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PubMed2003

The relationship between attitudes towards menstruation and sexual attitudes, desires, and behavior in women.

We studied 114 romantically involved women to examine empirically the psychological connections between menstruation and sexuality. As menstruation is a distinctive sign of both reproductive potential and sexual maturity, we hypothesized that the attitudes women have towards menstruation will correlate with their sexual attitudes, desires, and behavior. As predicted, a comfort with personal sexuality was associated with a comfort with menstruation as a normal, publicly acceptable event. This association remained after controlling for liberal attitudes and disgust sensitivity. In addition, women who had engaged in sexual relations with their current partner during menses were significantly more comfortable with menstruation, more aroused by romantic and unconventional sexual activities, and less sensitive to disgust.

Adult↗

PubMed1989

Women's theories of menstruation and biases in recall of menstrual symptoms.

Previous research is consistent with the proposition that people use implicit theories of personal stability or change in remembering the attributes they possessed in the past. However, there has been little systematic investigation of the relation between these implicit theories and memory biases. In this study, the relation between women's theories of menstrual distress and their recollections of physical and affective symptoms was examined. Ss completed daily questionnaires in which they evaluated themselves on several physical and affective symptoms. Later, some Ss were asked to recall the ratings they had made on a day when they were menstruating; others recalled a day when they were not menstruating. At the time of recall, all Ss were in the intermenstrual phase. Finally, Ss completed a measure designed to assess their theories of how they are typically affected by menstruation. The recollections of Ss who recalled the menstrual state were biased so as to be consistent with their theories of menstrual distress: The more a woman believed in the phenomenon of menstrual distress, the more she exaggerated, in recall, the negativity of her symptoms during her last period. The recollections of women asked to recall the intermenstrual state were unrelated to their theories of menstruation. Furthermore, consistent with previous research, the daily questionnaire ratings revealed that physical symptoms varied with menstrual cycle phase, whereas affective symptoms did not. Finally, comparisons between subjects' theories and daily ratings revealed that, on average, women exaggerate the degree to which they experience changes during menstruation.

Adaptation, Psychological↗

PubMed2005

Menstruation-free interval and ongoing pregnancy in IVF using GnRH antagonists.

BACKGROUND: The purpose of this study was to evaluate prospectively the association between the achievement of ongoing pregnancy and the time interval from the end of menstruation until the administration of HCG (menstruation-free interval) in patients treated by IVF. METHODS: A fixed dose of 200 IU of recombinant FSH (rFSH) was started in 90 patients on day 2 of the menstrual cycle and daily GnRH antagonist was initiated on day 6 of stimulation. Triggering of final oocyte maturation was performed with 10,000 IU of HCG as soon as three follicles of > or =17 mm were present at ultrasound. RESULTS: Single embryo transfer was performed in 64.6% of the patients who reached embryo transfer (53/82). Ongoing pregnancy rate per embryo transfer was 18.3% (95% CI 11.4-28.0%). The menstruation-free interval significantly predicted the probability of ongoing pregnancy in a logistic regression analysis, controlling for female age and LH on day 1 of stimulation (odds ratio for the menstruation-free interval: 0.70; 95% CI: 0.54-0.92). CONCLUSION: The longer the interval from the end of menstruation until the administration of HCG, the lower the probability of ongoing pregnancy in patients stimulated with recombinant FSH and GnRH antagonist for IVF.

Adult↗

PubMed1990

Effects of progesterone antagonist, lilopristone (ZK 98.734), on induction of menstruation, inhibition of nidation, and termination of pregnancy in bonnet monkeys.

