Phase Of Menstrual Cycle Research Articles

PEAK EXPIRATORY FLOW RATE DURING VARIOUS PHASES OF MENSTRUAL CYCLE IN ASTHMATICS PRESENTING TO A TERTIARY CARE CENTRE

Introduction: Asthma is a chronic inflammatory lung disease characterized by airway hyper responsiveness and reversible airway obstruction. Worsening of asthma symptoms and pulmonary functions in relation to menstruation has been documented by some authors. Objectives: To determine peak expiratory flow rate during various phases of menstrual cycle among adult asthmatic women. Methods: A Prospective studyof1 year duration (July 2020 to June2021) A consecutive series of 100 patients with asthma, attending the outpatient clinic of department of chest diseases, satisfying inclusion criteria were included in the study. The socio demographic details and the relevant clinical details was collected using the socio demographic Performa prepared specifically for the study, Patients asked to record asthma symptom scores, morning Peak Expiratory Flow Rate (m-PEFR) (best out of 3 readings taken) daily during the one month screening period to identify women with and without pre-menstrual asthma Results And Discussion: From our study we found highest mean PEFR value is during post ovulatory phase. Lowest during perimenstrual phase. Fall in PEFR seen mostly during perimenstrual phase (43%). Then during preovulatory phase (34%). No such fall seen during periovulatory and postovulatory phase. Severe symptoms were present during perimenstrual phase (19%) and preovulatory phase (14%) only. Similarly, moderate symptoms also during perimenstrual (22%) and preovulatory phase (21%). Both severe and moderate symptoms were not seen during periovulatory and postovulatory phase. Conclusion: Premenstrual exacerbation of asthma occurs in a significant proportion of female adult asthmatics. Thus proper history including menstrual variation of asthma of all these patients should be taken for effective management.

The reproductive function of women with infertility after suffering COVID-19 infection

The aim was to assess the status of reproductive function of infertile women after COVID-19 infection. Materials and methods. The thorough examination included 120 patients who appealed to the reproductive clinic for infertility treatment. These women were divided into 2 groups: the main group - 80 women after COVID-19 infection (exclusion criteria - patients solely with the male factor of infertility), and the comparison group included 40 patients without COVID-19 infection in anamnesis. Results. Patients with infertility and "long-COVID" have more pronounced disorders of the reproductive function compared to women without history of COVID-19 infection, namely: a decrease in the ovarian reserve (28.8% vs. 10.0%; p<0.05), various menstrual disorders (35.0% vs. 12.5%; p<0.05), including amenorrhea, irregular menstrual cycle and luteal phase insufficiency, high prevalence of genitourinary infections (37.5% vs. 17.5%; p<0.05). Against these disorders background, patients with "long-COVID" have significantly inferior results of in vitro fertilization programs: one in five has "poor ovarian response" (21.3% vs. 2.5%; p<0.05). Clinical pregnancy was diagnosed in 22.5% of patients versus 40.0% (p<0.05), and 2 women had a pregnancy loss in the 1st trimester, while all 16 women in the comparison group carried fetuses to live birth, i.e., the live birth rate was 20.0% versus 40.0% (p<0.05). Conclusions. Determined changes in reproductive function may be directly or indirectly related to the "long-COVID" consequences, namely, a high level of stress, anxiety and depression, pernicious habits, general fatigability that leads to a sedentary lifestyle, sleep disturbances, the developing or exacerbation of somatic pathologies, among which stand out metabolic disorders and pathology of the liver and gastrointestinal tract. This study was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the abovementioned institution. Informed consents of the women were obtained for participation in this study. The author declares no conflicts of interest.

Menstrual cycle influences on cue-induced smoking cravings and heart rate variability.

Women experience greater difficulties in quitting smoking than men, though the hormonal factors contributing to this sex difference remain to be clarified. The current study aimed to examine menstrual cycle effects on smoking cue-induced cravings as well as examine dynamic reproductive hormone change as a potential mediator underlying any cycle effects observed. Twenty-one women who smoke underwent two laboratory sessions - one in the mid-follicular phase and the other in the late luteal phase - involving an in-vivo smoking cue task, administered before and after exposure to a psychosocial laboratory stressor. Heart rate variability (HRV) and subjective smoking cravings were assessed in response to the cue task. The degree of change in the urinary metabolites of estradiol and progesterone from 2 days before to the day of each laboratory session was measured. Results revealed that both before and following exposure to psychosocial stress, highly nicotine-dependent women exhibited smaller cue-induced increases in HRV relative to the follicular phase. In contrast, less nicotine-dependent women exhibit an increase in HRV in both menstrual cycle phases. Results furthermore suggest that menstrual cycle effects seen in highly nicotine-dependent women are driven by the decline in estradiol and progesterone occurring in the late luteal phase. Though limited by a small sample size, this study suggests that withdrawal from reproductive hormones in the late luteal phase may alter highly nicotine-dependent women's physiological response to smoking cues, which may reflect greater difficulty resisting temptation. These findings may provide some insight regarding women's greater difficulty in maintaining abstinence after quitting smoking.

The effects of menstrual cycle phases on immune function and inflammation at rest and after acute exercise: A systematic review and meta-analysis.

