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PubMed1998

[Spontaneous menstruation in patients with Turner syndrome in our observations].

OBJECTIVES: Patients with Turner syndrome (TS) may present a wide spectrum of gonadal function including spontaneous menstruation and fertility. DESIGN: The aim of our study was to present the patients with Turner syndrome (TS) with spontaneous menstruations considering specific karyotype and X-inactivation processes. MATERIALS AND METHODS: 5 women from group of 55 patients in age from 15 to 38 years with diagnosis of TS and gonadal function were found. Clinical analysis included the evaluation of spontaneous pubertal development and hormones levels. Cytogenetic analysis was performed on peripheral blood samples using GTG banding technique. X inactivation studies were done by dynamic RBG technique. RESULTS: In two patients with mosaic karyotype and predominant 46,XX line two pregnancies were observed. They had regular menses and normal sexual development. In one patient (karyotype: 45,X[2]/46,XX[98]) spontaneous abortions and premature birth were present. Second patient was (46,XX[245]/46,X,r(X)(p22q26)[5]) in pregnancy in this time. Another three patients menstruated irregularly. The menarche appeared later. The karyotypes were: 46,X,del(X)(p11.3) in two patients and 45,X[64]46,X,r(X) (p22q26)[18]/46,XX[4] in one. CONCLUSIONS: We conclude that spontaneous menstruations and possibility of pregnancy depend on specific karyotype in patients with TS.

Adolescent↗

PubMed1999

Bone density in a population of long term oral contraceptive pill users does not differ from that in menstruating women.

Prevention of osteoporosis is a major public health issue. Amenorrhoeic women have lower bone density than normally menstruating women, which is related to the duration of amenorrhoea and the severity of oestrogen deficiency. Bone mineral density (BMD) in amenorrhoeic women can be improved by oestrogen replacement in the form of the combined oral contraceptive pill (COCP), so increased BMD might be an important non-contraceptive benefit of the COCP in menstruating women. Previous studies have been variably reported, but have used different methodologies for measurement of BMD. We measured BMD using the DEXA technique in long term COCP users and compared this with menstruating women who had never used the COCP. No differences in bone density were found, suggesting that the COCP does not improve bone mass in menstruating women who are adequately oestrogenised by their own ovaries.

Absorptiometry, Photon↗

PubMed1989

A content analysis of educational media about menstruation.

Researchers and practitioners frequently have criticized educational media's coverage of menstruation as being too oriented toward the "hygienic crisis" while de-emphasizing the emotional and other developmental aspects of puberty. In the present study, 31 audiovisual media currently available for sale/rental were reviewed for content related to the physical and psychological aspects of menstruation, the portrayal of adolescent girls, parents, and peers, and the relationship of menstruation to the developmental process. Seven films were produced by sanitary product manufacturers; 24 by other commercial filmmakers. The majority of the media depicted female anatomy by animated images and related the menstrual process to pubertal development. The relationship between menstruation and reproduction was mentioned in three cases. In general, variations in physical and emotional responses were described as normal. In all cases, fear and embarrassment were acknowledged. Openness in discussions among peers and with female adults was emphasized.

Adolescent↗

PubMed1988

Imagery associated with menstruation in advertising targeted to adolescent women.

Education about menstruation is not restricted to school instruction or information provided by adults and peers; exposure to advertisements in teen media provides imagery depicting menstruation and feminine role expectations. This paper analyzes the imagery in advertisements for sanitary products and products for the relief of menstrual symptoms. A 25% random sample of Seventeen magazine issues from 1976 to 1986 stratified by year were reviewed. A total of 135 ads for sanitary products and 32 ads for products for the relief of menstrual discomfort were analyzed. Each ad was examined for recurrent themes in text, context and tone. Data collected were examined for similarities in themes across both product type and time. The ads depict menstruation as a "hygienic crisis" that is best managed by an effective "security system" affording protection and "peace of mind." The failure of adequate protection places the woman at risk for soiling, staining, embarrassment and odor. Menstruating women are depicted as dynamic, energetic and always functioning at their optimal level. Such imagery may encourage guilt and diminished self-esteem in the adolescent who experiences discomfort. A lack of maternal, teacher or male figures in the ads is evident; the importance of peer support is reinforced.

