Exogenous prostaglandins (PGs) have been reported to suppress or to promote the function of the primate corpus luteum in vitro and in vivo, but the role of endogenous ovarian prostaglandins in regulating luteal function during the menstrual cycle is unknown. Infusion (via osmotic pump) of the prostaglandin-synthesis inhibitor sodium meclofenamate into the corpus luteum, but not via the jugular vein, during the midluteal phase of the menstrual cycle resulted in a decline in progesterone levels and premature menses in rhesus monkeys (Macaca mulatta). These results suggest that meclofenamate suppresses the production of an obligatory luteotropic prostaglandin or other metabolite of arachidonic acid. We were unable to confirm that ovarian prostaglandin synthesis was diminished during treatment, since we could not consistently measure a gradient in PGE or PGF₂(α) across the ovary. Dispersed cells from the macaque corpus luteum produced PGF₂(α) in vitro. Production was stimulated by exposure to arachidonic acid and was inhibited by meclofenamate and another prostaglandin-synthesis inhibitor, flurbiprofen. Although the two drugs were potent inhibitors of prostaglandin synthesis in vitro, intraluteal infusion of flurbiprofen in monkeys did not mimic the luteolytic effects of meclofenamate. These studies provide the first evidence of an obligatory luteotropic role for a metabolite of arachidonic acid during the primate luteal phase. However the data suggest that the luteolytic effect of meclofenamate in vivo is not mediated entirely by the inhibition of local prostaglandin synthesis. Further studies are needed to determine the mechanism(s) of meclofenamate-induced luteolysis and to identify the putative obligatory luteotropin.

These studies were undertaken to characterize the adenylate cyclase system of the primate (rhesus monkey) corpus luteum, and to correlate gonadotropin-sensitive adenylate cyclase activity with the functional activity of the corpus luteum at specific stages of the luteal phase of the menstrual cycle, particularly near the time of luteolysis. The conversion of [α-³²P] ATP to [³²P] cAMP was assayed in preparations of luteal tissue obtained from rhesus monkeys at midluteal phase of the menstrual cycle. Cyclic AMP production was influenced by the pH, osmolality, and ionic strength of the assay buffer, and was acutely sensitive to Mg⁺². Michaelis-Menten kinetics were seen when the ATP:Mg ratio was constant. The gonadotropins, hLH and hCG but not hFSH, stimulated cAMP production in a similar dose-dependent manner. Deglycosylated hCG blocked the stimulation of adenylate cyclase by hLH and hCG. The addition of GTP increased maximal activation of adenylate cyclase by hLH or hCG but did not alter sensitivity to the hormones. The adenylate cyclase of macaque luteal tissue did not respond to the addition of isoproterenol or epinephrine; furthermore, these catecholamines did not affect hCG-stimulation of adenylate cyclase. Forskolin and fluoride stimulated cAMP production in a dose-dependent manner. The activity of adenylate cyclase was examined in corpora lutea obtained from rhesus monkeys at specific stages in the luteal phase of the menstrual cycle (days 3-5, 6-8, 9-12, 13-15, 16-menses after the midcycle LH surge). Basal adenylate cyclase activity, activity stimulated by GMP-P(NH)P, GTP, GTP + hLH, and GTP + hCG, sensitivity of the enzyme to hLH (measured by K(act)), and peripheral progesterone levels were low in the early luteal phase (days 3-5), increased by midluteal phase (days 6-8 and 9-12), and then decreased by the late luteal phase days 13-15 and 16-menses). In contrast, there were no significant differences among the age groups tested for forskolin-stimulated activity. Thus the adenylate cyclase system of the rhesus monkey undergoes significant changes during the luteal phase which are associated with the development and regression of the corpus luteum of the menstrual cycle. Mechanisms which modulate gonadotropin and nucleotide activation of adenylate cyclase without interfering directly with the catalytic unit are implicated in the changes which accompany luteolysis.

