While hormonal changes during the ovulatory cycles affect multiple body systems, medical management, including medication dosing remains largely uniform between the sexes. Little is known about sex-specific pharmacology in women. Although hormonal fluctuations of the normal menstruating process alters women's physiology and brain biochemistry, medication dosing does not consider such cyclical changes. Using schizophrenia as an example, this paper illustrates how a woman's clinical symptoms can change throughout the ovulatory cycle, leading to fluctuations in medication responses. Effects of sex steroids on the brain, clinical pharmacology are discussed. Effective medication dose may be different at different phases of the menstrual cycle. Further research is needed to better understand optimal treatment strategies in reproductive women; we present a potential clinical trial design for examining optimal medication dosing strategies for conditions that have menstruation related clinical fluctuations.
Biochemistry ; Brain ; Clothing ; Female ; Humans ; Male ; Menstrual Cycle ; Menstruation ; Pharmacology ; Pharmacology, Clinical ; Physiology ; Psychopharmacology ; Schizophrenia ; Steroids

OBJECTIVETo explore the value of nutrition management in obese patients with type 2 diabetes mellitus(T2DM) after laparoscopic sleeve gastrectomy(LSG).

METHODSClinical data of 22 obese T2DM patients undergoing LSG from March 2013 to July 2015 in Fudan University Pudong Medical Center were collected. All the patients strictly followed the specialized instruction by nutritionists: diabetic and low calorie diet 3347.2 to 5020.8 kJ (800 to 1200 kcal) per day before the operation; low calorie liquid diet 2510.4 kJ(600 kcal) per day before operation for promoting gastric emptying; fasting diet before postoperative ventilation; clear liquid diet 1673.6 to 2510.4 kJ (400 to 600 kcal) per day after postoperative ventilation (liquid intake >2000 ml); low fat liquid diet 2928.8 to 3765.6 kJ (700 to 900 kcal) per day (protein 60 g per day at least, 2000 ml liquid) 2 weeks after the operation; semi-liquid diet 1 month after operation and gradually normal diet. All the 22 patients were followed up at 1 week, 1, 3, 6 months after operation on time. Changes of body weight, waist circumference, hip circumference, body mass index(BMI), blood glucose indexes induding fasting blood glucose(FBG), 2-hour postparandial blood glucose(PBG), fasting C-peptide, 2-hour postprandial C-peptide, fasting serum inculin(FINS), 2-hour postprandial inculin(INS), HbAlc, blood pressure and blood lipid indexes were observed and analyzed before and 1 week, 1, 3, 6 months after operation.

RESULTSThe average age of 22 patients (10 men and 12 women) was 38.6 years (18 to 66 years). The duration of diabetes varied from 1 month to 15 years. Comorbidity included 12 patients of high blood pressure, 14 of fatty liver, 1 of coronary heart disease, 1 of gout, 1 of chronic thyroiditis and 1 of menstrual disorder. LSG was performed successfully in all the patients and no severe complications and transference to laparotomy occurred. As compared to pre-operation, at 6 months after operation, the average body weight decreased from (103.9±20.2) kg to (80.9±12.6) kg (t=6.294, P=0.000), waist circumference from (118.6±13.8) cm to (96.4±8.0) cm (t=6.331, P=0.000), hip circumference from (116.9±12.6) cm to (104.0±7.7) cm (t=3.854, P=0.000), BMI from (36.2±5.9) kg/mto (27.9±3.5) kg/m(t=5.630, P=0.000), showing a decreasing trend over time. There was no underweight patient after 6 months follow-up. As compared to pre-operation, at 6 months after operation, the average FBG reduced from (7.4±1.4) mmol/L to (6.0±0.9) mmol/L (t=3.172, P=0.003), 2 h PBG from (14.1±4.9) mmol/L to (7.5±2.2) mmol/L (t=7.026, P=0.000), FINS from (160.0±71.9) mIU/L to (43.8±20.8) mIU/L (t=7.259, P=0.000), 2-hour postprandial INS from (437.6±261.4) mIU/L to (140.5±104.6) mIU/L (t=5.858, P=0.000), fasting C-peptide from (1.1±0.6) μg/L to (0.7±0.3) μg/L (t=3.560, P=0.000), 2-hour postprandial C-peptide from (2.5±0.9) μg/L to (1.5±0.7) μg/L (t=3.865, P=0.000), HbAlc from (8.0±1.6)% to (5.9±0.6)% (t=5.953, P=0.000), showing a decreasing trend over time except FBG, 2h postprandial C-peptide and HbAlc(all P<0.05). FBG and 2-hour PBG of 16 patients returned to normal 3 months after the operation. Blood pressure and trigly ceride decreased obviously 6 months after operation compared to pre-operation with significant difference(P<0.05). At 6 months after operation, blood pressure of 8 comorbidity patients with high blood pressure became normal (8/12, 66.7%) and of 4 patients improved(4/12, 33.3%); B ultrasound examination revealed normal in 11 comorbidity patients with fatty liver(11/14,78.6%) and improvement in 3 patients (3/14,15.4%). Blood uric acid of the gout patient and the menstruation of the menstrual disorder patient returned to normal 3 months and 1 month after the operation respectively.

