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Reproductive Biology and Endocrinology... Jan 2022Sleep is vital to human bodily function. Growing evidence indicates that sleep deprivation, disruption, dysrhythmia, and disorders are associated with impaired... (Review)
Review
Sleep is vital to human bodily function. Growing evidence indicates that sleep deprivation, disruption, dysrhythmia, and disorders are associated with impaired reproductive function and poor clinical outcomes in women. These associations are largely mediated by molecular-genetic and hormonal pathways, which are crucial for the complex and time sensitive processes of hormone synthesis/secretion, folliculogenesis, ovulation, fertilization, implantation, and menstruation. Pathologic sleep patterns are closely linked to menstrual irregularity, polycystic ovarian syndrome, premature ovarian insufficiency, sub/infertility, and early pregnancy loss. Measures of success with assisted reproductive technology are also lower among women who engage in shift work, or experience sleep disruption or short sleep duration. Extremes of sleep duration, poor sleep quality, sleep disordered breathing, and shift work are also associated with several harmful conditions in pregnancy, including gestational diabetes and hypertensive disorders. While accumulating evidence implicates pathologic sleep patterns in impaired reproductive function and poor reproductive outcomes, additional research is needed to determine causality and propose therapeutic interventions.
Topics: Female; Humans; Infertility, Female; Neurotransmitter Agents; Pregnancy; Prognosis; Reproduction; Risk Factors; Sleep; Sleep Quality
PubMed: 35042515
DOI: 10.1186/s12958-022-00889-3 -
Journal of Ethnopharmacology Jan 2024Ding-kun-dan (DKD), as one of well-known traditional Chinese medicine (TCM), is considered as an effective prescription to regulate menstruation, benefit Qi and nourish... (Randomized Controlled Trial)
Randomized Controlled Trial
ETHNOPHARMACOLOGICAL RELEVANCE
Ding-kun-dan (DKD), as one of well-known traditional Chinese medicine (TCM), is considered as an effective prescription to regulate menstruation, benefit Qi and nourish the blood. Previous studies had showed that DKD could improve sex hormone levels, insulin resistance, metabolism abnormalities and regulate immunity in animal models with polycystic ovary syndrome or endometriosis, however, little study conducted to reveal its clinical efficacy in Primary Dysmenorrhea (PD).
AIM OF THE STUDY
To compare the effect of Ding-kun-dan (DKD) with Marvelon on relief of symptoms and change of serum pain-related factors in patients with primary dysmenorrhea.
MATERIALS AND METHOD
136 patients with primary dysmenorrhea were randomly assigned to the DKD group (n = 73, take one tablet per day from 5th day of the menstrual cycle for 10 days every 28 days) and the Marvelon group (n = 63, take one tablet per day from 5th day of the menstrual cycle for 21 days every 28 days), the therapeutic effects were analyzed through evaluating the change of VAS scores, CMSS scores and the level of PGF, PGE, PGF/PGE and NO during the 12 weeks intervention.
RESULTS
Both DKD and Marvelon could effectively relief pain and other associated symptoms at each visit (Baseline, 4 week, 8 week and 12 week). Although Marvelon was significantly superior to DKD in reducing VAS scores, the total CMSS, CMSS severity and duration scores at each posttreatment follow-up (P < 0.01), VAS scores in the DKD group decreased significantly over time while scores in the COC group only dropped rapidly after the first two months of treatment. Efficacy gap between two interventions continuously narrowed over time and the efficacy of DKD became non-inferior at the 12 week compared to that of Marvelon (the difference between groups, - 0.78%; 95% confidence interval (CI), -13.67%-12.75%; non-inferiority margin, 15%). DKD group had better efficacy on mild pain compared to that of the COC group with no statistical difference (75% VS 61.9%, P > 0.05). DKD and Marvelon could effectively reduce PGF, PGE and higher PGF/PGE in patients with PD. There was no statistical difference in the level of PGF, PGE, PGF/PGE and NO between DKD and Marvelon group at each follow-up. No serious adverse effect was observed.
