Serum immunoglobulins E are related to menstrual cycle

During a cross sectional epidemiological survey on a general population sample, 596 fertile women underwent total serum IgE determination. They completed an interviewer-administered standardized questionnaire and were categorized according to their menstrual period. They were divided into two groups: those from days 10 to 20, who were considered to be in the periovulatory phase, and those in the other phases. IgE mean values were significantly different (p = 0.01) in the two groups: particularly, lower IgE values were found in those in periovulatory phase, after accounting for smoking habit and atopic status. By multiple regression analysis, taking into account the independent effects of menstrual period, age, smoking habit, hours of fast, skin prick test reactivity and presence of cough, significantly lower IgE values in the periovulatory phase were found. We hypothesize the possibility that a decrease of IgE concentration occurs during midcycle: a reduced immune response might facilitate the ovuli implantation. Further studies are necessary to longitudinally investigate the trend of IgE in the same women, as well as the distributions and the trends of other immunoglobulins.     

Ischemic but not thermal pain sensitivity varies across the menstrual cycle

OBJECTIVE AND METHOD: Findings from both animal and human research suggest that pain sensitivity changes across the menstrual cycle; however, among humans the nature of these menstrual cycle effects remains unclear. The present study used a repeated-measures design to evaluate changes in thermal and ischemic pain responses during three phases of the menstrual cycle, midfollicular (postmenstrual), ovulatory, and mid-to-late luteal (premenstrual), in 11 healthy women. The cycle phase during which subjects began their participation was determined randomly. Plasma levels of estrogen, progesterone, luteinizing hormone (LH), testosterone, and beta-endorphin were determined at each experimental session. Participants also completed a daily diary of physical and emotional symptoms for two complete menstrual cycles before the experimental sessions. RESULTS: The results indicated that women showed less ischemic pain sensitivity during the midfollicular compared with the ovulatory and mid-to-late luteal phases, but thermal pain responses did not vary significantly across menstrual cycle phases. Physical and emotional symptoms were minimal and did not change significantly across the menstrual cycle. CONCLUSIONS: These findings indicate greater ischemic but not thermal pain sensitivity among women after the midcycle LH surge. The practical relevance and potential mechanisms of these findings are discussed.     

Expression of genes that contribute to proliferative and metastatic ability in breast cancer resected during various menstrual phases

BACKGROUND: Retrospective studies show significant improvements in survival among women who had breast cancer resected during the luteal phase of their menstrual cycle compared with the follicular phase. We hypothesised that tumour tissue would show cyclical changes in expression of genes whose products might contribute to metastatic potential. METHODS: We studied 32 premenopausal women with operable breast cancer. We assayed hormones to define more accurately the menstrual phase during which surgery was done. We used northern blot analysis of RNA from fresh-frozen tumour specimens to study the patterns of expression of genes for proteolytic enzymes (cysteine proteinase cathepsin L and aspartyl proteinase cathepsin D; matrix metalloproteinases MMP-9 and MMP-2), tissue inhibitors of metalloproteinases TIMP-1 and TIMP-2, and TP53. RESULTS: There was a significantly higher level of expression of RNA for cathepsin L, MMP-9, and TP53 (p=0.005, 0.03, 0.03, respectively) in tumours that were resected during the follicular and periovulatory phases of the menstrual cycle than at other times in the cycle. A similar but non-significant trend was seen for MMP-2 and cathepsin D. A non-significant trend in the opposite direction was seen for TIMP-1 and TIMP-2. INTERPRETATION: We found that tumour expression of genes that may contribute to proliferative capacity and metastatic potential can change in breast cancer during the course of the menstrual cycle. The finding could provide a molecular explanation for the reports of improved survival in some breast-cancer patients whose tumours were removed during the luteal phase of the menstrual cycle. Larger studies are required to extend our study, assess mechanisms of gene regulation, and verify any relevant influence in long-term survival.     

