Induction Of Menstruation Research Articles

The Effect of Jeeraka and Krishna Jeeraka Choorna in the Induction of Menstruation

Menstruation is a normal body function initiated in response to ovarian hormones which inturn is controlled by the hypothalamo-pituitary axis. Menstrual patterns can also be an indicator of health status of the reproductive tract and self-awareness of the reproductive well-being. The causes may be varying right from disturbances in hypothalamus, pituitary, ovary and uterus influencing general health. Hence women who do not get their menstruation on the expected date will try to consume food/medicines whichever they think will induce menstruation at the earliest. The choice of medication to do so is very limited and there are no certain medicines which a gynecologist can prescribe to her patient’s in order to bring the menstruation at the earliest which is not expected at the date.
 So it will be a great boon to the woman if it can be replaced by natural remedies with no side effects. Present study has been undertaken to evaluate the combined effect of Jeeraka and Krishna jeeraka choorna in the induction of menstruation. 20 patients complaining of Anartava (amenorrhea) of more than 40 days, attending the OPD & IPD of Prasuti Tantra & Stree Roga Department, Sri Dharmasthala Manjunatheswara Ayurveda Hospital, Kuthpady, Udupi, were selected for the study. Based on the assessment criteria, the data was graded and statistically analysed using wilcoxon’s signed rank test and paired T test. After the intervention it was observed that the medicine is having good action in induction of menstruation (85%).

Mifepristone induced progesterone withdrawal reveals novel regulatory pathways in human endometrium

In women, a single dose of the antiprogestin mifepristone (RU486) in the secretory phase rapidly renders the endometrium unreceptive and is followed by endometrial breakdown and menstruation within 72 h. This model provides a system to identify progesterone-regulated genes, which may be involved in endometrial receptivity and the induction of menstruation. We used cDNA microarrays to monitor the response of the endometriuim over 24 h following administration of mifepristone in the mid-secretory phase. We identified 571 transcripts whose expression was significantly altered, representing 131 biochemical pathways. These include new progesterone regulated members of the Wnt, matrix metalloproteinase (MMP), prostaglandin (PG) and chemokine regulatory pathways. Transcripts involved in thyroid hormone metabolism and signalling such as type II iodothyronine deiodinase and thyroid receptors were also found to be highly regulated by progesterone antagonism in the endometrium. Transcripts required for thyroid hormone synthesis such as thyroid peroxidase (TPO) and thyroglobulin (TG) were also expressed, indicating that the endometrium may be a site of thyroxin production. These results add to the existing knowledge of the role of the Wnt, chemokine, MMP and PG pathways in receptivity and early menstrual events. They provide in vivo evidence supporting direct or indirect regulation of many new transcripts by progesterone. We have also identified for the first time the very early transcriptional changes in vivo in response to progesterone withdrawal. This greatly increases our understanding of the pathways leading to menstruation and may provide new approaches to diagnose and treat menstrual disorders.

Estrogen protection against coronary heart disease: Are the relevant effects of estrogen mediated through its effects on uterus – such as the induction of menstruation, increased bleeding, and the facilitation of pregnancy?

Women in the age group of 20-50 are shown to have much less susceptibility to Coronary Heart Disease (CHD) and other atherosclerotic diseases as compared to men. Exact cause of which is not precisely known and estrogen is constantly shown to be associated with this phenomenon. Improvement of serum HDL concentration and improvement of endothelial functions are some of the proposed mechanisms through which estrogen is believed to mediate this effect. Estrogen therapy however has failed to protect women with bilateral oophorectomy and hysterectomy. Similarly inability of endogenous estrogen to protect women, who have undergone hysterectomy with functioning ovaries from CHD, questions the currently accepted mechanisms through which estrogen brings about these protective effects. Ineffectiveness of estrogen therapy as prophylaxis against CHD in men further questions the credibility of the currently accepted protective mechanisms of estrogen. Estrogen has variety of effects of on uterus, to induce menstruation, to induce bleeding, facilitative role in pregnancy, fetal growth and development. As these physiological effects either directly or indirectly result in loss of cholesterol from cardiovascular compartment, it is proposed that cholesterol-losing effects of estrogen are more important than its presently believed beneficial effects. The small amount that is lost causes movement of cholesterol from atheroma towards plasma and thereby retards the progress of atherosclerosis. These cholesterol-losing effects of estrogen enable women to enjoy freedom from CHD during their reproductive age, as compared to men of comparable age group. Statistical data obtained from blood donors indirectly support the proposed hypothesis.

Effects of a Progesterone Antagonist, Lilopristone (ZK 98.734), on Induction of Menstruation, Inhibition of Nidation, and Termination of Pregnancy in Bonnet Monkeys

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.

