Lecture 5:The Menstrual Cycle - Harvard Universitypeople.fas.harvard.edu/~anth1380/Slides/Lecture...
Transcript of Lecture 5:The Menstrual Cycle - Harvard Universitypeople.fas.harvard.edu/~anth1380/Slides/Lecture...
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Lecture 5:The Menstrual CycleLecture 5:The Menstrual Cycle
•• The OvaryThe Ovary
•• The Menstrual CycleThe Menstrual Cycle•• Follicular phaseFollicular phase•• Luteal phaseLuteal phase
•• Menstrual cycle and mate Menstrual cycle and mate choicechoice
•• Cycle related psychological Cycle related psychological changeschanges
•• Cycle related Cycle related physiological changesphysiological changes
Behavioral Biology of Women 2007
The OvaryThe Ovary The OvaryThe Ovary
Function of the OvaryFunction of the Ovary
•• Target Organ: Generates mature germ cells Target Organ: Generates mature germ cells in response to hormonal control signalsin response to hormonal control signals
•• Endocrine Gland: Sends signals of its own Endocrine Gland: Sends signals of its own
to uterus, the hypothalamus and pituitary.to uterus, the hypothalamus and pituitary.
Ovary with FolliclesOvary with Follicles
Each
immature
egg is
called a
primary
oocyte and
is
contained
in a
follicle.
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Follicular DevelopmentFollicular Development Decline in Oocytes as we AgeDecline in Oocytes as we Age
The Follicular PhaseThe Follicular Phase
Menstrual CycleMenstrual Cycle
(1) LH
and
FSH
low at
start of
cycle
HH--PP--O AxisO AxisHypothalamusHypothalamus--PituitaryPituitary--Ovarian AxisOvarian Axis
HYPOTHALAMUS
GnRH
(Gonadotropin Releasing
Hormone)
ANTERIOR PITUITARY
Low FSH(2) Low FSH
stimulates
Hypothalamus
to release GnRH
which signals
anterior pituitary
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HH--PP--O AxisO Axis
(3) Anterior
Pituitary
releases more
FSH and LH
HYPOTHALAMUS
ANTERIOR PITUITARY
OVARY
Follicle
FSH (Follicle Stimulating Hormone) LH (Leutenizing Hormone)
Estrogens
GnRH
(4) FSH
stimulates
follicle to
produce
estrogen
(estradiol)
Follicular DevelopmentFollicular Development Development of Development of Graffian Graffian FollicleFollicle
Graafian Graafian FollicleFollicle
•• Granulosa Cells Granulosa Cells --
Smaller cells on inside Smaller cells on inside
of follicle. Convert of follicle. Convert
testosterone into testosterone into
estradiol under influence estradiol under influence
of FSH.of FSH.
•• Theca Cells Theca Cells -- Cells on Cells on
outside. LH stimulates outside. LH stimulates
theca cells to make theca cells to make
testosterone. Some testosterone. Some
Estrogen made de novo.Estrogen made de novo.
(5) Cells
differentiate
in the
follicle,
forming The
Graffian
Follicle
(6) Increasing
amounts of
Estrogen are
produced by
Graffian
Follicles, one
becomes
“Dominant
Follicle”
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HYPOTHALAMUS
ANTERIOR PITUITARY
OVARY
Follicle
FSH LH
Estrogens
GnRH Negative Feedback
(7) Increase
in estrogen
sends a
‘Negative
Feedback”
signal to the
Hypothalam
us and
Anterior
Pituitary to
stop
producing
GnRH FSH
HYPOTHALAMUS
ANTERIOR PITUITARY
OVARY
Follicle
FSH LH
Estrogens
GnRH
Negative Feedback
(7) Increase
in estrogen
sends a
‘Negative
Feedback”
signal to the
Hypothalam
us and
Anterior
Pituitary to
stop
producing
GnRH FSH
HYPOTHALAMUS
ANTERIOR PITUITARY
OVARY
Follicle
FSH LH
GnRH
Negative Feedback
Positive Feedback
Estrogens
(8) At some point increasing
estrogen switches to positive
feedback.