Chronotropic competence in endurance trained heart transplant recipients: heart rate is not a limiting factor for exercise capacity

Soy isoflavones are hypothesized to be responsible for changes in hormone action associated with reduced breast cancer risk. To test this hypothesis, we studied the effects of isoflavone consumption in 14 premenopausal women. Isoflavones were consumed in soy protein powders and provided relative to body weight (control diet, 10 +/- 1.1; low isoflavone diet, 64 +/- 9.2; high isoflavone diet, 128 +/- 16 mg/day) for three menstrual cycles plus 9 days in a randomized cross-over design. During the last 6 weeks of each diet period, plasma was collected every other day for analysis of estrogens, progesterone, LH, and FSH. Diet effects were assessed during each of four distinctly defined menstrual cycle phases. Plasma from the early follicular phase was analyzed for androgens, cortisol, thyroid hormones, insulin, PRL, and sex hormone-binding globulin. The low isoflavone diet decreased LH (P = 0.009) and FSH (P = 0.04) levels during the periovulatory phase. The high isoflavone diet decreased free T3 (P = 0.02) and dehydroepiandrosterone sulfate (P = 0.02) levels during the early follicular phase and estrone levels during the midfollicular phase (P = 0.02). No other significant changes were observed in hormone concentrations or in the length of the menstrual cycle, follicular phase, or luteal phase. Endometrial biopsies performed in the luteal phase of cycle 3 of each diet period revealed no effect of isoflavone consumption on histological dating. These data suggest that effects on plasma hormones and the menstrual cycle are not likely to be the primary mechanisms by which isoflavones may prevent cancer in premenopausal women.     

Expression of pS2, c-erbB-2, and cathepsin D during the menstrual cycle in human breast cancers

BACKGROUND: Many studies have addressed the effect of the timing of surgery for breast cancer relative to menstrual cycle phase, with conflicting results. Explanations for the possibility that survival could be altered by the appropriate timing of breast cancer surgery in humans remain speculative. METHODS: We examined the expression of three estrogen related proteins (c-erbB-2, cathepsin D, pS2) in the breast tumors from 69 premenopausal women sampled in different phases of the menstrual cycle. Data on S-phase fraction and hormone receptor expression were also analyzed. Immunohistochemical assays were used to measure the proteins of interest. S-phase fraction was determined by flow cytometry. Analyses were performed based on fraction of cells staining positive for the protein, density of stain, and a histoscore that combined both fraction of positive cells and density. RESULTS: We found no differences in c-erbB-2, cathepsin D, hormone receptor, or S-phase levels in tumors sampled in the follicular versus luteal phase, or perimenstrual versus periovulatory phase. The exception was pS2, which was expressed at greater levels during the luteal than during the follicular phase of the cycle (p < 0.01); but there was no difference in pS2 expression when the patients were classified as periovulatory versus perimenstrual. CONCLUSIONS: Our findings do not support a variation in c-erbB-2, cathepsin D, S-phase fraction, or receptor expression as an explanation for the differences in breast cancer prognosis when surgery is timed by menstrual cycle phase. The finding that pS2 (an indicator of hormone sensitivity, and possibly better prognosis) is expressed at higher levels in tumor samples during the luteal phase suggests that the biologic profile of breast tumors may vary with the menstrual cycle and that these variations deserve further study.     

The effects of gender, menstrual phase and practice on the perceived location of the midsagittal plane

Women show menstrual phase-related cognitive changes that suggest altered hemispheric activation for a particular task, such that they demonstrate the greatest lateral performance differences on prototypical left hemisphere tasks during the luteal phase and on prototypical right hemisphere tasks during menstruation. Additionally, menstrual phase may alter total cerebral responsiveness, such that response times and performance accuracy for many tasks are best during the luteal phase and most impaired during the menstrual phase. We evaluated the effect of menstrual phase on spatial bisection (a perceptuospatial task) to help further understand hormonally-mediated changes in interhemispheric dynamics. Healthy young adult women and men blindly pointed to their midsagittal plane with either hand. Women were repeatedly tested according to menstrual phase, and men were tested at similar intervals. The mean pointing error in the luteal phase differed significantly from that of all other phases and did not differ significantly from those of men, who pointed significantly to the left across test sessions. These findings suggest that, in space bisection tasks, women are more likely to have asymmetric hemispheric activation during the luteal phase than during the menstrual phase. Thus, space bisection did not resemble other prototypical right hemisphere behaviors. The luteal phase may have nonspecifically activated both hemispheres on this task instead of suppressing right hemisphere function, and a slight functional asymmetry favoring the right hemisphere may have been promoted. In addition, intermanual pointing discrepancies in both subject groups decreased over repeated sessions. This suggests that, while practice alters an internal kinesthetic reference, it does not influence an imaginal extrapersonal spatial reference.     

