Blog of the Society for Menstrual Cycle Research

New Research Indicates Link between Early Menarche and Endometriosis

March 11th, 2010 by Elizabeth Kissling

Drawing of uterine cross-section indicating endometriosis.In a controlled study of 268 Australian women with surgically confirmed moderate-to-severe endometriosis (cases) and 244 women without endometriosis (controls), researchers found that characteristics of a woman’s early menstrual cycles were associated with later development of endometriosis. Data showed those who did not start their menstrual cycle until after they turned 14 had a significantly reduced risk of later developing endometriosis.

Duration of the cycle, intensity of flow, and preferred choice of menstrual product showed no association with endometriosis.

The results are published in the American Journal of Obstetrics and Gynecology, December 2009. You can read the abstract here.

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Is PMDD Genetic?

March 9th, 2010 by Elizabeth Kissling

White lab mouse sitting in a gloved palm.

Guest Post by Amber Steele, University of Cambridge

There have been a couple of stories in the press recently touting a study by Joanna Spencer and colleagues suggesting that PMDD may be genetic. I had a cursory look through the paper and read the article. Changes in dendritic branching of neurons in the limbic system across the menstrual cycle, owing to changes in estrogen, has been well documented in the female mice and rat. Additionally, changes in neuronal activity and accompanying receptor activity is also well document during periods of hormone change, again in the female mice and rat models. Individual differences in how this change occurs and the fact that it can be linked to differences in genes make sense. It seems that Spencer et al., have identified one of probably many genes that mediates these differences. This is not the first time that a gene of this kind has been identified or implicated. For example, Susan Girdler at Chapel Hill has done some interesting work on PMDD and suggests a genetic i.e., differing protein response to a hormone, difference in response to progesterone that might, in part, explain symptoms associated with PMDD.

The fact that Spencer et al., found a relationship to anxious behavior does not say anything conclusively about PMS or PMDD. It only states that if you have this variant then your levels of anxiety may change as estrogen fluctuates.

The news article is exploiting the findings from the Spencer study to construct a simplistic view of varying responses to hormone change within and across women. I suppose the author of the news article thought it might be interesting to examine the debate on whether or not there is a “clinically disordered” state during the luteal phase of the menstrual cycle in some women and whether it should be recognized officially. While it may do this, it also perpetuates misunderstandings and stereotypes about women’s hormones and their emotional states.

Amber Steele is a graduate student at the University of Cambridge with a biomedical background. She is writing a thesis is on wellbeing over the menstrual cycle and how it relates to hormonal “biomarkers” cortisol and progesterone.

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Of Hot Flushes, Lie Detectors, and Stress

March 7th, 2010 by Elizabeth Kissling

Guest Post by Jerilynn C. Prior, Centre for Menstrual Cycle and Ovulation Research

A hot flush causes failure on a lie detector test! The same galvanic skin response (in simple terms—clammy skin) is positive in both. Why? Because—with every flush—there is massive dogs’ breakfast of neurotransmitters and brain stress hormones released. These are the same brain chemicals that are produced as we struggle to create a plausible falsehood. Both arise from a fundamental, brain pathway that mediates both our physical and emotional responses to “threats” (be they nutritional, emotional, physical or some combination of stressors).

Some years ago a psychologist from London Ontario showed that menopausal women’s hot flushes were increased by stressful environment (1). Menopausal women who regularly experienced eight hot flushes a day attended two randomly-ordered 4-hour sessions a week apart. During the sessions they had flushes objectively documented by galvanic skin response. When they were forced to experience a chaotic environment, loud noises, unpleasant videos and bright lights, each of these women experienced more hot flushes; they did not in the alternative calm and pleasant session (1). Likewise, the large Study of Women Across the Nation showed that perimenopausal women who reported “trouble paying for basics” (like food and shelter) had more hot flushes than did those with economic and social security (2).

What do men know about birth control and periods?

March 4th, 2010 by Elizabeth Kissling

Here’s a hint: the title of the new study by the National Campaign to Prevent Teen and Unplanned Pregnancy is How Misperceptions, Magical Thinking, and Ambivalence Put Young Adults at Risk for Unplanned Pregnancy.

The study [PDF] surveyed American singles ages 18–29 about their perceptions about and use of contraception. Twenty-eight percent of young men think that wearing two condoms at a time is more effective than just one. Twenty-five percent think that women can prevent pregnancy by douching after sex. Eighteen percent believe that they can reduce the chance of pregnancy by doing it standing up.

A staggering 42% of men and 40% of women believe that the chance of getting pregnant within a year while using the birth control pill is 50% or greater (despite research suggesting that the pill is typically 92% effective).

And many unmarried young adults believe they are infertile. Although available data suggest that about 8.4% of women 15–29 have impaired fecundity (measured as an inability to conceive or carry a baby to term): 59% of women and 47% of men say it is at least slightly likely they are infertile (19% of women and 14% of men describe it as quite or extremely likely.

