Menstrual cycle effects on common medical conditions

291Five percent of menstruating women have severe premenstrual symptoms and impairment of functioning defined as premenstrual dysphoric disorder (PMDD). Clinically significant premenstrual symptoms occur in at least an additional 20% of menstruating women. The diagnosis of PMDD should be confirmed by prospective symptom charting over 2 menstrual cycles to confirm the timing of the symptoms and to rule out other diagnoses. The burden of illness of PMDD includes disruption of parenting and partner relationships and decreased productivity in work roles. In addition, women with PMDD have increased use of health care services such as clinician visits and increased use of prescription medications and over-the-counter preparations. The etiology of PMDD is multifactorial. In particular, dysregulation of the serotonin and allopregnanolone systems is implicated. Several effective treatment options exist, including serotonergic antidepressant medications and an oral contraceptive that contains ethinyl estradiol and drosperinone. In addition, other hormones that suppress ovulation, anxiolytics, cognitive therapy, chasteberry and calcium may be helpful.Cinq pour cent des femmes menstruées ont des symptômes prémenstruels sévères et une incapacité du fonctionnement appelée trouble dysphorique prémenstruel (TDPM). Au moins 20 % de femmes menstruées de plus ont des symptômes prémenstruels cliniquement significatifs. Il faut confirmer le diagnostic de TDPM en suivant les symptômes de façon prospective au cours de deux cycles menstruels afin de confirmer le moment de l'apparition des symptômes et d'exclure d'autres diagnostics. Le fardeau morbide imposé par le TDPM comprend la perturbation des relations avec les enfants et le partenaire et une baisse de productivité au travail. Les femmes atteintes de TDPM ont en outre recours davantage aux services de santé comme les visites aux cliniciens et prennent davantage de médicaments d'ordonnance et en vente libre. L'étiologie du TDPM est multifactorielle. La dysrégulation des systèmes de la sérotonine et de l'allopregnanolone en particulier est mise en cause. Il existe plus d'un traitement efficace possible, y compris des antidépresseurs sérotonin-ergiques et un contraceptif oral qui contient de l'éthinyloestradiol et de la drosperinone. D'autres hormones qui bloquent l'ovulation, des anxiolytiques, la thérapie cognitive, le gattilier (Vitex agnus castus) et le calcium peuvent en outre aider. Review Paper Examen critique DiagnosisAbout 80% of women report at least mild premenstrual symptoms, 20%-50% report moderate-to-severe premenstrual symptoms, and about 5% report severe symptoms for several days with impairment of functioning.

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“…42,47 It is presumed that the menstrual cycle fluctuations of gonadal hormones influence some of the symptoms of these medical conditions.…”

Section: Epidemiologymentioning

confidence: 99%

Premenstrual Dysphoric Disorder: Burden of Illness and Treatment Update

Pearlstein¹,

Steiner²

2012

FOC

103

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“…E 2 is known to modulate insulin sensitivity and, consequently, glucose homeostasis, but the mechanisms underlying this action are not clearly understood. Fluctuations in glucose homeostasis are observed during the menstrual cycle, and diabetes becomes more resistant to treatment during the luteal phase (1). When cycles are irregular or too long, the incidence of diabetes increases (2), and during the last trimester of gestation, when hormonal changes are pronounced, insulin action is decreased (3).…”

Section: Muscle Glut4 Regulation By Estrogen Receptors Er␤ and Er␣mentioning

confidence: 99%

Muscle GLUT4 regulation by estrogen receptors ERβ and ERα

Barros

Machado

Warner

et al. 2006

Proc. Natl. Acad. Sci. U.S.A.

235

184

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Estrogen is known to influence glucose homeostasis with dominant effects in the liver, but the role of estrogen receptors in muscle glucose metabolism is unknown. In the present study, we investigated the expression of the two estrogen receptors, ERα and ERβ, and their influence on regulation of the glucose transporter, GLUT4, and its associated structural protein, caveolin-1, in mouse gastrocnemius muscle. Immunohistochemical analysis revealed that ERα and ERβ are coexpressed in the nuclei of most muscle cells, and that their levels were not affected by absence of estradiol [in aromatase-knockout (ArKO) mice]. GLUT4 expression on the muscle cell membrane was not affected by loss of ERβ but was extremely reduced in ERα -/- mice and elevated in ArKO mice. RT-PCR confirmed a parallel reduction in GLUT4 mRNA levels in ERα -/- mice. Upon treatment of ArKO mice with the ERβ agonist 2,3-bis(4-hydroxyphenyl)propionitrile, GLUT4 expression was reduced. By immunofluorescence and Western blotting, caveolin-1 expression was higher in ArKO mice and lower in ERβ -/- and ERα -/- mice than in WT littermates. GLUT4 and caveolin-1 were colocalized in WT and ArKO mice but not in ERβ -/- and ERα -/- mice. These results reveal that ERα is a positive regulator of GLUT4 expression, whereas ERβ has a suppressive role. Both ERβ and ERα are necessary for optimal caveolin-1 expression. Taken together, these results indicate that colocalization of caveolin-1 and GLUT4 is not an absolute requirement for muscle glucose metabolism but that reduction in GLUT4 could be contributing to the insulin resistance observed in ERα -/- mice.

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“…Estrogen also plays an important role in glucose homeostasis, and is known to modulate insulin sensitivity [33]. Variations in human glucose homeostasis are observed during the menstrual cycle, and diabetes becomes more resistant to treatment during the luteal phase [34]. Individuals with mutations in genes encoding aromatases, enzymes that convert androgens to estrogens, also display truncal obesity, insulin resistance, and hyperlipidemia [35].…”

Section: Mechanisms Involved In Fermented Soypaste Antiobesity Activitymentioning

confidence: 99%