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Menopause (New York, N.Y.) Apr 2011Expression of tissue factor (TF), the primary initiator of coagulation, is enhanced in decidualized human endometrial stromal cells (HESC) during the... (Review)
Review
Expression of tissue factor (TF), the primary initiator of coagulation, is enhanced in decidualized human endometrial stromal cells (HESC) during the progesterone-dominated luteal phase. Progesterone also augments a second HESC hemostatic factor, plasminogen activator inhibitor-1 (PAI-1). In contrast, progestins inhibit HESC matrix metalloproteinase (MMP)-1, 3 and 9 expression to stabilize endometrial stromal and vascular extracellular matrix. Through these mechanisms decidualized endometrium is rendered both hemostatic and resistant to excess trophoblast invasion in the mid-luteal phase and throughout gestation to prevent hemorrhage and accreta. In non-fertile cycles, progesterone withdrawal results in decreased HESC TF and PAI-expression and increased MMP activity and inflammatory cytokine production promoting the controlled hemorrhage of menstruation and related tissue sloughing. In contrast to these well ordered biochemical processes, unpredictable endometrial bleeding associated with anovulation reflects absence of progestational effects on TF, PAI-1 and MMP activity as well as unrestrained angiogenesis rendering the endometrium non-hemostatic, proteolytic and highly vascular. Abnormal bleeding associated with long-term progestin-only contraceptives results not from impaired hemostasis but from unrestrained angiogenesis leading to large fragile endometrial vessels. This abnormal angiogenesis reflects progestational inhibition of endometrial blood flow promoting local hypoxia and generation of reactive oxygen species that increase production of angiogenic factors such as vascular endothelial growth factor (VEGF) in HESCs and Angiopoietin-2 (Ang-2) in endometrial endothelial cells while decreasing HESC expression of angiostatic, Ang-1. The resulting vessel fragility promotes bleeding. Aberrant angiogenesis also underlies abnormal bleeding associated with myomas and endometrial polyps however there are gaps in our understanding of this pathology.
Topics: Female; Humans; Menstruation; Metrorrhagia; Thromboplastin
PubMed: 21499503
DOI: 10.1097/GME.0b013e31820bf288 -
Biology of Reproduction May 2020Here we have summarized what is currently known about menstruating animal species with special emphasis on non-primate species: length of their menstrual cycle,... (Review)
Review
Here we have summarized what is currently known about menstruating animal species with special emphasis on non-primate species: length of their menstrual cycle, ovulation, implantation, placentation, decidualization, and endometrial characteristics. Having an overview of all the possible animal models that can be used to study menstruation and the menstrual cycle could be useful to select the one that better matches the needs of the individual research projects. The most promising species to study menstruation seems to be the spiny mouse Acomys cahirinus. It is a rodent that could be easily held in the existing laboratory facilities for rats and mice but with the great advantage of having spontaneous menstruation and several human-like menstrual cycle characteristics. Among the species of menstruating bats, the black mastiff bat Molossus ater and wild fulvous fruit bat Rousettus leschenaultii are the ones presenting the most human-like characteristics. The elephant shrew seems to be the less suitable species among the ones analyzed. The induced mouse model of menstruation is also presented as an adaptable alternative to study menstruation.
Topics: Animals; Endometrium; Female; Humans; Menstrual Cycle; Menstruation; Models, Animal
PubMed: 32129461
DOI: 10.1093/biolre/ioaa029 -
International Journal of Environmental... Nov 2023Period poverty is a global issue that needs to be addressed as a public health crisis. It is directly related to Sustainable Health Goals three, four, five, six, and... (Review)
Review
Period poverty is a global issue that needs to be addressed as a public health crisis. It is directly related to Sustainable Health Goals three, four, five, six, and eight. Period poverty adversely affects the health of anyone capable of menstruating, which is nearly half of the world population, at the physiological, emotional, and psychosocial level. Biases, cultural beliefs, ethical reproductive justice issues, social stigma, and systemic factors contribute to period poverty. Every month, certain menstruators are disproportionately impacted by period poverty and struggle to access basic hygienic necessities. Important stakeholders include not only the individual who experiences menses but also educators and school systems, healthcare professionals, policymakers, public health officials, and researchers. Everyone has a role in addressing period poverty by voting for officials that proactively support legislation, policy, and programs at all levels to effectively advocate for menstrual equity and address barriers contributing to period poverty. This includes policies that increase access to menstrual hygiene products, safe menstrual management methods, and reproductive and women's health education. Programs globally that focus on capacity building and sustainability strategies can be used as models to reduce period poverty, thereby fostering a sense of empowerment and menstruators' sense of autonomy, dignity, and equality.