The effects of a copper-intrauterine device on the uterine artery blood flow in regularly menstruating women

The aim of the study was to evaluate the effect of a copper-intrauterine device (IUD) on uterine artery blood flow during the midluteal phase and on the first day of the menstrual cycle using pulsed colour Doppler ultrasonography. Twenty-one regularly menstruating women (18-45 years) who were willing to use copper-IUD contraception participated in the study. The patients were first examined without the IUD in the midluteal phase 6-9 days before the expected onset of menstruation and on the first day of menstruation, after which the IUD was inserted. Three months later the patients were examined again on the corresponding cycle days. The patients estimated the level of dysmenorrhoeic pain with a scoring system. Transvaginal ultrasonography with colour flow imaging was used to measure the pulsatility index (PI) in the uterine arteries. There were no significant changes in the uterine artery blood flow after the insertion of the IUD during menstruation or in the midluteal phase. In patients with increased IUD-related pain during menstruation (n = 5), however, there was a decrease in PI (2.87 +/- 0.52 versus 2.41 +/- 0.23, P = 0.05) after IUD insertion. The decrease in the mean PI was present in all five patients. In conclusion, copper-IUD does not induce any major changes in the resistance of the uterine artery blood flow, although during menstruation in patients with increased menstrual pain after IUD insertion there seems to be a decrease in the uterine artery PI.     

Food intake and the menstrual cycle: a retrospective analysis, with implications for appetite research

The biological regulation of appetite is currently an important topic in nutrition, since hyperphagia has been implicated as the prime cause of obesity. Cyclical fluctuations in food intake occur in women across the menstrual cycle, with a periovulatory nadir and a peak in the luteal phase. These alterations in food intake, in response to ovarian steroid hormone changes may be more than 2.5 MJ/day, with the mean reported changes shown in 19 separate studies of 1.0 MJ/day. Hormonal induced fluctuations in food intake could, therefore, contribute to energy imbalance and consequent weight gain. Further, in nutrition studies involving women subjects where the menstrual cycle phase is not controlled, hormonally induced changes in food selection and intake may mask the often considerably smaller changes in response to experimental variables in appetite research.     

The pediatrician and the sexually active adolescent. Treatment of common menstrual disorders

Menstrual disorders in adolescents are a common medical problem. For young adolescents, the onset of menses is a time of dramatic physical and psychological change. Providing education to young women regarding the normal process of puberty helps ease some of the anxiety regarding this change. Health professionals can participate in the education of young women by defining the normal process of puberty and menstruation. Menstrual disorders, such as dysmenorrhea, irregularities in menstrual flow, and premenstrual symptoms, can be effectively diagnosed and treated in the adolescent population.     

The menstrual cycle and its effect on inflammatory bowel disease and irritable bowel syndrome: a prevalence study

OBJECTIVE: Female patients with bowel disease commonly report worsening symptoms in relation to the menstrual cycle. Our aim was to determine the nature of gastrointestinal symptoms correlating with the menstrual cycle in women with inflammatory and irritable bowel disease. METHODS: This was a retrospective study involving 49 women with ulcerative colitis (UC), 49 women with Crohn's disease (CD), 46 women with irritable bowel syndrome (IBS), and 90 healthy community controls. Participants were interviewed using a questionnaire including information regarding general health, medication history, pregnancy, as well as premenstrual and menstrual symptoms. Chi2 testing and logistic regression modeling were used to test for differences in frequencies between groups and for risk analysis. RESULTS: Premenstrual symptoms were reported by 93% of all women but statistically more often by patients with CD (p < 0.01). CD patients were also more likely to report increased gastrointestinal symptoms during menstruation ( < 0.01), diarrhea being the symptom reported most often. All disease groups had a cyclical pattern to their bowel habits significantly more than controls (p=0.01). Cyclical symptoms included diarrhea, abdominal pain, and constipation. Logistic regression revealed an odds ratio (OR) of 1.1 (95% CI 0.9-1.2) for experiencing bowel symptoms during the premenstrual and menstrual phases and an OR of 2.0 (95% CI 1.2-3.2) for experiencing a cyclical pattern in bowel habit changes in women with bowel disease. CONCLUSION: The prevalence of menstrually related symptoms is high, and appears to affect bowel patterns. The physiological and clinical effects of the menstrual cycle should be taken into consideration when assessing for disease activity.     

