Difference in endocrine features between men and women supports a biological hypothesis in affective disorders among women. Studies done showed high probability that mood changes in associated with hormonal alterations, particularly that of estrogen and progesterone. There are cyclic morphological changes occurring in the female reproductive system in response to these hormones. The cytohormonal maturation index (CHMI) is used to evaluate the female hormonal milieu. A differential of the three types of cells is expressed as percentages of the parabasal (P), the intermediate (I), and the superficial (S) cells, in that order. Predominance of the intermediate cells reflect high levels of progesterone, and the superficial cells that of estrogen. This study aims to compare the correlation of CHMI with ovulatory phase between women of reproductive age with affective disorder and normal control; and to compare the CHMI of the two groups. Eight women of reproductive age (mean age = 29.62 +/- 7.95), diagnosed to have affective disorders and having an episode of mania/hypomania or depression, underwent Paps smear. Written consents were obtained. LMP and PMP were obtained to determine the current ovulatory phase. The control group is composed of seven women of same age group (mean age = 29.29 +/- 6.65) having no manifestations of any psychiatric illnesses. Paps smear was performed by a Gynecology Resident. A Pathology Resident blinded to the study reviewed the slides for CHMI. Fishers exact I test and Mann-Whitney U test were utilized. A p value of 0.05 was considered as statistically significant. There is a significant difference in the proportion of agreement between the ovulatory phase and the CHMI between the two groups (p=0.045). However, there is no difference in the percentages of progesterone and estrogen between the two groups (p=0.247 and 0.452, respectively).
Human ; Female ; Adult ; WOMEN ; FOLLICULAR PHASE ; MOOD DISORDERS ; ;

OBJECTIVE: The aim was to evaluate whether the differences of PG concentration in follicular and peritoneal fluid during preovulatory phase exist between the women with and without endometriosis. MATERIAL AND METHODS: Twenty-three patients with endometriosis, 8 were stage I-II and 15 were stage III-IV, and another 23 patients without endometriosis were undergone laparotomy during late follicular phase. Peritoneal fluid from 46 patients and follicular fluid from 42 patients were obtained, and these samples were analyzed double times for PGF2alpha, PGE2 and estradiol. RESULTS: The mean level of PGF2alphain the peritoneal fluid was significantly higher in the group with endometriosis than in the control(P=0.0293), especially more significant in stage I-II endometriosis. Although there was no significant difference of PGF2alphaconcentration in the follicular fluid between the groups, the stage III-IV endometriosis group showed slightly higher PGF2alphalevel than both the stage I-II group and the control(P=0.0604). And also, there was significant positive correlation with the level of PGF2alphaand estradiol in the follicular fluid only in the endometriosis group(r=0.4988, P=0.0154), not in the control. However, there was no difference in the level of PGE2 and estradiol in the peritoneal or follicular fluid between the groups. CONCLUSION: Some alterations of PGF2alphalevel exist in the women with endometriosis. These are significantly higher PGF2alphalevel in peritoneal fluid with mild endometriosis and slightly higher PGF2alphalevels in follicular fluid with extensive endometriosis during preovulatory phase, which suggest that PGF2alphamay play some roles in subfertility associated with endometriosis.
Ascitic Fluid* ; Dinoprost* ; Dinoprostone ; Endometriosis* ; Estradiol ; Female ; Follicular Fluid ; Follicular Phase* ; Humans ; Infertility ; Laparotomy

