Proliferative Phase Of Menstrual Cycle Research Articles

The Relationship between Decorin and VEGF in Endometriosis.

To evaluate immunohistochemical (IHC) staining of decorin and vascular endothelial growth factor (VEGF) of ovarian and endometrial tissues in patients with and without endometriosis. Study Design: Descriptive study. Department of Obstetrics and Gynecology, ZeynepKamil Training and Research Hospital, Istanbul, Turkey, between Istanbul, TurkeyJanuary 2018 and June 2019. Thirty patients, who underwent total abdominal hysterectomy (TAH) + bilateral salpingo-oophorectomy (BSO)/unilateral salpingo-oophorectomy (USO) and were in the proliferative phase of menstrual cycle,were included. The study population consisted of 20 patients (patient group) with an endometriomaand the control group consisted of 10 patients who were operated for benign gynecological pathologies.The ovarian and endometrial tissue specimens were collected from the archives. IHC staining was performed using decorin and VEGF. Decorin analysis showed a significantly higher intensity of staining in both endometrial and ovarian tissues in control group than patient group. Patients with endometriosis had a lower intensity of staining of decorin and a higher intensity of staining of VEGF compared to control group. There was a negative, statistically significant concordance between VEGF and decorin staining of endometrial tissues of both groups (concordance rate -0.560, p=0.001). Therewas a negative, statistically significant concordance between VEGF and decorin staining of ovarian tissues of both groups (concordance rate -0.564, p<0.001). Angiogenesis plays a critical role in endometriosisand interaction between decorin and VEGF,which suggests that decorin may be a promising molecule for the treatment of endometriosis. Key Words: Decorin, Endometriosis, Immunohistochemical staining, Vascular endothelial Growth factor.

EFFECT OF ANTIBIOTIC TREATMENT FOR CHRONIC ENDOMETRITIS ON ART CYCLE OUTCOME

To determine the prevalence of chronic endometritis (CE) in infertile women undergoing ART and effect of antibiotic treatment on the pregnancy rate in the frozen embryo transfer (FET) cycles We recruited 78 infertile women undergoing ART in tertiary level fertility clinic. Endometrial samples were obtained in proliferative phase of menstrual cycle and subjected to immuno-histochemical (CD138) and histopathological diagnosis of CE. Antibiotic treatment comprising of Tab doxycycline 100 mg BD for 14 days followed by fixed dose combination of Tab ciprofloxacin 500mg and Tab tinidazole 600 mg BD for 14 days was administered to the CE diagnosed women and subsequently their histopathologic cure rate was assessed by repeat biopsy. Women with persistent chronic endometritis were treated with Tab clindamycin 300mg BD for 14 days. Frozen embryo transfer with at least one good quality embryo was done for all women and further reproductive outcomes were studied and compared In our study, mean age and BMI were 30.5 + 4.5years and 26.6 + 4.29 kg/m2. Majority of women had primary infertility (53/79, 67%). Twenty-six out of 78 infertile women were diagnosed with CE (33.3%). The cure rate after antibiotic treatment was 69.8%. Pregnancy rate and miscarriage rate in cured CE and non-CE group were 66.7% & 25% and 55.7% & 27.5% respectively (p value:- 0.41). There was lower pregnancy rate (37.5%) and higher miscarriage rate (33%) in women with persistent CE although it did not reach statistical significance. (p value: - 0.16) High prevalence of CE is noted in infertile women undergoing ART and antibiotic treatment may improve reproductive outcomes in these women

