Duration Of Menstrual Cycle Research Articles

Record review of baboons with histologically confirmed endometriosis in a large established colony.

Spontaneous endometriosis was diagnosed in 43 baboons over a 14-year period. Thirty-seven have died; five remain alive; one was sold and lost to follow-up. The average age at diagnosis was 17.2 years; 29 (67%) were between 12 and 21 years of age. Fifteen (35%) were diagnosed by biopsy and received surgical excision of the endometriotic tissue; four of these were identified during caesarian section, confirming one prior report of endometriosis in pregnant animals. Twenty-eight (65%) were diagnosed at or shortly preceding necropsy. When diagnosed by a palpable abdominal mass, there was a significantly greater likelihood the animal died or was killed as a result of complications of endometriosis. When diagnosis was at necropsy, there was a significantly greater likelihood that the animal died from causes unrelated to endometriosis. Early identification with surgical removal appears to provide a benefit for both survival and delivering offspring after diagnosis. In twenty-one baboons (49%), endometriosis affected multiple sites within the peritoneal cavity. In the remaining baboons, lesions were more localized. Ovarian involvement was seen in sixteen (37%) of these baboons. This paper is the first to describe significant ovarian involvement in baboons, previously considered a limitation of the usefulness of this species as an animal model. We also describe the first reported endometriosis seeding of an abdominal surgery scar in a baboon. Many of these baboons were middle aged, had few or no offspring, or had evidence of a long duration of uninterrupted menstrual cycles, consistent with risk factors for women. Endometriosis was an incidental finding in 17 (40%) of these baboons, consistent with previous reports of minimal endometriosis as a common asymptomatic finding in baboons and in women. Overall, endometriosis in baboons presents a spontaneously occurring animal model that shares important features with the disease in women and the rhesus macaque.

Disturbance of the Duration in the Menstrual Cycle under the Influence of Tight Clothing

We investigated the influence of skin pressure by clothing on the duration of menstrual cycle with 33 young adult women. The average age was 19.9 ± 2.1 years (mean ± SD), stature 159.5 ± 5.6cm and body mass 50.9 ± 5.5kg. Thirty-three women participated as subjects. They wore their usual clothing including foundation garments, panty stocking, pants or skirt and T-shirt or blouse and cardigan for the first 4 months from December to March (‘Tight 1’). For the second 4 months from April to July, the women wore loose clothes, i.e., they did not wear foundation garments at home. Skirt and jeans were worn loosely (‘Loose’). For the last 4 months, from August to November, they wore their clothes as tightly as possible, compared to ‘Tight 1’ (‘Tight 2’). Each participant marked the first day of the occurrence of menses in the pocket diary throughout the year. The main results were summarized as follows: 1) The average duration of the menstrual cycle was 44.2 ± 14.9 days (mean ±) in ‘Tight 1’, 30.4 ± 3.0 days in ‘Loose’ and 47.4 ± 22.7 days in ‘Tight 2’. 2) The number of months when the menses did not occur was 38 for ‘Tight 1’, 6 for ‘Loose’ and 40 for ‘Tight 2’. 3). The number of participants who had a duration of the menstrual cycles for more than 40 days, was 25 participants for ‘Tight’, 10 for ‘Loose’ and 29 for ‘Tight’. It can be concluded that skin pressure by clothing could disturb the duration in the menstrual cycle.

Asthma and sex hormones.

