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The reaction of PRL, TSH, GH, LH and FSH has been studied after the administration of TRH and LHRH to 15 acromegalic women of fertile age. According to the presence or absence of menstruation the patients were divided into 2 groups: 8 patients menstruated regularly, 7 had secondary amenorrhoea. The results of the two groups were compare with each other and to findings in a group of healthy controls (9 women). It was found that in secondary amenorrhoea basal PRL values significantly exceeded those registered in the menstruating group and in the controls. PRL reaction was similar in the controls and the secondary amenorrhoea group, but the menstruating patients showed lower values than those of the control group. TSH release did not differ in the three groups. In secondary amenorrhoea paradoxical GH-reaction after TRH-LHRH in the 15th minute significantly exceeded the value of the menstruating group and its whole course pointed to a more intensive reaction. In secondary amenorrhoea both basal LH and FSH secretion as well as LH and FSH release fell far below the values of the menstruating group. The onset of amenorrhoea was not related to the duration of acromegaly. Disturbances of gonadotrophin secretion may be induced by disorders of regulatory mechanisms as well as by the damaging effect of the adenoma on normal pituitary tissue.
Based upon a model of individual differences in menstrual experiences the study concerns the question of similarities and difference in menstrual experience and attitudes between mothers and their daughters. 60 mothers (mean age 46.5 years) and 60 daughters (mean age 19.9 years) were investigated using a comprehensive questionnaire which included standardized measures such as the German version of the Menstrual Attitude Questionnaire. Comparisons of both groups revealed significant differences in relation to sex education, preparation for menstruation, and the experience of menarche, which were described more positive by the generation of the daughters. Differences in menstrual cycle effects on wellbeing and behavior were less clear. Behavioral changes and restrictions both demonstrated the significance of the mothers influence on their daughters. Inspite of more positive conditions for a "menstruation related socialization" mothers and daughters showed only slight differences in their menstrual attitudes. This result could confirm the importance and persistence of cultural norms.
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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.
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.
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.
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.
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.
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.
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.
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.
Seventy per cent of the patients aged 45 years or under and suffering from diabetic ketoacidosis who were seen in one diabetic clinic over five years were women. The association of menstruation with ketoacidosis was assessed over two and a half years, and it was found that menstruation was associated with ketoacidosis more often than would be expected by chance (P less than 0-01). Two hundred women were interviewed and 76 observed that menstruation changed their diabetic control. Fifty-three found that control deteriorated and hyperglycaemia occurred, while 23 found that control improved and hypoglycaemia was a common problem. Menstruation appears to be an important factor in influencing control of diabetes. The mechanism of the changes observed has not yet been determined, but it seems to be a subject worthy of further investigation.
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.
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.
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.
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.
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.