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Wood, David. "Menstrual Disorder of the Adolescent." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7678.
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Parker, Melissa, and n/a. "The MDOT Study: Prevalence of Menstrual Disorder of Teenagers; exploring typical menstruation, menstrual pain (dysmenorrhoea), symptoms, PMS and endometriosis." University of Canberra. Health Sciences, 2006. http://erl.canberra.edu.au./public/adt-AUC20070813.161519.
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There are few data available about the menstrual patterns of Australian teenagers and
the prevalence of menstrual disorder in this age group.
Aims
To establish the typical experience of menstruation in a sample of 16-18 year
old women attending ACT Secondary Colleges of Education.
To determine the number of teenagers experiencing menstrual disorder that
could require further investigation and management.
Method
The MDOT questionnaire was used to survey participants about their usual pattern of
menstruation, signs and symptoms experienced with menses and how menstruation
affected various aspects of their lives including school attendance, completion of
school work, relationships, social, sexual and physical activity. Data analysis included
exploration of aggregated data, as well as individual scrutiny of each questionnaire to
determine menstrual disturbance requiring follow up. Those participants whose
questionnaire indicated a requirement for further investigation, and who consented to
being contacted, were followed up through an MDOT Clinic.
Results
One thousand and fifty one (1,05 1) completed questionnaires - 98% response rate.
The typical experience of menstruation in the MDOT sample includes: bleeding
patterns within normal parameters for this age group; menstrual pain, 94%; cramping
pain, 71 %; symptoms associated with menstruation, 98.4%; PMS symptoms, 96%;
mood disturbance before or during periods, 73%; school absence related to
menstruation, 26%; high menstrual interference on one or more life activity, 55.8%;
asymptomatic menstruation, 1 %; True response to 'My periods seem pretty normal'
7 1.4%.
Statistically significant associations were found between each and all of: menstrual
pain, symptoms, interference on life activities and school absence. The prevalence of
significant menstrual disturbance in the sample is approximately 25% where: 2 1 %
experienced severe pain; 26% reported school absence; 33% had seen a GP about
periods; 26.9% think there is something wrong with periods; 23.5% require follow up
based on individual scrutiny of each questionnaire; 10- 14% require further
investigation to rule out endometriosis. Referral and investigation of menstrual pain,
symptoms, and diagnosis of menstrual pathology in the sample was low.
Conclusion
The MDOT questionnaire has helped to establish a clearer picture of typical
menstruation in the population sample. Where 1% of girls reported having
asymptomatic menstruation, the majority of teenagers in the study reported menstrual
pain and symptoms that could be experienced as part of the dysmenorrhoeic syndrome
of symptoms, PMS, or underlying pathology such as endometriosis. Due to the
overlap in symptoms and a propensity to be dismissive of menstrual pain and
symptoms, many girls are suffering menstrual morbidities that could be well managed
with NSAIDs and the oral contraceptive pill (OCP) if non-pathological, or
investigated further if a menstrual pathology is suspected.
Considering these results the reported school absence rate of 26% is not surprising.
Whilst this study does not cost the true impact of menstrual disturbance on schooling,
the results of the MDOT questionnaire reflect significant physical and emotional
impact on a considerable number of teenager's lives which could also have
repercussions on education, schooling performance and other areas of their lives.
Future research is planned to determine the MDOT questionnaire's validity for
identifying pathological menstrual disorder so it can act as a screening tool to
facilitate earlier detection. Replication of the MDOT study should be done in younger
teenagers (from menarche) to determine menstrual disturbance in the younger age
group.
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Wiklund, Liselotte. "Premenstrual Dysphoric Disorder : A Review of Neural and Cognitive Changes in Women with PMDD." Thesis, Högskolan i Skövde, Institutionen för biovetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-14302.
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Around 3-8% of all women in reproductive age suffer from premenstrual dysphoric disorder (PMDD) which disenables them to live an ordinary life during the luteal phase (premenstrual phase) of the menstrual cycle. Throughout the premenstrual phase these women experience emotional, cognitive and physiological changes. Hitherto, the etiology of this disorder is unknown. Some consider the source of this state as non-biological, claiming that PMDD is a social construction imbedded in gender roles, that suggests that women should not show aggressive behavior or depressive mood unless it is during the premenstrual stage. Contradictory, research made in cognitive neuroscience claim that the origin is biological. It is assumed that the increased symptoms in women with PMDD is a result from dysfunctional sensitivity for the progesterone metabolite allopregnanolone that has a receptor in the GABAA system, hence, producing an anxious effect from high levels of allopregnanolone instead of the expected sedative, soothing effects. Research suggest that structural and functional changes occur in brain areas such as the hippocampus, parahippocampus, amygdala, cerebellum as well as in brainderived neurotrophic factor which is important for brain plasticity, growth and survival of neurons. Cognitive behaviors such as anticipation for negative stimuli, working memory and lack of cognitive control also seem to be affected by PMDD. Nonetheless, the evidence is inconsistent, the area of research face multiple issues in regards to study designs, hence making generalization at this point difficult. In sum, this essay reviews recent studies conducted in neuroscience of cognitive changes in women with PMDD, with focus on functional, structural and behavioral changes between the phases of the cycle.
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Kolbäck, Erika, and Annelie Bodin. "Ett liv med Premenstruellt dysforiskt syndrom : - en intervjustudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-253663.
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Bakgrund: PMDS är en relativt okänd diagnos. Det är en progression av Premenstruellt syndrom (PMS) men allvarligare och är ibland invalidiserande för den som lider utav det. Prevalensen av PMDS är cirka fem procent av alla fertila kvinnor. Syfte: Syftet var att undersöka hur kvinnor med diagnosen PMDS upplevde hur det är att leva med diagnosen, vilken behandling de provat samt bemötandet som de fått i kontakt med vården. Metod: För att kunna besvara syftet så valdes en kvalitativ studie i form av intervjuer. Detta för att få en utökad förståelse kring PMDS och vad sjukdomen innebär. Intervjuerna var semistrukturerade och sju kvinnor inkluderades i studien. Inklusionskriterierna för denna studie var kvinnor med diagnosen PMDS som har varit i kontakt med sjukvården och blivit diagnostiserade med sjukdomen. Intervjuerna analyserades med hjälp av innehållsanalys enligt Graneheim och Lundman (2004). Resultat: PMDS tycks fortfarande vara en relativt okänd diagnos inom sjukvården och en del av informanterna var inte nöjda med vården de mottagit medan andra haft tur och hittat rätt väg på en gång. Det är en svår diagnos att leva med som inkräktar på såväl vardagsliv som arbetsliv och alla mänskliga relationer. Informanterna anser att en utökad förståelse och hjälp från vården skulle underlätta deras leverne. Slutsats: Mer kunskap krävs inom både vården och för samhället i stort då detta är en allvarlig diagnos som behöver upptäckas i tid så dessa kvinnor kan få rätt hjälp. Det är livsavgörande att kvinnor med diagnosen PMDS får de verktyg de behöver för att kunna leva ett fullvärdigt liv.Background: PMDD is a relatively unknown diagnosis. There is a progression of Premenstrual Syndrome (PMS), but serious and sometimes debilitating for the sufferer out of it. The prevalence of PMDD is about five percent of all women of childbearing potential. Purpose: The purpose of this study was to examine how women diagnosed with PMDD experienced how it is to live with the diagnosis, the treatment they have tried, and the response they got in contact with health services. Method: A qualitative survey based on interviews was made in order to comprehend the diagnosis PMDS and its symptoms. Seven women participated in semi-structured interviews. The terms and conditions in this survey included women diagnosed with PMDS by and in contact with the health care system. The interviews were analyzed in accordance to Graneheim and Lundman’s content analysis. Results: The result indicated that PMDS is a relatively unknown condition within the health care system. Some of the informants were not pleased with the treatment given. Others received efficient treatment straight away. PMDS is burdensome to live with and it affects working life as well as social relations in common life. Conclusion: Acquaintance, both within the health care system and the society as a whole, is crucial for women diagnosed with PMDS. PMDS is a serious diagnosis which has to be discovered early in order to give these women efficient treatment. It is essential that women diagnosed with PMDS get efficient tools to handle their diagnosis in order to live vital lives.
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Timby, Erika. "Allopregnanolone effects in women : clinical studies in relation to the menstrual cycle, premenstrual dysphoric disorder and oral contraceptive use." Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-50058.
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Background: Premenstrual dysphoric disorder (PMDD) affects 3–8% of women in fertile ages. Combined oral contraceptives (OCs) are widely used and some users experience adverse mood effects. The cyclicity of PMDD symptoms coincides with increased endogenous levels of allopregnanolone after ovulation. Allopregnanolone enhances the effect of γ-aminobutyric acid (GABA) on the GABAA receptor, the principal inhibitory transmitter system in the brain. The sensitivity to other GABAA receptor agonists than allopregnanolone (i.e. benzodiazepines, alcohol and the 5 β epimer to allopregnanolone, pregnanolone) has been reported to depend on menstrual cycle phase and/or PMDD diagnosis. Isoallopregnanolone, the 3 β epimer to allopregnanolone, has previously been used to verify specific allopregnanolone GABAA receptor effects. Saccadic eye velocity (SEV) is a sensitive and objective measurement of GABAA receptor function. Aims: To study the pharmacological effects, and any effect on gonadotropin release, of intravenous allopregnanolone in healthy women. A second aim was to explore whether allopregnanolone sensitivity differs over the menstrual cycle or during OC use in healthy women, and thirdly in PMDD patients. Methods: Ten women were challenged with a cumulative dose of intravenous allopregnanolone in the follicular phase of the menstrual cycle. The effect on FSH and LH was compared to women exposed to isoallopregnanolone. A single dose of allopregnanolone was administered once in the follicular phase and once in the luteal phase in another ten healthy women and in ten PMDD patients, and additionally in ten women using OCs. Repeated measurements of SEV, subjectively rated sedation and serum concentrations after allopregnanolone injections were performed in all studies. Results: Allopregnanolone dose-dependently reduced SEV and increased subjectively rated sedation. Healthy women had a decreased SEV response in the luteal phase compared to the follicular phase. By contrast, PMDD patients had a decreased SEV response and subjectively rated sedation response to allopregnanolone in the follicular phase compared to the luteal phase. There was no difference in the SEV response to allopregnanolone between women using oral contraceptives and healthy naturally cycling women. Allopregnanolone decreased serum levels of FSH and LH whereas isoallopregnanolone did not affect FSH and LH levels. Conclusion: Intravenous allopregnanolone was safely given and produced a sedative response in terms of SEV and subjectively rated sedation in women. The sensitivity to allopregnanolone was associated with menstrual cycle phase, but in the opposite direction in healthy women compared to PMDD patients. The results suggest mechanisms of physiological tolerance to allopregnanolone across the menstrual cycle in healthy women and support that PMDD patients have a disturbed GABAA receptor function. In addition, one of our studies suggests that allopregnanolone might be involved in the mechanism behind hypothalamic amenorrhea.
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Henz, Aline. "Diagnóstico da síndrome pré-menstrual : comparação de dois instrumentos - registro diário da intensidade dos problemas (DRSP) e instrumento de rastreamento de sintomas pré-menstruais (PSST)." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2016. http://hdl.handle.net/10183/139773.
