Analytical and biological variation of biomarkers of oxidative stress during the menstrual cycle.

Little information is available on the intra-individual variability of oxidative stress biomarkers in healthy individuals and even less in the context of the menstrual cycle. The objective of this study was to characterize the analytical and biological variability of a panel of 21 markers of oxidative damage, antioxidant defence and micronutrients in nine healthy, regularly menstruating women aged 18-44 years. Analyses included measurement of lipid peroxidation, antioxidant enzymes and antioxidant vitamins. Blood specimens were collected, processed and stored using standardized procedures on days 2, 7, 12, 13, 14, 18, 22 and 28 in one cycle for each subject. Replicate analyses of markers were performed and two-way nested random effects ANOVA was used to describe analytical, intra-individual and inter-individual variability. No statistically significant differences at alpha=0.05, or temporal effects across the menstrual cycle were observed. Analytical variability was the smallest component of variance for all variables. The ICC among replicates ranged from 0.80 to 0.98. Imprecision based on quality control materials ranged from 1 to 11%. The critical differences between serial results varied greatly between assays ranging from 6 to 216% of the mean level. These results provide important initial information on the variability of biomarkers of oxidative stress, antioxidant defence and micronutrients across the menstrual cycle.     

Changes of markers of oxidative stress during menstrual cycle

The levels of urinary hydrogen peroxide and thiobarbituric acid reactive substances have been compared during the menstrual cycle of 12 regularly menstruating women. Higher level of both indices of oxidative stress (normalized with respect to creatinine content) were found in the luteal phase of the cycle. These results give further evidence for the usefulness of urinary hydrogen peroxide and thiobarbituric acid reactive substances as potential biomarkers of oxidative stress and for the antioxidant action of estrogens.     

Isometric strength and endurance during the menstrual cycle.

Seven healthy young women, 3 whom had been taking oral contraceptives, were examined during the course of 2 menstrual cycles to assess their isometric strength, their endurance during a series of 5 fatiguing isometric contractions at a tension of 40% MVC, and their blood pressures and heart rates during those fatiguing contractions. Two sets of experiments were performed, one in which the subject's forearm temperature was allowed to vary as a function of T A, and one with the muscle temperature stabilized by immersion of the forearm in water at 37 degrees C. During exposure to ambient temperatures, isometric strength and both the heart rate and blood pressure responses at rest and at the end of a fatiguing, sustained isometric exercise, were not significantly different during any phase of the menstrual cycle in any subject. In contrast, the isometric endurance in the women not taking oral contraceptives varied sinusoidally in all 5 contractions with a peak endurance midway through the ovulatory phase and the lowest endurance mid-way through the luteal phase of the menstrual cycle. The isometric endurance of the women taking oral contraceptives did not vary during their menstrual cycle. After stabilization of the temperature of the muscles of the forearm in water at 37 degrees C, the isometric endurance of the normal subjects showed a hyperbolic response with the maximal endurance at the beginning and end of their cycles, and the shortest endurance at mid-cycle. Here again, however, the isometric endurance of the women taking oral contraceptives did not vary after immersion of their forearms in the 37 degree C water.     

Analytical and biological variation of biomarkers of oxidative stress during the menstrual cycle

Little information is available on the intra-individual variability of oxidative stress biomarkers in healthy individuals and even less in the context of the menstrual cycle. The objective of this study was to characterize the analytical and biological variability of a panel of 21 markers of oxidative damage, antioxidant defence and micronutrients in nine healthy, regularly menstruating women aged 18–44 years. Analyses included measurement of lipid peroxidation, antioxidant enzymes and antioxidant vitamins. Blood specimens were collected, processed and stored using standardized procedures on days 2, 7, 12, 13, 14, 18, 22 and 28 in one cycle for each subject. Replicate analyses of markers were performed and two-way nested random effects ANOVA was used to describe analytical, intra-individual and inter-individual variability. No statistically significant differences at α=0.05, or temporal effects across the menstrual cycle were observed. Analytical variability was the smallest component of variance for all variables. The ICC among replicates ranged from 0.80 to 0.98. Imprecision based on quality control materials ranged from 1 to 11%. The critical differences between serial results varied greatly between assays ranging from 6 to 216% of the mean level. These results provide important initial information on the variability of biomarkers of oxidative stress, antioxidant defence and micronutrients across the menstrual cycle.     

P300 and the menstrual cycle

Event-related potentials (ERPs) were elicited with an auditory discrimination paradigm in 20 adult female subjects on the first day of their menstrual cycles and approximately 14 days later. The amplitude and latency of the N1, P2, N2 and P3 (P300) components were measured for the two assessment times. No differences in either amplitude or latency for any of the components were observed as a function of menstrual cycle. Half the subjects who took oral contraceptives were compared to the other half who did not. No differences or interactions between these subgroups were obtained for any component amplitude or latency. It was concluded that menstrual cycle and use of oral contraceptives do not affect the P3 or other ERP components.     

