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PubMed2004

The association of progesterone, infant formula use and pacifier use with the return of menstruation in breastfeeding women: a prospective cohort study.

OBJECTIVES: This study sought to explore hormonal and postnatal factors, which are associated with the return of menstruation in breastfeeding mothers. DESIGN: A prospective cohort study in Bristol, UK. Ninety-one breastfeeding mothers of mixed parity were recruited at community-based antenatal clinics. Eighty-five mothers completed all stages and informed us about the return of menstruation. Data were collected from interviews and questionnaires antenatally, immediately postnatally, and 1 week, 4 weeks and 6 months later. Blood samples were taken at all time points except at 6 months. Associations between hormone levels, postnatal factors and the return of menstruation were explored using univariate and multivariate statistical survival analysis. RESULTS: Sixty-five (76%) mothers were still breastfeeding at 6 months and 46 (54%) of these were fully breastfeeding (not giving formula milk); 21 (32%) mothers started menstruating in the first 6 months whilst they were still breastfeeding and 14 were fully breastfeeding at 6 months. Survival analysis modelling showed that formula use (RR=4.27; 95% CI=1.89, 9.67), pacifier (dummy) use (RR=3.26; 95% CI=1.35, 7.84) and lower postnatal progesterone levels (P=0.006) each made a significant contribution to the chance of earlier resumption of menstruation. Prolactin and oestradiol levels showed no associations with the return of menstruation. CONCLUSIONS: Higher postnatal progesterone levels are associated with delayed menstruation; while the use of pacifiers and infant formula milk are associated with an earlier return to menstruation.

Adult↗

PubMed1999

Menstruation requirements as a barrier to contraceptive access in Kenya.

BACKGROUND: In many countries, non-menstruating women are routinely denied contraceptive services even when pregnancy can easily be ruled out. OBJECTIVE: To determine whether menstruation requirements in Kenya constitute a barrier to access for potential family planning clients. DESIGN: Prospective and retrospective observational study. SETTING: Nine family planning clinics in western Kenya. SUBJECTS: Women presenting as new clients at Ministry of Health family planning clinics. INTERVENTIONS: Researchers used prospective tracking and retrospective record reviews to compare the menstrual status of women presenting for family planning services with that of women who received methods in family planning clinics. MAIN OUTCOME MEASURES: Dichotomous outcomes (menstruating versus non-menstruating women). RESULTS: During the eight-week period that tally sheets were used in the one hospital and eight health centres, 45% of the 760 women presenting for services as new clients were not menstruating (clinic range = 19%-70%). In contrast, information from clinic registers and client records in the same nine clinics showed that the (weighted) proportion of registered new clients who were menstruating was 85% (n = 102). We estimated that 78% of non-menstruating women (35% of all potential new clients) were sent away without services. CONCLUSION: For most women turned away, it is likely that pregnancy could be ruled out easily with a history and an examination. Menstruation as a pre-condition for provision of contraception wastes valuable resources and denies women their right to contraception.

Ambulatory Care Facilities↗

PubMedDate not supplied

Menstruation: knowledge, attitude and practices of students in Ile-Ife, Nigeria.

This study investigated students' knowledge of, beliefs, attitude to and practices during menstruation. Data was collected from a sample of 200 students from Ile-Ife using the multi-stage sampling technique. Only 5% of respondents could correctly define menstruation. Materials used to manage menstruation include sanitary pad, pieces of cloths, toilet rolls, cotton wool, tampon and shoulder pad foam. Practices vary on menstruating and non-menstruating days with 11(39.3%) of the 28 practices classified as healthy, 6(21.43%) as potentially harmful and 11(39.3%) as uncertain. Three (21.43%) of the listed 14 beliefs and taboos are potentially health-promoting, 5(35.71%) are potentially not health-promoting while 6(42.86%) are potentially harmless. Menstruation is associated with restrictions in diet and social interaction with 8%, 20.5% and 5% seeing menstruation as abnormal, dirty and a disease respectively. Findings from this study would be helpful in planning educational programmes to correct misinformation and promote healthy practices among women during menstruation.

