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PubMed1984

Prospective assessment of menstrually related mood disorders.

For prospective longitudinal confirmation of menstrually related mood changes, the authors selected a 100-mm visual analogue scale for twice-daily self-rating of mood. The advantages of this method are simplicity; increased compliance; ease of graphic presentation, allowing evaluation of severity and relationship to menstruation; and greater uniformity among studies of menstrually related syndromes. In a preliminary application of this measure to 20 women with self-diagnosed premenstrual syndrome, eight (40%) had a mean depression rating during the week before menstruation that was 30% higher than during the week after cessation of menstruation.

Adult↗
PubMed1999

Differences in the urinary excretion of 6-beta-hydroxycortisol/cortisol between Asian and Caucasian women.

The urinary ratio of 6-beta-hydroxycortisol/cortisol has been used as a noninvasive probe for human cytochrome P450 3A4 isoforms (CYP3A4). Ethnic-related differences in the ratio have not been evaluated. The aim of this study was to determine if there are differences in the ratio between Asian and Caucasian women over a menstrual cycle. First-morning urine samples were collected every other day starting from the second day of menstruation for a complete menstrual cycle from 15 Asians and 16 Caucasian women who were 18 to 40 years old, healthy, nonsmoking, and alcohol and drug free, including oral contraceptives. Urine concentrations of 6-beta-hydroxycortisol and cortisol were measured by high-pressure liquid chromatography (HPLC). For statistical analysis, three phases of the menstrual cycle were evaluated: menstruation (days 1-4), follicular or postmenstruation (days 6-10), and the luteal phase (days 21-24) based on the average menstrual cycle (28 days). Statistical analysis was performed by an independent sample t-test using the Bonferroni correction for repeated measures. Large intersubject and intrasubject variations of the 6-beta-hydroxycortisol/cortisol ratios were observed during the menstrual cycles in both ethnic groups. Asian women had a statistically significant lower ratio than Caucasian women did for all three phases of the menstrual cycle: 2.2 +/- 1.1 versus 5.1 +/- 3.5, 2.1 +/- 1.1 versus 6.0 +/- 4.9, and 2.8 +/- 1.6 versus 5.6 +/- 3.0 for the menstruation, follicular, and luteal phases, respectively. The two- to threefold lower 6-beta-hydroxycortisol/cortisol ratios in Asian women suggest that Asian women may have a lower CYP3A activity compared with Caucasian women. Differences in ethnicity may mask potential gender-related effects if ethnic background is not evaluated as a contributing factor.

Adolescent↗
PubMed2006

Tamoxifen treatment after adjuvant chemotherapy has opposite effects on bone mineral density in premenopausal patients depending on menstrual status.

PURPOSE: Adjuvant chemotherapy followed by tamoxifen is a standard treatment option for women with intermediate or high-risk hormone receptor-positive breast cancer. Premenopausal women treated with chemotherapy often develop early menopause and thus, enter a period of accelerated bone loss. We conducted a prospective study of the effect of sequential adjuvant therapy with chemotherapy followed by tamoxifen on bone mineral density (BMD) in premenopausal patients. PATIENTS AND METHODS: One hundred eleven premenopausal women with early breast cancer were treated with adjuvant chemotherapy. Patients with hormone receptor-positive tumors went on to tamoxifen 6 months after the beginning of the chemotherapy (tamoxifen group), while those with hormone receptor-negative tumors received no further therapy (control group). The effect of tamoxifen and menstrual status on BMD was studied. RESULTS: Tamoxifen treatment and menopausal status correlated significantly with the changes in lumbar spine BMD (P < .0001). A significant bone loss was noted in those tamoxifen-treated patients who continued to menstruate after chemotherapy. At 3 years of follow-up, menstruating patients on tamoxifen had lost -4.6% of their baseline BMD values, while a modest gain of +0.6% was noted in the control group. In contrast, bone loss was reduced among tamoxifen-treated women as compared with controls in patients who developed chemotherapy-induced early menopause. In amenorrheic patients, the lumbar spine BMD values decreased -6.8% in tamoxifen users and -9.5% in the controls, respectively. CONCLUSION: We conclude that tamoxifen usage was associated with bone loss in patients who continued to menstruate after adjuvant chemotherapy. On the contrary, tamoxifen decreased bone loss in those women who developed chemotherapy-induced amenorrhea.