A chronic in ammatory state of the airways is considered the hallmark of asthma (1). However, the incidence, severity, and prognosis of asthma can be affected by a number of factors, including the patient's sex and age. The sex of the fetus seems to in uence the development of the respiratory apparatus. In fact, between weeks 28 and 40 of gestation, the lungs are in a more advanced state in females than in males (2), a fact which could explain, at least in part, the higher incidence of respiratory distress in male infants (3). Clinical observations and epidemiologic studies agree that childhood asthma is more frequent in boys than in girls (4). Moreover, in some children, usually boys, asthmatic symptoms that started in infancy disappear around puberty (5), while many girls have the disease only during adolescence (6). Age has been implicated in the severity of asthma. Asthma beginning during adulthood is generally more severe than childhood-onset asthma (7). Asthma that starts around the menopause or in old age is generally quite severe (5). According to two recent epidemiologic investigations, the patient's sex and age affect the hospitalization rate for asthma (8, 9), which is a marker of severity. In the ®rst study (a retrospective study of 33 269 patients), the admission rate of boys in the 0±10-year age group was almost twice that of girls. In the next decade, sex differences in the hospitalization rate were irrelevant, although there was a small, but signi®cant prevalence of females. At all ages above 20 years, hospital admission rates were higher in women than men, with a female/ male ratio ranging from 3:1 in subjects aged 20±50 years to 2.5:1 in those over 50 years of age (8). Similar data were reported by Elliasson (9). Both studies found a relationship between the age and sex of the patient and the severity of the asthma attack as indicated by duration of hospitalization. In fact, the duration of hospitalization increased with age in both sexes; moreover, hospital stays were longer in women over 30 years of age than in men of the same age (8, 9). Abbreviations. FSH: follicle-stimulating hormone; LH: luteinizing hormone; NK cell: natural killer cell; IL-1, -4, -5, -6: interleukin-1, -4, -5, -6; TGF-b: tumor growth factor-beta; PEFR: peak expiratory ow rate. Allergy 2001: 56: 13±20 Printed in UK. All rights reserved Copyright # Munksgaard 2001

Abnormal genital tract bleeding

The etiology of abnormal genital tract bleeding encompasses a wide range of disorders that can be secondary to anatomic changes of the female genital tract, infection, endocrinologic disorders, malignancies, and systemic illness. Appropriate workup is guided by age-related differential diagnoses for abnormal bleeding. Modern diagnostic tools can quickly focus the evaluation and allow timely intervention. Most abnormal genital tract bleeding is uterine bleeding, which is one of the most common gynecologic problems that health care providers will face. It accounts for approximately 15% of office visits and 25% of gynecologic operations. Abnormal uterine bleeding in reproductive-age women is defined as bleeding at abnormal or unexpected times or by excessive flow at the time of an expected menses. The average menstrual cycle length and duration of flow is 28 days and 4 days, respectively, with an average blood loss of 35cc (1). Any bleeding should be considered abnormal in premenarchal girls and in postmenopausal women except for those with predictable withdrawal bleeding taking hormone replacement therapy. This article will review the categories of abnormal genital tract bleeding and the diagnostic tools needed to establish the correct diagnosis. Common clinical cases will be presented to illustrate the presenting symptoms, differential diagnoses, workup, treatment, and long-term follow-up.

Does moderate alcohol consumption affect fertility? Follow up study among couples planning first pregnancy

Objective : To examine the effect of alcohol consumption on the probability of conception.Design : A follow up study over six menstrual cycles or until a clinically recognised pregnancy occurred...

Caffeine Intake and Fecundability: A Follow-up Study among 430 Danish Couples Planning Their First Pregnancy

Fecundability has been defined as the ability to achieve a recognized pregnancy. Several studies on caffeine and fecundability have been conducted but have been inconclusive. This may be explained partly by lack of stratification by smoking. Furthermore, few researchers have tried to separate the effect of caffeine from different sources (coffee, tea, cola, and chocolate). Clearly, the relationship between caffeine and fecundability needs further research, given the high prevalence of caffeine intake among women of childbearing age. We examined the independent and combined effects of smoking and caffeine intake from different sources on the probability of conception. From 1992 to 1995, a total of 430 couples were recruited after a nationwide mailing of a personal letter to 52,255 trade union members who were 20 to 35 years old, lived with a partner, and had no previous reproductive experience. At enrollment and in six cycles of follow-up, both partners filled out a questionnaire on different factors including smoking habits and their intake of coffee, tea, chocolate, cola beverages, and chocolate bars. In all, 1596 cycles and 423 couples were included in the analyses. The cycle-specific association between caffeine intake and fecundability was analyzed in a logistic regression model with the outcome at each cycle (pregnant or not pregnant) in a Cox discrete model calculating the fecundability odds-ratio (FR). Compared to nonsmoking women with caffeine intake less than 300 mg/d, nonsmoking women who consumed 300 to 700 mg/d caffeine had a FR of 0.88 [95% confidence interval (CI) 0.60–1.31], whereas women with a higher caffeine intake had a FR = 0.63 (95% CI 0.25–1.60) after adjusting for female body mass index and alcohol intake, diseases of the female reproductive organs, semen quality, and duration of menstrual cycle. No dose–response relationship was found among smokers. Among males, the same decline in point estimates of the FR was present. Smoking women whose only source of caffeine was coffee (>300 mg/d) had a reduced fecundability odds-ratio (FR = 0.34; 95% CI 0.12–0.98). An interaction between caffeine and smoking is biologically plausible, and the lack of effect among smokers may be due to faster metabolism of caffeine. Our findings suggest that especially nonsmoking women who wish to achieve a pregnancy might benefit from a reduced caffeine intake.

