Characterization of symptoms and edema distribution in premenstrual syndrome

Carpal tunnel tendon and sub-synovial connective tissue mechanics are affected by reduced venous return

BACKGROUND

The effects of blood flow occlusion and sex-specific differences in tendon-subsynovial connective tissue relative strain are not well understood. Thus, the purpose of this study was to investigate the influence of blood flow, biological sex, and finger movement speed on carpal tunnel tendon mechanics to further develop our understanding of carpal tunnel syndrome.

METHODS

Colour Doppler ultrasound imaging quantified relative motion between flexor digitorum superficialis tendon and subsynovial connective tissue in 20 healthy male and female participants during repetitive finger flexion-extension under brachial occlusion of blood flow and two movement speeds (0.75 & 1.25 Hz).

FINDINGS

Flexor digitorum superficialis and subsynovial connective tissue displacement decreased with occlusion (small effect) and fast speed (large effect). Speed × Condition interactions were found for mean FDS displacement and peak FDS velocity, where slow speed with occlusion reduced both outcomes. Movement speed had a small but significant effect on tendon-subsynovial connective tissue shear outcomes, where MVR decreased with fast finger motion.

INTERPRETATION

These results suggest the influence of localized edema through venous occlusion on tendon-subsynovial connective tissue gliding within the carpal tunnel. This insight further develops our understanding of carpal tunnel syndrome pathophysiology and suggests ramifications on carpal tunnel tissue motion when the local fluid environment of the carpal tunnel is disturbed.

New insights on the impact of gut microbiota on premenstrual disorders. Will probiotics solve this mystery?

Premenstrual disorders (PMDs) refer to premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), where both are characterized by physical and psychological changes occurring in the luteal phase of menstrual cycle. According to the available theories, there is no single accusation succeeded to explain the pathophysiology of PMDs. However, there is emerging evidence for the role of gut microbiota (GM) in PMDs, supported by the diverging impact of GM on our body systems. The direct secretory function of GM and their integration in hormonal, neurotransmitters and bioactive compounds secretion and activity reinforce this speculation. Moreover, the bidirectional relation between GM and steroid hormones and the impact of diet, drugs, and inflammation on both, GM and PMDs incidence and severity justify the need for more studies to determine the actual role of GM in PMDs and the possible potential of probiotics and prebiotics as therapeutic options.

Role of Inflammation, Oxidative Stress, and Mitochondrial Changes in Premenstrual Psychosomatic Behavioral Symptoms with Anti-Inflammatory, Antioxidant Herbs, and Nutritional Supplements

Premenstrual syndrome (PMS) significantly lowers the quality of life and impairs personal and social relationships in reproductive-age women. Some recommendations are that inappropriate oxidative stress and inflammatory response are involved in PMS. Various nutritional supplements and herbs showed neuro-psycho-pharmacological activity with antioxidant and anti-inflammatory properties. This study aims to determine the systematic review of randomized controlled trials (RCTs) of herbal medicine and nutritional supplements in PMS. We also comprehensively highlighted the role of oxidative stress, inflammation, and mitochondrial changes on PMS with the application of computational intelligence. We used PRISMA and research question-based techniques to collect the data for evaluation of our study on different databases such as Scopus, PubMed, and PROSPERO from 1990 to 2022. The methodological quality of the published study was assessed by the modified Jadad scale. In addition, we used network visualization and word cloud techniques to find the closest terms of the study based on previous publications. While we also used computational intelligence techniques to give the idea for the classification of experimental data from PMS. We found 25 randomized controlled studies with 1949 participants (mean ± SD: 77.96 ± 22.753) using the PRISMA technique, and all were high-quality studies. We also extracted the closest terms related to our study using network visualization techniques. This work has revealed the future direction and research gap on the role of oxidative stress and inflammation in PMS. In vitro and in vivo studies showed that bioactive molecules such as curcumin, allicin, anethole, thymoquinone, cyanidin 3-glucoside, gamma-linoleic acid, and various molecules not only have antioxidant and anti-inflammatory properties but also other various activities such as GABA-A receptor agonist, serotonergic, antidepressant, sedative, and analgesic. Traditional Unani Herbal medicine and nutritional supplements can effectively relieve PMS symptoms as they possess many bioactive molecules that are pharmacologically proven for the aforementioned properties. Hence, these biomolecules might influence a complex physical and psychological disease process like PMS. However, more rigorous research studies are recommended for in-depth knowledge of the efficacy of bioactive molecules on premenstrual syndrome in clinical trials.

Whole and segmental body composition changes during mid-follicular and mid-luteal phases of the menstrual cycle in recreationally active young women

BACKGROUND

Changes in oestradiol and progesterone hormones and associated fluid retention during the menstrual cycle phases might affect body composition (BC) in women.

AIM

The main objectives of this study were to determine the changes in whole and segmental BC by dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance (BIA) during the mid-follicular (MFP) and mid-luteal (MLP) phases.

