Disturbances In Women Research Articles

Metabolic Disturbance in Women with Polycystic Ovary Syndrome and its Impact on Bone Turnover

Background: Insulin resistance and abdominal obesity are main characteristics of polycystic ovary syndrome, women with this syndrome at high risk for prolong term metabolic disorders. Obesity, insulin resistance, and hyperinsulinemia affect the hormones that control calcium homeostasis. Lower levels of serum vitamin D and higher levels of serum parathyroid hormone were found in women with polycystic ovary syndrome. However, high levels of parathyroid hormone can reduce bone mineral density and increase bone turnover. Objectives: The present study aimed to measure the parameters of bone metabolism including parathyroid hormone, calcium, and phosphorous in serum of women with polycystic ovary syndrome and compare their levels with healthy controls. Also, investigate the possible impact of metabolic alterations in polycystic ovary syndrome on bone turnover. Material and Method: This case-control study included 82 women from 20 to 37 years of age. All women were selected from Infertility Center in Baghdad Teaching Hospital during the period from 1 June 2019 to 30 August 2019. Women were divided into two groups: group (1) involved 42 women with polycystic ovary syndrome and group (2) involved 40 healthy women (act as controls). Each Serum specimen was analyzed for the measuring of parathyroid hormone, calcium, phosphorous, fasting insulin, fasting glucose, and homeostasis model assessment of insulin resistance (HOMA-IR). Results: Significantly higher serum levels of parathyroid hormone, calcium,fasting insulin, and fasting glucose with lower levels of serum phosphorous in women with polycystic ovary syndrome as compared with healthy women. In addition, significant positive correlation was found between serum parathyroid hormone and waist circumference (r=0.609, p=0.00001) as well as between serum parathyroid hormone and HOMA-IR (r= 0.781, p=0.00001). Conclusion: The metabolic disturbance found in polycystic ovary syndrome tend to support the relation between this syndrome and defective bone metabolism. High prevalence of obesity and high levels of insulin, HOMA-IR, and parathyroid hormone were found in women with this syndrome which in turn affect bone turn over. Thus, women with polycystic ovary syndrome are at risk for the development of metabolic bone disease.

Neuroprotective Effect of Cyperi rhizome against Corticosterone-Induced PC12 Cell Injury via Suppression of Ca2+ Overloading.

Cyperi Rhizoma (CR) is a well-known functional food and traditional herbal medicine in Asian countries for the treatment of menstrual or emotional disturbances in women. Recent studies have shown the pharmacological effects of CR on neuronal diseases, such as Parkinson’s disease (PD) and depression. Thus, the neuroprotective effect of CR might play a vital role in exerting its effect. Here, corticosterone-induced PC12 cells were applied to screen the active fraction of CR and evaluate its neuroprotective effect. The results indicated that the fraction containing medium-polarity chemical constituents (CR-50E) displayed the best protection effect. CR-50E could increase the cell viability and reduce cell apoptosis through inhibiting oxidative stress and decreasing the lactate dehydrogenase LDH release induced by corticosterone. Further, the mechanism of action was explored by cell metabolomics. The result showed CR-50E mediated the sphingolipids metabolism of corticosterone-induced PC12 cells, which suggested inhibition of Ca2+ overloading may involve the protection of CR-50E against cell damage. The expression levels of three key proteins in calcium transport, including phospholipase A2 (PLA2), calcium/calmodulin independent protein kinase II (CaMK II), and caspase-3, confirmed the above result by Western blot. The findings suggest that CR-50E can suppress the disequilibrium of calcium homeostasis-mediated apoptosis by improving the abnormal sphingolipids metabolism as well as remedying the damage of the cell membrane.

