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Hamilton K, Harper JC. Young adult's views on using a poster to learn about fertility: redesigning the fertility education poster. HUM FERTIL 2024; 27:2345675. [PMID: 38804247 DOI: 10.1080/14647273.2024.2345675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/10/2024] [Indexed: 05/29/2024]
Abstract
Fertility awareness should be taught to everyone. The International Reproductive Health Education Collaboration (IRHEC) designed a fertility poster in 2019 but did not have a specific target group in mind. Studies have been conducted in Denmark and Sweden to determine how the poster can be redesigned. In this study, we carried out focus groups with young adults in the UK to ask their views of the poster, with the aim of redesigning it. Six focus groups were undertaken with twenty seven, 18-25 year olds. Five questions were asked: 1. What are your thoughts, feelings, and reactions to the poster? 2. Did you learn anything from the poster? 3. How has reading the poster impacted your opinions or thoughts about having children? 4. What are your opinions about using a poster format to inform and start reflections regarding family building? 5. Reading through each point are there any changes to be made? Content analysis was performed. Themes identified revealed the information on the poster gave the participants some anxiety and apprehension, especially regarding the effect of age on fertility, perceptions of IVF, and gaps in knowledge. The fertility education poster is a good resource for education, but other resources should be developed.
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Affiliation(s)
- Katie Hamilton
- EGA Institute for Women's Health, University College London, London, UK
| | - Joyce C Harper
- EGA Institute for Women's Health, University College London, London, UK
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2
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Quintana DS, Glaser BD, Kang H, Kildal ESM, Audunsdottir K, Sartorius AM, Barth C. The interplay of oxytocin and sex hormones. Neurosci Biobehav Rev 2024; 163:105765. [PMID: 38885888 DOI: 10.1016/j.neubiorev.2024.105765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/31/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
The neuropeptide oxytocin has historically been associated with reproduction and maternal behavior. However, more recent research has uncovered that oxytocin has a much wider range of roles in physiology and behavior. Despite the excitement surrounding potential therapeutical applications of intranasally administered oxytocin, the results of these intervention studies have been inconsistent. Various reasons for these mixed results have been proposed, which tend to focus on methodological issues, such as study design. While methodological issues are certainly important, emerging evidence suggests that the interaction between oxytocin and sex hormones may also account for these varied findings. To better understand the purpose and function of the interaction of oxytocin with sex hormones, with a focus on estrogens, progesterone, and testosterone, we conducted a comprehensive thematic review via four perspectives: evolutionary, developmental, mechanistic, and survival. Altogether, this synergistic approach highlights the critical function of sex hormone activity for accomplishing the diverse roles of oxytocin via the modulation of oxytocin release and oxytocin receptor activity, which is also likely to contribute to the heterogeneity of outcomes after oxytocin administration.
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Affiliation(s)
- Daniel S Quintana
- Department of Psychology, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway; NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway.
| | - Bernt D Glaser
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Heemin Kang
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Emilie S M Kildal
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Lovisenberg Diakonale Sykehus, Oslo, Norway
| | - Kristin Audunsdottir
- Department of Psychology, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | | | - Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
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Harley KG, Watson A, Robertson S, Vitzthum VJ, Shea A. Menstrual Cycle Characteristics of U. S. Adolescents According to Gynecologic Age and Age at Menarche. J Pediatr Adolesc Gynecol 2024; 37:419-425. [PMID: 38570085 DOI: 10.1016/j.jpag.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/06/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024]
Abstract
STUDY OBJECTIVE To characterize typical menstrual cycle characteristics in adolescents and determine how these differ with age at menarche or years since menarche (gynecologic age). METHODS We surveyed 13 to 18-year-old U.S. users of the Clue app (N = 6,486) and linked their responses to app-recorded cycle data (N=38,916 cycles). We analyzed cycle characteristics including cycle length, cycle variability, period length, experience of heavy flow, and dysmenorrhea in relation to gynecologic age and menarcheal age using mixed effects models. RESULTS With increasing gynecologic age, we observed dose-dependent associations of lower odds of cycle irregularity (defined as cycles that were highly variable, short, or long) and higher odds of reporting ≥1 day of heavy flow. Individuals <1 year post-menarche had lower odds of heavy flow (Odds Ratio (OR) = 0.3; 95% confidence interval (CI): 0.1, 0.6), and increased odds of having a highly variable cycle (OR = 2.6; 95% CI: 1.3, 5.2) or short cycles (OR = 5.0; 95% CI: 2.3, 11.0) compared to those who were 6+ years post-menarche. We also found associations with early and late age at menarche. Compared to menarcheal age of 14+ years, menarcheal age ≤10 years was associated with shorter cycle length (β = -1.63 days; 95% CI: -2.51, -0.75), increased odds of dysmenorrhea (OR = 3.2; 95% CI: 2.3, 4.6), and decreased odds of high cycle variability (OR = 0.8; 95% CI: 0.6, 1.0). CONCLUSION Cycle characteristics in adolescence are associated with menarcheal age and gynecologic age. Notably, highly variable cycles are common, especially among those with younger gynecologic age or older menarcheal age.
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Affiliation(s)
- Kim G Harley
- Wallace Center for Maternal, Child, and Adolescent Health, School of Public Health, University of California, Berkeley, California.
| | - Annalisa Watson
- Wallace Center for Maternal, Child, and Adolescent Health, School of Public Health, University of California, Berkeley, California
| | - Samantha Robertson
- Department of Electrical Engineering and Computer Science, University of California, Berkeley
| | - Virginia J Vitzthum
- Department of Medicine, University of British Columbia, Canada; Indiana University, Bloomington, Indiana
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Gombert-Labedens M, Alzueta E, Perez-Amparan E, Yuksel D, Kiss O, de Zambotti M, Simon K, Zhang J, Shuster A, Morehouse A, Pena AA, Mednick S, Baker FC. Using Wearable Skin Temperature Data to Advance Tracking and Characterization of the Menstrual Cycle in a Real-World Setting. J Biol Rhythms 2024; 39:331-350. [PMID: 38767963 PMCID: PMC11294004 DOI: 10.1177/07487304241247893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
The menstrual cycle is a loop involving the interplay of different organs and hormones, with the capacity to impact numerous physiological processes, including body temperature and heart rate, which in turn display menstrual rhythms. The advent of wearable devices that can continuously track physiological data opens the possibility of using these prolonged time series of skin temperature data to noninvasively detect the temperature variations that occur in ovulatory menstrual cycles. Here, we show that the menstrual skin temperature variation is better represented by a model of oscillation, the cosinor, than by a biphasic square wave model. We describe how applying a cosinor model to a menstrual cycle of distal skin temperature data can be used to assess whether the data oscillate or not, and in cases of oscillation, rhythm metrics for the cycle, including mesor, amplitude, and acrophase, can be obtained. We apply the method to wearable temperature data collected at a minute resolution each day from 120 female individuals over a menstrual cycle to illustrate how the method can be used to derive and present menstrual cycle characteristics, which can be used in other analyses examining indicators of female health. The cosinor method, frequently used in circadian rhythms studies, can be employed in research to facilitate the assessment of menstrual cycle effects on physiological parameters, and in clinical settings to use the characteristics of the menstrual cycles as health markers or to facilitate menstrual chronotherapy.
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Affiliation(s)
| | - Elisabet Alzueta
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | | | - Dilara Yuksel
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | | | - Katharine Simon
- Department of Cognitive Science, University of California, Irvine, CA, USA
| | - Jing Zhang
- Department of Cognitive Science, University of California, Irvine, CA, USA
| | - Alessandra Shuster
- Department of Cognitive Science, University of California, Irvine, CA, USA
| | - Allison Morehouse
- Department of Cognitive Science, University of California, Irvine, CA, USA
| | | | - Sara Mednick
- Department of Cognitive Science, University of California, Irvine, CA, USA
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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5
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Homam Safiah M, Kalalib Al Ashabi K, Khalayli N, Hodaifa Y, Kudsi M. The prevalence of menstrual changes in COVID-19 vaccinated women: A cross-sectional study. Prev Med Rep 2024; 44:102804. [PMID: 39040951 PMCID: PMC11261097 DOI: 10.1016/j.pmedr.2024.102804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/24/2024] Open
Abstract
Background This study aimed to examine the prevalence of menstrual cycle changes (MCs) and their patterns among healthy Syrian women following the administration of the first and second doses of a vaccine. Methods A cross-sectional online survey following campaigns for COVID-19 vaccines was conducted in 2022 from June 26 to August 3. Data collected included the participants' demographic characteristics, vaccination status, and multiple-choice questions for MCs changes after the first and second doses. Results Of 236, 89.8 % completed all shots of the vaccine. After the first dose, 36.9 % reported MCs, and 35 % after the second dose. Most women did not experience changes in menstrual cycle frequency-81.8 % after the first dose and 83.4 % after the second dose. Similarly, most women did not observe changes in cycle length, or menstrual flow quantity-5.5 % after the first dose and 8 % after the second dose reported spotting. Dysmenorrhea was reported by 15.7 % and 14.1 % of women after the first and second doses, respectively. Conclusion MCs are a potential symptom that a healthy woman at childbearing age could have after a different type of COVID-19 vaccine. MCs patterns do not significantly differ following vaccine doses.
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Affiliation(s)
- Mhd Homam Safiah
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | | | - Naram Khalayli
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Yara Hodaifa
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Maysoun Kudsi
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
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6
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Mackenzie ACL, Chung S, Hoppes E, Mickler AK, Cartwright AF. Measurement of changes to the menstrual cycle: A transdisciplinary systematic review evaluating measure quality and utility for clinical trials. PLoS One 2024; 19:e0306491. [PMID: 39052601 PMCID: PMC11271926 DOI: 10.1371/journal.pone.0306491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
Despite the importance of menstruation and the menstrual cycle to health, human rights, and sociocultural and economic wellbeing, the study of menstrual health suffers from a lack of funding, and research remains fractured across many disciplines. We sought to systematically review validated approaches to measure four aspects of changes to the menstrual cycle-bleeding, blood, pain, and perceptions-caused by any source and used within any field. We then evaluated the measure quality and utility for clinical trials of the identified instruments. We searched MEDLINE, Embase, and four instrument databases and included peer-reviewed articles published between 2006 and 2023 that reported on the development or validation of instruments assessing menstrual changes using quantitative or mixed-methods methodology. From a total of 8,490 articles, 8,316 were excluded, yielding 174 articles reporting on 94 instruments. Almost half of articles were from the United States or United Kingdom and over half of instruments were only in English, Spanish, French, or Portuguese. Most instruments measured bleeding parameters, uterine pain, or perceptions, but few assessed characteristics of blood. Nearly 60% of instruments were developed for populations with menstrual or gynecologic disorders or symptoms. Most instruments had fair or good measure quality or clinical trial utility; however, most instruments lacked evidence on responsiveness, question sensitivity and/or transferability, and only three instruments had good scores of both quality and utility. Although we took a novel, transdisciplinary approach, our systematic review found important gaps in the literature and instrument landscape, pointing towards a need to examine the menstrual cycle in a more comprehensive, inclusive, and standardized way. Our findings can inform the development of new or modified instruments, which-if used across the many fields that study menstrual health and within clinical trials-can contribute to a more systemic and holistic understanding of menstruation and the menstrual cycle.
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Affiliation(s)
- Amelia C. L. Mackenzie
- Global Health and Population, FHI 360, Washington, District of Columbia, United States of America
| | - Stephanie Chung
- Global Health and Population, FHI 360, Durham, North Carolina, United States of America
- Department of Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - Emily Hoppes
- Global Health and Population, FHI 360, Durham, North Carolina, United States of America
| | - Alexandria K Mickler
- Research, Technology and Utilization Division, United States Agency for International Development and the Public Health Institute, Office of Population and Reproductive Health, Bureau for Global Health, Washington, District of Columbia, United States of America
| | - Alice F. Cartwright
- Global Health and Population, FHI 360, Durham, North Carolina, United States of America
- Department of Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
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Hosoya S, Itoi S, Piedvache A, Osuga Y, Morisaki N, Koga K. Timing of Coronavirus Disease 2019 (COVID-19) Vaccination and Effects on Menstrual Cycle Changes. Obstet Gynecol 2024; 144:e10-e12. [PMID: 38949547 DOI: 10.1097/aog.0000000000005624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Affiliation(s)
- Satoshi Hosoya
- Center for Regenerative Medicine, National Center for Child Health and Development, and Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shiori Itoi
- Department of Social Medicine, National Center for Child Health and Development, and Department of Obstetrics and Gynecology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Aurelie Piedvache
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kaori Koga
- Department of Reproductive Medicine, Chiba University Graduate School of Medicine, and Department of Obstetrics and Gynecology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Santabarbara KL, Helms ER, Stewart TI, Armour MJ, Harris NK. Menstrual cycle patterns and their relationship with measures of well-being and perceived performance metrics in competitive and recreational resistance-trained athletes. J Sports Med Phys Fitness 2024; 64:694-706. [PMID: 38916093 DOI: 10.23736/s0022-4707.24.15752-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND There is mixed evidence on how the menstrual cycle (MC) affects sports performance, with many studies showing variations in performance during different phases of the MC, while other evidence shows that the MC's effects on performance may be trivial. Therefore, this exploratory longitudinal monitoring study was designed to investigate MC characteristics and symptoms in a resistance-trained (RT) population to look for associations between measures of well-being and perceived performance metrics across the MC. METHODS RT females reported their workout habits, perceived performance metrics, and measures of well-being while tracking their MC with detailed methods via daily check-ins in an app. RESULTS Most MC characteristics and symptoms in the present RT population aligned with previous research on the general population. However, the frequency of irregular cycles was higher than in previous research on the general population. The amount of individual variation and within-subject cycle-to-cycle variation in MC characteristics and MC symptoms was also high. All measures of well-being were significantly associated with specific days of the MC, demonstrating a change in well-being based on the timing of the MC. Several perceived performance metrics were significantly associated with changes across the MC, while others were not. CONCLUSIONS Overall, with the current evidence as it stands, a highly individualized approach should be taken for any training or performance considerations surrounding the MC due to the high levels of individual variation.