SUBJECTS AND METHODS

Thirty recreationally active young women participated in this study. BC was measured by DXA and BIA during MFP and MLP. A mixed linear model for repeated measures analysis was used to determine the differences between the two phases.

RESULTS

Body mass was higher during MLP than MFP, while total body water, total and segmental fat mass and fat percentages measured by both BIA and DXA were similar during the two phases. DXA-derived fat-free mass and soft lean mass in the android region were higher during MLP than MFP. Large variability in individual responses was evident.

CONCLUSION

On average, whole and segmental BC variables do not change significantly between MFP and MLP. However, given the large variability among the individual responses, it is suggested to perform repeated BC measurements during the same phase of the menstrual cycle.

Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil

OBJECTIVE

 To investigate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in university students, the factors associated with PMS, the most prevalent symptoms, and the interference of symptoms in academic, family, social, and work activities.

METHODS

 This cross-sectional study included 1,115 university students aged ≥ 18 years from the University of Rio Verde, Goiás. Premenstrual syndrome and PMDD were identified using the Premenstrual Symptoms Screening Tool. Associations with sociodemographic, behavioral, reproductive, nutritional, and health factors were investigated using the Poisson regression.

RESULTS

 The prevalence of PMS was 46.9% (95% confidence interval [CI] 44.0-49.8), and of PMDD, 11.1% (95% CI 9.3-13.0). The most prevalent symptoms were physical, such as breast tenderness, bloating, e weight gain (73%); followed by psychological ones such as overeating/food cravings, tearful/more sensitive to rejection (> 60%). More than 30% of the patients reported that the symptoms interfered in a moderate-to-severe way in their social and academic activities. After adjusted analysis, PMS was more prevalent in those who were attending the 1^st/2^nd semester of college (prevalence ratio [PR] 1.44; 95% CI 1.14-1.80), those who consumed alcohol in the last 30 days (PR 1.23; 95% CI 1.04-1.47), and those who had depression (PR 1.49; 95% CI 1.30-1.71).

CONCLUSION

 Almost half of the university students had PMS and ∼ 11%, PMDD. Physical symptoms were the most common and interfered in a moderate-to-severe way in various aspects of life. Attending the first semesters, consuming alcohol, and having depression were risk factors for PMS. The identification of risk factors for PMS is essential to prevent symptoms and reduce the impact of the syndrome.

Changes in Knee Vastii Muscle Activity in Women with Patellofemoral Pain Syndrome During the Menstrual Cycle

BACKGROUND

Changes in hormonal levels during the menstrual cycle are known to affect muscle electromyographic (EMG) activity, but no studies have investigated the effect of hormonal changes on the EMG activity of muscles around the knee in patients with patellofemoral pain syndrome (PFPS).

OBJECTIVE

To evaluate the EMG activity of the vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles during toe rise and heel rock tasks in different phases of the menstrual cycle in women with PFPS.

DESIGN

Cross sectional study.

SETTING

Rehabilitation Research Center at the School of Rehabilitation Sciences of Shiraz University of Medical Sciences.

PARTICIPANTS

Ten women with PFPS between 18 and 40 years of age.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

The VL/VMO amplitude ratio and differences between onset (onset VL-onset VMO) of vastii muscle activity were measured in the affected limb during rise and rock tasks in the follicular and ovulatory phases of the menstrual cycle. The signals were analyzed with MATLAB software.

RESULTS

During both tasks, there were no significant changes in onset differences in vastii muscles between the ovulatory and follicular phases. However, the amplitude ratio (VL/VMO) was significantly lower in the ovulatory phase compared to the follicular phase (P = .035 for rise tasks and .010 for rock tasks).

CONCLUSION

The menstrual cycle may affect some EMG parameters. These factors can be taken into account when planning sports and rehabilitation training programs.

Variability of apparent diffusion coefficient in the brain in women during follicular and luteal phases of the menstrual cycle

PURPOSE

To investigate the variability of apparent diffusion coefficient (ADC) in the brain in women during follicular and luteal phases of the menstrual cycle.

METHODS

The present study included 32 females of reproductive age with regular menstruation. The participants were divided into two groups as group 1: females in the follicular phase, and group 2: females in the luteal phase. The regions of interest were manually drawn on the structures of the T2-weighted images (frontal gray and white matter, parietal gray and white matter, temporal gray and white matter, occipital gray and white matter, cerebellar gray and white matter, caudate nucleus, putamen, thalamus, internal capsule, pons, cerebrospinal fluid (CSF) in the frontal and in the occipital horn of the lateral ventricle and CSF in the middle part of the lateral ventricle). ADC values were averaged for each patient. We used Kruskal-Wallis ANOVA for more than two groups but used Mann Whitney U test for comparison of ADC values between the group of 18 females in the follicular phase and the group of 14 females in the luteal phase.

RESULTS

No statistically significant differences were observed among the groups in terms of the ADC value of each neuroanatomic structure that was evaluated.