OBJECTIVE: To understand the physiologic effects and secretion pattern of inhibin A and inhibin B throughout menstrual cycle in the normal reproductive women, serum values of inhibin A and inhibin B were measured. METHODS: Inhibin A and inhibin B levels were measured in 320 serum samples from 160 normal reproductive women by solid phase sandwich ELISA. RESULTS: In the normal reproductive women, inhibin A is secreted in low serum levels until the mid- proliferative phase, begins to increase in the late proliferative phase (16.53+/-1.57 pg/ml), reaches the peak in the early secretory and mid-secretory phase (45.56+/-2.37 and 45.85+/-2.08 pg/ml), and subsequently decreases in the late secretory phase. We found that inhibin B begins to increase in the early proliferative phase (65.40+/-4.08 pg/ml), is secreted in high concentration in the proliferative phase, reaches the peak in the ovulatory phase (110.74+/-9.83 pg/ml), and thereafter declines rapidly to the lowest level in the mid-secretory phase (29.59+/-2.08 pg/ml). CONCLUSION: In conclusion, serum inhibin A levels peak during the luteal phase, indicating the greatest production by the corpus luteum and serum inhibin B levels increase during the follicular phase, indicating the greatest production by follicles in early stage of development. Inhibin A is associated with the luteal function and inhibin B, the follicular function. Both inhibins are associated with the follicular maturation and development.
Corpus Luteum ; Enzyme-Linked Immunosorbent Assay ; Female ; Follicular Phase ; Humans ; Inhibins* ; Luteal Phase ; Menstrual Cycle*

OBJECTIVE: The purpose of the present study was to determine whether a relationship exists between the clinical symptoms (dysmenorrhea and infertility) and prostaglandin (PG) concentrations in follicular and peritoneal fluid in the women with endometriosis during the late follicular phase of the menstrual cycle. METHODS: Thirty patients with pelvic endometriosis diagnosed by pelvic surgery were enrolled. Eight patients were suffering from severe dysmenorrhea and 11 had history of primary or secondary infertility among them. Endometriosis patients were grouped by the presence of each symptom and compared with 33 control patients without endometriosis. Peritoneal fluid was collected in the beginning of peritoneal opening and dominant follicular fluid was aspirated by syringe needle at the time of operation. Then PGE2 and PGF2a concentration were measured at each tube. RESULTS: Follicular fluid PGF2a levels were increased in 30 endometriosis patients (P=0.003), and the levels were significantly higher in 11 patients with infertility compared with the control (P=0.001). Peritoneal fluid PGF2a levels were significantly higher in 8 patients with severe dysmenorrhea compared with the others or the control (P=0.028). Follicular or peritoneal fluid PGE2 levels were not different between any group and the control. There was no significant correlation between size of endometrioma and each PG levels. CONCLUSION: Severe dysmenorrhea in endometriosis patients would be related with the high level of peritoneal fluid PGF2a concentration, and infertility in endometriosis would be related with the high level of follicular fluid PGF2a concentration.
Ascitic Fluid* ; Dinoprostone* ; Dysmenorrhea ; Endometriosis* ; Female ; Follicular Fluid ; Follicular Phase ; Humans ; Infertility ; Menstrual Cycle ; Needles ; Prostaglandins ; Syringes

BACKGROUND/AIMS: The female sex hormones are thought to affect gastrointestinal function. However, the relationship between female sex hormone and gastrointestinal function has not been identified. The aim of this study was to evaluate the relationship between constipation and hormonal changes in young women and to find the difference of colon transit time (CTT) across the menstrual cycle. METHODS: Two hundred and five students completed questionnaires. CTT as well as serum estradiol and progesterone levels were measured in 15 regularly menstruating volunteers. RESULTS: One hundred and six experienced changes in bowel habit across menstrual cycle. The mean estradiol concentration in the follicular phase was not significantly different from that in the luteal phase (118.0 +/- 28.8 pg/mL vs. 76.9 +/- 10.5 pg/mL, p > 0.05). The mean progesterone concentration in the luteal phase was significantly higher than that in the follicular phase (3.0 +/- 0.9 ng/mL vs. 1.2 +/- 0.4 ng/mL, p < 0.05). The mean CTT was not significantly delayed in the luteal phase than the time in the follicular phase (45 +/- 20 vs. 35 +/- 22 hours, p > 0.05). However, CTT was delayed at the progesterone peak in 11 of 15 (73.3%) women. CONCLUSIONS: Our study suggested a possible role of female sex hormones as a cause of constipation in young women.
Colon* ; Constipation ; Estradiol ; Female ; Follicular Phase ; Gonadal Steroid Hormones ; Humans ; Luteal Phase ; Menstrual Cycle* ; Progesterone ; Volunteers ; Surveys and Questionnaires