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Affiliation(s)
- Kimberly L Santabarbara
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand -
- Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, USA -
| | - Eric R Helms
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
- Department of Exercise Science and Health Promotion, Florida Atlantic University, Laboratory of Muscle Physiology, Boca Raton, FL, USA
| | - Tom I Stewart
- Human Potential Center, Auckland University of Technology, Auckland, New Zealand
| | - Mike J Armour
- NICM Health Research Institute, Western Sydney University, Sydney, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand
| | - Nigel K Harris
- Human Potential Center, Auckland University of Technology, Auckland, New Zealand
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Shearston JA, Upson K, Gordon M, Do V, Balac O, Nguyen K, Yan B, Kioumourtzoglou MA, Schilling K. Tampons as a source of exposure to metal(loid)s. ENVIRONMENT INTERNATIONAL 2024; 190:108849. [PMID: 38963987 DOI: 10.1016/j.envint.2024.108849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Between 52-86% of people who menstruate in the United States use tampons-cotton and/or rayon/viscose 'plugs'-to absorb menstrual blood in the vagina. Tampons may contain metals from agricultural or manufacturing processes, which could be absorbed by the vagina's highly absorptive tissue, resulting in systemic exposure. To our knowledge, no previous studies have measured metals in tampons. OBJECTIVES We evaluated the concentrations of 16 metal(loid)s in 30 tampons from 14 tampon brands and 18 product lines and compared the concentrations by tampon characteristics. METHODS About 0.2 - 0.3 g from each tampon (n = 60 samples) were microwave-acid digested and analyzed by inductively coupled plasma mass spectrometry (ICP-MS) to determine concentrations of arsenic, barium, calcium, cadmium, cobalt, chromium, copper, iron, manganese, mercury, nickel, lead, selenium, strontium, vanadium, and zinc. We compared concentrations by several tampon characteristics (region of purchase, organic material, brand type) using median quantile mixed models. RESULTS We found measurable concentrations of all 16 metals assessed. We detected concentrations of several toxic metals, including elevated mean concentrations of lead (geometric mean [GM] = 120 ng/g), cadmium (GM = 6.74 ng/g), and arsenic (GM = 2.56 ng/g). Metal concentrations differed by region of tampon purchase (US versus European Union/United Kingdom), by organic versus non-organic material, and for store- versus name-brand tampons. Most metals differed by organic status; lead concentrations were higher in non-organic tampons while arsenic was higher in organic tampons. No categoriy had consistently lower concentrations of all or most metals. DISCUSSION Tampon use is a potential source of metal exposure. We detected all 16 metals in at least one sampled tampon, including some toxic metals like lead that has no "safe" exposure level. Future research is needed to replicate our findings and determine whether metals can leach out of tampons and cross the vaginal epithelium into systemic circulation.
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Affiliation(s)
- Jenni A Shearston
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA; Department of Environmental Science, Policy, & Management and the School of Public Health, University of California Berkeley, Berkeley, CA, USA.
| | - Kristen Upson
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Milo Gordon
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Vivian Do
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Olgica Balac
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Khue Nguyen
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Beizhan Yan
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | | | - Kathrin Schilling
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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Schleifenbaum L, Stern J, Driebe JC, Wieczorek LL, Gerlach TM, Arslan RC, Penke L. Ovulatory cycle shifts in human motivational prioritisation of sex and food. Horm Behav 2024; 162:105542. [PMID: 38636206 DOI: 10.1016/j.yhbeh.2024.105542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/19/2024] [Accepted: 04/03/2024] [Indexed: 04/20/2024]
Abstract
Previous research on the endogenous effects of ovarian hormones on motivational states in women has focused on sexual motivation. The Motivational Priority Shifts Hypothesis has a broader scope. It predicts a shift from somatic to reproductive motivation when fertile. In a highly powered preregistered online diary study across 40 days, we tested whether 390 women report such an ovulatory shift in sexual and eating motivation and behaviour. We compared 209 naturally cycling women to 181 women taking hormonal contraceptives (HC) to rule out non-ovulatory changes across the cycle as confounders. We found robust ovulatory decreases in food intake and increases in general sexual desire, in-pair sexual desire and initiation of dyadic sexual behaviour. Extra-pair sexual desire increased mid-cycle, but the effect did not differ significantly in HC women, questioning an ovulatory effect. Descriptively, solitary sexual desire and behaviour, dyadic sexual behaviour, appetite, and satiety showed expected mid-cycle changes that were diminished in HC women, but these failed to reach our strict preregistered significance level. Our results provide insight into current theoretical debates about ovulatory cycle shifts while calling for future research to determine motivational mechanisms behind ovulatory changes in food intake and considering romantic partners' motivational states to explain the occurrence of dyadic sexual behaviour.
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Affiliation(s)
- Lara Schleifenbaum
- Georg August University Goettingen, Germany; Leibniz ScienceCampus Primate Cognition, Germany
| | | | | | | | - Tanja M Gerlach
- Georg August University Goettingen, Germany; Leibniz ScienceCampus Primate Cognition, Germany; Queen's University Belfast, UK
| | | | - Lars Penke
- Georg August University Goettingen, Germany; Leibniz ScienceCampus Primate Cognition, Germany.
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Tkachenko OY, Kahland T, Lindenwald D, Heistermann M, Drummer C, Daskalaki M, Rüger N, Behr R. In vitro matured oocytes have a higher developmental potential than in vivo matured oocytes after hormonal ovarian stimulation in Callithrix jacchus. J Ovarian Res 2024; 17:120. [PMID: 38824584 PMCID: PMC11144324 DOI: 10.1186/s13048-024-01441-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/19/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND The common marmoset, Callithrix jacchus, is an invaluable model in biomedical research. Its use includes genetic engineering applications, which require manipulations of oocytes and production of embryos in vitro. To maximize the recovery of oocytes suitable for embryo production and to fulfil the requirements of the 3R principles to the highest degree possible, optimization of ovarian stimulation protocols is crucial. Here, we compared the efficacy of two hormonal ovarian stimulation approaches: 1) stimulation of follicular growth with hFSH followed by triggering of oocyte maturation with hCG (FSH + hCG) and 2) stimulation with hFSH only (FSH-priming). METHODS In total, 14 female marmosets were used as oocyte donors in this study. Each animal underwent up to four surgical interventions, with the first three performed as ovum pick-up (OPU) procedures and the last one being an ovariohysterectomy (OvH). In total, 20 experiments were carried out with FSH + hCG stimulation and 18 with FSH-priming. Efficacy of each stimulation protocol was assessed through in vitro maturation (IVM), in vitro fertilization (IVF) and embryo production rates. RESULTS Each study group consisted of two subgroups: the in vivo matured oocytes and the oocytes that underwent IVM. Surprisingly, in the absence of hCG triggering some of the oocytes recovered were at the MII stage, moreover, their number was not significantly lower compared to FSH + hCG stimulation (2.8 vs. 3.9, respectively (ns)). While the IVM and IVF rates did not differ between the two stimulation groups, the IVF rates of in vivo matured oocytes were significantly lower compared to in vitro matured ones in both FSH-priming and FSH + hCG groups. In total, 1.7 eight-cell embryos/experiment (OPU) and 2.1 eight-cell embryos/experiment (OvH) were obtained after FSH + hCG stimulation vs. 1.8 eight-cell embryos/experiment (OPU) and 5.0 eight-cell embryos/experiment (OvH) following FSH-priming. These numbers include embryos obtained from both in vivo and in vitro matured oocytes. CONCLUSION A significantly lower developmental competence of the in vivo matured oocytes renders triggering of the in vivo maturation with hCG as a part of the currently used FSH-stimulation protocol unnecessary. In actual numbers, between 1 and 7 blastocysts were obtained following each FSH-priming. In the absence of further studies, FSH-priming appears superior to FSH + hCG stimulation in the common marmoset under current experimental settings.
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Affiliation(s)
- Olena Y Tkachenko
- Platform Degenerative Diseases, German Primate Center-Leibniz Institute for Primate Research, Kellnerweg 4, 37077, Göttingen, Germany.
| | - Tobias Kahland
- Platform Degenerative Diseases, German Primate Center-Leibniz Institute for Primate Research, Kellnerweg 4, 37077, Göttingen, Germany
| | - Dimitri Lindenwald
- Platform Degenerative Diseases, German Primate Center-Leibniz Institute for Primate Research, Kellnerweg 4, 37077, Göttingen, Germany
| | - Michael Heistermann
- Endocrinology Laboratory, German Primate Center-Leibniz Institute for Primate Research, Kellnerweg 4, 37077, Göttingen, Germany
| | - Charis Drummer
- Platform Degenerative Diseases, German Primate Center-Leibniz Institute for Primate Research, Kellnerweg 4, 37077, Göttingen, Germany
| | - Maria Daskalaki
- Platform Degenerative Diseases, German Primate Center-Leibniz Institute for Primate Research, Kellnerweg 4, 37077, Göttingen, Germany
| | - Nancy Rüger
- Platform Degenerative Diseases, German Primate Center-Leibniz Institute for Primate Research, Kellnerweg 4, 37077, Göttingen, Germany
| | - Rüdiger Behr
- Platform Degenerative Diseases, German Primate Center-Leibniz Institute for Primate Research, Kellnerweg 4, 37077, Göttingen, Germany.
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12
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Sinai D, Avni C, Toren P. Beyond physical pain: A large-scale cohort study on endometriosis trends and mental health correlates. J Psychosom Res 2024; 182:111809. [PMID: 38795400 DOI: 10.1016/j.jpsychores.2024.111809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 05/27/2024]
Abstract
BACKGROUND This study investigates the increased prevalence of endometriosis in Israel and its association with psychiatric comorbidities, focusing on the timing of psychiatric diagnoses in relation to endometriosis diagnosis. METHODS Employing a retrospective cohort analysis, we reviewed data from 1,291,963 patients in a large scale medical database, identifying 24,259 cases (1.88%) of endometriosis. The analysis included demographic details, ICD-10 diagnoses of endometriosis and mental health conditions, and medication use patterns. RESULTS A marked rise in endometriosis diagnosis was observed, particularly among women born between 1973 and 1978. Those with endometriosis were more likely to have psychiatric disorders-such as mood disorders, anxiety, PTSD, and eating disorders-than the control group, with the majority of psychiatric diagnoses occurring prior to endometriosis detection, except for PTSD. The study also highlighted significant sociocultural and socioeconomic disparities in endometriosis diagnosis, suggesting barriers to healthcare access and the influence of cultural factors. Limitations include potential biases from the retrospective design and the specific context of Israel's healthcare system, which may limit generalizability. CONCLUSIONS The significant rise in endometriosis and its strong association with psychiatric comorbidities, predominantly preceding the diagnosis of endometriosis, underscores the necessity for integrated care approaches. The disparities in diagnosis rates call for culturally sensitive healthcare practices and early psychiatric interventions.
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Affiliation(s)
- Dana Sinai
- Ramat-Chen Brüll Mental Health Center, Clalit Health Services Community Division, Tel-Aviv District, Tel-Aviv, Israel; Geha Mental Health Data Research Center, Petah Tikva, Israel; Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel.
| | - Chen Avni
- Ramat-Chen Brüll Mental Health Center, Clalit Health Services Community Division, Tel-Aviv District, Tel-Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Paz Toren
- Ramat-Chen Brüll Mental Health Center, Clalit Health Services Community Division, Tel-Aviv District, Tel-Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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13
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Shim J, Han S, Baek J. Factors influencing menstrual regularity among female workers: a cross-sectional analysis study. BMC Womens Health 2024; 24:299. [PMID: 38769497 PMCID: PMC11103980 DOI: 10.1186/s12905-024-03142-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 05/13/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Regularity of menstrual cycles is an important indicator of women's health and fertility, and female workers are exposed to several factors, such as sleep disorders, stress, and shift work, that affect their menstrual regularity. This makes it necessary to comprehensively identify the determinants of menstrual regularity. Therefore, this study identified the factors affecting menstrual regularity among female workers from physiological, psychological, and situational dimensions based on the theory of unpleasant symptoms. METHODS This was a secondary analysis of the 2010-2012 Korea National Health and Nutrition Examination Survey and utilized the data of 2418 female workers. Based on the theory of unpleasant symptoms, physiological factors included age, age at menarche, childbirth experience, body mass index, and sleep duration. Psychological factors included stress level, depressive mood, and suicidal ideation. Situational factors included education level, household income, consumption of alcohol, engagement in smoking, and work schedule. The χ²-test and hierarchical logistic regression analysis were performed, reflecting the complex sample design. RESULTS Age at menarche, childbirth experience, and body mass index among physiological factors and education level and work schedule among situational factors were found to be related to menstrual regularity. A higher risk of menstrual irregularities was found among those who had given birth (versus those who had not), had a high age at menarche (versus those with a low age at menarche), were obese (versus those who had a normal body mass index), had elementary school-level or lesser educational achievements (versus those with college graduate-level or higher educational achievements), and who had a shift work schedule (versus those with a fixed schedule). CONCLUSIONS Intervention is needed for female workers who have these risk factors, and special attention must be paid to female workers who have a shift work schedule. Additionally, since body mass index can be controlled, intervention concerning body mass index is necessary to reduce menstrual irregularity.
