Lecture 5 HMS Siklus Menstruasi

7/24/2019 Lecture 5 HMS Siklus Menstruasi

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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 mateMenstrual cycle and matechoicechoice

Cycle related psychologicalCycle related psychologicalchangeschanges

Cycle relatedCycle relatedphysiological 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 cellsTarget Organ: Generates mature germ cellsin response to hormonal control signalsin response to hormonal control signals

Endocrine Gland: Sends signals of its ownEndocrine Gland: Sends signals of its ownto 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 ofDevelopment of GraffianGraffian FollicleFollicle

GraafianGraafian FollicleFollicle

Granulosa CellsGranulosa Cells --Smaller cells on insideSmaller cells on inside

of follicle. Convertof follicle. Convert

testosterone intotestosterone into

estradiol under influenceestradiol under influence

of FSH.of FSH.

Theca CellsTheca Cells -- Cells onCells onoutside. LH stimulatesoutside. LH stimulates

theca cells to maketheca cells to make

testosterone. Sometestosterone. 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

N

egativeFeedback

PositiveFeedback

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

NegativeFeedback

PositiveFeedback

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 andovulation to

occur.

OvulationOvulation

Fallopian Tube & Corpus Luteum

Mittelschmerz


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The Luteal PhaseThe Luteal Phase (12) Emptyfollicle isnow called

the CorpusLuteum.

HYPOTHALAMUS

ANTERIOR PITUITARY

OVARY

Follicle Corpus Luteum

FSH LH

ProgesteroneEstrogens

GnRH

NegativeFeedback

PositiveFeedback

(13) Corpus Luteum producesEstrogen and Progesterone

HYPOTHALAMUS

ANTERIOR PITUITARY

OVARY

Follicle Corpus Luteum

UTERUS

FSH LH

ProgesteroneEstrogens

GnRH

N

egativeFeedback

PositiveFeedback

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 theStimulates growth of cells in the lining of the

uterus, the cervix and the vaginauterus, the cervix and the vagina


Stimulates growth of cells in the lining of theStimulates growth of cells in the lining of the

uterus, the cervix and the vaginauterus, the cervix and the vagina Causes breast to increase progesterone receptorCauses breast to increase progesterone receptor

densitydensity


Stimulates growth of cells in the lining of theStimulates growth of cells in the lining of theuterus, the cervix and the vaginauterus, the cervix and the vagina

Causes breast to increase progesterone receptorCauses breast to increase progesterone receptordensitydensity

Initiates proliferative phase in uterusInitiates proliferative phase in uterus


Stimulates growth of cells in theStimulates growth of cells in thelining of the uterus, the cervixlining of the uterus, the cervix

and the vaginaand the vagina

Causes breast to increaseCauses breast to increaseprogesterone receptor densityprogesterone receptor density

Initiates proliferative phase inInitiates proliferative phase inuterusuterus

Causes changes in cervicalCauses changes in cervicalmucousmucous

What about Progesterone?What about Progesterone?

Builds up the lining of the uterus forBuilds up the lining of the uterus forfertilizationfertilization


Builds up the lining ofBuilds up the lining ofthe uterus for fertilizationthe uterus for fertilization

Increased concentrationIncreased concentrationin breast in luteal phasein breast in luteal phase


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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


Builds up the lining of the uterus forBuilds up the lining of the uterus forfertilizationfertilization

Increased concentration in breast in lutealIncreased concentration in breast in lutealphasephase

Initiates secretory phase ofInitiates secretory phase of endometriumendometrium Signals the pituitary to stop producing LHSignals the pituitary to stop producing LH

Inside the UterusInside the Uterus

ProliferativeProliferativePhasePhase Estrogen initiates aEstrogen initiates a

proliferative phaseproliferative phase

when glands ofwhen glands of

uterine lining thickenuterine lining thicken

and grow and bloodand grow and blood

supply proliferatessupply proliferates

Inside the UterusInside the Uterus

SecretorySecretoryPhasePhase

Progesterone causesProgesterone causesthe uterus to enter athe uterus to enter a

secretory phasesecretory phase

when it secreteswhen it secretesembryoembryo--nourishingnourishing

substancessubstances

(16)

Progesterone

initiates

Secretory

Phase in

uterus


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Secretory Phase of UterusSecretory Phase of Uterus

