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1.
Wiad Lek ; 74(1): 64-67, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33851589

RESUMO

OBJECTIVE: The aim: To evaluate the parameters of menstrual function in 1015 women of reproductive age and to establish the relationship between the detected menstrual disorders and the development of migraine and/or irritable bowel syndrome (IBS). PATIENTS AND METHODS: Materials and methods: During 2018-2020, a survey of women of reproductive age in the Ternopil region (Ukraine) was conducted. To interview the study respondents, we developed a questionnaire that assessed the parameters of menstrual function (age of menarche; regularity and cyclicity of menstrual changes; duration of the menstrual cycle and menstruation itself; the amount of blood loss with the pictogram, the presence of clots and their size) identify characteristic changes in health, symptoms of irritable bowel syndrome and migraine associated with the menstrual cycle. Data analysis was performed by statistical and mathematical method. RESULTS: Results and conclusions: In 72.2 % of respondents, the study revealed deviations from the normal course of the menstrual cycle. In particular, an increase in blood loss during menstruation and the appearance of clots larger than 1 cm were observed in 40.8 % of women. Among patients with menstrual dysfunction, 51.8 % of patients had symptoms of irritable bowel syndrome, and 44.1 % had signs of migraine. Thus, the relationship between cyclic menstrual disorders and the formation of IBS and migraine, which significantly affects the deterioration of health, performance of women of childbearing age.


Assuntos
Síndrome do Intestino Irritável , Ciclo Menstrual , Feminino , Humanos , Inflamação , Síndrome do Intestino Irritável/complicações , Distúrbios Menstruais , Ucrânia
2.
Niger J Clin Pract ; 24(3): 308-312, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33723102

RESUMO

Background: Primary dysmenorrhea (PD) is characterized by symptoms including sweating, headache, nausea, vomiting, diarrhea, tremulousness, usually begins adolescence, those can be associated with autonomic dysfunction affecting pulmonary functions. Aim: The aim of the present study is to investigate the impacts of PD on pulmonary function tests. Subjects and Methods: A prospective cross-sectional design was selected. All subjects were invited to admit to the Department of Obstetrics and Gynecology outpatient unit for venous blood test detecting the levels of estrogen and progesterone during the follicular and luteal phase of their menstrual cycle. After drawing blood, women were taken to the pulmonary function tests laboratory to perform the test. The comparisons between Group PD and Group Control were performed by the independent samples t-test or Mann-Whitney U test. Intragroup comparisons were completed by paired samples t-test. Results: The comparisons between Group PD and Group Control among estrogen and progesterone in follicular and luteal phase, pulmonary function test results did not show any significance (P > 0.05). The intragroup comparisons of estrogen and progesterone levels, and pulmonary functions test results revealed no significant difference (P > 0.05). Conclusion: The present study showed that PD does not influence the spirometric measurements and also respiratory functions are not impaired by the different phases of menstrual cycle.


Assuntos
Dismenorreia , Ciclo Menstrual , Adolescente , Estudos Transversais , Feminino , Humanos , Estudos Prospectivos
3.
Georgian Med News ; (310): 83-86, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33658414

RESUMO

The recent data have shown that in addition to biological and psychosocial mechanisms, individual pain perception can be altered by satiety level as well. Some studies confirm that there is a relationship between being fed by sucrose and hyperalgesia in animals, while others show that ketogenic diet can be associated with decreased pain sensitivity to thermal stimuli. It can be argued that the effect of satiety level on pain perception is mediated by gastrointestinal hormones and endogenous opioids. Pharmacological stimulation of kappa-opioid receptors decreases stress and promotes analgesia. Accordingly, these changes can be inhibited by applying antagonists. Our study aims to assess pain perception induced by mechanical experimental irritation in women during different satiety levels in follicular phase of ovarian-menstrual cycle. The sample of the study was comprised of volunteer students aged 18-23 (women, mean age 19,5±2,9). Ovarian-menstrual cycle of the women participating in the research were evaluated using the questionnaires. All the studies were performed in the follicular phase of menstrual cycle (7-11 days of the cycle). At the first stage, study was conducted in starvation state - after 10-12 hours after the last meal, the second stage - in primary, sensory-motor satiety 20-30 minutes after a mixed meal intake. Every participant has been offered a standard, mixed meal (including proteins, fats, carbohydrates). Mechanical pain sensitivity was evaluated using computerized algometer - AlgoMed (Medoc, Ltd, Ramat Yishai, Israel), which was delivering mechanical stimuli to the participants; Meanwhile, mechanical pressure threshold, mechanical pain threshold and pain tolerance threshold were determined. According to this data, the reason of relatively diminished pain perception during primary satiety should be alterations of gastrointestinal tract that take place after food ingestion: Mechano- and chemoreceptors of initial segments in digestive system, particularly in stomach and in duodenum get irritated; that is followed by activation of several humoral factors and duodenal afferentation. In addition, by some authors duodenal release of cholecystokinin is believed to be hypothetical cause of decreased pain sensitivity after 20-30 minutes from the last mixed meal and is thought to have antinociceptive effect on endogenous opioid system.