(FSHRH & LhRH
(9) Hypothalamus secretes
more GnRh - particularly
LhRH at this point.
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HYPOTHALAMUS
ANTERIOR PITUITARY
OVARY
Follicle
FSH
GnRH
Negative Feedback
Positive Feedback
Estrogens
LH
(10) When a threshold amount of LhRH
is reached, the anterior pituitary release
a massive dose of LH.
(11) This
massive
surge in LH
causes the
follicle to
rupture and
ovulation to
occur.
OvulationOvulation
Fallopian Tube & Corpus Luteum
Mittelschmerz
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The Luteal PhaseThe Luteal Phase (12) Empty
follicle is
now called
the Corpus
Luteum.
HYPOTHALAMUS
ANTERIOR PITUITARY
OVARY
Follicle Corpus Luteum
FSH LH
ProgesteroneEstrogens
GnRH
Negative Feedback
Positive Feedback
(13) Corpus Luteum produces
Estrogen and Progesterone
HYPOTHALAMUS
ANTERIOR PITUITARY
OVARY
Follicle Corpus Luteum
UTERUS
FSH LH
ProgesteroneEstrogens
GnRH
Negative Feedback
Positive Feedback
Endometrium, Cervix, Vagina
(14) Estrogen and
Progesterone cause
changes in
reproductive organs.
(15) LH and
Progesterone also
involved in
negative
feedback loops.
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What is Estrogen Doing?What is Estrogen Doing?
•• Stimulates growth of cells in the lining of the Stimulates growth of cells in the lining of the
uterus, the cervix and the vaginauterus, the cervix and the vagina
What is Estrogen Doing?What is Estrogen Doing?
•• Stimulates growth of cells in the lining of the Stimulates growth of cells in the lining of the
uterus, the cervix and the vaginauterus, the cervix and the vagina
•• Causes breast to increase progesterone receptor Causes breast to increase progesterone receptor
densitydensity
What is Estrogen Doing?What is Estrogen Doing?
•• Stimulates growth of cells in the lining of the Stimulates growth of cells in the lining of the
uterus, the cervix and the vaginauterus, the cervix and the vagina
•• Causes breast to increase progesterone receptor Causes breast to increase progesterone receptor
densitydensity
•• Initiates proliferative phase in uterusInitiates proliferative phase in uterus
What is Estrogen Doing?What is Estrogen Doing?
•• Stimulates growth of cells in the Stimulates growth of cells in the
lining of the uterus, the cervix lining of the uterus, the cervix
and the vaginaand the vagina
•• Causes breast to increase Causes breast to increase
progesterone receptor densityprogesterone receptor density
•• Initiates proliferative phase in Initiates proliferative phase in
uterusuterus
•• Causes changes in cervical Causes changes in cervical
mucousmucous
What about Progesterone?What about Progesterone?
•• Builds up the lining of the uterus for Builds up the lining of the uterus for
fertilizationfertilization
What about Progesterone?What about Progesterone?
•• Builds up the lining of Builds up the lining of
the uterus for fertilizationthe uterus for fertilization
•• Increased concentration Increased concentration
in breast in luteal phasein breast in luteal phase
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What about Progesterone?What about Progesterone?
•• Builds up the lining of the uterus for fertilizationBuilds up the lining of the uterus for fertilization
•• Increased concentration in breast in luteal phaseIncreased concentration in breast in luteal phase
•• Initiates secretory phase in uterusInitiates secretory phase in uterus
What about Progesterone?What about Progesterone?