Antiprogesterone RU 486—a Drug for Non-Surgical Abortion

RU 486 is the first steroidal antiprogesterone in clinical use. It acts by binding to progesterone receptor, thus blocking the effects of progesterone at the uterine level, and provoking endometrial necrosis and shedding. RU 486 can, therefore, be used to interrupt early human pregnancy. In pregnancies of up to 7-8 weeks duration, the rate of complete abortions with RU 486 has ranged from 50% to 90%. The success rate can, however, be augmented up to 95%-100% by combining RU 486 with a low dose prostaglandin. RU 486 induced abortion has been well tolerated by women and highly acceptable to them. The bleeding starts 2-3 days after RU 486 administration lasting for 12-14 days. Possible clinical uses of RU 486 include induction of menstruation, late post-coital contraception, induction of labour after intrauterine fetal death, preoperative cervical ripening and treatment of progesterone receptor positive mammary tumours. When administered in the follicular phase of the cycle, RU 486 inhibits follicular development. In addition, the antiglucocorticoid properties of RU 486 have been used in symptomatic treatment of hypercortisolemia of Cushings disease. The pharmacokinetics of RU 486 are characterised by high micromolar serum concentrations, long half-life of 26-48 hours and substantial metabolism after oral administration. Although effective and well tolerated, RU 486 has aroused great moral controversy, which is currently hampering further testing and distribution of the drug. So far RU 486 has been accepted for termination of pregnancy in France and in the Peoples Republic of China, to be used with prostaglandins and under strict medical surveillance.

Progesterone antagonist lilopristone: A potent abortifacient in the common marmoset

The effects of a progesterone antagonist ZK 98.734 (lilopristone) on implantation, early pregnancy, and midpregnancy were studied in the common marmoset, Callithrix jacchus jacchus. Treatment (5 mg/da intramuscularly for 3 consecutive days) on day (n = 8) after the midcycle peak in estradiol levels in mated animals induced a premature drop in plasma progesterone levels and shortened the ovarian cycle length. Treatment on day 20 (n = 5) or day 40 (n = 5) induced a drop in progesterone levels and decidual collapse. In three animals treated on day 40, vaginal bleeding was observed within 46 hours of the initiation of treatment. Treatment on day 80 resulted in expulsion of the fetuses with a mean induction abortion interval of 39 hours (range, 20 to 48 hours). The progesterone antagonistic effects of ZK 98.734 could be a result of the decrease in progesterone synthesis by the corpus luteum and/or placenta in addition to the interference with the progesterone binding to its cellular receptors in the target organ. Our study suggests that ZK 98.734 has potential for fertility regulation. Clinical trials for postcoital contraception, induction of menstruation, and early abortifacient effects are warranted.

Bio-psycho-social aspects of gonadal dysgenesis

Gonadal dysgenesis is the commonest cause of primary amenorrhea. Women with such a disease syndrome feel physically healthy but they lack the two bodily functions which are exclusively feminine: menstruation and child-bearing. The present study of 86 Chinese women with gonadal dysgenesis showed that their congenital abnormalities did not interfere with their school and work achievement, but these women were found to be socially inhibited. Only 21 women (24.4%) were ever married and only 10 other women (6.5%) had formed heterosexual relationships. The major deterrent factor was infertility. Whilst hormonal therapy made these women feel better because of the induction of menstruation and breast development, clinic visits to obtain such hormones were upsetting in 27 (31.4%) of them. Observations in a 2-year period did not show that these women were able to overcome their psychosocial difficulties, despite support and encouragement. Possible intervention strategies are discussed.

8 Anti-progesterones in obstetrics, ectopic pregnancies and gynaecological malignancy

Table 2 summarizes the proven and potential uses of anti-progesterones in obstetrics and gynaecology. In addition to their role in the induction of menstruation and the interruption of first-trimester pregnancy, anti-progesterones can definitely accelerate cervical ripening and promote the termination of second-trimester pregnancy, especially in combination with exogenous prostaglandins. Furthermore, anti-progesterones can also initiate labour in the obstetric complication of fetal death in utero, leading to delivery of the fetus and placenta without additional medical treatment and without surgery in the majority of patients. The wider use of anti-progesterones for the induction of labour, with or without other adjuvants such as oxytocin or prostaglandin analogues, is still uncertain and awaits further study. Anti-progesterones may also be useful in the medical treatment of early ectopic pregnancy, either alone or in combination with other medicines. Preliminary results indicate that progesterone receptor antagonists may also be useful both for the initiation and promotion of lactation as well as the possible management of advanced breast cancer containing progesterone receptors. Finally, the usefulness of anti-progesterones in other gynaecological malignancies containing progesterone receptors, such as endometrial or ovarian cancers, awaits further study.