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Introdução: O diagnóstico da Síndrome Pré-menstrual (SPM) é um desafio. O uso de questionários estruturados está bem estabelecido, e a ferramenta mais aceita é o DRSP, um questionário prospectivo auto preenchido por ao menos dois meses. O PSST é um questionário retrospectivo de autoaplicação, preenchido em um único momento. Objetivo: comparar estes dois instrumentos (PSST e DRSP) para o diagnóstico da SPM. Método: Um estudo transversal com 127 mulheres entre 20 a 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, altura, Índice de Massa Corporal (IMC). Após exclusão de casos de depressão através do Prime-MD, as pacientes completaram o PSST e foram orientadas a preencherem o DRSP durante dois meses. A concordância entre os dois questionários foi avaliado pelo cálculo de Kappa (k) e valores do coeficiente PABAK. Resultados: Do total de mulheres que atenderam ao chamado, 282 (74%) preencheram os critérios de elegibilidade e responderam o PSST. Entre estas 282 mulheres, somente 127 (45%) completaram o questionário diário (DRSP) por dois ciclos. O percentual das mulheres com diagnóstico de SPM através do DRSP foi de 74,8%, e pelo PSST foi 41,7%. O percentual das mulheres com diagnóstico de TDPM pelo DRSP foi de 3,9%, e pelo PSST foi de 34,6%. Assim, verificou-se uma maior prevalência de SPM com o DRSP do que com o PSST. De outra parte a TDPM foi mais dignosticada pelo PSST do que com o DRSP. O número de pacientes consideradas “normais” foi semelhante com os dois instrumentos. Na avaliação entre os dois instrumentos verificou-se não haver nenhuma concordância (Kappa = 0,12) nos resultados do diagnóstico de SPM e TDPM (Coeficiente Pabak resultou = 0,39). Para a trigem de SPM/TDPM o PSST tem uma sensibilidade de 79% e especificidade de 33,3%. Conclusão: O PSST deve ser considerado como uma ferramenta de triagem diagnóstica. Conclui-se que os casos SPM/TDPM do PSST devem ser sempre melhor avaliados pelo DRSP.Background: The diagnosis of Premenstrual Syndrome (PMS) is a challenge. The use of structured questionnaires is well established and the most accepted is the DRSP, a prospectively self-administered questionnaire that needs two months at least to be completed. The PSST is a retrospective self-scale questionnaire, filled at a single time. Aim: To compare these two instruments (PSST and DRSP) to diagnosis PMS. Methods: A cross-sectional study with 127 women between 20 and 45 years with PMS complaints. The women were evaluated about weight, high, Body Mass Index (BMI). After the exclusion of depression by the Prime-MD Questionnaire, the PSST was completed and the women were oriented to complete the DRSP for two months. The agreement between the two questionnaires was assessed by calculating the Kappa (k) and PABAK values. Results: 282 (74% of all the women) women met eligibility criteria and answered the PSST. Only 127 (45% of the 282 women) completed the daily questionnaire (DRSP) for two cycles. The percentual of women with PMS diagnosis by the DRSP was 74.8%, and by PSST was 41.7%. The percentual of women with PMDD diagnosis by the DRSP was 3.9%, and by the PSST was 34.6%. The number of patients considered “normal” (with the symptoms above the necessary for the diagnostic the PMS) was similar with both questionnaires. We found no agreement between the two instruments (Kappa = 0.12) in the diagnosis of PMS and PMDD (Pabak coefficient keep this result = 0.39). For screening PMS/PMDD the PSST has a sensitivity of 79% and a specificity 33.3%. Conclusion: The PSST should be considered as diagnostic screening tool. We concluded that positive PMD/PMDD cases of PSST should be ever better evaluated by DRSP.
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Accortt, Eynav Elgavish. "FRONTAL ALPHA ELECTROENCEPHALOGRAPHY (EEG) ASYMMETRY AS A RISK FACTOR FOR PRE-MENSTRUAL DYSPHORIC DISORDER (PMDD); A PSYCHOPHYSIOLOGICAL AND FAMILY HISTORY APPROACH." Diss., The University of Arizona, 2009. http://hdl.handle.net/10150/193864.
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Premenstrual dysphoric disorder (PMDD) is a severe dysphoric form of premenstrual syndrome (PMS) that is included as a diagnosis for further study in the DSM-IV (APA, 2000). A primary aim of the present study was to characterize the co-occurrence of PMDD and major depression, in a sample that spans the entire range of depressive severity. The range included non-depressed controls, women meeting criteria for dysthymia, and women meeting criteria for current Major Depressive Disorder (MDD). Co-occurrence of MDD and PMDD were only statistically significant when considering Lifetime MDD. Resting frontal electroencephalographic (EEG) asymmetry has been hypothesized to tap a diathesis toward depression or other emotion-related psychopathology. Another primary aim was to assess Frontal EEG asymmetry in college women who meet criteria for Pre-Menstrual Dysphoric Disorder (n = 25) and 25 matched controls. Participants were assessed four times in a two week period. Women reporting low premenstrual dysphoric symptomatology exhibited greater relative left frontal activity at rest than did women high in premenstrual dysphoric symptomatology. These results are consistent with a diathesis-stress model for premenstrual dysphoric symptomatology. A secondary aim was to assess whether individuals with PMDD or menstrual related mood variability, but no current diagnosis of depression, have an increased family history of depression. Promising evidence of a relationship between family history of MDD and a likelihood of PMDD was discovered. A trend was found for Spectrum PMDD women: a higher rate of Family History of MDD (36%) than non PMDD women (19.6%). Ideally, resting frontal electroencephalographic (EEG) asymmetry could help us learn more about the etiology of depression and hormonal-related depression specifically, and test whether they may share etiological factors.
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Beddig, Theresa [Verfasser], and Christine [Akademischer Betreuer] Kühner. "Ambulatory Assessment of Psychological and Psychoendocrinological Characteristics across the Menstrual Cycle in Women with Premenstrual Dysphoric Disorder / Theresa Beddig ; Betreuer: Christine Kühner." Heidelberg : Universitätsbibliothek Heidelberg, 2020. http://d-nb.info/1218785233/34.
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Eisenlohr-Moul, Tory A. "Expression of Borderline Personality Disorder Symptoms across the Ovulatory Cycle: A Multilevel Investigation." UKnowledge, 2013. http://uknowledge.uky.edu/psychology_etds/24.
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Borderline Personality Disorder (BPD) is a disabling condition characterized by chronic emotion dysregulation and behavioral impulsivity. Prospective studies that test proposed mechanisms of within-person change in BPD hold the key to improving symptom predictability and control in this disorder. A small body of evidence suggests that fluctuations in estradiol such as those occurring naturally at ovulation during the monthly female reproductive cycle may increase symptoms in women with BPD (DeSoto et al., 2003). Furthermore, there is preliminary evidence that both self-esteem and feelings of social rejection are highest at ovulation, when estradiol peaks (Durante and Hill, 2009; Eisenlohr-Moul et al., under review). Such feelings have been reliably linked to increases in BPD-related behavior in all individuals (e.g., Twenge et al., 2002). The purpose of this dissertation was to test a cyclical vulnerability model for women with BPD in which ovulatory estradiol shifts are associated with reductions in felt social acceptance, which in turn are associated with increased BPD symptom expression. 40 women, sampled to achieve a flat distribution of BPD symptoms, completed 28 daily diaries online, as well as four 1-hour weekly visits to the laboratory to complete longer assessments and provide saliva samples, which were assayed for estradiol. In addition, participants underwent the Structured Clinical Interview for the Diagnosis of BPD at the end of the study.
Results of multilevel models revealed the opposite of the predicted effects of within-person changes in estradiol and their interaction with trait BPD. The data suggest a pattern in which women high in trait BPD show increases in felt acceptance and reductions in BPD symptom expression at higher levels of conception probability and higher-than-usual levels of estradiol. Women low in trait BPD show the opposite pattern in some cases. Several alternative moderators were tested, and results suggest that some risk factors for BPD (e.g., Neuroticism, Sexual Abuse) interact with high trait levels of estradiol to predict greater symptoms. Both average levels of estradiol and monthly fluctuations in estradiol may have relevance for women with BPD. It is recommended that future studies utilize clinical samples and additional physiological measures to further elucidate the mechanisms through which estradiol exerts clinically-relevant change.
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Dias, Rodrigo da Silva. "Estudo comparativo do fenótipo clínico de mulheres com transtorno afetivo bipolar em fase reprodutiva da vida com e sem piora pré-menstrual do humor." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5142/tde-28052010-101220/.
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O impacto da flutuação dos hormônios esteróides sobre o curso do Transtorno Afetivo Bipolar durante a vida reprodutiva das mulheres é pouco estudado. Encontramos ainda muitas lacunas no conhecimento quanto a sua apresentação clínica e as suas implicações na evolução do Transtorno Afetivo Bipolar, especialmente sua associação com a ciclagem rápida e o seu valor preditivo para recorrência. Métodos: Mulheres com Transtorno Afetivo Bipolar (tipos I, II ou sem outra especificação) participantes do Systematic Treatment Enhancement Program for Bipolar Disorder, com idade entre 16 e 40 anos, foram divididas em dois grupos: com e sem relato de exacerbação pré-menstrual do Transtorno Afetivo Bipolar na avaliação inicial do estudo. Estes grupos foram comparados em relação às características clínicas do Transtorno Afetivo Bipolar, de vida reprodutiva e tratamento na entrada do estudo. Longitudinalmente, foi comparado o tempo de recorrência entre as pacientes que iniciaram o estudo eutímicas utilizando análise de sobrevivência Kaplan Meier e a regressão de Cox. O número de episódios entre as pacientes que foram seguidas por um período de um ano também foi comparado. Resultados: Das 706 mulheres que completaram o questionário, 490 (69,4%) relataram exacerbação pré-menstrual. Na entrada do estudo, quando comparadas ao grupo sem exacerbação pré-menstrual, as mulheres com exacerbação pré-menstrual encontravam-se mais deprimidas, apresentavam mais comorbidades psiquiátricas, sintomas do humor com uso de contraceptivos hormonais, ciclos menstruais irregulares, e estavam recebendo menos tratamento farmacológico. Mulheres com exacerbação pré-menstrual também relataram mais episódios de humor durante o ano anterior e eram mais susceptíveis de apresentar ciclagem rápida neste mesmo período. Na avaliação prospectiva, entre as mulheres que iniciaram o estudo eutímicas (exacerbação pré-menstrual n = 66, sem exacerbação pré-menstrual n = 63), o grupo com exacerbação pré-menstrual teve um tempo de recaída mais rápido ao se incluir estados subsindrômicos associados a recaídas em mania, depressão ou estado misto. O tempo médio de recidiva de 50% da amostra foi de 4,5 meses para as mulheres com a exacerbação pré-menstrual, em comparação com 8,5 meses para as do grupo sem exacerbação pré-menstrual (p = 0,02). A exacerbação prémenstrual também foi um fator significativamente associado a maior gravidade dos sintomas depressivos e de elevação do humor entre as mulheres com um ano de seguimento. Conclusões: As mulheres com Transtorno Afetivo Bipolar que relataram exacerbação pré-menstrual apresentaram uma maior comorbidade psiquiátrica, maior número de episódios do humor no ano anterior e ciclagem rápida. A avaliação prospectiva mostrou uma taxa de recorrência maior, mais estados subsindrômicos e maior número de episódios, mas não ciclagem rápida, nas mulheres do grupo exacerbação pré-menstrual. Nossos resultados sugerem que a exacerbação pré-menstrual pode ser considerada um marcador clínico preditor de um fenótipo clínico mais complexo e associado a uma pior evolução da doença em mulheres em idade reprodutiva com Transtorno Afetivo Bipolar.The impact of hormonal fluctuation during the menstrual cycle on the course of bipolar disorder in women is poorly studied. We also found many gaps in knowledge about its clinical presentation and its implications for the evolution of Bipolar Disorder, especially the association with rapid cycling and its predictive value for recurrence. Methods: Women with Bipolar Disorder (types I, II or Not Otherwise Specificated ) participants Systematic Treatment Enhancement Program for Bipolar Disorder, aged between 16 and 40, were divided into two groups: with and without reports of Premenstrual Exacerbation of Bipolar Disorder in the baseline assessment. These groups were compared to clinical features of BD, reproductive life and treatment at study entry. The time difference of recurrence between groups who were euthymic at the baseline assessment were done with survival analysis Kaplan Meier\'s survival curve and Cox regression models. The number of episodes between the patients who were followed for a period of one year was also compared. Results: Of 706 women who completed the questionnaire, 490 (69.4%) reported premenstrual exacerbation. At study entry, compared to those without premenstrual exacerbation, women with premenstrual exacerbation were more depressed, had more psychiatric comorbidities, mood symptoms with the use of hormonal contraceptives, irregular menstrual cycles, and were receiving less drug treatment. Women with premenstrual exacerbation also reported more mood episodes during the previous year and were more likely to state rapid cycling in the same period. In a prospective evaluation among women who started the study in euthymic mood state (premenstrual exacerbation n = 66, without premenstrual exacerbation n = 63), the premenstrual exacerbation group had a smaller time to relapse when associated subsyndromal mood states to relapse in mania, depression or mixed state. The median time to relapse of 50% of the sample was 4.5 months for women with premenstrual exacerbation, compared with 8.5 months for the group without premenstrual exacerbation (p = 0,02). The premenstrual exacerbation was also a significantly positive factor for a greater severity of depressive symptoms and elevation of mood among women with one year of follow-up. Conclusions: Women with Bipolar Disorder who reported premenstrual exacerbation had a higher psychiatric comorbidity, greater number of episodes of mood in the previous year and rapid cycling. Prospective evaluation showed a higher rate of recurrence, more states and more subsyndromal episodes, but not rapid cycling among women in the premenstrual exacerbation. Our results suggest that premenstrual exacerbation can be considered a clinical marker predictor of a worse clinical phenotype and associated with a worst disease progression in women of reproductive with bipolar affective disorder
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Bannbers, Elin. "The Effect of Steroid Hormones in the Female Brain During Different Reproductive States." Doctoral thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-175409.