Assuntos
Limiar da Dor , Dor , Adolescente , Adulto , Animais , Feminino , Fase Folicular , Humanos , Hiperalgesia , Ciclo Menstrual , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-33561085

RESUMO

Background: The increase in exercise levels in the last few years among professional and recreational female athletes has led to an increased scientific interest about sports health and performance in the female athlete population. The purpose of the IronFEMME Study described in this protocol article is to determine the influence of different hormonal profiles on iron metabolism in response to endurance exercise, and the main markers of muscle damage in response to resistance exercise; both in eumenorrheic, oral contraceptive (OC) users and postmenopausal well-trained women. Methods: This project is an observational controlled randomized counterbalanced study. One hundered and four (104) active and healthy women were selected to participate in the IronFEMME Study, 57 of which were eumenorrheic, 31 OC users and 16 postmenopausal. The project consisted of two sections carried out at the same time: iron metabolism (study I) and muscle damage (study II). For the study I, the exercise protocol consisted of an interval running test (eight bouts of 3 min at 85% of the maximal aerobic speed), whereas the study II protocol was an eccentric-based resistance exercise protocol (10 sets of 10 repetitions of plate-loaded barbell parallel back squats at 60% of their one repetition maximum (1RM) with 2 min of recovery between sets). In both studies, eumenorrheic participants were evaluated at three specific moments of the menstrual cycle: early-follicular phase, late-follicular phase and mid-luteal phase; OC users performed the trial at two moments: withdrawal phase and active pill phase. Lastly, postmenopausal women were only tested once, since their hormonal status does not fluctuate. The three-step method was used to verify the menstrual cycle phase: calendar counting, blood test confirmation, and urine-based ovulation kits. Blood samples were obtained to measure sex hormones, iron metabolism parameters, and muscle damage related markers. Discussion: IronFEMME Study has been designed to increase the knowledge regarding the influence of sex hormones on some aspects of the exercise-related female physiology. Iron metabolism and exercise-induced muscle damage will be studied considering the different reproductive status present throughout well-trained females' lifespan.


Assuntos
Exercício Físico/fisiologia , Ferro/metabolismo , Fase Luteal/fisiologia , Ciclo Menstrual/fisiologia , Treinamento de Resistência , Adulto , Creatina Quinase , Feminino , Fase Folicular/fisiologia , Hepcidinas , Humanos , Distúrbios do Metabolismo do Ferro , Metabolismo/efeitos dos fármacos , Pessoa de Meia-Idade , Contração Muscular/efeitos dos fármacos , Músculo Esquelético/metabolismo
6.
J Strength Cond Res ; 35(4): 894-901, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33555830

RESUMO

ABSTRACT: Umlauff, L, Weil, P, Zimmer, P, Hackney, AC, Bloch, W, and Schumann, M. Oral contraceptives do not affect physiological responses to strength exercise. J Strength Cond Res 35(4): 894-901, 2021-This study investigated the effect of oral contraceptive (OC) use on acute changes in steroid hormone concentrations and tryptophan (TRP) metabolites in response to strength exercise. Twenty-one women (age: 23 ± 3 years), 8 combined OC users (OC group) and 13 naturally cycling women (menstrual cycle [MC] group), participated. Testing was performed during the pill-free interval for the OC group and the follicular phase for the MC group. Subjects completed an intense strength exercise protocol (4 × 10 repetitions back squat). Blood samples were taken at baseline (T0), post-exercise (T1), and after 24 hours (T2) to determine serum concentrations of cortisol, estradiol, testosterone, TRP, and kynurenine (KYN). Statistical significance was defined as p ≤ 0.05. At T0, the OC group showed higher cortisol (OC: 493.7 ± 47.1 ng·mL-1, MC: 299.1 ± 62.7 ng·mL-1, p < 0.001) and blood lactate (OC: 1.81 ± 0.61 mmol·L-1, MC: 1.06 ± 0.30 mmol·L-1, p = 0.001) and lower estradiol (OC: 31.12 ± 4.24 pg·mL-1, MC: 38.34 ± 7.50 pg·mL-1, p = 0.023) and KYN (OC: 1.15 ± 0.23 µmol·L-1, MC: 1.75 ± 0.50 µmol·L-1, p = 0.005). No significant interactions (group × time, p > 0.05) were found for the hormones and TRP metabolites assessed. Oral contraceptive use did not affect the physiological response of steroid hormones and TRP metabolites to acute strength exercise during the low hormone phase of the contraceptive or MC in healthy young women, even when some baseline concentrations differed between groups. Consequently, these findings provide important implications for practitioners testing heterogeneous groups of female athletes.