New approach of risk factors and background diseases role in acute ischemic stroke in elderly and senile-aged patients in Uzbekistan

We aim to study the characteristics of risk factors and background diseases in elderly and senile patients with acute ischemic stroke (AIS). In-depth analysis included 282 observations of different types of AIS in individuals aged 42–60 years (95 observations), elderly (133 patients aged 60–74 years) and senile (54 patients aged 75–90 years) age. Among people aged 42–60 years, there was a 2-fold predominance of men with AIS (66.2%) as compared with senile aged patients (31.5%). The pattern of prevalence of women with age was established, so if at the age of 42–60 years their percentage with AI was 33.7%, then at the age of 75–90 years - 68.5%. Among men aged 42–60 years and 60–74 years, there was a significant (P < 0.05) prevalence of Atherotrombotic Stoke (AS) (p < 0.05), which was 65.6% and 66.7%, respectively, compared with 21.9% and 31.1% of AS observations in women. Patients aged 42-60 years in the structure of background diseases revealed the prevalence of arterial hypertension (AH) (90.5%), the presence of atherosclerosis (87.4%) of cardiac rhythm and rheumatism (45.3 and 47.4%, respectively), diabetes mellitus (23.2%). There was a significant predominance of atherosclerosis, arterial hypertension, ischemic heart disease, TIA, rheumatism in men (p < 0.05), and diabetes mellitus and heart rhythm disturbances in women (p < 0.05). There was a leveling of gender differences in the structure of background diseases due to an increase in the proportion of atherosclerosis in women (p < 0.05), and diabetes in elderly men (p < 0.05).

Assessment of hemostatic disturbances in women with established rheumatoid arthritis

ObjectivesThis study was aimed to assess hemostatic disturbances in female patients with established rheumatoid arthritis (RA) in relation to menopausal status and disease activity.MethodNinety women were included in the study, 42 patients and 48 age-matched healthy controls. There were no differences between the investigated groups regarding the presence of traditional cardiovascular risk factors. Two global hemostatic assays were employed, namely endogenous thrombin potential (ETP) and overall hemostasis potential (OHP). The parameters of the ETP assay (ETP, C-max, t-lag, t-max) and OHP assay (overall coagulation potential (OCP) and overall fibrinolytic potential (OFP)) were assessed. Moreover, the parameters of the fibrin clot (lag time, Max Abs, and slope) were measured by clot turbidity and scanning electron microscopy (SEM). Both patients and controls were divided into four subgroups according to menopause status.ResultsThe premenopausal controls differed significantly from all other subgroups in terms of diminished levels of ETP (p = 0.02), C-max (p = 0.01), OCP (p = 0.02), OHP (p = 0.001), and Max Abs (p = 0.008), while OFP (p = 0.0001) was increased. This tendency was not seen in the premenopausal RA patients compared with the postmenopausal RA patients. SEM images showed denser clots composed of thinner fibers in samples from RA patients. The disease activity measured by DAS28 correlated with OCP and OHP (r = 0.54; p = 0.001 and r = 0.44; p = 0.003, respectively) indicating persistent hypercoagulable condition in the whole group of RA patients.ConclusionsOur results point towards coagulation activation in premenopausal women with established RA. The patients were well characterized, which enabled assessment in a real-life setting.Key Points• Extensive assessment points towards persistent coagulation activation in premenopausal women with established rheumatoid arthritis.• Impaired thrombin generation and fibrin formation are associated with menopause in healthy women, while rheumatoid arthritis closes the gap within patients regarding menopause.• Fibrin morphology is unfavorably altered and fibrinolysis is decreased in patients with established rheumatoid arthritis.• Increased activity of thrombin activatable fibrinolysis inhibitor (TAFI) may contribute to impaired fibrinolysis in patients with rheumatoid arthritis.

MON-212 Relevance of Fasting and Oral Glucose Tolerance Testing (OGTT)-derived Metrics of Insulin Resistance on Capturing the Impact of Glucoregulatory Status on Reproductive Disturbance in Women