BACKGOUND: This study was designed to examine the effects of female hormones and the menstrual cycle on postoperative pain. METHODS: Ninety women who underwent gynecologic surgery involving a lower abdominal incision were asked for information regarding their menstrual cycles, and blood samples were obtained to determine the progesterone and estrogen levels of the patients at the time of surgery. Patient controlled analgesia was applied to control postoperative pain and an estimate of the consumption of analgesic drugs by the patients was made. Analgesic consumption and pain scores were recorded at 2, 24, and 48 hours after operation. RESULTS: There was no relationship observed between the concentration of progesterone and estrogen and the consumption of analgesic drugs. However, patients that were in the luteal phase at the time of surgery consumed a significantly lower amount of analgesic drugs during the 2-24 hours following surgery than patients that were in the follicular phase (19.4 +/- 6.5 ml vs 24.6 +/- 11.0 ml, P < 0.05), Theree was, no significant difference in pain scores between two menstrual phases. CONCLUSIONS: This study demonstrates that there is less postoperative pain experienced by patients that are in the luteal phase of their menstrual cycle at the time of surgery than in patients that were in the follicular phase of their menstrual cycle, however, the results of this study did not reveal a relationship between the blood concentration of female hormones and postoperative pain.
Analgesia, Patient-Controlled ; Analgesics ; Estrogens ; Female* ; Follicular Phase ; Gynecologic Surgical Procedures ; Humans ; Luteal Phase ; Menstrual Cycle* ; Pain, Postoperative* ; Progesterone

Alteration in the hormone level associated with menstrual cycle influences the interaction between the urethra and bladder as well as detrusor function, maybe due to the common embryological origin of lower female genital and urinary tract. We tried to investigate the effect of the menstrual cycle on cystometric diagnosis through this retrospective study. 60 women with regular menstruation were enrolled in this study. The study groups were divided into 2 groups, Group I was women whose symptoms were not influenced by the menstrual cycle, Group II was women whose symptoms were adversely affected premenstrually. The majority of normal cystometric diagnosis were made in the luteal phase (Group I: 42.9% vs 4.4%, p<0.05; Group II: 50.0% vs 22.2%, p<0.05). But diagnosis of genuine stress incontinence, detrusor instability, mixed genuine stress incontinence and detrusor instability were frequently made in the follicular phase of mentruation. Normal cystometric diagnosis in the group II were more commom than the group II ( 36.8% vs 19.7%, p<0.05 ). The results of this study reveal that the timing of cystometric evaluation may influence the the detection of a positive diagnosis. In patients whose symptom are influenced by their menstrual cycle, the luteal phase may not be the correct time to make an accurate diagnosis.
Diagnosis ; Female ; Follicular Phase ; Humans ; Luteal Phase ; Menstrual Cycle* ; Menstruation ; Retrospective Studies ; Urethra ; Urinary Bladder ; Urinary Tract

OBJECTIVES: It was reported that symptoms change according to menstrual cycles, aggravation of symptoms 3 to 7 days before menstruation in bipolar disorder for example. Therefore, this study was to investigate the correlation among the change of symptoms, serum lithium level, estradiol and progesterone levels. METHODS: For women with bipolar disorder, we divided by menstrual cycle into three groups; middle follicular phase, middle luteal phase and late luteal phase. We estimated serum lithiumlevel, estradiol and progesterone of each phase, and assessed the change of symptoms using Hamilton Rating Scale for Depression and Manic-State Rating Scale. Consequently they were divided into symptom changed group and not changed group. RESULTS: Serum lithium levels of patients with bipolar disorder were significantly decreased in middle luteal phase compared with in middle follicular phase, and it was sustained in low level to late follicular phase. Although there were no statistically significant differences, there was more decreased serum lithium level in symptom changed group than in symptom unchanged group. Serum lithium levels were not statistically correlated with both estradiol and progesterone levels. When symptom changed group was compared with symptom not changed group, there was a significant correlation between changes of symptom and estradiol level. CONCLUSION: The possible mechanism of the change of symptoms according to menstrual cycle in bipolar disorder may be in estrogen level and due to the effect of serum lithium level change according to menstrual cycle. The investigation of this mechanism will contribute to the treatment and the prevention of recurrence symptons in bipolar disorder.
Bipolar Disorder* ; Depression ; Estradiol ; Estrogens ; Female ; Follicular Phase ; Humans ; Lithium* ; Luteal Phase ; Menstrual Cycle* ; Menstruation ; Progesterone ; Recurrence

OBJECTIVE: To determine if salivary ferning correlates significantly with sonographic indices in identifying the fertile period, and whether it may be used as a cheaper, and more convenient way to aid infertility patients in achieving pregnancy.