Adolescent↗

PubMed1996

Characteristics of menstruation in women infected with human immunodeficiency virus.

OBJECTIVE: To determine the characteristics of menstruation in women infected with human immunodeficiency virus (HIV) and the impact of immunosuppression on menstruation in HIV-infected women. METHODS: In this cross-sectional study, 197 HIV-infected and 189 HIV-uninfected women were interviewed about menstruation and abnormal vaginal bleeding during the previous 12 months. Information was also obtained about CD4+ T-lymphocyte levels of HIV-infected women and other factors, including drug use and weight loss, that might affect menstruation. RESULTS: The number and duration of menses in HIV-infected women were not significantly different from those of uninfected women. During a 12-month period, 154 (78%) of 197 HIV-infected women and 150 (80%) of 188 uninfected women had 10-14 menses (P = .74). The proportions of women in the two groups with intermenstrual bleeding, postcoital bleeding, or no bleeding were also similar. In HIV-infected women, menstruation and the prevalence of abnormal vaginal bleeding were not significantly different by CD4+ T-lymphocyte level. By multiple logistic regression analysis, neither HIV infection nor CD4+ T-lymphocyte level less than 200 cells/microL was associated with intermenstrual bleeding, postcoital bleeding, or no bleeding. CONCLUSION: The results of this study suggest that neither HIV infection nor immunosuppression has a clinically relevant effect on menstruation or other vaginal bleeding. Most HIV-infected women menstruate about every 25-35 days, suggesting monthly ovulation and an intact hypothalamic-pituitary-ovarian axis.

Adult↗

PubMed2026

Hip Arthroscopy During Female Menstruation: A Retrospective Analysis of Safety and Clinical Outcomes With 24-Month Follow-Up.

OBJECTIVES: To investigate the safety and clinical outcomes of hip arthroscopy performed during menstruation in reproductive-age female patients, and to determine whether surgery during menstruation increases intraoperative risks or adversely affects postoperative recovery. Currently, clear clinical guidelines regarding the timing of elective orthopedic surgeries relative to the menstrual cycle are lacking, often leading to unnecessary surgical rescheduling. Therefore, this study aimed to provide evidence-based guidance for perioperative management and optimal surgical scheduling, thereby addressing a critical clinical need. METHODS: This retrospective cohort study included reproductive-age female patients who underwent hip arthroscopy at the First Medical Center of Chinese PLA General Hospital, the Fourth Medical Center of Chinese PLA General Hospital, and the Department of Sports Medicine at the Second Hospital of Shandong University from December 2018 to September 2023. Patients were categorized into the menstruation group (MP) and the non-menstruation group (NMP) based on whether they were menstruating on the day of surgery. The NMP group consisted of equally sized ovulatory (OP) and luteal (LP) phases. Perioperative outcomes included: intraoperative blood loss, anesthetic dosage, operative time, hemoglobin (Hb) change (within 24 h postoperatively), prothrombin time (PT), and activated partial thromboplastin time (APTT). Postoperative outcomes included analgesic consumption, duration of analgesic use, time to first unassisted weight-bearing ambulation, complications, and urinary tract infections. Functional outcomes were assessed at 24-month follow-up using the Visual Analog Scale (VAS), Modified Harris Hip Score (mHHS), International Hip Outcome Tool-12 (iHOT-12), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and Hip Outcome Score-Sports Specific Subscale (HOS-SSS). RESULTS: Of 884 eligible patients, 28 were included in the MP group and 56 matched patients in the NMP group. Operative time, anesthetic use, Hb change, PT, and APTT were comparable between the two groups (all p > 0.05). No serious complications or urinary tract infections occurred in either group. At the 24-month follow-up, both groups demonstrated significant improvements in VAS, mHHS, iHOT-12, HOS-ADL, and HOS-SSS (all p < 0.001), with no statistically significant differences observed between the groups. CONCLUSIONS: Hip arthroscopy during menstruation does not increase intraoperative bleeding, impair coagulation, or delay functional recovery for female patients. Menstruation should not be considered a contraindication when appropriate perioperative management is applied.

