Phases Of Menstrual Cycle In Women Research Articles

Hyperpigmentation after sclerotherapy: modern possibilities for prevention and treatment

Sclerotherapy is one of the most popular and most common techniques for the removal of delated reticular veins and telangiectasias on the lower limbs. Despite the vast pooled experience, this procedure can be accompanied by a number of undesirable side effects, of which post-injection hyperpigmentation, which frequency reaches 80%, is the most unpleasant one. The development of postsclerotherapy hyperpigmentation (PSHP) is associated with extravasation and destruction of red blood cells, which results in transformation of haemoglobin into hemosiderin pigment. PSHP is, by definition, a variant of post-traumatic hemosiderin pigmentation. The likelihood of occurrence and persistence of PSHP is determined by a number of hard controllable factors, including the calibre and location of the target veins, the type, concentration and physical form of the sclerosing agent, the sclerotherapy technique, the method and duration of post-procedural compression, patients’ ethnicity, iron metabolism disorders, concomitant use of a number of drugs, a menstrual cycle phase in women, etc. Hyperpigmentation significantly decreases the patients’ quality of life, which determines the need for the prevention and treatment of this undesirable side effect of phlebosclerosing treatment. Recommendations for prevention of PSHP include a detailed history taking aimed at identifying potential risk factors, in the presence of which it is advisable to use various systemic and topical drugs in the post-procedural period in order to prevent the skin hemosiderin deposition, as well as to apply the extended-cycle compression. In the case of PSHP, procedures aimed at the destruction and utilization of hemosiderin, such as Q-Switched laser and IPL therapy, as well as various peeling options intended to speed up the replacement of pigmented skin with normal, can be applied. For the PSHP prevention and treatment, the use of Contractubex containing cepalin onion extract in combination with allantoin and heparin is a matter of interest. Contractubex is a drug originally intended to optimize wound healing and prevent the formation of hypertrophic scars. At the same time, there is ample publications discussing the possible use of this drug for the management of post-traumatic hyperpigmentation due to the combined action of its components. Our clinical experience confirms the effectiveness of Contractubex in the treatment of PSHP, which determines the feasibility of conducting full-fledged clinical trials and accumulating more pooled experience in this area.

The Effects of Sex, Oral Contraception, and Menstrual Cycle Phase on Intraocular Pressure, Central Corneal Thickness, and Foveal Thickness: A Descriptive Analysis.

The primary goal of this study was to investigate the effects of sex, oral contraceptive (OC) use, and menstrual cycle phase on common ocular parameters assessed during ophthalmic evaluations, namely intraocular pressure (IOP), central corneal thickness (CCT), and foveal thickness (FT), in young healthy adults. We measured IOP, CCT, and FT in 60 participants (16 men, 16 contraceptive users, and 28 cycling women) over two sessions that characterized the menstrual cycle phase in women. For men in our study, two sessions were separated by two weeks. For women, the two sessions were scheduled during the follicular and luteal phases of the menstrual cycle. There was a trend towards higher IOP in men, and the difference was significant for white, non-Hispanic subjects and for white subjects considered separately. There was also a trend for thicker corneas in women, but men had significantly thicker foveae. CCT and FT were not different between men and OC-users, hinting at a moderating hormonal effect of oral contraceptive use. We found that IOP, CCT, and FT were equivalent between the follicular and luteal phases, which may be owing to the timing of our sessions. However, our findings strongly suggest that clinicians should consider contraceptive use during routine ophthalmic evaluations, as it could inform glaucomatous risk in women.

Differences in autonomic heart rate modulation during rest and after a supramaximal anaerobic test in relation to gender and the menstrual cycle in women