Adult↗
PubMed2003

Estrogen-metabolizing gene polymorphisms, but not estrogen receptor-alpha gene polymorphisms, are associated with the onset of menarche in healthy postmenopausal Japanese women.

Both onset and cessation of menstruation have strong genetic inclination. We aimed to identify genetic factors influencing the onset of menarche and natural menopause in a Japanese population by investigating the polymorphisms of estrogen receptor-alpha and estrogen-metabolizing enzyme genes. Three hundred seventeen postmenopausal Japanese women, aged 46 yr and over, were enrolled in this study under informed consent. Genomic DNA was extracted from peripheral leukocytes, and PCR-based restriction fragment length polymorphism assays were used to determine estrogen receptor-alpha: PvuII, XbaI, and estrogen-metabolizing enzymes; CYP17, estrogen biosynthesis (high activity, A2/A2, CYP1A1), hydroxylation (high inducibility, vt/vt, and COMT), inactivation (low activity, L/L) genotypes. There were no significant differences in ages at menarche and natural menopause or years of menstruation among each PvuII or XbaI genotype and seven combinations of PvuII and XbaI genotypes. We found that ages at menarche in women with A1/A2 (higher activity of CYP17; 13.6 +/- 1.2 yr) were significantly earlier than in those with A1/A1 (lower activity of CYP17; 14.1 +/- 1.3 yr). There were no significant differences in age at natural menopause and years of menstruation among each CYP17, CYP1A1, or COMT genotype. The small sample size of each combination of estrogen-metabolizing genotypes made it impractical to evaluate the effects of the interdependency of each genotype, including extreme genotype categories such as A2/A2L/Lvt/vt vs. A1/A1H/Hwt/wt genotypes, on ages at menarche and/or natural menopause. The results suggest that the estrogen-metabolizing CYP17 genotype influences age at menarche in healthy postmenopausal Japanese women.

Aged↗
PubMed1997

Biological mechanisms underlying the clinical effects of RU 486: modulation of cultured endometrial stromal cell stromelysin-1 and prolactin expression.

During in vitro decidualization of human endometrial stromal cells (HESCs), medroxyprogesterone acetate (MPA) inhibits expression of the potent extracellular matrix (ECM)-degrading protease stromelysin-1 (MMP-3), but enhances PRL expression. Consistent with its priming role in vivo, estradiol (E2) augments these effects. In the current study, immunoblot analysis revealed that coincubation with 10(-6) M RU 486 blocked the inhibition in HESC-secreted MMP-3 levels (50,000 mol wt) evoked by 10(-8) M E2 + 10(-7) M MPA. Although MPA can act as a glucocorticoid, the HESCs were refractory to 10(-7) M dexamethasone added alone or with E2. Because E2 elevates progesterone but not glucocorticoid receptor levels, MPA and RU 486 control MMP-3 expression as a progestin and antiprogestin, respectively. To study RU 486 involvement in steroid withdrawal leading to menstruation, HESCs were decidualized during 10 days incubation with E2 + MPA, and parallel cultures were kept in E2 + MPA or withdrawn to either control or RU 486-containing medium. Compared with E2 + MPA-suppressed HESCs, increases in levels of secreted MMP-3 (2.0-fold), and its 2.1-kilobase messenger RNA (10-fold) were observed in HESCs after 4 days of withdrawal to control medium, with much greater increases seen in RU 486-containing medium (10-fold protein, 100-fold messenger RNA). Previously, we showed that RU 486 up-regulated E2 + MPA-inhibited plasminogen activator expression in the cultured HESCs. Extrapolation of these in vitro observations to endometrial events following RU 486 administration suggests that coordinate enhancement of MMP-3 and plasminogen activator expression promotes proteolysis of the stromal/decidual ECM, which leads to endometrial sloughing. Moreover, destabilization of endometrial microvessels resulting from degradation of their surrounding ECM is consistent with the heavy menstrual bleeding stemming from RU 486 administration. However, in contrast to the marked RU 486-initiated reversal of MMP-3 expression, RU 486 did not significantly reverse E2 + MPA-enhanced PRL secretion by the cultured HESCs. Interestingly, decidual PRL, unlike decidual MMP-3, does not appear to play a role in menstruation. Interleukin-1 beta counteracted E2 + MPA-mediated inhibition of secreted MMP-3 levels, implying that leukocyte/trophoblast-derived cytokines can modulate steroid-regulated MMP-3 expression by stromal/decidual cells during menstruation and pregnancy.