Cyclical alteration in heart rate variability among young eumenorrheic women

Introduction: The female sex hormones are known to have a cardioprotective role in premenopausal women compared to postmenopausal women.1,2,5 The key hormone estrogen and progesterone shows a cyclical variation along the different phases of menstrual cycle. Parasympathetic activity via vagus is known to improve the cardiac function compared to sympathetic activity.3 Heart rate variability (HRV) is one of the sensitive and non-invasive method to record the cardiac autonomic activity.4 Thus we chose this study to assess how the female sex hormones affect autonomic activity on the heart during the phases of menstrual cycle. Aim: To assess the effect of cyclical alteration in female sex hormones on cardiac autonomic activity by HRV. Materials and Methods: After getting institutional ethics committee clearance, short term HRV (5 minutes) was recorded in fifty young female volunteers aged between 20-30 years within normal range of BMI and regular menstrual cycle in supine posture after 10 minutes rest using PHYSIO PAC PP4 Medicaid system Chandigarh in the autonomic function lab, Department of Physiology, Sri Venkateshwaraa Medical College Hospital and Research Center, Ariyur, Pondicherry. Statistical analysis was done using SPSS 17 version. Results: The sympathetic parameters like (low frequency domain) LF nu, LF/HF ratio was significantly increased in the premenstrual phase. The parasympathetic parameters like (high frequency domain) HF nu, TP (total power) were significantly increased in the proliferative phase of the menstrual cycle. Conclusion: Thus the cardioprotective role of female sex hormones in premenopausal women was more pronounced in the proliferative phase of menstrual cycle. Keywords: Heart rate variability, Cardioprotective, Premenstrual phase, Proliferative phase.

Expression of Pirna in Tissues of Ovarian Endometriosis Cysts

Study Objective To identify the expression of PIWI associated RNA (piRNA) in tissues of endometrium and endometrioid ovarian cysts and to evaluate differences in the expression of piRNA between eutopic and ectopic endometrium. Design Prospective observational cohort study; Level II-1. Setting Federal State Budget Institution «The National Medical Research Center for Obstetrics, Gynecology and Perinatology», Moscow. Patients or Participants The study included 21 patients of reproductive age (30.27 ± 3.78 years) with endometrioid ovarian cysts. Paired samples of endometrial tissues were collected during surgery in the proliferative phase of menstrual cycle. Tissue samples for further analysis were selected after histological examination. The analysis of piRNA expression was carried out by the new generation sequencing on the Illumina platform, followed by processing of the data by bioinformatics analysis. Interventions Laparoscopic surgery for endometriod ovarian cysts and endometrial biopsy followed by histopathologic and piRNA expression analysis of obtained tissue. Measurements and Main Results According to the sequencing data, 197 piRNA were identified in the tissues of the eutopic endometrium and endometrioid ovarian cysts. The analysis of differential expression revealed predominantly reduced expression of piRNA in the ectopic endometrium relative to the eutopic endometrium. In total 30 differentially expressed piRNA were identified, including 4 with increased and 26 with reduced expression. Using bioinformatic methods, possible gene targets of differentially expressed piRNA were found. Functional analysis of potential targets of differentially expressed piRNA revealed signaling pathways and cellular processes that may contribute to the development of endometriosis. Conclusion The data obtained suggest that alterations in piRNA expression of ectopic endometrium and subsequent disturbances in the expression of their target genes may be significant link in our search for the pathogenesis of endometriosis.

Endometrial immunocompetent cells in proliferative and secretory phase of normal menstrual cycle.

Menstruation was presented as a result of inflammatory process. The total and relative numbers of the endometrial immunocompetitive cells vary during the different phases of the menstrual cycle. The aim of this morphological study is to make a contribution to understanding different distribution of leukocyte types during proliferative and secretory phase of normal menstrual cycle. The study included 40 women (20 in proliferative and 20 in secretory phase of the menstrual cycle). Exploratory curettage performed as preoperative preparation due to uterine myomas. Immunophenotyping was performed by immunoalkaline phosphatase (APAAP) using monoclonal antibodies: CD15, CD20, CD30, CD45RO, CD56, CD57 and CD68. The results were statistically analysed using SPSS 20.0 software. Natural killer (NK) cells are dominant during secretory, and CD45RO T lymphocytes are dominant during proliferative phase of the menstrual cycle. During the secretory phase of menstrual cycle, leukocytes make 30% of total endometrial cells. NK cells (CD56+ bright subpopulation), activated T lymphocytes, macrophages and B lymphocytes significantly increase in their number during the secretory phase of menstrual cycle. Significant changes in endometrial leukocyte populations during proliferative and secretory phase of the menstrual cycle are emphasized. Changes in dominance of different leukocyte subpopulations are determined by hormonal and microenvironmental changes in modulatory factors that have not yet been fully explained.