The effects of a progesterone antagonist, lilopristone (ZK 98.734), on induction of menstruation, inhibition of implantation or pregnancy, and termination of early and mid-pregnancy were studied in bonnet monkeys. In the regularly menstruating animals, administration of lilopristone (25 mg/day, s.c.) during the mid-luteal phase (Days 20-22 of the menstrual cycle) induced menstruation within 2-4 days after the initiation of treatment. A premature drop in circulating progesterone levels was also observed. The luteolytic effect of lilopristone was prevented by exogenous treatment with hCG; however, the animals showed premature menstruation, in spite of high progesterone levels (above 4 ng/ml). Treatment around the time of implantation (between Days 8 and 12 after the mid-cycle peak in estradiol levels) in mated animals provided 100% pregnancy protection. Treatment of pregnant animals on Days 30-32 of the menstrual cycle, i.e. about Day 20 after the estradiol peak, induced abortion in 8 of 10 animals. A significant (p less than 0.05) decrease in serum progesterone levels was observed on Day 3 after the initiation of treatment. However, the decrease was slower (slope: -0.36, r: 0.96) compared to that observed in nonpregnant animals (slope: -0.72, r: 0.95). In the other two animals, pregnancy was not affected. However, when the treatment was delayed until about Day 50 after the estradiol peak, all four animals aborted. This study suggests that lilopristone is a progesterone antagonist with a potential to induce menstruation, inhibit nidation, and terminate pregnancy. The antifertility effects are mediated through blocking progesterone action at the endometrium as well as decreasing progesterone bioavailability, which appears to be due to its effects on gonadotropin release.

Animals↗

PubMed2001

Familial Mediterranean fever and menstruation.

OBJECTIVE: To study the prevalence, the nature and the genotype correlation of menstruation associated familial Mediterranean fever attacks. METHODS: One hundred and forty-one female patients with familial Mediterranean fever were studied. A questionnaire regarding the presence and nature of menstruation associated with familial Mediterranean fever was designed and filled in by the authors during the patients' visits to the familial Mediterranean fever clinic. The patients who had a positive history for this manifestation were analysed for their familial Mediterranean fever mutations. RESULTS: Ten out of 141 familial Mediterranean fever female patients (7%) had menstruation-associated familial Mediterranean fever attacks. These patients varied in their disease age of onset and disease duration. Increase of colchicine dose, daily or during the perimenstrual period or oral contraceptives were beneficial in preventing these familial Mediterranean fever attacks. No correlation was found with specific mutations causing familial Mediterranean fever. CONCLUSIONS: Menstruation-associated familial Mediterranean fever attacks are relatively uncommon. They are not related to the age of the women, the chronicity of their disease or to the mutations they bear. Various therapeutic approaches have to be tried in order to abolish these attacks. A decrease in oestrogen level during menstruation may have a role in this unique manifestation of familial Mediterranean fever.

Adolescent↗

PubMed1986

Methods for quantitative and qualitative evaluation of vaginal microflora during menstruation.

The quantitative and qualitative changes in the bacterial flora of the vagina during menstruation have received inadequate study. Similarly, the effect of vaginal tampons on the microbial flora as well as the relationship between the microbial flora of the vagina and that of the tampon has not been adequately evaluated. The purposes of the present study were (i) to develop quantitative methods for studying the vaginal flora and the flora of tampons obtained during menstruation and (ii) to determine whether there were differences between the microflora of the tampon and that of the vaginal vault. Tampon and swab samples were obtained at various times from eight young healthy volunteers for 8 to 10 menstrual cycles. Samples consisted of swabs from women wearing menstrual pads compared with swab and tampon samples taken at various times during the menstrual cycle. Samples were analyzed for total facultative and anaerobic bacterial counts, and the six dominant bacterial species in each culture were identified. Statistical evaluation of the results indicates that total bacterial counts decreased during menstruation and that swab and tampon samples yielded similar total counts per unit weight of sample. The numbers of bacteria in tampons tended to be lower than in swabs taken at the same time. Overall, during menstruation, the concentrations of lactobacilli declined, but otherwise there was little difference among the species found during menstruation compared with those found in intermenstrual samples. Cotton tampons had little discernible effect on the microbial flora.

Adult↗

PubMed1991

[Relationship between iron nutrition and nutriment intakes in the menstruating and menopausal women].