Humans↗

PubMed2006

Attitudes and feelings towards menstruation and womanhood in girls at menarche.

AIM: To elucidate early adolescent girls' attitudes, thoughts and feelings towards menstruation and their bodies. METHODS: 309 12-y-old girls answered questionnaires. One part of the questionnaire dealt with thoughts and feelings towards menstruation. The other part dealt with thoughts and feelings towards menstruation and sex and ability to communicate on aspects of womanhood. RESULTS: Postmenarcheal girls were less positive towards menstruation than premenarcheal girls (p = 1 x 10(-6)). Many girls (43%) did not reaffirm the statement "I like my body" and almost one quarter stated being teased for their appearance. Many of the girls claimed that they had been called "cunt" (38%) or "whore" (46%). If called "cunt" or "whore", 17% stated that they felt alone, 76% felt anger and 50% were offended. Mothers were those with whom girls could most easily "chat" about their period. Sixty-seven per cent received information about menstruation from school nurses. CONCLUSION: Wanting to be an adult and liking that their body develops seem to be associated with a more positive feeling towards menstruation. Furthermore, mothers' timing and ability to communicate attitudes towards menstruation and the body are as important as those in a girl's immediate environment.

Attitude↗

PubMed1995

Preparing girls for menstruation: recommendations from adolescent girls.

This study asked adolescent girls who had been menstruating for one to three years how they would prepare younger girls for the event, and how they would advise parents to prepare their daughters. To this end, 157 9th-grade girls rated their own experience of menarche (in terms of preparation, initial response, parents' roles, and sources of information) and answered four open-ended questions. The girls emphasized the need for emotional support and assurance that menstruation was normal and healthy--not bad, frightening, or embarrassing. They stressed the pragmatics of menstrual hygiene and the subjective experience of menstruation (how it would actually feel), while down-playing the biological aspects and the link between menstruation and self-definition as a woman. Most girls had talked about menstruation with their mothers, but few had discussed it with their fathers. They saw mothers as critically important but often unable to meet their needs. Many girls felt uncomfortable talking about menstruation with fathers, wanting them to be supportive but silent; others believed that fathers should be excluded completely. Responses suggested several ways early preparation could be revised, including a shift in focus from the biology of menstruation to the more personal, subjective, and immediate aspects of the experience. Responses also supported a conceptualization of menstrual education as a long-term, continuous process, beginning well before menarche and continuing long after.

Adolescent↗

PubMed1998

The substantial impact of von Willebrand disease on menstruation.

von Willebrand disease (vWd) is the most common of all congenital bleeding disorders with an estimated prevalence of 1-3% in the general population. However, the gynecological complications have not been thoroughly described.Objective: To compare the clinical and quality of life aspects of vWd in menstruating women in relation to a cohort of menstruating women in the general population.Methods: A patient questionnaire and provider survey of the medical and quality of life aspects of menstruation was administered to 81 menstruating vWd patients registered at four geographically linked Hemophilia Treatment Centers. The questionnaire was also administered to 150 menstruating women volunteers that comprised a control group used to determine normal coagulation levels in menstruating women. We assessed the impact on quality of life of menses in both of the cohorts by a Likert scale of 1-10 with 10 being "most significant impact" using 7 quality of life parameters with those comparisons by Wilcoxon rank sum test.Results: 88% of the vWd patients (pts) had type I vWd, the remaining Type II or unknown. The mean age of the vWd patients was 31.6 +/- 10.3; the mean age of the control group was 35.5 +/- 7.6. The following comparisons were made using chi(2) and Wilcoxon rank sum test:Conclusions: vWd markedly diminishes the quality of life during menses. This observation warrants efforts to reduce the attendant morbidities of vWd in menstruating women.