Heart rate variability in different phases of menstrual cycle among healthy medical students of a teaching institution, South India

Background: Cardiac autonomic function in females depends on the fluctuations in the level of endogenous sex hormones during menstrual cycle. Heart rate variability (HRV) is a non-invasive test that helps to assess the function autonomic nervous system mainly the sympathovagal balance. Aims and Objective: The aim of the study was to evaluate the HRV in different phases of menstrual cycle in healthy females of a teaching institution, South India. Materials and Methods: A cross-sectional study was conducted among 19 regularly menstruating females in the age group of 18–24 years of age after taking informed consent and institutional ethical clearance. Sympathovagal balance was assessed using HRV analysis in the proliferative and secretory phases of menstrual cycle. Results: This study observed an increase in low frequency (LF) in normalized units domain as well as/high frequency (HF) ratio in the secretory phase and an increase in the HF normalized units domain in the proliferative phase, though statistically non-significant. A significant increase in the resting heart rate was noted among the secretory phase compared to the proliferative phase of menstrual cycle (P < 0.001). Conclusion: An increased sympathetic activity during secretory phase and an increased vagal activity in the proliferative phase were observed, which could be explained due to the fluctuating levels of sex hormones. The knowledge about the sympathetic modulation in the secretory phase can explain the symptoms of premenstrual syndrome, which can in turn improve the quality of life among females.

Laparoscopic Evaluation of Female Factor in Bangladeshi Infertile Couple

Background: Infertility prevails in good number in our society, causing social disharmony and distress. Laparoscopy is now a very effective tool for diagnosis and evaluation of female infertility.&#x0D; Method: This cross sectional study was conducted in Infertility Unit of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, from July, 2012 to June 2014. The aim of the study is to identify common pelvic pathologies of female factor infertility by laparoscopy so that early detection and treatment modalities can be instituted. Total 230 sub fertile patients attending OPD were selected for this study. Patients with DM, HTN, known case of hypothyroidism and male factor infertility was excluded from study. Detailed clinical history of every patient was recorded on a pre-set questionnaire and physical examination was performed. Laparoscopy was scheduled in proliferative phase of menstrual cycle.&#x0D; Results: Among the study subjects, 130 (56.5%) had primary infertility while 100 (43.5%) secondary infertility. On laparoscopy, 64.4% patient had normal sized uterus, 31 % had bulky uterus. Two patients had bicornuate uterus in secondary infertility cases. Uterus was restricted in mobility in 41% of patients due to endometriosis, pelvic inflammatory disease (PID) or previous pelvic surgery. Fibroid uterus was detected in 30(13%) and 10(4.3%) cases of primary and secondary infertility cases respectively. Bilateral tubal blockage was present in 16(6.9%) and 17 (7.4%) cases of primary and secondary infertility respectively. Forty (17.4%) cases of primary infertility were detected as polycystic ovaries (PCO) which was 30(13%) in cases of secondary infertility. Endometriosis was found in total 9(3.9%) patient in both the groups. Pelvic adhesion was found in 22(9.5%) and 21 (9.1%) cases of primary and secondary infertility respectively.&#x0D; Conclusion: Laparoscopy could diagnose a substantial number of portion pelvic pathology. In a developing country like Bangladesh, earlier and justified intervention with laparoscopy can save time and expense of infertility treatment by diagnosing pelvic factor responsible for infertility.&#x0D; Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 29-35

Measurement of uterine volume in patients with endometriosis and its clinical significance