•• Builds up the lining of the uterus for Builds up the lining of the uterus for
fertilizationfertilization
•• Increased concentration in breast in luteal Increased concentration in breast in luteal
phasephase
•• Initiates secretory phase of Initiates secretory phase of endometriumendometrium
•• Signals the pituitary to stop producing LHSignals the pituitary to stop producing LH
Inside the UterusInside the Uterus
Proliferative Proliferative PhasePhase
•• Estrogen initiates a Estrogen initiates a
““proliferative phaseproliferative phase””
when glands of when glands of
uterine lining thicken uterine lining thicken
and grow and blood and grow and blood
supply proliferatessupply proliferates
Inside the UterusInside the Uterus
Secretory Secretory PhasePhase
•• Progesterone causes Progesterone causes
the uterus to enter a the uterus to enter a
““secretory phasesecretory phase””
when it secretes when it secretes
embryoembryo--nourishing nourishing
substancessubstances
(16)
Progesterone
initiates
Secretory
Phase in
uterus
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Secretory Phase of UterusSecretory Phase of Uterus
•• The The endometrium endometrium
is now heavily is now heavily
vascularizedvascularized
•• There is active There is active
Secretion of Secretion of
nutrientnutrient--rich rich
medium for medium for
embryonic embryonic
growthgrowth
•• Embryo can only Embryo can only
implant in a implant in a
secretory secretory lininglining
(17) If no
fertilization
occurs, Corpus
Luteum dies
and
endometrium
sloughs off
Changes in Cervical Mucous
• Normally forms a maze of tangled
fibers
• Under influence of estrogen fibers line
up permitting sperm
to get through
Changes in Cervix
• Closes soon after ovulation
Changes in Vagina
• Vagina becomes drier with increasing
progesterone
Changes in the BreastsChanges in the Breasts
•• Estrogen causes breast Estrogen causes breast
cells to start to dividecells to start to divide
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Changes in the BreastsChanges in the Breasts
•• Estrogen causes breast Estrogen causes breast
cells to start to dividecells to start to divide
•• Estrogen increases Estrogen increases
progesterone receptors progesterone receptors
= increased = increased
progesterone levelsprogesterone levels
Changes in the BreastsChanges in the Breasts
•• Estrogen causes breast Estrogen causes breast
cells to start to dividecells to start to divide
•• Increased receptivity to Increased receptivity to
progesterone progesterone ——
increased progesterone increased progesterone
levelslevels
•• Increased tendernessIncreased tenderness
Changes in the BreastsChanges in the Breasts
•• Estrogen causes breast Estrogen causes breast
cells to start to dividecells to start to divide
•• Estrogen increases Estrogen increases
progesterone receptors progesterone receptors
= increased= increased
progesterone levelsprogesterone levels
•• Increased tendernessIncreased tenderness
•• Increased nipple Increased nipple
sensitivitysensitivity
What Triggers Menstruation?What Triggers Menstruation?
•• No fertilizationNo fertilization
•• Corpus Luteum Corpus Luteum
regresses after about regresses after about
12 days12 days
What Triggers Menstruation?What Triggers Menstruation?
•• No fertilizationNo fertilization
•• Corpus Luteum Corpus Luteum
regresses after about regresses after about
12 days12 days
•• Progesterone Progesterone
production drops off production drops off
sharplysharply
1111
What Triggers Menstruation?What Triggers Menstruation?
•• No fertilizationNo fertilization
•• Corpus Luteum Corpus Luteum
regresses after about regresses after about
12 days12 days
•• Progesterone Progesterone
products drops off products drops off
sharplysharply
•• Endometrium Endometrium
sloughs offsloughs off
The Menstrual Cycle and The Menstrual Cycle and
differences in differences in ……
•• Mate ChoiceMate Choice
•• Mood (including PMS)Mood (including PMS)
•• CognitionCognition
•• Sensation and PerceptionSensation and Perception
The Menstrual Cycle & Mate ChoiceThe Menstrual Cycle & Mate Choice
•• Women preferred males with Women preferred males with
more feminized faces. more feminized faces.
BUT…
Preference for Feminized FacesPreference for Feminized Faces
Cycle PhaseCycle Phase
0
2
4
6
8
10
12
14
16
18
20
Japanese Men Caucasian Men
Low Conception RiskHigh Conception Risk
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Preference for Feminized FacesPreference for Feminized Faces
RelationshipsRelationships
0
2
4
6
8
10
12
14
Short Term
Context
Long Term
Context
Low Conception RiskHigh Conception Risk
The Menstrual Cycle &The Menstrual Cycle &
Male Scent Attractiveness Male Scent Attractiveness
•• Women preferred Women preferred
scent of more scent of more
symmetrical men atsymmetrical men at
midcyclemidcycle
Gangestad & Thornhill 1998
•• No difference when at No difference when at
low fertility risklow fertility risk
The Menstrual Cycle &The Menstrual Cycle &
Male Scent AttractivenessMale Scent Attractiveness
WhatWhat’’s happening here?s happening here?