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Affiliation(s)
- Joohee Shim
- College of Nursing, Yeungnam University College, Daegu, Republic of Korea
| | - Seungwoo Han
- Department of Nursing, Kwangju Women's University, Gwangju, Republic of Korea
| | - Jihyun Baek
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University; Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Republic of Korea.
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54896, Republic of Korea.
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14
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Mengelkoch S, Cunningham K, Gassen J, Targonskaya A, Zhaunova L, Salimgaraev R, Hill SE. Longitudinal associations between women's cycle characteristics and sexual motivation using Flo cycle tracking data. Sci Rep 2024; 14:10513. [PMID: 38714675 PMCID: PMC11076276 DOI: 10.1038/s41598-024-60599-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/25/2024] [Indexed: 05/10/2024] Open
Abstract
In the current research, we used data from a sample of 16,327 menstrual cycle tracking app users to examine the association between menstrual cycle characteristics and sexual motivation tracked over 10 months of app use. Guided by past work that finds links between menstrual cycle characteristics related to conception risk and sexual motivation, we found that (a) between-women, shorter (r = - 0.04, p = 0.007), more regular cycles predicted small increases in sexual motivation (r = - 0.04, p = 0.001); (b) within-women, shorter cycles predicted greater sexual motivation that month (r = - 0.04, p < 0.001) and (c) the next month (βs: - 0.10 to - 0.06, ps < 0.001), but (d) changes in sexual motivation did not reliably precede changes in cycle length (βs: - 0.01 to 0.02, ps > 0.15). Within-woman analyses also revealed that (e) shorter cycles were followed by more frequent reports of fatigue (β = - 0.06, p < 0.001), insomnia (β = - 0.03, p < 0.001), and food cravings (β = - 0.04, p < 0.001). Together, results suggest that menstrual cycles characteristics and sexual motivation may covary together in ways that reflect changing investments in reproduction. Small effect sizes and lack of experimental control warrant cautious interpretations of results.
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Affiliation(s)
- Summer Mengelkoch
- Laboratory for Stress Assessment and Research, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095-7076, USA.
| | - Katja Cunningham
- Department of Psychology, Texas Christian University, Fort Worth, TX, 76129, USA
| | - Jeffrey Gassen
- Laboratory for Stress Assessment and Research, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, 90095-7076, USA
| | | | | | | | - Sarah E Hill
- Department of Psychology, Texas Christian University, Fort Worth, TX, 76129, USA
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15
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Cunningham AC, Pal L, Wickham AP, Prentice C, Goddard FGB, Klepchukova A, Zhaunova L. Chronicling menstrual cycle patterns across the reproductive lifespan with real-world data. Sci Rep 2024; 14:10172. [PMID: 38702411 PMCID: PMC11068910 DOI: 10.1038/s41598-024-60373-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024] Open
Abstract
The intricate hormonal and physiological changes of the menstrual cycle can influence health on a daily basis. Although prior studies have helped improve our understanding of the menstrual cycle, they often lack diversity in the populations included, sample size, and the span of reproductive and life stages. This paper aims to describe the dynamic differences in menstrual cycle characteristics and associated symptoms by age in a large global cohort of period-tracking application users. This work aims to contribute to our knowledge and understanding of female physiology at varying stages of reproductive aging. This cohort study included self-reported menstrual cycle and symptom information in a sample of Flo application users aged 18-55. Cycle and period length and their variability, and frequency of menstrual cycle symptom logs are described by the age of the user. Based on data logged by over 19 million global users of the Flo app, the length of the menstrual cycle and period show clear age-associated patterns. With higher age, cycles tend to get shorter (Cycle length: D ¯ = 1.85 days, Cohen's D = 0.59) and more variable (Cycle length SD: D ¯ = 0.42 days, Cohen's D = 0.09), until close to the chronological age (40-44) suggesting menopausal transition, when both cycles and periods become longer (Cycle length: D ¯ = 0.86 days, t = 48.85, Cohen's D = 0.26; Period length: D ¯ = 0.08, t = 15.6, Cohen's D = 0.07) and more variable (Cycle length SD: D ¯ = 2.80 days, t = 111.43, d = 0.51; Period length SD: D ¯ = 0.23 days, t = 67.81, Cohen's D = 0.31). The proportion of individuals with irregular cycles was highest in participants aged 51-55 (44.7%), and lowest in the 36-40 age group (28.3%). The spectrum of common menstrual cycle-related symptoms also varies with age. The frequency of logging of cramps and acne is lower in older participants, while logs of headache, backache, stress, and insomnia are higher in older users. Other symptoms show different patterns, such as breast tenderness and fatigue peaking between the ages of 20-40, or mood swings being most frequently logged in the youngest and oldest users. The menstrual cycle and related symptoms are not static throughout the lifespan. Understanding these age-related differences in cycle characteristics and symptoms is essential in understanding how best to care for and improve the daily experience for menstruators across the reproductive life span.
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Affiliation(s)
- Adam C Cunningham
- Flo Health UK Limited, 27 Old Gloucester Street, London, WC1N 3AX, UK.
| | - Lubna Pal
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Aidan P Wickham
- Flo Health UK Limited, 27 Old Gloucester Street, London, WC1N 3AX, UK
| | - Carley Prentice
- Flo Health UK Limited, 27 Old Gloucester Street, London, WC1N 3AX, UK
| | | | - Anna Klepchukova
- Flo Health UK Limited, 27 Old Gloucester Street, London, WC1N 3AX, UK
| | - Liudmila Zhaunova
- Flo Health UK Limited, 27 Old Gloucester Street, London, WC1N 3AX, UK
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16
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Nijboer ACS, Sellitto M, Ruitenberg MFL, Kerkkänen KIL, Schomaker J. Food-related exploration across the menstrual cycle. Appetite 2024; 196:107261. [PMID: 38342313 DOI: 10.1016/j.appet.2024.107261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/13/2024]
Abstract
When deciding what to eat we constantly weigh different aspects of the options at hand and make trade-offs between exploiting opportunities with a known outcome (e.g., eating your usual meal) and exploring novel opportunities with a potentially better outcome (e.g., trying a new dish). Environmental factors, such as scarcity, have previously been shown to tip the balance towards either exploration or exploitation. Studies in animals have further linked female steroid hormones (including estradiol and progesterone) to exploratory behavior. Previous work in humans has suggested that food preferences and food intake also change over the menstrual cycle. However, it remains unknown whether exploratory behavior in food choices also changes across the menstrual phases in humans. In a rating phase, 112 adult women (age range 18-45 years) on or off hormonal birth control rated 40 food items on desirability. In the choice phase, participants made binary choices between food items. On some trials, a surprise box replaced one of the two food options, allowing us to examine exploratory choices. Women off hormonal birth control reported their average cycle length and time since the first day of their last menstruation. Analysis of the percentage surprise choices across the menstrual cycle indicated a small, but significant effect, with exploratory choice behavior tending to increase around the middle of/later during the cycle. This provides preliminary novel evidence that hormonal fluctuations are associated with food-related exploratory choice behavior. Importantly, these effects were observed beyond effects of other food-related factors. Future studies should investigate the nature of these effects using more direct hormonal measures.
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Affiliation(s)
- A C S Nijboer
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - M Sellitto
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - M F L Ruitenberg
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - K I L Kerkkänen
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - J Schomaker
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands.
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17
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Schieren A, Koch S, Pecht T, Simon MC. Impact of Physiological Fluctuations of Sex Hormones During the Menstrual Cycle on Glucose Metabolism and the Gut Microbiota. Exp Clin Endocrinol Diabetes 2024; 132:267-278. [PMID: 38382644 PMCID: PMC11093651 DOI: 10.1055/a-2273-5602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/18/2024] [Indexed: 02/23/2024]
Abstract
Diabetes mellitus is one of the most prevalent chronic diseases. Previous studies have shown differences in glucose metabolism between males and females. Moreover, difficulties in medication adherence have been reported in females with type 2 diabetes. These observations are believed to be caused by fluctuations in sex hormone concentrations during the menstrual cycle. Furthermore, gut microbiota is linked to female host metabolism and sex hormone production. Understanding the interactions between fluctuating hormone concentrations during the menstrual cycle, gut microbiota, and glucose metabolism in humans is significant because of the increasing prevalence of diabetes and the consequent need to expand preventive efforts. A literature search was performed to determine and summarize the existing evidence, deduce future research needs to maintain female health, and investigate the relationship between the physiological menstrual cycle and glucose metabolism. Studies from 1967 to 2020 have already examined the relationship between variations during the menstrual cycle and glucose metabolism in healthy female subjects using an oral-glucose tolerance test or intravenous glucose tolerance test. However, the overall number of studies is rather small and the results are contradictory, as some studies detected differences in glucose concentrations depending on the different cycle phases, whereas others did not. Some studies reported lower glucose levels in the follicular phase than in the luteal phase, whereas another study detected the opposite. Data on gut microbiota in relation to the menstrual cycle are limited. Conflicting results exist when examining the effect of hormonal contraceptives on the gut microbiota and changes in the course of the menstrual cycle. The results indicate that the menstrual cycle, especially fluctuating sex hormones, might impact the gut microbiota composition.The menstrual cycle may affect the gut microbiota composition and glucose metabolism. These results indicate that glucose tolerance may be the greatest in the follicular phase; however, further well-conducted studies are needed to support this assumption.
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Affiliation(s)
- Alina Schieren
- University of Bonn, Institute of Nutrition and Food Sciences, Nutrition
and Microbiota, Bonn, Germany
| | - Sandra Koch
- University of Bonn, Institute of Nutrition and Food Sciences, Nutrition
and Microbiota, Bonn, Germany
| | - Tal Pecht
- University of Bonn, Life & Medical Sciences (LIMES) Institute,
Department for Genomics and Immunoregulation, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Systems Medicine,
Bonn, Germany
| | - Marie-Christine Simon
- University of Bonn, Institute of Nutrition and Food Sciences, Nutrition
and Microbiota, Bonn, Germany
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18
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Dittmar M, Möllgaard L, Engelhard F. Menstrual cycle phases and dosage of synthetic hormonal contraceptives influence diurnal rhythm characteristics of distal skin temperature. Chronobiol Int 2024; 41:684-696. [PMID: 38634452 DOI: 10.1080/07420528.2024.2342945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
This study aimed to explore how natural menstrual cycle phases and dosage of oral hormonal contraceptives (OC) influence the diurnal rhythm of distal skin temperature (DST) under real-life conditions. Participants were 41 healthy females (23.9 ± 2.48 y), comprising 27 females taking monophasic hormonal oral contraceptives (OC users) and 14 females with menstrual cycles (non-OC users). Wrist DST was continuously recorded and averaged over two consecutive 24-hour days during (pseudo)follicular and (pseudo)luteal menstrual phases. Diurnal rhythm characteristics, i.e. acrophase and amplitude, describing timing and strength of the DST rhythm, respectively, were calculated using cosinor analysis. Results show that non-OC users experienced earlier diurnal DST maximum (acrophase, p = 0.019) and larger amplitude (p = 0.016) during the luteal phase than during the follicular phase. This was observed in most (71.4%) but not all individuals. The OC users showed no differences in acrophase or amplitude between pseudoluteal and pseudofollicular phases. OC users taking a higher dosage of progestin displayed a larger amplitude for DST rhythm during the pseudoluteal phase (p = 0.009), while estrogen dosage had no effect. In conclusion, monophasic OC cause changes in diurnal DST rhythm, similar to those observed in the luteal phase of females with menstrual cycles, suggesting that synthetic progestins act in a similar manner on skin thermoregulation as progesterone does.
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Affiliation(s)
- Manuela Dittmar
- Department of Human Biology, Zoological Institute, Christian-Albrechts-University, Kiel, Germany
| | - Leefke Möllgaard
- Department of Human Biology, Zoological Institute, Christian-Albrechts-University, Kiel, Germany
| | - Felicia Engelhard
- Department of Human Biology, Zoological Institute, Christian-Albrechts-University, Kiel, Germany
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19
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Ecochard R, Stanford JB, Fehring RJ, Schneider M, Najmabadi S, Gronfier C. Evidence that the woman's ovarian cycle is driven by an internal circamonthly timing system. SCIENCE ADVANCES 2024; 10:eadg9646. [PMID: 38598621 PMCID: PMC11006216 DOI: 10.1126/sciadv.adg9646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/06/2024] [Indexed: 04/12/2024]
Abstract
The ovarian cycle has a well-established circa-monthly rhythm, but the mechanisms involved in its regularity are unknown. Is the rhythmicity driven by an endogenous clock-like timer or by other internal or external processes? Here, using two large epidemiological datasets (26,912 cycles from 2303 European women and 4786 cycles from 721 North American women), analyzed with time series and circular statistics, we find evidence that the rhythmic characteristics of the menstrual cycle are more likely to be explained by an endogenous clock-like driving mechanism than by any other internal or external process. We also show that the menstrual cycle is weakly but significantly influenced by the 29.5-day lunar cycle and that the phase alignment between the two cycles differs between the European and the North American populations. Given the need to find efficient treatments of subfertility in women, our results should be confirmed in larger populations, and chronobiological approaches to optimize the ovulatory cycle should be evaluated.
