Lower peripheral circulation in eumenorrheic young women with premenstrual symptoms

BACKGROUND: A majority of women from all cultures and socioeconomic levels experience diverse psychosomatic and behavioral symptoms premenstrually, a phenomenon commonly termed premenstrual syndrome, although symptoms and discomfort levels vary from woman to woman. The underlying pathological mechanisms of premenstrual syndrome remain unknown; however, altered function or even slight disorder of the blood circulation system, which contributes to the orchestrations of the human internal environment, could cause bio-psychological changes leading to complaints and ultimately compromising a woman's overall health. The present study, therefore, investigates to what extent and how the menstrual cyclicity of peripheral circulation is associated with premenstrual symptomatology. METHODS: Twenty-one eumenorrheic young women participated in this study. All subjects were investigated during the follicular and late luteal phases. Cycle phase was determined by the onset of menstruation and oral temperature and was verified by concentrations of ovarian hormones, estrone, and pregnanediol in a urine sample taken early in the morning. Peripheral circulation was evaluated with the Astrim (Sysmex, Kobe), a portable non-invasive monitoring device using the principle of near-infrared spectroscopy, which calculates the venous oxygenation index (VOI) based on the ratio of light absorption of oxyhemoglobin and deoxyhemoglobin, a proven reliable indicator of peripheral blood circulation. The Menstrual Distress Questionnaire was applied to measure physical, emotional, and behavioral symptoms accompanying the menstrual cycle of the subjects. RESULTS: The oral temperature and urinary ovarian hormones adjusted for creatinine significantly increased in the late luteal phase in all subjects. While 10 subjects experienced no symptoms during the menstrual cycle, 11 subjects had apparent physical and psychological discomfort in the late luteal phase. We found that VOI decreased more significantly in the late luteal phase than in the follicular phase only in women with premenstrual discomfort although the symptoms were not unbearable enough to cause the disruption of daily activities. CONCLUSION: Several models have tried to explain the etiopathogenesis of premenstrual syndrome. Although causes and consequences remain enigmatic, our data suggest that the peripheral circulation could alter in the luteal phase, which might be partly associated with premenstrual psychosomatic symptoms in eumenorrheic young women

Altered autonomic nervous system activity as a potential etiological factor of premenstrual syndrome and premenstrual dysphoric disorder

<p>Abstract</p> <p>Background</p> <p>Premenstrual syndrome (PMS) encompasses a wide variety of cyclic and recurrent physical, emotional, and behavioral symptoms occurring during the late luteal phase of the menstrual cycle and abating shortly following the beginning of menses. Although PMS is widely recognized, its etiopathogenesis is not yet understood. The present study investigates whether the activity of the autonomic nervous system, which plays a vital role in orchestrating physiological homeostasis within the human body, is altered during the menstrual cycle of women with different degrees of premenstrual symptomatology.</p> <p>Methods</p> <p>Sixty-two women in their 20s to 40s with regular menstrual cycles participated in this study. All subjects were examined during the follicular and late luteal phases. Cycle phase was determined by the onset of menstruation and oral temperature and was verified by concentrations of ovarian hormones, estrone, and pregnanediol in a urine sample taken early in the morning. Autonomic nervous system activity was assessed by means of heart-rate variability (HRV) power spectral analysis during supine rest. The Menstrual Distress Questionnaire was used to evaluate physical, emotional, and behavioral symptoms accompanying the menstrual cycle of the subjects. The subjects were categorized in three groups, Control, PMS, and premenstrual dysphoric disorder (PMDD) groups, depending on the severity of premenstrual symptomatology.</p> <p>Results</p> <p>No intramenstrual cycle difference in any of the parameters of HRV was found in the Control group, which had no or a small increase in premenstrual symptoms. In contrast, Total power and high frequency power, which reflect overall autonomic and parasympathetic nerve activity, respectively, significantly decreased in the late luteal phase from the follicular phase in the PMS group. As for the PMDD group, which had more severe symptoms premenstrually, heart-rate fluctuation as well as all components of the power spectrum of HRV were markedly decreased regardless of the menstrual cycle compared to those of the other two groups.</p> <p>Conclusion</p> <p>Several theories have been proposed to explain the underlying mechanisms of PMS with its complex web of bio-psycho-social factors. Although causes and consequences continue to elude, the present study provides intriguing and novel findings that the altered functioning of the autonomic nervous system in the late luteal phase could be associated with diverse psychosomatic and behavioral symptoms appearing premenstrually. In addition, when symptoms become more severe (as seen in women with PMDD), the sympathovagal function might be more depressed regardless of the menstrual cycle.</p