TheThe endometriumendometriumis now heavilyis now heavily

vascularizedvascularized

There is activeThere is activeSecretion ofSecretion of

nutrientnutrient --richrich

medium formedium for

embryonicembryonic

growthgrowth

Embryo can onlyEmbryo can onlyimplant in aimplant in a

secretorysecretory lininglining

(17) If no

fertilization

occurs, CorpusLuteum dies

and

endometrium

sloughs off

Changes in Cervical Mucous

Normally forms amaze of tangled

fibers

Under influence ofestrogen fibers line

up permitting sperm

to get through

Changes in Cervix

Closes soon afterovulation

Changes in Vagina

Vagina becomesdrier with increasing

progesterone

Changes in the BreastsChanges in the Breasts

Estrogen causes breastEstrogen causes breastcells to start to dividecells to start to divide


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Estrogen causes breastEstrogen causes breast

cells to start to dividecells to start to divide

Estrogen increasesEstrogen increasesprogesterone receptorsprogesterone receptors

= increased= increased

progesterone levelsprogesterone levels


Estrogen causes breastEstrogen causes breast

cells to start to dividecells to start to divide

Increased receptivity toIncreased receptivity toprogesteroneprogesterone

increased progesteroneincreased progesterone

levelslevels

Increased tendernessIncreased tenderness


Estrogen causes breastEstrogen causes breastcells to start to dividecells to start to divide

Estrogen increasesEstrogen increasesprogesterone receptorsprogesterone receptors

= increased= increased

progesterone levelsprogesterone levels

Increased tendernessIncreased tenderness

Increased nippleIncreased nipplesensitivitysensitivity

What Triggers Menstruation?What Triggers Menstruation?

No fertilizationNo fertilization Corpus LuteumCorpus Luteum

regresses after aboutregresses after about

12 days12 days


No fertilizationNo fertilization Corpus LuteumCorpus Luteum

regresses after aboutregresses after about12 days12 days

ProgesteroneProgesterone

production drops offproduction drops off

sharplysharply


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No fertilizationNo fertilization Corpus LuteumCorpus Luteumregresses after aboutregresses after about

12 days12 days

ProgesteroneProgesterone

products drops offproducts drops off

sharplysharply

EndometriumEndometrium

sloughs offsloughs off

The Menstrual Cycle andThe Menstrual Cycle and

differences indifferences 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 withWomen 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

1012

14

16

18

20

Japanese Men Caucasian Men

Low Conception RiskHigh Conception


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Preference for Feminized FacesPreference for Feminized Faces

RelationshipsRelationships

0

2

4

6

8

1012

14

Short Term

Context

Long Term

Context

Low Conception RiskHigh Conception

The Menstrual Cycle &The Menstrual Cycle &

Male Scent AttractivenessMale Scent Attractiveness

Women preferredWomen preferredscent of morescent of moresymmetrical men atsymmetrical men at

midcyclemidcycle

Gangestad & Thornhill1998

No difference when atNo difference when atlow fertility risklow fertility risk

The Menstrual Cycle &The Menstrual Cycle &

Male Scent AttractivenessMale Scent Attractiveness

WhatWhats happening here?s happening here?

Gangestad & Thornhill1998

AndrostenolAndrostenol 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 hadKrug et al. (l996) found that women hadstronger physiological responses tostronger physiological responses to

imagining loss of investment from theirimagining loss of investment from their

romantic partner when they were in theromantic partner when they were in the

ovulatoryovulatoryphase of the menstrual cyclephase of the menstrual cycle

Mood and PMSMood and PMS

Many, many studies. MostMany, many studies. Mostshow that mood is highest midshow that mood is highest mid--

cycle, lowestcycle, lowestperimenstruallyperimenstrually..

Percentages of Women who Report PMSPercentages of Women who Report PMS

25%25%5%5%DizzinessDizziness

69%69%34%34%SkinSkin

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

PremenstrualPremenstrual

AssessmentAssessment

FormForm

MenstrualMenstrual

DistressDistress

QuestionnaireQuestionnaire

SymptomSymptom

(from Nelson, 2000)


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PMS and reproductive hormonesPMS and reproductive hormones

No physiologicalNo physiologicalabnormalities haveabnormalities have

been consistentlybeen consistently

linked with steroidlinked with steroid

hormonehormone

concentrations inconcentrations in

women with PMSwomen with PMS


No physiologicalNo physiologicalabnormalities have beenabnormalities have been

consistently linked withconsistently linked withsteroid hormonesteroid hormoneconcentrations in womenconcentrations in womenwith PMSwith PMS

