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The purpose of this paper is to examine the female hormonal cycle throughout a woman's life and its effects on the singing voice. Dealing with vocal issues brought on by hormonal fluctuations can be extremely frustrating for the professional singer, as these issues can wreak havoc on performance and practice schedules. The best weapon of defense against its unpredictability is information. Unfortunately, data on the female hormonal cycle and its effects on the voice is not covered in most standard vocal pedagogy books. Information on the subject is often relegated to a small section of a chapter, and even then usually describes only the symptoms: edema, hoarseness, and loss of high notes and power. The question as to why these symptoms happen every month and during menopause, and whether there is anything that can be done to alleviate them, remains largely unanswered. A candid discourse on the subject of hormones and the female voice has begun, but now must brought into the open. It is a subject that needs to be broached in voice studios everywhere. Can the effects of hormonal fluctuations on the voice be managed? What treatments are there for the symptoms; are they safe; are they effective? How can we further the dissemination of information on this subject? This paper will attempt to answer these questions by compiling data from the studies and research of esteemed doctors and scientists on this subject into one document, making it easy for young students and interested voice teachers to access this important information. It is my goal with this monograph to help and inform my readers. The human larynx is directly influenced by lifelong cyclical hormonal fluctuations. A woman's monthly cycle, which lasts from puberty to menopause, causes changes in hormone concentrations. These changes can affect a woman's physical and emotional states, causing bloating, and temporary abnormalities in sleep, mood, concentration levels, and energy. These effects are also seen in the vocal tract, where edema, vocal fatigue, decreased range, and lowering of the fundamental frequency can occur. The monthly symptoms of hormonal change are called premenstrual syndrome, or PMS. Similarly, the symptoms manifested in the larynx are called premenstrual vocal syndrome, or PMVS. This paper is an examination and exploration of the effects of PMS and PMVS on the singing voice. To do so, it provides a brief overview of the steroid hormones: estrogen, progestogen, and androgen. These three hormones are responsible for the development and maturation of primary and secondary sexual characteristics. It is only through studying the specific functions of each of the steroid hormones that it is made clear why some women suffer so profoundly each month from PMS and PMVS. Additionally, this paper provides information regarding the benefits and drawbacks of oral contraceptives, or OCPs. OCPs contain synthetic hormones that mimic the body's own natural hormones, and they regulate the body's levels of estrogen and progesterone, which prevents ovulation. In addition to their contraceptive use, OCPs are used to treat endometriosis, acne, and irregular periods. By preventing the body's hormonal levels from fluctuating, OCPs have proven highly effective as a treatment of PMS and PMVS. Further, the changes to the voice during pregnancy will be examined. The increased hormonal concentrations associated with pregnancy act upon the reproductive organs, muscles, bone, cerebral cortex, and mucosa, as well as the larynx. This paper also explores what happens to the voice throughout the stages of menopause, the symptoms of which can range from moderate to quite severe. Treatment options are discussed, including both hormone replacement therapy and alternative methods. Lastly, this paper shares information gathered from a survey of singers regarding their own experiences with PMS and PMVS, OCPs, pregnancy, and menopause. / Music Performance

To obtain descriptive information concerning female bodybuilders and women who weight train, a questionnaire concerning training regimes, menstrual history and dieting strategies was developed and administered with the EDI included as part of the questionnaire. Factors assessed included: incidence of menstrual irregularity, scores on the Eating Disorder Inventory (EDI), prevalence of behaviors associated with eating disorders, and mean body fat. Subjects were between the ages of 18 and 35 and included individuals from Personal Health Classes at Virginia Tech, the Virginia Tech Weight Lifting Club, and Goad's Gym in Blacksburg, Virginia. Subjects were classified by activity (weight lifters versus controls), involvement (high, moderate and low) and competition (noncompetitive and competitive). Chi-square analysis indicated that there was no difference in incidence rates of menstrual irregularity between weight lifters (WLs) and controls (Cs); however, the rates of both groups were higher than the general population. Although there was no difference in menstrual function of involvement groups, 50% of the competitors, significantly more than non-competitors, were classified as oligomenorrheic or amenorrheic. All subject groups had mean scores approaching anorexic patient norms on the EDI Bulimia and Maturity Fears subscales. WLs were significantly higher on Drive for Thinness than Cs and more WLs had subscale scores higher than the mean scores presented for anorexics. Additionally, significantly more WLs reported uncontrollable urges to eat, fear of fat, and history of anorexia. Mean %BF of the WLs was 20.18% with competitors being significantly leaner than non-competitors. The high degree of menstrual dysfunction in both WLs and Cs is confusing; yet, the 27% incidence of oligomenorrhea and amenorrhea in WLs is much higher than the rates documented for the general population. The high Drive for Thinness and incidence of negative eating behaviors indicate that the prevalence of eating disorders in this population may progress as this relatively new sport evolves and competitive participation increases. / M.S.