Topics: Female; Humans; Menstruation; Public Health; Hygiene; Schools; Poverty; Health Knowledge, Attitudes, Practice
PubMed: 38063548
DOI: 10.3390/ijerph20237118 -
British Medical Journal Apr 1964
Topics: Female; Humans; Menstruation; Personality; Personality Disorders
PubMed: 14113473
DOI: No ID Found -
BMC Medicine Dec 2023Preliminary evidence demonstrates some parameters of metabolic control, including glycaemic control, lipid control and insulin resistance, vary across the menstrual...
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.
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.
Topics: Female; Humans; Cholesterol, HDL; Cross-Sectional Studies; Biological Specimen Banks; Menstruation; Menstrual Cycle; Risk Factors; Insulin Resistance; Triglycerides; Glucose
PubMed: 38066548
DOI: 10.1186/s12916-023-03195-w -
BMC Women's Health Sep 2020Traditionally, menstrual education has consisted of lectures directed toward women. The objective of this study was to design an innovative menstrual education (ME)...
BACKGROUND
Traditionally, menstrual education has consisted of lectures directed toward women. The objective of this study was to design an innovative menstrual education (ME) program that reflects the needs of both young women and men, and verify its effectiveness.
METHODS
A mixed-method design was used to determine the program needs and assess young adults' knowledge and perceptions of menstruation and menstrual products. Focus group interviews were conducted with 14 young adults, and 150 young adults participated in an online survey. After developing the ME program, 10 young adults participated in a study to verify its effectiveness.
RESULTS
Interview results showed young adults wanted more information about menstrual products. The online survey revealed significant differences in knowledge based on participants' general characteristics and experience; exposure to menstruation and menstrual products positively impacted knowledge and perception. In addition, the results indicated young adults wanted ME content access via mobile and in-person modalities, designed for both genders, drawing on menstrual experts' knowledge. Based on these results, a multi-experimental menstrual education (MEME) program was designed and included: hands-on exposure to 60 menstrual products, product demonstrations with a female perineal model, a YouTube video created by the researchers, a true-or-false quiz, and question-and-answer sessions with menstrual experts.
CONCLUSIONS
This study clarified the requirements of an innovative menstrual education program. It led to high satisfaction among participants, and improved knowledge and perceptions of menstruation and menstrual products. The online survey showed a correlation between the extent of received ME, and respondents' perception of menstrual products. This implied that a MEME program could change perceptions when conducted systematically; by extension it could ameliorate menstruation challenges attributed to poverty. Future research could further verify the effectiveness of the MEME program, using a larger sample, and examine its suitability for incorporation into official ME curricula at universities and companies.
TRIAL REGISTRATION
This trial was registered in a Clinical Research Information Service in Korea linked with the World Health Organization's International Clinical Trial Registry Platform (WHO's ICTRP) (no. KCT0004715 ), Registered 07 Feb 2020.
Topics: Female; Focus Groups; Health Knowledge, Attitudes, Practice; Humans; Interviews as Topic; Male; Menstrual Hygiene Products; Menstruation; Perception; Qualitative Research; Republic of Korea; Sex Education; Young Adult
PubMed: 32993611
DOI: 10.1186/s12905-020-01007-4 -
Health Research Policy and Systems Jan 2021Progress has been made in recent years to bring attention to the challenges faced by school-aged girls around managing menstruation in educational settings that lack... (Review)
Review
Progress has been made in recent years to bring attention to the challenges faced by school-aged girls around managing menstruation in educational settings that lack adequate physical environments and social support in low- and middle-income countries. To enable more synergistic and sustained progress on addressing menstruation-related needs while in school, an effort was undertaken in 2014 to map out a vision, priorities, and a ten-year agenda for transforming girls' experiences, referred to as Menstrual Hygiene Management in Ten (MHM in Ten). The overarching vision is that girls have the information, support, and enabling school environment for managing menstruation with dignity, safety and comfort by 2024. This requires improved research evidence and translation for impactful national level policies. As 2019 marked the midway point, we assessed progress made on the five key priorities, and remaining work to be done, through global outreach to the growing network of academics, non-governmental organizations, advocates, social entrepreneurs, United Nations agencies, donors, and national governments. This paper delineates the key insights to inform and support the growing MHM commitment globally to maximize progress to reach our vision by 2024. Corresponding to the five priorities, we found that (priority 1) the evidence base for MHM in schools has strengthened considerably, (priority 2) global guidelines for MHM in schools have yet to be created, and (priority 3) numerous evidence-based advocacy platforms have emerged to support MHM efforts. We also identified (priority 4) a growing engagement, responsibility, and ownership of MHM in schools among governments globally, and that although MHM is beginning to be integrated into country-level education systems (priority 5), resources are lacking. Overall, progress is being made against identified priorities. We provide recommendations for advancing the MHM in Ten agenda. This includes continued building of the evidence, and expanding the number of countries with national level policies and the requisite funding and capacity to truly transform schools for all students and teachers who menstruate.