PreventingPreventing luteallutealphase withphase withmifepristonemifepristone (progesterone(progesteroneantagonist) did not preventantagonist) did not preventsymptoms (Schmidt et al.,symptoms (Schmidt et al.,1991)1991)


No physiological abnormalitiesNo physiological abnormalitieshave been consistently linkedhave been consistently linkedwith steroid hormonewith steroid hormoneconcentrations in women withconcentrations in women withPMSPMS

PreventingPreventing luteallutealphase withphase withmifepristonemifepristone (progesterone(progesteroneantagonist) did not preventantagonist) did not preventsymptoms (Schmidt et al.,symptoms (Schmidt et al.,1991)1991)

But completely shutting downBut completely shutting downthe cycle withthe cycle with GnRHGnRH antagonistantagonistdid (Brown et al., 1993)did (Brown et al., 1993)

Do WesternDo Western Women seem to experience PMS moreWomen seem to experience PMS more

because have many more menstrual cycles?because have many more menstrual cycles?

Age of menarcheAge of menarche (17 v. 12)(17 v. 12) Age of first pregnancyAge of first pregnancy (18 v. 26)(18 v. 26) Number of pregnanciesNumber of pregnancies (6 v. 2)(6 v. 2) Amount of time spent inAmount of time spent in lactationallactational amenorrheaamenorrhea

(10 years v. 3 months)(10 years v. 3 months)

Number of menstrual cycles experienced by HGNumber of menstrual cycles experienced by HGwomen?women? 1010--2020 (Dennis, 1992)(Dennis, 1992)

Number of menstrual cycles experienced byNumber of menstrual cycles experienced byModern Western women not on hormonalModern Western women not on hormonalcontraceptives?contraceptives? 300300

Compare hunterCompare hunter--gathering societies to Modern Western:gathering societies to Modern Western:

CognitionCognition

When asked on a questionnaire if they haveWhen asked on a questionnaire if they havemenstruation related cognitive changesmenstruation related cognitive changes

20% of women say20% of women say yes.yes.

CognitionCognition

When asked on a questionnaire if they haveWhen asked on a questionnaire if they havemenstruation related cognitive changesmenstruation related cognitive changes20% of women say20% of women say yes.yes.

No differences in learning and memoryNo differences in learning and memoryacross menstrual cycle in most of theacross menstrual cycle in most of thedozens of studies.dozens of studies.


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CognitionCognition

When asked on a questionnaire if they haveWhen asked on a questionnaire if they havemenstruation related cognitive changesmenstruation related cognitive changes20% of women say20% of women say yes.yes.

No differences in learning and memoryNo differences in learning and memoryacross menstrual cycle in most of theacross menstrual cycle in most of thedozens of studies.dozens of studies.

Academic performance does not seem to beAcademic performance does not seem to besignificantly affected by menstrual cyclesignificantly affected by menstrual cyclephase.phase.

Kimura et al. (l988)Kimura et al. (l988)

Women performed better with verbal skillWomen performed better with verbal skill(repeating tongue twisters) and muscular(repeating tongue twisters) and muscularcoordination (finger tapping) when estrogencoordination (finger tapping) when estrogen

was high (was high (midlutealmidlutealphase).phase).


Women performed better with verbal skillWomen performed better with verbal skill(repeating tongue twisters) and muscular(repeating tongue twisters) and muscularcoordination (finger tapping) when estrogencoordination (finger tapping) when estrogenwas high (was high (midlutealmidlutealphase).phase).

Women performed better on a measure ofWomen performed better on a measure ofspatialspatial--perceptual skill (Rod and Frame test)perceptual skill (Rod and Frame test)during menstruation (early follicular)during menstruation (early follicular)


Women performed better with verbal skillWomen performed better with verbal skill(repeating tongue twisters) and muscular(repeating tongue twisters) and muscularcoordination (finger tapping) when estrogen wascoordination (finger tapping) when estrogen washigh (high (midlutealmidlutealphase).phase).