Induction of menstruation by antiprogesterone ZK 98.299 in cycling bonnet monkeys

The antiprogestin ZK 98.299 (11β-(4-dimethylaminophenyl)-17α-hydroxy-17β -(3-hydroxypropyl)-13 α-methyl-4,9-gonadien-3-one) was administered s.c. (30 mg/day) to two groups of cycling bonnet monkeys. In Group I (n = 6), it was injected from day 16 to 18 and in Group II (n = 9) from day 21 to 23 of the cycle. Each animal served as its own control and in the pretreatment cycle the vehicle (benzyl benzoate: castor oil, 1:4) was administered. During the treatment cycle of these animals the peak in estradiol levels was observed between days 8 to 11 of the menstrual cycle. In Group I animals, administration of ZK 98.299 induced vaginal bleeding in three of the six animals within two days of its first injection. In the remaining three animals the menstrual cycle length was prolonged. However, in all the six animals a premature drop in serum progesterone levels was observed. On the other hand, in Group II in seven animals with ovulatory treatment cycles, administration of ZK 98.299 induced vaginal bleeding within four days of the first dose and significantly shortened the cycle length. A significant decline in progesterone levels was observed in these animals also. However, in two animals in each group, ZK 98.299 induced vaginal bleeding while the serum progesterone levels were still high. Post-treatment cycles were ovulatory but the cycle length was marginally increased in some animals. In two animals of Group II, in which the treatment cycle turned out to be anovulatory, ZK 98.299 did not induce bleeding and had no effect on serum progesterone levels. This study shows that when administered during the luteal phase ZK 98.299 induces vaginal bleeding and premature luteal regression in bonnet monkeys. However, induction of vaginal bleeding may not be associated with drop in progesterone levels. ZK 98.299, therefore, appears to have potential for fertility control which warrants clinical evaluation.

Fertility control in women: Results with RU 486 by the end of 1985

RU 486 is the first antiprogesterone to be used clinically. It inhibits the action of the hormone at the receptor level in target tissues. Its action is particularly significant in the endometrium where it prevents the initiation and progression of pregnancy in the first weeks (contragestive effects). The data indicate that the compound can be used for: (1) voluntary interruption of pregnancy between 6 and 10 weeks, (2) induction of menstruation during the fifth week of amenorrhea, and (3) post-coital contraception. Current trials include its use as a once-a-month menses inducer. It can also be utilized for therapeutic interruption at a late stage of pregnancy, and tried as adjuvant treatment in some case of breast cases. The data on RU 486 have been obtained through studies in physio-pharmacological endocrinology and biochemistry. The development of this antihormone represents a concerted research effort between biology and medicine.

Antiprogesterone activity of RU 486 and its contragestive and other applications.

RU 486 is the first antiprogesterone to be used clinically. It inhibits the action of the hormone at the receptor level in target tissues. Its action is particularly significant in the endometrium where it prevents the initiation and progression of pregnancy in the first weeks (contragestive effect). The data indicate that the compound can be used for: voluntary interruption of pregnancy between 6 and 10 weeks; induction of menstruation during the fifth week of amenorrhoea, and post-coital contraception. Current trials include its use as a once-a-month menses inducer. It can also be utilized for therapeutic interruption at a late stage of pregnancy, and tried as adjuvant treatment in some cases of breast cancer. The data on RU 486 have been obtained through studies in physio-pharmacological endocrinology and biochemistry. The development of this antihormone represents a concerted research link between biology and medicine.

Induction of menstruation by an antiprogesterone steroid (RU 486) in primates: site of action, dose-response relationships, and hormonal effects

The antiprogesterone compound RU 486 (17 beta-hydroxy-11 beta-[4-dimethylaminophenyl]-17 alpha-[ 1-propynyl]estra-4,9-dien-3-one; Roussel-Uclaf, Paris, France) was used to induce menstruation in a randomized controlled trial. Castrated adult female cynomolgus monkeys (n = 17) received sequential subcutaneous Silastic capsules of estradiol or progesterone over a 49-day regimen which stimulated the steroidal milieu of the fertile ovarian/menstrual cycle. RU 486 was injected at 10.0, 1.0 to 3.0, or 0.1 mg/kg from days 31 to 34 of this protocol. At all concentrations tested, menstruation followed RU 486 injection within 48 hours and persisted through 72 hours. No bleeding followed placebo injections. All monkeys that menstruated after RU 486 administration also manifested vaginal bleeding after removal of exogenous steroid treatments. No changes in daily serum follicle-stimulating hormone, luteinizing hormone, prolactin, or serum and urinary free cortisol accompanied RU 486 treatment. We conclude that (1) RU 486 promptly induces menstruation by a local action upon the endometrium; (2) familiar endometrial proliferation and withdrawal bleeding can redevelop after exposure to this compound; (3) no effects of RU 486 on serum cortisol or pituitary gonadotropins were noted; and (4) extensive combination therapy with estrogen and progesterone causes mild hyperprolactinemia.