CONCLUSION

We did not determine a significant difference among volunteers at the two different phases of the menstrual cycle in terms of ADC values measured from different regions of the brain. However, although not statistically significant, ADC values measured from almost all parts of the brain were higher at the luteal phase than at the follicular phase.

MRI reveals menstrually-related muscle edema that negatively affects athletic agility in young women

Context

About 10% of Japanese female athletes are afflicted by menstrually-related edema, mainly in the lower limbs, and, with few studies on this problem, the effect on performance remains unclear.

Objective

To quantitatively evaluate fluid retention in the calf in female students over their menstrual cycle using magnetic resonance imaging (MRI) and to determine the relationship of MRI changes and athletic performance.

Design

The menstrual cycle was divided into 5 phases: menstrual, follicular, ovulatory, early luteal, and late luteal with sampling done in either morning (AM) or afternoon (PM) sessions. At each phase, MRI of the calf (7:00–8:00, 14:00–16:00), body composition and hormones (7:00–8:00), and athletic performance (14:00–16:00) were evaluated.

Participants

13 adult healthy Japanese female students with eumenorrhea.

Results

Estradiol levels decreased significantly in the menstrual phase and the follicular phase compared to the early luteal phase (P = 0.001, P = 0.024 respectively). Menstrual phase estradiol levels were significantly lower compared to the ovulatory phase (P = 0.015), and the late luteal phase (P = 0.003). Progesterone levels decreased significantly in the menstrual phase and the follicular phase compared to the ovulatory phase (P = 0.012, P = 0.009 respectively), the early luteal phase (both P = 0.007), and the late luteal phase (P = 0.028, P = 0.029 respectively), and it along with a significant decrease in the ovulatory phase compared to the early luteal phase (P = 0.010). AM T2 signals were significantly lower in the menstrual phase compared to the ovulatory phase (P = 0.043) but not other phases. PM T2 signals increased significantly in the menstrual phase compared to the follicular phase (P = 0.003), ovulatory phase (P = 0.009), and the late luteal phase (P = 0.032), and the difference between the AM and PM values increased significantly in the menstrual phase compared to the other 4 phases (P<0.01). A negative correlation between fluid retention and agility was observed.

Conclusion

In female students fluid retention during the menstrual phase could be a factor that influences athletic agility.

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.

Comparison between the lifestyles of university students with and without premenstrual syndromes

Introduction

Premenstrual syndrome is a common disorder in reproductive age and it is associated with decreased quality of life in women. In view of various factors contributing to outbreak of PMS (premenstrual syndrome) among women, the present study intended to compare lifestyles of university students with and without premenstrual syndromes living in dormitories of Qazvin University of Medical Sciences in 2015.

Methods

The descriptive cross-sectional study recruited 200 university students with and without PMS from students living in dormitories. Data were collected using questionnaires of premenstrual symptoms, questionnaires for diet, perceived stress, and unhealthy behavior. Data were analyzed using descriptive statistics, independent samples t-test, Mann-Whitney, Chi-square, and logistic regression in SPSS version 23.

Results

The results showed that nutrition style (p=0.001), perceived stress (p=0.001), and exposure to passive tobacco smoke (p=0.001) were different between the two groups. Logistic regression analysis showed that nutrition style (p=0.001, OR=0.861), exposure to passive tobacco smoke (p=0.008, OR=2.059), and stress (p=0.001, OR=1.088) were different in both groups.

Conclusion

The research results proved that lifestyle, especially healthy eating habits, and decreasing stress and unhealthy behavior can influence PMS. Therefore, interventions are recommended to improve PMS symptoms.

Abnormal Spontaneous Brain Activity in Women with Premenstrual Syndrome Revealed by Regional Homogeneity

Background: Previous studies have revealed that the etiologies of premenstrual syndrome (PMS) refer to menstrual cycle related brain changes. However, its intrinsic neural mechanism is still unclear. The aim of the present study was to assess abnormal spontaneous brain activity and to explicate the intricate neural mechanism of PMS using resting state functional magnetic resonance imaging (RS-fMRI). Materials and Methods: The data of 20 PMS patients (PMS group) and 21 healthy controls (HC group) were analyzed by regional homogeneity (ReHo) method during the late luteal phase of menstrual cycle. In addition, all the participants were asked to complete a daily record of severity of problems (DRSP) questionnaire. Results: Compared with HC group, the results showed that PMS group had increased ReHo mainly in the bilateral precuneus, left inferior temporal cortex (ITC), right inferior frontal cortex (IFC) and left middle frontal cortex (MFC) and decreased ReHo in the right anterior cingulate cortex (ACC) at the luteal phase. Moreover, the PMS group had higher DRSP scores, and the DRSP scores positively correlated with ReHo in left MFC and negatively correlated with ReHo in the right ACC. Conclusion: Our results suggest that abnormal spontaneous brain activity is found in PMS patients and the severity of symptom is specifically related to the left MFC and right ACC. The present findings may be beneficial to explicate the intricate neural mechanism of PMS.