Background/Aim. Heart rate variability (HRV) and heart rate recovery (HRR) show differences between genders, and dissimilarities were also reported in women in various menstrual cycle (MC) phases. The aim of this research was to analyze cardiac autonomic indices during rest and in re-covery after the Wingate test between genders in the young, sedentary population and to investigate whether a MC phase in women can influence these indi-ces. Methods. Twenty-five females (20.5 ? 0.7 years) and sixteen males (20.4 ? 0.7 years) performed the Wingate anaerobic test on a cycle ergometer while their HRR and resting and recovery HRV indices were obtained. In fe-males, data were collected during three distinctive MC phases. Results. The natural logarithm of low-frequency (lnLF) HRV marker and the natural logarithm of high-frequency (lnHF) HRV marker were higher in males dur-ing rest compared to women in all MC phases, except in the late follicular phase, where no differences in lnHF be-tween genders were observed. Markedly higher lnLF and lnHF were recorded in males after the Wingate test. There were no differences in HRV between women in various MC phases during rest. Surprisingly, parasympathetic time-domain marker (the square root of the mean squared dif-ferences of successive NN intervals, RMSSD) and lnLF were both higher in the early follicular phase in compari-son to the luteal phase of MC during recovery. HRR was faster in men in comparison to women in all MC phas-es. Conclusion. Males show greater HRR and total varia-bility during rest and recovery, but it appears that resting parasympathetic activity is similar when females are in the late follicular phase of MC. Intra-female resting autonomic variability is not affected by the sex hormonal cycle. Post-exercise HRV in the early follicular phase reflects a signifi-cantly favourable autonomic profile in comparison to the luteal phase of MC.

Disgust sensitivity in relation to menstrual cycle phase in women with and without an infection.

The compensatory prophylaxis hypothesis (CPH) proposes that evolved psychological mechanisms enhance the avoidance of potential contaminants during periods of reproductive immunomodulation in order to decrease a chance of infection. However, the results of previous studies are inconclusive. Our aim was to investigate the differences in disgust sensitivity during phases of menstrual cycle in regularly cycling young healthy women and among women who reported having an infection. The disgust sensitivity was measured using Two Domains of the Three Domain Disgust Scale (TDDS), Padua Inventory (PI), and photographs during the internet-based survey. Women (N = 527) were divided by phases of menstrual cycle using two different methods on the basis of reported cycle length and the number of days since the onset of their most recent menstrual bleeding. The women who had an infection and who were in luteal phase had higher scores in Pathogen Disgust Domain than women in follicular phase. However, they did not differ in other assessments of disgust sensitivity. The results provide weak support for the CPH hypothesis. We found differences in disgust sensitivity in women who declared having an infection-participants in the luteal phase scored higher in the Pathogen Domain Scale of TDDS than women in the follicular phase. We suggest that future studies should measure levels of sex steroids and immunological markers of infection.

Effect of sex, menstrual cycle phase, and monophasic oral contraceptive pill use on local and central arterial stiffness in young adults.

Arterial stiffness is associated with increased cardiovascular disease risk. Previous sex-based investigations of local and central stiffness report inconsistent findings and have not controlled for menstrual cycle phase in women. There is also evidence that sex hormones influence the vasculature, but their impact on arterial stiffness across a natural menstrual (NAT) or oral contraceptive pill (OCP) cycle has been understudied. This study sought to 1) examine potential sex differences in local and central stiffness, 2) compare stiffness profiles between NAT and OCP cycles, and 3) investigate the relationship between duration of OCP use and arterial stiffness. Sex hormone concentrations, β-stiffness index (local stiffness), and carotid-femoral pulse wave velocity [cfPWV (central stiffness)] were assessed in 53 healthy adults (22 ± 3 yr old, 20 men, 15 NAT women, and 18 OCP women). All participants were tested three times: men on the same day and time 1 wk apart, NAT women in menstrual, midfollicular and luteal phases of the menstrual cycle, and OCP women in placebo, early active and late active pill phases. β-Stiffness was higher in men than NAT and OCP women ( P < 0.001), whereas cfPWV was similar between groups ( P = 0.09). β-Stiffness and cfPWV did not differ across or between NAT and OCP cycles ( P > 0.05 for both) and were not associated with duration of OCP use (β-stiffness: r = 0.003, P = 0.99; cfPWV: r = -0.26, P = 0.30). The apparent sex differences in local, but not central, stiffness highlight the importance of assessing both indexes in comparisons between men and women. Furthermore, fluctuating sex hormone levels do not appear to influence β-stiffness or cfPWV. Therefore, these stiffness indexes may need to be assessed during only one cycle phase in women in future investigations. NEW & NOTEWORTHY We observed higher local, but not central, arterial stiffness in men than women. We also demonstrated that there are no differences in arterial stiffness between naturally cycling women and women who use monophasic oral contraceptive pills, and that the duration of oral contraceptive pill use does not influence arterial stiffness.

