The effects of nightwork on psychological changes during the menstrual cycle

This study investigated whether the temporal stress of working at night interferes with nurses' experience of different phases of the menstrual cycle Twenty-four, rotatmg-shift nurses recorded data on a hand-held computer at the start and end of each day and every 2 hours during their shifts for a period of 28 days The measures included a sleep diary, self-ratings of mood and symptoms, and two cognitive performance tasks Using a pooled time series analysis, it was found that some of the self-report measures showed a significant interaction between type of shift worked and menstrual cycle phase For example, alertness was found to be lower towards the end of the night shift during the premenstrual phase compared to other phase and shift combinations However, some of the measures showed only main effects of cycle phase or were nonsignificant Retrospective measures from a larger sample showed an association between the number of nights worked per year and duration of premenstrual and menstrual problems, and seventy of premenstrual problems The results suggest that nightwork may alter some aspects of nurses' psychological experience of the menstrual cycle     

Cardiovascular functioning during the menstrual cycle

Variations in cardiovascular functioning during the ‘normal’ menstrual cycle have been little researched. Resting‐blood pressures, resting‐heart rate, rate‐pressure product (RPP) and a derived index of fitness (Schneider Index) were monitored throughout natural, hormonally defined menstrual cycles. Volunteers were 26 women (20–48 years) who had regular (25–35 days) cycles. Their blood pressures and heart rate (at rest and according to Schneider’s protocol) were measured at the same time daily (Monday–Friday) for 5 weeks. Daily, early morning‐urine samples were assayed for sex hormones enabling accurate definition of cycle phase for each woman. Resting systolic‐blood pressure was significantly higher in the ovulatory phase (P<0·05) than in the follicular or luteal phases, but resting‐diastolic pressures did not differ significantly between phases. Resting‐heart rate was significantly higher in both ovulatory (P<0·01) and luteal (P<0·01) phases than in the menstrual and follicular phases. The Schneider Index was higher during the follicular phase than during the ovulatory (P<0·005) or luteal (P<0·01) phases, the RPP was higher during the ovulatory phase than during the bleeding (P<0·05) and follicular (P<0·005) phases. These findings provide a pattern of menstrual cycle‐related variation in cardiovascular functioning that can be related to established actions of the ovarian steroids.     

Sensory changes during the ovulatory phase of the menstrual cycle in healthy women.

This study compared the pain sensitivity in healthy women at the abdomen and lower back (presumed referral areas of menstrual pain), thigh and arm (control areas), in the menstrual, ovulatory, luteal and premenstrual phases of confirmed ovulatory cycles, with that of males. The pressure pain threshold (PPT) and pinch pain threshold (PiPT) was determined by an electronic pressure algometer, heat pain threshold (HPT) by a contact thermode and tactile threshold (TT) with von Frey hairs. The abdominal PPT was significantly lower in females in all menstrual phases as compared to the control sites ( p<0.0007). The abdominal and lower back HPT was significantly lower in females in all menstrual phases compared with control areas, and to the sites in males ( p<0.002). The TT was significantly reduced in females compared with males ( p< 0.013). There was no difference in the PiPT between females and males. In males, the HPT, PPT and TT were not different within any site. During the ovulatory phase, the HPT was significantly reduced at the abdomen and the PPT at the back compared with the menstrual, luteal and premenstrual phases (p<0.0002). There were no within-menstrual phase variations in the PiPT and TT at any site, or for the HPT and PPT at the control areas. The reduced thresholds in menstruating women may be due to the presence of latent uterine algogenic stimuli, and the increased levels of oestrogen and leuteinizing hormone at ovulation may enhance nociception by acting both at the peripheral and central level, resulting in the hypersensitivity changes at the abdomen and lower back areas.     