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Affiliation(s)
- René Ecochard
- Pôle de Santé Publique, Service de Biostatistique, Hospices Civils de Lyon, Lyon 69424 Cedex 03, France
- Laboratoire Biostatistique Santé, Université Claude Bernard Lyon I, UMR CNRS 5558 UCBL, Lyon 69000, France
| | - John B. Stanford
- Office of Cooperative Reproductive Health, Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, 84108 UT, USA
| | - Richard J. Fehring
- College of Nursing, Marquette University, Milwaukee, P.O. Box 1881 WI, USA
| | - Marie Schneider
- College of Nursing, Marquette University, Milwaukee, P.O. Box 1881 WI, USA
- Institute for Natural Family Planning, Milwaukee, P.O. Box 1881 WI, USA
| | - Sam Najmabadi
- Office of Cooperative Reproductive Health, Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, 84108 UT, USA
| | - Claude Gronfier
- Centre de Recherche en Neurosciences de Lyon (CRNL), Neurocampus, Inserm U1028, CNRS UMR5292, Université de Lyon, Lyon 69500, France
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20
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Abdullah WH. Menstrual changes after COVID-19 vaccination among menstruators of reproductive age: A cross- sectional study from Erbil City, Iraq. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003079. [PMID: 38574177 PMCID: PMC10994343 DOI: 10.1371/journal.pgph.0003079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
The COVID-19 vaccination has been reported to have various post-vaccination effects, including potential changes in the menstrual cycle among menstruators of reproductive age. The aim of this study is to investigate the relationship between COVID-19 vaccination and menstrual changes among menstruators within Iraqi society and contribute to the knowledge about COVID-19 vaccine-related menstrual changes. The cross-sectional study involved a sample of 400 menstruators residing in Erbil City, Kurdistan Region, Iraq. The study specifically focused on individuals who were both infected and uninfected by COVID-19 and had received the COVID-19 vaccine. Individuals with hormonal diseases or those who had undergone hormonal therapy were excluded from the study. To ensure representation from different areas of Erbil City, the study was conducted in four primary healthcare centers selected based on geographic direction: South, East, North, and West sides. The author utilized a structured questionnaire to assess and compare changes in the menstrual cycle before and after receiving the COVID-19 vaccine. The study found that a significant proportion (71.8%) of the participants experienced menstrual changes after receiving the COVID-19 vaccination, particularly after receiving both doses. These changes included alterations in the characteristics and symptoms of the menstrual cycle compared to before vaccination. The findings suggest that the COVID-19 vaccination can potentially affect the menstrual cycle in women of reproductive age. In conclusion, by revealing distinct changes in cycle characteristics and symptomatology, the study findings contribute to an expanding body of evidence supporting the connection between vaccination and menstrual alterations. Future studies with larger sample sizes and diverse populations are warranted to validate and expand upon the results of this study.
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Affiliation(s)
- Warda Hassan Abdullah
- Department of Midwifery, College of Nursing, Hawler Medical University, Erbil, Kurdistan Region, Iraq
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21
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Piasecki J, Škarabot J, Spillane P, Piasecki M, Ansdell P. Sex Differences in Neuromuscular Aging: The Role of Sex Hormones. Exerc Sport Sci Rev 2024; 52:54-62. [PMID: 38329342 DOI: 10.1249/jes.0000000000000335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Males and females experience different trajectories of neuromuscular function across the lifespan, with females demonstrating accelerated deconditioning in later life. We hypothesize that the menopause is a critical period in the female lifespan, during which the dramatic reduction in sex hormone concentrations negatively impacts synaptic input to the motoneuron pool, as well as motor unit discharge properties.
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Affiliation(s)
- Jessica Piasecki
- Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, UK
| | - Jakob Škarabot
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Padraig Spillane
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Mathew Piasecki
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - Paul Ansdell
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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22
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Scott D, Bruinvels G, Norris D, Lovell R. The Dose-Response in Elite Soccer: Preliminary Insights From Menstrual-Cycle Tracking During the FIFA Women's World Cup 2019. Int J Sports Physiol Perform 2024; 19:331-339. [PMID: 38198788 DOI: 10.1123/ijspp.2022-0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/27/2023] [Accepted: 11/26/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE This preliminary study examined the influence of estimated menstrual-cycle (MC) phase on responses to soccer matches and training sessions in preparation for and during the FIFA (Fédération internationale de football association) Women's World Cup 2019. METHODS Twenty outfield players representing a national team were tracked over a 45-day period. External (10-Hz global positioning system; total and distance covered at high-metabolic power [≥20 W·kg-1]) and internal load measures (minutes ≥80% heart-rate maximum, sessional ratings of perceived exertion) were collected during all training and matches, with single-item wellness measures (fatigue, soreness, sleep quality, and sleep duration) collected each morning prior to activity. MC phase was estimated individually via an algorithm, informed from pretournament survey responses and ongoing symptom reporting (FitrWoman). Model comparison statistics were used to determine the impact of estimated MC phase in nonhormonal contraceptive users (n = 16). RESULTS Sessional rating of perceived exertion responses to total distances ≥5 km were higher during the luteal phase (+0.6-1.0 au; P ≤ .0178) versus menstruation (phase 1), but no other observable dose-response trends were observed. Sleep, fatigue, and soreness ratings were not typically associated with MC phase, with the exception of exacerbated fatigue ratings in luteal versus follicular phase 48 hours postmatch (-0.73 au, P = .0275). CONCLUSIONS Preliminary findings suggest that estimated MC phase may contribute to the understanding of the dose-response to soccer training and matches.
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Affiliation(s)
- Dawn Scott
- Performance, Medical & Innovation Department, Washington Spirit Soccer Club, Washington, DC, USA
- School of Health Sciences, Western Sydney University, Penrith, Australia
| | - Georgie Bruinvels
- Orreco Ltd, Galway, Ireland
- University College London, London, United Kingdom
- St Mary's University, London, United Kingdom
| | - Dean Norris
- School of Health Sciences, Western Sydney University, Penrith, Australia
| | - Ric Lovell
- School of Health Sciences, Western Sydney University, Penrith, Australia
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
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23
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Edelman A, Boniface ER, Male V, Cameron S, Benhar E, Han L, Matteson KA, van Lamsweerde A, Pearson JT, Darney BG. Timing of Coronavirus Disease 2019 (COVID-19) Vaccination and Effects on Menstrual Cycle Changes. Obstet Gynecol 2024; 143:585-594. [PMID: 38412506 PMCID: PMC10953681 DOI: 10.1097/aog.0000000000005550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/01/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To assess whether menstrual cycle timing (follicular or luteal phase) of coronavirus disease 2019 (COVID-19) vaccine administration is associated with cycle length changes. METHODS We used prospectively collected (2021-2022) menstrual cycle tracking data from 19,497 reproductive-aged users of the application "Natural Cycles." We identified whether vaccine was delivered in the follicular or luteal phase and also included an unvaccinated control group. Our primary outcome was the adjusted within-individual change in cycle length (in days) from the average of the three menstrual cycles before the first vaccination cycle (individuals in the unvaccinated control group were assigned a notional vaccine date). We also assessed cycle length changes in the second vaccination cycle and whether a clinically significant change in cycle length (8 days or more) occurred in either cycle. RESULTS Most individuals were younger than age 35 years (80.1%) and from North America (28.6%), continental Europe (33.5%), or the United Kingdom (31.7%). In the vaccinated group, the majority received an mRNA vaccine (63.8% of the full sample). Individuals vaccinated in the follicular phase experienced an average 1-day longer adjusted cycle length with a first or second dose of COVID-19 vaccine compared with their prevaccination average (first dose: 1.00 day [98.75% CI, 0.88-1.13], second dose: 1.11 days [98.75% CI, 0.93-1.29]); those vaccinated in the luteal phase and those in the unvaccinated control group experienced no change in cycle length (respectively, first dose: -0.09 days [98.75% CI, -0.26 to 0.07], second dose: 0.06 days [98.75% CI, -0.16 to 0.29], unvaccinated notional first dose: 0.08 days [98.75% CI, -0.10 to 0.27], second dose: 0.17 days [98.75% CI, -0.04 to 0.38]). Those vaccinated during the follicular phase were also more likely to experience a clinically significant change in cycle length (8 days or more; first dose: 6.8%) than those vaccinated in the luteal phase or unvaccinated (3.3% and 5.0%, respectively; P <.001). CONCLUSION COVID-19 vaccine-related cycle length increases are associated with receipt of vaccination in the first half of the menstrual cycle (follicular phase).
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Affiliation(s)
- Alison Edelman
- Department of Obstetrics and Gynecology, Oregon Health & Science University, and Oregon Health & Science University-Portland State University, School of Public Health, Portland, Oregon; the Department of Metabolism Digestion and Reproduction, Imperial College London, London, United Kingdom; Obstetrics and Gynaecology, University of Edinburgh and Chalmers Centre, Edinburgh, Scotland; Natural Cycles USA Corp, New York, New York; the Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts; and the National Institute of Public Health, Center for Population Health Research, Cuernavaca, Mexico
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Hamidovic A, Cho S, Smadi S, Davis J. Visuospatial Function in Women with Premenstrual Dysphoric Disorder. J Clin Med 2024; 13:2004. [PMID: 38610770 PMCID: PMC11012488 DOI: 10.3390/jcm13072004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Background/Objectives: Premenstrual dysphoric disorder (PMDD) is an understudied psychiatric condition affecting reproductive-age women who experience negative mood in the luteal phase of the menstrual cycle. Cognitive functions in PMDD are not well understood as patients have been tested in the luteal phase. This may confound study results due to noted emotional interferences, as well as the potential opposing effects of the sex hormones estradiol and progesterone. In the present study, we evaluated visuospatial function in the follicular phase in women with PMDD and healthy controls, and further examined the effect of estradiol as research into the hormonal mediation of visuospatial function in reproductive-age women has produced mixed results. Methods: To this end, we analyzed estradiol concentrations using the gold standard mass spectrometry. Serum samples were collected in the early follicular and mid/late follicular subphases when estradiol is low and high, respectively, while progesterone is low and steady. We assessed visuospatial function using the classic mental rotation task. Results: Women with PMDD had a higher mental rotation total score (t = 2.17; p < 0.05). The addition of six demographic, biological, and anthropomorphic variables in a hierarchical fashion accounted for 45.3% of the total variance in the final model with diagnosis remaining statistically significant (t = 4.36; p < 0.001). Estradiol did not mediate the group difference and was not significantly associated with visuospatial function. Conclusions: The present results provide support for new research directions into the potential biological mechanisms that underlie the pathophysiology of PMDD, represented as enhanced visuospatial ability in women with PMDD in the follicular phase. We review the theory that PMDD is a disorder of the enhanced excitation-to-inhibition ratio, with a focus on findings to date from brain imaging research.
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Affiliation(s)
- Ajna Hamidovic
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, USA;
| | - Soojeong Cho
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, USA;
| | - Shahd Smadi
- College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.S.); (J.D.)
| | - John Davis
- College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.S.); (J.D.)
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Patel U, Broad A, Biswakarma R, Harper JC. Experiences of users of period tracking apps: which app, frequency of use, data input and output and attitudes. Reprod Biomed Online 2024; 48:103599. [PMID: 38295553 DOI: 10.1016/j.rbmo.2023.103599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/02/2023] [Indexed: 02/02/2024]
Abstract
RESEARCH QUESTION What are the experiences of users of period tracking apps in relation to which apps they use, their frequency of use, the type of data and their attitudes to period tracking apps? DESIGN This was an observational mixed-methods study using an online survey designed using Qualtrics XM. The survey included 50 open-ended and multiple choice questions, but only specific questions were analysed in this study. The survey was promoted via social media for 22 days between 30 June and 21 July 2021. RESULTS Of the 375 total participants, 326 responses were complete and included in analysis. In the results section further down, this is explained as 330 complete responses, with 4 additional responses excluded due to data inconsistencies. The participants' age range was 14-54 years, with a mean of 26.0 (±7.81) years. Most participants (61.9%) had been using a period tracking app for 2 years or longer. Of these 85.6% entered more data when on their period, 31% at a frequency of once a day. There were approximately equivalent proportions of participants who felt that entering data into their app was either 'part of their normal routine' (43.3%) or 'not a priority' (38.0%). Thematic analysis of the participants' experiences of using period-tracking apps revealed five main themes: symptom tracking and understanding general health; concerns with period start date predictions; the problems with fertility tracking; concerns about cost; and concerns about data privacy. CONCLUSIONS The infrequency of data inputting and the wide range of symptoms tracked reflects the differing needs of participants from their period-tracking apps. This highlights the need for increased education and research into understanding the realities of variations in using apps.
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Affiliation(s)
- Uma Patel
- Institute for Women's Health, University College London, London, UK
| | - Anna Broad
- Institute for Women's Health, University College London, London, UK
| | - Rina Biswakarma
- Institute for Women's Health, University College London, London, UK
| | - Joyce C Harper
- Institute for Women's Health, University College London, London, UK..
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Pound M, Massey H, Roseneil S, Williamson R, Harper CM, Tipton M, Shawe J, Felton M, Harper JC. How do women feel cold water swimming affects their menstrual and perimenopausal symptoms? Post Reprod Health 2024; 30:11-27. [PMID: 38271095 DOI: 10.1177/20533691241227100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE This study aimed to determine how women felt cold water swimming affected their menstrual and perimenopausal symptoms. STUDY DESIGN An online survey that asked women who regularly swim in cold water about their experiences. The survey was advertised for 2 months on social media. Questions related to cold water swimming habits and menstrual and perimenopausal symptoms were analysed. MAIN OUTCOME MEASURES Quantitative and qualitative data including; frequency of menstrual and menopause symptoms, the effect of cold water swimming on these symptoms. RESULTS 1114 women completed the survey. Women reported that cold water swimming reduced their menstrual symptoms, notably psychological symptoms such as anxiety (46.7%), mood swings (37.7%) and irritability (37.6%). Perimenopausal women reported a significant improvement in anxiety (46.9%), mood swings (34.5%), low mood (31.1%) and hot flushes (30.3%). The majority of women with symptoms swam specifically to reduce these symptoms (56.4% for period and 63.3% for perimenopause symptoms). Women said they felt it was the physical and mental effects of the cold water that helped their symptoms. For the free text question, five themes were identified: the calming and mood-boosting effect of the water, companionship and community, period improvements, an improvement in hot flushes and an overall health improvement. CONCLUSION Women felt that cold water swimming had a positive overall effect on menstrual and perimenopause symptoms. Studies on other forms of exercise to relieve menstrual and perimenopause symptoms may show similar findings.