Cells, Cultured↗
PubMed2000

Vascular endothelial growth factor expression in human endometrium is regulated by hypoxia.

Endometrial growth and repair after menstruation are associated with profound angiogenesis. Abnormalities in these processes result in excessive or unpredictable bleeding patterns and are common in many women. It is therefore important to understand which factors regulate normal endometrial angiogenesis. Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen that plays an important role in normal and pathological angiogenesis. In this study we show that expression of VEGF is regulated by hypoxia in human endometrium. Culture in vitro for 24 h under hypoxic conditions resulted in a 2- to 6-fold increase in VEGF secretion by both stromal and epithelial cells isolated from human endometrium. Quantitative RT-PCR was used to measure VEGF messenger ribonucleic acid (mRNA) levels in these cells. After hypoxia, VEGF mRNA levels increased 1.8-fold in stromal cells and 3.4-fold in glandular epithelial cells. The mRNA for each VEGF splice variant increased to an equal extent. The increase in VEGF secretion by stromal and epithelial cells in response to hypoxia was not altered by treatment at the same time with estradiol or progesterone. In situ hybridization of human endometrium during menstruation, when steroid levels are low but the tissue is subject to ischemia, showed strong hybridization to VEGF mRNA in both stromal and glandular cells. These results show that local factors, such as hypoxia, can regulate VEGF expression in the endometrium. This may play an important part in normal endometrial repair after menstruation. The secretion of VEGF by endometrial cells under hypoxic conditions may also be important in the pathogenesis of endometriosis, because it would be predicted to assist revascularization of desquamated endometrial explants when they attach at ectopic sites.

Adult↗
PubMed2005

Progestins regulate the expression and activity of the forkhead transcription factor FOXO1 in differentiating human endometrium.

Menstruation, or cyclic shedding of nonpregnant endometrial tissue with associated bleeding, occurs only in humans and a few other species. This breakdown of the endometrium in response to falling ovarian progesterone levels is a complex process, characterized by local leukocyte infiltration, expression and activation of matrix metalloproteinases, and apoptosis. Spontaneous decidualization (differentiation) of the stromal compartment precedes the cyclic shedding of the endometrium in various menstruating species but the mechanisms that link these processes are not understood. In this study, we identified FOXO1 as a key transcription factor responsible for mediating apoptosis of decidualized human endometrial stromal cells (HESCs) in response to progesterone withdrawal. We demonstrate that medroxyprogesterone acetate (MPA, a synthetic progestin) enhances the expression of FOXO1 in differentiating HESCs while simultaneously inducing cytoplasmic retention and inactivation of FOXO1. Withdrawal of MPA from decidualized HESCs results in rapid nuclear accumulation of FOXO1, increased BIM expression, a proapoptotic FOXO1 target gene, and cell death. Conversely, silencing of FOXO1 expression completely abolishes cell death induced by MPA withdrawal. In summary, the observation that differentiating HESCs become dependent on progesterone signaling for survival through induction and reversible inactivation of FOXO1 suggests a novel mechanism that links decidualization of the endometrium to menstruation.

Active Transport, Cell Nucleus↗
PubMed2004

Prevalence of migraine on each day of the natural menstrual cycle.

Diary data from 155 women were analyzed using within-woman analysis. Compared with all other times of the cycle, migraine was 1.7 times more likely to occur during the 2 days before menstruation and 2.1 times more likely to be severe and 2.5 times more likely to occur during the first 3 days of menstruation and 3.4 times more likely to be severe. This confirms that migraine at menstruation is different from nonmenstrual attacks, even within individuals.