Assuntos
Anticoncepcionais Orais Combinados , Exercício Físico , Adulto , Estradiol , Feminino , Fase Folicular , Humanos , Ciclo Menstrual , Adulto Jovem
7.
JAMA Netw Open ; 3(12): e2027928, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33346844

RESUMO

Importance: Menstrual cycle dysfunction is associated with insulin resistance, a key feature early in the pathogenesis of type 2 diabetes. However, the evidence linking irregular and long menstrual cycles with type 2 diabetes is scarce and inconsistent. Objectives: To evaluate the associations between menstrual cycle characteristics at different points throughout a woman's reproductive life span and risk of type 2 diabetes and the extent to which this association is modified by lifestyle factors. Design, Setting, and Participants: This prospective cohort study included 75 546 premenopausal US female nurses participating in the Nurses' Health Study II from 1993 to June 30, 2017. Data analysis was performed from February 1 to December 30, 2019. Exposures: Self-reported usual length and regularity of menstrual cycles at the age ranges of 14 to 17 years, 18 to 22 years, and 29 to 46 years. Main Outcomes and Measures: Incident type 2 diabetes identified through self-report and confirmed by validated supplemental questionnaires. Results: Among the 75 546 women in the study at baseline, the mean (SD) age was 37.9 (4.6) years (range, 29.0-46.0 years). A total of 5608 participants (7.4%) had documented new cases of type 2 diabetes during 1 639 485 person-years of follow-up. After adjustment for potential confounders, women reporting always having irregular menstrual cycles between the age ranges of 14 to 17 years, 18 to 22 years, and 29 to 46 years were, respectively, 32% (95% CI, 22%-44%), 41% (95% CI, 23%-62%), and 66% (95% CI, 49%-84%) more likely to develop type 2 diabetes than women reporting very regular cycles (within 3-4 days of expected period) in the same age range. Similarly, women reporting a usual cycle length of 40 days or more between the age ranges of 18 to 22 years and 29 to 46 years were, respectively, 37% (95% CI, 19%-57%) and 50% (95% CI, 36%-65%) more likely to develop type 2 diabetes during follow-up compared with women reporting a usual cycle length of 26 to 31 days in the same age ranges. These associations appeared to be stronger among women with overweight or obesity, a low-quality diet, and low levels of physical activity. The relative excess risk of type 2 diabetes due to the interaction between irregular and long menstrual cycles and the overall unhealthy lifestyle score was 0.73 (95% CI, 0.57-0.89) and 0.68 (95% CI, 0.54-0.83), respectively. Conclusions and Relevance: In this cohort study of US female nurses participating in the Nurses' Health Study II, irregular and long menstrual cycles throughout life were associated with a greater risk of type 2 diabetes, particularly among women with overweight or obesity, a low-quality diet, and low levels of physical activity.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Ciclo Menstrual , Distúrbios Menstruais/complicações , Adolescente , Adulto , Diabetes Mellitus Tipo 2/epidemiologia , Dieta/efeitos adversos , Feminino , Humanos , Incidência , Estilo de Vida , Distúrbios Menstruais/epidemiologia , Distúrbios Menstruais/fisiopatologia , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Obesidade/complicações , Obesidade/fisiopatologia , Sobrepeso/complicações , Sobrepeso/fisiopatologia , Estudos Prospectivos , Saúde Reprodutiva , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
8.
Medicine (Baltimore) ; 99(50): e23630, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327341