Bakgrund: Periodisering av träning kan vara av intresse för tränande kvinnor och deras coacher då hormonerna fluktuerar under menscykelns faser. Mycket forskning om styrketräning är gjorda på män. Att studera ökning av muskelstyrka hos kvinnor är komplext då deras hormoner fluktuerar månadsvis och anses kunna påverka studieresultat under menstruationscykeln. Syftet med litteraturstudien var att sammanställa studierna som finns inom ämnet och därefter dra nytta av kvinnors hormoner för att optimera muskelstyrka och att undvika risken för nya skador eller drabbas av de risker styrketräning kan minska. Syfte: Att granska och sammanställa studier gällande eventuella skillnader i muskelstyrka under menscykelns olika faser samt gällande eventuell effekt av periodiserad träning på muskelstyrkan i menscykeln faser.  Metod: En systematisk översiktsstudie med både interventionsstudier och observationsstudier inkluderade. En första sökning gjordes på PubMed och fem studier valdes ut och kvalitetsgranskades enligt PEDro scale. Därefter utökades sökningen för observationsstudier vilket gjordes på Google scholar. Där framkom ytterligare fyra studier och dessa granskades enligt SBU:s granskningsmall för observationsstudier.  Resultat: Resultatet tyder på att det inte finns någon tydlig skillnad mellan faserna då resultatet skiljde sig mellan de olika studierna. Forskningen inom ämnet är för bristfällig för att komma till någon adekvat slutsats gällande resultatet.  Konklusion: Vidare forskning, samt fler studier med samma utfallsmått behövs för att kunna dra slutsatser utifrån frågeställningarna. / Background: To periodize training can be of interest for athletic females and their coaches because the hormones fluctuate during the menstrual cycle. A large part of the research in strength training has been done on men. To study an increase in muscle strength in women is complex because their hormones fluctuate monthly and are considered to be able to influence study results during the menstrual cycle. The purpose of this literature study was to compile the studies available in the subject and then take advantage of women's hormones to optimize muscle strength and to avoid the risk of new injuries or suffer from the risks strength training can reduce.  Objective: The aim of this study was to review and to compile studies regarding the possible differences in muscle strength during the menstrual cycle and the possible effect of periodized training applied to the different phases of the menstrual cycle.  Method: A systematic review study included observational studies and intervention studies. The search was done on PubMed and five studies were included, then quality reviewed according to PEDro scale. The search for observational studies were made on Google scholar and four studies were selected, then reviewed according to the SBU’s review template for observational studies.  Results: The results indicated that there is no evident difference between the phases as the results were different between the different studies. The research on the subject is too insufficient to make an adequate conclusion. Conclusion: Further research, as well as more studies with the same outcome measure, are needed to be able to come to a conclusion based on the issues.

The final, definitive version of this paper has been published in Acta radiologica by SAGE Publications Ltd, All rights reserved.Final publication is available at http://acr.sagepub.com/ / 京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19582号 / 医博第4089号 / 新制||医||1014(附属図書館) / 32618 / 京都大学大学院医学研究科医学専攻 / (主査)教授 山田 泰広, 教授 戸井 雅和, 教授 羽賀 博典 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

The control of prolactin secretion is a complex interaction of peptides and neurotransmitters acting either in an inhibitory or stimulating way to effect final secretion of this hormone from the lactotrope cell in the anterior hypothalamus. These factors may act either directly on the lactotrope cell or indirectly by changing either dopamine restraint of prolactin secretion or by modulating peptide substances or neurotransmitters higher up in the hypothalamus. Gonadal steroids may also modulate the effect of peptides or dopamine at the level of the lactotrope. Prolactin's major role in the female rat is one of milk production post - partum, nurturing the young. It probably also has other physiological functions and may play a part in the menstrual cycle although this is controversial. Certainly, pulsatile secretion of prolactin during the menstrual cycle is well established and in the luteal phase this is concomitant with the secretion of luteinizing hormone. Theories explaining the synchronous surges seen during this phase of the menstrual cycle have been proposed and GnRH has been implicated in the genesis of the concordance of these secretory spikes. Using a potent GnRH antagonist an experiment was undertaken to establish the role of GnRH by blocking this hypothalamic peptide and observing the effect that this had on luteinizing hormone, prolactin and follicle stimulating hormone. In the first part of the thesis the control of prolactin secretion is reviewed. In the following section, an experiment was performed using a potent GnRH antagonist. A dose response curve was established for the antagonist action on LH. Then a twice maximum dose of this peptide was administered to three subjects in the midluteal phase of the menstrual cycle and the response of LH, prolactin and FSH was measured. The results indicate that although the GnRH antagonist significantly blocked LH secretory peaks, this action was not observed for either prolactin or FSH. This result is perhaps at variance with previous data which suggested that GnRH was responsible for concordant secretory spikes of LH and prolactin in the midluteal phase of the menstrual cycle.