Rationale. Hyperandrogenism, a cardinal feature of polycystic ovary syndrome (PCOS), is associated with metabolic comorbidities, particularly insulin resistance (IR). Compensatory hyperinsulinemia is posited to augment ovarian androgen production, either via increased luteinizing hormone (LH) or directly on ovarian thecal cells. The degree to which this pathophysiology can be detected in women without extreme manifestations of hyperinsulinemia is unclear, and contributes to uncertainty regarding the impact of IR on ovarian folliculogenesis. Further, the use of numerous surrogate indices of IR have likely contributed to the conflicting evidence on the strength and directionality of associations between IR, androgen production and ovarian follicle populations. Objective. To investigate the degree to which fasting- and OGTT-derived surrogate indices of IR are associated with LH, total testosterone (TT) or ovarian morphology in a sample of women spanning regular cycles, normoandrogenic anovulation (NA-Anov) and hyperandrogenic anovulation (HA-Anov). Methods. Women with HA-Anov (biochemical and/or clinical HA and irregular cycles; N=44), NA-Anov (irregular cycles and absence of clinical and/or biochemical HA; N=31) and controls (regular cycles and absence of clinical or biochemical HA; N=42) underwent a transvaginal ultrasound, OGTT and physical exam to assess hirsutism and anthropometry. Follicle number per ovary (FNPO) were determined from offline assessments using the Grid Method. Blood samples were analyzed for glucose, insulin, LH, and TT. The degree of association between IR metrics and LH, TT and FNPO 2-9mm were evaluated using Pearson correlation coefficients or partial correlations, accounting for BMI where appropriate. Results. AUCinsulin and WBISI, as OGTT-derived indices of IR, were associated with increased LH (P<0.05) and TT (P<0.05) whereas the Stumvoll indices (original and Tosi) were only associated with LH (P<0.05). None of the OGTT-derived measures were associated with FNPO. In contrast, no fasting measure of IR was associated with LH and only HOMA-IR showed a weak correlation with TT (P<0.05). Further, increasing IR as judged by HOMA-IR, QUICKI and FGIR were associated with fewer follicles (P<0.05). Conclusions. OGTT-derived measures reflect perturbations in LH and TT production, versus fasting measures which more closely associate with changes in ovarian morphology. These data suggest that markers that capture peripheral IR and compensatory hyperinsulinemia best align with endocrinological disturbances whereas changes in ovarian morphology may parallel hepatic IR and β-cell function which reflect more progressed disruptions in glucoregulatory status. Support: Cornell, CIHR, NIH/NCATS, USDA

0849 Sleep Disturbance in Women with and Without HIV: The Role of Psychosocial Factors

0849 Sleep Disturbance in Women with and Without HIV: The Role of Psychosocial Factors

Determinants of Insomnia among Mothers during Postpartum Period in Northwest Ethiopia.

Objective Postpartum period is a state of instability that may be accompanied by mood liability, anxiety, insomnia, and neuropsychiatric disturbance in women. This neuropsychiatric disturbance has a negative influence on the child's psychological and physical development. Our aim was to see the level of sleep difficulties among postpartum mothers in three obstetric care settings in Ethiopia. Method Institutional based cross-sectional study was conducted at one referral hospital and two health centers. A total of 988 postpartum mothers had been interviewed for sleep difficulties by using Athens Insomnia Scale (AIS). Adjusted Odd Ratio (AOR) and 95% Confidence Interval (CI) were used and P-value <0.05 was used for indicating significant variables. Result The prevalence of sleep difficulty between four to six weeks of postpartum period was 21.8% (215/988). Marital status of divorced/widowed/separated [AOR= 2.29, 95% CI (1.40, 6.08)], no educational opportunity [AOR= 2.35, 95% CI (1.57, 3.51)], having poor social support [AOR=2.82, 95% CI (1.63, 4.88)], alcohol use [AOR=1.58, 95% CI (1.13, 2.22)], history of depression [AOR=1.93, 95% CI (1.13, 3.31)], and who has poor support from husband [AOR=1.94, 95% CI (1.18, 3.18)] had association with sleep difficulty. Conclusion There is a high magnitude of sleep difficulties during four to six weeks of postpartum period in postpartum mothers and they are associated with many preventable risk factors.