Gangestad & Thornhill 1998
•• Androstenol Androstenol levels?levels?
•• Type of bacteria?Type of bacteria?
•• Fatty acids?Fatty acids?
•• HLA Gene type?HLA Gene type?
Jealousy and Menstrual PhaseJealousy and Menstrual Phase
•• Krug et al. (l996) found that women had Krug et al. (l996) found that women had
stronger physiological responses to stronger physiological responses to
imagining loss of investment from their imagining loss of investment from their
romantic partner when they were in the romantic partner when they were in the
ovulatory ovulatory phase of the menstrual cyclephase of the menstrual cycle
Mood and PMSMood and PMS
•• Many, many studies. Most Many, many studies. Most show that mood is highest midshow that mood is highest mid--cycle, lowest cycle, lowest perimenstruallyperimenstrually..
Percentages of Women who Report PMSPercentages of Women who Report PMS
25%25%5%5%DizzinessDizziness
69%69%34%34%Skin Skin
BlemishesBlemishes
70%70%30%30%AnxietyAnxiety
76%76%43%43%SadnessSadness
77%77%24%24%BackachesBackaches
77%77%36%36%SwellingSwelling
83%83%34%34%Weight GainWeight Gain
84%84%35%35%Breast PainBreast Pain
Premenstrual Premenstrual
Assessment Assessment
FormForm
Menstrual Menstrual
Distress Distress
QuestionnaireQuestionnaire
SymptomSymptom
(from Nelson, 2000)
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PMS and reproductive hormonesPMS and reproductive hormones
•• No physiological No physiological
abnormalities have abnormalities have
been consistently been consistently
linked with steroid linked with steroid
hormone hormone
concentrations in concentrations in
women with PMSwomen with PMS
PMS and reproductive hormonesPMS and reproductive hormones
•• No physiological No physiological abnormalities have been abnormalities have been consistently linked with consistently linked with steroid hormone steroid hormone concentrations in women concentrations in women with PMSwith PMS
•• Preventing Preventing luteal luteal phase with phase with mifepristone mifepristone (progesterone (progesterone antagonist) did not prevent antagonist) did not prevent symptoms (Schmidt et al., symptoms (Schmidt et al., 1991)1991)
PMS and reproductive hormonesPMS and reproductive hormones
•• No physiological abnormalities No physiological abnormalities have been consistently linked have been consistently linked with steroid hormone with steroid hormone concentrations in women with concentrations in women with PMSPMS
•• Preventing Preventing luteal luteal phase with phase with mifepristone mifepristone (progesterone (progesterone antagonist) did not prevent antagonist) did not prevent symptoms (Schmidt et al., symptoms (Schmidt et al., 1991)1991)
•• But completely shutting down But completely shutting down the cycle with the cycle with GnRH GnRH antagonist antagonist did (Brown et al., 1993)did (Brown et al., 1993)
Do WesternDo Western Women seem to experience PMS more Women seem to experience PMS more
because have many more menstrual cycles?because have many more menstrual cycles?
•• Age of menarche Age of menarche (17 v. 12)(17 v. 12)
•• Age of first pregnancy Age of first pregnancy (18 v. 26)(18 v. 26)
•• Number of pregnancies Number of pregnancies (6 v. 2)(6 v. 2)
•• Amount of time spent in Amount of time spent in lactational lactational amenorrhea amenorrhea (10 years v. 3 months)(10 years v. 3 months)
•• Number of menstrual cycles experienced by HG Number of menstrual cycles experienced by HG women? women? 1010--2020 (Dennis, 1992)(Dennis, 1992)
•• Number of menstrual cycles experienced by Number of menstrual cycles experienced by Modern Western women not on hormonal Modern Western women not on hormonal contraceptives? contraceptives? 300300
Compare hunterCompare hunter--gathering societies to Modern Western: gathering societies to Modern Western:
CognitionCognition
•• When asked on a questionnaire if they have When asked on a questionnaire if they have
menstruation related cognitive changes menstruation related cognitive changes ––
20% of women say 20% of women say ““yes.yes.””