RESUMO

BACKGROUND: Previous cesarean scar defect (PCSD) is a gynecological disease that can cause bleeding after intercourse, prolonging menstrual period, intermenstrual bleeding, dysmenorrhea, and even lead to infertility. Chinese herbal medicine plays an important role in the treatment of gynecological diseases in China and East Asia. This study aims to assess the efficacy and safety of Chinese herbal medicine for PCSD. METHODS: We search the following databases: PubMed, the Cochrane Library, Chinese Biomedical Literature Database (CB), Chinese Science and Technique Journals Database (VIP), EMBASE, Chinese National Knowledge Infrastructure Database (CNKI), and the Wanfang Database. Other sources will also be searched like Google Scholar and gray literature. All databases mentioned above are searched from the start date to the latest version. Randomized controlled trials will be included which recruiting PCSD participants to assess the efficacy and safety of Chinese herbal medicines against controls (placebo or other therapeutic agents). Primary outcomes will include the size of PCSD, menstrual cycle, menstrual phase, menstrual volume, duration of disease, security index. Two authors will independently scan the searched articles, extract the data from attached articles, and import them into Endnote X8 and use Microsoft Excel 2013 to manage data and information. We will assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by consensus or the participation of a third party. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. The meta-analysis in this review will use RevMan 5.3 software. RESULTS: The study aims to evaluate the efficacy and safety of the treatment that Chinese herbal medicine for PCSD. CONCLUSION: This study of the meta-analysis could provide evidence for clinicians and help patients to make a better choice. INPLASY REGISTRATION NUMBER: INPLASY202090080.


Assuntos
Cesárea/efeitos adversos , Cicatriz/tratamento farmacológico , Cicatriz/etiologia , Medicamentos de Ervas Chinesas/uso terapêutico , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Endometriose/prevenção & controle , Feminino , Humanos , Ciclo Menstrual/efeitos dos fármacos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Infecção da Ferida Cirúrgica/prevenção & controle
9.
BMJ ; 371: m3464, 2020 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-32998909

RESUMO

OBJECTIVE: To evaluate whether irregular or long menstrual cycles throughout the life course are associated with all cause and cause specific premature mortality (age <70 years). DESIGN: Prospective cohort study. SETTING: Nurses' Health Study II (1993-2017). PARTICIPANTS: 79 505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes and who reported the usual length and regularity of their menstrual cycles at ages 14-17 years, 18-22 years, and 29-46 years. MAIN OUTCOME MEASURES: Hazard ratios and 95% confidence intervals for all cause and cause specific premature mortality (death before age 70 years) were estimated from multivariable Cox proportional hazards models. RESULTS: During 24 years of follow-up, 1975 premature deaths were documented, including 894 from cancer and 172 from cardiovascular disease. Women who reported always having irregular menstrual cycles experienced higher mortality rates during follow-up than women who reported very regular cycles in the same age ranges. The crude mortality rate per 1000 person years of follow-up for women reporting very regular cycles and women reporting always irregular cycles were 1.05 and 1.23 for cycle characteristics at ages 14-17 years, 1.00 and 1.37 for cycle characteristics at ages 18-22 years, and 1.00 and 1.68 for cycle characteristics at ages 29-46 years. The corresponding multivariable adjusted hazard ratios for premature death during follow-up were 1.18 (95% confidence interval 1.02 to 1.37), 1.37 (1.09 to 1.73), and 1.39 (1.14 to 1.70), respectively. Similarly, women who reported that their usual cycle length was 40 days or more at ages 18-22 years and 29-46 years were more likely to die prematurely than women who reported a usual cycle length of 26-31 days in the same age ranges (1.34, 1.06 to 1.69; and 1.40, 1.17 to 1.68, respectively). These relations were strongest for deaths related to cardiovascular disease. The higher mortality associated with long and irregular menstrual cycles was slightly stronger among current smokers. CONCLUSIONS: Irregular and long menstrual cycles in adolescence and adulthood are associated with a greater risk of premature mortality (age <70 years). This relation is slightly stronger among women who smoke.


Assuntos
Ciclo Menstrual , Distúrbios Menstruais/epidemiologia , Mortalidade Prematura , Saúde Reprodutiva/estatística & dados numéricos , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Causas de Morte , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Medição de Risco , Fatores de Risco , Autorrelato , Fumar/epidemiologia , Estados Unidos/epidemiologia
10.
Arch. med. deporte ; 37(199): 348-353, sept.-oct. 2020. graf
Artigo em Inglês | IBECS | ID: ibc-199348