The immune system plays an important role in mediating exercise responses and adaptations. However, whether fluctuating hormone concentrations across the menstrual cycle may impact these processes remains unknown. The aim of this systematic review with meta-analysis was to compare baseline concentrations as well as exercise-induced changes in immune and inflammatory parameters between menstrual cycle phases. A systematic literature search was conducted according to the PRISMA guidelines using Pubmed/MEDLINE, ISI Web of Science, and SPORTDiscus. Of the 159 studies included in the qualitative synthesis, 110 studies were used for meta-analysis. Due to the designs of the included studies, only the follicular and luteal phase could be compared. The estimated standardized mean differences based on the random-effects model revealed higher numbers of leukocytes (-0.48 [-0.73; -0.23], p < 0.001), monocytes (-0.73 [-1.37; -0.10], p = 0.023), granulocytes (-0.85 [-0.1.48; -0.21], p = 0.009), neutrophils (-0.32 [-0.52; -0.12], p = 0.001), and leptin concentrations (-0.37 [-0.5; -0.23], p = 0.003) in the luteal compared to the follicular phase at rest. Other parameters (adaptive immune cells, cytokines, chemokines, and cell adhesion molecules) showed no systematic baseline differences. Seventeen studies investigated the exercise-induced response of these parameters, providing some indications for a higher pro-inflammatory response in the luteal phase. In conclusion, parameters of innate immunity showed cycle-dependent regulation at rest, while little is known on the exercise responses. Due to a large heterogeneity and a lack of cycle phase standardization among the included studies, future research should focus on comparing at least three distinct hormonal profiles to derive more specific recommendations for exercise prescription.

P-334 Transcriptomic patterns in early-secretory and mid-secretory endometrium in a natural menstrual cycle immediately before in vitro fertilization and embryo transfer

Abstract Study question To evaluate endometrial transcriptomic patterns in early-secretory phase (ESP) and mid-secretory phase (MSP) in a natural menstrual cycle before IVF-ET Summary answer Endometial ranscriptomic patterns in ESP and MSP immediately before IVF-ET appear to differ according to IVF-ET outcome, which may be implicated in endometrial receptivity. What is known already Biologic processes and molecular participants in the transition from ESP to MSP endometrium underscore the complex events in preparing for embryo implantation. Previously reported genes with altered expression during endometrial transition from the ES phase to the MS phase were frequently involved in ion binding, cell cycle regulation, transport of signaling proteins, or immune modulation. Although several studies have compared gene expression in the receptive phase and pre-receptive phases in an attempt to identify a molecular signature characteristic of a receptive endometrium, a consensus has not been reached regarding the genes accounting for transcriptomic differences between phases. Study design, size, duration Differentially expressed genes (DEGs) in the MSP, compared to the ESP, were identified using NanoString nCounter data in both the pregnant and non-pregnant groups. Participants/materials, setting, methods A total of 30 patients whose endometrial tissues were obtained in a natural menstrual cycle immediately before IVF-ET were included. Endometrial dating was histologically confirmed as ESP (cycle day 16 to 18) or MSP (cycle day 19 to 21) according to Noyes criteria. The patients were divided into two groups depending on IVF-ET outcome: pregnant (n = 14; 7 in ESP and 7 in MSP) or non-pregnant (n = 16; 8 in ESP and 8 in MSP). Main results and the role of chance A total of 14 DEGs were identified when comparing the ES phase and MS phase endometrium in the pregnant group. A total of 12 DEGs were identified when comparing the ES phase and MS phase endometrium in the non-pregnant group Nine genes were upregulated in the MS phase endometrium, compared to the ES phase endometrium, in both the pregnant and non-pregnant groups: adrenoceptor alpha 2A (ADRA2A), interleukin 1 receptor-associated kinase 2 (IRAK2), a disintegrin and metalloproteinase with thrombospondin repeats 15 (ADAMTS15), serpin family E member 1 (SERPINE1), integrin subunit beta 3 (ITGB3), transmembrane protein 252 (TMEM252), huntingtin associated protein 1 (HAP1), C2 calcium-dependent domain containing 4A (C2CD4A), and integrin subunit alpha 2 (ITGA2). Four genes were upregulated in the MS phase endometrium, compared to the ES phase endometrium, only in the pregnant group: TMEM37, galactosidase beta 1 like 2 (GLB1L2), Rho family GTPase 3 (RND3), and cytochrome P450 family 24 subfamily A member 1 (CYP24A1). One gene (ADAMTS8) was downregulated and one gene (monoamine oxidase A [MAOA]) was upregulated in the MS phase endometrium, compared to the ES phase endometrium, only in the non-pregnant group. Limitations, reasons for caution Firstly, since our sample size was relatively small, our results should be considered preliminary. Secondly, because endometrial tissue samples wee not obtained in IVF-ET cycle, they may not reflect changes in an actual pregnancy cycle.Thirdly, there may have been embryonic effects on implantation that were not accounted for. Wider implications of the findings TMEM37, GLB1L2, RND3, and CYP24A1 were upregulated only in the pregnant group; ADAMTS8 was downregulated while MAOA was upregulated only in the non-pregnant group.These novel DEGs, which have not been previously studied, may have functional significance during the WOI and serve as potential biomarkers of endometrial receptivity. Trial registration number not applicable

P-419 Oocytes quality in random start protocols for fertility preservation: insights from follicular steroidogenesis.