Evaluation of the efficacy, tolerability and cycle control of a monophasic oral contraceptive containing gestodene and ethinylestradiol (Minulet®) in women over 35 years of age

The efficacy, tolerability and cycle control of a monophasic oral contraceptive preparation containing gestodene (75μg) plus ethinylestradiol (30 μg) (Minulet®) were studied in 139 women aged over 35 years (mean age 37.12 ± 2.47 years) in a prospective, open-label, non-comparative study. Each subject received one tablet daily for 21 days followed by 7 days without medication, for six cycles. Of the 809 cycles studied, 96.04% had normal withdrawal bleeding, without breakthrough bleeding or spotting. The mean menstrual cycle length and duration of withdrawal bleeding were similar before and after treatment. The percentage of severe withdrawal bleeding cycles was reduced and the percentage of mild withdrawal bleeding cycles increased following treatment. No incidence of amenorrhea was observed and no pregnancies were reported. Five subjects withdrew due to adverse events. The most frequent symptoms reported during the study were breast tenderness, headache, nausea, nervousness and depression. Minulet, a low-...

Epidemiology of endometriosis among parous women

To report the prevalence of endometriosis and its associated risk factors among multiparous women, and to determine the relationship between the location and depth of this disease and certain medical and behavioral characteristics. Over a 6-year period, 3384 multiparous women underwent laparoscopy for tubal sterilization. Endometriosis was detected in 126 patients (3.7%), who were consequently evaluated for severity of the disease. To conduct a case-control study, 504 patients with no evidence of endometriosis were randomly selected from a group of women who underwent sterilization. Information obtained through physical examination and a self-administered questionnaire was studied by multivariate logistic regression analysis. Most endometriosis lesions were minimal. Factors associated with an increased risk for endometriosis included: advanced age (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.1-3.7), Asian race (OR 8.6, 95% CI 1.4-20.1), long cycle length (OR 1.8, 95% CI 1.1-2.7), one live birth (OR 2.2, 95% CI 1.1-4.3), long duration of intrauterine device use (OR 3.0, 95% CI 1.1-8.1), and long duration of uninterrupted menstrual cycles (OR 2.9, 95% CI 1.3-6.4). Present oral contraceptive use was protective for disease (OR 0.5, 95% CI 0.2-0.9). The role of these factors varied among different disease locations (ovary, uterus and tubes, posterior broad ligaments and cul-de-sac), and depth (superficial or deep). The prevalence of endometriosis is relatively low among multiparous women, and certain menstrual and reproductive characteristics are associated with its development. Furthermore, the relationship between various factors and endometriosis appears to be site and depth specific. Our findings suggest that asymptomatic endometriosis may be clinically important.

Menstrual patterns in women with congenital heart disease.

To examine the extent to which congenital heart disease (CHD) influences ovarian function, 98 women (mean age 32.7 years) were asked to complete a mailed questionnaire regarding their menstrual patterns. Patients were divided into acyanotic (60%) and cyanotic (38.8%) groups. Cycle lengths, duration of menstrual cycle, regularity of menses, amount of flow, and breakthrough bleeding were compared in these two groups and against age-matched controls. The mean age of menarche for the sample (13.4 years) was significantly different (p < 0.004) when compared to their controls (12.5 years). With the exception of breakthrough bleeding, statistical differences were not found between the study population and the controls. When the menstrual histories of cyanotic women were compared with those of acyanotic women, differences were found for all categories of menstrual patterns with the exception of the amount of menstrual flow. Menstrual patterns of cyanotic women compared to controls were found to be significantly different for all categories with the exception of amount of flow. In general, women with CHD have menstrual patterns similar to those in the general population.