CONCLUSIONAs for obese patients with T2DM undergoing LSG, reasonable nutrition management is helpful to decrease body weight, and to obtain an ideal improvement of blood glucose and blood lipid levels.

Adolescent ; Adult ; Aged ; Bariatric Surgery ; Blood Glucose ; physiology ; Body Weights and Measures ; C-Peptide ; blood ; physiology ; Caloric Restriction ; Combined Modality Therapy ; Comorbidity ; Coronary Disease ; complications ; Diabetes Mellitus, Type 2 ; complications ; therapy ; Diet Therapy ; methods ; Diet, Diabetic ; Endoscopy ; Fatty Liver ; complications ; surgery ; Female ; Food, Formulated ; Gastrectomy ; Glycated Hemoglobin A ; physiology ; Gout ; complications ; surgery ; Hashimoto Disease ; complications ; Humans ; Hypertension ; complications ; surgery ; Insulin ; blood ; physiology ; Lipids ; blood ; physiology ; Male ; Menstruation Disturbances ; complications ; surgery ; Middle Aged ; Obesity ; complications ; therapy ; Perioperative Care ; methods ; Thyroiditis ; complications ; Treatment Outcome ; Triglycerides ; blood ; physiology

Serum anti-Mullerian hormone (AMH) levels are regarded as an age-specific marker for predicting the ovarian reserve in women of reproductive age. Some studies have shown that the luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio can be used as a predictor of ovarian reserve. The purpose of this study was to assess the variation of LH/FSH ratio with aging and to evaluate the correlation between serum LH/FSH ratio and AMH levels as a predictor of the ovarian reserve in normo-ovulatory women. We retrospectively analyzed the day 3 serum hormone levels in 1,251 patients (age range: 20-50 yr) between January 2010 and January 2011. We divided the patients into 6 groups according to their age. Relation between serum AMH level and LH/FSH ratio was analyzed statistically. The serum AMH level was inversely correlated with age (r = -0.400, P < 0.001). A significant negative correlation was found between serum LH/FSH ratio and age (r = -0.213, P < 0.001). There was a significant partial correlation between serum LH/FSH ratio and AMH level when adjusted by age (r = 0.348, P < 0.001). The LH/FSH ratio could be considered as a useful marker for the ovarian reserve and could be applied to the clinical evaluation with AMH.
Adult ; Aging/blood ; Anti-Mullerian Hormone/*blood ; Female ; Follicle Stimulating Hormone/*blood ; Humans ; Luteinizing Hormone/*blood ; Menstruation/blood/physiology ; Middle Aged ; Ovarian Reserve/*physiology ; Ovulation/*blood/physiology ; Retrospective Studies ; Young Adult