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Women are twice as likely as men to suffer from depression and anxiety disorders and have an increased risk of onset during periods associated with hormonal changes, such as the postpartum period and the menopausal transition. Furthermore, some women seem more sensitive to normal hormone fluctuations across the menstrual cycle, since approximately 3-5% suffers from premenstrual dysphoric disorder (PMDD). Why these disorders are so common in women has not been established but there is a probable involvement of the ovarian hormones. The aim of this thesis was to investigate the effect of the ovarian hormones on the female brain during different reproductive states using psychological tests known to affect brain activity in different ways. Paper one examined the effect of the ovarian hormones on prepulse inhibition (PPI) on the acoustic startle response (ASR) and comprised cycling women and postmenopausal women. The cycling women had lower levels of PPI compared to postmenopausal women and postmenopausal women with moderate estradiol levels had lower PPI compared to postmenopausal women with low estradiol levels. Paper two examined the effect of anticipation and affective modulation on the ASR in women with PMDD and healthy controls. Women with PMDD have an increased modulation during anticipation of affective pictures compared to healthy controls during the luteal phase of the menstrual cycle. Paper three examined brain activity during response inhibition among women with PMDD and healthy controls by the use of a Go/NoGo task and fMRI. Women with PMDD displayed a decreased activity in the left insula during follicular phase and an increased activity during the luteal phase compared to controls. Paper four comprised women in the postpartum period and non-pregnant controls to examine brain activity during response inhibition. While this study revealed decreased activity at 4 weeks postpartum compared to 48 hours postpartum we cannot ascertain the role of the ovarian steroids, since none of the significant brain areas correlated with ovarian steroid or neurosteroid serum concentrations. The results of this thesis demonstrate that the ovarian hormones, or at least various hormonal states, have a probable impact on how the female brain works.
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Franklin, Kim. "Hur påverkar funktionell hypotalamisk amenorré (FHA) fertilitet och eventuell graviditet hos kvinnor med anorexia nervosa?" Thesis, Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-105708.
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Bakgrund: Ett av sex par har någon gång upplevt problem relaterat till fertilitet under sina reproduktiva år och efter 30 års ålder är infertilitet vanligare hos kvinnor än hos män. Flera delar av menstruationscykeln består av energikrävande processer som exempelvis ägglossning och produktion av könshormoner. Näringsbrist och låg energitillgänglighet leder till brist på substrat till dessa energikrävande processer och i västvärlden orsakas låg energitillgänglighet vanligen av en ätstörning som anorexia nervosa, vilket kan leda till funktionell hypotalamisk amenorré (FHA) hos kvinnor. FHA resulterar i en minskad frisättning av könshormonerna östrogen och progesteron vilket kan leda till infertilitet. En av 20 kvinnor har erfarenhet av ätstörning under graviditeten men få studier har undersökt hur en historik med ätstörning påverkar fertilitet och graviditet. Syfte: Syftet med studien var att undersöka om FHA hos kvinnor med anoreci leder till nedsatt fertilitet och komplikationer vid en eventuell graviditet. Metod: En litteratursökning genomfördes på PubMed och Web of Science med sökorden amenorrhea, fertility, eating disorders, anorexia nervosa, reproduction (1999-2021). Resultat: Åtta studier inkluderades och resultatet visade att kvinnor med anorexi födde färre barn och hade större sannolikhet för att ha genomgått fertilitetsbehandling än friska kvinnor i kontrollgruppen. Vidare visade resultatet att kvinnor med anorexi oftare rapporterade komplicerade graviditeter med till exempel lägre fostertillväxt, prematur födsel och kejsarsnitt. Slutsats: Utifrån resultatet i den aktuella litteraturstudien kan konkluderas att kvinnor med FHA på grund av en ätstörning har lägre fertilitet än friska kvinnor. Kvinnor med ätstörning upplever i högre utsträckning mer komplicerade graviditeter och även fosterutvecklingen verkar påverkas negativt och därför kan tätare kontroller under och efter graviditet vara nödvändigt för dessa kvinnor. Resultatet kan vidare tolkas som att den negativa påverkan på reproduktionsförmågan kan vara reversibel när ätstörninssymptomen behandlats.Background: One in six couples has sometime during their reproductive years experienced problems related to fertility and after the age of 30, infertility is more common in somen than in men. Several parts of the menstrual cycle require a lot of energy, such as ovulation and the production of sex hormones. Malnutrition and low energy availability is usually caused by an eating disorder such as anorexia nervosa, which can lead to functional hypothalamic amenorrhea (FHA) in women. FHA leads to a reduced release of the sex hormones estrogene and progesterone, which leads to infertility. One in 20 women have experience of an eating disorder during pregnancy, but few studies have examined how a history og eating disorder affects fertility and pregnancy. Aim: The aim of this study was to investigate whether FHA in women with anorexia nervosa leads to reduced fertility and complications in a potential pregnancy. Method: A literature search was made on PubMed and Web of Science with the keyword´s amenorrhea, fertility, eating disorders, anorexia nervosa reproduction (1999-2021). Results: Eight studies were included, and the results showed that women with anorexia gave birth to fewer children and were more likely to have experienced fertility treatment than healthy women in the control group. Furthermore, the results showed that women with anorexia more often reported more complicated pregnancies with, e.g., lower fetal growth, premature birth, and cesarean section. Conclusion: Based on the results of the current literature study, it can be concluded that women with FHA due to an eating disorder have lower fertility than healthy women. Women with an eating disorder experience more complicated pregnancies and fetal development also seems to be negatively affected and therefore more frequent checks during and after pregnancy may be necessary fore these women. The results can further be interpreted as that the negative impact on reproductive health is reversible when symptoms of eating disorder are treated.
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Cavanagh, Kerry D. "Coping with menstrual distress /." Title page, contents and abstract only, 1991. http://web4.library.adelaide.edu.au/theses/09PM/09pmc377.pdf.
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Gingnell, Malin. "Ovarian Steroid Hormones, Emotion Processing and Mood." Doctoral thesis, Uppsala universitet, Obstetrik & gynekologi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-199791.
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It is known that some psychiatric disorders may deteriorate in relation to the menstrual cycle. However, in some conditions, such as premenstrual dysphoric disorder (PMDD), symptomatology is triggered mainly by the variations in ovarian steroid hormones. Although symptoms induced by fluctuations in ovarian steroids often are affective, little is known about how emotion processing in women is influenced by variations, or actual levels, of ovarian steroid hormones. The general aim of this thesis was to evaluate menstrual cycle effects on reactivity in emotion generating and controlling areas in the corticolimbic system to emotional stimulation and anticipation, in healthy controls and women with PMDD. A second aim was to evaluate corticolimbic reactivity during long-term administration of exogenous ovarian steroids. In study I, III and IV effects of the menstrual cycle on emotional reactivity in women with PMDD was studied. In study I, women with PMDD in displayed higher amygdala reactivity than healthy controls to emotional faces, not in the luteal phase as was hypothesised, but in the follicular phase. No difference between menstrual cycle phases was obtained in women with PMDD, while healthy controls had an increased reactivity in the luteal phase. The results of study I was further elaborated in study III, where women with PMDD were observed to have an increased anticipatory reactivity to negative emotional stimuli. However, no differences in amygdala reactivity to emotional stimuli were obtained across the menstrual cycle. Finally, in study IV the hypothesis that amygdala reactivity increase in the luteal phase in women with PMDD is linked to social stimuli rather than generally arousing stimuli was suggested, tested and supported. In study II, re-exposure to COC induced mood symptoms de novo in women with a previous history of COC-induced adverse mood. Women treated with COC reported increased levels of mood symptoms both as compared to before treatment, and as compared to the placebo group. There was a relatively strong correlation between depressive scores before and during treatment. The effects of repeated COC administration on subjective measures and brain function were however dissociated with increased aversive experiences accompanied by reduced reactivity in the insular cortex.
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Johnston, Cutting Smart. "Menstrual dysfunction and eating behaviors in weight training women." Thesis, Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/90950.
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To obtain descriptive information concerning female bodybuilders and women who weight train, a questionnaire concerning training regimes, menstrual history and dieting strategies was developed and administered with the EDI included as part of the questionnaire. Factors assessed included: incidence of menstrual irregularity, scores on the Eating Disorder Inventory (EDI), prevalence of behaviors associated with eating disorders, and mean body fat. Subjects were between the ages of 18 and 35 and included individuals from Personal Health Classes at Virginia Tech, the Virginia Tech Weight Lifting Club, and Goad's Gym in Blacksburg, Virginia. Subjects were classified by activity (weight lifters versus controls), involvement (high, moderate and low) and competition (noncompetitive and competitive).
Chi-square analysis indicated that there was no difference in incidence rates of menstrual irregularity between weight lifters (WLs) and controls (Cs); however, the rates of both groups were higher than the general population. Although there was no difference in menstrual function of involvement groups, 50% of the competitors, significantly more than non-competitors, were classified as oligomenorrheic or amenorrheic.
All subject groups had mean scores approaching anorexic patient norms on the EDI Bulimia and Maturity Fears subscales. WLs were significantly higher on Drive for Thinness than Cs and more WLs had subscale scores higher than the mean scores presented for anorexics. Additionally, significantly more WLs reported uncontrollable urges to eat, fear of fat, and history of anorexia. Mean %BF of the WLs was 20.18% with competitors being significantly leaner than non-competitors.
The high degree of menstrual dysfunction in both WLs and Cs is confusing; yet, the 27% incidence of oligomenorrhea and amenorrhea in WLs is much higher than the rates documented for the general population. The high Drive for Thinness and incidence of negative eating behaviors indicate that the prevalence of eating disorders in this population may progress as this relatively new sport evolves and competitive participation increases.M.S.
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Bain, Christine. "The investigation and treatment of abnormal uterine bleeding in the premenopausal woman." Thesis, University of Aberdeen, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247762.