Abstract Study question Is follicular steroidogenesis impaired in women undergoing random start protocols for fertility preservation? Summary answer The phase of menstrual cycle at initiation of ovarian stimulation does not influence the endocrine microenvironment surrounding oocytes. What is known already Cryopreservation of oocytes is the gold standard for fertility preservation in women with cancer. Random start protocols have been introduced for oocytes cryopreservation in these patients to shorten the duration of ovarian stimulation. However, albeit generally reassuring, available evidence is still insufficient to rule out a sub-optimal cycle outcome of random start protocols. Study design, size, duration The present study was conducted to provide evidence on the validity of random start protocols by exploring the quality of ovarian steroidogenesis. The primary outcome was comparing levels of steroids in the follicular fluid between women initiating the random start protocol in the luteal phase and those initiating in the follicular phase (considered as controls since equivalent to the conventional protocols). We excluded those requiring concomitant letrozole assumption. Participants/materials, setting, methods Seventy-one women with cancer were prospectively recruited during a 24-month period. Thirty-three initiated in luteal phase while 38 in follicular phase. All women were stimulated with recombinant FSH and GnRH antagonists. At the time of oocytes retrieval, follicular fluids were pooled, and a sample was frozen at -80 °C. All samples were assayed concomitantly after thawing, by liquid chromatography tandem mass spectrometry. The concentration of 15 different steroid hormones was determined. Main results and the role of chance Baseline characteristics of the two groups were similar. No differences emerged in anamnestic data and ovarian reserve variables. Cycle outcome did not also differ, the two study groups being similar in terms of total dose of gonadotropins, duration of stimulation, number of developed follicles and number of oocytes retrieved. The median [interquartile range] number of frozen mature oocytes was 9 [5-14] and 10 [5-21] in women who initiated in the luteal and the follicular phase, respectively (p = 0.42). None of the 15 tested steroid hormones differed. Two subgroup secondary analyses were performed to rule out confounders. First, we excluded women who were on estroprogestins at the time of recruitment (leaving 31 women initiating in the follicular phase and 32 in the luteal phase). Levels of steroids in the follicular fluids were still mainly similar. We observed a significant difference only for androstenedione, levels being higher for women initiating stimulation in the follicular phase. Second, we compared women in the early (up to day 5) and late follicular phase (26 and 12 cases, respectively). Levels of steroids in the follicular fluids did not differ except for cortisone, the concentration being higher in the early follicular phase. Limitations, reasons for caution Our study is not randomized, inevitably exposing our results to confounders. Assessment of intraovarian steroidogenesis is an indirect evidence of oocyte quality. Multiple comparisons were done, exposing our findings to type I errors (such as, in our opinion, the differences that emerged in the secondary analyses). Wider implications of the findings Random start protocols have become the standard of care for fertility preservation in women with cancer in the absence of robust evidence. Our data supports the validity of random start protocols in terms of quality of ovarian response since none of the tested hormones differed. Trial registration number Not applicable

O-232 Extracellular vesicles secreted by the maternal endometrium functionally regulate processes related to embryo development and implantation in human blastocysts

Abstract Study question What is the response of human embryos in a transcriptomic level to the uptake of extracellular vesicles (EVs) secreted by the human endometrium? Summary answer EVs secreted by the maternal endometrium induce a transcriptomic response in human embryos that modulates molecular mechanisms related to embryo development and implantation. What is known already Communication between the maternal endometrium and the embryo is essential for a successful implantation, and EV role in this cross-talk has been recently established. Results of our previous experiments showed that endometrial EVs carry miRNAs and proteins related to endometrial receptivity, embryo implantation process and early embryo development, and that they can be uptaken by human blastocysts. However, there are no studies which address the transcriptomic response of human embryos to the uptake of these EVs, which would demonstrate the functional relevance of this communication system. Study design, size, duration Endometrial biopsies were collected from oocyte donors (n = 20) with confirmed fertility, on oocyte retrieval day, and primary human endometrial epithelial cells (pHEECs) were isolated and in vitro cultured. Hormonal treatment was added to mimic secretory phase of menstrual cycle. Conditioned medium was collected and EVs were isolated and characterized. Day 5 human blastocysts (n = 24) were divided into two groups (n = 12/group) and cultured in vitro with or without these EVs. RNA-sequencing of these embryos was performed. Participants/materials, setting, methods Conditioned media from pHEECs was pooled into 4 replicates (n = 5 biopsies/replicate) and EVs were isolated by ultracentrifugation. Characterization was performed by western blot, nanoparticle tracking analysis and transmission electron microscopy (TEM). Human blastocysts were devitrified and cultured in vitro for 24h with or without EVs previously isolated. RNA-sequencing analysis was performed, and DESeq2 was used to identify differentially expressed genes (FDR&amp;lt;0.05). QIAGEN Ingenuity Pathway Analysis (IPA) was used to perform the functional enrichment analysis. Main results and the role of chance EVs presented a size range within 100-300nm, and expression of EV protein markers HSP70, TSG101, CD9 and CD81. EV morphology was corroborated by TEM. RNA-sequencing identified 26610 genes, being significant 519 upregulated and 395 downregulated in EV-embryos compared with control. Among top20 most significant upregulated genes, CSF1R (log2FoldChange [logFC]=3.36) has been associated with formation of blastocyst cavity, and PLOD2 (logFC=2) deficiency leads to early embryonic lethality. Genes related to antioxidant defense, as PDK1 (logFC=2.82), or vesicle trafficking, as SEC24D (logFC=2.17), were also upregulated. Regarding top20 downregulated genes, DAB2IP (logFC=-1.19) negative regulation was found beneficial in early pregnancy, and DUSP6 (logFC=-2.07) was associated with cell differentiation and pluripotency. Functional analysis demonstrated positive regulation of biological processes related to embryonic development, cellular invasion and migration, cell cycle, cellular organization, and cell viability in EV-embryos. Contrary, there was a negative regulation of processes related to cell death, apoptosis, and DNA fragmentation. Some pathways upregulated in EV-embryos were NANOG role in embryonic pluripotency (z-score [z]=1.89), unfolded protein response (z = 3.05), involved in cellular homeostasis, VEGF signaling (z = 1.67), that regulates trophoblast adaptation to hypoxia, and integrin signaling (z = 3.36), which regulates trophoblast adhesion and differentiation; PTEN signaling (z=-1.73) was inhibited in EV-embryos, suppression of which prevents apoptosis. Limitations, reasons for caution This is an in vitro study in which conditions of endometrial cell culture could not mimic the intrauterine environment. Wider implications of the findings EVs secreted by the maternal endometrium and uptaken by human blastocysts regulate processes related to embryo development and implantation, suggesting the functional relevance of this endometrial-embryo crosstalk during the implantation process. This study opens further research insight to define potential targets of implantation success and embryo competence. Trial registration number Not applicable