Cardiovascular reactivity to mental stress: relationship with menstrual cycle and gender

The purpose of the present study was to determine the fluctuation in cardiovascular reactivity to mental stress during the menstrual cycle by comparing heart rate variability (HRV), and other physiological and psychological data in females with those in males. Cardiovascular reactivity to two mental tasks was measured in 14 females during the follicular and luteal phase of menstruation over two menstrual cycles. The same tasks were subsequently given to a matched pair of males (N=14), at the same intervals as their corresponding females. Heart rate, blood pressure and HRV were used as indices of cardiovascular reactivity. Subjective mental workload was measured at the end of each task. Power spectral analysis of HRV showed that the high frequency (HF) component in HRV decreased more during the luteal phase than the follicular phase. The low frequency (LF) component in HRV and the LF/HF ratio in the luteal phase were significantly higher than that in the follicular phase. The LF component and the LF/HF ratio were significantly lower in females than in males; conversely, the HF component was significantly higher in females than in males. Neither significant effects of menstrual cycle, gender and mental stress nor any significant interactions were found for mental workload. These findings indicate that sympathetic nervous activity in the luteal phase is significantly greater than in the follicular phase whereas parasympathetic nervous activity is predominant in the follicular phase. The results also suggest that predominance of sympathetic nervous activity in males compared with a dominant parasympathetic nervous activity in females.     

Asymmetry and the menstrual cycle in women

Fluctuating asymmetry (FA) is small random deviations from perfect bilateral symmetry that are thought to accumulate during development. FA is therefore a measure of one component of fitness, that is, developmental stability. This work is not concerned with permanent between-individual differences in asymmetries but rather with temporary within-individual changes in asymmetry that are related to the menstrual cycle (cyclical asymmetry, CA). We present evidence from studies of non-sexually selected traits (ear and digit size) and a sexually selected trait (breast size) that, in characters made up wholly or in part of soft tissue, CA varies across the menstrual cycle in women. It is highest at the beginning and end of the cycle, when women are generally infertile, and low in mid-cycle, when fertility is highest. Furthermore in mid-cycle there is an indication of a transitory (24-hour) increase in CA followed by a substantial decrease, which may indicate ovulation. Temporal changes in CA could therefore be used by males to indicate a female's position in the cycle. We discuss these findings in relation to (1) our understanding of the evolution of human mating systems, (2) the practical implications of these data in the treatment of infertility and to facilitate contraception, and (3) their relevance to exercise and dieting as a means to minimize across-cycle increases in asymmetry.     

Effects and analysis of the menstrual cycle

The menstrual cycle is much more than a cycle of periods. Menstruation is only one manifestation of the ovarian cycle which is itself associated with more than 200 physical, psychological and behavioural changes. Numerous medical disorders also appear to be modulated by cyclical ovarian activity. Objective assessment of these cyclical changes can be difficult. One approach is by trend analysis, which can be used to provide both qualitative and quantitative information concerning daily menstrual cycle data. The application of this technique to the assessment of menstrual cycle symptoms and the premenstrual syndrome are demonstrated.     

Influence of menstrual cycle and oral contraceptives on tolerance to uncompensable heat stress

In this study we examined the influence of menstrual cycle phase and oral contraceptive use on thermoregulation and tolerance during uncompensable heat stress. Eighteen women (18-35 years), who differed only with respect to oral contraceptive use (n = 9) or non-use (n = 9), performed light intermittent exercise at 40 degrees C and 30% relative humidity while wearing nuclear, biological and chemical protective clothing. Their responses were compared during the early follicular (EF, days 2-5) and mid-luteal (ML, days 19-22) phases of the menstrual cycle. Since oral contraceptives are presumed to inhibit ovulation, a quasi-early follicular (q-EF) and quasi-mid-luteal (q-ML) phase was assumed for the users. Estradiol and progesterone measurements verified that all subjects were tested during the desired phases of the menstrual cycle. Results demonstrated that rectal temperature (Tre) was elevated in ML compared with EF among the non-users at the beginning and throughout the heat-stress trial. For the users, Tre was higher in q-ML compared with q-EF at the beginning, and for 75 min of the heat-stress exposure. Tolerance times were significantly longer during EF [128.1 (13.4) min, mean (SD)] compared with ML [107.4 (8.6) min] for the nonusers, indicating that these women are at a thermoregulatory advantage during the EF phase of their menstrual cycle. For the users, tolerance times were similar in both the q-EF [113.0 (5.8) min] and q-ML [116.8 (11.2) min] phases and did not differ from those of the non-users. It was concluded that oral contraceptive use had little or no influence on tolerance to uncompensable heat stress, whereas tolerance was increased during EF for non-users of oral contraceptives.     