Adolescent↗
PubMed1996

Immunolocalization of the matrix metalloproteinases gelatinase B and stromelysin 1 in human endometrium throughout the menstrual cycle.

Immunolocalization techniques were used to examine the distribution of the matrix metalloproteinases gelatinase B and stromelysin 1 in human endometrial specimens, taken across the normal menstrual cycle. Gelatinase B was produced by glandular epithelial cells for approximately 7 days during the proliferative phase, with polymorphonuclear leucocytes, macrophages and eosinophils providing most of this enzyme at menstruation. There was no evidence that gelatinase B is produced by stromal cells or mast cells during the cycle. Immunoreactive gelatinase B in glandular epithelial cells was greatest during the late proliferative phase and just after ovulation; its presence in glandular secretion and the uterine fluid was optimal during the peri-implantation phase. Gelatinase B was clearly associated with an influx of polymorphonuclear leucocytes, macrophages and eosinophils just before, and during, menstruation. In contrast, immunostaining for stromelysin 1 was much weaker than that for gelatinase B, and was present only around stromal cells and limited to microfocal locations at times coincident with stromal oedema (days 8-10 and 21-22). Both enzymes were widely distributed in specimens just before and during menstruation, and were particularly prominent in connective tissue stroma and vascular basement membranes. Specimens at the early proliferative stage were devoid of both enzymes. The data provide further evidence supporting a role for metalloproteinases in endometrial biology, not only in matrix remodelling during the cycle, but also in glandular secretions potentially relevant to blastocyst recognition and implantation. Our observations emphasize the functional importance of specific cell types and the temporal regulation of gelatinase B and stromelysin 1 throughout the normal menstrual cycle.

Collagenases↗
PubMedDate not supplied

[Relations among arm, arm muscle, arm fat areas and menarche in adolescents in the municipality of Botucatu].

The authors show the relations among arm circumference, arm muscle and arm fat areas with or without menarche, by carrying out an anthropometric study in 717 adolescents in the municipality of Botucatu. It must be emphasized that those adolescents who had already menstruated presented significantly higher nutritional indicators than those who had not menstruated yet. There was an increase in fat tissue and lean body mass in those adolescents who had already menstruated. Body changes might be expressed by calculating muscle and arm fat areas using triceps skinfold and arm circumference.

English Abstract↗
PubMed2003

Changes in saccadic latencies over the human menstrual cycle.

The study assessed differences in sensorimotor processing as reflected in measurements of saccadic latencies at 3 different stages in the menstrual cycle (menstruation, early luteal, and premenstruation) in naturally cycling women (n = 13), and at the same time intervals in women taking an oral contraceptive (n = 6), and male controls (n = 8). Subjects (M age = 22.0 yr., SD = 2.2 yr.) were recruited by questionnaire from the student population of the University of Cambridge. Latencies were measured using a portable infrared scleral oculometer. Changes in latency across the menstrual cycle occurred only in the naturally cycling women (F(2.11) = 5.95, p < .05). Premenstrual latencies were greater (199.3 +/- 12.7 msec., M +/- SD) compared to those during menstruation (191.9 +/- 11.1 msec.) or midcycle (196.9 +/- 12.7 msec.). These findings could account for the loss of musculoskeletal coordination reported by some women prior to menstruation and suggests that administration of an oral contraceptive may alleviate this effect.

Adult↗
PubMed1996

Menstrual cycle, arousal-induction, and intelligence test performance.

Regularly menstruating students (aged 19 to 25 yr.) were tested in the morning under high and low arousal-induction conditions (with time-pressure instructions vs without time-pressure instructions) during either midcycle (n = 16 or menstruation phase (n = 16) to study the interactive effects of menstrual phases and time-pressure stress-induced arousal on intelligence test scores on Raven's Standard Progressive Matrices and Hundal's General Mental Ability Test. A crossover interactive effect of menstrual phase and stress-induced arousal was found on performance of the Hundal test, suggesting that performance of subjects who were tested during the midcycle phase (putatively High Basal Arousal) was impaired under the time-pressure instructions condition (High-induced Arousal) as compared to performance under the without time-pressure instructions condition (Low-induced Arousal), with the reverse pattern of effects being true for subjects who were tested during the menstruation phase. Scores on Hundal's test conform to the Yerkes-Dodson (1908) law which relates arousal to task performance and suggests that the menstrual cycle and performance on the intelligence test was arousal-based. No effects, however, were observed for Raven's Matrices, raising the possibility that task characteristics may mediate the relationship between arousal and performance.