CONCLUSION
Ding-kun-dan is another available, effective and safe method for patients with primary dysmenorrhea to choose, especially for those who are suffered from mild pain and/or contraindicated to hormonal agents.
Topics: Female; Humans; Desogestrel; Dinoprostone; Double-Blind Method; Dysmenorrhea; Endometriosis; Medicine, Chinese Traditional; Prospective Studies
PubMed: 37517569
DOI: 10.1016/j.jep.2023.116975 -
Proceedings of the National Academy of... Jul 2021The contraceptive effect of breastfeeding remains essential to controlling fertility in many developing regions of the world. The extent to which this negative effect of...
The contraceptive effect of breastfeeding remains essential to controlling fertility in many developing regions of the world. The extent to which this negative effect of breastfeeding on ovarian activity is sensitive to ecological conditions, notably maternal energetic status, has remained controversial. We assess the relationship between breastfeeding duration and postpartum amenorrhea (the absence of menstruation following a birth) in 17 World Fertility Surveys and 284 Demographic Health Surveys conducted between 1975 and 2019 in 84 low- and middle-income countries. We then analyze the resumption of menses in women during unsupplemented lactation. We find that a sharp weakening of the breastfeeding-postpartum amenorrhea relationship has globally occurred over the time period analyzed. The slope of the breastfeeding-postpartum amenorrhea relationship is negatively associated with development: higher values of the Human Development Index, urbanization, access to electricity, easier access to water, and education are predictive of a weaker association between breastfeeding and postpartum amenorrhea. Low parity also predicts shorter postpartum amenorrhea. The association between exclusive breastfeeding and maintenance of amenorrhea in the early postpartum period is also found in rapid decline in Asia and in moderate decline in sub-Saharan Africa. These findings indicate that the effect of breastfeeding on ovarian function is partly mediated by external factors that likely include negative maternal energy balance and support the notion that prolonged breastfeeding significantly helps control fertility only under harsh environmental conditions.
Topics: Adolescent; Adult; Africa South of the Sahara; Amenorrhea; Asia; Breast Feeding; Contraception; Female; Humans; Middle Aged; Postpartum Period; Pregnancy; Socioeconomic Factors; Young Adult
PubMed: 34253613
DOI: 10.1073/pnas.2025348118 -
Headache Mar 2023In this prospective cohort study, characteristics of perimenstrual and non-perimenstrual migraine attacks in women were compared with migraine attacks in men.
OBJECTIVE
In this prospective cohort study, characteristics of perimenstrual and non-perimenstrual migraine attacks in women were compared with migraine attacks in men.
BACKGROUND
Women report longer migraine attacks and more accompanying symptoms than men in cross-sectional questionnaire studies, but this has not been confirmed in longitudinal studies. Supposed differences could result from different characteristics specific to perimenstrual migraine attacks, or of attacks in women in general.
METHODS
This cohort study was performed among patients with migraine who were treated at the Leiden Headache Clinic. We assessed differences in migraine attack characteristics between men and women who were prospectively followed by a previously validated electronic headache diary. The primary outcome was "attack" duration. Differences between perimenstrual (Days -2 to +3 of the menstrual cycle) and non-perimenstrual attacks in women versus attacks in men were corrected for age, chronic migraine, and medication overuse headache.
RESULTS
A total of 1347 women and 284 men were included, reflecting the preponderance of women in migraine prevalence. Crude median (first and third quartile [Q1-Q3]) attack duration in men was 32.1 [17.7-53.6] h, compared to 36.7 [21.9-62.4] h for non-perimenstrual migraine attacks and 44.4 [17.9-79.0] h for perimenstrual migraine attacks in women. After correction for confounding, perimenstrual migraine attacks were 1.62 (95% confidence interval [CI] 1.47-1.79; p < 0.001) and non-perimenstrual 1.15 (95% CI 1.05-1.25; p = 0.003) times longer compared to migraine attacks in men. The mean relapse percentage in men was 9.2%, compared to 12.6% for non-perimenstrual migraine attacks, and 15.7% for perimenstrual migraine attacks. Relapse risk was greater for perimenstrual (odds ratio [OR] 2.39, 95% CI 1.93-2.95; p < 0.001), but not for non-perimenstrual (OR 1.18, 95% CI 0.97-1.45; p = 0.060) attacks. Migraine attacks in women were more often accompanied by photophobia, phonophobia, and nausea, but less often aura.