Medical examinations related to iron nutrition (hemoglobin concentration, serum ferritin concentration and transferrin saturation) and measurements of daily nutriment intakes based on three day dietary records were carried out for 440 female subjects from adolescence to menopause, and the relationships between both parameters were compared. The subjects could be reasonably divided into 3 age groups of menstruating I (17-29 years), II (30-53 years) women and menopausal (48-69 years) women by the one-way analysis of variance. The occurrence of iron deficiency including iron deficient anemia was above 45% both in menstruating I and menstruating II women. In addition, the average amounts of iron intake were 8.7 and 10.2 mg/day in these groups, respectively. These values were below the recommended intake of iron (12 mg/day) for females of these ages in Japan. In menopausal women, the occurrence of iron deficiency decreased to 11.3%, which corresponded to the increase of average iron intake to 11.2 mg/day. Irrespective of age groups, there were almost no significant correlations between the results of medical examinations and the amounts of daily iron intake. Although no improvement in hemoglobin concentration and transferrin saturation was observed in 62 menstruating women, who received 10 mg iron daily as sodium ferrous citrate for 2 months, the average serum ferritin concentrations were significantly increased at 1 and 2 months after the supplement and 2 weeks after they stopped. These therapeutic trials indicate the relationship between iron deficiency and low iron intake in menstruating women.

Adult↗

PubMed1995

Early adolescent girls' understanding of menstruation.

Sixth grade girls (N = 224) were queried about their preparation for and expectations about menarche, their parents' roles in preparation, and their understanding of the biological basis of menstruation, characteristics of the menstrual cycle, menstrual hygiene, and menstrual-related physical and psychological changes. Although girls viewed themselves as prepared for menarche, and claimed they had discussed it with their mothers, their explanations of menstruation reflected at best incomplete knowledge, and more typically a variety of misconceptions or ignorance. In attempting to explain menstruation, they tended to focus on one particular element of the process (e.g., eggs or blood or the uterus), and were not able to integrate the elements into a comprehensive whole. Girls' knowledge of the location and function of reproductive structures was faulty, and most did not understand how they were interrelated. Girls associated a variety of negative physical and psychological changes with menstruation, indicating that although they had not yet learned the biology of menstruation, they already had learned and internalized the cultural stereotypes and myths about menstrual symptomatology. In view of reports of high levels of sexual activity, often at very young ages, and without protection, and the high risk for acquiring sexually transmitted diseases, the failure to adequately educate girls about their own anatomy and physiology has serious implications.

Child↗

PubMed1993

Treatment of menstruation-associated migraine headache with subcutaneous sumatriptan.

OBJECTIVE: To evaluate the efficacy and safety of sumatriptan, a 5-HT1 receptor agonist, in patients with menstruation-associated migraine. METHODS: Two double-blind, placebo-controlled, single-attack parallel group studies of subcutaneous sumatriptan were conducted for the acute treatment of migraine. A retrospective analysis of 1104 patients produced 157 women who were treated for a menstruation-associated migraine (defined as a migraine beginning between 1 day before and 4 days after the onset of menstrual flow) and 512 women treated for nonmenstrual migraine. We excluded 435 other patients who were either male (123), women with hysterectomies (260), or women with missing data (52). Patients with moderate or severe pain were treated with 6 mg subcutaneous sumatriptan or placebo. One hour after treatment, response rates of headache severity and associated symptoms were measured. Menstruation-associated migraine patients were compared to female patients with nonmenstrual migraine. Migraine recurrence was analyzed retrospectively for 24 hours. RESULTS: At 1 hour, 80% of the sumatriptan-treated menstrual-migraine patients had pain relief (reduction of severe or moderate pain to mild or no pain), compared to 19% of the placebo patients (P < .001). Sumatriptan also treated nausea and photophobia more effectively in menstrual-migraine patients than did placebo. Response rates for pain and associated symptoms were similar between patients with menstruation-associated and nonmenstrual migraines. Adverse effects were also similar between the groups. CONCLUSION: Sumatriptan was as effective and well tolerated for menstruation-associated migraine as it was for nonmenstrual migraine.

Adolescent↗

PubMed1996

Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration.