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Affiliation(s)
- Megan Pound
- EGA Institute for Women's Health, University College London, London, UK
| | - Heather Massey
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | | | | | - C Mark Harper
- University Hospitals Sussex NHS Foundation Trust, Worthing, UK
- Sørlandet Sykehus, Kristiansand, Norway
| | - Mike Tipton
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Jill Shawe
- University of Plymouth and Royal Cornwall Hospitals NHS Trust, Cornwall, UK
| | - Malika Felton
- Department of Rehabilitation and Sport Sciences, Bournemouth University, Poole, UK
| | - Joyce C Harper
- EGA Institute for Women's Health, University College London, London, UK
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Li H, Curry CL, Fischer-Colbrie T, Onnela JP, Williams MA, Hauser R, Coull BA, Jukic AMZ, Mahalingaiah S. Seasonal variations of menstrual cycle length in a large, US-based, digital cohort. Int J Hyg Environ Health 2024; 256:114308. [PMID: 38103472 PMCID: PMC10872302 DOI: 10.1016/j.ijheh.2023.114308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Huichu Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA
| | | | | | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA
| | - Anne Marie Z Jukic
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, 27709, NC, USA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, MA, USA.
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Alshakhouri M, Sharpe C, Bergin P, Sumner RL. Female sex steroids and epilepsy: Part 2. A practical and human focus on catamenial epilepsy. Epilepsia 2024; 65:569-582. [PMID: 37925609 DOI: 10.1111/epi.17820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/06/2023]
Abstract
Catamenial epilepsy is the best described and most researched sex steroid-specific seizure exacerbation. Yet despite this there are no current evidence-based treatments, nor an accepted diagnostic tool. The best tool we currently have is tracking seizures over menstrual cycles; however, the reality of tracking seizures and menstrual cycles is fraught with challenges. In Part 1 of this two-part review, we outlined the often complex and reciprocal relationship between seizures and sex steroids. An adaptable means of tracking is required. In this review, we outline the extent and limitations of current knowledge on catamenial epilepsy. We use sample data to show how seizure exacerbations can be tracked in short/long and even irregular menstrual cycles. We describe how seizure severity, an often overlooked and underresearched form of catamenial seizure exacerbation, can also be tracked. Finally, given the lack of treatment options for females profoundly affected by catamenial epilepsy, Section 3 focuses on current methods and models for researching sex steroids and seizures as well as limitations and future directions. To permit more informative, mechanism-focused research in humans, the need for both a consistent classification of catamenial epilepsy and an objective biomarker is highlighted.
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Affiliation(s)
| | - Cynthia Sharpe
- Department of Paediatric Neurology, Starship Children's Health, Auckland, New Zealand
| | - Peter Bergin
- Neurology Department, Auckland Hospital, Te Whatu Ora, Auckland, New Zealand
| | - Rachael L Sumner
- School of Pharmacy, University of Auckland, Auckland, New Zealand
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29
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Ecochard R, Leiva R, Bouchard TP, Van Lamsweerde A, Pearson JT, Stanford JB, Gronfier C. The menstrual cycle is influenced by weekly and lunar rhythms. Fertil Steril 2024:S0015-0282(23)02076-9. [PMID: 38206269 DOI: 10.1016/j.fertnstert.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To study whether the menstrual cycle has a circaseptan (7 days) rhythm and whether it is associated with the lunar cycle (also defined as the synodic month, it is the cycle of the phases of the Moon as seen from Earth, averaging 29.5 days in length). DESIGN Cross-sectional study. SUBJECTS A total of 35,940 European and North American women aged 18-40 years. EXPOSURE Data were collected in real-life conditions. INTERVENTION No intervention was performed. MAIN OUTCOME MEASURE The onset of menstruation was assessed in prospectively measured menstrual cycles (311,064 cycles) over 3 full years (2019-2021). Associations were calculated between the onset of menstruation and the day of the week, and between the onset of menstruation and the lunar phase. RESULTS In this large data set, a circaseptan (7-day) rhythmicity of menstruation was observed, with a peak (acrophase) of menstrual onset on Thursdays and Fridays. This circaseptan rhythm was observed in every age group, in every phase of the lunar cycle, and in all seasons. This feature was most pronounced for cycle durations between 27 and 29 days. In winter, the circaseptan rhythm was found in cycles of 27-29 days, but not in other cycle lengths. A circalunar rhythm was also statistically significant, but not as clearly defined as the circaseptan rhythm. The peak (acrophase) of the circalunar rhythm of menstrual onset varied according to the season. In addition, there was a small but statistically significant interaction between the circaseptan rhythm and the lunar cycle. CONCLUSION Although relatively small in amplitude, the weekly rhythm of menstruation was statistically significant. Menstruation occurs more often on Thursdays and Fridays than on other days of the week. This is particularly true for women whose cycles last between 27 and 29 days. Circalunar rhythmicity was also statistically significant. However, it is less pronounced than the weekly rhythm.
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Affiliation(s)
- René Ecochard
- Pôle de Santé Publique, Service de Biostatistique, Lyon, France; Laboratoire Biostatistique Santé, Université Claude Bernard Lyon I, Lyon, France
| | - Rene Leiva
- Bruyère Research Institute, CT Lamont Primary Health Care Research Centre, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Thomas P Bouchard
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Joseph B Stanford
- Office of Cooperative Reproductive Health, Division of Public Health Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
| | - Claude Gronfier
- Centre de Recherche en Neurosciences de Lyon (CRNL), Neurocampus, Université de Lyon, Lyon, France.
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McLagan B, Dexheimer J, Strock N, Goldstein S, Guzman S, Erceg D, Schroeder ET. The role of transcutaneous electrical nerve stimulation for menstrual pain relief: A randomized control trial. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241266455. [PMID: 39066557 PMCID: PMC11282568 DOI: 10.1177/17455057241266455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 05/15/2024] [Accepted: 06/13/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Abdominal pain due to menses (primary dysmenorrhea) is an extremely pervasive and debilitating symptom affecting up to 90% of menstruating individuals. OBJECTIVE The objective of this randomized control trial was to investigate the effect of a commercial transcutaneous electrical nerve stimulation unit, Therabody PowerDot® (Therabody Inc., Los Angeles) on dysmenorrhea compared with non-steroidal anti-inflammatory drug use. DESIGN This was a randomized cross-over study. METHODS A total of 47 participants agreed to participate in the study, with 34 completing it. Participants completed treatments across three consecutive menstrual cycles in randomized order: single-unit transcutaneous electrical nerve stimulation (Uno), dual unit transcutaneous electrical nerve stimulation (Duo), and non-steroidal anti-inflammatory drug use (Control). Upon onset of dysmenorrhea, participants applied transcutaneous electrical nerve stimulation to their abdomen for a minimum of 30 min. Control participants were instructed to take non-steroidal anti-inflammatory drugs as needed. Surveys were used to record pain before and after treatment. We hypothesized that the PowerDot would decrease self-reported pain scores, and decrease non-steroidal anti-inflammatory drug consumption during menses. RESULTS Participants experienced a statistically and clinically significant reduction in pain during the Control (-3.52 ± 1.9), Uno (-2.10 ± 1.6), and Duo (-2.19 ± 1.7) cycles (p < 0.001). The doses of non-steroidal anti-inflammatory drugs consumed during the Control cycle (3.5 ± 2.6), was significantly different as compared with that of Uno (1.5 ± 3.0), or Duo (1.1 ± 2.6) (p = 0.004). CONCLUSIONS Use of a commercial transcutaneous electrical nerve stimulation unit results in significant decrease in pain. Although not as robust as the relief in pain induced by non-steroidal anti-inflammatory drugs, the adverse events of transcutaneous electrical nerve stimulation are minimal in comparison. Therefore, transcutaneous electrical nerve stimulation appears to be a viable alternative to pain relief from dysmenorrhea. CLINICAL TRIAL REGISTRATION NCT05178589.
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Affiliation(s)
- Bailey McLagan
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | | | | | - Shayna Goldstein
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Stephanie Guzman
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - David Erceg
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - E Todd Schroeder
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
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31
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Yong EL, Teoh WS, Huang ZW. Polycystic ovary syndrome v.2023: Simplified diagnostic criteria for an East Asian phenotype. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:669-678. [PMID: 38920160 DOI: 10.47102/annals-acadmedsg.202369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Introduction Two decades after the Rotterdam 2003 consensus workshop, there have been considerable advances in elucidating the pathophysiology and epidemiology of polycystic ovary syndrome (PCOS). This has prompted the re-examination of the features that characterise this common condition. Current definitions have led to great heterogeneity in the prevalence of PCOS and have contributed to inconsistent treatment protocols and assessment of therapeutic outcomes. Diagnosis is further complicated by the lack of universal agreement on threshold cut-offs for ovarian dysfunction and ethnic differences in hirsutism; both of which are key features in the definitions that are commonly used currently. These challenges often result in dissatisfaction with medical care among PCOS patients and their physicians. Method Our factor analysis mathematically identified anti-Mullerian hormone (AMH), associated polycystic ovarian morphology (PCOM) and serum testosterone as the only significant cluster associated with menstrual cycle length variability. Results and Conclusion As such, we propose a simplified criteria wherein the presence of at least 2 of the 3 features below would be sufficient to define PCOS: (1) chronic oligo-ovulation or anovulation as indicated by oligomenorrhea (cycle lengths >35 days) or amenorrhea; (2) PCOM: raised AMH ≥37.0 pmol/L instead of transvaginal ultrasound assessment of ovaries; and (3) Androgen excess, or raised serum androgens above the laboratory reference for women. Further studies are required to examine whether the proposed criteria would reduce diagnostic confusion and improve care and outcomes, especially among patients of East Asian ethnicities.
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Affiliation(s)
- Eu-Leong Yong
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore
| | - Wei Shan Teoh
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore
| | - Zhong Wei Huang
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore
- NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Vogel K, Larsen B, McLellan C, Bird SP. Female Athletes and the Menstrual Cycle in Team Sports: Current State of Play and Considerations for Future Research. Sports (Basel) 2023; 12:4. [PMID: 38275983 PMCID: PMC10818287 DOI: 10.3390/sports12010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
Over the past ten years there has been a dramatic rise in female sport participation and accompanying female professional national leagues across multiple sports, yet research has not followed suit. Although there are known variations between female and male physiology, training protocols in female sport are predominantly underpinned by research undertaken in male athletes. The hormonal variability experienced by women across the menstrual cycle, as well as the menstrual cycle variability between women, may contribute to the complexity of conducting rigorous physiological studies, leading to a paucity of robust sports-specific research that can be confidently applied to female athletes. Moreover, barriers exist in female sport that potentially limit the ability to conduct research, including the lack of full-time programs and limited resources. Recently, there has been increased interest in the potential effects of fluctuations in the female sex hormones, progesterone and oestrogen, on sport performance across different phases of the menstrual cycle. However, current research evaluating the menstrual cycle and physical performance (such as strength, speed, aerobic fitness, and athletes' perception of their performance) have shown inconsistent results. Additionally, methodological design across studies has shown little consistency, making it difficult to draw firm conclusions, which potentially prevents female athletes optimising their physical and sporting performance. It further impacts coaches and sports science researchers in their ability to provide appropriate training recommendations and educational opportunities. It is important to progress in female athlete research with an understanding of how the unique physiology of female athletes may influence their ability to physically perform in their respective sport, which requires representation in sports science research. This paper will provide an overview on current evidence and limitations within menstrual cycle research and provide considerations and directions for future research in this space within team sports.
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Affiliation(s)
- Kurt Vogel
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; (K.V.); (B.L.); (C.M.)
- Centre for Health Research, University of Southern Queensland, Ipswich, QLD 4305, Australia
- Lions Football Club, Richlands, QLD 4077, Australia
- Brisbane Tigers Rugby League Club, Coorparoo, QLD 4151, Australia
| | - Brianna Larsen
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; (K.V.); (B.L.); (C.M.)
- Centre for Health Research, University of Southern Queensland, Ipswich, QLD 4305, Australia
| | - Chris McLellan
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; (K.V.); (B.L.); (C.M.)
- Florida Panthers, Sunrise, FL 33323, USA
| | - Stephen P. Bird
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; (K.V.); (B.L.); (C.M.)