An Analysis of Menstrual Symptoms, Menstrual Attitudes, Physical Stress and Psychological Stress According to the Menstrual Cycle Phase.

Women undergo an array of menstrual symptoms, depending on the menstrual cycle period. This study aimed to gain a more objective understanding of the impact of menstruation by examining differences in menstrual symptoms, menstrual attitude, physical stress, and psychological stress across the menstrual cycle. This study was conducted from Apr to Jun 2021 in the Gyeonggi Province of Korea. Women aged ≥20 yr were divided into premenstrual (n=17), menstrual (n=8), and postmenstrual periods (n=23). Menstrual symptoms and menstrual attitudes were assessed using questionnaires. Quantitative electroencephalography was used to assess the physical stress indices (left and right), and the psychological stress indices (left and right), with brainwave parameters quantified by frequency series power spectrum analysis. Data were compared using the non-parametric tests. More menstrual symptoms were experienced in the menstrual period than in the premenstrual period (Z=2.16, P=.031). Menstrual attitudes did not significantly differ among menstrual periods (Z=1.20, P=.231). Physical stress indices were high (≥10 μV) throughout the menstrual cycle and there were significant differences among the three periods (left: χ2=4.00, P=.035, right: χ2=5.78, P=.046). Psychological stress indices were >1 μV during the premenstrual and menstrual periods. Women experience more severe and diverse menstrual symptoms in the menstrual period than in other periods. Objective investigations are needed to inform an effective approach for addressing negative menstruation-related experiences.

Adrenocorticotropic hormone secretion in response to anticipatory stress and venepuncture: The role of menstrual phase and oral contraceptive use

IntroductionOral contraceptives (OCs) are primarily known for their effects on the reproductive system, but they can also impact the hypothalamic–pituitary–adrenal (HPA) axis. The present study aimed to compare plasma adrenocorticotropic hormone (ACTH) responses to the anticipatory stress of participating in a scientific experiment and venepuncture in OC users versus naturally cycling (NC) women, with a focus on variations throughout the menstrual cycle. MethodsWe recruited 131 young women (average age 20.5) and obtained blood samples to measure plasma ACTH concentrations immediately after venepuncture and again after 15 min of group activities designed to facilitate interpersonal attachment and stress-buffering. ResultsACTH levels decreased in 70% of all participants throughout the group activities. A two-way repeated measures ANOVA highlighted a significant interaction between time and OC use, indicating differential changes in ACTH levels during social interaction between OC users and NC women. Further, the post-hoc analysis revealed that a period of stress-buffering group activities significantly decreased ACTH levels in NC women during menstrual and secretory phases, but not during the proliferative phase. In contrast, OC users did not display a decrease during group activities, regardless of the phase. ConclusionThis study underscores the influence of OC use on stress regulation, demonstrating that OCs not only modulate reproductive functions but also impact ACTH stress reactivity. Additionally, it emphasizes the importance of considering hormonal contraceptive use and menstrual cycle phases when assessing female stress responses.

Menstrual cycle, heart rate variability (HRV), and mood: Is cyclicity of HRV associated with cyclicity of mood symptoms?