Sleep disturbance in women who undergo surgical menopause compared with women who experience natural menopause

Women who undergo surgical menopause (SM) experience a relatively more acute and precipitous drop of estrogen compared with women who experience natural menopause (NM). Few studies, however, have compared sleep quality in women who experience natural versus SM. Participants were 526 postmenopausal women (mean age 60.2 ± 7.64). All participants completed self-report questionnaires about insomnia symptoms, sleep-interfering behaviors, depression, sleep quality, and gynecological history. Analysis of covariance was conducted to compare women who experienced NM versus SM on sleep variables. Logistic regression analysis was used to determine whether NM or SM groups predicted insomnia status. Regression-based moderation analysis was conducted to explore the moderating effect of type of menopause on the relationship between sleep-interfering behaviors and insomnia symptoms. Among the sample, 81.6% (n = 429) reported going through NM and 18.4% (n = 97) reported going through SM. The SM group was significantly younger by 7.2 years (P < 0.001). Women in the SM group reported significantly worse sleep quality (P = 0.007), especially for sleep duration (P = 0.001) and habitual sleep efficiency (P = 0.010) compared with women in the NM group. Regression analysis indicated that individuals in the SM group were 2.131 (95% CI 1.055-4.303) times more likely to have insomnia compared with the NM group (P = 0.027). In addition, women in the SM group who displayed more sleep-interfering behaviors also had a higher severity of insomnia symptoms compared with women who experience NM (ß = 0.26, P = 0.03). Menopause can be both physically and psychologically challenging, but women who undergo SM experience worse sleep quality compared with women who experience NM, and may benefit from behavioral interventions.

Sleep disturbances in women with and without polycystic ovary syndrome in an Australian National Cohort.

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. Sleep disturbances may be more prevalent in PCOS. It is not known if this relationship is independent of other factors. To examine the prevalence of sleep disturbances in a large community-based cohort study in women with and without PCOS and its relationship to clinical, demographic and comorbid factors. We examined data from survey 5 (2009) of the Australian Longitudinal Study on Women's Health (n=6578, n=484 PCOS and n=6094 non-PCOS). Sleep duration and disturbances were self-reported. Three classes of sleep pattern were derived during latent class analysis (normal sleep duration with average sleep, normal sleep duration with sleep symptoms and short sleep duration with sleep symptoms) and compared between women with and without PCOS using multivariate regression, adjusting for body mass index (BMI), depressive symptoms, demographic and comorbid factors. Women with PCOS had similar sleep duration but were more likely to experience difficulty sleeping often (RRR 1.67, 1.20-2.33, P=0.003) and sometimes (RRR 1.39, 1.07-1.80, P=0.015), with restless sleep reported occasionally (RRR, 1.35 1.00-1.83, P=0.049). They reported severe tiredness often (RRR 1.48, 95% CI 1.08-2.04, P=0.016) and described more sleep difficulties within the last 12months (OR 1.29, 1.04-1.60, P=0.018) on adjusted analyses. Compared to the class of average sleep duration with no sleep disturbances, PCOS was associated with increased relative risk of having average sleep duration with sleep symptoms (RRR 1.40, 95%CI 1.11-1.77, P=0.004) and short sleep duration with sleep symptoms (RRR 1.46, 95%CI 1.07-1.99, P=0.016) on adjusted analyses. Sleep disturbances are more prevalent amongst women with PCOS after adjusting for BMI, depressive symptoms, demographic and comorbid factors. Targeted screening and management of sleep disturbances is warranted in PCOS.

Time Course of Attentional Biases Toward Body Shapes in Women Who Are Overweight or Obese

Although attentional bias toward body-related stimuli has been implicated as a vulnerability factor for body image disturbances, the time course of attentional biases toward body shapes in women who are overweight or obese is not clear. Using a dot-probe task and a between-subjects design, we assessed attentional biases (including facilitated attention, delayed disengagement, and avoidance) toward fat and thin body images in women who were overweight or obese (body mass index, BMI ≥ 25 kg/m2; n = 25) and normal-weight controls (BMI < 25 kg/m2; n = 25). Three stimulus presentation times were used: 100 ms, 500 ms, and 2000 ms. Women who were overweight or obese reported a stronger relative preference for Thin over Neutral images. All participants showed attentional bias toward thin body images in the initial orientation (100 ms) and later avoidance (2000 ms) stage, whereas only the women who were overweight or obese showed a bias toward fat body-related images when displayed for 500 ms, indicating difficulty disengaging from fat body-related stimuli. Slower attentional disengagement from fat body stimuli might be a cognitive marker for body image disturbance in women who are overweight or obese.

