE-17, 28, 47, 66, 85, 99, 100, 138, 153, 154, 183, 209) in 20 breast milk samples were measured by gas chromatography with high resolution mass spectrometer. The mean level of PBDEs in breast milk was 3.93+/-1.74 ng/g lipid. The estimated PBDE daily intake for a breastfed infant was 20.6 ng/kg b.w./day after delivery. After maternal age, pre-pregnant BMI, and parity were adjusted, increased PBDEs in breast milk was related with decreased birth outcome, particularly for birth weight and length, chest circumference, and Quetelet's index of infants. No significant differences in PBDEs were found between the two groups of menstrual cycle length higher and lower than 30 days after we adjusted for maternal age, pre-pregnant BMI, and parity. In utero exposure to low doses of PBDEs may result in lower birth weight and short or birth length. Our findings are limited based on the low doses of PBDEs and the small sampling size.

Cohort Studies↗
PubMed2004

Early and late hormonal responses to the microdose gonadotropin-releasing hormone agonist in normal menstruating women.

OBJECTIVE: To assess the effect of a microdose gonadotropin-releasing hormone (GnRH) agonist on the LH, FSH, and E2 secretion in normal menstruating women. DESIGN: Prospective study. SETTING: Tertiary teaching hospital. PATIENT(S): Five normal menstruating women. INTERVENTION(S): Five microg of triptorelin was injected daily in 5 women for 7 days beginning from the cycle day 3. In the next cycle, the same amount of triptorelin was injected into the same women daily for 3 days. MAIN OUTCOME MEASURE(S): Serial serum FSH, LH, and E2 levels. RESULT(S): The FSH levels peaked (27.53 +/- 6.34 IU/L) after 5 hours, and the LH levels peaked (34.35 +/- 7.81 IU/L) by 4 hours. The increased gonadotropin levels persisted even after the second and third day of the GnRH-agonist injections, although the peak levels were not as high as observed with the first injection (19.56 IU/L in the second day, 9.15 IU/L in the third day for FSH; 32.18 IU/L in the second day, 13.59 IU/L in the third day for LH). The down-regulation of gonadotropins was established in 4 days. When the GnRH-agonist was administered for 7 days, the E2 level began to increase 6 days after the last injection. When the GnRH-agonist was administered for 3 days, the E2 level began to increase 3 days after the last injection. CONCLUSION(S): Pituitary down-regulation could be achieved even with a microdose of GnRH agonist. The increased level of gonadotropins persisted for 3 days at this dose. The duration of the down-regulation was influenced by the duration of GnRH-agonist administration.

Adult↗
PubMed2004

Perceptions of Indian women regarding menstruation.

Although menstruation is still considered a natural event by women in India, perceptions about menstruation are changing. We report on our study of 1150 urban and 850 rural women. The urban women included high school and college students, professional women, and housewives. A 10-point questionnaire was pretested in a clinic setting and then administered to the study group. The responses show that 80% of high school and college students and professional women wish to have infrequent menses or no menses at all. In contrast, 70% of rural women prefer to have monthly menses. The authors wish to initiate a debate on this issue among health care providers and women's groups.

Adult↗
PubMedDate not supplied

Laparoscopic approach to an endometriotic vault fistula causing posthysterectomy "menstruation".

Endometriosis is a commonly prevalent disease but can include rare complaints posing a challenge to surgical treatment. We describe an unreported cause of menstruation after hysterectomy, which was revealed as an endometriotic tubo-ovarian mass that fistulated into the vaginal vault. A 37-year-old woman experienced monthly vaginal bleeding after hysterectomy. At laparoscopy a tubo-ovarian endometriotic mass was revealed with a fistula into the vaginal vault. The mass was adherent to the left ureter and the sigmoid colon. Laparoscopic excision of the mass and fistula after ureterolysis and bowel dissection was performed. This case describes an unreported cause of posthysterectomy menstruation. The management outlines the optimal surgical management of laparoscopic techniques combined with vaginal access to achieve complete excision with minimal patient morbidity.

Abdominal Pain↗
PubMed2006

Sex hormones and pain in regularly menstruating women with fibromyalgia syndrome.

UNLABELLED: Fibromyalgia syndrome (FMS) is more prevalent in women than in men. The skewed sex distribution in the prevalence has prompted questions of if and how sex hormones may be involved in the pathophysiology of FMS. In this study, we evaluated the levels of sex hormones and pain sensitivity at different phases of a menstrual cycle in regularly menstruating women with FMS relative to age-matched healthy women. Participants (n = 74 in each group) underwent a 9-day urine test to identify the date of ovulation. Three laboratory visits were scheduled to ascertain the varying levels of estrogen (E) and progesterone (P): Late-follicular phase (high E, low P); mid-luteal phase (high E, high P); and perimenstrual phase (low E, low P). At each visit, blood was drawn and ischemic pain testing was performed. The groups did not differ in the fluctuation of luteal hormone, follicular-stimulating hormone, E, and testosterone across a menstrual cycle. FMS patients showed slightly elevated P levels during the mid-luteal phase relative to healthy women but levels were within the normal range. Women with FMS showed consistently lower pain thresholds and tolerance relative to healthy women throughout the menstrual cycle. Pain threshold at the late follicular phase was modestly related to the P level. The results suggest that the disproportionate prevalence of females with FMS is not likely to be attributable to hormonal factors. Furthermore, the role of sex hormones in pain sensitivity for both FMS and healthy women seems to be limited. PERSPECTIVE: Normally menstruating women with FMS and healthy women do not seem to show fluctuating threshold and tolerance to the ischemic pain test. The role of sex hormones in the hyperalgesia of FMS appears limited.

Adult↗