Sex differences and functional hemispheric asymmetries during number comparison

BackgroundGlobal-local stimuli are hierarchical structures consisting of a larger global structure which is composed of smaller local stimuli. Numbers are also constructed hierarchically, with multi-digit numbers being made up from single digits. During two-digit number comparison, compatible items (larger number contains larger unit digit, e.g., 53 vs. 68) are processed faster and more accurately than incompatible items (smaller number contains larger unit digit, e.g., 58 vs. 63). This so-called unit-decade-compatibility effect has challenged the holistic model of number processing and suggests that the processing of number magnitudes occurs at least in part, decomposed, i.e., separately for each digit. Thus, the compatibility effect is indicative of how decomposed numbers are processed, thereby sharing similarities with traditional global-local processing of hierarchical stimuli.The goal of this study was to investigate whether factors that have been shown to reliably influence global-local processing also affect the compatibility effect during number comparison. Those include visual hemifield, sex, and menstrual cycle phase in women.MethodOne hundred sixty participants, 77 naturally cycling women and 83 men, completed a two-digit number comparison task twice, with test-sessions time-locked to the early follicular or mid-luteal cycle phase in women. Number comparison stimuli were presented to the right or left hemifield, respectively.ResultsWe observed a stronger compatibility effect in the right visual hemifield compared to left visual hemifield and in women compared to men, but no evidence for an influence of menstrual cycle phase in women could be found.ConclusionHemispheric asymmetries in holistic versus decomposed number processing could be demonstrated for the first time, suggesting a similar hemispheric modulation for number magnitude processing as for global-local processing.

Emotional interference and attentional processing in premenstrual syndrome

Background and objectivesPremenstrual syndrome (PMS) is characterized by menstrual cycle-related affective, behavioral, and/or somatic symptoms. By applying the emotional Stroop task (EST) the current study examined if changes in processing emotional information, which have been demonstrated in affective disorders, are also present in PMS. MethodsVia online screening, telephone interviews, and daily records over two months 55 women for the PMS group (on the basis of the specific inclusion criteria and a prospectively confirmed PMS) and 55 ‘non-PMS’ controls were recruited. All participants completed three emotional Stroop tasks (EST) with neutral and negative word, picture, and facial stimuli, during the follicular and luteal phase of the menstrual cycle. ResultsMixed 2 × 2 univariate analyses of variance and post-hoc comparisons showed primarily a greater emotional Stroop effect with respect to picture and facial stimuli in the luteal menstrual cycle phase in women with PMS, compared to the control group. No significant group differences were observed for word stimuli. With respect to the facial stimuli, a kind of paradox effect was revealed (Stroop facilitation) in the PMS group. LimitationsThis study provides important information regarding cognitive processes in women suffering from PMS that have to be interpreted in the light of the following limitations: a limited representativeness of the sample, the determination of menstrual cycle phases based on symptom diaries but not hormone levels, and a limited interpretability of our results as causal relationships. ConclusionsOur findings are in line with the assumption that alterations in cognitive-emotional processes are associated with PMS. Further research on the etiology of PMS should focus more on cognitive-emotional processing and its interaction with biological changes relating to the menstrual cycle.

The Impact of Menstrual Cycle Phase on Economic Choice and Rationality.

It is well known that hormones affect both brain and behavior, but less is known about the extent to which hormones affect economic decision-making. Numerous studies demonstrate gender differences in attitudes to risk and loss in financial decision-making, often finding that women are more loss and risk averse than men. It is unclear what drives these effects and whether cyclically varying hormonal differences between men and women contribute to differences in economic preferences. We focus here on how economic rationality and preferences change as a function of menstrual cycle phase in women. We tested adherence to the Generalized Axiom of Revealed Preference (GARP), the standard test of economic rationality. If choices satisfy GARP then there exists a well-behaved utility function that the subject’s decisions maximize. We also examined whether risk attitudes and loss aversion change as a function of cycle phase. We found that, despite large fluctuations in hormone levels, women are as technically rational in their choice behavior as their male counterparts at all phases of the menstrual cycle. However, women are more likely to choose risky options that can lead to potential losses while ovulating; during ovulation women are less loss averse than men and therefore more economically rational than men in this regard. These findings may have market-level implications: ovulating women more effectively maximize expected value than do other groups.