Homocysteine during the menstrual cycle in depressive women

BACKGROUND: Two possible factors that may have a causal relation with both depressive disorder and cardiovascular disease are elevated homocysteine and steroid hormones. Our previous study found significant changes in the plasma homocysteine concentration during the menstrual cycle in healthy women. The purpose of this study therefore was to test homocysteine in depressive women treated with fluoxetine during the menstrual cycle. MATERIALS AND METHODS: Thirteen premenopausal women suffering from mixed anxiety-depressive disorder and a control group of 15 healthy women were enrolled in this study. The homocysteine concentration was determined by high-performance liquid chromatography with fluorescence detection, and estradiol, progesterone and cortisol by RIA methods. RESULTS: We found significantly higher plasma homocysteine concentrations in the follicular phase than in the luteal phase of the menstrual cycle in both the depressive group (P < 0.003) and the controls (P < 0.0009). Moreover, the patient values of total homocysteine were significantly higher in the follicular phase (P < 0.03) and also in the luteal phase (P < 0.007) than the values of the controls. Estradiol and cortisol were significantly higher in the follicular phase of the patients compared with the control group. CONCLUSION: According to our results, women suffering from mixed anxiety-depressive disorder have not only significantly different concentrations of homocysteine in the follicular and luteal phase of the menstrual cycle but also higher plasma homocysteine compared with healthy women. More elevated homocysteine in the depressive than in the healthy premenopausal women points to the notion that psychological factors might be important when considering the homocysteine concentration.     

Urinary polyamine excretion during the menstrual cycle

Urinary polyamines were measured by a fluorometric thin-layer chromatographic technique in samples collected daily throughout a single menstrual cycle by each of 13 healthy women. Polyamine excretion fluctuated considerably, but excretion of putrescine, spermidine, and spermine combined was consistently greatest during menstruation, sometimes extending into the early follicular phase of the cycle. Enhanced excretion of polyamines was also noticed in many individuals at the approximate time of ovulation.     

Postural vasoconstriction in women during the normal menstrual cycle

1. Postural vasoconstriction in the foot was examined in 15 women during the menstrual, follicular and luteal phases of the menstrual cycle, and in 13 age-matched men on two separate occasions, in a constant-temperature environment (22 degrees C). 2. Skin blood flow was measured using laser Doppler flowmetry with the subject lying down, first with the foot maintained at heart level, then with the foot lowered passively 50 cm below the heart. In six of the women, at the time of experiment, serum oestradiol and progesterone were determined by radioimmunoassay. In four women and three men, foot swelling rate was also measured in the dependent foot using a strain gauge plethysmograph in addition to the postural changes in flow. At each visit, in all subjects, arterial blood pressure, heart rate, body temperature, foot skin temperature and body weight were also recorded. 3. The men showed no significant changes in all the variables assessed. In contrast, in women during the luteal phase diastolic and mean arterial pressures were significantly reduced, whereas heart rate, body temperature, foot skin temperature and body weight were significantly increased, as compared with the follicular and menstrual phases of the cycle. 4. During the follicular phase, when oestradiol concentration was high, there were significant reductions in dependent flow and foot swelling rate associated with a significantly augmented postural fall in flow, whereas during the luteal phase, when both oestradiol and progesterone levels were high, there were significant increases in dependent flow and foot swelling rate associated with a significantly impaired postural fall in flow.(ABSTRACT TRUNCATED AT 250 WORDS)     

Inflammatory and endothelial markers during the menstrual cycle

Background The menstrual cycle exhibits a pattern of repeated inflammatory activity. The present study aims to evaluate inflammatory and endothelial markers during the two phases of a menstrual cycle. Methods The study cohort consisted of 102 women with regular menstrual cycles. Inflammatory and endothelial markers (interleukin-6 [IL-6], pentraxin-3 [PTX-3], hs-C reactive protein [hs-CRP], sE-selectin, sP-selectin, intracellular and vascular cell adhesion molecules [ICAM-1 and VCAM-1] and cathepsins L, B and S) were measured during the early follicular and the late luteal phase of a normal menstrual cycle. Results Pentraxin-3 (PTX-3) and hs-CRP were significantly higher during the follicular phase compared to the luteal phase (p?p?=?0.025). The other inflammatory and endothelial markers, with the exception of cathepsin B, were higher, albeit not significantly, during the follicular phase. Conclusions Inflammatory activity, expressed mainly by members of the pentraxin family, is higher during the early follicular compared to the luteal phase. This could be associated to menstruation but the exact mechanisms behind this pattern are unclear and might involve the ovarian hormones or an effect on hepatocytes.     