Pericardial Fat Relates to Disturbances of Glucose Metabolism in Women with the Polycystic Ovary Syndrome, but Not in Healthy Control Subjects.

Objective The objective of the present study is to investigate the relationship of cardiac fat depots with disturbances of the carbohydrate metabolism in women with PCOS. Methods An oral glucose tolerance test (OGTT) was realized, and metabolic parameters were collected in 48 women with PCOS and in 20 controls. Intramyocardial fat (MYCL) and pericardial fat (PERI) were measured using 1H-magnetic resonance spectroscopy and imaging. Results Only in PCOS women, PERI was positively and independently related to parameters of glucose metabolism (HbA1c: p = 0.001, fasting plasma glucose: p < 0.001, stimulated glucose at 30 and 60 minutes in the OGTT). Thus, the disposition index, insulin sensitivity, and adiponectin also declined with the increase of PERI in women with PCOS; however, these results were not independent of BMI and age. In addition, PERI was positively related to atherogenic lipid profiles, BMI, waist circumference, CRP, and liver fat in women with PCOS. A negative relation of PERI with triglycerides and a positive relation with BMI and waist circumference could be observed in the controls. No relationship of MYCL with diabetes-specific parameters could be found in the study population. Conclusion PERI is related to metabolic disturbances in women with PCOS, but not in metabolically healthy lean subjects. This clinical trial was registered at ClinicalTrials.gov and has the registration number NCT03204461.

Pilot randomized controlled trial of auricular point acupressure for sleep disturbances in women with ovarian cancer.

Sleep disturbance is a significant problem affecting around 50% of cancer patients. Non-pharmacological interventions can be used to improve sleep quality in cancer patients, but little is known about the feasibility, acceptability, and effectiveness of auricular point acupressure (APA) to reduce sleep disturbance in women with ovarian cancer undergoing chemotherapy. A pilot randomized controlled trial was conducted at a publicly funded hospital in southern Taiwan. Fifty-five eligible women were approached and 47 women participated. Women randomly assigned to the control group (n = 24) received sleep hygiene practices alone. Women in the intervention group (n = 23) received sleep hygiene practices and APA treatment which involved gentle fingertip pressure at acupoints on the external ear. The Pittsburgh Sleep Quality Index (PSQI) was completed at four time points. Forty women completed the trial giving a retention rate of 85%. Women receiving the intervention reported a 65% reduction in sleep disturbance according to PSQI global scores from Time 1 (mean = 13.2) to Time 2 (mean = 4.65) after 4 weeks of APA treatment. There was a further 10% decrease in PSQI scores at Time 3 (mean = 4.21) after 6 weeks of APA treatment. Compared to controls, women receiving APA had significantly lower PSQI mean global scores at both Time 2 and Time 3 (p < .001). APA treatment for women with ovarian cancer produced significantly improved sleep. Participants found the procedure easy to perform. Pilot findings support the feasibility of a longitudinal study with a larger, representative sample.

Oral glucose tolerance test vs fasting plasma glucose determination for the assessment of glucose metabolism disturbances in women with Polycystic Ovary Syndrome

Oral glucose tolerance test vs fasting plasma glucose determination for the assessment of glucose metabolism disturbances in women with Polycystic Ovary Syndrome

Computed tomography predictors of mortality, stroke and conduction disturbances in women undergoing TAVR: A sub-analysis of the WIN-TAVI registry