OBJECTIVES: To evaluate a clinical examination during menstruation and plasma CA-125 concentrations to diagnose deep endometriosis. DESIGN: Prospective study in 61 women scheduled for a laparoscopy, a retrospective study in 140 women with deep endometriosis, and a clinical validation study in 16 women with painful pelvic nodularities during menstruation. SETTING: University Hospital Gasthuisberg, a tertiary referral center. RESULTS: In the retrospective study, deep endometriosis was detected by routine clinical examination in only 36% of women. Lesions infiltrating deeper than 15 mm were detected in 50%. In the prospective study pelvic nodularities were detected by routine clinical examination in 4 women but were detected in 22 by clinical examination during menstruation. The latter was highly reliable to diagnose deep endometriosis, cystic ovarian endometriosis, and cul-de-sac obliteration. CA-125 concentrations were higher during menstruation and correlated with deep endometriosis and with deep and cystic ovarian endometriosis. Nodularities at clinical examination or follicular phase CA-125 concentrations > 35 U/mL are useful to decide that a bowel preparation should be given, achieving a sensitivity of 87% and a specificity of 83%. In the clinical validation study, deep endometriosis was found in 14 of 16 women. CONCLUSION: Clinical examination during menstruation can diagnose reliably deep endometriosis, cystic ovarian endometriosis, or cul-de-sac adhesions. This test, preferentially combined with a follicular phase CA-125 assay, should be used to decide whether a preparation for bowel surgery should be given.

CA-125 Antigen↗

PubMed1997

Resumption of menstruation after amenorrhea in women treated by endometrial ablation and myometrial resection.

STUDY OBJECTIVE: To evaluate the prevalence of resumption of menstruation after an interval of amenorrhea in women treated by endometrial ablation and myometrial resection. DESIGN: Retrospective analysis. SETTING: Tertiary care university-affiliated teaching hospital. PATIENTS: One hundred fifty-seven consecutive patients treated for menorrhagia refractory to medical therapy. INTERVENTIONS: Loop resection or rollerball ablation of the endometrium. MEASUREMENTS AND MAIN RESULTS: At 6 to 12 months postoperatively, 50. 6% of patients were amenorrheic and 35.1% had hypomenorrhea. Over follow-up of 13 to 30 months, 45.1% of women became amenorheic and 40.5% had satisfactory hypomenorrhea. Resumption of menstruation after any interval of amenorrhea occurred in 27.2% of amenorheic patients. We observed an increasing trend to resumption of menstruation after rollerball ablation (29.4%) compared with loop resection (26.7%) and after preoperative endometrial suppression with buserelin (37.5%) and leuprolide (27.1%) compared with danazol (12.5%) and goserelin (10.5%). Resumption of menstruation occurred in 44.4% of women who did not have preoperative endometrial suppression. CONCLUSIONS: Our results suggest that resumption of menstruation does occur after a variable interval of amenorrhea following endometrial ablation and myometrial resection. It could potentially be used as a marker of failure of endometrial destruction.

Amenorrhea↗

PubMed1991

Menstruation: symptoms, management and attitudes in university students.

The aim of the study was documentation of the attitude towards and management of menstruation in Afrikaans speaking university students. Of 130 questionnaires issued, 102 (78.5%) were analysed. Severe symptoms occurred in 23% of the women. Premenstrually, the major symptoms were irritability, moodiness, breast tenderness, skin changes and increased appetite. During menstruation, dysmenorrhea was the most important symptom. Although only 17.6% of the women consulted a physician during the 2 years preceding the study, 47.1% used medication for symptoms. Seventy-six (74.5%) of the women accepted menstruation as an integral part of a woman's life whereas 19.6% preferred not to menstruate. In this latter group, the majority reported severe symptoms. Fear of consulting a physician for menstrual symptoms was documented.

Adult↗

PubMed1983

Induction of menstruation by an antiprogesterone steroid (RU 486) in primates: site of action, dose-response relationships, and hormonal effects.

The antiprogesterone compound RU 486 (17 beta-hydroxy-11 beta-[4-dimethylaminophenyl]-17 alpha-[ 1-propynyl]estra-4,9-dien-3-one; Roussel-Uclaf, Paris, France) was used to induce menstruation in a randomized controlled trial. Castrated adult female cynomolgus monkeys (n = 17) received sequential subcutaneous Silastic capsules of estradiol or progesterone over a 49-day regimen which stimulated the steroidal milieu of the fertile ovarian/menstrual cycle. RU 486 was injected at 10.0, 1.0 to 3.0, or 0.1 mg/kg from days 31 to 34 of this protocol. At all concentrations tested, menstruation followed RU 486 injection within 48 hours and persisted through 72 hours. No bleeding followed placebo injections. All monkeys that menstruated after RU 486 administration also manifested vaginal bleeding after removal of exogenous steroid treatments. No changes in daily serum follicle-stimulating hormone, luteinizing hormone, prolactin, or serum and urinary free cortisol accompanied RU 486 treatment. We conclude that (1) RU 486 promptly induces menstruation by a local action upon the endometrium; (2) familiar endometrial proliferation and withdrawal bleeding can redevelop after exposure to this compound; (3) no effects of RU 486 on serum cortisol or pituitary gonadotropins were noted; and (4) extensive combination therapy with estrogen and progesterone causes mild hyperprolactinemia.