C-reactive protein across the menstrual cycle

C-reactive protein (CRP) is a widely used, sensitive biomarker of inflammation. Studies conducted among users of exogenous hormones suggest that estrogen increases CRP, whereas progesterone decreases CRP. Examinations of CRP in normally cycling women suggest the opposite: CRP is negatively associated with endogenous estrogen and positively associated with endogenous progesterone. This work evaluates the association between menstrual cycle-related hormone changes and events (menstruation and ovulation) and CRP. Eight female subjects gave urine and blood samples from twelve days across the menstrual cycle, for a total of eleven cycles. Blood samples were assayed for CRP; urine samples for beta-follicle stimulating hormone (betaFSH), pregnanediol 3-glucuronide (PDG), and estrone glucuronide (E1G). Ovulation day was estimated using hormone levels. Presence or absence of menses was reported by subjects. Analyses were conducted with random-effects linear regression. All cycles were ovulatory; day of ovulation was identified for nine cycles. A ten-fold increase in progesterone was associated with a 23% increase in CRP (P = 0.01), a ten-fold increase in estrogen was associated with a 29% decrease in CRP (P = 0.05), and menses was associated with a 17% increase in CRP (P = 0.18); no association between ovulation or FSH and CRP was found. Hormone changes across the menstrual cycle should be controlled for in future studies of inflammation in reproductive-age women.     

Fear recognition across the menstrual cycle

This study assesses the mediating role of stage of menstrual cycle in the recognition of emotional expressions. It was hypothesised that fear recognition ability would be stronger at high-oestrogen stages of the menstrual cycle. The accuracy of recognising emotional expressions was compared across 50 women who were at different stages of their menstrual cycle. It was found that accuracy to recognise emotions was significantly affected by the interaction between stages of the menstrual cycle and the emotion being displayed. Further analysis revealed that for the emotion expression of fear alone, participants were significantly more accurate at the preovulatory surge (highest oestrogen levels) than at menstruation (oestrogen levels at lowest point). The results have implications for the processes that underlie fear processing and a possible insight into the sexual dimorphism of this ability and conditions that show variations in fear recognition (e.g., autism, Turner syndrome).     

Perceptual-motor performance during the menstrual cycle

Study I: Choice reaction times were measured in 12 normally menstruating women using a numerals-keys serial response task with three set sizes (two, four, and eight). Testing was carried out at four successive phases of the menstrual cycle corresponding with different states of neuroendocrine activity. They were, respectively: (i) 2nd day of flow; (ii) 4th day after cessation of flow (preovulation); (iii) 12th day after flow (postovulation); and (iv) 3rd day before next (estimated) flow. No consistent relationship between performance and phase of the cycle could be demonstrated. The only significant effect was an increase in reaction time with increasing set size. The study provides no support for the theory that variations in estrogen and progesterone levels may cause behaviorally relevant changes in central nervous system functioning. Study II: Four women suffering from premenstrual tension were examined thrice weekly on the same task for 4 consecutive weeks. Three hours prior to testing, a blood sample was drawn and assayed for estrogen, progesterone, and gonadotropin (LH). Performance on the serial choice response task bore no consistent relationship to blood levels of any of the three hormones. Performance before ovulation (as determined by peak LH level) did not differ significantly from that after ovulation. These results concur with those of Study I: there was no reliable relationship between hormonal status and performance.     

Variations in leucocyte count during menstrual cycle.

The neutrophil counts of seven women, three tkaing oral contraceptives and four nottaking them, showed cyclical variations during the menstrual cycle, most consistentlya fall in the neutrophil count at menstuation. The neutrophil count in women not taking oral contraceptives rose to a peak twice during each cycle. One womennot taking oral contraceptives was studied in detail over eight consecutive menstrualcycles. She showed two neutrophil peaks per cycle and a similiar variation in themonocyte count. The eosinophil count showed a reciprocal relation with the neutrophil count and the basophil count fell in mid-cycle. The changes in her neutrophil count seemed to follow changes in oestrogen level with a delay of one to two days. Oestrogen probably promotes release of neutrophils from the bone marrow rather than from the marginated pool.     

Psychosocial stress and infertility

Experimental, theoretical, psychological, and economic barriers have caused physicians to rely on biomedical treatments for infertility at the exclusion of more environmentally oriented ones (e.g., psychosocial stress therapy). An evolutionary model is described for the origin of reproductive failure, suggesting why mammals evolved to be reproductively responsive to the environment and why psychosocial stress should have an especially strong impact on fertility problems. A study of the causal role of psychosocial stress in infertility is then summarized. The paper concludes with implications for future directions for the treatment of infertility and related human reproductive problems.