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The research described in this thesis attempts to rationalise aspects of secondary care for premenopausal women with abnormal uterine bleeding, in particular investigation and assessment of a new method of endometrial ablation. The work was performed in a gynaecology unit with an established research record in endometrial ablative methods. The hospital is the main referral centre for women with menstrual disorders, enabling a centralised and stable population to be available. Chapter 1 outlines the past and present methods for the investigation and surgical treatment of abnormal uterine bleeding. Epidemiological factors for abnormal menstrual loss are discussed, as well as aetiology and the development of clinical evaluation. The equipment requirements for both transcervical resection of the endometrium (TCRE) and microwave endometrial ablation (MEATM) are described with a review of the literature to date on endometrial ablation. Chapter 2 presents a randomised comparative study of outpatient hysteroscopy and endometrial biopsy with endometrial biopsy alone for abnormal uterine bleeding. Outpatient hysteroscopy was successfully performed in almost 85% of women randomised to this procedure compared to 92% successfully receiving an endometrial biopsy alone. Hysteroscopy was found to be acceptable and viewed as a reassuring investigation. However, there was no difference in clinical outcomes between the two groups. Chapter 3 describes the subjects and methods used in a prospective randomised trial comparing MEATM with TCRE. Operative details and outcomes at one year are presented. MEATM was found to be a significantly faster endometrial ablative method than TCRE. The postoperative stay was less with MEATM, though not significantly and analgesic requirements were low in both groups. Satisfaction and acceptability rates with treatment were equivalent.
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Julian, Sophia. "Impact of the clinical process on outcomes of menstrual disorders." Thesis, University of Leicester, 2007. http://hdl.handle.net/2381/29534.
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Introduction: Menstrual disorders have a significant impact on the health and well being of women. There are wide, unexplained variations in treatment and investigation in primary care. Rates of referral to secondary care, where surgery is a more likely outcome, also vary. Aim: To examine the outcomes of a new model of care for women with menstrual disorders, known as the Bridges Project, involving implementation of an evidence based, GP led pathway of care integrated across primary and secondary sectors. Study Design: A prospective non-random comparison of two services: women attending the Bridges pathway and those attending a consultant-led one-stop menstrual clinic (OSMC). Outcomes were assessed after eight months and included treatment modalities, health status (SF-36 and menstrual questionnaire), an investigation of patient experience of care using the Patient Career Diary (PCD) and qualitative interviews, resource use and cost, adherence to guidelines and patient preferences for care. Setting: A large teaching hospital and one Primary Care Trust (PCT). Results: Between March 2002 to June 2004, 99 women in the Bridges pathway were compared to 94 women attending the OSMC. There were no statistically significant differences in mode of treatment or health status between them at eight months. Interviews demonstrated that women experience significant problems when accessing care for menstrual disorders and perceive their problems to be of low priority within the health service. The PCD demonstrated statistically significant differences for the Bridges group in several aspects of care: information and ease of access (P<0.001), choice of doctor (P = 0.020), waiting time (P<0.001), and sense of co-ordination between sectors (P< 0.001). There were significantly fewer outpatient appointments in the Bridges scheme (PO.001) with no increase in primary care workload. The cost per patient for the Bridges project was £751.72 compared to £1022.54 in the OSMC group. Conclusion: Although there were no differences between groups in the types of treatment (conservative, medical or surgical) women received, the new model of care resulted in significant improvements in patients' experiences of care whilst maintaining clinical quality at reduced cost through more efficient resource use.
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Kask, Kristiina. "Hormones, Mood and Cognition." Doctoral thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9365.
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Ovarian steroid hormones are neuroactive steroids with widespread actions in the brain, and are thus able to influence mood, behavior and cognition. In this thesis the effects of progesterone withdrawal and the direct effects of the progesterone metabolite allopregnanolone are evaluated. Allopregnanolone, through binding to the GABAA receptor complex, enhances inhibitory neurotransmission, thus exerting anxiolytic, sedative and antiepileptic effects. The acoustic startle response (ASR) is a withdrawal reflex evoked by sudden or noxious auditory stimuli, and can be measured in humans as an eye blink. ASR is significantly increased in several anxiety disorders, and notably also during progesterone withdrawal. Sensorimotor gating can be assessed by measuring prepulse inhibition of the startle response (PPI). The CNS circuits regulating PPI are sensitive to hormone fluctuations. GABAergic drugs are involved in cognitive impairment and animal studies have indicated that allopregnanolone may inhibit learning. The main purpose of this research was to evaluate the behavioral effects of progesterone withdrawal on the startle response and sensorimotor gating in PMDD patients and healthy controls, in healthy third trimester pregnant women and healthy postpartum women. A second aim was to evaluate allopregnanolone effects on memory and cognition in healthy women and also on the startle response and PPI. We found that PMDD patients have an increased startle response across the menstrual cycle and a deficiency in sensorimotor gating during the late luteal phase. Ovarian steroids affect sensorimotor gating; pregnant women have lower levels of PPI than late postpartum women. Acutely administered allopregnanolone did not affect the ASR or PPI. Allopregnanolone impairs episodic memory in healthy women. In conclusion, our studies suggest that ovarian steroids, including allopregnanolone, do not influence the startle response. Ovarian steroids affect sensorimotor gating; pregnancy, a condition with high levels of ovarian steroids, suppresses PPI. Theoretically, the variability in PPI across reproductive events is due to effects mediated by the progesterone or estradiol receptors but is not mediated by allopregnanolone. PMDD patients display decreased PPI during the late luteal phase, suggesting underlying pathophysiology in common with other anxiety disorders. The most vulnerable memory system, the episodic memory, is impaired by the allopregnanolone in healthy women.
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Kaiserauer, Susanne B. "Nutritional and physiological influences on menstrual status of amenorrheic runners." Virtual Press, 1987. http://liblink.bsu.edu/uhtbin/catkey/490118.
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Women with exercise associated amenorrhea display a disturbance in basal and exercise levels of reproductive, anti-reproductive and stress hormones. Co-incident with chronic exercise are other factors, which alone, also affect the menstrual cycle. Therefore, amenorrheic runners (AR), regularly menstruating runners (RMR) and regularly menstruating sedentary controls (RMSC) were compared for plasma progesterone levels, plasma lipid levels, menstrual cycle characteristics, physical characteristics and nutritional adequacy to determine if the difference in menstrual status could be explained, and to determine whether exercise alone could be attributed as the cause of menstrual cycle disturbances.Plasma progesterone levels were significantly lower in the AR group (. 28 + .02 ng/ml) than in the RMR group (.41 + .06 ng/ml) and the RMSC group (.49 + .06 ng/ml) in the follicular phase. Regularly menstruating runners demonstrated lower plasma progesterone levels in the luteal phase (9.76 + 1.05 ng/ml) than RMSC subjects (10.24 + 2.21 ng/ml). Regularly menstruating runners had a significantly shorter luteal phase length relative to their cycle length (.35 + .01) than RMSC subjects (.46 + .01). Mean age, incidence of parity, age of menarche, height, weight, body composition, max V02 and number of miles run per week did not differ between the RMR and AR subjects. Amenorrheic runners took in significantly less fat, red meat, phosphorous and total calories than the RMR subjects. Serum LDL-C was significantly higher in the AR subjects (89.2 + 9.7 mg/dl) than in the RMR subjects in both the luteal (67.8+ 3.4 mg/dl) and follicular (66.8+ 5.6 mg/dl) phases. Serum HDL-C was significantly higher in the RMR subjects in both the luteal (62.9+ 4.1 mg/dl) and follicular (59.2+ 2.9 mg/dl) phase, and in the AR subjects (63.9+ 4.2 mg/dl), than in the RMSC subjects in the luteal (49.2+ 5.9 mg/dl) and follicular (47.2+ 2.4 mg/dl) phase. Serum VLDL-C did not differ between any groups.This investigation demonstrates that hormonal and lipid level alterations with exercise are significantly different in the amenorrheic runner. However, regularly menstruating runners display alterations which may represent and intermediate or potential phase of menstrual cycle disturbances. The nutritional inadequacy or energy imbalance separates amenorrheic runners from regularly menstruating runners. Thus, it appears that exercise alone is not enough to cause the hormonal disturbances that trigger amenorrhea, and, that exercise associated amenorrhea is not unlike other amenorrheas of hypothalamic origin.
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Edmunds, Cynthia Ekstein. "Diet, body weight patterns and menstrual status of competitive female body builders." Thesis, This resource online, 1990. http://scholar.lib.vt.edu/theses/available/etd-06082009-170852/.
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Zervou, Sevasti I. "Mediators of uterine relaxation and contractility in the human non-pregnant uterus." Thesis, University of Warwick, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364631.
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Sambrook, Alison M. "Short and long term clinical outcomes following endometrial ablation in women with heavy menstrual bleeding." Thesis, University of Aberdeen, 2010. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=167810.
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Short and long term clinical outcomes following endometrial ablation in women with heavy menstrual bleeding. Randomised trials evaluating second generation endometrial ablation techniques are discussed and critically reviewed in this thesis. Patterns of referral, socio-demographic and clinical details, primary care treatment, of women referred with heavy menstrual loss are also considered as are three randomised trials of surgical treatments for the treatment of heavy menstrual bleeding. Microwave endometrial ablation (MEATM) and thermal balloon ablation (TBall) both achieved high levels of satisfaction (-1%, 95% CI (-11, 9)). Microwave had a significantly shorter operating time, reduced usage of anti-emetics and opiate analgesia, increased discharge by six hours and fewer device failures. Comparing MEA™ in the postmenstrual phase to MEA™ following standard drug based endometrial preparation there was no significant difference at five years in menstrual outcomes, health related quality of life, or need for subsequent treatment Ten years following MEATM or transcervical resection of the endometrium (TCRE), the hysterectomy rate after ten years was significantly different with 17% in the MEATM and 28% in the TCRE arm (95% CI -0.21, -0.13). In conclusion primary care guidelines should be followed whilst establishing patient preference prior to referral to secondary care. Microwave ablation has been shown to be an effective treatment in the short, medium and long-term. It can successfully be performed in an outpatient setting in the post menstrual phase and is acceptable under local anaesthesia.
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Lewis, Michele D. "Menstrual cycle dysfunction and weight loss practices among college-age women." Thesis, This resource online, 1996. http://scholar.lib.vt.edu/theses/available/etd-11012008-063217/.
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Rickenlund, Anette. "Hormonal mechanisms of menstrual disturbances, metabolic disorders and effects of oral contraceptives in female athletes /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-148-2/.
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Vilanova, Larissa Soares Reis 1987. "Disfunções temporomandibulares = estudos sobre dor, mastigação e diagnóstico = Temporomandibular disorders: studies on pain, mastication and diagnostic." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/288648.