A Clinical Study of Ninjin'yoeito With Regard to Frailty

Frailty in older people is strongly associated with poor nutrition, which is particularly important in the present-day superaging society. This study initially investigated a number of cases of frailty where there was a speedy recovery after administration of a dual deficiency of qi and blood preparation, ninjin'yoeito (NYT), formulated for frail patients who suffer from kiketuryokyo status. Based on these observations, a more extensive investigation involving a greater number of cases was completed. The findings of the effects of NYT on frailty are reported here

トウザイ ユウゴウ シンシン イリョウ ノ テイゲン シンシン イガク カラ コンシン イガク エノ パラダイム シフト

心身医学は, Descartesの心身二元論以来, 西洋近代医学が身体を客体としてのみ扱かってきたことへの反省にたって生まれてきた. 一方, 東洋の伝統的技法では, 自らの内側から主体としての身体を体験することにより健康を得る. 日本独特の身体概念である「身(み)」は, 客観的身体のみならず, 主観的身体および間主観的でスピリチュアルな深層意識的身体までを包含する成層的な統合体であり, そのアプローチでは西洋で重視される分析的な視点(自我)と東洋で重視される包括的な視点(気づき)の両立が重要となる.我々は, 心身医学に, ユング心理学を基に東洋の叡智をとりいれて開発されたソマティクス(=ボディワーク)であるプロセス指向心理学を導入した. この東西融合心身医療は, 「精神(マインド)」と「身体(ボディ)」の相関を扱う"心身医学"から, 「魂(スピリット)」と「身」の相関を扱う"魂身医学"へのパラダイムシフトを促すものと考えられた.Mind-body medicine was born of reflection that modern Western medicine had regarded body as a mere object since Descartes\u27s mind-body dualism. On the other hand, in Eastern arts it is believed that one becomes healthy through experiencing one\u27s body as the subject in one\u27s self. "Mi", a concept of body peculiar to Japan, refers to a stratum of objective body, subjective body and depth-psychological body that is intersubjective and spiritual. And "Mi" should be approached both from the analytical viewpoint (ego) and from the inclusive viewpoint (awareness) at the same time. Authors have introduced one of Somatics (i.e. bodywork) called process oriented psychology, developed through the fusion of Jung\u27s psychology and Eastern wisdom. The new mind-body medicine integrating the East and the West seems to encourage a paradigm shift from "mind-body medicine" that literally deals with the relationship between mind and body to "spiritual-somatics medicine" one that focuses on the relationship between spirituality and "Mi"

Adequate Reduction Degree of Pituitary Gonadotropin Level in the Clinical Management of Short-Term Hormone Replacement Therapy of Women with Menopausal Symptoms

The purpose of this study was to clarify the adequate reduction rate of pituitary gonadotropins in ideal clinical management of short-term hormone replacement therapy (ST-HRT) in postmenopausal women with undefined symptoms. Subjects included a total 324 postmenopausal patients between 48 and 61 years of age who visited the Department of Obstetrics and Gynecology at Osaka Medical College Hospital for the consult of menopausal symptoms. Subjects received oral administration of conjugated equine estrogen (0.625 mg/day) and progestin (2.5 mg/day) for 8 weeks as conventional HRT. HRT was markedly effective in 28.7% of cases, effective in 40.7%, fairly effective in 21.9%, and ineffective in 8.6% of cases. The plasma concentration of follicle stimulating hormone (FSH) and luteinizing hormone (LH) after administration decreased significantly (P＜0.001) by 58.1% and 59.9% for markedly effective cases, and by 31.0% and 36.1% for effective cases. On the other hand, decrease in FSH and LH concentration were 14.1% and 1.3% for the fairly effective and 8.5% and -5.1% for ineffective cases, demonstrating a significantly greater decrease in plasma FSH and LH levels in the markedly effective and effective cases than those in ineffective cases (P＜0.001). There were significant differences in the reduction rates of plasma FSH and LH levels between in cases showing (59.9% and 53.2%) and not showing the adverse effects (24.8% and 25.9%), respectively (P＜0.0001). In conclusion, efficacy of ST-HRT was significantly correlated to the degree of decrease in plasma FSH and LH levels in patients with undefined symptoms. In addition, efficacy appeared to be correlated to the incidence of side effects. The degree of reduction of FSH (24.8-31.0%) and LH (25.9-36.1%) from the baseline may possibly be used as the suitable therapeutic window for hormone levels during HRT. The present results suggest that plasma gonadotropin levels could be a useful indicator for the management of patients undergoing short-term HRT for women with menopausal symptoms