O impacto da flutuação dos hormônios esteróides sobre o curso do Transtorno Afetivo Bipolar durante a vida reprodutiva das mulheres é pouco estudado. Encontramos ainda muitas lacunas no conhecimento quanto a sua apresentação clínica e as suas implicações na evolução do Transtorno Afetivo Bipolar, especialmente sua associação com a ciclagem rápida e o seu valor preditivo para recorrência. Métodos: Mulheres com Transtorno Afetivo Bipolar (tipos I, II ou sem outra especificação) participantes do Systematic Treatment Enhancement Program for Bipolar Disorder, com idade entre 16 e 40 anos, foram divididas em dois grupos: com e sem relato de exacerbação pré-menstrual do Transtorno Afetivo Bipolar na avaliação inicial do estudo. Estes grupos foram comparados em relação às características clínicas do Transtorno Afetivo Bipolar, de vida reprodutiva e tratamento na entrada do estudo. Longitudinalmente, foi comparado o tempo de recorrência entre as pacientes que iniciaram o estudo eutímicas utilizando análise de sobrevivência Kaplan Meier e a regressão de Cox. O número de episódios entre as pacientes que foram seguidas por um período de um ano também foi comparado. Resultados: Das 706 mulheres que completaram o questionário, 490 (69,4%) relataram exacerbação pré-menstrual. Na entrada do estudo, quando comparadas ao grupo sem exacerbação pré-menstrual, as mulheres com exacerbação pré-menstrual encontravam-se mais deprimidas, apresentavam mais comorbidades psiquiátricas, sintomas do humor com uso de contraceptivos hormonais, ciclos menstruais irregulares, e estavam recebendo menos tratamento farmacológico. Mulheres com exacerbação pré-menstrual também relataram mais episódios de humor durante o ano anterior e eram mais susceptíveis de apresentar ciclagem rápida neste mesmo período. Na avaliação prospectiva, entre as mulheres que iniciaram o estudo eutímicas (exacerbação pré-menstrual n = 66, sem exacerbação pré-menstrual n = 63), o grupo com exacerbação pré-menstrual teve um tempo de recaída mais rápido ao se incluir estados subsindrômicos associados a recaídas em mania, depressão ou estado misto. O tempo médio de recidiva de 50% da amostra foi de 4,5 meses para as mulheres com a exacerbação pré-menstrual, em comparação com 8,5 meses para as do grupo sem exacerbação pré-menstrual (p = 0,02). A exacerbação prémenstrual também foi um fator significativamente associado a maior gravidade dos sintomas depressivos e de elevação do humor entre as mulheres com um ano de seguimento. Conclusões: As mulheres com Transtorno Afetivo Bipolar que relataram exacerbação pré-menstrual apresentaram uma maior comorbidade psiquiátrica, maior número de episódios do humor no ano anterior e ciclagem rápida. A avaliação prospectiva mostrou uma taxa de recorrência maior, mais estados subsindrômicos e maior número de episódios, mas não ciclagem rápida, nas mulheres do grupo exacerbação pré-menstrual. Nossos resultados sugerem que a exacerbação pré-menstrual pode ser considerada um marcador clínico preditor de um fenótipo clínico mais complexo e associado a uma pior evolução da doença em mulheres em idade reprodutiva com Transtorno Afetivo Bipolar. / The impact of hormonal fluctuation during the menstrual cycle on the course of bipolar disorder in women is poorly studied. We also found many gaps in knowledge about its clinical presentation and its implications for the evolution of Bipolar Disorder, especially the association with rapid cycling and its predictive value for recurrence. Methods: Women with Bipolar Disorder (types I, II or Not Otherwise Specificated ) participants Systematic Treatment Enhancement Program for Bipolar Disorder, aged between 16 and 40, were divided into two groups: with and without reports of Premenstrual Exacerbation of Bipolar Disorder in the baseline assessment. These groups were compared to clinical features of BD, reproductive life and treatment at study entry. The time difference of recurrence between groups who were euthymic at the baseline assessment were done with survival analysis Kaplan Meier\'s survival curve and Cox regression models. The number of episodes