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]

Numerous outbreaks of epidemic myalgic encephalomyelitis noted menstrual irregularities and a tendency toward relapse before or during menstruation.[2][3][4]

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.[5]

Many women with epilepsy have patterns of seizure activity linked to their menstrual cycles, called catamenial epilepsy.[6][7][8][9] Seizure activity increases just before ovulation and just before menstruation.[10]

Abrupt estrogen withdrawal, such as what occurs just prior to menstruation, can trigger migraines.[11][12] Women with rheumatoid arthritis experienced reduced symptoms after ovulation, owing potentially to the anti-inflammatory effects of progesterone and estrogen.[13]

In a retrospective study, 72% of women with fibromyalgia reported a worsening of symptoms just before their periods.[14]

Women with these diseases may experiencing a worsening of symptoms at specific points in their menstrual cycle, particularly just before or around their periods.[15]

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.[16]

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.[17]


See also[edit | edit source]


References[edit | edit source]

  1. http://www.amjmed.com/article/S0002-9343(98)00173-9/abstract
  2. Shelokov, Alexis; Habel, Karl; Verder, Elizabeth; Welsh, William (August 1957), "Epidemic Neuromyasthenia — An Outbreak of Poliomyelitis-like Illness in Student Nurses", New England Journal of Medicine, 1957 (257): 345-355, doi:10.1056/NEJM195708222570801 
  3. Albrecht, Robert (March 21, 1964). "Epidemic Neuromyasthenia Outbreak in a Convent in New York State". Journal of the American Medical Association. 187: 904–907. 
  4. Poskanzer, David C.; Henderson, Donald A.; Kunkle, E. Charles; Kalter, Seymour S.; Clement, Walter B.; Bond, James O. (1957), "Epidemic Neuromyasthenia — An Outbreak in Punta Gorda, Florida", New England Journal of Medicine, 1957 (257): 356-364, doi:10.1056/NEJM195708222570802, PMID 13464939 
  5. http://archinte.jamanetwork.com/article.aspx?articleid=208109
  6. http://www.seizure-journal.com/article/S1059-1311(07)00233-6/abstract
  7. http://onlinelibrary.wiley.com/doi/10.1002/ana.20214/abstract;jsessionid=6C4279A672141BB3D4C3A2C30AD44751.f01t04
  8. http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1157.1997.tb01197.x/abstract
  9. http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2006.00672.x/abstract
  10. http://archinte.jamanetwork.com/article.aspx?articleid=208109
  11. http://jama.jamanetwork.com/article.aspx?articleid=202685
  12. http://archinte.jamanetwork.com/article.aspx?articleid=208109
  13. http://www.amjmed.com/article/0002-9343(83)90789-1/abstract
  14. http://www.tandfonline.com/doi/abs/10.3109/03009749709065698
  15. Zierau, Oliver (2012). "Role of female sex hormones, estradiol and progesterone, in mast cell behavior". Front Immunol. 
  16. http://archinte.jamanetwork.com/article.aspx?articleid=208109
  17. http://jama.jamanetwork.com/article.aspx?articleid=202685


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