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Orientador: Renata Cunha Matheus Rodrigues GarciaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Disfunções temporomandibulares (DTM) são condições orofaciais patológicas comuns caracterizadas por dor na articulação temporomandibular e/ou nos músculos da mastigação. A DTM é uma condição comum de dor, especialmente em mulheres durante a fase reprodutiva. Desta maneira os objetivos dessa tese foram (1) avaliar se as flutuações hormonais ocorridas durante o ciclo menstrual alteram a sensibilidade dolorosa (SD), força máxima de mordida (FMM) e performance mastigatória (PM) de voluntárias com DTM, (2) avaliar se os movimentos mandibulares e a qualidade do sono alterariam com o tratamento com placas oclusais estabilizadoras e (3) comparar o diagnóstico baseado no Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) avaliando a confiabilidade e calibração entre o treinamento formal em relação a autoinstrução com documentos e filme. Para tanto, cinquenta voluntárias foram selecionadas e divididas em dois grupos de 25 participantes: (1) voluntárias com DTM e ciclos menstruais regulares e (2) voluntárias com DTM e utilizando contraceptivos orais. Foram analisados a sensibilidade dolorosa (SD) por meio da escala visual analógica, força máxima de mordida (FMM) por meio de sensores e performance mastigatória (PM) por meio do peneiramento. Essas variáveis foram avaliadas durante o período de quatro fases de um ciclo menstrual completo. As mesmas 50 voluntárias diagnosticados com SD participaram do segundo estudo, que foram analisadas a intensidade da dor (escala visual analógica), qualidade do sono (Escala de Sonolência Epworth (ESS) e Índice de Qualidade de Sono de Pittsburgh (PSQI), e movimentos mandibulares ¿ amplitude de movimento e movimentos mastigatórios (cinesiografia) antes e depois de dois meses do tratamento com placa estabilizadora. Medidas repetidas GLIMMIX foram utilizados para a análise de dados seguido pelo teste de Tukey (P ? 0,05). Para o terceiro estudo foi utilizada uma amostra diferente, um total de 32 indivíduos (27 pacientes com DTM e 9 assintomáticos) foram examinados por meio do DC/TMD. Seis examinadores foram divididos em dois grupos com diferentes tipos de treinamento, (1) treinamento formal e de calibração em um centro de treinamento para o DC/TMD e (2) autoinstrução com o uso de documentos e vídeo. Após a primeira avaliação o segundo grupo passou pelo treinamento formal, sendo considerado o grupo (3) Autoinstrução + curso. A avaliação da confiabilidade foi realizada ao longo de um dia inteiro compreendendo em um exame clínico em 16 pacientes para cada um dos três grupos. O coeficiente kappa foi utilizado para calcular a confiabilidade dos diagnósticos do DC/TMD. Em relação aos resultados, foram encontradas diferenças na SD entre a fase lútea (quarta avaliação) e ovulatória (terceira avaliação) (p = 0,01), de ambos os grupos. Não foram encontradas diferenças em FMM (P = 0,34) ou PM (P = 0,43), entre os grupos experimental e controle. Sensibilidade à dor foi reduzido após o tratamento (P = 0,0001). O tratamento melhorou a amplitude de movimento, aumentando a abertura bucal (P = 0,0001) e movimento ântero-posterior (P = 0,01), bem como a velocidade de abertura máxima (P = 0,0001) e de fechamento (P = 0,04) durante a mastigação, após o tratamento. Houve diferenças nos índices de qualidade de sono para PSQI (P = 0,0001) e ESS (P = 0,04) após o tratamento da dor miofacial. No terceiro estudo, a confiabilidade foi boa em todos os três grupos de examinadores para todos os diagnósticos, exceto para a mialgia local e dor miofascial com referência no grupo Autoinstrução + curso. O curso melhorou a confiabilidade para a mialgia e artralgia quando comparado com a auto-instrução. Desta maneira, flutuações de estrogênio pode influenciar a sensibilidade à dor de pacientes com DTM, mas não afeta a função mastigatória. O tratamento de indivíduos com dor miofascial com placas estabilizadoras foi eficaz reduzindo a dor, e esta opção de tratamento melhora a qualidade do sono e movimentação mandibular. A confiabilidade da calibração do DC/TMD por meio do treinamento formal e da auto-instrução são semelhantes, exceto para os subgrupos de Mialgia. A auto-instrução seguida de treinamento formal melhora a confiabilidade da calibração do DC/TMD
Abstract: Temporomandibular disorders (TMD) are common chronic orofacial pathology conditions characterized by pain in the temporomandibular joint and/or muscles of mastication. The TMD is a common pain condition, especially in women during their reproductive phase. Thus the objectives of this thesis were (1) to evaluate whether the hormonal fluctuations that occur during the menstrual cycle alter pain sensitivity (PS), maximum bite force (MBF) and masticatory performance (MP) to volunteers with TMD, (2) evaluate if jaw movements and sleep quality would change with treatment with stabilizing occlusal splint and (3) compare the diagnosis based on the Diagnostic Criteria for Temporomandibular Disorders (DC / TMD) to evaluate the reliability and calibration between formal training in relation to self-instruction with documents and film. For this purpose, fifty volunteers were selected and divided into two groups of 25 participants: (1) volunteers with regular menstrual cycles and TMD, and (2) voluntary with TMD and using oral contraceptives. Pain sensitivity (PS) by using a visual analog scale, maximum bite force (MBF) using sensors and masticatory performance (MP) through screening were analyzed. These variables were measured for a period of four phases of a complete menstrual cycle. The same 50 volunteers diagnosed with PS participated in the second study, pain intensity (visual analogue scale), quality of sleep (Epworth Sleep Scale (ESS) and Index of Pittsburgh Sleep Quality (PSQI) were analyzed, and mandibular movements - range of motion and chewing movements (kinesiography) before and after two months of treatment with stabilizing splints. Repeated measures GLIMMIX were used for data analysis followed by Tukey¿s test (P ? .05). For the third study a different sample was used, a total of 32 patients (27 patients with TMD and 9 asymptomatic) were examined using DC/TMD. Six examiners were divided into two groups with different training, (1) formal training and calibration at a DC/TMD training center and (2) self-instruction with the use of documents and video. After the first evaluation, the second group went through the formal training, considered the group (3) self-instruction + course. The reliability assessment was performed over a full day comprising in a clinical examination of 16 patients for each of the three groups. The Cohen's kappa coefficient was used to calculate the reliability of the DC/TMD diagnoses. Regarding the results, differences between the PS in luteal phase (Fourth evaluation) and ovulatory phase (third evaluation) were found (p = 0.01) in both groups. No differences in MBF (P = 0.34) or MP (P = 0.43) were found between the experimental and control groups. Sensitivity to pain was reduced after treatment (P = 0.0001). The treatment improved range of motion, increasing mouth opening (P = 0.0001) and anterior-posterior movement (P = 0.01) and the maximum opening speed (P = 0.0001) and closing (P = 0.04) during mastication after treatment. There were differences in the sleep quality scores for PSQI (P = 0.0001) and ESS (P = 0.04) after the treatment of myofascial pain. On the third study, the reliability was good in all three groups of examiners for all diagnoses, except for Myofascial pain with referral in the Self + course group. The course group improved reliability for myalgia and arthralgia compared to self-instruction. Thus, estrogen fluctuations may influence the pain sensitivity of TMD patients, but does not affect masticatory function. Treatment of MFP subjects with stabilized splints was effective reducing pain, and this treatment option improves sleep quality and jaw motion. The reliability of the calibration of DC / TMD through formal training and self-education are similar, except for subgroups of Myalgia. The self-instruction followed by formal training improves the reliability of the calibration of DC / TMD
Doutorado
Protese Dental
Doutora em Clínica Odontológica
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Robeldo, Thaiane Alcarde. "Influência da citroterapia na produção de prostaglandinas e citocinas por mulheres durante a menstruação." Universidade Federal de São Carlos, 2017. https://repositorio.ufscar.br/handle/ufscar/9217.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Imbalances in the production of prostaglandins (PGs) secreted during menstrual cycles, especially F2α and E2, have been associated with the occurrence of dysmenorrhea and excessive uterine bleeding. Depending on the magnitude of these dysfunctions, the use of non-hormonal anti-inflammatories continues to be indicated to block the synthesis of PGs and to control the clinical outcome. However, since this type of therapeutic option produces side effects that may restrict its use for long periods, the use of herbal products has been proposed as an alternative treatment. Studies and reports have shown that Tahitian lemon (Citrus latifolia) acts controlling the menorrhagia and dysmenorrhea. Although the forms of action are not known, the inhibition of the cascade of arachidonic acid production is one of the possibilities that deserve to be investigated. Thus, to contribute to the elucidation of the mechanisms of action, we propose to study the effect of Tahitian lemon juice on the production of PGs and cytokines involved in the synthesis pathways of PGs in healthy women during menstruation. To that aim, normal volunteers during the menacing period were randomly divided into three groups and treated for two consecutive days from the beginning of menstruation, with Lemon (G1, n = 15), Meloxicam (G2, n = 14) and compared with a Control group (G3, n = 13) formed by volunteers who did not undergo any type of intervention. On the second day of menstruation, menstrual and peripheral blood samples were collected for the determination of PGE2, PGF2α, IL-1β, TNFα and IL-6 in order to analyze the uterine and systemic effects of cytotherapy. In addition, cells from whole blood were cultured, whether or not stimulated with LPS, to evaluate the effects of Tahitian lemon on the production of PGs (PGF2α and PGE2), and the in vitro inflammatory response (IL-1β, IL- 6, TNF-α). The results showed a higher concentration of PGF2α in the menstrual blood of the Tahitian lemon group and a lower concentration of PGE2 and PGF2α in the Meloxicam group. Regarding the inflammatory cytokines, it was observed that only the concentration of TNFα in menstrual blood was lower in the Lemon group. However, in the supernatant of the cell culture, the Tahitian lemon was able to induce the higher production of TNFα by the cells supplemented by the patient's own serum and treated with LPS for 24 hours. Conclusion: Tahitian lemon appears to act in the cascade of production of the PGF2α from uterus, that may favor events associated with vascular contraction, in a distinct way in relation to Meloxicam activity.
Desequilíbrios na produção de prostaglandinas (PGs) secretadas durante os ciclos menstruais, principalmente as do tipo F2α e E2, têm sido associados à ocorrência de dismenorreia e sangramento uterino excessivo. Dependendo da magnitude dessas disfunções, o uso de anti-inflamatórios não hormonais continua sendo indicado para bloquear a síntese de PGs e controlar o quadro clínico. Entretanto, como esse tipo de opção terapêutica apresenta resultados variáveis e pode produzir efeitos colaterais que restringem sua utilização, o emprego da fitoterapia vem sendo proposto como alternativa terapêutica. Trabalhos e relatos têm mostrado que o limão Taiti (Citrus latifolia) atua de forma eficaz no controle da menorragia não estrutural e da dismenorreia. Embora as formas de atuação não sejam conhecidas, a inibição da cascata de produção dos ácidos araquidônicos é uma das possibilidades que merece ser investigada. Deste modo, para contribuir com a elucidação dos mecanismos de ação, propomos estudar o efeito do suco do limão Taiti na produção de PGs e de citocinas envolvidas nas vias de síntese das PGs em mulheres saudáveis durante a menstruação. Para isso, voluntárias na fase do menacme foram divididas de forma aleatória em três grupos e tratadas a partir do início da menstruação por dois dias consecutivos com Limão (G1, n=15) ou Meloxicam (G2, n=14) e comparadas com grupo Controle (G3, n=13) formado por participantes que não sofreram qualquer tipo de intervenção. Para isso, amostras de fluído menstrual e sangue periférico foram coletadas no segundo dia da menstruação para dosagem de PGE2, PGF2α, IL-1β, TNF-α e IL-6 com o propósito de avaliar o efeito uterino e sistêmico da citroterapia. Além disso, foram realizadas cultura de células a partir de sangue total, estimuladas (24h) ou não com LPS, para medir os efeitos do limão Taiti na resposta inflamatória in vitro (IL-1β, IL-6, TNF-α). Os resultados mostraram uma maior concentração de PGF2α no fluído menstrual do grupo que consumiu o suco do limão Taiti e uma concentração menor de PGE2 e PGF2α no grupo tratado com Meloxicam. Em relação às citocinas inflamatórias, observou-se que somente a concentração de TNF-α no sangue menstrual foi menor no grupo Limão. Em relação à concentração de TNF-α no sangue periférico, não houve diferenças significativas entre os grupos, entretanto no sobrenadante da cultura celular, o limão Taiti foi capaz de induzir maior produção de TNF-α pelas células suplementadas pelo soro da própria paciente e estimuladas com LPS. Em conclusão: o limão Taiti possivelmente atua na cascata de produção de PGF2α do útero, podendo favorecer os eventos associados com a contração uterina, de uma forma distinta em relação aos mecanismos de atividade associados ao Meloxicam.