Self-Focused Attention and Symptoms Across Menstrual Cycle Phases in Women With and Without Premenstrual Disorders

Premenstrual disorders, which include premenstrual dysphoric disorder and premenstrual syndrome involve cyclically occurring affective, behavioral, and physical symptoms. Despite high comorbidity rates and symptom overlap with mood and anxiety disorders, there has been a lack of research investigating psychological constructs that contribute to etiology and/or maintenance of premenstrual disorders. The current study hypothesized that self-focused attention (SFA) on emotional and somatic symptoms may contribute to premenstrual distress. Participants were 61 women, including 29 women with a premenstrual disorder (PMD subgroup) and 32 controls. Participants rated symptoms and SFA responses each day for 30 days. Findings indicated that women in the PMD group reported greater use of SFA responses to symptoms compared to the control group, and during the premenstrual compared to intermenstrual phases. SFA partially mediated the relationship between menstrual cycle phase and symptoms. The interaction between physiological menstrual cycle changes and psychological contributions provides a more comprehensive explanation for premenstrual disorders, and future research is warranted to clarify this relationship.

Duplex ultrasonography findings are not related to menstrual cycle phases in women with early symptoms of lower extremity chronic venous disease.

To investigate if duplex ultrasonography findings change according to the menstrual cycle phases in women with early symptoms of lower extremity chronic venous disease. Thirty women (60 extremities) aged 18-50 years with regular menstrual cycles who presented with complaints of telangiectasia and/or trunk varices with accompanying leg pain were evaluated prospectively by duplex ultrasonography at three different times of a single menstrual cycle. Previous DVT or menstrual irregularities were exclusion criteria. All exams were performed by the same radiologist, under the same conditions. Reflux was provoked in the deep veins, great saphenous vein (GSV), and small saphenous vein (SSV) using the Valsalva maneuver. Reflux times in each vein and average diameters of the GSV and SSV were recorded. Reflux times showed no significant differences in any of the vein segments and the diameters of GSV and SSV were similar in the different menstrual phases (p > 0.05). Reflux was not predominant at any specific phase, and its presence was independent of menstrual phase. Reflux was not specific to a particular phase of menstrual cycle in women with early symptoms of chronic venous disease.

Oxytocin administration selectively improves olfactory detection thresholds for lyral in patients with schizophrenia

Olfaction plays an important role in mammalian social behavior. Olfactory deficits are common in schizophrenia and correlate with negative symptoms and low social drive. Despite their prominence and possible clinical relevance, little is understood about the pathological mechanisms underlying olfactory deficits in schizophrenia and there are currently no effective treatments for these deficits. The prosocial neuropeptide oxytocin may affect the olfactory system when administered intranasally to humans and there is growing interest in its therapeutic potential in schizophrenia. To examine this model, we administered 40IU of oxytocin and placebo intranasally to 31 patients with a schizophrenia spectrum illness and 34 age-matched healthy control participants in a randomized, double-blind, placebo-controlled, cross-over study. On each test day, participants completed an olfactory detection threshold test for two different odors: (1) lyral, a synthetic fragrance compound for which patients with schizophrenia have specific olfactory detection threshold deficits, possibly related to decreased cyclic adenosine 3',5'-monophosphate (cAMP) signaling; and (2) anise, a compound for which olfactory detection thresholds change with menstrual cycle phase in women. On the placebo test day, patients with schizophrenia did not significantly differ from healthy controls in detection of either odor. We found that oxytocin administration significantly and selectively improved olfactory detection thresholds for lyral but not for anise in patients with schizophrenia. In contrast, oxytocin had no effect on detection of either odor in healthy controls. Our data indicate that oxytocin administration may ameliorate olfactory deficits in schizophrenia and suggest the effects of intranasal oxytocin may extend to influencing the olfactory system. Given that oxytocin has been found to increase cAMP signaling in vitro a possible mechanism for these effects is discussed.

The impact of sex hormone concentrations on decision-making in females and males.