Lack of association between changes in plasma leptin concentration and in food intake during the menstrual cycle

BACKGROUND: Changes in plasma leptin concentration and food intake occur during the menstrual cycle; because leptin regulates food intake, one could hypothesize that changes in plasma leptin concentration and in food intake are associated throughout the menstrual cycle. However, no data have ever been provided to support such a relationship. The aim of our study was to investigate, during the different phases of the menstrual cycle, (a) the changes in plasma leptin concentration and, if such changes were demonstrated, (b) the potential relationship between the changes in plasma leptin concentration and food intake. DESIGN: The study was designed as an observational study. The plasma leptin concentration was determined in 16 healthy, young women during different phases of the menstrual cycle. At the same time, the basal metabolic rate (BMR), respiratory quotient (RQ) and food intake (FI) were also determined. RESULTS: The plasma leptin concentration increased throughout the menstrual cycle (P < 0.01 for trend) and was significantly correlated with plasma progesterone concentration (r = 0.55, P < 0.007, for follicular phase, r = 0.58, P < 0.02, for the periovulatory period and r = 0.57, P < 0.02, for the luteal phase). No significant differences in BMR and fasting RQ throughout the different phases of the menstrual cycle were found. In contrast, FI significantly declined in the periovulatory phase. No significant correlations between BMR, RQ and FI values and fasting plasma leptin concentration at all menstrual phases were found. CONCLUSION: Changes in plasma leptin concentration and in food intake were found at different phases of the menstrual cycle. Nevertheless, no correlation among those parameters at any phase of the menstrual cycle was observed.     

Changes in blood pressure during the normal menstrual cycle.

1. Changes in blood pressure during the normal menstrual cycle are not well documented, and previous studies have given conflicting results. 2. Thirty normotensive women and ten mildly hypertensive women measured their blood pressure at home each morning for 6 weeks, under standardized conditions, using a UA-751 semi-automatic sphygmomanometer. All had normal menstrual cycles and subjects entered the study at different phases of the cycle. 3. Blood pressure was higher at the onset of menstruation than at most other phases of the cycle (systolic blood pressure, P less than 0.05; diastolic blood pressure, P less than 0.001). Adjusted diastolic blood pressure was higher in the follicular than in the luteal phase (mean difference 1.23 mmHg, P less than 0.001). Similarly, blood pressure was lower during days 17-26 than during the remainder of the cycle (adjusted mean difference in systolic blood pressure -0.65 mmHg, P = 0.07; adjusted mean difference in diastolic blood pressure -1.19 mmHg, P less than 0.001). 4. Similar patterns were seen in normotensive and hypertensive subjects, and changes in plasma 17 beta-oestradiol and progesterone concentrations were also similar in the two groups.     

Renal haemodynamics and extracellular homeostasis during the menstrual cycle

Renal haemodynamics and extracellular homeostasis during the menstrual cycle were studied in 14 healthy women (age 21-41 years) who were not taking oral contraceptives in the follicular (Period I) and luteal phase (Period II). The glomerular filtration rate [( 51Cr] EDTA clearance) and the effective renal plasma flow ([125I] hippuran clearance) increased from Period I to II by a median of 6.3% (95% confidence interval (CI): 0.6-9.2%) and 7.3% (95% CI: -0.4-22%) respectively. Serum sodium decreased from period I to II (p less than 0.01) by a median of 1 mmol/l (95% CI: -2.0 to -0.5 mmol/l) and the urinary excretion rate of potassium increased (p less than 0.02) from a median value of 35 mumol/min in Period I to 45 mumol/min in Period II. The extracellular fluid volume did not change between the two periods but the concentration of water in serum increased (p less than 0.05) from a median value of 91.7-92.0 g/100 g in Period II. Serum total protein and serum albumin both showed a borderline statistically significant decrease from Period I to II. The investigation demonstrated a number of physiological and biochemical changes from the follicular to the luteal phase, most of which in a lower scale mimic well known changes that occur during pregnancy.     