Adult↗
PubMed1996

Ocular hypertensive effect of menopause with and without systemic hypertension.

BACKGROUND: Mean intraocular pressure in postmenopausal women is higher than that in menstruating women. Intraocular pressure is positively correlated with systemic blood pressure. No previous study has compared intraocular pressure in postmenopausal women with systemic hypertension and those without. PURPOSE: To investigate the effects of menopause on intraocular pressure in subjects with and without high blood pressure, after eliminating those factors that can affect intraocular pressure. METHODS: Normotensive menstruating and menopausal, along with hypertensive menopausal subjects of the same age groups were studied. Intraocular pressure was measured with the Goldmann applanation tonometer. RESULTS: The mean intraocular pressure of the normotensive and hypertensive postmenopausal women were 0.73+/-0.27 (p<0.05), and 1.09+/-0.34 (p<0.01) mmHg higher than normotensive menstruating women respectively. The mean intraocular pressure of hypertensive postmenopausal women was 0.36+/-0.15 mmHg (p<0.05) higher than that of normotensive postmenopausal women. CONCLUSIONS: Menopause significantly increases intraocular pressure. Mean intraocular pressure of hypertensive postmenopausal women was significantly (p<0.05) higher than that of normotensive postmenopausal women. Knowledge of the normal level of intraocular pressure during various stages of female sexual life may help glaucoma screeners.

Age Factors↗
PubMed1995

Premenstrual exacerbation of symptoms in multiple sclerosis is attenuated by treatment with weak electromagnetic fields.

It has been suspected that hormonal factors contribute to the etiology and pathogenesis of multiple sclerosis (MS). A direct relationship between MS and endocrine functions is suggested by changes in disease activity during the phases of the menstrual cycle. A subset of women with MS experience premenstrual worsening of symptoms which improve dramatically with the onset of menstruation. The biological mechanisms underlying these changes in disease activity are unexplained but may be related to cyclical fluctuations in gonadal sex steroid hormones, abrupt changes in the activity of the endogenous opioid peptides and fluctuations in plasma melatonin levels which affect neuronal excitability and immune functions. Extracerebral application of weak electromagnetic fields (EMFs) in the picotesla range intensity has been reported efficacious in the treatment of MS with patients experiencing sustained improvement in motor, sensory, autonomic, affective and cognitive functions. The present report concerns two women with chronic progressive stage MS who experienced, coincident with increasing functional disability, regular worsening of their symptoms beginning about a week before menstruation and abating with the onset of menstruation. These symptoms resolved two months after the initiation of treatment with EMFs. The report supports the association between the endocrine system and MS and indicates that brief, extracranial applications of these magnetic fields modifies the activity of neuroendocrine systems which precipitate worsening of MS symptoms premenstrually.

Adult↗
PubMed1993

Peak bone mass and affecting factors in Korean women.

Maximizing peak bone mass is advocated as a way to prevent osteoporosis. To evaluate the peak bone mass and the affecting factors in Korean women, we analyzed bone stiffness in 116 middle school students, 118 high school students and 115 female college students by using the Achilles densitometer (Lunar Corporation). Peak bone stiffness of Korean women was relatively lower than that of white women (94% of white women) and a rapid rise of bone stiffness was observed in those subjects 3-4 years after menarche. In adolescent females without menstruation, the bone stiffness was lower than that of adolescent girls with menstruation. The factors affecting the peak bone mass was similar to the risk factors of post menopausal osteoporosis: menstruation status, calcium intake and physical activity. The amount of calcium intake in Korean girls at the critical age (3-4 years after menarche) was lower than the RDA (requirement of daily allowance) at this age. To improve any program aimed at maximizing peak bone mass, further intensive study will be required to evaluate some other common factors affecting peak bone mass in Korean.