Journal Article↗

PubMed2000

Investigation of menstruation recovery after LH-RH agonist therapy for premenopausal patients with breast cancer.

BACKGROUND: Recently Luteinizing hormone-releasing hormone (LH-RH) agonist has been used for premenopausal patients with breast cancer as endocrine therapy. However, there is no consensus regarding recovery of menstruation after long-term treatment with LH-RH agonist. We investigated recovery of menstruation after this treatment. METHODS: We investigated 28 premenopausal patients with breast cancer who underwent operation at Chiba Cancer Center Hospital in 1995 or 1996. The patients were treated with LH-RH agonist (goserelin) for 24 months as an adjuvant therapy, and were observed for more than 6 months after the last goserelin depot. Ages ranged 31-55 years old from at the time of last treatment. We defined recovery of menstruation as regular menstruation occurring more than three times. RESULTS: There were 22 patients in the recovery group (range: 31-53 years, mean 45.1 years). There were 6 patients in the non-recovery group (range: 50-55 years, mean 52.2 years). The overall recovery rate was 78.6%. Recovery rate was 81.8% for the patients under 50 years, and 66.7% for over 51 years. We separated all patients into groups by age at 5 years intervals, and investigated the distribution of the recovery time. In the recovery group (22 patients), there were 15 patients (68.2%) who confirmed recovery of menstruation within 6 months. CONCLUSION: Our investigation suggested that the recovery of menstruation after this therapy would occur in those less than 50 years old, within 6 months from the last treatment.

Adult↗

PubMed2003

Mimicking the events of menstruation in the murine uterus.

Menstruation and endometrial regeneration occur during every normal reproductive cycle in women and some Old World primates. Many of the cellular and molecular events of menstruation have been identified by correlative or in vitro studies, but the lack of a convenient model for menstruation in a laboratory animal has restricted functional studies. In this study, a mouse model for menstruation first described by Finn in the 1980s has been modified for use in a commonly used inbred strain of mouse. A decidual stimulus was applied into the uterine lumen of appropriately primed mice and leukocyte numbers and apoptosis were examined over time following progesterone withdrawal. Endometrial tissue breakdown was initiated after 12-16 h, and by 24 h, the entire decidual zone had been shed. Re-epithelialization was nearly complete by 36 h and the endometrium was fully restored by 48 h. Leukocyte numbers increased significantly in the basal zone by 12 h after progesterone withdrawal, preceding stromal destruction. Stromal apoptosis was detected by TUNEL staining at 0 and 12 h but decreased by 16 h after progesterone withdrawal. This mouse model thus mimics many of the events of human menstruation and has the potential to assist in elucidation of the functional roles of a variety of factors thought to be important in both menstruation and endometrial repair.

Animals↗

PubMed1997

[Tainted femininity--traces of traditional menstruation myths in product advertising of feminine hygiene products].

OBJECTIVE: Does the portrayal of menstruation in menstrual product advertisements reflect cultural myths about menstruation? METHODS: We analyse the reception of menstruation in contemporary and historical menstruation product advertisements. RESULTS: In menstrual product advertisements, menstruation is depicted as an unclean attribute, discrediting an ideal femininity and creating the need to conceal it. CONCLUSION: This tendency to taboo menstruation in menstrual product advertising contributes--by conveying a negative definition of femaleness--to a negative self-perception, particularly in young women.

Advertising↗

PubMed1991

Relationship between serum testosterone and sex hormone binding globulin in menstruating and postmenopausal women.

The relationship between total testosterone (T), sex hormone binding globulin (SHBG) and calculated non-SHBG-bound testosterone (NST) was studied in randomly collected blood samples from healthy menstruating (n = 61) and postmenopausal (n = 65) women. In 12 of the menstruating women, blood samples were also collected more frequently during the menstrual cycle. Total T and SHBG were positively correlated in menstruating women in random samples as well as during different phases of the menstrual cycle, but not in postmenopausal women. Upper and lower limits of NST were independent of SHBG in menstruating but not in postmenopausal women. The data are at variance with the common concept about SHBG regulation and suggest a kind of compensatory mechanism in order to maintain a constant androgen homeostasis in menstruating but not in postmenopausal women. Consequently, supranormal total T or subnormal SHBG values do not necessarily indicate hyperandrogenicity in normally menstruating women.

