Menstrual cycle

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The menstrual cycle plays a role in the variation of symptoms and symptom severity in many immunological, neurological, and female predominant diseases.

Cycles and phases[edit | edit source]

Ovarian cycle[edit | edit source]

Follicular phase[edit | edit source]

Ovulation[edit | edit source]

Luteal phase[edit | edit source]

Uterine cycle[edit | edit source]

Menstruation[edit | edit source]

Proliferative phase[edit | edit source]

Secretory phase[edit | edit source]

Immune changes[edit | edit source]

Populations of Tregs increase peak just before ovulation and bottom out during the luteal phase, just before menstruation.

Progesterone and estrogen have anti-inflammatory effects.

Health effects in ME/CFS[edit | edit source]

Women who develop CFS report at higher rates a history of irregular cycles, amenorrhea, anovolutory cycles and sporadic bleeding between periods.[1]

Health effects in other conditions[edit | edit source]

The menstrual cycle can have effects on the timing and severity of symptoms of women suffering from many different conditions, including epilepsy, migraines, asthma, rheumatoid arthritis and irritable bowel syndrome.[2]

Many women with epilepsy have patterns of seizure activity linked to their menstrual cycles, called catamenial epilepsy.[3][4][5][6] Seizure activity increases just before ovulation and just before menstruation.[7]

Abrupt estrogen withdrawal, such as what occurs just prior to menstruation, can trigger migraines.[8][9] Women with rheumatoid arthritis experienced reduced symptoms after ovulation, owing potentially to the anti-inflammatory effects of progesterone and estrogen.[10]

In a retrospective study, 72% of women with fibromyalgia reported a worsening of symptoms just before their periods.[11]

Women with these diseases may experiencing a worsening of symptoms at specific points in their menstrual cycle, particularly just before or around their periods.[12]

Managing premenstrual symptoms[edit | edit source]

Nonsteroidal anti-inflammatory agents are occasionally effective in women with menstrual migraine, as are beta blockers, calcium channel blockers, ergotamine, antidepressants, estrogen and estradiol.[13]

Pathophysiology of menstrual symptoms[edit | edit source]

Estrogen may directly affect blood vessels by stimulating nitric oxide release. Women with a history of menstrual migraine had a heightened activation of the nitro oxide and L-arginine pathways, especially during the luteal phase.[14]


See also[edit | edit source]


References[edit | edit source]


The information provided at this site is not intended to diagnose or treat any illness.

From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history