RESUMO

Iron is necessary for adequate deliver oxygen to the tissues since it is an essential component of the haemoglobin. However, iron deficiency remains a common problem among athletes, particularly for women experiencing the menstrual bleeding every month. The iron losses through menstrual blood loss during the early follicular phase (or menses) and an inadequate dietary intake of iron are two important factors contributing to this disease. Furthermore, the large hormonal changes that women experience along the menstrual cycle, especially in oestrogen and progesterone may influence on the optimization of iron absorption. Iron absorption is mainly mediated by hepcidin hormone, which seems to be affected by several stimulus and factors such as oestrogen and progesterone concentrations. Moreover, the regular practice of exercise is another important modulator of this hormone. Therefore, premenopausal active females are the most susceptible population to develop an iron deficiency or iron deficiency anemia, affecting their health and performance due to the less iron availability within the body and consequently a reduction of haemoglobin which compromise the oxygen transport. To date, most studies have not explored the acute post-exercise hepcidin response taking endogenous and exogenous sexual hormones influence into account. This narrative review will focus on how iron homeostasis is modulated by different factors mainly influenced by exercise and female sexual hormones


El hierro es necesario para suministrar adecuadamente el oxígeno a los tejidos, ya que es un componente esencial de la hemoglobina. Sin embargo, la deficiencia de hierro sigue siendo un problema común entre los atletas, particularmente para las mujeres que experimentan el sangrado menstrual cada mes. Las pérdidas de hierro producidas tras la el sangrado menstrual durante la fase folicular temprana (o menstruación), además de una ingesta dietética inadecuada de hierro son dos factores importantes que contribuyen a esta enfermedad. Además, los grandes cambios hormonales que experimentan las mujeres a lo largo del ciclo menstrual, especialmente en el estrógeno y la progesterona, pueden influir en la optimización de la absorción de hierro. La absorción de hierro está mediada principalmente por la hormona hepcidina, que parece verse afectada por varios estímulos y factores como las concentraciones de estrógeno y progesterona. Además, la práctica regular de ejercicio es otro importante modulador de esta hormona. Por lo tanto, las mujeres activas premenopáusicas son la población más susceptible de desarrollar una deficiencia de hierro o anemia ferropénica, lo que afecta a su salud y rendimiento debido a la menor disponibilidad de hierro en el cuerpo y en consecuencia, a la reducción de la hemoglobina que compromete el transporte de oxígeno. Hasta la fecha, la mayoría de los estudios no han explorado la respuesta aguda de la hepcidina después del ejercicio teniendo en cuenta la influencia de las hormonas sexuales endógenas y exógenas.E sta revisión narrativa se centrará en cómo la homeostasis del hierro es modulada por diferentes factores influenciados principalmente por el ejercicio y las hormonas sexuales femeninas


Assuntos
Humanos , Feminino , Homeostase/fisiologia , Ferro/metabolismo , Hepcidinas/metabolismo , Deficiência de Ferro/metabolismo , Atletas , Exercício Físico/fisiologia , Fatores Sexuais , Ciclo Menstrual/metabolismo , Interleucina-6/metabolismo
12.
Obstet Gynecol ; 136(4): 666-674, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925608

RESUMO

OBJECTIVE: To evaluate the effects of age and season on menstrual cycle length and basal body temperature (BBT). We also examined the effects of climate on cycle length and BBT, taking into account Japanese geographic and social characteristics. METHODS: In this retrospective cohort study, we analyzed data from 6 million menstrual cycles entered into a smartphone application from 310,000 females from 2016 to 2017. Only those who entered more than 10 cycles in 2 years were included. Generalized estimation equations were used to adjust for confounding factors and for within-person correlations of multiple records. Multiple regression analysis was conducted, with age, external average temperature, precipitation amount, and sunshine hours as confounding factors. RESULTS: The mean menstrual cycle length increased from age 15-23 years, subsequently decreased up to age 45 years, and then increased again. Average follicular phase body temperature showed no significant age-dependent changes, but luteal phase body temperature gradually increased up to 29 years and then stabilized and started to decrease after age 42 years. A significant association between external temperature and body temperature (follicular and luteal phase) was observed, though menstrual cycle length did not show such an association. CONCLUSION: These results, derived from data self-entered into a smartphone application, revealed underrecognized age-dependent and seasonal changes in menstrual cycle length and BBT, which will contribute to a better understanding of female reproductive health in the modern world.