In a very good short essay about the study at The Sexist, Amanda Hess links men’s lack of knowledge about contraception to their lack of knowledge about menstruation and physiology more generally, and illustrates with some telling anecdotes. There are a few more examples in the video at right, in which Amanda corners several men and asks them to explain how hormonal birth control works.

It all seems quite shocking, until one remembers that abstinence-only sex education that includes lessons about the ineffectiveness of condoms and other contraceptives has been standard in the U.S. since 1996. (See here for U.S. Government definitional criteria for abstinence-only sex education. At present, 22 states have opted out of receiving federal funding, so that they may provide accurate and comprehensive sex education.)

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New Technique for Management of Hot Flashes

March 4th, 2010 by Elizabeth Kissling

The Indianapolis Star has a short interview today with Professor Janet S. Carpenter of Indiana University’s School of Nursing. Dr. Carpenter is conducting a study of whether menopausal women can control hot flashes through breathing techniques.

She told the Star:

Breathing techniques are something nurses use all the time. After surgery, we teach patients to inhale and take deep breaths to clear the lungs of anesthesia. We also teach patients slow, deep breathing to decrease anxiety. Because the study is blinded, I can’t talk specifically about what the two breathing programs are.

Some research seemed to show that it helped hot flashes. We actually think breathing techniques change a woman’s physiology so she will have fewer hot flashes, and if she has the same number of hot flashes, she will cope with them better.

I’ll look forward to seeing the results of her study (maybe I can talk her into presenting them at the next meeting of the Society for Menstrual Cycle Research!). If her hypothesis is correct, we’ll have an easy, cheap, and medication-free method for helping women cope with the discomfort of hot flashes.


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Cervical Cancer Vaccine NOT Recommended for Older Women

March 2nd, 2010 by Elizabeth Kissling
HPV virus magnified.

HPV virus magnified.

Although it pains me to see how low the threshold is for defining “older women” in this research, I am glad to see that the findings of this longitudinal study confirm that the HPV vaccine is of little to no benefit to older women. The study was published in Journal of the National Cancer Institute last month.

In a 7-year population-based cohort study in Costa Rica, the researchers looked at more than 9000 women in four age groups: ages 18–25, 26–33, 34–41, and ≥42 years to assess whether women’s age and the duration of carcinogenic HPV infections influenced subsequent persistence of infection and risk of cervical cancer. They found that regardless of the woman’s age, newly detected infections were associated with very low absolute risks of persistent infection or cancer.

Although cervical cancer is more common in older women, it usually develops many years – even decades – after exposure to a carcinogenic virus. The research team found that the rate of newly detected infections dropped with age — to 13.5 percent in women 42 and older, from 35 percent in women 18 to 25. In younger and older women alike, new infections generally cleared up without treatment.

The researchers concluded that the potential benefitof prophylactic vaccination or frequent HPV screening to prevent or detect new carcinogenic HPV infections is low in women aged 34 years and older.

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Menstruation, Menopause, and HIV

March 1st, 2010 by Elizabeth Kissling

Menopausal women seeking relief from hot flash in front of electric fan.

POZ magazine and poz.com claim to be the leading publication and website in the U.S. about HIV/AIDS. The March 2010 issue has a great article by Suzanne Bopp about menstruation, menopause, and HIV. As with medical and cultural knowledge about HIV itself, understanding of how HIV affects menstruation continues to evolve. Irregular menstruation is a common complaint of women with HIV, but

“[Today] we have a better grasp of factors associated with abnormal menstrual cycles: substance abuse, AIDS, wasting disease—it relates more to overall nutritional status,” says Kristine Patterson, MD, clinical assistant professor at the University of North Carolina School of Medicine in Chapel Hill. “If the body doesn’t have enough fat, production of estrogen and progesterone shuts down,” Patterson says. This can happen anytime a woman loses too much weight, and it is exacerbated by advanced HIV disease, which causes the body to burn calories more rapidly.

. . . .

Researchers do know, however, that female hormones affect the virus—and that sex hormones generally have an impact on immunity. “We know that where a premenopausal woman is in her menstrual cycle affects her infectiousness,” Patterson says. “Estrogen plays a role—not only in HIV and the interplay of HIV and meds, but also in [the likelihood of] women transmitting and acquiring HIV.” Estrogen’s role may explain why women progress to AIDS at lower viral loads than men.

Highly recommended. Read the whole thing.


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Pain Don’t Hurt

February 25th, 2010 by Elizabeth Kissling

A small study recently published in the European Journal of Pain found that women’s sensitivity to pain does not appear to be increased by the menstrual cycle. The study did not assess perceptions of menstrual pain, but measured pain sensitivity to cold pressor, heat, and ischemic pain at different points throughout the cyle: the early follicular, late follicular, and luteal phases. Men were also tested three times, controlling for number of days between testing sessions. The researchers found that the phase of the menstrual cycle did not affect women’s pain sensitivity, nor did it affect gender differences in pain. (Contrary to popular belief, research indicates that in general, healthy women are more sensitive to pain than healthy men.)