Adult↗

PubMed1982

Toxic-shock syndrome not associated with menstruation. A review of 54 cases.

An increasing proportion of reported cases of toxic-shock syndrome (TSS) are not associated with menstruation (13.2% of reported cases with onset in 1981). The 54 cases of TSS not associated with menstruation reported through the U.S.A. national surveillance system between January, 1980, and June, 1981, were either associated with Staphylococcus aureus infections (cutaneous or subcutaneous lesions, infected surgical wounds, bursitis, mastitis, adenitis, lung abscess, or primary bacteraemia) or followed childbirth by vaginal delivery and caesarean section. Patients with TSS not associated with menstruation differed significantly in age and racial distributions from those with menstruation-associated TSS, and 17 of them were male. The clinical features of TSS not associated with menstruation and the characteristics of the S. aureus strains isolated from these patients were similar to those observed in TSS related to menstruation. The median incubation period of the disease in the post-surgical cases was 2 days. TSS can occur in many clinical settings in patients of both sexes and of all ages and racial groups.

Adolescent↗

PubMed1990

Migraine and menstruation: a pilot study.

OBJECTIVE: To define the term "menstrual" migraine and to determine the prevalence of "menstrual" migraine in women attending the City of London Migraine Clinic. DESIGN: Women attending the clinic were asked to keep a record of their migraine attacks and menstrual periods for at least 3 complete menstrual cycles. RESULTS: Fifty-five women completed the study. "Menstrual" migraine was defined as "migraine attacks which occur regularly on or between days -2 to +3 of the menstrual cycle and at no other time". Using this criterion, 4 (7.2%) of the women in our population had "menstrual" migraine. All 4 women had migraine without aura. A further 19 (34.5%) had an increased number of attacks at the time of menstruation in addition to attacks at other times of the cycle. Eighteen (32.7%) had attacks occurring throughout the cycle but with no increase in number at the time of menstruation. Fourteen (25.5%) had no attacks within the defined period during the 3 cycles studied. DISCUSSION: A small percentage of women have attacks only occurring at the time of menstruation, which can be defined as true "menstrual" migraine. This group is most likely to respond to hormonal treatment. The group of 34.5% who have an increased number of attacks at the time of menstruation in addition to attacks at other times of the month could be defined as having "menstrually related" migraine and might well respond to hormonal therapy. The 32.7% who have attacks throughout the menstrual cycle without an increase at menstruation are unlikely to respond to hormonal therapy. The 25.5% who do not have attacks related to menstruation almost certainly will not respond to hormonal therapy.

Adolescent↗

PubMed1998

The effects of a copper-intrauterine device on the uterine artery blood flow in regularly menstruating women.

The aim of the study was to evaluate the effect of a copper-intrauterine device (IUD) on uterine artery blood flow during the midluteal phase and on the first day of the menstrual cycle using pulsed colour Doppler ultrasonography. Twenty-one regularly menstruating women (18-45 years) who were willing to use copper-IUD contraception participated in the study. The patients were first examined without the IUD in the midluteal phase 6-9 days before the expected onset of menstruation and on the first day of menstruation, after which the IUD was inserted. Three months later the patients were examined again on the corresponding cycle days. The patients estimated the level of dysmenorrhoeic pain with a scoring system. Transvaginal ultrasonography with colour flow imaging was used to measure the pulsatility index (PI) in the uterine arteries. There were no significant changes in the uterine artery blood flow after the insertion of the IUD during menstruation or in the midluteal phase. In patients with increased IUD-related pain during menstruation (n = 5), however, there was a decrease in PI (2.87 +/- 0.52 versus 2.41 +/- 0.23, P = 0.05) after IUD insertion. The decrease in the mean PI was present in all five patients. In conclusion, copper-IUD does not induce any major changes in the resistance of the uterine artery blood flow, although during menstruation in patients with increased menstrual pain after IUD insertion there seems to be a decrease in the uterine artery PI.