Renal haemodynamics and extracellular homeostasis during the menstrual cycle

Renal haemodynamics and extracellular homeostasis during the menstrual cycle were studied in 14 healthy women (age 21–41 years) who were not taking oral contraceptives in the follicular (Period I) and luteal phase (Period II). The glomerular filtration rate ([⁵¹Cr] EDTA clearance) and the effective renal plasma flow ([¹²⁵I] hippuran clearance) increased from Period I to II by a median of 6.3% (95% confidence interval (CI): 0.6–9.2%) and 7.3% (95% CI: -0.4–22%) respectively. Serum sodium decreased from period I to II (p<0.01) by a median of 1 mmol/l (95% CI: -2.0 to -0.5 mmol/l) and the urinary excretion rate of potassium increased (p<0.02) from a median value of 35 μmol/min in Period I to 45 μmol/min in Period II. The extracellular fluid volume did not change between the two periods but the concentration of water in serum increased (p<0.05) from a median value of 91.7–92.0 g/100 g in Period II. Serum total protein and serum albumin both showed a borderline statistically significant decrease from Period I to II. The investigation demonstrated a number of physiological and biochemical changes from the follicular to the luteal phase, most of which in a lower scale mimic well known changes that occur during pregnancy.     

不孕症患者子宫内膜运动功能的研究

目的：探讨不孕症患者子宫内膜运动功能的周期性变化规律。方法：应用经阴道超声对84例不孕症患者的卵泡早期、卵泡中期、卵泡晚期以及黄体早期的子宫内膜运动分别作连续3min检测并录像，再应用计算机媒体播放软件对图像进行放大、快速播放，观测并记录子宫内膜运动的类型、运动频率、运动速度等指标。结果：84例患者336次检测中，显示运动278次（82．74％），无运动51次（15．18％），图像显示不清7次（2．08％）。共检测到7种运动类型。卵泡早期及中期、晚期、黄体早期子宫内膜运动发生率逐渐增高（P〈O．05）。不同时期子宫内膜运动类型的构成比不同，4个时期子宫内膜运动均以Ⅰ型为主，且卵泡早期至黄体早期子宫内膜Ⅰ型运动比例逐渐增加fP〈0.05）。卵泡期Ⅰ型运动传播时间逐渐缩短，黄体早期则显著延长（P〈0．05）。卵泡早期、中期运动频率较卵泡晚期低，卵泡晚期运动频率较黄体早期高（P〈0．05）。结论：子宫内膜运动功能发生周期性变化。经阴道超声及计算机媒体播放软件能直观、有效的检测子宫内膜运动功能。     

Erythrocyte cation fluxes during the menstrual cycle in normal female subjects

1. Studies of erythrocyte cation transport mechanisms in vitro were performed on eight normotensive, premenopausal female subjects at the mid-points of the follicular and luteal phases of their menstrual cycles. Concurrent plasma concentrations of 17 beta-oestradiol, progesterone, aldosterone and renin activity were measured. 2. Ouabain-resistant, frusemide-resistant rubidium influx (an index of passive potassium diffusion) was significantly lower in the luteal than the follicular phase. 3. In further studies in four of the eight subjects, the mean rate constant of the rubidium influx measurement was also lower in the luteal than in the follicular phase. 4. There were no changes in Na+-K+ co-transport, sodium pump activity or intracellular cation concentrations throughout the cycle. 5. There was a tenfold fall in the mean plasma 17 beta-oestradiol/progesterone ratio, as well as increases in plasma aldosterone concentration and renin activity between the mid-follicular and mid-luteal phases. 6. We conclude that changes in plasma oestrogen/progesterone ratio during the menstrual cycle may be associated with alterations in passive potassium diffusion.     

Serotonin concentrations in plasma and variations during the menstrual cycle.