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Prinsloo, Judith Cecilia. "The relationship between body composition components, risk for disordered eating and irregular menstrual patterns among long-distance athletes / J. Prinsloo." Thesis, North-West University, 2008. http://hdl.handle.net/10394/2327.
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Coelho, Gabriela Morgado de Oliveira. "Associação de componentes dietéticos com desordens alimentares e seus agravos em adolescentes atletas tenistas e não atletas." Universidade do Estado do Rio de Janeiro, 2015. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=8254.
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Adolescentes apresentam rápido crescimento e intensas mudanças corporais que os tornam vulneráveis em termos nutricionais. A prática de restrições alimentares, bastante comum entre adolescentes, pode levar a inadequações nutricionais que parecem ser o primeiro sinal para o início de uma desordem alimentar (DA). A participação feminina no esporte e o número de casos de DA em adolescentes atletas de modalidades que exigem exposição do corpo, agilidade e leveza dos movimentos, como o tênis, têm aumentado nos últimos anos. As DA podem levar a complicações de saúde como irregularidades menstruais (IM) e baixa densidade mineral óssea (DMO), caracterizando a Tríade da Mulher Atleta (TMA). Desta forma, acredita-se que alguns componentes dietéticos podem ter associação com DA e seus agravos. O objetivo do presente estudo foi avaliar a associação de componentes dietéticos com desordens alimentares, irregularidades menstruais e composição corporal em adolescentes atletas tenistas e não atletas do sexo feminino. Trata-se de estudo do tipo transversal. Foram realizadas avaliações do desenvolvimento puberal pela auto-aplicação dos critérios de Tanner; da composição corporal pela absortometria radiológica de dupla energia (DXA); dos parâmetros dietéticos por registro alimentar de três dias alternados; das DA pela aplicação de três questionários validados (Eating Attitudes Test - EAT-26, Bulimic Investigatory Test, Edinburgh- BITE e o Body Shape Questionnaire - BSQ); do ciclo menstrual por questionário validado e da DMO também pelo DXA. A Tríade da Mulher Atleta (TMA) foi estabelecida pela presença concomitante de DA e/ou baixa disponibilidade de energia (BDE), IM e baixa DMO. Foram realizadas associações por meio de correlações de Spearman entre as variáveis numéricas de componentes dietéticos com DA e composição corporal. Também foram realizadas associações por meio do teste qui-quadrado, teste exato de Fisher ou prova binomial para as variáveis categóricas de adequação dos componentes dietéticos com DA e seus agravos. Participaram do estudo 75 adolescentes (25 tenistas, 50 não atletas) apresentando desenvolvimento puberal similar. Atletas obtiveram melhor perfil da composição corporal quanto ao tecido adiposo. Quanto à ingestão de macronutrientes, os carboidratos merecem destaque. Em ambos os grupos, a maioria das participantes apresentaram baixa ingestão de carboidratos, sendo este percentual de inadequação significativamente maior para as atletas. Os micronutrientes que obtiveram maior percentual de inadequação foram folato e cálcio em ambos os grupos. Verificou-se que 92%, 32% e 24% das atletas e 72%, 8% e 30% das não atletas preencheram critérios para DA e/ou BDE, IM e baixa massa óssea, respectivamente. Apesar de adolescentes atletas tenistas e não atletas apresentarem prevalência de DA similares, as não atletas apresentaram maior insatisfação com a imagem corporal pelo teste BSQ. No entanto, as atletas parecem estar em situação mais grave uma vez que apresentaram maior prevalência de BDE e de IM. A DMO e a prevalência de TMA foram similares entre os grupos. Foi verificada associação inversa e significativa entre alguns componentes dietéticos (principalmente energia e carboidratos) e os escores do teste BSQ. Foi possível concluir que a baixa ingestão de alguns componentes dietéticos, principalmente energia e carboidratos, podem funcionar como marcadores para desordens alimentares em ambos os grupos a fim de previnir posteriores consequências à saúdeAdolescents have a rapid growth and and intense body changes that make them vulnerable in nutritional terms. The practice of dietary restrictions, quite common among adolescents, can lead to nutritional inadequacies that appear to be the first signal for the start of disordered eating (DE). The female sports participation and the number of DE cases in adolescent athletes from sports that require bodys exposure, agility and soft movements, like tennis, have increased in recent years. DE can lead to serious health complications such as menstrual irregularities (MI) and low bone mineral density (BMD), constituting the female athlete Triad (FAT). Thus, it is believed that certain dietary components may be associated with DE and its complications. The aim of this study was to evaluate the association of dietary components with disordered eating, menstrual irregularities and body composition in female adolescent tennis players and controls. This was a cross-sectional study. We carried out assessments of pubertal development by Tanner stage self-assessments; body composition by dual energy x-ray absorptiometry (DXA); dietary parameters by three-day food records; DE by the application of three validated questionnaires (Eating Attitudes Test - EAT-26, Bulimic Investigatory Test, Edinburgh- BITE and the Body Shape Questionnaire - BSQ), menstrual status through a validated questionnaire and BMD also by DXA. The Female athlete Triad (FAT) was established by the concomitant presence of DE and/or low energy availability (LEA), MI and low BMD. Associations were performed using Spearman`s correlations between numerical variables of dietary components with DE and body composition. Also associations were performed using chi-square test, Fisher's exact test or binomial test for categorical variables of dietary components adequacy with DE and its complications. The study enrolled 75 adolescents (25 female tennis players, 50 controls) presenting with similar pubertal development. Athletes had better body composition profile, regarding the adipose tissue. As for the intake of macronutrients, carbohydrates are noteworthy. In both groups, most participants had low intake of carbohydrates, being this frequency of inadequacy significantly higher for athletes. Micronutrients with the greatest percentage of inadequacy were folic acid and calcium in both groups. It was found that 92%, 32% and 24% of the athletes and 72%, 8% and 30% of controls met the criteria for DE and / or LEA, MI, low bone mass, respectively. Although adolescent tennis players and controls present with similar prevalence of DA, the controls showed greater dissatisfaction with body image by BSQ test. However, the athletes seem to be in a more serious situation since they had a higher prevalence of LEA and MI. BMD and the prevalence of FAT were similar between groups. Significant inverse association was found between some dietary components (mainly energy and carbohydrates) and scores of BSQ test. It was concluded that low dietary intakes of some dietary components, mainly energy and carbohydrates, may function as markers for disordered eating in both groups in order to prevent further health consequences
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Lobato, Valeria Vignolo. "Influência do ciclo menstrual nas alterações de limiar de dor à pressão (LDP) na musculatura mastigatória de mulheres com sinais e sintomas de disfunção temporomandibular." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/25/25135/tde-25062007-074508/.
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O objetivo deste trabalho foi analisar a influência do ciclo menstrual nas alterações de limiar de dor à pressão (LDP) na musculatura mastigatória de mulheres com sinais e sintomas de Disfunção Temporomandibular (DTM). Inicialmente 47 voluntárias entre 18 e 40 anos participaram do estudo, das quais 36 foram incluídas no experimento: 15 com sinais e sintomas de DTM (7 sob terapia com contraceptivos orais (CO) e 8 sem CO) e 21 saudáveis, sem sinais e/ou sintomas de DTM (8 com CO e 13 sem CO). Os LDPs dos músculos masseter e temporais (anterior, médio e posterior), e do tendão de Aquiles foram medidos bilateralmente, por meio de um algômetro, durante 2 ciclos menstruais consecutivos, nas 4 diferentes fases: menstrual (dias 1-3), folicular (dias 5-9), periovulatória (dias 12-16) e lútea (dias 19-23). Em cada fase do ciclo, as voluntárias relataram sua dor em uma Escala de Análise Visual (EVA). Os resultados foram submetidos à análise de variância a 3 critérios para mensurações repetidas, a um nível de significância de 5%.Foram encontrados LDPs significativamente menores nos músculos temporal e masseter e no tendão de Aquiles das mulheres com DTM quando comparado às mulheres assintomáticas, independentemente da fase do ciclo e do uso de contraceptivos (p < 0,05). De uma maneira geral, os LDPs foram maiores em mulheres em terapia com contraceptivos orais, quando comparado às mulheres sem terapia. Parece não existir influência das diferentes fases do ciclo menstrual no LDP, independentemente da presença ou não de DTM.The aim of this study was to investigate the influence of the menstrual cycle on the Pain Pressure Threshold (PPT) figures of the masticatory muscles in women with signs and symptoms of Temporomandibular Disorders (TMD). Forty-seven volunteers (ages between 18-40 years-old) were initially recruited for this purpose. According to the criteria adopted, 36 were included. The experimental group was composed of 15 women with myofascial pain (RDC/TMD) (7 under oral contraceptive medication), while 21 women with no TMD signs or symptoms (8 under oral contraceptive medication) composed the control group. The PPT values of masseter and temporalis (anterior, middle, and posterior regions) muscles, as well as the Achilles? tendon were bilaterally screened during two consecutive menstrual cycles, in the following phases: menstrual (day 1-3), follicular (day 5-9), periovulatory (day 12-16) and luteal (day 19-23). A visual analog scale (VAS) was used to address subjective pain in each menstrual phase. Data were submitted to 3-way ANOVA for repeated measurements, with a 5% significant level. The PPT values were significantly lower in the temporalis, masseter, and the Achilles? tendon of TMD patients when compared with the asymptomatic controls, regardless of the menstrual cycle phase or the use of oral contraceptives (p<.05). Overall, the PPT values were higher for patients under oral contraceptive therapy, while VAS was, in general higher at the menstrual phase (p<.05). It appears that the different phases of menstrual cycle have no influence on the PPT values, regardless of the presence of a previous condition, as myofascial pain.
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Southwick, Carla. "The Risk of the Female Athlete Triad in Collegiate Athletes and Non-Athletes." DigitalCommons@USU, 2008. https://digitalcommons.usu.edu/etd/66.
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Prior research has found the female athlete triad in both female athletes and female non-athletes. This study consisted of 192 female participants attending Utah State University with 103 collegiate athletes and 89 non-athletes. The instruments used included the EAT-26, menstrual cycle history questionnaire, osteoporosis questionnaire, and time spent in exercise questionnaire. Results from the present study found a statistically significant difference between athletes and non-athletes being at risk for the triad with female athletes having a higher percentage (4.8%, 3.4%). No statistical significant correlation was found between the risk of the triad and excessive amounts of time spent in exercise in athletes (r=.113, p=.256) and non-athletes (r=-.041, p=.706). When athletes were divided into lean and non-lean athletes statistical significance was found with non-lean (17.4%) sport athletes (χ²(1,N=103)=83.971, p<.01) having a higher overall percentage of being at risk of the triad compared to the athletes involved in lean (5%) sports.
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Lin, li mei, and 林麗美. "A study of menstrual experiences and help-seeking behaviors for menstrual disorder''''''''s women." Thesis, 1995. http://ndltd.ncl.edu.tw/handle/23312199275287894879.
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Jácome, Mariana Filipa Fernandes. "O contributo da terapêutica hormonal na Síndrome Pré-menstrual – A perspetiva atual." Master's thesis, 2021. http://hdl.handle.net/10316/98339.