CONCLUSION
Compared to attacks in men, both perimenstrual and non-perimenstrual migraine attacks are of longer duration and are more often accompanied by associated symptoms. A sex-specific approach to migraine treatment and research is needed.
Topics: Humans; Female; Male; Cohort Studies; Prospective Studies; Sex Characteristics; Cross-Sectional Studies; Migraine Disorders; Longitudinal Studies; Headache
PubMed: 36942410
DOI: 10.1111/head.14488 -
Human Reproduction (Oxford, England) Mar 2021Does endometrium harbour functionally active microorganisms and whether the microbial composition differs between proliferative and mid-secretory phases?
STUDY QUESTION
Does endometrium harbour functionally active microorganisms and whether the microbial composition differs between proliferative and mid-secretory phases?
SUMMARY ANSWER
Endometrium harbours functionally alive microorganisms including bacteria, viruses, archaea and fungi whose composition and metabolic functions change along the menstrual cycle.
WHAT IS KNOWN ALREADY
Resident microbes in the endometrium have been detected, where microbial dysfunction has been associated with reproductive health and disease. Nevertheless, the core microorganismal composition in healthy endometrium is not determined and whether the identified bacterial DNA sequences refer to alive/functionally active microbes is not clear. Furthermore, whether there are cyclical changes in the microbial composition remains an open issue.
STUDY DESIGN, SIZE, DURATION
RNA sequencing (RNAseq) data from 14 endometrial paired samples from healthy women, 7 samples from the mid-secretory phase and 7 samples from the consecutive proliferative phase were analysed for the microbial RNA sequences.
PARTICIPANTS/MATERIALS, SETTING, METHODS
The raw RNAseq data were converted into FASTQ format using SRA Toolkit. The unmapped reads to human sequences were aligned to the reference database Kraken2 and visualised with Krona software. Menstrual phase taxonomic differences were performed by R package metagenomeSeq. The functional analysis of endometrial microbiota was obtained with HUMANn2 and the comparison between menstrual phases was conducted by one-way ANOVA. Human RNAseq analysis was performed using miARma-Seq and the functional enrichment analysis was carried out using gene set enrichment analysis (GSEA; HumanCyc). The integration of metabolic pathways between host and microbes was investigated. The developed method of active microbiota mapping was validated in independent sample set.
MAIN RESULTS AND THE ROLE OF CHANCE
With the novel metatranscriptomic approach, we mapped the entire alive microbiota composing of >5300 microorganisms within the endometrium of healthy women. Microbes such as bacteria, fungi, viruses and archaea were identified. The validation of three independent endometrial samples from different ethnicity confirmed the findings. Significant differences in the microbial abundances in the mid-secretory vs. proliferative phases were detected with possible metabolic activity in the host-microbiota crosstalk in receptive phase endometrium, specifically in the prostanoid biosynthesis pathway and L-tryptophan metabolism.
LARGE SCALE DATA
The raw RNAseq data used in the current study are available at GEO GSE86491 and at BioProject PRJNA379542.
LIMITATIONS, REASONS FOR CAUTION
These pioneering results should be confirmed in a bigger sample size.
WIDER IMPLICATIONS OF THE FINDINGS
Our study confirms the presence of active microbes, bacteria, fungi, viruses and archaea in the healthy human endometrium with implications in receptive phase endometrial functions, meaning that microbial dysfunction could impair the metabolic pathways important for endometrial receptivity. The results of this study contribute to the better understanding of endometrial microbiota composition in healthy women and its possible role in endometrial functions. In addition, our novel methodological pipeline for analysing alive microbes with transcriptional and metabolic activities could serve to inspire new analysis approaches in reproductive medicine.