- Centre for Health Research, University of Southern Queensland, Ipswich, QLD 4305, Australia
- Basketball New Zealand, Wellington 6012, New Zealand
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Hantsoo L, Jagodnik KM, Novick AM, Baweja R, di Scalea TL, Ozerdem A, McGlade EC, Simeonova DI, Dekel S, Kornfield SL, Nazareth M, Weiss SJ. The role of the hypothalamic-pituitary-adrenal axis in depression across the female reproductive lifecycle: current knowledge and future directions. Front Endocrinol (Lausanne) 2023; 14:1295261. [PMID: 38149098 PMCID: PMC10750128 DOI: 10.3389/fendo.2023.1295261] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/13/2023] [Indexed: 12/28/2023] Open
Abstract
The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different reproductive stages across the female lifespan. Despite growing evidence about the impact of gonadal hormones on mood disorders, no previous review has examined the interaction between such hormonal changes and the HPA axis within the context of depressive disorders in women. We will focus on HPA axis function in depressive disorders at different reproductive stages including the menstrual cycle (e.g., premenstrual dysphoric disorder [PMDD]), perinatally (e.g., postpartum depression), and in perimenopausal depression. Each of these reproductive stages is characterized by vast physiological changes and presents major neuroendocrine reorganization. The HPA axis is one of the main targets of such functional alterations, and with its key role in stress response, it is an etiological factor in vulnerable windows for depression across the female lifespan. We begin with an overview of the HPA axis and a brief summary of techniques for measuring HPA axis parameters. We then describe the hormonal milieu of each of these key reproductive stages, and integrate information about HPA axis function in depression across these reproductive stages, describing similarities and differences. The role of a history of stress and trauma exposure as a contributor to female depression in the context of HPA axis involvement across the reproductive stages is also presented. This review advances the pursuit of understanding common biological mechanisms across depressive disorders among women. Our overarching goal is to identify unmet needs in characterizing stress-related markers of depression in women in the context of hormonal changes across the lifespan, and to support future research in women's mental health as it pertains to pathophysiology, early diagnosis, and treatment targets.
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Affiliation(s)
- Liisa Hantsoo
- Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kathleen M. Jagodnik
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, MA, United States
| | - Andrew M. Novick
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ritika Baweja
- Department of Psychiatry and Behavioral Health, Penn State Health, Hershey, PA, United States
- Department of Obstetrics and Gynecology, Penn State Health, Hershey, PA, United States
| | - Teresa Lanza di Scalea
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Women’s Health, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Erin C. McGlade
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake, UT, United States
- Department of Veterans Affairs, Mental Illness Research, Education, and Clinical Center (MIRECC), Salt Lake, UT, United States
| | - Diana I. Simeonova
- Department of Psychiatry and Behavioral Sciences, Brain Health Center, Emory University School of Medicine, Atlanta, GA, United States
- Goizueta Business School, Emory University, Atlanta, GA, United States
| | - Sharon Dekel
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, MA, United States
| | - Sara L. Kornfield
- Center for Women’s Behavioral Wellness, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michelle Nazareth
- Department of Neuroscience, The Johns Hopkins University, Baltimore, MD, United States
| | - Sandra J. Weiss
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, United States
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MacGregor KA, Ho FK, Celis-Morales CA, Pell JP, Gallagher IJ, Moran CN. Association between menstrual cycle phase and metabolites in healthy, regularly menstruating women in UK Biobank, and effect modification by inflammatory markers and risk factors for metabolic disease. BMC Med 2023; 21:488. [PMID: 38066548 PMCID: PMC10709933 DOI: 10.1186/s12916-023-03195-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Preliminary evidence demonstrates some parameters of metabolic control, including glycaemic control, lipid control and insulin resistance, vary across the menstrual cycle. However, the literature is inconsistent, and the underlying mechanisms remain uncertain. This study aimed to investigate the association between the menstrual cycle phase and metabolites and to explore potential mediators and moderators of these associations. METHODS We undertook a cross-sectional cohort study using UK Biobank. The outcome variables were glucose; triglyceride; triglyceride to glucose index (TyG index); total, HDL and LDL cholesterol; and total to HDL cholesterol ratio. Generalised additive models (GAM) were used to investigate non-linear associations between the menstrual cycle phase and outcome variables. Anthropometric, lifestyle, fitness and inflammatory markers were explored as potential mediators and moderators of the associations between the menstrual cycle phase and outcome variables. RESULTS Data from 8694 regularly menstruating women in UK Biobank were analysed. Non-linear associations were observed between the menstrual cycle phase and total (p < 0.001), HDL (p < 0.001), LDL (p = 0.012) and total to HDL cholesterol (p < 0.001), but not glucose (p = 0.072), triglyceride (p = 0.066) or TyG index (p = 0.100). Neither anthropometric, physical fitness, physical activity, nor inflammatory markers mediated the associations between the menstrual cycle phase and metabolites. Moderator analysis demonstrated a greater magnitude of variation for all metabolites across the menstrual cycle in the highest and lowest two quartiles of fat mass and physical activity, respectively. CONCLUSIONS Cholesterol profiles exhibit a non-linear relationship with the menstrual cycle phase. Physical activity, anthropometric and fitness variables moderate the associations between the menstrual cycle phase and metabolite concentration. These findings indicate the potential importance of physical activity and fat mass as modifiable risk factors of the intra-individual variation in metabolic control across the menstrual cycle in pre-menopausal women.
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Affiliation(s)
- Kirstin A MacGregor
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Scotland, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Carlos A Celis-Morales
- School Cardiovascular and Metabolic Health, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, Scotland, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Jill P Pell
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Iain J Gallagher
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Scotland, UK
- Centre for Biomedicine and Global Health, School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Sighthill Court, Edinburgh, UK
| | - Colin N Moran
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Scotland, UK.
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Hosseinzadeh P, Peck JD, Burks HR, Souter I, Xing A, Craig LB, Diamond MP, Hansen KR. Follicular phase length is not related to live birth outcome in women with unexplained infertility undergoing ovarian stimulation with intrauterine insemination cycles in a multicenter trial. F S Rep 2023; 4:361-366. [PMID: 38204957 PMCID: PMC10774873 DOI: 10.1016/j.xfre.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 01/12/2024] Open
Abstract
Objective To evaluate the effect of follicular phase length (FPL) on pregnancy outcomes and endometrial thickness (ET) among women with unexplained infertility undergoing ovarian stimulation with intrauterine insemination (OS-IUI) with clomiphene citrate, letrozole, or gonadotropins. Design Cohort analysis of the Reproductive Medicine Network's Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation randomized controlled trial. Setting Multicenter randomized controlled trial. Patients A total of 869 couples with unexplained infertility who underwent OS-IUI treatment cycles as part of the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation study. Interventions FPL was evaluated as a categorical variable defined by quintiles (q1: ≤11 days, q2: 12 days, q3: 13 days, q4: 14-15 days, and q5: ≥16 days). Main outcome measures Clinical pregnancy, live birth rates, and ET. Results Decreasing FPL quintiles did not reduce clinical pregnancy or live birth rates in unadjusted or adjusted models with all treatment groups combined or when stratified by the ovarian stimulation medication. All FPL categories had significantly thinner ET compared with the 5th quintile (≥16 days) among women treated with clomiphene citrate or letrozole. Similar but diminished associations were observed among women who underwent ovarian stimulation with gonadotropins, but the observed differences were limited to those with FPL of 12 days or shorter when compared with FPL ≥16 days. Conclusions Although shorter FPL was associated with reduced ET, it was not associated with the outcomes of clinical pregnancy or live birth in women with unexplained infertility undergoing OS-IUI in all treatment groups combined. Similar patterns existed when analyses of clinical pregnancy and live birth rates were stratified by treatment. Clinical trial registration NCT01044862.
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Affiliation(s)
- Pardis Hosseinzadeh
- Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Jennifer D. Peck
- Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
- Department of Biostatistics and Epidemiology, University of Oklahoma College of Public Health, Oklahoma City, Oklahoma
| | - Heather R. Burks
- Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Irene Souter
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Harvard Medical School, Massachusetts General Hospital Fertility Center, Boston, Massachusetts
| | - Angela Xing
- Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - LaTasha B. Craig
- Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Michael P. Diamond
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan
- Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia
| | - Karl R. Hansen
- Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
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Hu X, Wu H, Yong X, Wang Y, Yang S, Fan D, Xiao Y, Che L, Shi K, Li K, Xiong C, Zhu H, Qian Z. Cyclical endometrial repair and regeneration: Molecular mechanisms, diseases, and therapeutic interventions. MedComm (Beijing) 2023; 4:e425. [PMID: 38045828 PMCID: PMC10691302 DOI: 10.1002/mco2.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/21/2023] [Accepted: 10/27/2023] [Indexed: 12/05/2023] Open
Abstract
The endometrium is a unique human tissue with an extraordinary ability to undergo a hormone-regulated cycle encompassing shedding, bleeding, scarless repair, and regeneration throughout the female reproductive cycle. The cyclical repair and regeneration of the endometrium manifest as changes in endometrial epithelialization, glandular regeneration, and vascularization. The mechanisms encompass inflammation, coagulation, and fibrinolytic system balance. However, specific conditions such as endometriosis or TCRA treatment can disrupt the process of cyclical endometrial repair and regeneration. There is uncertainty about traditional clinical treatments' efficacy and side effects, and finding new therapeutic interventions is essential. Researchers have made substantial progress in the perspective of regenerative medicine toward maintaining cyclical endometrial repair and regeneration in recent years. Such progress encompasses the integration of biomaterials, tissue-engineered scaffolds, stem cell therapies, and 3D printing. This review analyzes the mechanisms, diseases, and interventions associated with cyclical endometrial repair and regeneration. The review discusses the advantages and disadvantages of the regenerative interventions currently employed in clinical practice. Additionally, it highlights the significant advantages of regenerative medicine in this domain. Finally, we review stem cells and biologics among the available interventions in regenerative medicine, providing insights into future therapeutic strategies.
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Affiliation(s)
- Xulin Hu
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
- Department of BiotherapyCancer Center and State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduSichuanChina
| | - Haoming Wu
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Xin Yong
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Department of Paediatrics, West China Second University Hospital, State Key Laboratory of Biotherapy and Collaborative Innovation Center of BiotherapySichuan UniversityChengduSichuanChina
| | - Yao Wang
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Shuhao Yang
- Department of OrthopedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Diyi Fan
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Yibo Xiao
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Lanyu Che
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Kun Shi
- Department of BiotherapyCancer Center and State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduSichuanChina
| | - Kainan Li
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | | | - Huili Zhu
- Department of Reproductive Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of EducationWest China Second University Hospital of Sichuan UniversityChengduSichuanChina
| | - Zhiyong Qian
- Department of BiotherapyCancer Center and State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduSichuanChina
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Barth C, Crestol A, de Lange AMG, Galea LAM. Sex steroids and the female brain across the lifespan: insights into risk of depression and Alzheimer's disease. Lancet Diabetes Endocrinol 2023; 11:926-941. [PMID: 37865102 DOI: 10.1016/s2213-8587(23)00224-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 10/23/2023]
Abstract
Despite widespread sex differences in prevalence and presentation of numerous illnesses affecting the human brain, there has been little focus on the effect of endocrine ageing. Most preclinical studies have focused on males only, and clinical studies often analyse data by covarying for sex, ignoring relevant differences between the sexes. This sex- (and gender)-neutral approach is biased and contributes to the absence of targeted treatments and services for all sexes (and genders). Female health has been historically understudied, with grave consequences for their wellbeing and health equity. In this Review, we spotlight female brain health across the lifespan by informing on the role of sex steroids, particularly oestradiol, on the female brain and on risk for diseases more prevalent in females, such as depression and Alzheimer's disease.
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Affiliation(s)
- Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Arielle Crestol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ann-Marie G de Lange
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychology, University of Oslo, Oslo, Norway
| | - Liisa A M Galea
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
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Moccia C, Cherubini M, Fortea M, Akinbote A, Padmanaban P, Beltran‐Sastre V, Haase K. Mammary Microvessels are Sensitive to Menstrual Cycle Sex Hormones. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2302561. [PMID: 37897317 PMCID: PMC10724440 DOI: 10.1002/advs.202302561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/04/2023] [Indexed: 10/30/2023]
Abstract
The mammary gland is a highly vascularized organ influenced by sex hormones including estrogen (E2) and progesterone (P4). Beyond whole-organism studies in rodents or cell monocultures, hormonal effects on the breast microvasculature remain largely understudied. Recent methods to generate 3D microvessels on-chip have enabled direct observation of complex vascular processes; however, these models often use non-tissue-specific cell types, such as human umbilical vein endothelial cells (HUVECs) and fibroblasts from various sources. Here, novel mammary-specific microvessels are generated by coculturing primary breast endothelial cells and fibroblasts under optimized culture conditions. These microvessels are mechanosensitive (to interstitial flow) and require endothelial-stromal interactions to develop fully perfusable vessels. These mammary-specific microvessels are also responsive to exogenous stimulation by sex hormones. When treated with combined E2 and P4, corresponding to the four phases of the menstrual cycle (period, follicular, ovular, and luteal), vascular remodeling and barrier function are altered in a phase-dependent manner. The presence of high E2 (ovulation) promotes vascular growth and remodeling, corresponding to high depletion of proangiogenic factors, whereas high P4 concentrations (luteal) promote vascular regression. The effects of combined E2 and P4 hormones are not only dose-dependent but also tissue-specific, as are shown by similarly treating non-tissue-specific HUVEC microvessels.