Objective: To measure the uterine volume by ultrasonic imaging in nullipara patients with endometriosis and analyze its clinical significance. Methods: From July 1st, 2016 to August 1st, 2017, 107 cases of nullipara patients with endometriosis hospitalized in Peking University First Hospital were selected as endometriosis group. Among 107 cases, 59 cases were in proliferative phase of menstrual cycle, 48 cases were in secretory phase; and 10 cases had an abortion history.Totally 101 cases of patients without endometriosis operated for other benign disease during the same period were chosen as the control group. All patients underwent laparoscopic surgery, and the diagnosis was confirmed by pathology. The uterine size was measured by transvaginal or transrectal color Doppler ultrasound, and the uterine volume was calculated according to the known formula. Results: The uterine volume of the endometriosis group [(69±26) cm(3)] was larger than that of the control group [(54±18) cm(3), P<0.01]. In the endometriosis group, the uterine volume of patients with pregnant history [(78±34) cm(3)] was larger than that of patients without pregnant history [(68±25) cm(3)]. The endometrial thickness in endometriosis group was higher than that of the control group [(9.1±3.5) versus (7.8±2.9) mm, P<0.05], and positively correlated with the uterine volume (r=0.39, P<0.05). The hemoglobin in endometriosis group was lower than that in the control group [(124±12) versus (131±10) g/L, P<0.01], and was negatively correlated with the uterine volume in the two groups (r(endometriosis)=-0.12, r(control)=-0.21; both P<0.05).The uterine volume of dysmenorrhea patients in the endometriosis group [(73±28) cm(3)] was greater than that of patients without dysmenorrhea [(62±19) cm(3), P<0.01]; both uterine volumes of patients with and without dysmenorrhea in endometriosis group were larger than those of patients with or without dysmenorrhea in the control group (P<0.05). The degree of dysmenorrhea in endometriosis group was positively correlated with the uterine volume (r=0.20, P=0.042). The uterine volume of stage Ⅳendometriosis patients [(79±30) cm(3)] was greater than that of stage Ⅲ patients in endometriosis group [(58±14) cm(3), P<0.01]. Conclusion: Patients with endometriosis are of increased uterine volume, which may be related to dysmenorrhea, menorrhagia and infertility.

Analysis of Vascular Hydrogen Sulfide Biosynthesis.

With potent vasodilatory and pro-angiogenic properties, hydrogen sulfide (H2S) is now accepted as the third gasotransmitter after nitric oxide (NO) and carbon monoxide. Endogenous H2S is mainly synthesized by cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). Akin to previous studies showing hormonal regulation of NO biosynthesis, we first reported that uterine and systemic artery H2S biosynthesis is regulated by exogenous estrogens in an ovariectomized sheep model of estrogen replacement therapy, specifically stimulating CBS, but not CSE, expression, in uterine (UA) and mesenteric (MA), but not carotid (CA), arteries in ovariectomized nonpregnant sheep. We have found significantly elevated H2S biosynthesis due to CBS upregulation under estrogen-dominant physiological states, the proliferative phase of menstrual cycle and pregnancy in primary human UAs. Our studies have pioneered the role of H2S biology in uterine hemodynamics regulation although there is still much that needs to be learned before a thorough elucidation of a role that H2S plays in normal physiology of uterine hemodynamics and its dysregulation under pregnancy complications can be determined. In this chapter we describe a series of methods that we have optimized for analyzing vascular H2S biosynthesis, including (1) real-time quantitative PCR (qPCR) for assessing tissue and cellular levels of CBS and CSE mRNAs, (2) immunoblotting for assessing CBS and CSE proteins, (3) semiquantitative immunofluorescence microscopy to specifically localize CBS and CSE proteins on vascular wall and to quantify their cellular expression levels, and (4) methylene blue assay for assessing H2S production in the presence of selective CBS and CSE inhibitors.

K-Ras 4A Transcript variant is up-regulated in eutopic endometrium of endometriosis patients during proliferative phase of menstrual cycle.