Adolescent↗

PubMed1979

Menstruation.

Societal attitudes to menstruation are largely negative, and so serve to reinforce the inferior social status of women. These attitudes have extended into medical practice and research on menstruation. As a result, much research on 'premenstrual syndrome' has been biased both in methodology and interpretation. Correlations between hormone levels, mood changes and other behavioural measures, which cycle together, are often incorrectly assumed to indicate causal relationships. These problems are discussed along with the report of a pilot study which used a new, and more comprehensive method of studying menstruation. This study has demonstrated numerous correlations between hormone levels, mood and psycho-physical performance. A relationship was found between task performance and early education about menstruation. Studied of the kind reported here provide a basis on which to formulate new questions about causal influences, which can only be established by entirely different methods of study.

Attitude to Health↗

PubMed1978

Young adolescents' beliefs concerning menstruation.

In order to explore the early socialization of attitudes and expectations about menstruation, 54 young adolescent girls (both pre- and postmenarcheal) and boys responded to a questionnaire assessing evaluative attitudes toward menstruation, expected symptomatology, perceived effects on moods and activities, and sources of information for these beliefs. The results showed that even premenarcheal girls and young boys have a reasonably well-defined and mostly negative set of attitudes and expectations. Most believed that menstruation is accompanied by physical discomforts, increased emotionality, and a disruption of activities and social interactions. Although the responses of the 3 groups were remarkably similar, premenarcheal girls had a somewhat less negative evaluation of menstruation than both postmenarcheal girls and boys. Other analysis showed that symptom expectations for "girls in general" were more severe than for selves, though these 2 sets of responses were highly correlated. On the basis of these findings and the data concerning sources of information, the possible role of socialization processes in the menstrual experience is discussed.

Adolescent↗

PubMed1993

Effects of breast feeding after resumption of menstruation on waiting time to next conception.

We investigate the association between breast feeding after resumption of menstruation and the duration from resumption of menses to the next conception. Data from a survey, "Breast-Feeding and Its Effect on Fertility," conducted in 1987 under the auspices of the Centre of Population Studies, Banaras Hindu University, India, were used. We used hazard models of conception rates after the return of menstruation with breast-feeding duration as a time-dependent covariate. The interaction of breast-feeding duration after resumption of menses and postpartum amenorrhea have a significant effect on the rate of conception after return of menses. After resumption of menstruation, when there is no breast feeding, the risk of conception increases with the increase in postpartum amenorrhea. However, breast feeding attenuates the effects of postpartum amenorrhea. These results suggest that breast feeding beyond the resumption of menstruation plays a significant role in the proximate determinants to reduce fertility.

Adult↗

PubMed1983

Recollections of menarche and women's subsequent experiences with menstruation.

Seventy college women aged 18 to 22 and 67 older women aged 30 to 45 completed a questionnaire comprised of multiple choice and open-ended questions covering recollections of menarche, preparation for menstruation, menstrual symptoms, and current attitude. The hypothesis that menarche was a significant developmental event that would be readily recalled by a majority of women regardless of age was confirmed. Almost all of the women remembered their first menstruation and the early experiences described by both groups were similar. Most women felt they were adequately prepared and a significant relationship was found between adequacy of preparation and positive reaction to menarche among the college women. Both groups reported a similar incidence of menstrual pain, bleeding, and amenorrhea. However, the incidence of menstrual symptoms in adult women was not significantly related to preparation for menstruation or to whether or not menarche was a positive event.

Adolescent↗

PubMed1994

Blood flow velocity in the uterine and ovarian arteries during menstruation.