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Affiliation(s)
- Carmen Moccia
- European Molecular Biology Laboratory, BarcelonaDr. Aiguader, 88Barcelona08003Spain
| | - Marta Cherubini
- European Molecular Biology Laboratory, BarcelonaDr. Aiguader, 88Barcelona08003Spain
| | - Marina Fortea
- European Molecular Biology Laboratory, BarcelonaDr. Aiguader, 88Barcelona08003Spain
| | - Akinola Akinbote
- European Molecular Biology Laboratory, BarcelonaDr. Aiguader, 88Barcelona08003Spain
- Heidelberg UniversityHeidelbergGermany
| | - Prasanna Padmanaban
- European Molecular Biology Laboratory, BarcelonaDr. Aiguader, 88Barcelona08003Spain
| | | | - Kristina Haase
- European Molecular Biology Laboratory, BarcelonaDr. Aiguader, 88Barcelona08003Spain
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Babir FJ, Riddell MC, Adamo LM, Richards DL, Gibala MJ. The effect of bodyweight exercise on 24-h glycemic responses determined by continuous glucose monitoring in healthy inactive adults: a randomized crossover study. Sci Rep 2023; 13:20884. [PMID: 38017140 PMCID: PMC10684602 DOI: 10.1038/s41598-023-48063-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/22/2023] [Indexed: 11/30/2023] Open
Abstract
Vigorous intermittent exercise can improve indices of glycemia in the 24 h postexercise period in apparently healthy individuals. We examined the effect of a single session of bodyweight exercise (BWE) on glycemic responses using continuous glucose monitoring (CGM) under controlled dietary conditions. Healthy inactive adults (n = 27; 8 males, 19 females; age: 23 ± 3 years) completed 2 virtually supervised trials spaced ~ 1 week apart in a randomized, crossover manner. The trials involved an 11-min BWE protocol that consisted of 5 × 1-min bouts performed at a self-selected pace interspersed with 1-min active recovery periods or a non-exercise sitting control period (CON). Mean heart rate during the BWE protocol was 147 ± 14 beats per min (75% of age-predicted maximum). Mean 24 h glucose after BWE and CON was not different (5.0 ± 0.4 vs 5.0 ± 0.5 mM respectively; p = 0.39). There were also no differences between conditions for measures of glycemic variability or the postprandial glucose responses after ingestion of a 75 g glucose drink or lunch, dinner, and breakfast meals. This study demonstrates the feasibility of conducting a remotely supervised BWE intervention using CGM under free-living conditions. Future studies should investigate the effect of repeated sessions of BWE training or responses in people with impaired glycemic control.
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Affiliation(s)
- Fiona J Babir
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Michael C Riddell
- School of Kinesiology and Health Science, York University, Toronto, ON, M3J 1P3, Canada
| | - Larissa M Adamo
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Douglas L Richards
- Department of Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4L8, Canada.
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Ciolfi Felice M, Søndergaard MLJ, Balaam M. Analyzing User Reviews of the First Digital Contraceptive: Mixed Methods Study. J Med Internet Res 2023; 25:e47131. [PMID: 37962925 PMCID: PMC10685276 DOI: 10.2196/47131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/29/2023] [Accepted: 09/28/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND People in Western countries are increasingly rejecting hormone-based birth control and expressing a preference for hormone-free methods. Digital contraceptives have emerged as nonhormonal medical devices that make use of self-tracked data and algorithms to find a user's fertile window. However, there is little knowledge about how people experience this seemingly new form of contraception, whose failure may result in unwanted pregnancies, high health risks, and life-changing consequences. As digital contraception becomes more widely adopted, examining its user experience is crucial to inform the design of technologies that not only are medically effective but also meet users' preferences and needs. OBJECTIVE We examined the user experience offered by Natural Cycles-the first digital contraceptive-through an analysis of app reviews written by its users worldwide. METHODS We conducted a mixed methods analysis of 3265 publicly available reviews written in English by users of Natural Cycles on the Google Play Store. We combined computational and human techniques, namely, topic modeling and reflexive thematic analysis. RESULTS For some users of digital contraception, the hormone-free aspect of the experience can be more salient than its digital aspect. Cultivating self-knowledge through the use of the technology can, in turn, feel empowering. Users also pointed to an algorithmic component that allows for increased accuracy over time as long as user diligence is applied. The interactivity of the digital contraceptive supports mutual learning and is experienced as agential and rewarding. Finally, a digital contraceptive can facilitate sharing the burden of contraceptive practices or highlight single-sided responsibilities while creating points of friction in the required daily routines. CONCLUSIONS Digital contraception is experienced by users as a tamed natural approach-a natural method contained and regulated by science and technology. This means that users can experience a method based on a digital product as "natural," which positions digital contraceptives as a suitable option for people looking for evidence-based nonhormonal contraceptive methods. We point to interactivity as core to the user experience and highlight that a digital contraceptive might allow for collaboration between partners around contraceptive practices and responsibilities. We note that the user diligence required for the digital contraceptive to provide accurate and frequent data is sometimes not enough. Future research could look at designing (and redesigning) digital contraceptives with primary users and intimate partners, enhancing the experience of tamed naturalness; exploring how trust fluctuates among involved actors and in interactions with the technology; and, ultimately, designing more inclusive approaches to digital contraception.
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Affiliation(s)
- Marianela Ciolfi Felice
- Division of Media Technology and Interaction Design, KTH Royal Institute of Technology, Stockholm, Sweden
| | | | - Madeline Balaam
- Division of Media Technology and Interaction Design, KTH Royal Institute of Technology, Stockholm, Sweden
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Ali ZE, Liperis G, Mincheva M, Serdarogullari M, Uraji J, Ammar OF, Fraire-Zamora JJ. From stress to success: exploring methods addressing psychosocial stress in couples trying to conceive. Hum Reprod 2023; 38:2277-2279. [PMID: 37558266 DOI: 10.1093/humrep/dead159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Affiliation(s)
- Zoya E Ali
- Research & Development Department, Hertility Health Limited, London, UK
| | - George Liperis
- Westmead Fertility Centre, Institute of Reproductive Medicine, University of Sydney, Westmead, NSW, Australia
| | | | - Munevver Serdarogullari
- Department of Histology and Embryology, Faculty of Medicine, Cyprus International University, Nicosia, Northern Cyprus via Mersin 10, Turkey
| | - Julia Uraji
- IVF Laboratory, TFP Düsseldorf GmbH, Düsseldorf, Germany
| | - Omar F Ammar
- Biomaterials Cluster, Bernal Institute, University of Limerick, Limerick, Ireland
- School of Engineering, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland
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Casto KV, Arthur LC, Lynch-Wells S, Blake KR. Women in their mid-follicular phase outcompete hormonal contraceptive users, an effect partially explained by relatively greater progesterone and cortisol reactivity to competition. Psychoneuroendocrinology 2023; 157:106367. [PMID: 37639799 DOI: 10.1016/j.psyneuen.2023.106367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
Early evidence suggests that hormonal contraceptive (HC) use alters psychological functioning and competitive behavior. Yet, there is limited data on endocrine models for explaining how HC use affects these outcomes. In this pre-registered and open-data study, we test if HC users and naturally cycling (NC) females in their low (mid-follicular) and high (mid-luteal) progesterone phase differ in competitive persistence and whether progesterone and cortisol reactivity mediate of this effect. HC users (N = 73) in the active hormone-exposure phase and NC participants in the mid-follicular (N = 69) or mid-luteal (N = 72) phase completed two behavioral measures of competitive persistence, holding up a weight for time followed by attempting to solve an unsolvable anagram. Participants also completed measures of handgrip strength and self-reported competitiveness as well as gave saliva samples before and after the tasks for hormone assay. Results showed that NC-follicular group had greater competitive persistence in the weight-holding task compared to both NC-luteal (d = 0.38) and HC use (d = 0.43) groups independent of physical strength and self-reported competitiveness covariates. Although anagram task performance showed similar trends for group differences, analyses for this task were inconclusive. Baseline progesterone did not mediate the effect of cycle phase group on competitive persistence. HC users showed relatively blunted cortisol and progesterone reactivity, and this effect partially mediated the difference in competitive persistence between HC users and the NC-follicular group. In sum, results suggest that HC use could downregulate competitive behavior at least partly by dampening cortisol-progesterone reactivity. These findings offer a new endocrine model for understanding HC use and cycle phase effects on motivational and energetic outcomes required for optimal performance in competitive contexts.
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Affiliation(s)
- Kathleen V Casto
- Social Sciences Division, New College of Florida, USA; Department of Psychological Sciences, Kent State University, USA.
| | - Lindsie C Arthur
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Siobhan Lynch-Wells
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Khandis R Blake
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
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Bruce LK, Kasl P, Soltani S, Viswanath VK, Hartogensis W, Dilchert S, Hecht FM, Chowdhary A, Anglo C, Pandya L, Dasgupta S, Altintas I, Gupta A, Mason AE, Smarr BL. Variability of temperature measurements recorded by a wearable device by biological sex. Biol Sex Differ 2023; 14:76. [PMID: 37915069 PMCID: PMC10619297 DOI: 10.1186/s13293-023-00558-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Females have been historically excluded from biomedical research due in part to the documented presumption that results with male subjects will generalize effectively to females. This has been justified in part by the assumption that ovarian rhythms will increase the overall variance of pooled random samples. But not all variance in samples is random. Human biometrics are continuously changing in response to stimuli and biological rhythms; single measurements taken sporadically do not easily support exploration of variance across time scales. Recently we reported that in mice, core body temperature measured longitudinally shows higher variance in males than cycling females, both within and across individuals at multiple time scales. METHODS Here, we explore longitudinal human distal body temperature, measured by a wearable sensor device (Oura Ring), for 6 months in females and males ranging in age from 20 to 79 years. In this study, we did not limit the comparisons to female versus male, but instead we developed a method for categorizing individuals as cyclic or acyclic depending on the presence of a roughly monthly pattern to their nightly temperature. We then compared structure and variance across time scales using multiple standard instruments. RESULTS Sex differences exist as expected, but across multiple statistical comparisons and timescales, there was no one group that consistently exceeded the others in variance. When variability was assessed across time, females, whether or not their temperature contained monthly cycles, did not significantly differ from males both on daily and monthly time scales. CONCLUSIONS These findings contradict the viewpoint that human females are too variable across menstrual cycles to include in biomedical research. Longitudinal temperature of females does not accumulate greater measurement error over time than do males and the majority of unexplained variance is within sex category, not between them.
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Affiliation(s)
- Lauryn Keeler Bruce
- UC San Diego Health Department of Biomedical Informatics, University of California San Diego, San Diego, CA, USA
| | - Patrick Kasl
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, 9500 Gilman Dr, , La Jolla, San Diego, CA, USA
| | - Severine Soltani
- Bioinformatics and Systems Biology, University of California San Diego, San Diego, CA, USA
| | - Varun K Viswanath
- Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, USA
| | - Wendy Hartogensis
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Stephan Dilchert
- Department of Management, Zicklin School of Business, Baruch College, The City University of New York, New York, NY, USA
| | - Frederick M Hecht
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Anoushka Chowdhary
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Claudine Anglo
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Leena Pandya
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Subhasis Dasgupta
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA
| | - Ilkay Altintas
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA
| | - Amarnath Gupta
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA
| | - Ashley E Mason
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Benjamin L Smarr
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, 9500 Gilman Dr, , La Jolla, San Diego, CA, USA.
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA.
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Kurahashi K, Hashimoto Y, Shiraishi K, Kubota N, Yoshitomi T. Choroidal Morphology and Systemic Circulation Changes During the Menstrual Cycle in Healthy Japanese Women. Cureus 2023; 15:e48124. [PMID: 38046755 PMCID: PMC10691935 DOI: 10.7759/cureus.48124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
PURPOSE Changes in systemic circulatory dynamics and choroidal thickness are poorly understood. This study aimed to investigate the time course of changes in choroidal morphology during normal menstrual cycles in healthy women using enhanced depth imaging optical coherence tomography (EDI-OCT). MATERIALS AND METHODS This prospective study included 15 left eyes of 15 healthy Japanese women (mean age, 20.2 ± 0.8 years) with a normal menstrual cycle. Using EDI-OCT, the subfoveal choroidal thickness (SCT) was manually measured during the late follicular and mid-luteal phases. Intraocular pressure (IOP), systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP), and heart rate (HR) were also evaluated during these phases. RESULTS SBP, DBP, and MBP were significantly elevated in the mid-luteal phase. The average SCT was significantly decreased in the mid-luteal phase. In contrast, there were no significant changes in IOP or HR. CONCLUSION These findings indicate that choroidal thickness decreases during the mid-luteal phase in healthy Japanese women with normal menstrual cycles depending on systemic circulatory dynamics. However, since the difference in the SCT values between the late follicular and the mid-luteal phase is not large (7 μm), the menstrual cycle may have little influence on the interpretation of choroidal thickness data in clinical practice.