Adolescent↗
PubMed1999

Relationship of the menstrual cycle to postoperative incidence of emesis after laparoscopic cholecystectomy.

Despite advances in anesthetic practice and surgical techniques, the overall incidence of postoperative vomiting (POV) ranges from 20% to 30% during the first 24 hours after surgery. Studies specifically examining the relationship between POV and the menstrual cycle demonstrate equivocal findings. The purpose of this study was to examine the relationship between the incidence of POV and the phase of the menstrual cycle, age, body mass index, history of POV, duration of anesthesia, and use of droperidol among 79 women undergoing laparoscopic cholecystectomy. Sixteen subjects were stratified to the menstruating group and 63 to the nonmenstruating group. Analysis of demographic data revealed no significant differences between groups. Chi square analysis indicated that women in the menstruating group were more likely to experience POV (chi 2 = 20.87, P < .01). Among those receiving droperidol (n = 43; 54%), analysis revealed that those in the menstruating group experienced POV at a significantly higher rate (chi 2 = 9.15, P < .05). A reduction of POV may be accomplished by scheduling elective surgery to avoid the correlating menstrual cycle peaks.

Adult↗
PubMed1998

[Cleaniness and hygiene from infancy to adolescence in Karabuk, Safranbolu, Eflani and Eskipazar].

This paper on cleanliness and hygiene from infancy to adolescence is obtained from knowledge collected by means of an interview with women and men informed on the subject. This research is consisted of four main chapters: 1. Environmental and physical hygiene; 2. Baby and child care; 3. Beliefs regarding menstruation; it is commonly called regl - of French origin - in Turkish, which is called "colored" (renkli) days in this area, due to the similarity in the sound of the two words; 4. Beliefs and practices concerning circumcision. This essay deals in washing clothes with usual cleaning agents or using ash alone and ashed water without scrubbing. The practice of hair removal among women and girls is described. Swadding clothes, cradles, pots called havruz and subek for urination of babies in the district, are dealt with in detail. The customs and practices regarding menstruation are described and classified. Before the use of bikini underpants, pads and the menstruation cloth was one of the most important items of a girl's dowry. The techniques used in circumcision in this region were carefuly studied and the beliefs regarding circumcision were put down. This research was completed in fifty one weeks. Various objects obtained during the research have been handed over to the Medical History Museum of Cerrahpasa Medical School.

Adolescent↗
PubMed2003

[Relationship between climacteric symptoms and serum neuropeptide Y level in postmenopausal women].

UNLABELLED: The aim of this study was to determine circulating levels of neuropeptide Y (NPY) in postmenopausal women with climacteric symptoms in comparison with regularly menstruating women in reproductive age and to assess the relationship between serum NPY levels and the presence of climacteric symptoms in postmenopausal women. MATERIALS AND METHODS: We studied 41 postmenopausal patients attending the Clinic of Gynecological Endocrinology, University of Medical Sciences, Poznań because of climacteric complaints. The controls were 20 regularly menstruating women in reproductive age. In the study group the severity of climacteric symptoms was assessed using the Kupperman index. Serum 17 beta-estradiol, follicle stimulating hormone (FSH) and NPY concentrations were measured by radioimmunoassay in both groups. RESULTS: The mean value of the Kupperman index in the study group was 23.4 points (SD +/- 10.4 points); 17 beta-estradiol serum concentration was lower than 0.014 ng/ml in 30 women from the study group and the mean serum estradiol level for the remaining group was 0.023 ng/ml (SD +/- 0.03 ng/ml); the mean serum FSH concentration in the study group was 98.2 Ul/l (SD +/- 11.8 IU/l), the mean serum NPY concentration in the study group was 18.4 ng/ml (SD +/- 8.3 ng/ml). The mean serum NPY concentration in the control group was 12.9 ng/ml (SD +/- 6.3 ng/ml) and was lower than in the study group (t-test: p < 0.05). The difference between serum NPY concentration in patients with a particular climacteric symptom and patients without was not statistically significant for any symptom (t-test: p > 0.05). CONCLUSION: Serum NPY level is higher in postmenopausal women than regularly menstruating women in reproductive age an may be responsible for climacteric symptoms presence.

Adult↗