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This study analyzes the intersection of multiple cultural themes and discourses present in discussion of the alternative menstrual hygiene product, the menstrual cup. Through the qualitative research methods of first-person interviewing and autoethnography, the study forms the characteristics of the American menstrual cultural model and how the model upheld by menstrual cup users differs from it. The study finds that access to alternative channels of information and an innate or learned acceptance of the body and bodily processes were indicators of whether or not an individual would be receptive to the cup. The mainstream consciousness was unlikely to foster bodily acceptance. Bodily acceptance was more likely encountered in individuals with interests invested in activities and lifestyle practices more likely to be labeled “alternative.” Using the cup also had a positive feedback effect in that it habituated users to and made them feel more comfortable with their bodies.

Short and long term clinical outcomes following endometrial ablation in women with heavy menstrual bleeding. Randomised trials evaluating second generation endometrial ablation techniques are discussed and critically reviewed in this thesis. Patterns of referral, socio-demographic and clinical details, primary care treatment, of women referred with heavy menstrual loss are also considered as are three randomised trials of surgical treatments for the treatment of heavy menstrual bleeding. Microwave endometrial ablation (MEATM) and thermal balloon ablation (TBall) both achieved high levels of satisfaction (-1%, 95% CI (-11, 9)). Microwave had a significantly shorter operating time, reduced usage of anti-emetics and opiate analgesia, increased discharge by six hours and fewer device failures. Comparing MEA™ in the postmenstrual phase to MEA™ following standard drug based endometrial preparation there was no significant difference at five years in menstrual outcomes, health related quality of life, or need for subsequent treatment Ten years following MEATM or transcervical resection of the endometrium (TCRE), the hysterectomy rate after ten years was significantly different with 17% in the MEATM and 28% in the TCRE arm (95% CI -0.21, -0.13). In conclusion primary care guidelines should be followed whilst establishing patient preference prior to referral to secondary care. Microwave ablation has been shown to be an effective treatment in the short, medium and long-term. It can successfully be performed in an outpatient setting in the post menstrual phase and is acceptable under local anaesthesia.

This study examined differences and relationships between high intensity, intermittent work and menstrual phase. Six performed (10) 6-second sprints on a cycle ergometer in the luteal (LP) and follicular phase (FP) of the menstrual cycle. The average 6-second work was greater in the LP (39.3 (3.4)Jkg) than during the FP (38.3 (3.1)Jkg). There was no difference in peak 6-second power (6.8(0.6)W/kg in FP, 6.9(0.6)W/kg in LP) and the drop-off in work (1.2(3.5)J/kg in FP and 1.0(2.7)J/kg in LP) between menstrual phases. There was no significant difference in sprint V02 or recovery V02 between FP (2.3 (O.S)rnL/kg/min and 24.1 (2.5)mL/kg/min) and LP (2 1.8(1.6)mL/kg/rnin and 23.7(2.8)mL/kg/min). In sprints 2 to 10, recovery V02 was greater in LP (26.3(2.4)mL/kg/min) than FP (25.0(2.6)rnL/kg/min). Recovery V02 and average 6- second work positively correlated (0.78 in FP, 0.77 in LP). In summary, oxygen consumption between sprints 2-10 and average work was greater in LP than FP.

Menstruation is triggered by a fall in circulating progesterone (P4), and to a lesser extent, oestradiol (E2) concentrations, and characterised by classical inflammatory features in the endometrium: breakdown of the basal lamina, tissue oedema and an influx of migratory leucocytes. During and following menstruation, endometrial inflammation is resolved and the endometrium is repaired. The successful resolution of acute inflammation in other tissues involves apoptosis and the phagocytic clearance of apoptotic cells. Human endometrial tissues were collected with informed patient consent and local research ethics committee approval. C57Bl/6 mice underwent an induced menstruation protocol (via sequential E2 and P4 exposure followed by P4 withdrawal), both with and without experimental inhibition of apoptosis (using the pan-caspase inhibitor, Q-VD-OPh). Coordinated apoptosis and neutrophil recruitment were hypothesised to be components of the menstrual event and to precede menstrual shedding in the human endometrium. Immunoreactivity histoscoring for cleaved caspase-3 (CC3) revealed extensive apoptosis in the normal human endometrium early in the ‘perimenstrual’ period, and careful stereological delineation of neutrophil (elastase+) recruitment showed a significant influx coincident with menstrual tissue breakdown. Apoptosis and neutrophil recruitment were hypothesised to follow similar courses in the endometria of mice undergoing an induced menstruation protocol, recapitulating human menstrual events. Immunoreactivity histoscoring for CC3 and stereological investigation into neutrophil (Ly6G+) recruitment in mouse endometrial tissues revealed almost identical extents and timings of apoptosis and neutrophil recruitment in women. Whole genome array evidence of differential apoptosis-related gene transcription in the endometria of women with heavy menstrual bleeding (HMB) compared to those of women with normal menstrual bleeding (NMB) led to the hypothesis that apoptosis may be dysregulated in women with HMB and that perhaps this may delay timely repair of the endometrium and lead to prolonged bleeding in consequence. Candidate differentially-regulated gene transcripts identified by the whole genome array were validated by means of RT-qPCR, although immunoreactivity histoscoring for CC3 did not reveal any differences in apoptosis or its localisation between women with NMB and HMB at the menstrual cycle time-points examined. Building on evidence of apoptotic transcriptional dysregulation in the endometria of women with HMB, it was hypothesised that experimental inhibition of apoptosis (via Q-VD-OPh) in a mouse model of induced menstruation could delay endometrial repair and delay resolution of endometrial inflammation. Some evidence of delayed early repair was obtained, alongside the discoveries of delayed inflammatory gene transcription and increased decidual proliferation (BrdU+) in apoptosis-inhibited mice. Apoptosis precedes the classical inflammatory features of menstruation in the human and mouse endometrium, with inhibition of apoptosis in the latter altering repair and the inflammatory micro-environment. An apoptosis-inhibited mouse model of menstruation may therefore represent a viable model for the further study of heavy menstrual bleeding.

The goal in doing this study has been studying public interpretations of media content in the commercials that this study uses. The analysis was based on two TV commercials for feminine hygiene products. Initially, they seemed to differ from each other, but soon the question whether or not they in fact did convey the same underlying message was raised. The theoretical premises on which the study was founded on are the gender perspective in advertising and the social construction of gender. To reveal the hidden signs appearing in these commercials and to find out their meanings, we used the method of semiotic analysis. To further find out how the audience interpreted the films and their possible messages, we performed qualitative interviews, followed by a reception analysis of these. The result we reached using the latter method is not unambiguous, but we were able to highlight the differences as well as to what degree personal interpretation influences people.

This study analyzes the intersection of multiple cultural themes and discourses present in discussion of the alternative menstrual hygiene product, the menstrual cup. Through the qualitative research methods of first-person interviewing and autoethnography, the study forms the characteristics of the American menstrual cultural model and how the model upheld by menstrual cup users differs from it. The study finds that access to alternative channels of information and an innate or learned acceptance of the body and bodily processes were indicators of whether or not an individual would be receptive to the cup. The mainstream consciousness was unlikely to foster bodily acceptance. Bodily acceptance was more likely encountered in individuals with interests invested in activities and lifestyle practices more likely to be labeled “alternative.” Using the cup also had a positive feedback effect in that it habituated users to and made them feel more comfortable with their bodies.

Dissertation, 2005.