POPULATION: Subjects who complain of difficulty achieving pregnancy and for whom follicle monitoring was indicated were recruited from the Outpatient Department in a tertiary hospital in Manila.

METHODOLOGY: Patients (n=40) with Primary or Secondary Infertility from April 2013 to August 2015 who require serial follicle monitoring as part of infertility work up were recruited in the study. For every follicle monitoring by ultrasound done by one sonologist, a salivary sample was obtained from the subject and the ferning pattern was determined and recorded by one pathologist blinded as to the day of the subject's menstrual cycle.

RESULTS: There was a total of 40 subjects who underwent 2 serial follicle monitoring during the study. The 1 st TVS (preovulatory) was done between Day 9 to 14 of the cycle with an average of Day 11. Correspondingly, salivary ferning done showed that there were 26 (65.0%) with Salivary Ferning 1 pattern and 14 (35.0%) with Salivary Ferning 2 pattern (p=0.35). This showed no significant difference between follicle monitoring and salivary ferning pattern and either may be used in identifying fertile period preovulatory. The 2nd TVS (postovulatory) was done between Day 12 to 21 with an average of Day 16. All the second ultrasound findings showed signs of ovulation. Correspondingly, there were 1 (2.0%) showed Salivary Ferning 1 pattern, 11 (27.5%) showed Salivary Ferning 2 Pattern and 28 (70.0%) showed Salivary Ferning 3 Pattern 9 (p=0.05). This showed no significant difference between follicle monitoring and salivary ferning pattern, hence, TVS follicle monitoring remains more reliable in identifying that ovulation has occurred.

CONCLUSION: Salivary ferning corresponded well with ultrasonographic findings during the preovulatory phase of the cycle, while no correlation was noted between the salivary ferning pattern and the postovulatory phase of the cycle. Hence, sonographic follicle monitoring remains a better predictor of ovulation, and more effective in identifying the fertile period

Human ; Female ; Adult ; Pregnancy ; Follicular Phase ; Luteal Phase ; Fertile Period ; Tertiary Care Centers ; Outpatients ; Pathologists ; Ovulation ; Ovarian Follicle ; Infertility

OBJECTIVE: To evaluate the changing pattern of serum leptin level and the correlation between estradiol level during the clomiphene citrate challenge test(CCCT) or controlled ovarian hyperstimulation(COH) cycle. METHODS: Twenty-seven women who underwent CCCT and fourteen women who underwent controlled ovarian hyperstimulation were recruited to measure the serum leptin level. After correction of serum concentration with body mass index(BMI), changes of leptin level and correlation with serum estradiol level during CCCT and COH cycle were analyzed. RESULTS: Circulating leptin levels were significantly correlated with BMI at each time point in CCCT cycle(P<0.01). In CCCT cycle, leptin/BMI level was significantly increased at midluteal phase compared to that of menstrual cycle day 3 and 10(p<0.05). In women with regular menstruation, leptin/BMI level at midluteal phase was significantly higher than that of menstrual day 3 and 10, but this difference was not seen in women with irregular menstruation. The leptin/BMI level in COH cycle showed increasing tendency throughout ovarian stimulation. But there was no significant correlation between leptin/BMI and estradiol level in CCCT and COH cycle. CONCLUSION: There is a significant correlation between BMI and circulating leptin level. Midluteal leptin level is significantly higher than that of follicular phase in CCCT cycle, and there is an increasing tendency in leptin level after ovarian stimulation in CCCT and COH cycle without statistical significance. These findings suggest that circulating estradiol concentration has no major influence on circulating leptin level.
Clomiphene* ; Estradiol ; Female ; Follicular Phase ; Humans ; Leptin* ; Menstrual Cycle ; Menstruation ; Ovulation Induction