K-Ras transcripts comprise two main isoforms: K-Ras 4A and K-Ras 4B, which act differently. The expression of both isoforms was reported in many human tissues. However, K-Ras 4B was the major expressed transcript variant. An increased expression of K-Ras 4B mRNA was reported in eutopic endometrium of endometriosis patients. In this way, we aimed to study the expression of K-Ras 4A transcript in eutopic endometrium related to endometriosis. Employing exon4-flanking primers, K-Ras isoforms were simultaneously amplified in a RT-PCR reaction. Quantitative real-time PCR was performed using GAPDH as an internal control. K-Ras 4A transcript expression in eutopic endometrium was analyzed by ΔΔC T method. We identified existence of both of K-Ras 4A and K-Ras 4B in eutopic endometrium of patients and controls. Quantitative real-time analysis demonstrated that K-Ras 4A expression was 2.7-fold higher in endometriosis than non-endometriosis eutopic samples. Interestingly, this overexpression mainly occurs through the proliferative phase of menstrual cycle. The findings bring to light the eminent role of K-Ras 4A in endometriosis. This splice variant which is known for promoting apoptosis could be an effective factor in balance between proliferation and death of eutopic endometrial cells.

Association of increased S100A8 serum protein with early pregnancy loss.

The contribution of systemic S100A8 protein in menstrual cycle, pregnancy, and early pregnancy loss (EPL) is not known. Altered expression of S100A8 in maternal decidua is associated with recurrent early pregnancy loss. The objective of this study was to investigate the systemic level of S100A8 in different phases of menstrual cycle, different trimester of pregnancy, and in EPL. Level of S100A8 was investigated in serum samples of the subjects through enzyme-linked immunosorbent assay (ELISA). S100A8 levels were elevated during proliferative phase of menstrual cycle. We found no statistical difference in S100A8 level in different trimester of pregnancy. S100A8 level was found to be significantly elevated in patients with EPL. This is the first study evaluating the systemic level of S100A8 predicting its role during menstrual cycle and pregnancy. It opens a new perspective in which S100A8 can be used as a prognostic marker for EPL.

P26.19: Thin endometrium as a possible reason of missed pregnancy

We would like to present a case report of 5 patients who had missed pregnancy in the first trimester. All these patients had uterine curettage in our clinic and normal embryo karyotype was proved. In all this cases uterine curettage over time was followed by hysteroscopy and repeated curettage because of remains of chorionic tissue. One woman had hysteroscopy and repeated curettage for this reason twice: one time - after abortion and the second time - after delivery. In all these cases the removal of the chorionic debris was not performed easily, because of intense attachment to uterine wall. We retrospectively revised ultrasound examinations of these patients in the absence of pregnancy (some time before the missed pregnancy), before and after hysteroscopy and repeated curettage. It was found out that the endometrium of all these women in the late proliferative phase of menstrual cycle was quite thin - 4-6,4 mm maximum and normal three layer structure of endometrium was seen only in 2 patients. 4 of 5 patients had implantation in uterine corners or in the isthmus. On the echograms before and after hysteroscopy and repeated curettage Doppler signs of deep location of chorionic vessels were seen, in one patient the uterine wall abnormality extended to serous layer. We suggest the connection between thin endometrium and impaired process of chorion invasion and decidual formation (deep trophoblast invasion) especially in cases of low implantation and implantation in uterine corners where endometrium is known to be thinner and decidual formation is often impaired. It seems that some mechanisms of self-protection (uterine protection) are settled down in these cases and, as a result, termination of pregnancy occurs. Undoubtedly, this suggestion needs further investigation.