Assuntos
Temperatura Corporal , Coleta de Dados/instrumentação , Fase Luteal/fisiologia , Ciclo Menstrual/fisiologia , Estações do Ano , Saúde da Mulher , Adolescente , Adulto , Fatores Etários , Big Data , Feminino , Humanos , Japão/epidemiologia , Saúde Reprodutiva , Estudos Retrospectivos , Smartphone , Fatores de Tempo
14.
J Headache Pain ; 21(1): 95, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746775

RESUMO

BACKGROUND: We performed a post hoc, subgroup analysis of a phase 3, randomized, double-blind, placebo-controlled study of erenumab for prevention of episodic migraine (STRIVE) to determine the efficacy and safety of erenumab in women with self-reported menstrual migraine. METHODS: Patients received placebo, erenumab 70 mg, or erenumab 140 mg subcutaneously once monthly during the 6-month double-blind treatment phase of STRIVE. Women who reported history of menstrual migraine and who were ≤ 50 years old were included in the analysis. Endpoints were change from baseline in monthly migraine days (MMD) and monthly acute migraine-specific medication days (MSMD; among patients who took acute migraine-specific medications at baseline), proportion of patients achieving ≥ 50% reduction from baseline in MMD, and incidence of adverse events. RESULTS: Among 814 women enrolled in STRIVE, 232 (28.5%) reported a history of menstrual migraine and were ≤ 50 years old. Of the 232 patients, 214 (92%) had a baseline MMD > 5, suggesting a high proportion of women with attacks outside of the 5-day perimenstrual window (2 days before and 3 days after the start of menstruation). Information on "migraine days" includes (and does not discriminate between) perimenstrual and intermenstrual migraine attacks. Between-group differences from placebo over months 4-6 for erenumab 70 mg and 140 mg were - 1.8 (P = 0.001) and - 2.1 (P < 0.001) days for MMD and - 1.6 (P = 0.002) and - 2.4 (P < 0.001) days for acute MSMD, respectively. The odds of having a ≥ 50% reduction from baseline in MMD over months 4-6 were 2.2 (P = 0.024) and 2.8 (P = 0.002) times greater for erenumab 70 mg and 140 mg, respectively, than for placebo. Erenumab had an overall safety profile comparable to placebo. CONCLUSION: Data from this subgroup analysis of women with menstrual migraine are consistent with data from the overall STRIVE episodic migraine population, supporting the efficacy and safety of erenumab in women who experience menstrual migraine. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02456740. Registered 28 May 2015.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antagonistas do Receptor do Peptídeo Relacionado ao Gene de Calcitonina/uso terapêutico , Ciclo Menstrual/efeitos dos fármacos , Transtornos de Enxaqueca/tratamento farmacológico , Adulto , Anticorpos Monoclonais Humanizados/farmacologia , Antagonistas do Receptor do Peptídeo Relacionado ao Gene de Calcitonina/farmacologia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Ciclo Menstrual/fisiologia , Pessoa de Meia-Idade , Transtornos de Enxaqueca/fisiopatologia , Autorrelato , Resultado do Tratamento , Adulto Jovem
15.
BMJ ; 370: m2519, 2020 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-32759285

RESUMO

OBJECTIVE: To compare the ongoing pregnancy rate between a freeze-all strategy and a fresh transfer strategy in assisted reproductive technology treatment. DESIGN: Multicentre, randomised controlled superiority trial. SETTING: Outpatient fertility clinics at eight public hospitals in Denmark, Sweden, and Spain. PARTICIPANTS: 460 women aged 18-39 years with regular menstrual cycles starting their first, second, or third treatment cycle of in vitro fertilisation or intracytoplasmic sperm injection. INTERVENTIONS: Women were randomised at baseline on cycle day 2 or 3 to one of two treatment groups: the freeze-all group (elective freezing of all embryos) who received gonadotropin releasing hormone agonist triggering and single frozen-thawed blastocyst transfer in a subsequent modified natural cycle; or the fresh transfer group who received human chorionic gonadotropin triggering and single blastocyst transfer in the fresh cycle. Women in the fresh transfer group with more than 18 follicles larger than 11 mm on the day of triggering had elective freezing of all embryos and postponement of transfer as a safety measure. MAIN OUTCOME MEASURES: The primary outcome was the ongoing pregnancy rate defined as a detectable fetal heart beat after eight weeks of gestation. Secondary outcomes were live birth rate, positive human chorionic gonadotropin rate, time to pregnancy, and pregnancy related, obstetric, and neonatal complications. The primary analysis was performed according to the intention-to-treat principle. RESULTS: Ongoing pregnancy rate did not differ significantly between the freeze-all and fresh transfer groups (27.8% (62/223) v 29.6% (68/230); risk ratio 0.98, 95% confidence interval 0.87 to 1.10, P=0.76). Additionally, no significant difference was found in the live birth rate (27.4% (61/223) for the freeze-all group and 28.7% (66/230) for the fresh transfer group; risk ratio 0.98, 95% confidence interval 0.87 to 1.10, P=0.83). No significant differences between groups were observed for positive human chorionic gonadotropin rate or pregnancy loss, and none of the women had severe ovarian hyperstimulation syndrome; only one hospital admission related to this condition occurred in the fresh transfer group. The risks of pregnancy related, obstetric, and neonatal complications did not differ between the two groups except for a higher mean birth weight after frozen blastocyst transfer and an increased risk of prematurity after fresh blastocyst transfer. Time to pregnancy was longer in the freeze-all group. CONCLUSIONS: In women with regular menstrual cycles, a freeze-all strategy with gonadotropin releasing hormone agonist triggering for final oocyte maturation did not result in higher ongoing pregnancy and live birth rates than a fresh transfer strategy. The findings warrant caution in the indiscriminate application of a freeze-all strategy when no apparent risk of ovarian hyperstimulation syndrome is present. TRIAL REGISTRATION: Clinicaltrials.gov NCT02746562.


