Postural control in women with premenstrual symptoms during oral contraceptive treatment

Does Phase of the Menstrual Cycle Affect Balance and Postural Control?

The aim of the study is to examine the effects of menstrual cycle phases (MCP) on balance and postural control. The study was carried out with 63 volunteer women. Digital ovulation kits and, a Menstrual Cycle Regularity Questionnaire (MCRQ) to detect menstrual cycle regularity and duration, Premenstrual Syndrome Questionnaire (PMSQ) to question the presence of premenstrual syndrome, Menstruation Attitude Questionnaire (MAQ) to assess menstrual attitudes, International Physical Activity Questionnaire Short Form (IPAQ-SF) to question physical activity level was used. Balance and postural oscillation were evaluated with Balance Master balance and performance test device and Tekscan MatScan™ Pressure Mat System, respectively. All evaluations were repeated twice, in the preovulatory period and the postovulatory period. When the evaluations of the preovulatory period and the postovulatory period were compared, there was %3 increase in the percent weight-bearing of the non-dominant extremity (p = 0.01) and %2.5 decrease in the percent weight-bearing of the dominant limb in the postovulatory period (p = 0.01). %8 increase in functional reach distances was detected in the postovulatory period (p < 0.01). It was determined that there was %7.4 decrease in the oscillation rate of the center of gravity in the static stance with eyes open and %9 decrease in the static stance with eyes closed in the postovulatory period (p = 0.35, p = 0.18, respectively). It has been determined that the balance and postural control of young women are negatively affected in the preovulatory period and the function improved from the preovulatory period to the postovulatory period.

The Disturbing Effect of Neuromuscular Fatigue on Postural Control Is Accentuated in the Premenstrual Phase in Female Athletes

This study explored the fatigue effect on postural control (PC) across menstrual cycle phases (MCPs) in female athletes. Isometric maximal voluntary contraction (IMVC), the center of pressure sway area (CoParea), CoP length in the medio-lateral (CoP_LX) and antero-posterior (CoP_LY) directions, and Y-balance test (YBT) were assessed before and after a fatiguing exercise during the follicular phase (FP), mid-luteal phase (LP), and premenstrual phase (PMP). Baseline normalized reach distances (NRDs) for the YBT were lower (p = 0.00) in the PMP compared to others MCPs, but the IMVC, CoParea, CoP_LX, and CoP_LY remained unchanged. After exercise, the IMVC and the NRD decrease was higher at PMP compared to FP (p = 0.00) and LP (p = 0.00). The CoParea, CoP_LX, and CoP_LY increase was higher in the PMP compared to FP (p = 0.00) and LP (p = 0.00). It was concluded that there is an accentuated PC impairment after exercise observed at PMP.

Changes in premenstrual symptoms in women starting or discontinuing use of oral contraceptives

It is not clear whether oral contraceptive (OC) treatment affects premenstrual symptoms in women. The aim of the present study was to evaluate changes in premenstrual symptoms (PMS) in women starting to use or discontinuing the use of OCs. Twenty-four healthy women with no previous diagnosis of premenstrual dysphoric disorder were included in this study with a prospective crossover design. Nineteen women completed daily ratings of somatic and mood symptoms during two hormonally different cycles, during a normal menstrual cycle and while using OCs. The menstrual cycle phases were hormonally verified and the low-dose, monophasic OCs were used in a 21/7 regimen. The onset of OC use significantly decreased premenstrual somatic symptoms, but it did not affect mood symptoms. In the women who discontinued OC use, no significant changes in neither somatic nor mood symptoms appeared in the premenstrual phase.

Constant performance in balance and proprioception tests across the menstrual cycle - a pilot study in well trained female ice hockey players on hormonal contraception

INTRODUCTION

It has yet to be explained why female athletes appear to suffer more often from non-contact ligament injuries during the first half of the menstrual cycle. Fluctuations in balance, caused by impaired proprioception due to increased fluid retention, may be relevant factors contributing to this anomaly in distribution. The aim of this study was therefore to uncover relationships between dynamic stability, proprioception and fluid retention in association with the menstrual cycle as a possible explanation for the observed changes in injury rates.

METHODS

Nine healthy, female, well trained ice hockey players on hormonal contraception with regular cycles were tested at least twelve times during one menstrual cycle. Bioimpedance analysis was applied to investigate body composition and fluid distribution. A joint position sense test was performed to characterize changes in proprioception, while unexpected perturbations on a balance board were used to obtain measures for dynamic postural control.

RESULTS

No distinct changes in proprioception, dynamic stability and fluid retention were identified across the menstrual cycle in this population. Weak correlations were found between parameters for dynamic stability and proprioception.

CONCLUSION

Variations in proprioception, dynamic stability and fluid retention seem unlikely to be major contributors to injury risk peaks, at least in this population of healthy trained athletes using hormonal contraception.

Menstrual cycle and knee joint position sense in healthy female athletes

PURPOSE

The aim of this study was to investigate the effect of menstrual cycle on knee joint position sense (JPS) in healthy female athletes.

METHODS

Sixteen healthy female athletes participated in this study. Serum estrogen and progesterone levels were collected during the three phases of menstrual cycle. The knee JPS was also measured during the same phases using a system comprise of skin markers, digital photography, and AutoCAD software. Absolute angular errors were calculated as well as changes in hormone levels between the three phases.

RESULTS

Serum estrogen concentration was significantly higher during the mid-luteal (179.5 Pg/ml) and mid-follicular (125.6 Pg/ml) phases as compared with the early-follicular (menses) (22.8 Pg/ml) phase (P = 0.0001). Also serum progesterone concentration was significantly higher during the mid-luteal phase (7.35 Ng/ml) as compared with the menses (0.58 Ng/ml) and mid-follicular (0.5 Ng/ml) phases (P = 0.0001). The greatest amount of mean (SD) value of absolute error was at menses (4.2°), and the least amount of it was at mid-luteal (2.5°) phase. Also, a significant difference was observed within three phases of menstrual cycle (P = 0.025).

CONCLUSION

The result of this study suggests that healthy female athletes have different levels of knee JPS across a menstrual cycle. JPS accuracy decreases in menses, when circulating sex-hormones levels are low. Therefore, female athletes are at higher risk of injury at menses and improving their awareness regarding the knee injury risk factors can be a fundamental step toward preventing injuries.

LEVEL OF EVIDENCE

Case series, Level IV.