BackgroundAortic valve calcification patterns were associated with short- and long-term outcomes in previous small observational datasets of patients undergoing transcatheter aortic valve implantation (TAVI). The specific impact of multi detector-row computed tomography (MDCT) findings on outcomes in women has not been reported. We sought to describe the associations between MDCT characteristics and clinical outcomes in a registry of 547 women undergoing TAVI. MethodsWIN-TAVI is the first all-female registry to study the safety and effectiveness of TAVI in women (n = 1019). Thirteen sites participated in the MDCT sub-study and contributed pre-TAVI MDCT studies in 547 consecutive subjects. All MDCT data were analyzed in an independent core lab blinded to clinical outcomes. Key measurements included number of valve leaflets, aortic annulus area and perimeter, left and right coronary artery height, aortic cusp calcium volume, commissural calcification and left ventricular outflow tract (LVOT) calcification. Calcium volume of the aortic valvular complex was quantified using a threshold relative to patient-specific contrast attenuation in the arterial blood pool. We examined univariate and multivariate associations between ECG-gated contrast MDCT characteristics and 1-year mortality or stroke, new pacemaker implantation and new onset atrial fibrillation (AF). ResultsThe CT sub-study sample had a mean age of 82.8 ± 6.3 years, mean logistic EuroSCORE of 17.8 ± 11.3%, and mean STS score of 8.2 ± 7.4%. Transfemoral access was used in 89.6% of patients. After multivariate adjustment, moderate or severe LVOT calcification was an independent predictor of 1-year mortality or stroke (HR = 1.91; 95% CI: 1.11–3.30; p = 0.02). Calcium volume in the right coronary cusp was an independent predictor of new pacemaker (HR = 1.18 per 100 m3 increment; p = 0.04), whereas calcium volume of the non-coronary cusp had a protective effect (HR = 0.78 per 100 mm3 increment; p = 0.004). Severe calcification of the non-coronary/right-coronary commissure was an independent predictor of new AF (HR = 5.1; p = 0.008). ConclusionComputed tomography provides important prognostic information in women undergoing TAVI. Moderate or severe LVOT calcification is associated to an almost two-fold increased risk of mortality or stroke at one year. Different calcification patterns of the aortic valve may predict diverse rhythm abnormalities.

Sleepwear with lateralized thermal properties for the treatment of sleep disturbance in women

PurposeThe authors’ innovation is specially constructed sleepwear – which the authors have dubbed “Janus Sleepwear” – for the treatment of sleep disturbance caused by thermal dysregulation, a problem most often seen in women. The authors have designed and tested a simple and comfortable garment with lateralized thermal properties that promotes either thermal conduction or thermal insulation depending upon body position. This innovation will allow sleepers to auto-regulate proximal skin temperature through subtle movements during brief transient arousals, preserving overall sleep architecture. The paper aims to discuss this issue.Design/methodology/approachThe authors have constructed several prototypes of sleepwear with lateralized thermal properties and conducted small-scale piloting of the garment. Volunteers wore the special sleepwear while awake and performed a series of controlled body position changes. Temperature at several proximal anatomical sites was monitored using temperature sensors known as iButtons.FindingsJanus Sleepwear can facilitate more rapid cooling, compared to control sleepwear, when the conductive side faces the ambient environment and can maintain temperature with less loss of heat when the insulating side faces the ambient environment.Originality/valueThermoregulation plays a key role in promoting and maintaining sleep. Thermal dysregulation and sleep disturbance most commonly occur in women. Sensitivity to ambient temperature stressors suggests it may prove beneficial for such women to maintain as narrow a temperature range as possible during sleep. A person wearing Janus Sleepwear will be able to effectively “steer” her body in response to subjective and subconscious perceptions of thermal discomfort to maintain optimal conditions while asleep.

Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies.

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting the reproductive, metabolic and psychological health of women. Clinic-based studies indicate that sleep disturbances and disorders including obstructive sleep apnea and excessive daytime sleepiness occur more frequently among women with PCOS compared to comparison groups without the syndrome. Evidence from the few available population-based studies is supportive. Women with PCOS tend to be overweight/obese, but this only partly accounts for their sleep problems as associations are generally upheld after adjustment for body mass index; sleep problems also occur in women with PCOS of normal weight. There are several, possibly bidirectional, pathways through which PCOS is associated with sleep disturbances. The pathophysiology of PCOS involves hyperandrogenemia, a form of insulin resistance unique to affected women, and possible changes in cortisol and melatonin secretion, arguably reflecting altered hypothalamic–pituitary–adrenal function. Psychological and behavioral pathways are also likely to play a role, as anxiety and depression, smoking, alcohol use and lack of physical activity are also common among women with PCOS, partly in response to the distressing symptoms they experience. The specific impact of sleep disturbances on the health of women with PCOS is not yet clear; however, both PCOS and sleep disturbances are associated with deterioration in cardiometabolic health in the longer term and increased risk of type 2 diabetes. Both immediate quality of life and longer-term health of women with PCOS are likely to benefit from diagnosis and management of sleep disorders as part of interdisciplinary health care.