We used a specific and sensitive radioenzymatic method to establish a reference interval for the concentration of serotonin in platelet-poor plasma in 98 healthy volunteers (49 men, 49 women). The interval was 0-11 nmol/L with a median of 2.8 nmol/L. No difference in concentration in relation to sex or age was observed. In a group of eight very old volunteers (ages 86-92 years), however, concentrations were increased. In addition, we monitored the plasma concentrations of serotonin in 20 healthy women (ages 26-45 years) through two menstrual cycles. Periovulatory and premenstrual concentrations were greater than the serotonin concentration at the start of menstruation.     

Changes in skin blood flow during the menstrual cycle: the influence of the menstrual cycle on the peripheral circulation in healthy female volunteers

1. It is known that females have a lower skin perfusion than males. In women there are also differences in blood flow at different reproductive stages of their lives. As an initial investigation of the possible contribution of sex hormones to these differences, we studied skin and forearm blood flow during the natural changes in hormone levels which occur during the menstrual cycle. 2. Thirty-one healthy female volunteers were studied. The effect of a standardized finger cooling test (immersion of a gloved hand in a 16 degrees C water bath) on finger skin temperature and on laser Doppler flux in the finger, and forearm blood flow (strain gauge venous occlusion plethysmography) was assessed at four different times during one cycle: during menstruation, 1 day before ovulation, 2 days after ovulation and at the mid-luteal phase. Test days were determined by daily measurements of basal body temperature and were confirmed afterwards by determinations of serum luteinizing hormone, follicle-stimulating hormone, 17 beta-oestradiol and progesterone. 3. Peripheral skin circulation varied significantly within one menstrual cycle. The extremes were a mean finger skin temperature of 25.9 +/- 3.0 degrees C in the luteal phase compared with 28.4 +/- 3.7 degrees C in the pre-ovulatory phase (P = 0.002). The respective values for the mean laser Doppler flux were 18.4 +/- 10.9 compared with 29.2 +/- 16.4 arbitrary units (P = 0.003). 4. Baseline forearm muscle blood flow also varied significantly (P = 0.04) within one menstrual cycle, with low values in the menstrual phase compared with the other phases.(ABSTRACT TRUNCATED AT 250 WORDS)     

Perfusion changes with photic stimulation during two phases of the menstrual cycle: a pilot study comparing controls and true menstrual migraine patients

This pilot study investigated the effect of menstrual cycle phase (late luteal and mid-follicular) on cerebral perfusion changes during photic stimulation in both controls (n = 5) and true menstrual migraine patients (n = 5). No significant differences in resting baseline perfusion were observed between the two groups during either phase of the menstrual cycle. During the late luteal phase, changes in perfusion within the occipital lobe due to photic stimulation were similar for both groups. However, during the mid-follicular phase, occipital perfusion during visual stimulation decreased for controls but significantly increased for true menstrual migraine patients (P < 0.05). A two way repeated measures anova also demonstrated a significant difference between menstrual migraine patients and controls for photic activation (P < 0.05).     

Haemodynamic responses to psychosocial stress during the menstrual cycle.

1. The haemodynamic effects of hormonal changes during the menstrual cycle were examined in 11 normotensive women (age 20-46 years). The subjects were studied on days 2-8 (follicular phase) and days 18-26 (luteal phase) in a randomized order. A standardized mental stress test and a 24 h recording of ambulatory blood pressure and heart rate were performed. 2. Pre-stress resting levels of heart rate and blood pressure were similar during the two phases of the menstrual cycle. 3. During mental stress, the heart rate response was significantly greater during the luteal phase than during the follicular phase (14.7 versus 9.7 beats/min; P less than 0.05). 4. Blood pressure, plasma catecholamine concentrations and subjective stress experience increased significantly in response to stress, without any significant differences between the two phases. 5. During 24 h ambulatory monitoring, higher levels of systolic blood pressure and heart rate were observed in the luteal phase than in the follicular phase (P less than 0.005 and P less than 0.0001, respectively). 6. These data indicate that cyclic variations in female sex hormones not only affect systolic blood pressure and heart rate, but also alter the haemodynamic responses to psychosocial stress.