Score prognosis for the infertile couple based on historical factors and sperm analysis

Objective: To identify variables, obtained from historical factors and sperm analysis, associated with greater chances of pregnancy in infertile couples. Methods: The study was carried out in Córdoba, Argentina. The characteristics of 247 couples consulting for infertility who achieved pregnancy within 3 years of their first visit were compared with those of 312 couples who did not become pregnant. We evaluated the relationship between the age of the woman and her partner, the type and duration of infertility, length of the last three menstrual cycles, history of pelvic surgery in the woman, and testicular volume, sperm density, motility and morphology in her partner, and the achievement of pregnancy. For the analysis, logistic regression was used. Results: Six variables had a predictive value: sperm morphology, the woman's age, type and duration of infertility, her history of pelvic surgery, and duration of menstrual cycles. Conclusions: The best prognosis for future fertility in infertile couples is correlated with a higher percentage of normal sperm morphology, younger woman's age, secondary infertility, fewer years of infertility, negative history of pelvic surgery, and abnormal menstrual cycles.

Hexachlorobenzene (HCB) suppresses circulating progesterone concentrations during the luteal phase in the cynomolgus monkey.

Hexachlorobenzene (HCB) is a known reproductive toxin. However, the full spectrum of its reproductive toxicity is unknown. Consequently, the effect of HCB on serum oestradiol (E2) and progesterone (P4) concentrations during the follicular (days 1-9), periovulatory (days 10-14) and luteal (days 15 to beginning of next menses) phases was investigated in the spontaneously cycling cynomolgus monkey. Adult female cynomolgus monkeys (n = 16) were randomly assigned to one of four treatment groups and orally doses with gelatin capsules containing HCB (0.0, 0.1, 1.0 and 10.0 mg kg-1 body wt. day-1) mixed with glucose. A 10-week acclimitization phase was followed by 13 weeks of dosing. HCB induced a dose-dependent suppression of serum P4 concentrations during the luteal phase. However, circulating levels of P4 were unaffected during the follicular and periovulatory phases of the menstrual cycle. Serum E2 concentrations, body weight, menstrual cycle length and duration of menses were not affected by HCB treatment. The range of menstrual cycle length and duration range of menses, however, were broader in the highest dose group. We conclude that HCB interfers with mechanisms regulating ovarian steroidogenesis and suppresses P4 levels during the luteal phase in the cynomolgus monkey.

Menstrual disturbances and fertility in chronic alcoholic women

Data on menstrual pattern, gynecological disorders and infertility were obtained from 51 chronic alcoholic women aged 20–42 years attending an outpatient clinic for alcoholics, using 51 randomly drawn age-matched healthy women as controls. A higher variability ( P < 0.05) in the duration of both menstrual cycle and menstrual flow was recorded in the chronic alcoholic women during active alcoholism. A higher frequency ( P < 0.05) of menstrual disturbances (70% vs. 55%) and uterine curettages (38% vs. 16%) were found in the alcoholic women. The latter reported more abortions (63% vs. 28%, P < 0.001) and miscarriages (23% vs. 8%, P < 0.05) than controls, but due to a higher number of pregnancies in the alcoholic group the proportion of abortions and miscarriages did not differ significantly. No differences existed between the groups regarding frequency of difficult conception. Social classification had no independent influence on the results. The study shows that chronic alcoholic women are more prone to menstrual abnormalities and are at greater risk of gynecological interventions, while they do not seem to have reduced fertility.