Animals↗

PubMed1999

Differences in menstrual bleeding characteristics, functional status, and attitudes toward menstruation in three groups of women.

This report examines differences in bleeding characteristics, functional status, and attitudes toward menstruation among three groups of women: (1) women who complain of abnormal uterine bleeding (AUB), (2) women who have similar menstrual patterns as those complaining of AUB but who do not perceive themselves to have abnormal bleeding, and (3) women without evidence of prolonged or excessive bleeding. Women who complain of AUB and women with heavy bleeding but not complaining of AUB, although similar on two important menstrual symptoms (very heavy bleeding or episodes of unusually heavy bleeding) differ on a number of other menstrual characteristics, including the frequency of short cycles, the probability of having an abnormally long period, and reporting of unusually heavy bleeding lasting longer than 1 day. Whether women reported concerns with menstruation or not, the majority of women in this analysis had fairly negative attitudes toward menstruation. However, this negativity toward menstruation did not translate into women wanting a hysterectomy, even for those with heavy bleeding. The major difference among the three groups of women was the strong negative effect of AUB on functional status. A majority of women complaining of AUB reported that the bleeding interfered significantly with their daily routine, making them unable to function at work and at home. These results suggest that although the main complaint of women with AUB is very heavy bleeding, a number of other specific menstrual characteristics differentiate women with AUB from other women with very heavy bleeding who do not perceive the bleeding to be problematic. The complaint of AUB appears to be related to how significantly bleeding affects daily functioning. Therefore, an important factor to assess when considering treatment of AUB is the extent to which bleeding symptoms significantly affect functional status.

Adult↗

PubMedDate not supplied

Iron status in 268 Danish women aged 18-30 years: influence of menstruation, contraceptive method, and iron supplementation.

The aim of the present study was to evaluate the influence of menstruation, method of contraception, and iron supplementation on iron status in young Danish women, and to assess whether iron deficiency could be predicted from the pattern of menstruation. Iron status was examined by measuring serum (S-) ferritin and hemoglobin (Hb) in 268 randomly selected, healthy, menstruating, nonpregnant Danish women aged 18-30 years. Iron deficiency (S-ferritin <16 microg/l) was observed in 9.7%, of the women, iron deficiency anemia (S-ferritin < 13 microg/l and Hb < 121 g/l) in 2.2%. Iron supplementation, predominantly as vitamin-mineral tablets containing 14-20 mg of ferrous iron was used by 35.1%. The median serum ferritin was similar in non-iron users and in iron users, whereas the prevalence of iron deficiency was 12.6% in nonusers vs. 4.3% in users, the prevalence of iron deficiency anemia 3.4% in nonusers vs. 0%, in users (p=0.17) In non-iron-supplemented women, S-ferritin levels were inversely correlated with the duration of menstrual bleeding (rs= -0.25, p<0.001) and with the women's assessment of the intensity of menstrual bleeding (r(s)= -0.27, p<0.001), whereas no such correlations were found in iron-supplemented women. The results demonstrate that even moderate daily doses of ferrous iron can influence iron status in women with small iron stores. Women using hormonal contraceptives had menstrual bleeding of significantly shorter duration than those using intrauterine devices (IUD) or other methods. There was a high prevalence of small and absent body iron stores in young women, suggesting that preventive measures should be focused on those women whose menstruation lasts 5 days or longer, who have menstrual bleeding of strong intensity, who use an IUD without gestagen, and who are blood donors.

Adolescent↗

PubMed2005

Characteristics of menstruation-related problems for adolescents and premarital women in Korea.