Effect of exercise on the pulmonary system in proliferative phase of menstrual cycle in a group of perimenopausal women

Background: Hormonal levels influence dynamic lung function parameters. Significant increase in both progesterone (37%) and estradiol (13.5%); where as, no change in plasma follicle stimulating hormone (FSH) and luteinizing hormone (LH) was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in proliferative phase of menstrual cycle in perimenopausal women. Material and Methods: The present study was conducted as a part of cardiopulmonary efficiency studies on two groups of nonathletes (n = 10) and athletes (n = 10) comparable in age and sex. Menstrual history was ascertained to confirm proliferative phase of menstrual cycle. Dynamic lung functions were measured in both groups before exercise and immediately after exercise. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid-expiratory flow (MMEF), peak expiratory flow rate (PEFR), and MEF 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.

Response of the respiratory system to exercise in proliferative phase of menstrual cycle in a group of perimenopausal obese homemakers

Background: The role of hormones on lung function tests were well known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle-stimulating hormone and luteinizing hormone was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the respiratory system in adaptability to exercise in proliferative phase of menstrual cycle in perimenopausal obese homemakers. Materials and Methods: Healthy young adult females between 42 and 45 years who regularly undergo training and participate in competitive middle distance running events for at least previous 3 years were considered in the control, whereas the study group did not have any such regular exercise program were obese homemakers. The two groups were in perimenopausal age group. They were made to undergo computerized spirometry after undergoing maximal exercise testing on a motorized treadmill. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters Maximum Mid Expiratory Flow rate (MMEF), peak expiratory flow rate, mid-expiratory flow 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.

Hormonal influence on the adaptability of the pulmonary system to exercise in proliferative phase of menstrual cycle in a group of perimenopausal women

Background: The role of estrogen on pulmonary function test (PFT) was well-known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle stimulating hormone (FSH) and luteinizing hormone LH was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in proliferative phase of menstrual cycle in perimenopausal women. Materials and Methods: Dynamic lung functions were assessed in two groups of perimenopausal women viz., athletes and non-athletes after treadmill exercise testing using computerized spirometry. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid expiratory flow MMEF, peak expiratory flow rate PEFR, and MEF 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase which is further accentuated by exercise.

Diagnostic Laparoscopy in the Evaluation of Female Factors in Infertility in Kashmir Valley

Objectives: To evaluate the female factors in infertility using laparoscopy in Kashmiri women. Materials and Methods: One hundred cases of infertility [primary and secondary] were included in this prospective study. Before the procedure, apart from complete history and detailed examination, baseline investigations (complete blood count, blood sugar, kidney and liver function tests, ECG, chest X-ray) were performed as per our institutional protocol for pre-anaesthesia check up. Laparoscopy was done in proliferative phase of menstrual cycle. To test the patency of tubes, chromotubation was done in all cases under laparoscopic vision by using 10-15 ml of autoclaved methylene blue dye. All the data was collected on pre-designed proforma and the results were tabulated and raw percentages calculated to describe the results. Results: In primary infertility group [n=82], most common laparoscopic finding was tubal occlusion in 15 (18.3%), followed by endometriotic deposits in 14 (17.1%) patients. Other findings were polycystic ovaries in 10 patients (12.2%), peritubal and periovarian adhesions in 6 patients (7.3%), fibroids in 6 patients (7.3%), genital tract tuberculosis in 5 patients (6.1%), ovarian cysts in 4 patients (4.8%), hypoplastic uterus in 2 patients (2.4%) and pelvic inflammatory diseases in 2 patients (2.4%), in this group. The commonest finding by laparoscopy in patients with secondary infertility [n=18] was tubal occlusion in 5 (27.7%), followed by peritubal and periovarian adhesions in 4 (22.2%) patients. Conclusion: laparoscopy is very effective and cheap method in evaluating infertile women and should be considered earlier in infertility workup for effective and early treatment decisions. 1Senior Resident department of obstetrics and gynecology, Sheri Kashmir Institute of Medical Sciences Medical College, Srinagar, J&K, India. 2Associate Professor department of obstetrics and gynecology, Sheri Kashmir Institute of Medical Sciences Medical College, Srinagar, J&K,India. 3Senior Resident department Of General and Minimal Access Surgery, Sheri Kashmir Institute of Medical Sciences Srinagar, J&K, India. 4Assistant Professor department of obstetrics and gynaecology, Sheri Kashmir Institute of Medical Sciences Medical College, Srinagar, J&K, India. Article History: Received 10 October 2013 Accepted 7 January 2014 Revised 25 December 2013 Available online 7 January 2014