World Health Organization multicenter study on menstrual and ovulatory patterns in adolescent girls: II. Longitudinal study of menstrual patterns in the early postmenarcheal period, duration of bleeding episodes and menstrual cycles

During a two-year study, 670 girls (aged 11–15 years) submitted menstrual diaries that started at the onset of their first menstrual bleeding (Group I), and 802 girls (aged 11–15 years) who had already experienced menarche prior to the study (Group II) kept similar diaries. The two groups were recruited in three centers: Colombo (urban), Peradeniya (rural), both in Sri Lanka, and Hong Kong. The mean duration of bleeding episodes was 4.7 days (SD 1.8) in Group I and 4.9 days (SD 1.4) in Group II. The median length of the first cycle after menarche was 34 days, with 38.3% of the cycles being longer than 40 days. By the 5th cycle the median length was 31 days, similar to that of Group II. The establishment of cycle regularity was defined by three successive cycles within the range of 10 days with none of the three cycles shorter than 20 or longer than 40 days. This regularity was achieved by 19% of the Group I girls in the first three cycles and by 67% of these girls during the entire study period, compared to 89% in Group II.

Photoperiod and ovulatory menstrual cycles in female macaque monkeys.

Macaques (Macaca mulatta and M. assamensis) which had been maintained on a 12L :12D light cycle for the previous 4 years and had 25-35-day menstrual cycles were randomly assigned to two groups. Those in Group 1 were kept in 12L :12D for 13 months. Those in Group 2 were subjected to three successive 5-month periods of 20L :4D, 4L :20D and 20L :4D. There were no significant differences between the two groups in the frequency, duration and percentage of ovulatory menstrual cycles, suggesting that photoperiod is not the sole regulator of seasonal breeding in these animals.

Hematologic abnormalities in adolescents who take oral contraceptive pills

Sexually active patients (12 to 19 years of age) participated in a study designed to determine if adolescents who take oral contraceptives are susceptible to hematologic abnormalities. This involved individual medical histories recording vitamin ingestin, alcohol consumption, type of contraceptive used, duration of usage and menstrual cycle. Blood samples were drawn for determinations of serum folate, B12, ferritin, blood count and polymorphonuclear leukocyte lobe count. Results indicate that adolescents with nutritionally poor diets are potentially high risks for developing folic acid deficiency while taking oral contraceptives. The data indicate no significant differences in the mean hemoglobin, red blood cell indices or polylobe count in either the patient or control group. The authors stress a need to gather more data on the effects of long term contraceptive pill usage. It is concluded that although contraceptive pill use appears to increase the risk of developing cellular folate deficiency, especially in white women, the pill appears to offer some protection against iron deficiency and is not associated with anemia.

Lunar and menstrual phase locking

In a selected population of 312 women, prospective menses records were maintained during the autumn of 1977. Women whose menstrual cycle duration approaches the cycle duration of the earth's moon (29.5 days) tend to ovulate in the dark phase of the lunar period. The dark phase encompasses the half-cycle of the month from last quarter, through new moon, to first quarter. Women showing irregular menses also tended to ovulate during the dark phase of the lunar period.

Failure of a single neonatal dose of testosterone to alter ovarian function in the Rhesus monkey.

Female rhesus monkeys (Macaca mulatta) were injected with an aqueous suspension of testosterone (T) 35 mg/kg within 24 hours following birt h. At 30 months of age observations on their menstrual cycles were beg un and continued for 1 year. Laparotomies were done and ovaries and ute ri examined and measured. Plasma progestins were determined by a modifi ed competitive protein-binding method on 5 control and 5 experimental animals every 3rd day for 27 days. Neither menstrual cycle length nor duration of menses of neonatally treated animals differed from controls. Ovarian and uterine sizes were the same as in controls and numbers of corpora lutea were similar. A similar cyclic pattern of plasma progestin with the peak secretion between Days 15 and 25 was found in both groups. The ability of these animals to conceive and maintain pregnancy is currently being tested. Higher doses of testoster one 105 mg/kg are also being tried in similar tests.

Changes During Clomiphene Citrate Therapy: A Study of Basal Body Temperature, Cervical Mucus, Vaginal Cytology, Spermatic Penetration, and Duration of Menstrual Cycle

Changes During Clomiphene Citrate Therapy: A Study of Basal Body Temperature, Cervical Mucus, Vaginal Cytology, Spermatic Penetration, and Duration of Menstrual Cycle