Talk:Menstrual Cycle

From Embryology

Postnatal Cycle Flexibility

A recent paper has demonstrated that the human menstral cycle can be modulated postnatally by environmental conditions as measured by changes in progesterone based upon age of migration from a relatively poor environment (Bangladesh) to a relatively better environment (UK). Nunez-de la Mora A, Chatterton RT, Choudhury OA, Napolitano DA, Bentley GR. Childhood Conditions Influence Adult Progesterone Levels. PLoS Med. 2007 May 15;4(5):e167 (More? PLoS Medicine - Article)


Average Luteal Progesterone Profiles by Group.jpg
Average Luteal Progesterone Profiles by Group
SYL - resident Bangladeshi sedentees from Sylhet

ADU - adult migrants

CHI - child migrants

2ndGEN - second-generation British-Bangladeshis

WHI - British women of European descent

Unadjusted mean luteal progesterone index values. Ovulation dates were estimated from oestradiol data available for the same individual menstrual cycles.

(More? PLoS Medicine - Article)

Average Luteal Progesterone by Age at UK Migration.jpg
Average Luteal Progesterone Profiles by Categories of Age at Migration to the UK
Women who migrated during infancy and early childhood (ages 0–8 y) had a significantly earlier age at menarche.

Women who migrated after menarche, length of time spent in the UK had no significant impact on luteal progesterone levels.

(More? PLoS Medicine - Article)

Data: Nunez-de la Mora A, Chatterton RT, Choudhury OA, Napolitano DA, Bentley GR. Childhood Conditions Influence Adult Progesterone Levels. PLoS Med. 2007 May 15;4(5):e167 (More? PLoS Medicine - Article)

Menstruation in Adolescents

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644006/?tool=pubmed

  • precocious puberty has been defined as any pubertal development occurring before age 8
  • paper shows earlier timings
  • range for menstrual cycles in adolescents is wider than in adults
    • adult normal cycle length is defined as being between 21 and 34 days.

terminologies and definitions used to describe abnormalities of menstrual bleeding

Can we achieve international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding? Fraser IS, Critchley HO, Munro MG, Broder M. Hum Reprod. 2007 Mar;22(3):635-43. Epub 2007 Jan 4. PMID: 17204526 | Hum Reprod.

  • terminologies and definitions around the symptom of abnormal uterine bleeding (AUB)
  • The major recommendations were to replace terms such as menorrhagia, metrorrhagia, hypermenorrhoea and dysfunctional uterine bleeding.
  • four key ‘menstrual dimensions’ should be cycle regularity, frequency of menstruation, duration and volume of menstrual flow.
    • Regularity should be specified as irregular, regular or absent.
    • Frequency should be specified as frequent, normal or infrequent.
    • Duration should be specified as prolonged, normal or shortened.
    • Volume should be specified as heavy, normal or light.

Table VII. Suggested normal limits for menstrual parameters in the mid-reproductive years

Clinical dimensions of menstruation and menstrual cycle Descriptive terms Normal limits (5th–95th percentiles) Frequency of menses (days) Frequent <24 Normal 24–38 Infrequent >38 Regularity of menses (cycle to cycle variation over 12 months; in days) Absent — Regular Variation ± 2 to 20 days Irregular Variation greater than 20 days Duration of flow (days) Prolonged >8.0 Normal 4.5–8.0 Shortened <4.5 Volume of monthly blood loss (ml) (Hallberg et al., 1966) Heavy >80 Normal 5–80 Light <5


corpus luteum

Luteal blood flow and luteal function. Takasaki A, Tamura H, Taniguchi K, Asada H, Taketani T, Matsuoka A, Yamagata Y, Shimamura K, Morioka H, Sugino N. J Ovarian Res. 2009 Jan 14;2:1. PMC2633338]

  • During corpus luteum formation
  • active angiogenesis occurs after the ovulatory LH surge
  • corpus luteum becomes one of the most highly vascularized organs in the body PMID: 9500609
  • corpus luteum blood flow
    • necessary to provide luteal cells with the large amounts of cholesterol needed for progesterone synthesis
    • to deliver progesterone to the circulation.

Sleep, Hormones, and Circadian Rhythms throughout the Menstrual Cycle

Sleep, Hormones, and Circadian Rhythms throughout the Menstrual Cycle in Healthy Women and Women with Premenstrual Dysphoric Disorder. Shechter A, Boivin DB. Int J Endocrinol. 2010;2010:259345. Epub 2010 Jan 18. PMID: 20145718 | PMC2817387

  • relationship exists between the sleep-wake cycle and hormone secretion
  • melatonin, cortisol, thyroid stimulating hormone (TSH), and prolactin (PRL), vary across the 24-hour day and are highly regulated by the circadian and sleep-wake cycles.
  • sleep complaints commonly occur during the postovulatory luteal phase (LP) in healthy women
  • premenstrual dysphoric disorder (PMDD) - a DSM-IV classified menstrual cycle-related mood disorder

endometrial and ovarian characteristics using three dimensional power Doppler ultrasound

http://www.rbej.com/content/7/1/151

patients who finally conceived was the presence of a triple-line pattern in the endometrium

Quantity and quality of retrograde menstruation: a case control study

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2789082/?tool=pubmed

  • menstruation is associated with a higher concentration of endometrial cells in peritoneal fluid (PF)
  • comparison with the nonmenstrual phase of the cycle, analysis of PF during menstruation showed an increased concentration of leucocytes (3.3 × 109/L vs 0.8 × 109/L, P = 0.03), erythrocytes (0.3 × 1012/L vs 0.02 × 1012/L, P = 0.006), hematocrit (0.03 L/L vs 0.003 L/L, P = 0.01) and hemoglobin (0.8 g/dL vs 0.1 g/dL, P = 0.01).

luteal phase changes

Suggested changes include:

  • fluid retention, weight gain, increased energy demands, changes in glucose uptake, a slower gastrointestinal transit time, altered lipid profiles, altered vitamin D, calcium, magnesium and iron metabolism, emotional hypersensitivity, generalized pain, and changes in dietary habits.

Changes in serum calcium, magnesium and inorganic phosphorus levels during different phases of the menstrual cycle. Dullo P, Vedi N. J Hum Reprod Sci. 2008 Jul;1(2):77-80. PMID: 19562050

Women's sexual interest

http://www.ncbi.nlm.nih.gov/pubmed/19306881

Women's sexual interest changes with hormonal fluctuations across the menstrual cycle.

"The observed increase in activation in the right medial orbitofrontal cortex (OFC) during the follicular phase may reflect a hormonally mediated increase in appetitive motivation and may prime women towards increased sexual interest and behavior around ovulation."

Progesterone and Progestin Receptors in the Brain

http://www.ncbi.nlm.nih.gov/pubmed/18436712 http://endo.endojournals.org/cgi/content/full/149/6/2737