STUDY FUNDING/COMPETING INTERESTS
This work is supported by the Spanish Ministry of Economy, Industry and Competitiveness (MINECO) and European Regional Development Fund (FEDER): grants RYC-2016-21199 and ENDORE SAF2017-87526-R; FEDER/Junta de Andalucía-Consejería de Economía y Conocimiento: MENDO (B-CTS-500-UGR18) and by the University of Granada Plan Propio de Investigación 2016 - Excellence actions: Unit of Excellence on Exercise and Health (UCEES) (SOMM17/6107/UGR). A.S.-L. and N.M.M. are funded by the Spanish Ministry of Science, Innovation and Universities (PRE2018-0854409 and FPU19/01638). S.A. has received honoraria for lectures from Merck. The funder had no role in this study.
Topics: Endometrium; Female; Humans; Menstrual Cycle; Menstruation; Microbiota; Sequence Analysis, RNA
PubMed: 33598714
DOI: 10.1093/humrep/deaa372 -
Journal of Clinical Medicine Feb 2024Gender-affirming hormone therapy (GAHT) is an important component in the process of transitioning for many transgender and gender-diverse (TGD) individuals. Multiple... (Review)
Review
Gender-affirming hormone therapy (GAHT) is an important component in the process of transitioning for many transgender and gender-diverse (TGD) individuals. Multiple medical organizations recommend fertility preservation counseling prior to initiation of GAHT; however, there remains little high-quality data regarding the impact of GAHT on fertility and reproductive function. A PubMed literature review was performed using Boolean search operators linking keywords or phrases such as "mouse", "rat", "primate", "animal model", "transgender", "gender", "estrogen", "testosterone", "fertility", and "fertility preservation". Recent research has produced a number of animal models of GAHT that utilize similar hormonal regimens and produce similar phenotypic results to those used and observed in human patients. Specific to testosterone(T)-containing GAHT, animals demonstrate loss of menstrual cyclicity with therapy, resumption of menses on cessation of therapy, suppression of gonadotropin levels, and physical changes such as clitoromegaly. Models mimicking GAHT for transmasculine individuals in the peripubertal period demonstrate that pretreatment with GnRHa therapy does not modify the effects of subsequent T administration, which were similar to those described in adult models. Both models suggest promising potential for future fertility with cessation of T. With estradiol (E)-containing GAHT, animals exhibit decreased size of testicles, epididymis, and seminal vesicles, as well as ongoing production of spermatocytes, and seminiferous tubule vacuolization. Given the ethical challenges of conducting human studies in this area, high-fidelity animal models represent a promising opportunity for investigation and could eventually transform clinical counseling about the necessity of fertility preservation. Future studies should better delineate the interactions (if any exist) between treatment attributes such as dosing and duration with the extent of reversibility of reproductive perturbations. The development of models of peripubertal feminizing GAHT is an additional area for future work.
PubMed: 38398495
DOI: 10.3390/jcm13041183 -
Therapeutic Advances in Gastroenterology 2020Many female inflammatory bowel disease (IBD) patients report symptoms exacerbation before and during menses. Our aim was to characterize their symptoms and specific risk...
BACKGROUND AND AIM
Many female inflammatory bowel disease (IBD) patients report symptoms exacerbation before and during menses. Our aim was to characterize their symptoms and specific risk factors in comparison with healthy controls.
METHODS
Female IBD patients aged 18-50 years were asked to fill out a questionnaire recording their demographic and disease characteristics, menstruation history and symptoms. Disease activity was defined by Harvey-Bradshaw index (HBI) for Crohn's disease (CD) patients and modified mayo score for ulcerative colitis (UC) patients. Healthcare providers answering an internet survey assessing bowel symptoms during menstruation served as healthy controls.