Topics: Adolescent; Child; Female; Global Health; Humans; Hygiene; Menstruation; School Health Services; Social Support
PubMed: 33388085
DOI: 10.1186/s12961-020-00669-8 -
Journal of Medicine and Life 2019During menstruation, endometrial hemostasis is achieved by platelet aggregation, fibrin deposition, and thrombus formation that interact with local endocrine and...
During menstruation, endometrial hemostasis is achieved by platelet aggregation, fibrin deposition, and thrombus formation that interact with local endocrine and immunological factors which cause termination of menstrual bleeding. Interactions between steroidal sex hormones and platelet functions are not well understood. The aim of this study was to evaluate the effect of platelet function during the menstrual cycle and luteal phase in women of reproductive age. The cross-sectional study on women of reproductive age included 44 healthy women. Platelet function was assessed by PFA-100TM analyzer with collagen/epinephrine and collagen/ADP cartridges during the menstrual cycle and luteal phase. There were no significant differences in platelet function between menstruation and ovulatory phase. Platelet activity in Arab collagen/epinephrine cartridge increased during menstruation compared to non-Arab ethnic subjects and no significant differences in platelet function were found when using collagen/ADP cartridge. This study suggested modulation in platelet functions during menstruation and luteal phase in women of reproductive age. Further studies, including a large number of subjects, platelet genetic and progesterone factors change in platelet clotting associated to menstrual cycle should be conducted.
Topics: Adult; Blood Platelets; Collagen; Cross-Sectional Studies; Epinephrine; Female; Humans; Menstruation; Ovulation; Premenopause
PubMed: 31666834
DOI: 10.25122/jml-2019-0005 -
PloS One 2016Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls. (Review)
Review
BACKGROUND
Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls.
OBJECTIVES
To summarise and critically appraise evidence for the effectiveness of menstruation management interventions in improving women and girls' education, work and psychosocial wellbeing in low and middle income countries.
METHODS
Structured systematic searches were conducted in peer-reviewed and grey literature to identify studies evaluating education and resource provision interventions for menstruation management. Individual and cluster randomised controlled trials were eligible for inclusion, as were non-randomised controlled trials. Study characteristics, outcomes and risk of bias were extracted using a piloted form. Risk of bias was independently assessed by two researchers.
RESULTS
Eight studies described in ten citations were eligible for inclusion. Studies were highly heterogeneous in design and context. Six included assessment of education-only interventions, and three provided assessment of the provision of different types of sanitary products (menstrual cups, disposable sanitary pads, and reusable sanitary pads). A moderate but non-significant standardised mean difference was found for the two studies assessing the impact of sanitary pad provision on school attendance: 0.49 (95%CI -0.13, 1.11). Included studies were heterogeneous with considerable risk of bias. Trials of education interventions reported positive impacts on menstrual knowledge and practices, however, many studies failed to assess other relevant outcomes. No trials assessed or reported harms.
CONCLUSIONS
There is insufficient evidence to establish the effectiveness of menstruation management interventions, although current results are promising. Eight trials have been conducted, but a high risk of bias was found and clinical heterogeneity precluded synthesis of most results. Whilst trials provided some indication of positive results, further research is needed to establish the role of menstruation hygiene management in education performance, employment and other psychosocial outcomes. This review provides a concise summary of present trials and highlights improvements for future work.
Topics: Education; Female; Humans; Hygiene; Income; Menstruation; Outcome Assessment, Health Care
PubMed: 26862750
DOI: 10.1371/journal.pone.0146985 -
International Journal of Environmental... Apr 2023Futsal performance has been extensively investigated in previous studies, demonstrating that the psychological state of the players or the playing position condition...
Futsal performance has been extensively investigated in previous studies, demonstrating that the psychological state of the players or the playing position condition performance. However, research with female indoor soccer players is scarce; therefore, menstruation has not been considered as a determinant aspect for performance in females. Previous research has shown the influence of menstruation on the psychological state and performance of players of different sports; however, there is no known research on female futsal players. For this reason, the aims of the present research were to establish the differences in pre-match psychological variables and offensive performance as a function of playing position, match result and menstruation. A total of 132 s division Spanish players participated in the research. All participants completed the Questionnaire of Psychological Needs of the Athlete-15, and their regular league matches were recorded and subsequently analyzed to determine their offensive performance. The results showed differences according to playing position: pivots and closers showed greater motivation than wings, while the pivots showed greater activation and shots on goal than the wings and closers. Regarding match results, pivots demonstrated more shots on goals than closers only when the match was lost. In addition, the motivation and activation of the pivots, as well as the number of shots on goal, were higher than that of the wings and closers only when they were not menstruating.
Topics: Female; Humans; Athletes; Athletic Performance; Household Articles; Menstruation; Soccer
PubMed: 37107711
DOI: 10.3390/ijerph20085429