Human decision-making has been frequently studied and sex differences have been reported. Interestingly, previous results of hormone concentration on decision-making are somewhat inconsistent, regarding the impact of menstrual cycle phase in women or the influence of testosterone concentration on decision-making in women and men. However, the influence of the female sex hormone concentration (estradiol, progesterone) and the impact of oral contraceptive intake have rarely been examined and data regarding the effect of daytime variations of male testosterone are lacking. Moreover if personality factors such as sensation seeking, impulsivity, and anxiety influence decision-making, sex-specific effects, act as modulators is unclear. In the present study 71 women and 45 men were enrolled. All participants performed an evaluated decision-making task measuring risk-taking behavior on the basis of contingencies (Haegler et al., 2010), which can be carried out several times without a learning effect. Saliva samples were collected to obtain estradiol, progesterone, and testosterone levels. Additionally, all participants completed questionnaires measuring various personality factors. Data analysis revealed no sex differences in decision-making and no significant impact of testosterone concentration on behavioral performance in women or men. However, a significant negative correlation between progesterone concentration of women in the luteal phase and their performance in the risk-averse condition was obtained. Interestingly, a significant correlation between trait anxiety and decision-making occurred in females and males. Despite similar risky decision-making of women and men and no influence of testosterone concentration, menstrual cycle phase showed an effect on risk taking in women. In contrary to other studies, our findings provide rather subtle evidence for hormonal influences in decision-making, which may be primarily explained by task factors.

Menstrual Phase as Predictor of Outcome After Mild Traumatic Brain Injury in Women

To determine whether menstrual cycle phase in women at the time of mild traumatic brain injury (mTBI) predicts 1-month outcomes. Six emergency departments; 5 in Upstate New York, and 1 in Pennsylvania. One hundred forty-four female participants (age, 16-60) who presented to participating emergency departments within 4 hours of mTBI. Nested cohort study with neurologic and quality-of-life outcome assessment, 1 month after enrollment. Female subjects aged 16 to 60 enrolled in the parent cohort study, with 1-month neurological determination data available, were classified into menstrual cycle groups by serum progesterone concentration and self-reported contraceptive use. Rivermead Post Concussion Questionnaire and EuroQoL/EQ5D. Women injured during the luteal phase of their menstrual cycle, when progesterone concentration is high, had significantly lower EuroQoL General Health Ratings and Index Scores than women injured during the follicular phase of their cycle or women taking oral contraceptives. Multivariate analysis confirmed a significant independent effect of menstrual cycle phase on EuroQoL Index Score and the Rivermead Post Concussion Questionnaire Somatic Subscore. Menstrual cycle phase and progesterone concentration at the time of mTBI affect 1-month quality-of-life and neurologic outcomes. This association has important implications for treatment and prognosis after mTBI.

Accuracy of Calendar-Based Methods for Assigning Menstrual Cycle Phase in Women

Background:Sex steroid hormone fluctuations during the menstrual cycle are considered a risk factor for noncontact anterior cruciate ligament injuries.Objective:To determine whether self-reported menstrual history data can be used to accurately categorize menstrual cycle events using calendar-based counting methods.Study Design:Descriptive laboratory study.Methods:Seventy-three women completed a menstrual history questionnaire and submitted to blood sampling for the first 6 days of menses and 8 to 10 days after a positive ovulation test over 2 consecutive months. Frequency counts determined whether appropriate criterion hormone (progesterone) levels were achieved at predefined calendar days.Results:For the criterion of progesterone >2 ng/mL, 18% and 59% of women attained it when counting forward 10 to 14 days after the onset of menses and counting back 12 to 14 days from the end of the cycle, respectively. Most women (76%) attained the criterion for ovulation 1 to 3 days after a positive urinary ovulation test. Regardless of the counting method employed, the criterion of progesterone >4.5 ng/mL for identifying midluteal phase was attained in 67% of cases. Serial blood sampling for 3 to 5 days after the positive urinary ovulation test captured 68% to 81% of the hormone values indicative of ovulation and 58% to 75% indicative of the luteal phase.Conclusion:These data suggest that self-reported menstrual history and calendar-based counting methods should not be used alone if accurate identification of ovulation is essential. A urinary ovulation test and serial blood samples for verification of progesterone postovulation enhance the proper identification of menstrual cycle events.Clinical Relevance:Given the cost of serial blood sampling on numerous days, the use of urinary ovulation kits and strategically selected serial blood sampling could significantly reduce participant burden and provide cost-effective measures for clinical studies related to anterior cruciate ligament injury epidemiology.