Eleven healthy women with regular menstrual cycles were examined with a combination of two-dimensional real-time ultrasound and color and spectral Doppler techniques on the 7th day after follicular rupture, and on the 1st, 2nd, 3rd and 4th days of menstrual bleeding. Both uterine arteries, arteries in the stroma and hila of both ovaries, in the wall of the largest follicle of the non-dominant ovary and in the wall of the corpus luteum were examined with the Doppler technique. The pulsatility index (PI) and the time-averaged maximum velocity were calculated. In the uterine arteries, the PI was highest on the first day of menstrual bleeding (median PI 3.2 for the dominant and 3.0 for the non-dominant uterine artery), after which it decreased to its lowest values on the second day (median PI 2.1 and 1.8, respectively) and third day (median PI 2.2 and 2.1, respectively). The time-averaged maximum velocity reached its highest value on the second and third days of menstruation. The corpus luteum was still visible on the first day of menstrual bleeding in all women, and on the second day in five. It was indistinguishable on the third and fourth days of menstruation in all women. In the dominant ovary, the time-averaged maximum velocity of flow in the arteries in the ovarian hilum decreased during menstrual bleeding and was lower during menstruation than in the preceding luteal phase. In the non-dominant ovary, neither the PI nor the time-averaged maximum velocity manifested any consistent changes during the period studied. We conclude that substantial changes in PI and time-averaged maximum velocity occur in the uterine arteries and in the arteries of the dominant ovary during menstruation.

Journal Article↗

PubMed2001

Effect of menstruation and intrapelvic injection of endometrium on inflammatory parameters of peritoneal fluid in the baboon (Papio anubis and Papio cynocephalus).

OBJECTIVE: Our purpose was to test the hypothesis that menstruation and intrapelvic injection of endometrium for the induction of endometriosis affect inflammatory parameters in peritoneal fluid from baboons. STUDY DESIGN: In the first part of this study, 107 laparoscopies were performed in 62 female baboons with a normal pelvis during menstruation, the follicular phase, and the luteal phase. In the second part of this study, 21 baboons were studied during paired laparoscopies in the follicular phase and the luteal phase of the cycle. In the third part of this study, 11 baboons were studied by paired laparoscopies during menses and during the nonmenstrual phase of the cycle. In the fourth part of this study, paired laparoscopies were performed in 7 baboons before and after intrapelvic injection of endometrium. Peritoneal fluid was aspirated and measured in all laparoscopies and assessed for leukocyte concentration. In the third and fourth parts of the study, peritoneal fluid was analyzed for the concentrations of inflammatory cytokines and for the proportions of cells with immunohistochemical staining positive for these cytokines. RESULTS: During menstruation, in comparison with nonmenstrual phases of the cycle, the leukocyte concentration of the peritoneal fluid was increased significantly, as were the proportions of peritoneal fluid cells with positive staining for tumor necrosis factor alpha, transforming growth factor beta(1), and intercellular adhesion molecule 1 and the peritoneal fluid concentrations of transforming growth factor beta(1) and interleukin 6. After intrapelvic injection of endometrium, the peritoneal fluid leukocyte concentration and the proportions of peritoneal fluid cells with positive staining for tumor necrosis factor alpha, transforming growth factor beta(1), CD3, and human leukocyte antigen (DR locus) significantly increased. CONCLUSION: Subclinical peritoneal inflammation occurs in baboons during menstruation and after intrapelvic injection of endometrium.

Animals↗

PubMed1979

The timing of menstruation-related symptoms assessed by a daily symptom rating scale.

A daily symptom rating scale (DSRS) was constructed from items previously used in questionnaires and rating scales measuring menstrual symptoms. The DSRS was found to have adequate reliability and validity. The profiles of symptom intensity of 65 women, mainly hospital staff, median age 19, during one menstrual cycle, with particular emphasis on the premenstrual week and menstruation are reported. Significant differences in ratings during the cycle were found. Ratings increased during the premenstrual week and were maximal on the days immediately preceding and following the onset of menstruation. No abrupt decline in ratings was found when menstruation commenced. Results were compared with answers to a menstrual distress questionnaire, previously administered to the same women and the questionnaire results were in good agreement with DSRS results on the day of maximum symptom intensity (the day immediately before or the day immediately after the onset of menstruation.