Comparison of adaptability of the pulmonary system to exercise in proliferative phase of menstrual cycle in a group of trained and untrained perimenopausal women

Background: The role of estrogen on pulmonary function test (PFT) was well-known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle stimulating hormone and leutinising hormone (FSH and LH)was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in proliferative phase of the menstrual cycle in perimenopausal women. Materials and Methods: 10 Subjects in each group were subjected to treadmill exercise testing and cardio-respiratory parameters were recorded. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid expiratory flow (MMEF), peak expiratory flow rate, mid expiratory flow 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.

Follicle-stimulating hormone levels in female workers exposed to urban pollutants

The aim of this study was to evaluate if there were alterations in FSH plasma levels in female outdoor workers (traffic policewomen and drivers) exposed to chemical urban stressors vs. control group. After excluding subjects with main confounding factors, traffic policewomen, drivers and indoor workers were matched by age, working life, socioeconomic status, marital status, menstrual cycle day, age of menarche, habitual consumption of Italian coffee and soy. A total of 129 female subjects were included in the study: Some 63 workers studied during proliferative phase and 66 during secretory phase of menstrual cycle. Proliferative phase of menstrual cycle: FSH mean values were significantly higher in traffic policewomen compared to controls (p < 0.05). Results suggest that in outdoor workers exposed to urban chemical stressors there are alterations in FSH levels; therefore FSH may be used as an early biological marker, valuable for the group, used in occupational set.

LOX family enzymes expression in vaginal tissue of premenopausal women with severe pelvic organ prolapse

The extracellular matrix proteins collagen and elastin provide tissue strength and resilience, whereas lysyl oxidase enzymes play a major role in their stabilization. This study examines the expression and tissue localization of lysyl oxidase family proteins in the anterior vaginal wall of premenopausal women with advanced pelvic organ prolapse (POP, n = 15) and asymptomatic controls (n = 11). All women were in the proliferative phase of menstrual cycle. Total mRNAs and proteins extracted from the vaginal tissue were examined by real-time polymerase chain reaction and immunoblotting, and tissue specimens were analyzed by immunohistochemistry. The expression of LOX, LOXL1, and LOXL3 genes as well as LOX and LOXL3 proteins were significantly reduced in POP patients (P < 0.05). Immunolocalization of LOX family proteins was confirmed in all vaginal specimens. We proposed that reduced expression of LOX enzymes may result in defective assembly of pelvic tissues and development of POP.

Relation between vaginal and endocervical pH in pre- and post-menopausal women

We aimed to verify whether vaginal fornix pH is related to endocervical pH and whether or not acid pH could contribute to the prophylactic treatment of vaginal infections. Four groups of healthy women with or without uterus were selected: pre-menopausal (>39 years) and post-menopausal (<61 years). Pre-menopausal non-hysterectomized women were further analysed in proliferative (8-12 days) and secretory phase (18-22 days) of the menstrual cycle. Endocervical and vaginal pH was determined by a digitally pH metro during the gynaecological examination. Vaginal pH is more acid than endocervical pH in pre- and post-menopausal women, 5.1 versus 6 and 5.4 versus 6.4 (P<0.001), respectively. Vaginal pH is related to endocervical pH in proliferative phase of menstrual cycle and post-menopausal women (P=0.009). Pre- and post-menopausal hysterectomized women presented more acid vaginal pH than non-hysterectomized women, 4.35 versus 5.1 and 4.9 versus 5.4 (P<0.05), respectively. Endocervical pH has not presented change during menstrual cycle and menopause, 6 and 6.4, respectively. Vaginal pH is related to endocervical pH in proliferative phase of menstrual cycle phase and post-menopausal women.