Female troubles: an analysis of menstrual cycle research in the NINR portfolio as a model for science development in women's health.

The National Institute for Nursing Research (NINR) has been active in developing a research portfolio of investigator-initiated studies in addressing the cause and consequences of menstrual cycle and menopause-related health problems. This chapter provides an overview of the nature and level of research activity funded by NINR since its inception in 1986, major findings generated by the most successful award recipients, the impact on the broader field of women's reproductive health and directions for future research. Presented here is an analysis of research designs and methodologies framed within the context of 4 stages of scientific development in the field: exploratory, descriptive studies in well women; illness as a biobehavioral phenomenon; knowledge generation in understudied populations; and the development and testing of clinical therapeutics for symptom management and health promotion strategies. Nursing science contributions to the NINR portfolio of women's health research has been focused primarily on the definition and management of the symptoms of premenstrual syndrome and menopause. The increasing numbers of intervention studies suggests a coming-of-age in nursing science with respect to the development of evidence-based outcome data for the management of menstrual cycle and menopause-related symptoms. Clearly, the range and diversity of NINR grant-funded activity suggest that menstrual cycle research is a strong area of interest in nursing science.

Making babies in the 21st century: new strategies, old dilemmas.

Self-regulation of assisted reproduction by the medical community is not working. The continuing ban on in vitro fertilization (IVF) embryo research will only further erode the opportunity to develop comprehensive policies to protect the growing numbers of infertile couples, former cancer patients, gamete donors and their offspring produced through assisted reproduction. The President's National Bioethics Advisory Commission (NBAC) with the help of the Institute of Medicine can serve as an effective policy-building body because of its expertise, public forum, and national authority. National guidelines have been developed for gene therapy and xenotransplantation which could serve as models for dealing with the thorny bioethical dilemmas of assisted reproduction. In the interim, research on the social and ethical aspects of assisted reproduction should be a high priority for the NIH.