In an effort to understand potential biological indices of menstrually-related mood changes experienced by some naturally cycling individuals, we previously investigated whether vagally-mediated HRV (i.e., a biomarker of physical and mental health) fluctuates across the menstrual cycle. Our recent meta-analysis revealed a significant decrease of HRV in the midluteal phase which, as two-follow up studies suggest, is correlated with progesterone. However, the question remains whether cyclicity of HRV is associated with cyclicity of mood symptoms. Fifty naturally-cycling participants (M=24.8 years, SD=5.8) were examined (10-min baseline EKG for HRV assessment, PANAS for mood assessment) in three precisely determined cycle phases (ovulatory, midluteal, menstrual) via ovulation testing. To test the idea that degree of midluteal (vs. menstrual phase) HRV suppression is associated with the degree of PANAS same-day mood deterioration in the midluteal phase (vs. menstrual phase), each person’s difference score in HRV between the two phases was assessed. This between-person factor was taken into multilevel models predicting PANAS items from menstrual cycle phase. Analyses revealed that greater midluteal phase suppression of HRV was associated with greater midluteal phase increases in distress, as well as several fear and anxiety variables. No differences in sadness or irritability were found. These findings suggest that cyclical HRV suppression and cyclical increase in mood symptoms tend to covary. Further work is needed to clarify whether cyclicity of HRV may serve as a biological index of menstrually-related mood disorders.

Menstrual Cycle Modulation of Neural Reward Responsiveness and its Associations with Anhedonia

During their childbearing years, women are nearly twice as likely as men to be diagnosed with depression. Despite this stark sex difference, there is a dearth of research examining the effects of the menstrual cycle and ovarian hormones on neural mechanisms underlying depression. Reduced neural reward responsiveness is linked to depression and anhedonia, and prior studies suggest that reward responsiveness may be modulated by ovarian hormones. In a sample of 74 naturally-cycling undergraduate women, the present study employed a within-subject design and multilevel modeling to examine effects of menstrual cycle phases (i.e., early follicular, periovulatory, and mid-luteal phases) and ovarian hormones (i.e., estradiol and progesterone) on an EEG measure of neural reward sensitivity—the Reward Positivity (RewP)—and associations between the RewP and anhedonia. Anhedonia scores were collected at a baseline session and the RewP and salivary hormone concentrations were collected once in each cycle phase. While the RewP did not vary by cycle phase, the RewP was most enhanced when both estradiol and progesterone were above the intra-individual average. Additionally, women with elevated anhedonia were characterized by a reduced RewP in the periovulatory phase as compared to the mid-luteal phase. Finally, the negative association between the RewP and anhedonia was strongest in the periovulatory phase. The present findings suggest that distinct patterns of variability in the RewP across the menstrual cycle may be associated with anhedonia. Future work should further examine these possibilities via longitudinal designs and hormone administration studies.

From menarche to menopause: psychoneuroendocrinology across the female reproductive lifespan

As reproductive hormones rise and begin to fluctuate with puberty and the beginning of the menstrual cycle (i.e., menarche), there is substantially increased risk of affective illness for females compared to males. Additional risk is associated with reproductive transition events characterized by dramatic hormone changes, including the decrease in progesterone and estradiol during the premenstrual phase, the abrupt withdrawal from high pregnancy hormone levels during the postpartum period, and the turbulent hormone flux that occurs during pubertal and menopausal transitions. As such, a differential sensitivity to normal changes in reproductive hormones during specific reproductive transition events may precipitate or exacerbate affective symptoms in susceptible women. Using a model of mood disorder susceptibility in which rapid and abrupt changes in reproductive hormones may trigger the onset of affective illness in vulnerable females, this symposium will present novel findings on psychosocial and biological mechanisms underlying hormone-related, transdiagnostic affective state change spanning the female reproductive lifespan – from menarche to menopause. Following a brief introduction by the Chair, Elizabeth Andersen, the first speaker, Hannah Klusmann, will present methods and recommendations for determining ovulation status in peripubertal females within one year of menarche and how mood sensitivity to hormone flux across the menstrual cycle differs by ovulation status. Katja Schmalenberger will present recent findings on the coupling of heart rate variability suppression and the cyclical increase in mood symptoms during the midluteal menstrual cycle phase. The third speaker, Crystal Schiller, will discuss findings from three studies that used a sex steroid manipulation in women with a history of postpartum depression to determine functional neuroimaging correlates of postpartum irritability symptoms. Danielle Swales’ presentation on the interaction of life stress and estradiol on reward processing during the menopause transition will conclude the symposium.

The Relationship between High Fiber Diet and Severity of Premenstrual Syndrome Symptoms in Medical Students of Pelita Harapan University

&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;47.8% of women worldwide experience symptoms of premenstrual syndrome and 20% of women experience symptoms that are severe enough to interfere with daily activities. This occurs during the last 14 days of the menstrual cycle or luteal phase, and it is caused by hormonal fluctuations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study is going to be conducted to determine the relationship between high fiber diet and the severity of premenstrual syndrome in adolescents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This study used a comparative analytic categorical study with two unpaired categories with a cross-sectional study design. The research sample is female students at the Faculty of Medicine, University of Pelita Harapan who met the inclusion criteria of at least 74 samples by judgmental sampling. Data were collected using a questionnaire in the form of a Premenstrual Symptom Scale, Esitimated Food Record and Perceived Stress Scale with the the chi-square method, and data analysis using SPSS 24.0.&lt;/p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 85 samples that matched the inclusion and exclusion criteria of this study. The majority of the sample came from the 2018 class (64.7%), 20 years old (61.2%), experiencing moderate stress (61.2%), and have normal body mass index (72.9%). Researcher found a p value of 0.309 (p&amp;gt; 0.05), which means that there is no significant relationship between a high-fiber diet and the severity of premenstrual syndrome symptoms.