This project studies the aesthetic nuances of contemporary menstrual poetic representations with the aim of undoing the stigma underlying them as well as fostering the development of a finer appreciation for period poetics and discursive portrayals. Through the lens of aesthetic theory, it looks into the ways in which menstruation not only can become languageable by dint of poetry, but also how it is permeated by its own system of aesthetic principles and characteristics. Using discourse analysis, this research explores the sociopolitical valence of menstrual aesthetics, while working against their neutralization in verse. By foregrounding the all-red discursive palettes of period sensation(s), flows and chromatic configurations, it makes a case for their dehegemonizing capacity, their potential to facilitate intermenstrual relatedness and most notably, their beauty.

Bakgrund: De hormonella förändringarna som sker under menstruationscykeln bidrar till variationer i olika fysiologiska processer som påverkar både kvinnors mående och prestation. Det är inte enbart det välstuderade premenstruella syndromet innan blödning som påverkar utan variationer i könshormonerna under hela menstruationscykeln påverkar olika fysiologiska processer. Forskning om optimering av styrke- och konditionsträning utgår ofta från studier med manliga deltagare som har testosteron som uppbyggande hormon. Forskning på kvinnor visar att de hormonella förändringarna under menstruationscykeln bidrar till variation i metabolism, styrka, inflammation, vätskebalans, kroppstemperatur och risk för skador. Syfte: Litteraturstudiens syfte var att undersöka hur menstruationscykeln påverkar prestationsförmågan hos idrottande kvinnor. Metod: En litteratursökning genomfördes i databaserna PubMed och Sport Discus. Även en utökad sökning och en sekundärsökning utfördes. Totalt inkluderades tio studier. Resultat: Fem studier undersökte skillnader i muskelstyrka mellan follikelfasen (första blödningsdag fram till ägglossning) och lutealfasen (ägglossning fram till dagen innan nästa blödning). Fyra av studierna visade en ökad muskelstyrka och större muskeltillväxt under follikelfasen och en av studierna visade ingen skillnad mellan faserna. Fem studier undersökte syreupptagningsförmåga mellan follikel- och lutealfas. Två av studierna visade en högre syreupptagningsförmåga under lutealfasen, och tre av studierna visade inga skillnader mellan faserna. Slutsats: Studierna kring muskelstyrka indikerar att effekten av styrketräning är störst under follikelfasen, varemot flera studier behövs för att kunna utreda hur menstruationscykeln påverkar kvinnors syreupptagningsförmåga. / Background: The hormonal changes that occur during the menstrual cycle contribute to variations in different physiological processors that affect both women's sensation and performance. It is not only the well-studied premenstrual syndrome of bleeding that affects women but the continuous variation in the steoridhormones throughout the menstrual cycle affect several physiological functions. Research on optimization strength and fitness training is often based on studies with male participants who have testosterone as the dominant anabolic hormone. Research on women shows that the hormonal changes during the menstrual cycle contribute to variation in metabolism, strength, inflammation, fluid balance, body temperature and risk of injury. Purpose: This literature study purpose was to investigate how menstrual cycles affect the performance of athletic women. Method: A literature search was carried out using the PubMed and Sport Discus databases. An extended search and a secondary search were also performed and a total of ten studies were included. Results: Five studies examined differences in muscle strength between the follicle phase (first bleeding day until ovulation) and the luteal phase (ovulation until the day before the onset of the next bleeding). Four of the studies showed increased muscle strength and greater muscle growth during the follicle phase while one study found no differences between the phases. Five studies investigated oxygen uptake and aerobic capacity between the follicle and luteal phase. Two of the studies reported an increased oxygen uptake during the luteal phase while the remaining three studies showed no differences between the phases. Conclusion: The studies on muscle strength indicate that effect of strength training is greatest during the follicle phase, whereas more studies are needed to investigate whether the menstrual cycle affects women's oxygen uptake capacity.