CognitionCognition
•• When asked on a questionnaire if they have When asked on a questionnaire if they have menstruation related cognitive changes menstruation related cognitive changes ––20% of women say 20% of women say ““yes.yes.””
•• No differences in learning and memory No differences in learning and memory across menstrual cycle in most of the across menstrual cycle in most of the dozens of studies.dozens of studies.
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CognitionCognition
•• When asked on a questionnaire if they have When asked on a questionnaire if they have menstruation related cognitive changes menstruation related cognitive changes ––20% of women say 20% of women say ““yes.yes.””
•• No differences in learning and memory No differences in learning and memory across menstrual cycle in most of the across menstrual cycle in most of the dozens of studies. dozens of studies.
•• Academic performance does not seem to be Academic performance does not seem to be significantly affected by menstrual cycle significantly affected by menstrual cycle phase.phase.
Kimura et al. (l988)Kimura et al. (l988)
•• Women performed better with verbal skill Women performed better with verbal skill
(repeating tongue twisters) and muscular (repeating tongue twisters) and muscular
coordination (finger tapping) when estrogen coordination (finger tapping) when estrogen
was high (was high (midluteal midluteal phase).phase).
Kimura et al. (l988)Kimura et al. (l988)
•• Women performed better with verbal skill Women performed better with verbal skill (repeating tongue twisters) and muscular (repeating tongue twisters) and muscular coordination (finger tapping) when estrogen coordination (finger tapping) when estrogen was high (was high (midluteal midluteal phase).phase).
•• Women performed better on a measure of Women performed better on a measure of spatialspatial--perceptual skill (Rod and Frame test) perceptual skill (Rod and Frame test) during menstruation (early follicular)during menstruation (early follicular)
Kimura et al. (l988)Kimura et al. (l988)
•• Women performed better with verbal skill Women performed better with verbal skill (repeating tongue twisters) and muscular (repeating tongue twisters) and muscular coordination (finger tapping) when estrogen was coordination (finger tapping) when estrogen was high (high (midluteal midluteal phase).phase).
•• Women performed better on a measure of spatialWomen performed better on a measure of spatial--perceptual skill (Rod and Frame test) during perceptual skill (Rod and Frame test) during menstruation (early follicular)menstruation (early follicular)
•• Postmenopausal women on estrogen replacement Postmenopausal women on estrogen replacement performed better at verbal and motor function than performed better at verbal and motor function than other post menopausal women not on Hormonal other post menopausal women not on Hormonal Replacement TherapyReplacement Therapy
Spatial Ability & Cycle Phase
-0.2
-0.1
0
0.1
0.2
0.3
0.4
Menstrual Midluteal
Z-Score Units
Math Speed/Accuracy&
Cycle Phase
-0.1
0
0.1
0.2
Females Males
Pre-Ovulatory
Mid-Luteal
Z-Score Units
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Cycle related physiological changesCycle related physiological changes
•• Body temperatureBody temperature
•• Food intake and carbohydrate metabolismFood intake and carbohydrate metabolism
•• WeightWeight
•• Alcohol metabolismAlcohol metabolism
•• SensitivitySensitivity
•• SpeechSpeech
•• Clinical ailmentsClinical ailments
Body TemperatureBody Temperature
•• Basal body temperature (temp when Basal body temperature (temp when
someone wakes up) is low during follicular someone wakes up) is low during follicular
phase, dips at ovulation and then rises phase, dips at ovulation and then rises
noticeably just after ovulation (~0.4 noticeably just after ovulation (~0.4
degrees) and then continues to rise for the degrees) and then continues to rise for the
rest of the cycle.rest of the cycle.