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Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaPremenstrual Syndrome (PMS) is an entity characterized by the presence of cyclical changes of varying severity, ranging from clinical signs and symptoms to psychological and behavioral changes. Premenstrual Dysphoric Disorder (PMDD) is the designation of the most severe form of PMS, which is an incapacitating condition that can significantly interfere with women's lives.The aim of this study is to review the literature about therapeutic approaches to PMS, specifically the role of hormonal methods in symptom relief.A bibliographic research was carried out on PubMed database and articles from the last 15 years were selected.According to current scientific evidence, combined oral contraceptives (COC) provide the greatest symptomatic relief, but there are several factors that determine their effectiveness, such as the type of progestogen or the administration regimen. Within hormonal methods, the COC composed by 20 µg of ethinylestradiol and 3 mg of drospirenone, prescribed as 24 active pills and 4 placebo pills demonstrated to be the most effective. The use of an isolated estrogen associated with a progestogen for endometrial protection is considered to be a second-line therapeutic option, although the studies on this subject have some limitations, such as small and heterogeneous samples and short-term follow-up. The studies with isolated progestogens did not reveal a statistically significant benefit. Gonadotropin releasing hormone agonists should only be used in specific and refractory cases and danazol is no longer indicated for PMS treatment.SPM and PMDD are complex entities and their therapeutic approach is still under investigation. However scientific evidence has shown that hormonal methods, especially COC with drospirenone play an important role in symptomatic relief.
A Síndrome Pré-menstrual (SPM) é uma entidade que se carateriza pela presença de alterações cíclicas de gravidade variável que vão desde sinais e sintomas clínicos a alterações psicológicas e comportamentais. Premenstrual Dysphoric Disorder (PMDD) é a designação da forma mais grave de SPM, tratando-se de uma condição incapacitante que pode comprometer significativamente a vida da mulher. O objetivo deste trabalho é realizar uma revisão da literatura sobre as abordagens terapêuticas na SPM, mais concretamente o papel dos métodos hormonais no alívio da sintomatologia.Para a sua elaboração foi realizada uma pesquisa bibliográfica na base de dados PubMed e foram selecionados artigos dos últimos 15 anos. Segundo a evidência científica atual, os contracetivos hormonais combinados orais (CHCO) são os que proporcionam maior alívio sintomático, mas há vários fatores que condicionam a sua eficácia como o tipo de progestativo ou o regime de administração. Dentro dos métodos hormonais o CHCO composto por 20 µg de etinilestradiol e 3 mg de drospirenona, administrado num regime de 24 comprimidos ativos e 4 comprimidos placebo foi o que demonstrou ter maior eficácia. A utilização de um estrogénio isolado associado a um progestativo para proteção endometrial é considerada uma opção terapêutica de segunda linha, embora os estudos existentes apresentem algumas limitações, nomeadamente amostras reduzidas e heterogéneas e tempo de follow-up curto. Os estudos realizados com progestativos isolados não revelaram benefício estatisticamente significativo na sua utilização. Os agonistas da hormona libertadora de gonadotrofinas só devem ser usados em casos mais específicos e refratários e o danazol atualmente já não tem indicação no tratamento da SPM.A SPM e a PMDD são entidades complexas e a abordagem terapêutica das mesmas é uma área ainda em investigação. No entanto, a evidência científica demonstrou que os métodos hormonais, principalmente os CHCO que contêm drospirenona desempenham um papel importante no alívio sintomático.
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Chen, Yueh-Hua, and 陳玥華. "Premenstrual Dysphoric Disorder (PMDD) is Associated with Abnormal Emotional Processing in the Pre-menstrual Phase." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/32762717725152938564.
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碩士國立陽明大學
腦科學研究所
101
Objective: PMDD is characterized by pre-menstrual emotional and physical symptoms severe enough to interfere with daily functions. Recent studies indicate that PMDD patients have abnormal brain activity across the menstrual phases in response to emotional stimuli. The underlying pathology remains unclear. This study aims to address emotional conflict processing in PMDD patients across menstrual phases. We hypothesized that PMDD patients would show abnormal emotional conflict monitoring mechanism, and predicted that PMDD patients would have a hypersensitive emotion-modulating circuitry during the symptomatic pre-menstrual phase. Methods: 12 right-handed PMDD patients and 12 healthy matched controls participated in the study. Participants underwent functional MRI while performing an emotional Stroop task using emotional face stimuli overlaid with congruent (C) or incongruent (I) emotional words. Hormone tests and psychological inventories were used to evaluate the physiological and mental state. Functional MRI was performed in the pre and post-menstrual phases. Results: No significant difference in behavior was found between PMDD patients and healthy controls in any of the phases. For the conflict comparison (I>C), PMDD patients showed enhanced fMRI activity in the anterior cingulate, the dorso-medial and lateral prefrontal cortices, and the superior parietal lobe when comparing the pre- and post-menstrual phases as well as when comparing each phase with healthy controls. Conclusions: The findings suggest that PMDD patients had cerebral hyper function during processing of emotional conflict in the pre-menstrual phase, and the brain activities were positively related to symptom severity. Significance: This fMRI study provides further understanding of brain function in symptomatic PMDD patients in context of mood symptoms, hormone levels, and emotional conflict.
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Amalathas, Aneline. "Trauma and psychophysiologic reactivity: menstrual phase, posttraumatic stress disorder, and performance on a loud tones task." Thesis, 2016. https://hdl.handle.net/2144/16782.
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The current study examines the effects of Posttraumatic Stress Disorder (PTSD) and menstrual cycle phase on psychophysiologic reactivity to a loud tones task in a population of female trauma survivors. Estradiol and progesterone fluctuate throughout the menstrual cycle; prior research has shown the variety of effects these hormones have on the Hypothalamic-Pituitary Adrenal (HPA) axis, glucocorticoids, stress and anxiety homeostasis, and conditionability. We hypothesized greater reactivity for participants with PTSD, and that menstrual cycle would moderate the effects of PTSD and performance on the loud tones task. Results indicated heart rate was higher in participants in the mid-luteal phase than early follicular phase. Several results were surprising, including that participants with PTSD demonstrated less startle reactivity and faster habituation (as measured using the left orbicularis electromyogram (O-EMG) measure) than participants in the trauma control group for. Considerations are made for demographics, sample size, and the number of potential underlying mechanisms for PTSD.
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Pessoa, Ana Rita Rocha. "Relação entre Perturbação Disfórica Pré-Menstrual e Depressão Perinatal: Revisão Sistemática." Master's thesis, 2021. http://hdl.handle.net/10316/98323.
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Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaCerca de 80-90% das mulheres em idade reprodutiva experienciam sintomas físicos e psicopatológicos na fase lútea do ciclo menstrual. Destas, 1.2 a 5% cumprem critérios de diagnóstico para Perturbação Disfórica Pré-Menstrual (PDPM). Além de gerar sofrimento significativo e interferência com o funcionamento social, ocupacional e interpessoal, esta síndrome surge num continuum de vulnerabilidade, associando-se a outras perturbações afetivas, noutras fases reprodutivas como a gravidez ou o período pós-parto (PP). No entanto, a literatura relativa a esta associação é escassa e apresenta grande variabilidade quer ao nível da metodologia adotada, quer dos resultados e conclusões, nem sempre confirmados por outros estudos e até inconsistentes. Partindo da pesquisa dos termos (premenstrual dysphoric disorder AND (postpartum depression OR pregnancy depression OR postnatal depression OR perinatal depression OR antenatal depression)), nas bases de dados PubMed, EMBASE, CINAHL, PsycINFO foram incluídos sete estudos originais, sendo seis observacionais retrospetivos e um prospetivo, publicados no período de 1999 a 2020. Todos apresentavam definição clara e operacional de PDPM e análise da relação desta com a depressão perinatal (DPN)(gravidez e até aos 12 meses pós-parto). Este estudo seguiu a metodologia Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).Apenas um estudo relacionou a PDPM com a depressão durante a gravidez, entre as 32 e as 42 semanas de gestação, com evidência de associação positiva entre PDPM e DPN. Este e outros cinco estudos, evidenciam uma relação positiva entre PDPM e depressão no PP, avaliada em períodos variáveis desde 2-4 dias até um ano após o nascimento. Apenas num estudo não se verificou associação significativa entre PDPM e DPP, esta avaliada às quatro semanas PP. Concluiu-se que a história de PDPM é fator predisponente para o desenvolvimento de depressão, pela associação positiva e significativa entre PDPM e DPN, principalmente no pós-parto. A presente revisão fundamenta a relevância de avaliar sistematicamente a história de Perturbação Disfórica Pré-Menstrual, pelos profissionais de saúde, no seguimento das mulheres ao longo do período perinatal.
Around 80-90% of women in reproductive age experiences physical and psycological symptoms during the luteal fase of menstrual cycle. Premenstrual dysphoric disorder (PMDD) afects 1.2 to 5% of those. Besides significant suffering and social, ocupacional and interpersonal impairment, this syndrome apears in a continuum of vulnerability being associated with other affetive disorders, in different reproductive phases, such as pregnancy and post partum period. However, the literature on this association is scarce and presents great variability in terms of the methodology adopted, the results and research, which are not always confirmed by other studies and even inconsistent.In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines, we conducted a comprehensive literature search with data-specific search terms (premenstrual dysphoric disorder AND (postpartum depression OR pregnancy depression OR postnatal depression OR perinatal depression OR antenatal depression)) in PubMed, EMBASE, CINAHL, PsycINFO databases. We included seven original studies, six with a retrospective study design and one prospetive study, published in 1999 to 2020, that collected history of PMDS and perinatal depression status (during pregnancy and twelve months after delivery) and association between these two.Only one study related PMDD with depression during pregnancy, evaluated between 32 and 42 weeks of gestation, with evidence of a positive association between PDPM and PND. This and five other studies show a positive relationship between PMDD and postpartum depression (PPD), assessed in periods ranging from 2-4 days to one year after birth. Only in one study there was no significant association between PDPM and PPD, which was assessed at four weeks PP.There appers to be a positive and significant association between history of PMDD and development of perinatal depression, particularly postpartum depression. This review supports the relevance of systematically assessing the history of Premenstrual Dysphoric Disorder, by health professionals, in monitoring women throughout the perinatal period.
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CHIANG, MENG-CHU, and 江孟筑. "Follow the Rhythm of Menstrual Cycle and Dance Between the Masculine and Feminine: Reconstruct Premenstrual Dysphoric Disorder in Intimate Relationships." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/np47c2.
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碩士國立臺北教育大學
心理與諮商學系碩士班
107
This study aimed to investigate the experience and feelings of couples confronting premenstrual dysphoric disorder (PMDD) in intimate relationships; however, it aims to broaden horizons of PMDD. Through semi-structured in-depth interviews with three unmarried heterosexual couples, including joint interview and individual interview collecting data in paired research and dyadic research. Furthermore, nine texts were gathered and analyzed by the thematic analysis within qualitative research approach. The results indicate that when couples confronted PMDD, their experience shared the features were as follows: First, women’s experience of PMDD has been pathologized, including: (a) premenstrual changes being pathologized in relationship context, (b) particularly focusing on physiological and psychological changes in the premenstrual phase since lacking knowledge of menstrual cycle. Second, the couples face many difficulties and challenges during PMDD, including: (a) Women keeping self-silencing on emotions caused by PMDD while men being at a loss to help his lover, (b) PMDD reflects potential relationship issues. Third, benefits to individual and intimate relationship, including: (a) learning from unexplainable pathologized phenomenon, (b) being reborn after suffering from PMDD which is an inevitable lesson in life and intimate relationships. Therefore, the conclusions are as follows: First, women’s PMDD experience is restricted to perspectives of pathology, which its diversification of significance is ignored. Second, PMDD is not only a personal issue but also relationship issues. Third, explicit premenstrual suffering implies psychological needs from intimate relationships and gender role pressure. Fourth, well balanced intimate relationship quality helps women to cope with premenstrual changes and stress caused by PMDD. Fifth, PMDD becomes an inevitable lesson for women to cultivate herself and the intimate relationship with her partner. According to the study, women’s subjective experience of premenstrual changes were pathologized by biased perspectives, so-called PMDD make menstruation a scapegoat for women’s emotional changes and relationship problems, which cost couples opportunities for mutual understanding. It is believed that women’s experience of premenstrual changes should be normalized through introspecting the non-pathological perspectives of PMDD. At the end, this study provided several suggestions and reflections to women and their partner, couple therapists, as well as the researchers in related fields.