Serum anti-Mullerian hormone (AMH) levels are regarded as an age-specific marker for predicting the ovarian reserve in women of reproductive age. Some studies have shown that the luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio can be used as a predictor of ovarian reserve. The purpose of this study was to assess the variation of LH/FSH ratio with aging and to evaluate the correlation between serum LH/FSH ratio and AMH levels as a predictor of the ovarian reserve in normo-ovulatory women. We retrospectively analyzed the day 3 serum hormone levels in 1,251 patients (age range: 20-50 yr) between January 2010 and January 2011. We divided the patients into 6 groups according to their age. Relation between serum AMH level and LH/FSH ratio was analyzed statistically. The serum AMH level was inversely correlated with age (r = -0.400, P < 0.001). A significant negative correlation was found between serum LH/FSH ratio and age (r = -0.213, P < 0.001). There was a significant partial correlation between serum LH/FSH ratio and AMH level when adjusted by age (r = 0.348, P < 0.001). The LH/FSH ratio could be considered as a useful marker for the ovarian reserve and could be applied to the clinical evaluation with AMH.
Adult ; Aging/blood ; Anti-Mullerian Hormone/*blood ; Female ; Follicle Stimulating Hormone/*blood ; Humans ; Luteinizing Hormone/*blood ; Menstruation/blood/physiology ; Middle Aged ; Ovarian Reserve/*physiology ; Ovulation/*blood/physiology ; Retrospective Studies ; Young Adult

OBJECTIVETo investigate the effect of calcium supplementation on bone mineral density (BMD) in Chinese women with different FokI vitamin D receptor (VDR) genotypes (FF, Ff, and ff) after weaning or resumption of menstruation during lactation.

METHODSA total of 40 subjects with the same FokI VDR genotype were randomly divided into two groups: one received calcium tablet (600 mg once daily as CaCO(3)) and the other placebo tablet once daily for 1 year. At baseline, BMD was measured by dual-energy X-ray absorptiometry at lumbar spine (L2-L4) and at left hip whereas serum PICP, serum OC, and urinary CTX, serum 25(OH)VitD(3), and serum estradiol were measured at weaning and 1 year thereafter.

RESULTSAfter the intervention, BMD at lumbar spine and at left hip increased significantly in all these women with a trend among different FokI VDR genotypes such as FF > Ff > ff (P<0.05, <0.01, and <0.001, respectively). BMD at lumbar spine in women with FF VDR genotype increased much more rapidly than in those with ff VDR genotype (P<0.05). Compared with the control group women with the FF genotype regained more BMD after calcium supplementation (P<0.05).

CONCLUSIONDaily calcium 600 mg supplementation has beneficial effect on the bone health of women with FF VDR genotype.

Adult ; Asian Continental Ancestry Group ; Bone Density ; drug effects ; Calcium, Dietary ; administration & dosage ; pharmacology ; Female ; Genotype ; Humans ; Menstruation ; physiology ; Weaning ; Young Adult

To establish guidelines to diagnosis and treatment for distending pain in breasts during menstruation in traditional Chinese medicine (TCM). With Delphimethod, sent to the second survey questionnaires to 40 gynecology experts in TCM and integrated traditional and western medicine and recovery 35 experts, and the questionnaires were analyzed with SPSS11. 5. The experts' activity and professional level is high. The experts are from all over China and express the typical opinions of all experts in this field. The items in the frame of the guidelines to diagnosis and treatment for distending pain in breasts during menstruation in traditional Chinese medicine are generally recognized. First draft of the guidelines has basically been formed.
Breast ; physiology ; China ; epidemiology ; Data Collection ; methods ; Female ; Guidelines as Topic ; standards ; Humans ; Medicine, Chinese Traditional ; methods ; Menstruation ; physiology ; Pain ; diagnosis ; Pain Management ; Surveys and Questionnaires

Endometriosis (EM) is one of the common and frequently encountered gynecological diseases that seriously influences women's health. Its morbidity reaches 10%-15% in women at reproductive ages, and shows an evident rising tendency. In recent years, the Chinese medicine treatment of EM has won favorable therapeutic effects with few adverse reactions. A brief review on this topic has been made through analyzing and summarizing recent pertinent literatures in terms of treatment depending on syndrome differentiation, cycle treatment, external treatment, integrative medicinal treatment, so as to try to know the status quo of Chinese medicine treatment on EM, and to provide some instructive views for clinical treatment and research.
Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endometriosis ; drug therapy ; etiology ; physiopathology ; Female ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; trends ; Menstruation ; drug effects ; physiology

OBJECTIVEThe effect of dietary restriction, intense exercise and menstrual dysfunction on bone mineral density remains controversial. The aim of this study was to assess the skeletal health status and relationship between bone mineral density and nutrient intake, menstrual status, estrogen level and other factos in Chinese adolescent dancers.