Body TemperatureBody Temperature
•• Basal body temperature (temp when someone wakes Basal body temperature (temp when someone wakes
up) is low during follicular phase, dips at ovulation up) is low during follicular phase, dips at ovulation
and then rises noticeably just after ovulation (~0.4 and then rises noticeably just after ovulation (~0.4
degrees) and then continues to rise for the rest of the degrees) and then continues to rise for the rest of the
cycle.cycle.
•• Temperature shift is used in research and natural Temperature shift is used in research and natural
family planning to detect ovulationfamily planning to detect ovulation
Basal Body TemperatureBasal Body Temperature
Food Intake and Carbohydrate Food Intake and Carbohydrate
MetabolismMetabolism
•• Food intake (and Food intake (and
basal metabolic basal metabolic
rate) are rate) are
consistently higher consistently higher
during during luteal luteal phase.phase.
Food Intake and Carbohydrate Food Intake and Carbohydrate
MetabolismMetabolism
•• Food intake (and basal Food intake (and basal
metabolic rate) are consistently metabolic rate) are consistently
higher during higher during luteal luteal phase.phase.
•• Increase in food intake is Increase in food intake is
primarily due to increased primarily due to increased
carbohydrate consumption.carbohydrate consumption.
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Food Intake and Carbohydrate Food Intake and Carbohydrate
MetabolismMetabolism
•• Food intake (and basal metabolic rate) Food intake (and basal metabolic rate) are consistently higher during are consistently higher during luteal luteal phase.phase.
•• Increase in food intake is primarily Increase in food intake is primarily due to increased carbohydrate due to increased carbohydrate consumption.consumption.
•• Women with PMS show a more Women with PMS show a more significant increase in appetite and significant increase in appetite and carbohydrate craving than women carbohydrate craving than women without PMS.without PMS.
WeightWeight
•• Approximately one third of women report a Approximately one third of women report a
change in body weight (1change in body weight (1--5 pounds) with 5 pounds) with
menstrual phase, usually menstrual phase, usually premenstrually premenstrually or or
perimenstrually perimenstrually depending on study. depending on study.
WeightWeight
•• Approximately one third of women report a Approximately one third of women report a
change in body weight (1change in body weight (1--5 pounds) with 5 pounds) with
menstrual phase, usually menstrual phase, usually premenstrually premenstrually or or
perimenstrually perimenstrually depending on study. depending on study.
•• When estrogens are given experimentally to When estrogens are given experimentally to
both rats and humans, there are increases in both rats and humans, there are increases in
sodium and chloride which cause fluid sodium and chloride which cause fluid
retention.retention.
WeightWeight•• Approximately one third of women Approximately one third of women report a change in body weight (1report a change in body weight (1--5 5 pounds) with menstrual phase, usually pounds) with menstrual phase, usually premenstrually premenstrually or or perimenstrually perimenstrually depending on study. depending on study.
•• When estrogens are given When estrogens are given experimentally to both rats and experimentally to both rats and humans, there are increases in sodium humans, there are increases in sodium and chloride which cause fluid and chloride which cause fluid retention.retention.
•• Fluid retention and increased food Fluid retention and increased food consumption may together account for consumption may together account for cycle related weight fluctuations.cycle related weight fluctuations.
Alcohol MetabolismAlcohol Metabolism
•• In study where In study where men and women men and women were given the were given the same amount of same amount of alcohol (not alcohol (not controlling for controlling for body weight), body weight), women got women got more more intoxicated and intoxicated and had a higher had a higher blood alcohol blood alcohol level than men. level than men.
Alcohol MetabolismAlcohol Metabolism
•• Unclear why Unclear why more affected more affected in latein late luteal luteal phase.phase.
1717
SensesSenses
•• Almost all of the Almost all of the
senses (visual, senses (visual,
auditory, tactile, and auditory, tactile, and
especially olfactory) especially olfactory)
appear to be more appear to be more
acute during the acute during the
follicular phase of follicular phase of
the menstrual cycle.the menstrual cycle.
SensesSenses
•• Almost all of the senses Almost all of the senses (visual, auditory, tactile, (visual, auditory, tactile, and especially olfactory) and especially olfactory) appear to be more acute appear to be more acute during the follicular during the follicular phase of the menstrual phase of the menstrual cycle.cycle.