Adolescent↗

PubMed1988

Serum CA 125 levels in patients with endometriosis: changes in CA 125 levels during menstruation.

We investigated serum CA 125 levels in 120 patients with benign gynecologic disease, and examined variations in CA 125 levels during the menstrual cycle in six normally cycling women. CA 125 levels were elevated transiently during menstruation, suggesting that blood samples taken during menstruation can give a false-positive result. Whereas the CA 125 values during the nonmenstrual part of the cycle were significantly higher in the patients with adenomyosis and advanced endometriosis (stages III and IV) than in those with a normal pelvis, there was no difference between the patients with mild endometriosis (stages I and II) and the normal-pelvis group. CA 125 levels during menstruation were significantly elevated, not only in women with adenomyosis and advanced endometriosis, but also in those with mild endometriosis, compared with those with a normal pelvis. These data suggest that the measurement of serum CA 125 during menstruation may increase the rate of detection of endometriosis over that in studies done during other phases of the cycle.

Antigens, Neoplasm↗

PubMed1982

Symptoms associated with menstruation.

Symptoms associated with menstruation during the teenage and young adult years may represent a spectrum of possibilities varying from a relatively benign deviation from normal to a serious life-threatening disease. Nevertheless, even for the young woman found to be without serious disease, menstrual problems have special meaning associated with the fear of being different from peers, concern about being less than complete or wholesome, and anxiety regarding future functioning as a normal woman. The physician must be aware of the adolescent's sensitivity in this area. Her apprehension should influence the manner in which the various abnormalities of menstruation are evaluated and managed. The physician must understand and appreciate the potential for profound emotional effects and psychological implications of menstrual conditions. The manner in which we care for the adolescent with menstrual symptoms will determine to a significant degree how successfully the patient will cope with abnormalities of menstruation.

Adolescent↗

PubMed2000

[The experience of menstruation and its disorders in 603 women using contraception in 1999].

AIM: An epidemiological survey completed during the first quarter of 1999 assesses the frequency of menstrual disorders as well as their effects on the lives of women using contraception. MATERIALS AND METHODS: The results presented involve a sample of 603 women, with 405 using the pill and 198 fitted with an IUD. The average age of onset of menstruation in the sampled population was 12.8 years. Although most women declared that they felt no anxiety at the time, over one-third of the women surveyed explained that they felt a certain hesitancy in discussing the topic. Even today, certain feelings, such as shame or pride, are still evoked in the interviews. Although over half believe that it is normal to menstruate, the process is nevertheless considered "somewhat bothersome" by certain women who also refer to "purification." Traditional cultural perspectives remain a strong influence. Menstrual disorders predating the initial use of contraception were reported in 150 women (occasional intermenstrual bleeding, 130 cases; other anomalies excluding metrorrhagia, 27 cases). Even if most of the women believe these problems to be inevitable, they also claim to be relatively troubled by these disorders, which often involve a considerable degree of discomfort. Such disorders are significantly more frequent in the "IUD" group, as well as in women who claim a very early onset of menstruation and those who consider explanations provided by the physician as "insufficient." CONCLUSION: The difference creates a certain fear with respect to any social or individual norm that may have been internalized. Thus the information presented in this study may provide ways and means to better understand women in general and our women patients in particular.

Adolescent↗

PubMedDate not supplied

Symptoms related to menstruation in adolescent Swiss girls: a longitudinal study.