The Menstrual Cycle Influences Emotion but Has Limited Effect on Cognitive Function.

From a psychological perspective, the menstrual cycle has been a research topic for more than 50 years. The most recent menstrual cycle research has been driven by an increased interest in sex differences in neuroscience, and the urge to understand sex disparities in prevalence, clinical presentation, and treatment response in psychiatric or neurologic disorders. Indeed, the menstrual cycle is an excellent model of ovarian steroid influence on emotion, behavior, and cognition. This review summarizes the emotion-related and cognitive findings of methodologically sound menstrual cycle studies. In particular, the review is devoted to the sex hormone-induced emotional disturbances in women with premenstrual dysphoric disorder, a subgroup of women responding with enhanced sensitivity to the normal fluctuations in endogenous hormone levels during the menstrual cycle. In addition, emotion processing and cognitive findings across the menstrual cycle in healthy women are also discussed. The overall conclusion is that that menstrual cycle differences in sexually dimorphic cognitive tasks are small and difficult to replicate. Emotion-related changes are more consistently found and are better associated with progesterone and the luteal phase, than with estradiol.

Ovarian surgery for symptom relief in women with polycystic ovary syndrome.

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effectiveness and harms of ovarian surgery as a treatment for symptomatic relief of hirsutism, acne and menstrual disturbances in women with PCOS.

Distinct Trajectories of Fatigue and Sleep Disturbance in Women Receiving Chemotherapy for Breast Cancer.

To examine self-reported severity of fatigue and disturbed sleep experienced daily by women with breast cancer during multiple cycles of chemotherapy, exploring potential classes of women experiencing similar symptom trajectories. . In a secondary analysis, classes of women experiencing similar patterns of fatigue and disturbed sleep were identified. . Oncology clinics in the United States. . 166 women with breast cancer receiving chemotherapy. . Severity scores were self-reported daily using an automated system. Classes of fatigue and disturbed sleep severity were identified using latent growth mixture modeling. . Fatigue, disturbed sleep, age, stage of disease, education, employment, marital status, chemotherapy regimen, hours lying down, and missed work. . Three fatigue classes were identified. Patterns of symptom trajectories for fatigue and disturbed sleep were distinguished by baseline symptom severity. . Identification of women at risk for fatigue and disturbed sleep may allow clinicians to intensify symptom management.

Effects of ultrasound-guided stellate-ganglion block on sleep and regional cerebral oxygen saturation in patients undergoing breast cancer surgery: a randomized, controlled, double-blinded trial.

Numerous factors could contribute to sleep disturbances in women with breast cancer. We hypothesized that stellate ganglion block (SGB) during surgery would preserve sleep after surgery and increase intraoperative regional cerebral oxygen saturation (rSO2) on the blocked side in patients undergoing breast cancer surgery. A randomized, double-blinded, controlled trial was conducted at the First Hospital of China Medical University from January 2016 to September 2016. Ninety-six patients who underwent radical breast cancer surgery requiring general anaesthesia were randomly assigned to one of two study groups: a control group that received a saline SGB and a block group that received a 0.25% ropivacaine hydrochloride SGB. The primary outcome measure was the postoperative sleep profile, which was assessed using the bispectral index on the first postoperative night. The secondary outcome measure was the intraoperative rSO2, monitored was throughout surgery using near-infrared spectroscopy. A total of 91 female patients (mean age: 45years; range 24-51years) were included in the study. The duration of sleep was significantly increased by 66.3min in the ropivacaine-SGB group compared with the saline-SGB group. No differences in rSO2 were observed on either the left or right side of the patients in either group 50min after anaesthesia induction. We conclude that ropivacaine-SGB combined with general anaesthesia might increase the first postoperative sleep duration without influencing the intraoperative rSO2 in female patients undergoing elective breast cancer surgery. Clinical trials.gov identifier NCT02651519.