Women performed better on a measure of spatialWomen performed better on a measure of spatial--perceptual skill (Rod and Frame test) duringperceptual skill (Rod and Frame test) duringmenstruation (early follicular)menstruation (early follicular)

Postmenopausal women on estrogen replacementPostmenopausal women on estrogen replacementperformed better at verbal and motor function thanperformed better at verbal and motor function than

other post menopausal women not on Hormonalother post menopausal women not on HormonalReplacement TherapyReplacement Therapy

Spatial Ability & Cycle Phase

-0.2

-0.1

0

0.1

0.2

0.3

0.4

Menstrual Midluteal

Z-ScoreU

nits

Math Speed/Accuracy&

Cycle Phase

-0.1

0

0.1

0.2

Females Males

Pre-Ovulatory

Mid-Luteal

Z-ScoreU

nits


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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 whenBasal body temperature (temp whensomeone wakes up) is low during follicularsomeone wakes up) is low during follicular

phase, dips at ovulation and then risesphase, dips at ovulation and then risesnoticeably just after ovulation (~0.4noticeably just after ovulation (~0.4

degrees) and then continues to rise for thedegrees) and then continues to rise for the

rest of the cycle.rest of the cycle.

Body TemperatureBody Temperature

Basal body temperature (temp when someone wakesBasal body temperature (temp when someone wakesup) is low during follicular phase, dips at ovulationup) is low during follicular phase, dips at ovulation

and then rises noticeably just after ovulation (~0.4and then rises noticeably just after ovulation (~0.4

degrees) and then continues to rise for the rest of thedegrees) and then continues to rise for the rest of the

cycle.cycle.

Temperature shift is used in research and naturalTemperature shift is used in research and naturalfamily planning to detect ovulationfamily planning to detect ovulation

Basal Body TemperatureBasal Body Temperature

Food Intake and CarbohydrateFood Intake and Carbohydrate

MetabolismMetabolism

Food intake (andFood intake (andbasal metabolicbasal metabolic

rate) arerate) areconsistently higherconsistently higher

duringduring luteallutealphase.phase.



Food intake (and basalFood intake (and basalmetabolic rate) are consistentlymetabolic rate) are consistently

higher duringhigher during luteallutealphase.phase. Increase in food intake isIncrease in food intake is

primarily due to increasedprimarily due to increased

carbohydrate consumption.carbohydrate consumption.


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Food intake (and basal metabolic rate)Food intake (and basal metabolic rate)are consistently higher duringare consistently higher during lutealluteal

phase.phase. Increase in food intake is primarilyIncrease in food intake is primarily

due to increased carbohydratedue to increased carbohydrateconsumption.consumption.

Women with PMS show a moreWomen with PMS show a moresignificant increase in appetite andsignificant increase in appetite andcarbohydrate craving than womencarbohydrate craving than womenwithout PMS.without PMS.

WeightWeight

Approximately one third of women report aApproximately one third of women report achange in body weight (1change in body weight (1--5 pounds) with5 pounds) with

menstrual phase, usuallymenstrual phase, usuallypremenstruallypremenstrually ororperimenstruallyperimenstrually depending on study.depending on study.

WeightWeight

Approximately one third of women report aApproximately one third of women report achange in body weight (1change in body weight (1--5 pounds) with5 pounds) with

menstrual phase, usuallymenstrual phase, usuallypremenstruallypremenstrually oror

perimenstruallyperimenstrually depending on study.depending on study.

When estrogens are given experimentally toWhen estrogens are given experimentally toboth rats and humans, there are increases inboth rats and humans, there are increases in

sodium and chloride which cause fluidsodium and chloride which cause fluid

retention.retention.

WeightWeight Approximately one third of womenApproximately one third of women

report a change in body weight (1report a change in body weight (1--55pounds) with menstrual phase, usuallypounds) with menstrual phase, usuallypremenstruallypremenstrually ororperimenstruallyperimenstruallydepending on study.depending on study.

When estrogens are givenWhen estrogens are givenexperimentally to both rats andexperimentally to both rats andhumans, there are increases in sodiumhumans, there are increases in sodiumand chloride which cause fluidand chloride which cause fluidretention.retention.

Fluid retention and increased foodFluid retention and increased foodconsumption may together account forconsumption may together account forcycle related weight fluctuations.cycle related weight fluctuations.

Alcohol MetabolismAlcohol Metabolism

In study whereIn study wheremen and womenmen and womenwere given thewere given thesame amount ofsame amount ofalcohol (notalcohol (notcontrolling forcontrolling for

body weight),body weight),women gotwomen gotmoremoreintoxicated andintoxicated andhad a higherhad a higher

blood alcoholblood alcohollevel than men.level than men.