The physiology of human reproduction.

The general physiological processes involved in human reproduction are reviewed. A discussion of ovum development the fertilization process preparation of the uterus for nidation physiological changes during pregnancy and cyclical hormonal interrelations initiating reproductive events is presented. The properties structure and function of human sperm in reproduction are explained. Traditional forms of contraception such as the condom diaphragm spermicides and the rhythm method are discussed. The modes of action and side effects of oral contraceptives and intrauterine devices are presented. Experimentation with new contraceptive methods such as subcutaneous progestin polymer implants and trimonthly progestin injections silastic vaginal rings impregnated with progestin copper-bearing IUDs induction of menstruation with prostaglandins and suppression of progesterone production during the luteal phase a postcoitum pill and immunization with purified human chorionic gonadotrophin is reviewed. A combination of progestin and testosterone is noted as a contraceptive agent being studied for men. Attempts to develop a safe effective and reversible vasectomy procedure have not yet met with adequate success. A table gives the phases in male and female reproduction potentially vulnerable to the intervention of contraceptive technology.

Beyond the Laboratory: Recent Research Advances in Fertility Regulation

At least 9 basically new contraceptive approaches have reached human clinical testing and provide hope for effective and convenient contraception. Several of these methods involve continuous long-term hormonal drug treatment which has caused some anxiety over adverse side reactions. These include use of low-dose progestin in daily oral doses to prevent passage of spermatoza without necessarily inhibiting ovulation. A subdermal capsule implanted yearly could also be used. Other hormonal treatments include vaginal rings or intrauterine devices that would continuously release ovulation-inhibiting steroids. Intramuscular injection of such steroids is also being studied. Endometrial implantation can be inhibited by oral steroids or copper IUD's. Induction of menstruation by oral steroids or prostaglandins is also possible. Post coital use of diethylstilbestrol appears effective, and cytotoxic agents are being tested to aid surgical sterilization. In males, subdermal testosterone can be used to inhibit spermatogenesis or sperm maturation, and a method of surgical vaso-occlusion of sperm transports that can be reversible is being sought. The mechanical techniques and intermittent drug treatments may provide a contraceptive method without medical anxiety.

A Case of Delayed Induction of Menstruation in Primary Amenorrhea

A23-year-old white woman, married for 2 years, was referred in March, 1935, for sterility. The patient had never menstruated. She had married at 21 years of age. Still having complete amennorhea 6 months later she consulted a physician who prescribed theelol and chorionic gonadotropin. This was taken for 3 months without results. The mother had not menstruated until she married, then only at irregular intervals, and there had been only one pregnancy. The patient's personal history was not remarkable. She stated that she felt well except for frontal headaches which occurred frequently when she was excited or tired. She fatigued easily. Physical examination revealed an attractive young woman of boyish figure whose height was 64.8 in. and weight 117.7 lbs. There was only slight mammary development. The pubic hair had a tendency towards masculine distribution. The axillary hair was abundant, and there was a sufficient excess of facial hair that treatment for its removal at regular intervals by electrolysis wa...

Hormonic induction of menstruation in amenorrheas of from three months' to nine years' duration

Hormonic induction of menstruation in amenorrheas of from three months' to nine years' duration

Induction of Menstruation in Women by Use of Ovarian Hormone.

In cooperation with Claire Conklin, it was found that the basal metabolism of half the women students examined was low and was about 15% below the Aub-Dubois standard. Some of these were studied for prolonged periods but others for only one day so that, in the latter, variations were not considered. It is a significant fact that all of the cases of amenorrhea fell in the low basal group. The basal metabolism of the following women was at times 15% below normal but showed slight variations.In a previous communication we reported the use of injections of 2000 to 4000 mouse units of ovarian hormone in women and that it was excreted in the urine. Owing to this fact we supposed that repeated injections would be necessary in order to have any marked effects. Consequently, we tried the effects of daily injections into a woman, 19 years old, who had not menstruated for 5 months. One thousand mouse units were injected every day for 9 days. Then they were stopped. At the end of 3 weeks she had a menstruation which ...