Assuntos
Peso ao Nascer , Blastocisto , Criopreservação , Fertilização In Vitro/métodos , Transferência de Embrião Único/métodos , Aborto Espontâneo/epidemiologia , Adulto , Gonadotropina Coriônica/sangue , Feminino , Humanos , Nascimento Vivo , Ciclo Menstrual , Complicações do Trabalho de Parto/epidemiologia , Gravidez , Taxa de Gravidez , Nascimento Prematuro/epidemiologia , Fatores de Tempo
16.
Artigo em Inglês | MEDLINE | ID: mdl-32739288

RESUMO

Natural progesterone (P4) has a unique pharmacodynamic activity and safety profile compared to the synthetic progestins. As a result, a class effect does not exist for both P4 and synthetic progestins, in terms of both their efficacy and safety. Progestogens act at the genomic level by binding to the nuclear receptors and modulating the expression of some target-genes. P4 and the synthetic progestins have a hugely variable affinity for binding not only to the P4 receptors but also to other members of the steroid receptor family including glucocorticoid receptor, androgen receptor and mineralocorticoid receptor. This leads to different and specific pharmacokinetic profiles, clinical pharmacodynamics, safety and efficacy. P4 produced in the luteal phase of the menstrual cycle has several physiological effects regulating menses and, in the pregnant uterus, controlling the development of endometrial receptivity preparing the endometrium for implantation. P4 and its associated metabolites are powerful biological agents through genomic action by the progesterone nuclear receptor with a finely tuned regulatory role throughout pregnancy, from conception until delivery. Extra-nuclear, non-classical mechanisms of action have also been identified, including steroid interactions with some membrane receptors [oxytocin receptors and γ-aminobutyric acid (GABAA), and the induction of a direct relaxing effect on uterine contractility by blockage of calcium influx. The extent of activity of P4 on the central nervous system (CNS) is modulated by the route of administration: oral P4 is affected by the presence of bacteria and associated enzymes secreted in the gut, the intestinal wall and by the liver, whereas vaginal P4 is not. P4 and two important metabolites, namely, allopregnanolone (3a,5a-tetrahydroP4) and 3a,5a-tetrahydrodeoxycorticosterone, exert neuroprotective effects on neonates. They are also natural positive modulators of the neuronal GABAA receptor, providing a clear pathway to explain the rapid dose-dependent psychopharmacological actions including anxiolytic, antidepressant, anaesthetic, anticonvulsant and analgesic effects. Fundamental structural differences exist between P4 and the synthetic progestins, resulting in different safety profiles when they are used during the menstrual cycle, in early and late pregnancy and in the alleviation of peri- or postmenopausal symptoms.


Assuntos
Progesterona , Progestinas , Endométrio , Feminino , Humanos , Recém-Nascido , Ciclo Menstrual , Gravidez , Progestinas/efeitos adversos , Receptores de Progesterona , Útero
17.
Eur. j. anat ; 24(supl.1): 23-28, ago. 2020.
Artigo em Inglês | IBECS | ID: ibc-195285

RESUMO

Nowadays menstrual blood is the only kind that neo-capitalist patriarchal decorum will not tolerate. At a time when the visual industry has successfully monetarised the "seduction of blood", the representation of this type of female fluid remains completely barred and relegated to invisibility. The identification of menstrual blood with pollution has become a hegemonic cultural construct that seeks to safeguard the ideals of purity and whiteness through which women's bodies are socially coded. Contemporary artistic practice has reacted against this state of affairs by turning this cultural dirtiness into a political tool with which to expand the limits of female body experience. From the early 1970s to the present, a number of women artists have made crucial contributions to this field of work known as menstrual art, in which the primary aim has been to formulate an alternative image of periods that could put women back in control of the most intimate aspects of their physical and emotional identity


