Effects of the Menstrual Cycle on Medical Disorders

Abstract

Exacerbation of certain medical conditions at specific phases of the menstrual cycle is a well-recognized phenomenon. We review the effects of the menstrual cycle on medical conditions, including menstrual migraine, epilepsy, asthma, rheumatoid arthritis, irritable bowel syndrome, and diabetes. We discuss the role of medical suppression of ovulation using gonadotropin-releasing hormone agonists in the evaluation and treatment of these disorders. Peer-reviewed publications from English-language literature were located via MEDLINE or from bibliographies of relevant articles. We reviewed all review articles, case reports and series, and therapeutic trials. Emphasis was placed on diagnosis and therapy of menstrual cycle-related exacerbations of disease processes. Abrupt changes in the concentrations of circulating ovarian steroids at ovulation and premenstrually may account for menstrual cycle-related changes in these chronic conditions. Accurate documentation of symptoms on a menstrual calendar allows identification of women with cyclic alterations in disease activity. Medical suppression of ovulation using gonadotropin-releasing hormone agonists can be useful for both diagnosis and treatment of any severe, recurrent menstrual cycle-related disease exacerbations.

Anatomic and Hormonal Changes in the Female Reproductive Tract Immune Environment during the Life Cycle: Implications for HIV/STI Prevention Research

“…7 Throughout childhood, both progesterone and estradiol are minimally present. Puberty is marked by a dramatic rise in secretions of lutenizing hormone followed by increased ovarian secretions of estradiol.…”

Significant effects of mild endogenous hormonal changes in humans: considerations for low-dose testing.

“…This is particularly true for autoimmune diseases such as Graves disease or Hashimoto thyroiditis (6), as well as rheumatoid arthritis and systemic lupus erythematosus, for example (7). It is well known that pregnancy is associated with change in immune response, followed by a frequent rebound postpartum, depending on the type of autoimmune disease (6,7). These changes in the immune system are likely due to a shift in cytokine balance secondary to hormonal changes (estrogen, progesterone, and/or cortisol) (7).…”

Women at Altitude: Effect of Menstrual-Cycle Phase on Acute Mountain Sickness During Deployment to High Altitude Terrain

“…The physiologic responses to the cyclic fluctuations in ovarian steroid hormones associated with the menstrual cycle in military-aged women are well known to affect certain disease states (Case and Reid, 1998) and could also alter responses to environmental Stressors (Norwood and Ursano, 1997). Little is known about specific effects of ovarian hormone fluctuations on responses to environmental conditions encountered by military women in operational environments, however.…”

“…In pre-menopausal women, the cyclic fluctuations of ovarian steroid hormones associated with menstrual-cycle phase changes influence many physiological processes and exacerbate some chronic disease conditions (Case and Reid, 1998). These hormone fluctuations can affect some of the pivotal physiologic processes that mediate altitude acclimatization, including ventilator/ control (Bayliss and Millhom, 1992;Lyons 3 1976) and fluid/volume regulation (Chapman et al, 1997;Fortney et al, 1988).…”