Bakgrund: Endometrios är en kronisk sjukdom som innebär att livmoderslemhinnan hittas på andra ställen i kroppen än i livmodern. De kvinnor som drabbas får ofta återkommande smärta och många har svårt att bli gravida. I Sverige uppskattas mellan 2 och 15 % av alla kvinnor ha endometrios. Personcentrerad omvårdnad användes som teoretisk förankring. Syfte: Syftet var att beskriva kvinnors upplevelse av att leva med endometrios. Metod: En litteraturöversikt med kvalitativ design och induktiv ansats baserad på 12 artiklar. Som analysmetod användes Fribergs analys i fem steg. Resultat: Resultatet redovisades i tre kategorier samt nio subkategorier: Sjukdomens påverkan på hälsa, (fysisk påverkan, psykisk påverkan samt infertilitet). Begränsat liv, (nära relationer, sociala sammanhang och aktiviteter samt arbete och utbildning). Ta kontroll, (kontakt med vården, beroende och ensamhet samt copingstrategier). Slutsatser: Kunskapen om sjukdomen är bristfällig både inom vården och i samhället. Om kunskapen ökar finns större möjligheter till att kvinnor får vård i tid och större förståelse för sin sjukdom. Vårdpersonalen får då också bättre kompetens för att kunna hjälpa kvinnorna att få ett bättre liv med ett personcentrerat förhållningssätt. / Background: Endometriosis is a chronic disease where the tissue lining the womb is found elsewhere in the body. Women with endometriosis have recurrent periods with pain that may also suffer from infertility. In Sweden, it is estimated that between 2 and 15% of all women have endometriosis. Person-centered care was used as a theoretic framework. Aim: The aim was to describe women's experiences of living with endometriosis. Method: A literature review containing 12 articles with a qualitative approach. Friberg´s analysis in five steps was used in the analysis process. Result: The result was presented in three categories and nine subcategories: The illness impact on health (Physical impact, Mental impact, and Infertility.) Limited life (Close relations, Social context and activities, Work and education). Taking control (Contact with healthcare, Dependence and loneliness and Coping strategies.) Conclusion: The lack of knowledge exists not only within the healthcare system but also in the society. With increased knowledge there are greater chances of women receiving accurate treatment and an understanding about the disease. Health care professionals will then also have better competence to help these women have a better life

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Denna studie är en designbaserad forskning som utforskar frågeställningen: Hur kan en genom design öka medvetenheten kring och underlätta spårningen av menscykelns känslomässiga påverkningar? Tillsammans med underfrågan: Hur kan en produkts design bidra till minskat stigma kopplat till menstruation? Detta görs genom att belysa hur ett användarcentrerat tankesätt och co-design metoder kan användas i syfte att designa för tabubelagda ämnen. Projektets syfte var att undersöka hur produktdesign kan stötta kvinnor i att enklare spåra och förstå sig på sin hälsa ur ett helhetsperspektiv. Detta för att främja ökad kontroll, välbehag och hälsosammare liv för kvinnor; samt i längden bidra till design för social hållbarhet. För att undersöka forskningsfrågan har metoderna expertintervju, marknadsundersökning och co-design workshop använts. Co-design workshopens utformning är ett exempel på hur teorin Troubling design har influerat metodutförandet. Detta eftersom teorin problematiserar tillämpningen av användarcentrerad design i relation till kvinnlig hälsa samt menar att design för kroppsliga upplevelser behöver omprövas i form av att ändra från ett problemlösningsfokus till att fokusera på kvinnans erfarenheter och därmed ej se den menstruerande kroppen som ett problem som går att “lösa”. Utfallet av expertintervjuer, marknadsundersökning och co-design workshop analyserades och utifrån detta skapades en kravspecifikation som blev grunden för designprocessen. Resultatet av designprocessen och därmed även studiens slutgiltiga designförslag som besvarar forskningsfrågan blev en brädspelsinspirerad kalender med tillhörande känslospårare och cykelvisualisering. Slutsatsen blev även att stigma effektivast motverkas genom normalisering av spårning samt ökad kunskap hos icke menstruerande. / This study is a design-based research that explores the question: How can one, through design, increase awareness and facilitate tracking of the emotional effects of the menstrual cycle? Together with the sub-question: How can a product’s design contribute to reduced stigma linked to menstruation? This is done by highlighting how a user-centered mindset and co-design methods can be used in order to design for tabooed topics. The purpose of the project was to investigate how product design can support women to more easily track and understand their health from a holistic perspective. This to promote increased control, well-being, and healthier lives for women; and in the long run contribute to design for social sustainability. To examine the research question, the methods expert interview, market research and co-design workshop have been used. The design of the Co-design workshop is an example of how the theory Troubling design has influenced the method execution. This because the theory problematizes the application of user-centered design in relation to women’s health and emphasizes that design for bodily experiences needs to be reconsidered in the form of changing from a problem-solving focus to focusing on the woman’s experiences and thus not seeing the menstruating body as a problem that can be “solved”. The outcome of expert interviews, market research and co-design workshop was analysed and based on this a requirement specification was created which became a starting point for the design process. The result of the design process and the study’s final design proposal which answers the research question became a board game-inspired calendar with enclosed emotion tracker and cycle visualization. The conclusion was further that stigma is most effectively counteracted through the normalization of tracking and increased knowledge among non-menstruating people.