WS02.01 Decreased fertility in female cystic fibrosis patients: peering into the endometrial factor using cutting-edge organoid models

Female CF patients suffer from sub-to infertility, often facing problems to become pregnant. Underlying reasons remain understudied. In particular, it is largely unknown whether dysfunction of the endometrium is involved, the womb’s inner lining and key tissue for embryo implantation and development. This gap is mainly due to lack of appropriate study models. Therefore, we develop and apply tissue-mimicking organoid models to indetail decipher molecular and functional aberrations in fertility-deficient CF endometrium as compared to healthy (fertile) endometrium. First, we established endometrial organoids (EMO) from the Cftrtm1Eur mouse model. These organoids show a smaller lumen than wildtype (WT) EMO, and do not swell in the FIS assay, both validating the CFTR defect. Currently, we are comparing expression of endometrial functionality/fertility markers in CF versus WT EMO, as well as their responsiveness to estrogen (E2) and progesterone (P4), which in vivo regulate the estrous cycle. Second, we develop(ed) organoids from CF patient endometrium. Before, we have shown that EMO from healthy endometrium can reliably reproduce all menstrual cycle phases under defined E2/P4 exposure. Currently, we are deciphering whether and how menstrual cycle phases, including the receptivity stage, are different between CF and healthy EMO. We already observed dissimilarities in the proliferative (E2) and secretory (P4) phase, such as increased apoptosis and decreased fertility marker expression, respectively. Taken together, we establish(ed) organoid models from CF endometrium as novel and powerful tools to gain insight into the endometrial factor in CF fertility deficiency. Importantly, the organoids will be highly apt to explore the impact of new-era CFTR modulators on the endometrium, at present unknown. Moreover, our study has the potential to reveal paths toward restoring reproductive fitness in CF patients, which can be tested using the organoids as (drug) screening platform.

The role of iron in the pathogenesis of endometriosis: a systematic review.

What is the role of iron in the pathophysiology of endometriosis? Iron excess is demonstrated wherever endometriotic tissues are found and is associated with oxidative stress, an inflammatory micro-environment, and cell damage; the iron-mediated oxidative stress is independently linked to subfertility, symptom severity, and malignant transformation. Iron is found in excess in endometriotic tissues, and multiple mechanisms have been studied and posited to explain this. It is clear that iron excess plays a vital role in promoting oxidative stress and cell damage. The evidence base is large, but no comprehensive reviews exist to summarize our understanding and highlight the overarching themes to further our understanding and suggest future directions of study for the field. This systematic review with a thematic analysis retrieved studies from the PubMed, Embase, Web of Science, and Cochrane Library databases and searches were conducted from inception through to August 2022. Human and animal studies published in the English language were included and identified using a combination of exploded MeSH terms ('Iron' and 'Endometriosis') and free-text search terms ('Iron', 'Ferric', 'Ferrous', 'Endometriosis', 'Endometrioma'). This review was reported in accordance with the PRISMA guidelines. All studies reporting original data concerning the role of iron or iron complexes in the pathophysiology of endometriosis were included. Studies that did not report original data or provided a review of the field were excluded. Bias analysis was completed for each included study by using the Newcastle-Ottawa scoring system. There were 776 records identified and these were screened down to 53 studies which met the eligibility criteria, including 6 animal and 47 human studies, with 3556 individual participants. Iron excess is demonstrated in various tissues and fluids, including ovarian endometriomas, ovarian follicles, ectopic endometriotic lesions, and peritoneal fluid. Markers of oxidative stress are strongly associated with high iron levels, and aberrant expression of iron-transport proteins has been demonstrated. Abnormal resistance to ferroptosis is likely. Iron-mediated oxidative stress is responsible for a pro-inflammatory micro-environment and is linked to subfertility, symptom severity, and, possibly, malignant transformation. A minority of the included studies were of objectively low quality with a high risk of bias and may lead to misleading conclusions. Additionally, multiple studies failed to appropriately characterize the included patients by known confounding variables, such as menstrual cycle phase, which may introduce bias to the findings. Current literature depicts a central role of aberrant iron mechanics and subsequent oxidative stress in endometriosis. It is likely that iron excess is at least partly responsible for the persistence and proliferation of ectopic endometriotic lesions. As such, iron mechanics represent an attractive target for novel therapeutics, including iron chelators or effectors of the iron-oxidative stress pathway. There are significant gaps in our current understanding, and this review highlights and recommends several topics for further research. These include the role of iron chelation, resistance to ferroptosis, the relationship between iron excess and localized hypoxia, systemic iron pathophysiology in endometriosis, and the role of oxidative stress in malignant transformation. J.W. and S.G.P. are supported by clinical fellowships at Liverpool University Hospital NHS Foundation trust. No additional funding was requested or required for the completion of this work. C.J.H. is supported by a Wellbeing of Women project grant (RG2137). D.K.H. is supported by a Wellbeing of Women project grant (RG2137) and an MRC clinical research training fellowship (MR/V007238/1). The authors have no conflicts of interest to declare. A protocol was prospectively registered with the PROSPERO database in August 2021 (CRD42021272818).