RESULTS
A total of 139 IBD patients, of whom 100 were CD patients, filled the questionnaire. The mean age was 30.4 [±7.7 standard deviation (SD)], mean disease duration was 7.8 (±6 SD), mean HBI was 4.7 (±3.8 SD), and mean Mayo score was 2.1 (±2.5 SD). A change in bowel habits during menstruation was reported by 72% of CD patients compared with 56% of UC patients ( = 0.07). Out of 258 healthy controls, 93% reported a change in bowel habits during menstruation compared with 68% of IBD patients ( < 0.001). However, other abdominal and constitutional symptoms were significantly more prevalent among IBD patients compared with healthy controls ( < 0.01 for most parameters). Smoking status, biologic treatment, and previous abdominal operation were found to significantly aggravate symptoms during menses in IBD patients.
CONCLUSION
IBD patients experience various symptoms during menses significantly more commonly than healthy women. Smoking, biologic treatment, and previous abdominal operations are risk factors for higher symptomatic burden. Following future validation and research, these results can help in patients' risk stratification and possibly in risk reduction.
PubMed: 32577133
DOI: 10.1177/1756284820929806 -
BMC Women's Health Apr 2023Heavy menstrual bleeding (HMB) is associated with impaired quality of life and may signal serious health problems. Unresolved challenges in measuring menstrual bleeding...
BACKGROUND
Heavy menstrual bleeding (HMB) is associated with impaired quality of life and may signal serious health problems. Unresolved challenges in measuring menstrual bleeding and identifying HMB have hampered research and clinical care. Self-reported bleeding histories are commonly used but these may be influenced by recall bias, personal beliefs regarding "normal" flow volume, and the experience of other physical symptoms or disruptions to daily life. The potential usefulness of menstrual-tracking mobile applications, which allow real-time user-entered data recording, for assessing HMB has not been studied. We evaluated recall bias in reported period duration, the relationship of tracked period duration and daily flow volume to subsequently reported period heaviness, variation in quality of life associated with increasing period heaviness, and the advantages and limitations of using app-tracked data for clinical and research purposes.
METHODS
An online questionnaire was distributed to current users of Clue, a commercially available menstrual health tracking app, asking them to characterize their last period. We compared responses to the user's corresponding Clue app-tracked data. The study sample comprised 6546 U.S.-based users (aged 18-45 years).
RESULTS
Increasing reported heaviness was associated with increasing app-tracked period length and days of heavy flow, impaired quality-of-life (especially body pain severity), and disrupted activities. Of those reporting having had a heavy/very heavy period, ~ 18% had not tracked any heavy flow, but their period length and quality-of-life indicators were similar to those who had tracked heavy flow. Sexual/romantic activities were the most affected across all flow volumes. Compared to app-tracked data, 44% recalled their exact period length; 83% recalled within ± 1 day. Overestimation was more common than underestimation. However, those with longer app-tracked periods were more likely to underestimate period length by ≥ 2 days, a pattern which could contribute to under-diagnosis of HMB.
CONCLUSION
Period heaviness is a complex construct that encapsulates flow volume and, for many, several other bleeding-associated experiences (period length, bodily impairments, disruptions of daily activities). Even very precise flow volume assessments cannot capture the multi-faceted nature of HMB as experienced by the individual. Real-time app-tracking facilitates quick daily recording of several aspects of bleeding-associated experiences. This more reliable and detailed characterization of bleeding patterns and experiences can potentially increase understanding of menstrual bleeding variability and, if needed, help to guide treatment.
Topics: Female; Humans; Menorrhagia; Quality of Life; Mobile Applications; Menstruation; Surveys and Questionnaires
PubMed: 37041503
DOI: 10.1186/s12905-023-02312-4 -
Journal of Infection and Chemotherapy :... May 2023Although several studies have investigated the association between coronavirus disease 2019 (COVID-19) vaccines and the menstrual cycle, available data are limited....