OBJECTIVE: This study was undertaken to compare the patterns of menstruation-related problems between adolescents and premarital women who visited the Young Lady Clinic (YLC) at Samsung Medical Center. STUDY DESIGN: This study includes 646 adolescents (aged 10-20, group I) and 591 premarital young women (aged 21-30, group II) who visited the YLC with menstruation-related problems (amenorrhea, oligomenorrhea, dysmenorrhea, abnormal uterine bleeding (AUB), etc.). Comparisons between the two groups were made with the use of chi(2)-test and Fisher's exact test. RESULTS: For primary amenorrhea, hypogonadotropic hypogonadism was more frequent in group I (p = 0.007), and eugonadism in group II (p = 0.0025). Chromosomal competent ovarian failure (p = 0.003) and hyperprolactinemia (p < 0.001) were more frequent causes of secondary amenorrhea in group II. Endometriosis without ovarian endometrioma was the more frequent laparoscopic finding for patients of group I (p = 0.0429). Regarding AUB, dysfunctional uterine bleeding (DUB) was more frequent for group I (p < 0.001) and endocrinopathies (p = 0.006) and benign lesions of genital tract (p < 0.0001) for group II. CONCLUSION: The menstruation-related problems showed different features for each group. These data might give us an insight, at least in part, into the menstruation-related problems of Korean young women.

Adolescent↗

PubMed1999

Menstruation: induction by matrix metalloproteinases and inflammatory cells.

Menstruation occurs at the end of a normal reproductive cycle in the human female, following the fall in progesterone resulting from the demise of the corpus luteum. Current data support a central role for the matrix metalloproteinases in menstruation but their focal pattern of expression within peri-menstrual and menstrual endometrium suggests local rather than hormonal regulation. This review emphasizes the similarities between menstruation and an inflammatory process and examines the relationship between cells of hemopoietic lineage, particularly mast cells, eosinophils, neutrophils and macrophages, and the local production and activation of matrix metalloproteinases within the endometrium. It proposes a complex of critical regulatory circuits, initially activated by the withdrawal of progesterone, which provide interactions between the migratory cells that produce a myriad of important regulatory molecules and endometrial stromal and epithelial cells which produce both chemokines and matrix metalloproteinases. These mechanisms could account for the focal nature of the tissue degradation at menstruation.

Animals↗

PubMed2000

Chronic hepatitis C is mild in menstruating women.

BACKGROUND AND AIMS: Women with chronic hepatitis C may have a slower rate of disease progression than men. We have previously demonstrated a relationship between hepatic iron concentration and liver fibrosis in patients with chronic hepatitis C. Our aim was to compare hepatic histologic findings, iron status and other factors putatively capable of determining the severity of chronic hepatitis between menstruating women and men of comparable age. METHODS: We studied 21 consecutive hepatitis C virus (HCV)-RNA positive menstruating women and 24 consecutive HCV-RNA positive men of comparable age, who underwent liver biopsy for chronic hepatitis C. Alcohol intake was recorded and blood tests, HCV genotyping, serum iron, unsaturated iron binding capacity, serum ferritin, hepatic iron concentration, and liver histology were evaluated. RESULTS: Menstruating women showed lower grading (2.7 +/- 1.5 vs 3.6 +/- 2, P = 0.09) and significantly lower staging (1.38 +/- 1.11 vs 2.42 +/- 1.64, P = 0.037) scores than men of comparable age. Among the factors putatively capable of determining the severity of chronic hepatitis, only the hepatic iron concentration correlated with the hepatic histologic staging in a multivariate analysis. Iron-depleted women (transferrin saturation < 20% and/or serum ferritin < 9 micrograms/L) showed significant lower hepatic histologic grading (1.75 +/- 0.7 vs 3.23 +/- 1.55, P = 0.027) and staging (0.75 +/- 1.03 vs 1.77 +/- 1.01, P = 0.026) scores than women with normal iron status. CONCLUSIONS: Menstruating women with chronic hepatitis C may have a milder disease compared to men of comparable age, possibly because of menstrual blood loss and lower hepatic iron concentration. Women with chronic hepatitis C and iron deficiency have a milder disease compared to women with normal iron status, suggesting that iron deficiency results in a slower rate of disease progression.

Adult↗