The influence of the menstrual cycle and hormonal contraceptives on cardiorespiratory fitness in physically active women: A systematic review and meta-analysis

ObjectiveTo systematically review and summarize the existing evidence related to the influence of the menstrual cycle (MC) and hormonal contraceptive (HC) use on V˙O2max in physically active women. MethodsThis systematic review and meta-analysis conforms to the PRISMA statement guidelines. Four (sub-)meta-analyses were performed. Two focused on longitudinal studies examining the same women several times to compare the V˙O2max during the different menstrual phases or oral contraceptive (OC) use and withdrawal. Two meta-analyses examined if there is a difference in V˙O2max between OC users and normally menstruating women by analyzing cross-sectional studies assigning physically active women to one of these two groups as well as intervention-based studies (cross-over studies, randomized controlled trials considering only the data of the intervention group) comparing women intra-individually with and without OCs. ResultsNine of the included studies (107 women) evaluated the influence of the MC, five studies (69 women) the impact of OCs on V˙O2max, and six studies investigated both topics (88 women). A mean difference of V˙O2max −0.03 ml/kg/min (95%CI –1.06 to 1.01) between the early follicular and luteal menstrual phase was observed. Between the active and inactive phases of OCs, a mean difference of −0.11 ml/kg/min (95%CI –2.32 to 2.10) was found. The inter-individual comparison of naturally menstruating women and OC users showed a mean difference in V˙O2max of 0.23 ml/kg/min (95% CI –2.33 to 2.79) in favor of OC use. The intra-individual comparison of the same women showed a mean decrease in V˙O2max of −0.84 ml/kg/min (95% CI –2.38 to 0.70) after a new start with OCs. ConclusionsOur meta-analyses showed no effects of the MC or the OCs on V˙O2max. More high-quality studies are needed determining the MC phases more precisely, including OCs with the current standard formulations and comparing the influence of different progestins.

The impact of the ovarian cycle on anxiety, allopregnanolone, and corticotropin releasing hormone changes after motherhood in female rats and women

Fluctuations in ovarian steroids across the estrous and menstrual cycle in female rats and women, respectively, are associated with changes in anxiety. Pregnancy causes long-term changes to ovarian hormone release, yet research on estrous- and menstrual-related changes in anxiety has focused on reproductively inexperienced females. Therefore, this study assessed whether the impact of estrous and menstrual cycles on anxiety differs pre- versus post-motherhood in female rats (n = 32) and a community sample of women (n = 63). Estrous cycle phase altered anxiety-like behavior in virgin rats, but had no effect in age-matched mother rats tested 1-month post-weaning. In humans, menstrual cycle phase was associated with ecological momentary assessed anxiety and mood in non-mothers, but not mothers; although, the menstrual cycle × reproductive status interaction for anxiety, but not mood, was rendered non-significant with age and cycle length as covariates. These findings suggest that changes in anxiety coincident with cycling hormones is an evolutionarily conserved feature of the estrous and menstrual cycle in rats and women, which is mitigated following motherhood in both species. We identified several potential mechanisms for the observed dissociation in estrous cycle effects on anxiety. Compared to virgin rats, mother rats had a lower peak and blunted decline in circulating allopregnanolone during proestrus, upregulated GABAA receptor subunit (α1, α2, α5, α4, ß2) mRNA in the ventral hippocampus, and altered corticotropin-releasing hormone mRNA across the estrous cycle in the basolateral amygdala. Together, these findings suggest that the mechanisms underlying anxiety regulation undergo fundamental transformation following pregnancy in female rats and humans.

A Role for the Serotonin Transporter in the Largely Unknown Molecular Pathophysiology of Premenstrual Dysphoric Disorder

Despite a prevalence of approximately 5% in females, premenstrual dysphoric disorder (PMDD) suffers from a lack of investigation at the neurochemical level in humans. The preferred fundamental study design in PMDD is to investigate neurobiology across the menstrual cycle, which inherently rules out direct brain tissue assays from postmortem study that are unable to be repeated in the same participant. Therefore, molecular imaging methods applicable for longitudinal designs are highly relevant for creating advances in PMDD. SEE CORRESPONDING ARTICLE ON PAGE 1081 SEE CORRESPONDING ARTICLE ON PAGE 1081 Increase in Serotonin Transporter Binding in Patients With Premenstrual Dysphoric Disorder Across the Menstrual Cycle: A Case-Control Longitudinal Neuroreceptor Ligand Positron Emission Tomography Imaging StudyBiological PsychiatryVol. 93Issue 12PreviewPremenstrual dysphoric disorder (PMDD) disrupts the lives of millions of people each month. The timing of symptoms suggests that hormonal fluctuations play a role in the pathogenesis. Here, we tested whether a heightened sensitivity of the serotonin system to menstrual cycle phase underlies PMDD, assessing the relationship of serotonin transporter (5-HTT) changes with symptom severity across the menstrual cycle. Full-Text PDF

Doppler Evaluation of Uterine Arteries in Different Phases of Menstrual Cycle in Young Adult Females with Regular Cycles