Alcohol MetabolismAlcohol Metabolism

Unclear whyUnclear whymore affectedmore affectedin latein late luteallutealphase.phase.


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SensesSenses

Almost all of theAlmost all of thesenses (visual,senses (visual,

auditory, tactile, andauditory, tactile, andespecially olfactory)especially olfactory)

appear to be moreappear to be more

acute during theacute during the

follicular phase offollicular phase of

the menstrual cycle.the menstrual cycle.

SensesSenses

Almost all of the sensesAlmost all of the senses(visual, auditory, tactile,(visual, auditory, tactile,

and especially olfactory)and especially olfactory)appear to be more acuteappear to be more acuteduring the follicularduring the follicularphase of the menstrualphase of the menstrualcycle.cycle.

Conflicting studiesConflicting studiesabout sensitivity to pain,about sensitivity to pain,but many show anbut many show anincrease sensitivity toincrease sensitivity topain atpain 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 acuteand 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, butConflicting studies about sensitivity to pain, butmany show an increase sensitivity to pain atmany show an increase sensitivity to pain at

midcyclemidcycle..

Some researchers speculate that heightenedSome researchers speculate that heightenedsensitivity during midsensitivity during mid--cycle may be useful forcycle may be useful for

increasing the probability of coitusincreasing the probability of coitus

SpeechSpeech

When asked to give a 3When asked to give a 3minute speech both regularminute speech both regular

stutters and non stuttersstutters and non stutters

were morewere more disfluentdisfluent (more(more

repetition, revision,repetition, revision,

disrhythmicdisrhythmicphonation,phonation,

interjection and tenseinterjection and tense

pauses)pauses)premenstruallypremenstrually thanthan

atat midcyclemidcycle..

Clinical AilmentsClinical Ailments

Epilepsy: 58% of female epileptics reportedEpilepsy: 58% of female epileptics reportedincreased seizuresincreased seizurespremenstruallypremenstrually comparedcomparedto only 9% during menstruation.to only 9% during menstruation.


Epilepsy (58% of femaleEpilepsy (58% of femaleepileptics reportedepileptics reported

increased seizuresincreased seizures

premenstruallypremenstrually comparedcomparedto only 9% duringto only 9% during

menstruation.menstruation.

Allergies and asthmaAllergies and asthmatend to worsentend to worsen

premenstruallypremenstrually..


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Epilepsy (58% of female epileptics reportedEpilepsy (58% of female epileptics reportedincreased seizuresincreased seizurespremenstruallypremenstrually compared tocompared to

only 9% during menstruation.only 9% during menstruation.

Allergies and asthmaAllergies and asthmatend to worsentend to worsenpremenstruallypremenstrually..

Herpes and eczema outbreaks more commonHerpes and eczema outbreaks more commonpremenstruallypremenstrually


Epilepsy (58% of female epilepticsEpilepsy (58% of female epilepticsreported increased seizuresreported increased seizures

premenstruallypremenstrually compared to only 9%compared to only 9%during menstruation.during menstruation.


Herpes and eczema outbreaks moreHerpes and eczema outbreaks morecommoncommonpremenstruallypremenstrually

Migraine headaches more commonMigraine headaches more commonnear ovulation and shortly thereafternear ovulation and shortly thereafter((perimenstruallyperimenstrually))


Epilepsy (58% of female epileptics reportedEpilepsy (58% of female epileptics reportedincreased seizuresincreased seizurespremenstruallypremenstrually compared tocompared toonly 9% during menstruation.only 9% during menstruation.


Herpes and eczema outbreaks more commonHerpes and eczema outbreaks more commonpremenstruallypremenstrually

Migraine headaches more common near ovulationMigraine headaches more common near ovulationand shortly thereafter (and shortly thereafter (perimenstruallyperimenstrually))

Rheumatoid arthritis symptoms are lowest whenRheumatoid arthritis symptoms are lowest whenovarian steroids are low (early follicular phase).ovarian steroids are low (early follicular phase).

Next Time...Next Time...

MenarcheMenarche

Puberty RitualsPuberty Rituals

Lecture 5 HMS Siklus Menstruasi

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Transcript of Lecture 5 HMS Siklus Menstruasi