Effects of Caffeine Consumption on Premenstrual Syndrome: A Prospective Study

OBJECTIVE: To test hypotheses concerning patterns of caffeine consumption as a function of menstrual cycle phase in women with premenstrual syndrome (PMS), as compared with controls. METHODS: Daily symptom ratings were obtained online for two consecutive menstrual cycles. Women displaying a 30% increase in PMS symptoms during the luteal phase in both cycles were assigned to the PMS group. Participants were screened using the Patient Health Questionnaire for the following exclusion criteria: pregnancy, caffeine sensitivity, and any diagnosis of psychiatric disorder within the past 6 months.RESULTS: Caffeine intake was higher during the follicular phase than during the luteal phase for both the PMS and non-PMS groups, [F (1, 67) = 7.86, P < 0.01]. There was no significant difference between the two groups in caffeine intake, [F (1, 67) = 0.93, P = 0.338] after adjusting for age, marital status, use of oral contraceptives, regular use of medication, and cigarette smoking. Moreover, caffeine consumption was lower during the luteal compared to the follicular phase of the menstrual cycle.CONCLUSION: Overall, results suggest that PMS-sufferers were as likely to consume caffeine as normal volunteers, and that women consumed more caffeine during the follicular compared to the luteal phase.

Sensory gating and sensorimotor gating in medication-free obsessive-compulsive disorder patients

Obsessive-compulsive disorder (OCD) is associated with deficits in inhibition mechanisms. This is reflected in reports showing impaired sensorimotor and sensory gating in OCD patients, as measured with prepulse inhibition (PPI) of the startle reflex and P50 suppression paradigms. However, most of the patients in these studies used medication and the results were not controlled for menstrual cycle phase in women. In this study PPI and P50 suppression were tested in 25 medication-free OCD patients and 25 healthy controls, using auditory stimuli and controlling for menstrual cycle effects. Subgroups were established, based on clinical variables (e.g. 'washers' and 'checkers'). No impairments in PPI or P50 suppression were found in the OCD group when compared with healthy controls. However, a subgroup of OCD patients ('checkers', n=12) showed increased P50 suppression. It was concluded that sensorimotor and sensory gating is not impaired in drug-free OCD patients, taking into account the menstrual cycle effects in women. These results do not support hypotheses linking deficits in these inhibition paradigms and the pathogenesis of OCD. The finding of an increased P50 suppression in the subgroup of 'checkers' deserves further investigation and underlines the value of studying subgroups of OCD.

Evidence for a Role of Progesterone in Menstrual Cycle-Related Variability in Prepulse Inhibition in Healthy Young Women

Prepulse inhibition (PPI) of the startle response is sensitive to sex, with healthy young women showing less PPI compared with age-matched men, and varies according to the menstrual cycle phase in women. Relatively less is known regarding sex and hormonal influences in prepulse facilitation (PPF). Menstrual phase-related variability in PPI is suggested to be mediated by fluctuating estrogen level, based on the observations of more PPI in women during the follicular, relative to the luteal, phase. No study has directly assessed the relationship between fluctuating hormones and PPI or PPF levels over the human ovarian cycle. To examine the roles of circulating ovarian hormones in PPI and PPF, 16 non-smoking regularly menstruating healthy women were tested during both the follicular and luteal phases on PPI and PPF and provided saliva samples for measurement of 17beta-estradiol (estrogen), progesterone and testosterone. The results showed higher levels of 17beta-estradiol and progesterone during the luteal, relative to the follicular, phase; and more PPI during the follicular phase and more PPF during the luteal phase with comparable startle amplitude and habituation during the two phases. A larger increase in progesterone was associated with a smaller decrease in PPI from the follicular to the luteal phase. No significant associations were found between changes in PPI/PPF and estrogen levels. The findings confirm lower PPI during the luteal, compared with the follicular, phase and suggest a role for progesterone, more specifically an antipsychotic-like PPI-restoration action of progesterone, during the luteal phase in PPI of young women.

Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome?