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Affiliation(s)
- Kana Kurahashi
- Department of Orthoptics, Fukuoka International University of Health and Welfare, Fukuoka, JPN
| | - Yuki Hashimoto
- Department of Orthoptics, Fukuoka International University of Health and Welfare, Fukuoka, JPN
| | - Kanon Shiraishi
- Department of Orthoptics, Fukuoka International University of Health and Welfare, Fukuoka, JPN
| | - Nonoka Kubota
- Department of Orthoptics, Fukuoka International University of Health and Welfare, Fukuoka, JPN
| | - Takeshi Yoshitomi
- Department of Orthoptics, Fukuoka International University of Health and Welfare, Fukuoka, JPN
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45
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Prado RCR, Kilpatrick MW. Menstrual Cycle and Performance: What Is Next? Sports Health 2023; 15:895-897. [PMID: 37731307 PMCID: PMC10606960 DOI: 10.1177/19417381231197609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
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Adnan T, Li H, Peer K, Peebles E, James K, Mahalingaiah S. Evaluation of Menstrual Cycle Tracking Behaviors in the Ovulation and Menstruation Health Pilot Study: Cross-Sectional Study. J Med Internet Res 2023; 25:e42164. [PMID: 37889545 PMCID: PMC10638629 DOI: 10.2196/42164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/28/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Menstrual cycle tracking apps (MCTAs) have potential in epidemiological studies of women's health, facilitating real-time tracking of bleeding days and menstrual-associated signs and symptoms. However, information regarding the characteristics of MCTA users versus cycle nontrackers is limited, which may inform generalizability. OBJECTIVE We compared characteristics among individuals using MCTAs (app users), individuals who do not track their cycles (nontrackers), and those who used other forms of menstrual tracking (other trackers). METHODS The Ovulation and Menstruation Health Pilot Study tested the feasibility of a digitally enabled evaluation of menstrual health. Recruitment occurred between September 2017 and March 2018. Menstrual cycle tracking behavior, demographic, and general and reproductive health history data were collected from eligible individuals (females aged 18-45 years, comfortable communicating in English). Menstrual cycle tracking behavior was categorized in 3 ways: menstrual cycle tracking via app usage, that via other methods, and nontracking. Demographic factors, health conditions, and menstrual cycle characteristics were compared across the menstrual tracking method (app users vs nontrackers, app users vs other trackers, and other trackers vs nontrackers) were assessed using chi-square or Fisher exact tests. RESULTS In total, 263 participants met the eligibility criteria and completed the digital survey. Most of the cohort (n=191, 72.6%) was 18-29 years old, predominantly White (n=170, 64.6%), had attained 4 years of college education or higher (n= 209, 79.5%), and had a household income below US $50,000 (n=123, 46.8%). Among all participants, 103 (39%) were MCTA users (app users), 97 (37%) did not engage in any tracking (nontrackers), and 63 (24%) used other forms of tracking (other trackers). Across all groups, no meaningful differences existed in race and ethnicity, household income, and education level. The proportion of ever-use of hormonal contraceptives was lower (n=74, 71.8% vs n=87, 90%, P=.001), lifetime smoking status was lower (n=6, 6% vs n=15, 17%, P=.04), and diagnosis rate of gastrointestinal reflux disease (GERD) was higher (n=25, 24.3% vs n=12, 12.4%, P=.04) in app users than in nontrackers. The proportions of hormonal contraceptives ever used and lifetime smoking status were both lower (n=74, 71.8% vs n=56, 88.9%, P=.01; n=6, 6% vs n=11, 17.5%, P=.02) in app users than in other trackers. Other trackers had lower proportions of ever-use of hormonal contraceptives (n=130, 78.3% vs n=87, 89.7%, P=.02) and higher diagnostic rates of heartburn or GERD (n=39, 23.5% vs n=12, 12.4%, P.03) and anxiety or panic disorder (n=64, 38.6% vs n=25, 25.8%, P=.04) than nontrackers. Menstrual cycle characteristics did not differ across all groups. CONCLUSIONS Our results suggest that app users, other trackers, and nontrackers are largely comparable in demographic and menstrual cycle characteristics. Future studies should determine reasons for tracking and tracking-related behaviors to further understand whether individuals who use MCTAs are comparable to nontrackers.
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Affiliation(s)
- Tatheer Adnan
- Harvard School of Public Health, Boston, MA, United States
| | - Huichu Li
- Harvard School of Public Health, Boston, MA, United States
| | - Komal Peer
- Harvard School of Public Health, Boston, MA, United States
| | | | - Kaitlyn James
- Massachusetts General Hospital, Boston, MA, United States
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Piasecki J, Guo Y, Jones EJ, Phillips BE, Stashuk DW, Atherton PJ, Piasecki M. Menstrual Cycle Associated Alteration of Vastus Lateralis Motor Unit Function. SPORTS MEDICINE - OPEN 2023; 9:97. [PMID: 37874413 PMCID: PMC10597975 DOI: 10.1186/s40798-023-00639-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/21/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Estrogen and progesterone are the primary female sex hormones and have net excitatory and inhibitory effects, respectively, on neuronal function. Fluctuating concentrations across the menstrual cycle has led to several lines of research in relation to neuromuscular function and performance; however evidence from animal and cell culture models has yet to be demonstrated in human motor units coupled with quantification of circulating hormones. Intramuscular electromyography was used to record motor unit potentials and corresponding motor unit potential trains from the vastus lateralis of nine eumenorrheic females during the early follicular, ovulation and mid luteal phases of the menstrual cycle, alongside assessments of neuromuscular performance. Multi-level regression models were applied to explore effects of time and of contraction level. Statistical significance was accepted as p < 0.05. RESULTS Knee extensor maximum voluntary contraction, jump power, force steadiness, and balance did not differ across the menstrual phases (all p > 0.4). Firing rate of low threshold motor units (10% maximum voluntary contraction) was lower during the ovulation and mid luteal phases (β = - 0.82 Hz, p < 0.001), with no difference in motor unit potentials analysed from 25% maximum voluntary contraction contractions. Motor unit potentials were more complex during ovulation and mid luteal phase (p < 0.03), with no change in neuromuscular junction transmission instability (p > 0.3). CONCLUSIONS Assessments of neuromuscular performance did not differ across the menstrual cycle. The suppression of low threshold motor unit firing rate during periods of increased progesterone may suggest a potential inhibitory effect and an alteration of recruitment strategy; however this had no discernible effect on performance. These findings highlight contraction level-dependent modulation of vastus lateralis motor unit function over the eumenorrheic cycle, occurring independently of measures of performance.
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Affiliation(s)
- Jessica Piasecki
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, UK.
| | - Yuxiao Guo
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Eleanor J Jones
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Bethan E Phillips
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Daniel W Stashuk
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Philip J Atherton
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Mathew Piasecki
- Centre of Metabolism, Ageing and Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
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48
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Salvatore GM, Bercovitz I, Arigo D. Women's comfort with mobile applications for menstrual cycle self-monitoring following the overturning of Roe v. Wade. Mhealth 2023; 10:1. [PMID: 38323149 PMCID: PMC10839505 DOI: 10.21037/mhealth-23-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/22/2023] [Indexed: 02/08/2024] Open
Abstract
Background The overturning of Roe v. Wade in June 2022 has many implications for American women of reproductive age, as well as for researchers focused on women's health in the United States (U.S.). Personal reproductive health data, such as information collected by menstrual cycle (MC) tracking applications (apps), can now be bought, sold, or accessed by law enforcement to enforce limits on abortion. American women have grown concerned about data privacy and have even deleted MC tracking apps following the overturning of Roe v. Wade. This concern is problematic as these apps may advance our understanding of women's MC experiences by capturing time-sensitive data. The present study was designed to provide updated insight into women's perceptions of these apps, including the response rate to a study of this nature and women's willingness to self-report demographic information in this context, following the Supreme Court decision. Methods A total of 206 women aged 18-60 years who were identified as pre- or perimenopausal completed an anonymous, cross-sectional survey between August and November 2022. Results Most respondents had experience using a MC app at the time of reporting; 53.4% (n=110) were current users, and an additional 48 participants had used MC tracking apps in the past. Over one-third of participants (38.3%; n=75) indicated that they had reconsidered using such an app because of current events; 30.3% (n=59) preferred methods of MC tracking that did not involve app-based technology, and 34.2% (n=67) reported that they are not willing to participate in research that involves daily tracking of the MC. Conclusions Overall, the feasibility of menstruation-related research that includes mobile apps is fairly low, given women's current comfort with this technology compared to the Roe era, and there is a need to establish criteria and protections for use of mobile apps in women's health research.
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Affiliation(s)
| | - Iris Bercovitz
- Department of Psychology, Rowan University, Glassboro, NJ, USA
| | - Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ, USA
- Department of Family Medicine, Rowan School of Osteopathic Medicine, Stratford, NJ, USA
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49
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Sides K, Kilungeja G, Tapia M, Kreidl P, Brinkmann BH, Nasseri M. Analyzing physiological signals recorded with a wearable sensor across the menstrual cycle using circular statistics. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1227228. [PMID: 37928057 PMCID: PMC10621043 DOI: 10.3389/fnetp.2023.1227228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/19/2023] [Indexed: 11/07/2023]
Abstract
This study aims to identify the most significant features in physiological signals representing a biphasic pattern in the menstrual cycle using circular statistics which is an appropriate analytic method for the interpretation of data with a periodic nature. The results can be used empirically to determine menstrual phases. A non-uniform pattern was observed in ovulating subjects, with a significant periodicity (p< 0.05) in mean temperature, heart rate (HR), Inter-beat Interval (IBI), mean tonic component of Electrodermal Activity (EDA), and signal magnitude area (SMA) of the EDA phasic component in the frequency domain. In contrast, non-ovulating cycles displayed a more uniform distribution (p> 0.05). There was a significant difference between ovulating and non-ovulating cycles (p< 0.05) in temperature, IBI, and EDA but not in mean HR. Selected features were used in training an Autoregressive Integrated Moving Average (ARIMA) model, using data from at least one cycle of a subject, to predict the behavior of the signal in the last cycle. By iteratively retraining the algorithm on a per-day basis, the mean temperature, HR, IBI and EDA tonic values of the next day were predicted with root mean square error (RMSE) of 0.13 ± 0.07 (C°), 1.31 ± 0.34 (bpm), 0.016 ± 0.005 (s) and 0.17 ± 0.17 (μS), respectively.
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Affiliation(s)
- Krystal Sides
- School of Engineering, University of North Florida, Jacksonville, FL, United States
| | - Grentina Kilungeja
- School of Engineering, University of North Florida, Jacksonville, FL, United States
| | - Matthew Tapia
- School of Engineering, University of North Florida, Jacksonville, FL, United States
| | - Patrick Kreidl
- School of Engineering, University of North Florida, Jacksonville, FL, United States
| | - Benjamin H. Brinkmann
- Bioelectronics Neurophysiology and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Mona Nasseri
- School of Engineering, University of North Florida, Jacksonville, FL, United States
- Bioelectronics Neurophysiology and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
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50
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Teh WT, Chung J, Holdsworth-Carson SJ, Donoghue JF, Healey M, Rees HC, Bittinger S, Obers V, Sloggett C, Kendarsari R, Fung JN, Mortlock S, Montgomery GW, Girling JE, Rogers PAW. A molecular staging model for accurately dating the endometrial biopsy. Nat Commun 2023; 14:6222. [PMID: 37798294 PMCID: PMC10556104 DOI: 10.1038/s41467-023-41979-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/26/2023] [Indexed: 10/07/2023] Open
Abstract
Natural variability in menstrual cycle length, coupled with rapid changes in endometrial gene expression, makes it difficult to accurately define and compare different stages of the endometrial cycle. Here we develop and validate a method for precisely determining endometrial cycle stage based on global gene expression. Our 'molecular staging model' reveals significant and remarkably synchronised daily changes in expression for over 3400 endometrial genes throughout the cycle, with the most dramatic changes occurring during the secretory phase. Our study significantly extends existing data on the endometrial transcriptome, and for the first time enables identification of differentially expressed endometrial genes with increasing age and different ethnicities. It also allows reinterpretation of all endometrial RNA-seq and array data that has been published to date. Our molecular staging model will significantly advance understanding of endometrial-related disorders that affect nearly all women at some stage of their lives, such as heavy menstrual bleeding, endometriosis, adenomyosis, and recurrent implantation failure.
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Affiliation(s)
- W T Teh
- University of Melbourne Department of Obstetrics and Gynaecology, Melbourne, Victoria, Australia
- Royal Women's Hospital, Melbourne, Victoria, Australia
- Melbourne IVF, Melbourne, Victoria, Australia
| | - J Chung
- University of Melbourne Department of Obstetrics and Gynaecology, Melbourne, Victoria, Australia
- Melbourne Bioinformatics, University of Melbourne, Melbourne, Victoria, Australia
| | - S J Holdsworth-Carson
- University of Melbourne Department of Obstetrics and Gynaecology, Melbourne, Victoria, Australia
- Royal Women's Hospital, Melbourne, Victoria, Australia
- Julia Argyrou Endometriosis Centre, Epworth HealthCare, Richmond, Victoria, Australia
| | - J F Donoghue
- University of Melbourne Department of Obstetrics and Gynaecology, Melbourne, Victoria, Australia
- Royal Women's Hospital, Melbourne, Victoria, Australia
| | - M Healey
- University of Melbourne Department of Obstetrics and Gynaecology, Melbourne, Victoria, Australia
- Royal Women's Hospital, Melbourne, Victoria, Australia
| | - H C Rees
- Royal Women's Hospital, Melbourne, Victoria, Australia
- Royal Children's Hospital, Melbourne, Victoria, Australia
| | - S Bittinger
- Royal Women's Hospital, Melbourne, Victoria, Australia
- Royal Children's Hospital, Melbourne, Victoria, Australia
| | - V Obers
- Melbourne Pathology, Collingwood, Victoria, Australia
| | - C Sloggett
- Melbourne Bioinformatics, University of Melbourne, Melbourne, Victoria, Australia
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute, Melbourne, Victoria, Australia
| | - R Kendarsari
- Institute for Molecular Bioscience, University of Queensland, St Lucia, Queensland, Australia
- Illumina Inc. 11 Biopolis Way, Singapore, 138667, Singapore
| | - J N Fung
- School of Biomedical Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - S Mortlock
- Institute for Molecular Bioscience, University of Queensland, St Lucia, Queensland, Australia
| | - G W Montgomery
- Institute for Molecular Bioscience, University of Queensland, St Lucia, Queensland, Australia
| | - J E Girling
- University of Melbourne Department of Obstetrics and Gynaecology, Melbourne, Victoria, Australia
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, Aotearoa, New Zealand
| | - P A W Rogers
- University of Melbourne Department of Obstetrics and Gynaecology, Melbourne, Victoria, Australia.
- Royal Women's Hospital, Melbourne, Victoria, Australia.
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