Bakgrund: Det har gjorts många studier som undersöker hur menstruation påverkar prestationen i träningen. Däremot saknas det forskning som undersöker om fysisk aktivitet verkar hälsofrämjande för välbefinnandet under menstruationen.  Syfte: Syftet med denna studie var att undersöka om fysisk aktivitet under menstruationen påverkar individers självskattade välbefinnande. Metod: Inklusionskriterier för studien var menstruerande individer som fyllt 18 år och var fysiskt aktiva. Studien utfördes med en kvantitativ ansats. Data insamlades via en webbenkät. Webbenkäten konstruerades ändamålsenligt utifrån studiens syfte, bestående av 59 frågor. Fördelat på fyra block: bakgrundsfrågor, fysisk aktivitet, välbefinnande plus tilläggsfrågor. Statistical Package for the Social Sciences (SPSS) användes för genomförandet av en deskriptiv frekvensanalys, relevant material tolkades genom korstabeller.  Resultat: Totalt svarade 168 individer på enkäten. Studien tydliggjorde att fysisk aktivitet påverkar välbefinnande under menstruationen. Det förekommer en stor variation gällande effekten på välbefinnande under menstruationen vid utförandet av fysisk aktivitet. Slutsats: Sammanfattningsvis tydliggjorde studiens resultat att fysisk aktivitet för de flesta bidrar med en hälsofrämjande effekt på välbefinnande under menstruationen. Fysisk aktivitet visade sig ha en positiv inverkan på välbefinnandet. Studiens resultat skulle kunna användas för spridning av kunskap för ett jämlikt samhälle. / Background: There have been many studies investigating how menstruation affects performance in exercise. However, there is a lack of research that examines whether physical activity has a health-promoting effect on well-being during menstruation. Purpose: The purpose of this study was to investigate whether physical activity during menstruation affects individuals' self-reported well-being. Methods: Inclusion criteria for the study were menstruating individuals who have reached the age of 18 and were physically active. The study was performed with a quantitative approach. Data was collected via an online survey. The online survey was constructed purposefully based on the purpose of the study, consisting of 59 questions. Divided into four blocks: background questions, physical activity, well-being plus additional questions. SPSS was used for the implementation of a descriptive frequency analysis, relevant material was interpreted through cross-tables.  Results: A total of 168 individuals responded to the survey. The study clarifies that physical activity affects well-being during menstruation. There is a large variation in the effect on well-being during menstruation when performing physical activity. Conclusion: The results of the study clarified that physical activity for most participants contributed to a health-promoting effect on well-being during menstruation. Physical activity was shown to have a positive effect on well-being. The results of the study could be used to spread knowledge for an equal society.

Cette recherche exploratoire tente de mieux saisir la représentation sociale des menstruations auprès d’une population de femmes et d’hommes québécois. S’inscrivant dans une approche socio-constructiviste du corps et utilisant le thème des menstruations pour en rendre compte, un questionnaire élaboré par l’auteure a été distribué selon la méthode «boule de neige»; 106 personnes (H=35 ; F=71) y ont répondu. Pour l’ensemble des participants, les résultats mettent en lumière un champ représentationnel majoritairement composé d’expressions négatives. Des prises de position différentes face aux menstruations sont remarquées entre les sexes ainsi que selon les différentes strates d’âge. Ces différences semblent tributaires à la fois du vécu expérientiel des menstruations particulier aux femmes et de la période du cycle de la vie dans laquelle se situent les participants et transitent, entre autres, par l’entremise des véhicules de transmission que sont les expressions populaires et les publicités des produits sanitaires.