•• Conflicting studies Conflicting studies about sensitivity to pain, about sensitivity to pain, but many show an but many show an increase sensitivity to increase sensitivity to pain at pain at midcyclemidcycle..
SensesSenses
•• Almost all of the senses (visual, auditory, tactile, Almost all of the senses (visual, auditory, tactile,
and especially olfactory) appear to be more acute and especially olfactory) appear to be more acute
during the follicular phase of the menstrual cycle.during the follicular phase of the menstrual cycle.
•• Conflicting studies about sensitivity to pain, but Conflicting studies about sensitivity to pain, but
many show an increase sensitivity to pain at many show an increase sensitivity to pain at
midcyclemidcycle. .
•• Some researchers speculate that heightened Some researchers speculate that heightened
sensitivity during midsensitivity during mid--cycle may be useful for cycle may be useful for
increasing the probability of coitusincreasing the probability of coitus
SpeechSpeech
•• When asked to give a 3 When asked to give a 3
minute speech both regular minute speech both regular
stutters and non stutters stutters and non stutters
were more were more disfluent disfluent (more (more
repetition, revision, repetition, revision,
disrhythmic disrhythmic phonation, phonation,
interjection and tense interjection and tense
pauses) pauses) premenstrually premenstrually than than
at at midcyclemidcycle. .
Clinical AilmentsClinical Ailments
•• Epilepsy: 58% of female epileptics reported Epilepsy: 58% of female epileptics reported increased seizures increased seizures premenstrually premenstrually compared compared to only 9% during menstruation.to only 9% during menstruation.
Clinical AilmentsClinical Ailments
•• Epilepsy (58% of female Epilepsy (58% of female
epileptics reported epileptics reported
increased seizures increased seizures
premenstrually premenstrually compared compared
to only 9% during to only 9% during
menstruation.menstruation.
•• Allergies and asthma Allergies and asthma ––
tend to worsen tend to worsen
premenstruallypremenstrually..
1818
Clinical AilmentsClinical Ailments
•• Epilepsy (58% of female epileptics reported Epilepsy (58% of female epileptics reported increased seizures increased seizures premenstrually premenstrually compared to compared to only 9% during menstruation.only 9% during menstruation.
•• Allergies and asthma Allergies and asthma –– tend to worsen tend to worsen premenstruallypremenstrually. .
•• Herpes and eczema outbreaks more common Herpes and eczema outbreaks more common premenstruallypremenstrually
Clinical AilmentsClinical Ailments
•• Epilepsy (58% of female epileptics Epilepsy (58% of female epileptics reported increased seizures reported increased seizures premenstrually premenstrually compared to only 9% compared to only 9% during menstruation.during menstruation.
•• Allergies and asthma Allergies and asthma –– tend to worsen tend to worsen premenstruallypremenstrually. .
•• Herpes and eczema outbreaks more Herpes and eczema outbreaks more common common premenstruallypremenstrually
•• Migraine headaches more common Migraine headaches more common near ovulation and shortly thereafter near ovulation and shortly thereafter ((perimenstruallyperimenstrually))
Clinical AilmentsClinical Ailments
•• Epilepsy (58% of female epileptics reported Epilepsy (58% of female epileptics reported increased seizures increased seizures premenstrually premenstrually compared to compared to only 9% during menstruation.only 9% during menstruation.
•• Allergies and asthma Allergies and asthma –– tend to worsen tend to worsen premenstruallypremenstrually. .
•• Herpes and eczema outbreaks more common Herpes and eczema outbreaks more common premenstruallypremenstrually
•• Migraine headaches more common near ovulation Migraine headaches more common near ovulation and shortly thereafter (and shortly thereafter (perimenstruallyperimenstrually))
•• Rheumatoid arthritis symptoms are lowest when Rheumatoid arthritis symptoms are lowest when ovarian steroids are low (early follicular phase).ovarian steroids are low (early follicular phase).
Next Time...Next Time...
•• MenarcheMenarche
•• Puberty RitualsPuberty Rituals