between the patients who were followed for a period of one year was also compared. Results: Of 706 women who completed the questionnaire, 490 (69.4%) reported premenstrual exacerbation. At study entry, compared to those without premenstrual exacerbation, women with premenstrual exacerbation were more depressed, had more psychiatric comorbidities, mood symptoms with the use of hormonal contraceptives, irregular menstrual cycles, and were receiving less drug treatment. Women with premenstrual exacerbation also reported more mood episodes during the previous year and were more likely to state rapid cycling in the same period. In a prospective evaluation among women who started the study in euthymic mood state (premenstrual exacerbation n = 66, without premenstrual exacerbation n = 63), the premenstrual exacerbation group had a smaller time to relapse when associated subsyndromal mood states to relapse in mania, depression or mixed state. The median time to relapse of 50% of the sample was 4.5 months for women with premenstrual exacerbation, compared with 8.5 months for the group without premenstrual exacerbation (p = 0,02). The premenstrual exacerbation was also a significantly positive factor for a greater severity of depressive symptoms and elevation of mood among women with one year of follow-up. Conclusions: Women with Bipolar Disorder who reported premenstrual exacerbation had a higher psychiatric comorbidity, greater number of episodes of mood in the previous year and rapid cycling. Prospective evaluation showed a higher rate of recurrence, more states and more subsyndromal episodes, but not rapid cycling among women in the premenstrual exacerbation. Our results suggest that premenstrual exacerbation can be considered a clinical marker predictor of a worse clinical phenotype and associated with a worst disease progression in women of reproductive with bipolar affective disorder

O impacto da flutuação dos hormônios esteróides sobre o curso do Transtorno Afetivo Bipolar durante a vida reprodutiva das mulheres é pouco estudado. Encontramos ainda muitas lacunas no conhecimento quanto a sua apresentação clínica e as suas implicações na evolução do Transtorno Afetivo Bipolar, especialmente sua associação com a ciclagem rápida e o seu valor preditivo para recorrência. Métodos: Mulheres com Transtorno Afetivo Bipolar (tipos I, II ou sem outra especificação) participantes do Systematic Treatment Enhancement Program for Bipolar Disorder, com idade entre 16 e 40 anos, foram divididas em dois grupos: com e sem relato de exacerbação pré-menstrual do Transtorno Afetivo Bipolar na avaliação inicial do estudo. Estes grupos foram comparados em relação às características clínicas do Transtorno Afetivo Bipolar, de vida reprodutiva e tratamento na entrada do estudo. Longitudinalmente, foi comparado o tempo de recorrência entre as pacientes que iniciaram o estudo eutímicas utilizando análise de sobrevivência Kaplan Meier e a regressão de Cox. O número de episódios entre as pacientes que foram seguidas por um período de um ano também foi comparado. Resultados: Das 706 mulheres que completaram o questionário, 490 (69,4%) relataram exacerbação pré-menstrual. Na entrada do estudo, quando comparadas ao grupo sem exacerbação pré-menstrual, as mulheres com exacerbação pré-menstrual encontravam-se mais deprimidas, apresentavam mais comorbidades psiquiátricas, sintomas do humor com uso de contraceptivos hormonais, ciclos menstruais irregulares, e estavam recebendo menos tratamento farmacológico. Mulheres com exacerbação pré-menstrual também relataram mais episódios de humor durante o ano anterior e eram mais susceptíveis de apresentar ciclagem rápida neste mesmo período. Na avaliação prospectiva, entre as mulheres que iniciaram o estudo eutímicas (exacerbação pré-menstrual n = 66, sem exacerbação pré-menstrual n = 63), o grupo com exacerbação pré-menstrual teve um tempo de recaída mais rápido ao se incluir estados subsindrômicos associados a recaídas em mania, depressão ou estado misto. O tempo médio de recidiva de 50% da amostra foi de 4,5 meses para as mulheres com a exacerbação