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The Cloth Pad Gets Around the African Continent

February 17th, 2010 by Chris Bobel

Ghana girls_with kitsWe at re: Cycling have been tracking the African-girls-miss-school-because-they-menstruate equation  for a while now.

Specifically, we’ve questioned the assumption that menstrual FLOW management is girls’ biggest menstrual problem  (it is not, says at least one recent study–cramps are!). And we’ve been  MORE critical of so-called altruistic solutions that are, underneath the (silent?) disposable wrapper,  little-more than consumer socialization. Menstrual shame, sexism and poverty are not ameliorated though the cultivation of brand loyalty. Girls need information, support and the tools to develop awareness of their bodies while learning to live sustainably–this does not come in the shape of a box of single-use products that ends up clogging landfills.

Making green products available to girls while supporting economic growth and self-sufficiency in the Global South seems a more enduring and girl-centered initiative and there are number of projects that are doing just that. There Elizabeth Scharpf’s SHE initaitive in Rwanda and Lunapads donation program in collaboration with a number of related initiatives:

Book Review: The Modern Period

February 8th, 2010 by Elizabeth Kissling

If I correctly understand the terms of SHM’s copyright agreement with Oxford University Press, I am permitted to publish this unedited version of my review as a “pre-print” article. The final version will be available only from Social History of Medicine.

Lara Freidenfelds, The Modern Period: Menstruation in Twentieth Century America, Baltimore: Johns Hopkins University Press, 2008. Pp. 242. £31/$60. ISBN 978 0-8018 9245 5.

Book cover: The Modern Period by Lara Freidenfelds Lara Freidenfelds, an historian currently teaching in Women’s Studies at Wellesley College, has written a thorough and engaging history of menstruation in twentieth century USA. Her title, The Modern Period, is more than a succinct description; it cleverly references her discussion throughout of how advancing Progressive values shaped beliefs and practices surrounding menstruation. These Progressive values included faith in scientific rationality, belief in the value of education, and unqualified endorsement of technological progress. The ‘modern period’ also references the evolution of menstrual management practices into a coherent whole and the movement away from practices and beliefs considered old-fashioned, such as worries about catching a chill or the use of cloth pads. Her analysis throughout addresses the class implications of modernization; that is, the perceived need to adopt modern practices of bodily presentation and self-control for class mobility. Such modernization, asserts Friedenfelds, is a key component of Americans’ ability to see themselves as middle-class across great gaps in education and income.

Another Risk Associated with Hormone Therapy

February 7th, 2010 by Elizabeth Kissling

A study to be published in the British Medical Journal’s Thorax,* which focuses on respiratory medicine, finds that estrogen-only hormone treatment for menopause symptoms is associated with higher risk of asthma. The study involved nearly 58,000 women over 12 years. The researchers compared women who had never used any form of hormone treatment, women who used estrogen plus progestin, and women who used estrogen only treatment.Cartoon drawing of human lungs

The women who had used hormone treatments were 21% more likely to develop asthma; those who had used estrogen-only treatments showed a 54% higher overall risk of asthma.

Asthma is generally more common in young women after menarche, and more severe in women than in men.

*Neither the study nor the abstract appear to be available online.

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‘Baby Brain’ Is a Myth

February 5th, 2010 by Elizabeth Kissling
Mama and baby elephant in Masai Mara National Reserve, Kenya

Mama and baby elephant in Masai Mara National Reserve, Kenya

When new moms are sometimes forgetful or spacey, it is often attributed to ‘baby brain’ or ‘mumnesia’ or some other clever appellation that reinforces the idea that pregnancy leads to memory loss. It’s another variation on the women-are-ruled-by-hormones meme. In my humble opinion, the sleep deprivation that often accompanies late pregnancy and life with a newborn is a far more likely cause of memory loss.

While the research team at the Centre for Mental Health Research of the Australian National University didn’t investigate my theory, their research found no evidence that pregnancy or motherhood affects women’s brain power.

Professor Christensen’s team recruited 1,241 women aged 20-24 in 1999 and 2003 and asked them to perform a series of tasks. The women were followed up at four-year intervals and asked to perform the same cognitive tests. A total of 77 women were pregnant at the follow-up assessments, 188 had become mothers and 542 remained childless. The researchers found no significant differences in cognitive change for those women who were pregnant or new mothers during the assessments and those who were not.

The researchers suggest that previous findings that appear to confirm the ‘baby brain’ phenomenon are likely due to biased sampling. Their study, published in the British Journal of Psychiatry, was the first time women had been recruited from the general population before pregnancy.

[Via Skepchick]

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Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.