Background: The menstrual cycle is nature's cyclical method of getting ready for pregnancy. The uterine lining grows each month in preparation for implantation by a fertilized ovum. Cyclic endometrium may be non-invasively assessed with Doppler sonography and leads to alterations in local vascular patterns. The pulsatility index (PI), which measures the uterine artery (UtA) impedance, displays a predictable pattern during the typical menstrual cycle. Aim: To evaluate the flow of blood through the uterine arteries in young adult women with regular cycles during various menstrual cycle stages. Place of study and duration of study: Department of Radiology, University Ultrasonography Clinic in Green Town, Lahore. Between January 2022 and October 2022. Methodology: A comparative study was carried out at the University Ultrasonography Clinic in Green Town, Lahore, Pakistan. In this study, 180 patients between the ages of 16 and 35 were enrolled using a convenient sampling technique.All the married, and unmarried ages between 13- and 40 years old having regular periods once a month were involved in this study. Results: 180 patients in all were involved in this study comprising 60 females of each phase of the menstrual phase, 23 patients age were 25 age, 19 patients were 23 age, 20 patients were 18 age, 15 patients were 22, and 9 patients were the age of 29,30,31 years. RI of the right ovary was 0.5938 ± 0.8, the mean RI of the left ovary was 6.5083 ± 0.92357 forthe 10-20 days phase cycle, RI of the right ovary was 0.5937 ± .05266, the mean RI of the left ovary was 10.6967 ± 1.13466 of 11-20 days phase cycle, RI of right ovary was 0.5925 ± .05423, mean RI of left ovary was 6.7083±1.10258 of 21-30 days phase cycle.The uterine artery's resistivity index is compared in three menstrual cycle phases which are days 1 to 10, 11 to 20, and 21 to 30. No statistical difference was found in the right three means of the uterine artery's resistivity index as P-value=0.989 &gt; ∞=0.05. The averages of the Resistivity index of the uterine artery(left)in the three phases of the menstrual cycle are proved to be equal as we failed to find statistically significant differences where P-value=0.975 &gt; ∞=0.050. Conclusion: In this study, we have concluded that endometrial thickness and uterine artery resistivity index, determined ultrasonographically depend upon the phase of the menstrual cycle. The endometrialthickness progressively increases throughout the menstrual phase with no change in the resistive index of both uterine arteries. Keywords: Doppler ultrasound, uterine arteries, resistive index, pulsative index, endometrium stripe thickness.

(104) Immunohistochemical Staining Reveals Estrogen, Androgen and Progesterone Receptors in the Vestibule

Abstract Introduction The introitus has three embryologic tissue types: ectoderm (vulva), endoderm (vestibule), and mesoderm (vagina). The vulva and vagina have been shown previously to have estrogen receptors (ER), androgen receptors (AR) and progesterone receptors (PR). ER and AR have been demonstrated in vaginal epithelial cells, as well as in fibroblasts and smooth muscle of underlying stroma. Vulvar ER and AR were demonstrated in epidermal keratinocytes and dermal fibroblasts of hair and non-hair bearing skin. AR were also seen in vulvar sebaceous glands, sweat glands, and hair follicles. PR was seen in vaginal epithelium, fibroblasts, and smooth muscle but not in the vulva. Despite the importance of the vestibule to sexual health, there is limited information regarding vestibular hormone receptors. Objective To better understand vestibular hormonal physiology, immunohistochemical (IHC) studies of ER, AR, and PR was performed on excised vestibulectomy tissue specimen. Methods IHC was performed on 7 vestibular specimen from eugonadal individuals with confirmed diagnosis of neuroproliferative vestibulodynia based on positive CD117 and PGP9.5 staining, consistent with excess mast cells and nerve endings, respectively. Specimen were also studied with primary antibodies (Anti-ERα, Ab 32063; Anti-AR, MI 06680; Anti-PR, Dako PGR636). Finally, sections were lightly counterstained with Gill-modified hematoxylin. Results ER and AR were richly expressed in tissue samples from all 7 patients. Dense labeling of both receptor types (AR on left, on ER right) was identified in the germinal layer of the epithelium (Fig. 1) with comparatively sparse expression in the subepithelial stroma. AR, but not ER, were noted in mucinous vestibular glands (Fig. 2). While labeling of PR was highly variable (Fig. 3), all samples showed evidence of moderate PR labeling in the subepithelial stroma. Variability may be due to menstrual cycle phase during which samples were obtained, however this information was not collected. Conclusions This preliminary study provides evidence of dense ER and AR expression in the vestibule, consistent with it being in part an androgenic organ. This supports the concept that the vestibule may be more effectively treated with combined testosterone and estradiol cream than with topical estradiol alone in patients with entrance dyspareunia from hormonally mediated vestibulodynia or genitourinary syndrome of menopause. Also consistent with these findings is that treatment with intravaginal DHEA, which converts to testosterone and estradiol intracrinologically and spreads to the vestibule, successfully resolves entrance dyspareunia, as shown in a previous clinical trial. While the significance of variable vestibular progesterone receptor expression is unclear, the addition of topical progesterone in patients with entrance dyspareunia may be considered. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Endoceutics, Inc