No disponible


Assuntos
Humanos , Feminino , Medicina nas Artes , Asco , Menstruação/fisiologia , Ciclo Menstrual/sangue , Ciclo Menstrual/fisiologia
18.
PLoS One ; 15(7): e0236025, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32658929

RESUMO

BACKGROUND: The need to control for the potential influence of menstrual cycle phase on resting metabolism (RMR) places a burden on research participants who must self-report onset of menstruation and researchers who must schedule metabolic testing accordingly. PURPOSE: To systematically review and analyze existing research to determine the effect of menstrual cycle on RMR. METHODS: We searched PubMed, CINAHL, MEDLINE, SPORTDiscus, and Scopus databases using the search terms "menstrual cycle and metabolic rate" and "menstrual cycle and energy expenditure." Eligibility criteria were English language, single-group repeated measures design, and RMR as either a primary or secondary outcome. Risk of bias was assessed based on study sample, measurement, and control of confounders. Differences between the follicular and luteal phases of the menstrual cycle were analyzed using the standardized mean difference in effect size. RESULTS: Thirty English-language studies published between 1930 and December 2019 were included in the systematic review, and 26 studies involving 318 women were included in the meta-analysis. Overall, there was a small but significant effect favoring increased RMR in the luteal phase (ES = 0.33; 95% CI = 0.17, 0.49, p < 0.001). DISCUSSION: Limitations include risk of bias regarding measurement of both menstrual cycle and RMR. Sample sizes were small and studies did not report control of potential confounders. Sub-group analysis demonstrated that in more recent studies published since 2000, the effect of menstrual phase was reduced and not statistically significant (ES = 0.23; 95% CI = -0.00, 0.47; p = 0.055). Until larger and better designed studies are available, based on our current findings, researchers should be aware of the potential confounding influence of the menstrual cycle and control for it by testing consistently in one phase of the cycle when measuring RMR in pre-menopausal women.


Assuntos
Metabolismo Basal , Ciclo Menstrual , Descanso/fisiologia , Feminino , Humanos
20.
Fertil Steril ; 114(2): 223-232, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641214

RESUMO

OBJECTIVE: To determine the susceptibility of the endometrium to infection by-and thereby potential damage from-SARS-CoV-2. DESIGN: Analysis of SARS-Cov-2 infection-related gene expression from endometrial transcriptomic data sets. SETTING: Infertility research department affiliated with a public hospital. PATIENT(S): Gene expression data from five studies in 112 patients with normal endometrium collected throughout the menstrual cycle. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Gene expression and correlation between viral infectivity genes and age throughout the menstrual cycle. RESULT(S): Gene expression was high for TMPRSS4, CTSL, CTSB, FURIN, MX1, and BSG; medium for TMPRSS2; and low for ACE2. ACE2, TMPRSS4, CTSB, CTSL, and MX1 expression increased toward the window of implantation. TMPRSS4 expression was positively correlated with ACE2, CTSB, CTSL, MX1, and FURIN during several cycle phases; TMPRSS2 was not statistically significantly altered across the cycle. ACE2, TMPRSS4, CTSB, CTSL, BSG, and MX1 expression increased with age, especially in early phases of the cycle. CONCLUSION(S): Endometrial tissue is likely safe from SARS-CoV-2 cell entry based on ACE2 and TMPRSS2 expression, but susceptibility increases with age. Further, TMPRSS4, along with BSG-mediated viral entry into cells, could imply a susceptible environment for SARS-CoV-2 entry via different mechanisms. Additional studies are warranted to determine the true risk of endometrial infection by SARS-CoV-2 and implications for fertility treatments.


Assuntos
Betacoronavirus/metabolismo , Infecções por Coronavirus/metabolismo , Endométrio/metabolismo , Endométrio/virologia , Regulação Viral da Expressão Gênica , Pneumonia Viral/metabolismo , Adulto , Fatores Etários , Betacoronavirus/genética , Infecções por Coronavirus/genética , Feminino , Humanos , Ciclo Menstrual , Pessoa de Meia-Idade , Pandemias , Peptidil Dipeptidase A/biossíntese , Peptidil Dipeptidase A/genética , Pneumonia Viral/genética , Medição de Risco/métodos , Internalização do Vírus , Adulto Jovem
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