Symptoms related to menstruation are reported in 140 Swiss girls according to postmenarcheal and chronological age. Premenstrual abdominal pains were present in 9-28% of the girls, depending on postmenarcheal age (i.e. years after menarche) (2-30% depending on chronological age). Dysmenorrhoea occurred in 44-64% of the girls according to postmenarcheal age (51-67% according to chronological age). Occasional severe dysmenorrhoea was the type most often reported, by 20-35% of the girls. Large intra-individual and inter-individual variabilities in the occurrence and severity of dysmenorrhoea were observed. The frequency of dysmenorrhoea increased in the first three postmenarcheal years and decreased thereafter. The prevalence of premenstrual headache was low, 0-5%. The frequency of headache during menstruation was 2-11% according to postmenarcheal age (2-19% by chronological age) which was low in comparison with other studies. Severe menstrual headache was more often reported than mild headache. Frequency of severe headache decreased in higher age groups. Other reported symptoms related to menstruation were general discomfort in 1-10% of the girls and premenstrual vaginal discharge in 10-22% according to postmenarcheal age (3-17% according to chronological age). Severe vaginal discharge was more frequent than mild discharge, 8-20% versus 0-3%. The frequency of vaginal discharge increased from the first to the fourth year after menarche.

Abdomen↗

PubMed2006

Disorders of menstruation and their effect on the quality of life in women with congenital factor VII deficiency.

AIMS AND OBJECTIVES: To review menstrual problems in women with congenital FVII deficiency and to study their effect on the quality of life during menstruation in women with congenital FVII deficiency. METHOD: 14 women with congenital factor VII deficiency registered with the Haemophilia Centre at the Royal Free Hospital were interviewed and their case notes reviewed. All women completed Pictorial Blood assessment Chart (PBAC) for assessment of menstrual blood loss and a quality of life questionnaire during menstruation. Similar questionnaire and PBAC was completed by an age matched healthy control group of 23 women. RESULTS: Median age of study group was 35 yrs and of control group 34 yrs. Median FVII level of the study group was 31.5 IU/dL Two women had severe FVII deficiency (FVII level < 10 IU/dL) and 12 women had mild-moderate FVII deficiency. 57% women (8/14) from study group had menorrhagia (PBAC score > 100) compared with 17% (4/23) women from the control group. Six women (43%) from the study group were diagnosed with anaemia due to heavy periods, compared to two (9%) in the control group. The quality of life scores during menstruation were significantly worse in the women with FVII deficiency, compared to controls. CONCLUSION: Women with factor VII deficiency exhibit a spectrum of bleeding symptoms, menorrhagia being one of the commonest symptoms. This has adverse effect on their quality of life.

Activities of Daily Living↗

PubMed1996

Coitus and menstruation in perimenopausal women.

The objective of the study was to determine whether coitus during menstruation in perimenopausal women is associated with increased menstrual flow defined as either heavier flow, more days of flow, or both. Initial interviews for the Stanford Menopause Study were conducted locally with 160 perimenopausal women. Six weeks later, additional data were gathered from 121 women. At a third interview, 6-10 weeks later at Stanford University, 56 of 57 subjects (mean age 48.8 +/- 3.9 SD) provided data on menstrual flow and coital behavior. At both the first and third interview, more than half of the women reported a pattern of increased menstrual flow. At the third interview, 83% of those reporting increased menstrual flow also reported a behavioral pattern of coitus during menses. Only 10% with diminished flow acknowledged such a pattern. Women who abstained from sex during menses were not less regular in coital activity at other times nor did the data reveal them to be less orgasmic than women who did not abstain. Our data reveal an association between coitus during menstruation and longer and/or heavier menstrual flow. The etiology of such increased flow is usually believed to be hormonal, but coitus during menstruation may be another important variable.

Coitus↗

PubMed2000

Menstruation in schoolgirls--1: The normal menarche.

The mean age for onset of menstruation (menarche) is 12.8 years. Many schools teach girls about puberty and menstruation and prepare them for the menarche. The school nurse has a valuable part to play in all aspects of menstruation in schoolgirls, psychological as well as physical. The early periods may be irregular and vary markedly in the amount of blood loss. It can take up a year or more for a steady pattern to develop. Dysmenhorrhoea may occur, which may be mild or of the severe spasmodic type. Premenstrual tension syndrome is less common in schoolgirls. Girls should be taught about the importance of hygiene, especially if tampons are used.

Adolescent↗