pré-menstrual, em comparação com 8,5 meses para as do grupo sem exacerbação pré-menstrual (p = 0,02). A exacerbação prémenstrual também foi um fator significativamente associado a maior gravidade dos sintomas depressivos e de elevação do humor entre as mulheres com um ano de seguimento. Conclusões: As mulheres com Transtorno Afetivo Bipolar que relataram exacerbação pré-menstrual apresentaram uma maior comorbidade psiquiátrica, maior número de episódios do humor no ano anterior e ciclagem rápida. A avaliação prospectiva mostrou uma taxa de recorrência maior, mais estados subsindrômicos e maior número de episódios, mas não ciclagem rápida, nas mulheres do grupo exacerbação pré-menstrual. Nossos resultados sugerem que a exacerbação pré-menstrual pode ser considerada um marcador clínico preditor de um fenótipo clínico mais complexo e associado a uma pior evolução da doença em mulheres em idade reprodutiva com Transtorno Afetivo Bipolar. / The impact of hormonal fluctuation during the menstrual cycle on the course of bipolar disorder in women is poorly studied. We also found many gaps in knowledge about its clinical presentation and its implications for the evolution of Bipolar Disorder, especially the association with rapid cycling and its predictive value for recurrence. Methods: Women with Bipolar Disorder (types I, II or Not Otherwise Specificated ) participants Systematic Treatment Enhancement Program for Bipolar Disorder, aged between 16 and 40, were divided into two groups: with and without reports of Premenstrual Exacerbation of Bipolar Disorder in the baseline assessment. These groups were compared to clinical features of BD, reproductive life and treatment at study entry. The time difference of recurrence between groups who were euthymic at the baseline assessment were done with survival analysis Kaplan Meier\'s survival curve and Cox regression models. The number of episodes between the patients who were followed for a period of one year was also compared. Results: Of 706 women who completed the questionnaire, 490 (69.4%) reported premenstrual exacerbation. At study entry, compared to those without premenstrual exacerbation, women with premenstrual exacerbation were more depressed, had more psychiatric comorbidities, mood symptoms with the use of hormonal contraceptives, irregular menstrual cycles, and were receiving less drug treatment. Women with premenstrual exacerbation also reported more mood episodes during the previous year and were more likely to state rapid cycling in the same period. In a prospective evaluation among women who started the study in euthymic mood state (premenstrual exacerbation n = 66, without premenstrual exacerbation n = 63), the premenstrual exacerbation group had a smaller time to relapse when associated subsyndromal mood states to relapse in mania, depression or mixed state. The median time to relapse of 50% of the sample was 4.5 months for women with premenstrual exacerbation, compared with 8.5 months for the group without premenstrual exacerbation (p = 0,02). The premenstrual exacerbation was also a significantly positive factor for a greater severity of depressive symptoms and elevation of mood among women with one year of follow-up. Conclusions: Women with Bipolar Disorder who reported premenstrual exacerbation had a higher psychiatric comorbidity, greater number of episodes of mood in the previous year and rapid cycling. Prospective evaluation showed a higher rate of recurrence, more states and more subsyndromal episodes, but not rapid cycling among women in the premenstrual exacerbation. Our results suggest that premenstrual exacerbation can be considered a clinical marker predictor of a worse clinical phenotype and associated with a worst disease progression in women of reproductive with bipolar affective disorder

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Missouri-Columbia, 2000. / Typescript. Vita. Includes bibliographical references (leaves 96-109). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 2000. / Typescript. Vita. Includes bibliographical references (leaves 96-109). Also available on the Internet.