METHODSSixty dancers and 77 healthy controls underwent measurements of bone density, body composition, and estrogen level. Nutrient intake, menstrual status and physical activity were assessed with questionnaires. The correlation between these factors were analyzed.

RESULTSThe dancers under study had a significantly lean body mass index (18.3 +/- 1.4 kg/m2 vs. 21.7 +/- 3.1 kg/m2), lower percentage of body fat (0.25 +/- 0.05 vs. 0.34 +/- 0.04) and later age at menarche (14.0 +/- 0.9 y vs. 13.0 +/- 1.3 y), and the estrogen level, daily calorie and fat intake in them were also lower than in the controls. All the dancers undertook intensive physical activity every day and up to 69% of them suffered from irregular menarche. Yet they had relatively high BMD and BMC of the total body and legs than the controls after adjusting for BMI and age. Site-specific BMD was positively correlated to BMI, body composition and training hours per week and negatively correlated to the age at menarche and menstrual frequency.

CONCLUSIONSThe relatively high BMD and BMC of the dancers at the total body and legs were probably caused by high levels of weight-bearing physical activity. To ameliorate disordered eating, especially low energy intake might be helpful to prevent the Triad and to improve the bone health in adolescent dancers.

Adolescent ; Bone Density ; China ; epidemiology ; Dancing ; physiology ; statistics & numerical data ; Energy Intake ; Exercise ; physiology ; Female ; Humans ; Menstruation Disturbances ; epidemiology ; Osteoporosis ; prevention & control ; Sex Characteristics

To establish guidelines to diagnosis and treatment for distending pain in breasts during menstruation in traditional Chinese medicine (TCM). With delphi method, survey questionnaires were sent to 40 gynecology experts in TCM and integrated traditional and western medicine, and recovery 35 experts were recoveried which, were analyzed by SPSS 11.5. The experts' activity and professional level was high. The expert's are from all over China and express the typical opinions of all experts in this field. The items in the frame of the guidelines to diagnosis and treatment for distending pain in breasts during menstruation in TCM are generally recognized, but different opinions from the card type, governance, in areas such as prescription standard also exist.
Female ; Guidelines as Topic ; Humans ; Medicine, Chinese Traditional ; methods ; Menstruation ; physiology ; Middle Aged ; Pain ; drug therapy ; epidemiology ; etiology ; Surveys and Questionnaires

The authors report a case of acute kidney injury (AKI) resulting from menstruation-related disseminated intravascular coagulation (DIC) in an adenomyosis patient. A 40-yr-old woman who had received gonadotropin for ovulation induction therapy presented with anuria and an elevated serum creatinine level. Her medical history showed primary infertility with diffuse adenomyosis. On admission, her pregnancy test was negative and her menstrual cycle had started 1 day previously. Laboratory data were consistent with DIC, and it was believed to be related to myometrial injury resulting from heavy intramyometrial menstrual flow. Gonadotropin is considered to play an important role in the development of fulminant DIC. This rare case suggests that physicians should be aware that gonadotropin may provoke fulminant DIC in women with adenomyosis.
Acute Kidney Injury/*diagnosis/etiology ; Adult ; Creatinine/blood ; Disseminated Intravascular Coagulation/*chemically induced/complications ; Endometriosis/*complications/diagnosis/surgery ; Female ; Fertilization in Vitro ; Gonadotropins/*adverse effects ; Humans ; Magnetic Resonance Imaging ; Menstruation/*physiology ; Uterus/pathology/surgery