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Wang, Jiali. "Recent developments of copula-based models to handle missing data of mixed-type in multivariate analysis." Phd thesis, 2018. http://hdl.handle.net/1885/163716.
Full textAbstract:
In this thesis, we propose innovative imputation models to handle
missing data of mixed-type. Our imputation models can handle 1)
multilevel data sets through random effects; 2) heterogeneity in
a population by specifying infinite mixture models; and 3) a
large number of variables using graphical lasso methods. Two
clinical data sets, a randomised control trial of acute stroke
care patients and a survey of menstrual disorder among teenagers,
are used for the real data application examples, although we
believe that the proposed methods can also be applied to other
data sets with similar structures.
In Chapter 2, we propose a copula based method to handle missing
values in multivariate data of mixed type in multilevel data
sets. Building upon the extended rank likelihood approach
combined with a multinomial probit model formulation, our model
is a latent variable model which is able to capture the
relationship among variables of different types as well as
accounting for the clustering structure. Our proposed method is
evaluated through simulations using both artificial data and the
acute stroke data set to compare it with several conventional
methods of handling missing data. We conclude that our proposed
copula based imputation model for mixed type variables achieves
good imputation accuracy and recovery of parameters in some
models of interest, and that adding random effects enhances
performance when the clustering effect is strong.
In Chapter 3, we consider an infinite mixture of elliptical
copulas induced by a Dirichlet process mixture to build a
flexible copula function as the imputation model. A slice
sampling algorithm is used in conjunction with a prior parallel
tempering algorithm to sample from the infinite dimensional
parameter space and to overcome the mixing issue when sampling
from a multimodal distribution. Using simulations, we demonstrate
that the infinite mixture copula model provides a better overall
fit compared to their single component counterparts, and performs
better at capturing tail dependence features of the data. The
application of this model is also demonstrated using the acute
stroke data set.
In Chapter 4, we propose a Gaussian copula model with a graphical
lasso prior to analyse the conditional associations among 100+
questions in a study of menstrual disorder among teenagers. Our
data come from a large population based study of menstrual
disorder in Australian teenagers conducted in 2005 and 2016
respectively. We also compare cohort differences of menstruation
over the 11-year interval and use the model to predict girls with
a higher risk of developing endometriosis. The model is based on
the model proposed in Chapter 2, but with a graphical lasso prior
to shrink the elements in the precision matrix of the Gaussian
distribution to encourage a sparse graphical structure. The level
of shrinkage is adaptable from the strength of the conditional
associations among questions in the survey. We find that
menstrual disturbance is more pronouncedly reported in 2016 than
a decade ago, and the questions in the questionnaire form several
clusters with strong associations.
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Motlová, Alžběta. "Poruchy menstruačního cyklu u baletek a orientačních běžkyň." Master's thesis, 2021. http://www.nusl.cz/ntk/nusl-437689.
Full textAbstract:
Title: Menstrual Disorders in Ballet Dancers and Orienteering Runners Objectives: The aim of this thesis is to determine prevalence of selected menstrual disorders in ballet dancers and orienteering runners. The data were analyzed and compared to available literature. Methods: The theoretical part of this thesis is a summary of available literature. The data for the research were collected by anonymous non-standardized questionnaire and processed by descriptive analysis, which was proceeded in Microsoft Excel 2010, Statistika and NCSS free version. Qualitative data were evaluated by qualitative analysis. Results: A total of 103 women participated in the research, 57 women from general population (control group), 24 ballet dancers and 22 orienteering runners. The significant higher age at menarché was found in ballet dancers group (Chi square, p = 0,038; p < 0,05) as well in group of orienteering runners (Chi square, p = 0,032; p < 0,05) compared to cotrol group. There was proved a significant deviation of prevalence of secondary amenorrhea in ballet dancers group compared to orienteering runners (Chi square, p = 0,024; p < 0,05). There was no significant difference in prevalence of dysmenorrhea among groups. We found a mild positive correlation between hours of training per week and intensity of...
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Moore, M. Junerose. "An examination of the reproductive health histories for menstrual cycle function of psychiatric patients in a long-term mental health care facility a research report submitted in partial fulfillment ... for the degree of Master of Science, Psychiatric-Mental Health Nursing ... /." 1991. http://catalog.hathitrust.org/api/volumes/oclc/68797684.html.
Full text
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Robinson, Tracey Leigh. "Bone mineral and menstrual cycle status in competitive female athletes : longitudinal study." Thesis, 1994. http://hdl.handle.net/1957/35670.
Full text
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Cockerell, Meredith G. "Relationship between menstrual cycle phases and cognitive function in femalse [sic] who use and do not use oral contraceptives." 2008. http://www.oregonpdf.org/index.cfm.
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Wen, Wan-Yin, and 溫婉吟. "A study on the Prevalence of Eating Disorders and Menstrual Dysfunction of high school students Female Athletes in Kaohsiung city." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/79043545735718418296.
Full textAbstract:
碩士國立高雄師範大學
體育學系
102
Purposes: To investigate the prevalence rate of eating disordered behaviors and menstrual dysfunction in high school female leanness athletes (dance and gymnastics ), non-leanness athletes (track and field, kendo, wushu, and golf ) , and non-athletes. Methods: The participants of this research were 124 high school students (47 leanness athletes, 18 non-leanness athletes, and 59 non-athletes) mean 14.9±1.7 years. All participants completed the Eating Attitudes Test (EAT-26) and menstrual history questionnaires to assessments of eating disordered and menstrual function. According to the EAT-26 questionnaire score, the respondents scoring ≧20 were considered “eating disorders”, and “menstrual dyfunction” includes amenorrhea, oligomenorrhea, and menstrual irregularity. The results of total participants’s BMI, percentage body fat, training characteristics, and the contents of questionnaires were reported by using descriptive statistical analysis method. Results: It was verified that 12.8%, 11.1%, and 10.2% of the leanness athletes, non-leanness athletes, and non-athletes met the criteria for eating disorders respectively, that 51.1%, 50%, and 42.4% of the three groups met the menstrual dyfunction respectively. The presence of primary amenorrhea was only observed in 6.4% (3 of 47) of leanness athletes, the secondary amenorrhea was observed in 2.1% (1 of 47) of leanness athletes, and 5.6% (1 of 18) of non-leanness athletes. We masured the %BF among the three groups evinced 20.5%, 22.1%, 25.3%, the lowest group from leanness athletes, and the %BF result had significantly different (p= 0.000) in three groups. Overall, that five leanness athletes (10.6%) and two non-athletes (3.4%) has two common clinical component of the Triad (eating disorders and menstrual dyfunction). Conclusions: Leanness athletes who had lower %BF, higher prevalence of amenorrhea, and who has higher prevalence of two common clinical component of eating disorders and menstrual dyfunction. Most importantly, continued efforts need to be directed at prevention through education of athletes, coaches, parents, and health care professionals. Key words: female athlete, eating disorders, amenorrhea, percentage body fat, adolescent
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Iacovides, Stella. "The impact of primary dysmenorrhoea on pain perception, quality of life, and sleep in young healthy women." Thesis, 2014.
Find full textAbstract:
Primary dysmenorrhoea, or painful menstruation in the absence of pelvic pathology, is a common, and often debilitating, gynaecological condition that affects between 45 to 95% of menstruating women. Despite the high prevalence, dysmenorrhoea is often poorly treated, and even disregarded, by health professionals, pain researchers, and the women themselves, who may accept it as a normal part of the menstrual cycle. The overall purpose of this thesis is two-fold: first, to contribute knowledge about the impact and consequences of recurrent severe menstrual pain on pain sensitivity, mood, quality of life and sleep in women with primary dysmenorrhoea, and secondly, to investigate day-time and night-time treatment of recurrent primary dysmenorrhoeic pain. For this thesis, I completed five separate studies on three different groups of young, otherwise healthy women with a history of severe primary dysmenorrhoea, and age-matched controls without dysmenorrhoea. The first two studies, presented in Chapter 2, addressed the question of whether women with primary dysmenorrhoea are hypersensitive to experimental pain. I used clinically-relevant experimentally-induced muscle pain stimuli (intramuscular injection of hypertonic saline and ischaemia) in referred and non-referred sites of menstrual pain, at different phases of the menstrual cycle. Women with dysmenorrhoea, compared to women without dysmenorrhoea, had increased sensitivity to deep-muscle pain both within the area of referred menstrual pain and at a remote pain-free site. Further, the increased muscle pain sensitivity was evident even in phases of the menstrual cycle when women did not have menstrual pain, illustrating that the changes in pain perception extend outside of the painful menstruation phase. These findings suggest that women with dysmenorrhoea show long-lasting changes in pain processing possibly because of the recurrent dysmenorrhoeic pain. A secondary aim of the study presented in Chapter 2a, was to determine the impact of menstrual cycle phase on experimentally-induced muscle pain sensitivity in women with and without primary dysmenorrhoea. My results suggest that menstrual cycle phase has no effect on pain sensitivity in either group of women.
As part of my studies, I investigated the impact of dysmenorrhoeic pain on quality of life and mood. I found that women with dysmenorrhoea had a significantly reduced quality of life (Chapter 3) and poorer mood (Chapter 2a and Chapter 5), during menstruation compared to their pain-free follicular phase, and compared to the menstruation phase of the pain-free control women. These data highlight the negative impact that primary dysmenorrhoea has on young women, for up to a few days every month.
Non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed as the first-line therapy for menstrual pain. Yet, severe dysmenorrhoeic pain is often poorly managed, especially at night, when the pain likely disrupts sleep. I conducted two studies investigating the effectiveness of diclofenac potassium, a readily-available NSAID with a low side-effect profile, compared to placebo, in alleviating severe primary dysmenorrhoeic pain across the day (Chapter 4), and during the night (Chapter 5). I also investigated the effectiveness of diclofenac potassium in improving subjective and objective sleep quality (Chapter 5). I found that the daily recommended dose (150 mg) of diclofenac potassium, administered at three timepoints across the first 24 hours of menstruation, significantly reduced perceived menstrual pain, compared to placebo. I confirmed that dysmenorrhoeic pain reduces polysomnographic and subjective measures of sleep quality compared with the pain-free follicular phase. I also showed, for the first time, that diclofenac potassium is effective, compared to placebo, in alleviating nocturnal pain, along with restoring subjective sleep quality and polysomnographic measures of objective sleep quality in women with severe primary dysmenorrhoea.
My studies have addressed several gaps in the knowledge about primary dysmenorrhoea. I have shown that women with primary dysmenorrhoea are hypersensitive to deep muscle pain, supporting the hypothesis of other researchers that the recurrent menstrual pain experienced by these women is associated with central sensitisation, and may predispose women with primary dysmenorrhoea to other chronic painful conditions. Therefore, limiting the monthly noxious input into the central nervous systems of these women, by means of effective treatment of dysmenorrhoea, may improve their long-term health. The research presented in this thesis further highlights the efficacy of diclofenac potassium in relieving not only day-time and night-time dysmenorrhoeic pain, but also in restoring objective and subjective pain-induced sleep disturbances in women with dysmenorrhoea. Further, my research has shown that dysmenorrhoeic pain has an immediate negative impact on quality of life and mood during menstruation. The results of this thesis show the multi-factorial impact of dysmenorrhoea and should stimulate further research about the long-term benefits of effective treatment of menstrual pain.