Adolescent↗

PubMed1996

Increased prevalence and recurrence of retrograde menstruation in baboons with spontaneous endometriosis.

This study was done to test the hypothesis that the incidence and recurrence of retrograde menstruation is higher in baboons with spontaneous endometriosis than in those without. A total of 399 laparoscopies was performed on 113 female baboons. Group 1 consisted of 84 animals with a normal pelvis (including 23 that later underwent induction of endometriosis and were assigned to group 4), group 2 comprised nine baboons with spontaneous endometriosis acquired during the last 2 years of the study, group 3 had 18 baboons with long-term spontaneous disease, and group 4 comprised 25 animals with induced endometriosis. Retrograde menstruation was defined by the presence of blood-stained peritoneal fluid (red or dark brown) during menses. Recurrence of retrograde menstruation was analysed during the first two laparoscopies in 13 baboons. Peritoneal fluid was 10 times more frequently blood-stained during menses (62%) than during non-menstrual phases (6%). Retrograde menstruation was observed more frequently in animals with spontaneous disease (groups 2 and 3, 83%) than in animals with a normal pelvis (group 1, 51%). Recurrence of retrograde menstruation was observed more frequently in baboons with spontaneous endometriosis (5/5) than in those without (3/8). The results of this study demonstrate that retrograde menstruation is common in baboons, with a higher prevalence and recurrence in animals with spontaneous endometriosis than in those without.

Animals↗

PubMed2005

Menstruation and amenorrhea: opinion of Brazilian women.

Contemporary women experience more menstrual cycles than their predecessors, and their menstrual patterns are modified by contraceptives. Amenorrhea is one side effect that has recently been advocated as desirable. This qualitative study investigated Brazilian women's views regarding the suppression of menstruation using hormones. Data were collected through eight focus groups, following a semistructured guideline. Sixty-four women, 21-51 years old, all menstruating regularly and all of whom had already initiated sexual activity and had no perceived infertility participated. Discussions were recorded, transcribed and entered into the computer, using the Ethnograph V 5.0 software to aggregate similar patterns. Thematic content analysis revealed that menstruation and amenorrhea were both seen with ambiguity. Although regarded as a nuisance, menstruation was associated with femaleness, youth, fertility and health. Most women, although they would like to be free from menstruation, feared negative consequences of induced amenorrhea and even regarded the proposition as a male intrusion into what they consider a natural female condition.

Adult↗

PubMed2004

Near-fatal asthma related to menstruation.

BACKGROUND: Menstruation has been suggested as a possible trigger of near-fatal asthma (NFA), but the evidence supporting this association remains weak. OBJECTIVE: We sought to assess the role of menstruation as a contributing factor in the development of NFA episodes in women of reproductive age. METHODS: Forty-four female patients of reproductive age with near-fatal attacks were enrolled in a multicenter study. Data on patient and clinical characteristics were collected. We also performed spirometric and allergy studies when the patients were in stable condition. RESULTS: Significantly more NFA episodes were observed on the first day of menstruation (11 [25%] patients) than on the remaining days (33 [75%] patients, P =.022), and patients who presented for care on the first day of menstruation used more inhaled salbutamol as rescue medication (9 [9.5] vs 1.8 [3.7] microg/d during the 7 days before the asthma exacerbation, P =.003). CONCLUSION: Menstruation might act as a contributing factor in the development of NFA episodes in patients with unstable asthma. Specific recommendations should be included in educational programs, and the self-management plans of asthmatic women of reproductive age should include the systematic recording of their asthma symptoms and pulmonary function in the perimenstrual phase.

Administration, Inhalation↗