INTRODUCTION
Although several studies have investigated the association between coronavirus disease 2019 (COVID-19) vaccines and the menstrual cycle, available data are limited. Therefore, this study investigated the effect of COVID-19 vaccines on the menstrual cycle and the effect of the menstrual cycle phase on the vaccine side effects during vaccine administration in Japan.
METHODS
A self-administered questionnaire was used to collect data on the date of vaccination; type of vaccine; type, grade, and duration of the side effects; regularity of menstruation; normal length of the menstrual cycle; and the day one date of menstruation around vaccination. The survey was conducted from October 2021 to March 2022.
RESULTS
The difference between the predicted and actual menstrual cycle length was 1.9 ± 3.0, 1.6 ± 2.8 (p = 0.557), and 2.5 ± 3.8 (p = 0.219) days before vaccination and after the first and second dose of the vaccine, respectively. In participants who received vaccinations twice within a single menstrual cycle, this difference was 1.3 ± 3.5 and 3.9 ± 3.3 (p = 0.045) days before and after vaccination, respectively. The grade and proportion of the side effects after the second dose of the vaccine was highest during the menstrual period and lowest during the ovulation period, with a significant effect on headache and chills.
CONCLUSION
COVID-19 vaccines tended to prolong the menstrual cycle. The side effects of the COVID-19 vaccine tended to be at a maximum when vaccination occurred during the menstrual period and minimal during the ovulation period.
Topics: Female; Humans; COVID-19 Vaccines; East Asian People; COVID-19; Menstrual Cycle; Menstruation; Vaccination
PubMed: 36623727
DOI: 10.1016/j.jiac.2023.01.003 -
European Review For Medical and... Dec 2022PSMD9 is a ubiquitous protein present at high concentrations in eukaryotic cells. It contributes to the degradation of intracellular proteins in the immune system. It is...
OBJECTIVE
PSMD9 is a ubiquitous protein present at high concentrations in eukaryotic cells. It contributes to the degradation of intracellular proteins in the immune system. It is part of the 26S proteasome complex, and its regulatory role on proteasomal activity as well as its effect on genetic transcription have been recognized. PSMD9 has been related with insulin secretion, and it regulates the ligand-dependent retinoid-target genes transcription. Importantly, PSMD9 rs74421874 (IVS3+nt460-G>A), rs3825172 (IVS3+nt437-C>T), and rs14259 SNPs have been previously linked to type 2 diabetes (T2D), maturity-onset diabetes of the young 3 (MODY3), overweight status and waist circumference, hypertension, hypercholesterolemia, cardiovascular disease, microvascular disease (retinopathy, neuropathy, and nephropathy), carpal tunnel syndrome, depression, anxiety, insomnia, and sleep hours.
MATERIALS AND METHODS
In this study, we analyzed the above-mentioned PSMD9 rs74421874 (IVS3+nt460-G>A), rs3825172 (IVS3+nt437-C>T), and rs14259 SNPs for linkage to the T2D quantitative traits of T2D age of onset, duration in years of combined oral hypoglycemic agents and insulin therapy and only insulin therapy, stress, and the birth weight of the subjects' children; and with the T2D qualitative phenotypes of irregular menses, couple infertility, and menopausal hot flashes.
RESULTS
We found that PSMD9 was linked to irregular menses of reproductive age, menopausal hot flashes, T2D age of onset, years of combined oral and insulin therapy and of insulin therapy; we also found that it shows only a tendency towards linkage to stress, birthweight, and couple infertility.
CONCLUSIONS
This is the first time that this gene is implicated with irregular menses of reproductive age (a trait of polycystic ovarian syndrome), hot flashes, T2D onset age, and duration years of combined oral and insulin therapy and only insulin therapies.
Topics: Humans; Age of Onset; Diabetes Mellitus, Type 2; Hot Flashes; Infertility; Insulin; Proteasome Endopeptidase Complex
PubMed: 36524506
DOI: 10.26355/eurrev_202212_30559