An increase in gastrointestinal (GI) symptoms, including bowel discomfort, abdominal pain/discomfort, bloating, and alterations in bowel patterns, has been reported during premenses and menses menstrual cycle phases and the perimenopause period in women with and without irritable bowel syndrome (IBS). This article reviews the literature related to one possible physiological mechanism-declining or low ovarian hormone levels--that may underlie the occurrence or exacerbations of abdominal pain/discomfort at times of low ovarian hormones (menses, menopause) in women with or without IBS. To identify English-only review and data-based articles, PubMed was searched between January 1980 and September 2008 using the following terms: irritable bowel syndrome, functional gastrointestinal disorders, gastrointestinal motility, immune, pain, hyperalgesia, menstrual cycle, menopause, pregnancy, estrogen, estradiol (E(2)), and progesterone. Studies in animals and in humans were included; drug trials were excluded. From our review of the literature, 18 papers were identified that were related either to the mechanisms accounting for menstrual cycle fluctuations (n = 12) or to the impact of menopausal status on symptoms of IBS (n = 6). One study reported that visceral pain sensitivity was significantly higher during menses than at other menstrual cycle phases in women with IBS (P < 0.05). Other menstrual cycle phase-linked symptoms, dysmenorrheal symptoms (cramping pain) in particular, were more intense in women with IBS. Animal studies have shed some light on the relationship of ovarian hormones to GI sensorimotor function. The increase in GI symptoms around the time of menses and early menopause occurs at times of declining or low ovarian hormones, suggesting that estrogen and progesterone withdrawal may contribute either directly or indirectly. This review highlights the need for confirmatory preclinical and clinical studies to unravel the role of ovarian hormones in women with IBS.

Colposcopically observed vascular changes in the cervix in relation to the hormonal levels and menstrual cycle.

We assessed colposcopically observed vascular changes occurring in the cervix in relation to cyclical hormonal variation in healthy women. Thirty women with regular menstrual cycles and willing to remain sexually abstinent during a menstrual cycle were enrolled. Colposcopy was performed during the peak of the estrogen and progesterone levels. The mean (+/-SD) diameter of the largest visible blood vessel differed significantly between the estrogenic phase (0.38 +/- 0.14 mm) as compared with the progestogenic phase (0.47 +/- 0.12 mm; p <.01). The blood vessels were more prominent and dense and had a well-defined outline during the progestogenic phase than the estrogenic phase; however, these differences were not statistically significant. There was borderline increase in the interleukin 8 level during the estrogenic phase. Physiological changes of increased vascularity of the cervix observed colposcopically during the progestogenic phase are normal. If such changes do not correspond to the menstrual cycle phase in women using vaginal microbicides in early-phase clinical trials, presence of inflammatory markers should be evaluated. Elevated interleukin 8 during the estrogenic phase needs further evaluation.

Menstrual cycle influences endothelial progenitor cell regulation: A link to gender differences in vascular protection?

Background The potential role of endothelial progenitor cells (EPCs) in the beneficial effects of estrogen on women's cardiovascular health is of great interest. We thus evaluated if menstrual cycle influences circulating levels of EPC subpopulations in normally menstruating women and if this could underline gender differences. Methods and results Ten women and ten men were recruited for this study. Peripheral blood samples were collected at each menstrual cycle phase in women and, three times over a one month period in men. Flow cytometry analysis revealed that, in women, the number of CD133+/CD34−, CD133+/CD34+ progenitor cells (PCs) and CD133+/CD34+/VEGF-R2+ EPCs per ml of blood fluctuated significantly throughout the cycle in synchronization with the level of circulating 17β-estradiol (17βE). Maturation of CD133+/VEGF-R2+ and CD133+/CD34−/VEGF-R2+ EPCs towards respective CD144+ advanced EPC (aEPC) subpopulations was reduced at mid-luteal phase. Greater mean global number of CD133+/CD34+ PC, CD133+/VEGF-R2+ and CD133+/CD34−/VEGF-R2+ EPC subpopulations was found in women and 17βE was identified as a predictive factor for the gender differences perceived. Finally, maturation of CD133+ and CD133+/CD34− towards respective EPCs or aEPCs was increased in women compared to men. Conclusions Our results suggest a physiological regulation of the availability of PC and EPC subpopulations in premenopausal women throughout menstrual cycle and reveal gender differences in the level and maturity of specific PC, EPC and aEPC subpopulations.This cyclic regulation in premenopausal women, may in part explain the lower prevalence of cardiovascular events at middle age compared with men or the timing of such events during the menstrual cycle.