Modulation of alloimmune response in vitro by an IgM-enriched immunoglobulin preparation (Pentaglobin)

OBJECTIVE: To describe endometrial wavelike activity, endometrial thickness, and texture in controlled ovarian hyperstimulation (COH) cycles. DESIGN: Prospective observational ultrasound study. SETTING: University hospital-based infertility clinic. PATIENT(S): Thirty-five COH cycles in 19 women with unexplained infertility. INTERVENTION(S): Transvaginal ultrasound examination was performed throughout COH cycles. Intrauterine insemination was performed after hCG administration. MAIN OUTCOME MEASURE(S): Endometrial wavelike activity, wave frequency, wave velocity, endometrial thickness, and endometrial texture. RESULT(S): Endometrial wavelike activity increased from menstruation to ovulation and decreased in the luteal phase. On day hCG+2, endometrial wave-like activity was observed in all cycles. Waves from cervix to fundus prevailed in the periovulatory phase. Endometrial wavelike activity was related significantly to endometrial thickness at the start of ovarian stimulation and in the luteal phase. Endometrial thickness increased throughout the cycle. Endometrial texture showed periovulatory a triple-line aspect. CONCLUSION(S): In COH cycles, endometrial wavelike activity is more pronounced than in spontaneous cycles. The number of follicles and endometrial wavelike activity were not correlated significantly. This is the first prospective study to provide longitudinal observational evidence that endometrial thickness increases throughout the COH cycle and that a triple line pattern develops.     

Perimenstrual complaints in women complaining of PMS, menorrhagia, and dysmenorrhea: toward a dismantling of the premenstrual syndrome

Four groups of women were compared in terms of their perimenstrual symptoms, reported menstrual blood loss and period pain, and neuroticism scores: three patient groups were referred to a Gynaecology Outpatient Clinic because of menorrhagia (N = 101), PMS (N = 104), dysmenorrhea (N = 56), and a control group (N = 105). The three patient groups showed considerable overlap in a number of symptoms. This has led us to postulate three factors contributing to perimenstrual complaints: a) a 'timing factor' linked to the ovarian cycle; b) a 'menstruation factor,' associated with the buildup of the endometrium and its shedding; and c) a 'vulnerability factor,' one aspect of which, 'neuroticism,' was measured in this study. Depressive symptoms, which were the most important in leading women to seek help for their PMS, were related to all three factors. Depressive mood changes seemed to be linked to the 'timing factor' but were noticeably worse and more prolonged in women with high neuroticism, heavy bleeding, or severe pain. One premenstrual symptom, food craving, was of considerable interest. This was weakly related to neuroticism, not apparently affected by the 'menstruation factor' and differed in severity between those in the PMS group and the other three groups. It is potentially relevant that both carbohydrate craving and depression are linked to serotonergic changes in the brain, which may prove to be particularly marked in the late luteal phase.     

Disruptions of social relationships accentuate the association between emotional distress and menstrual pain in young women.

This study examined the effects of social support on dysmenorrhea and whether social support moderates the relationship between negative emotions and painful symptoms. Women (N?=?184) completed questionnaires on menstrual symptoms, depression, anxiety, and social networks. Depression and anxiety were strongly associated with menstrual pain. Women who no longer had access to their prior support providers manifested more symptoms than did women with stable social relations. In addition, this disruption in their social networks moderated the relationship between distress and menstrual pain. Results indicate that loss of social support is a significant contributor to menstrual symptoms and point to the importance of considering specific aspects of social support in studying its effect on health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Menstrual cycle, beta-endorphins, and pain sensitivity in premenstrual dysphoric disorder.

This study examined pain sensitivity and pain modularity mechanisms (e.g., beta-endorphin levels, blood pressure) in women with premenstrual dysphoric disorder (PMDD; n=27) and healthy controls (n=27) during the follicular and luteal phases of the menstrual cycle. Physiological measures were taken during rest and ischemic pain testing. In both cycle phases, PMDD women (a) displayed lower resting cortisol and beta-endorphin levels and (b) exhibited shorter pain threshold and tolerance times and greater pain unpleasantness ratings during pain. PMDD women also reported greater pain unpleasantness and intensity and had lower beta-endorphin levels in their luteal phase and tended to display higher blood pressure levels at rest and during pain testing. Results suggest that endogenous opioids may be pathophysiologically relevant to PMDD and that the hypothalamic-pituitary-gonadal axis may modulate pain sensitivity in PMDD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Endometriosis in adolescent women

With the aim of determining an effective therapy for adolescent women with endometriosis, the authors analyzed the results of laparotomy performed on 16 cases of female teenagers over a seven-year period. All patients, whose average age of menarche is 12.8, were diagnosed with endometriosis between two months and nine years after the menarche, with an average interval of 5.2 years. The chief symptoms are dysmenorrhea, pelvic pain and abdominal fullness. Of the three patients of unicornuate uterus with rudimentary horn, endometriosis was found only involving the adnexa on the side of the rudimentary horn, two of the three patients had absence of affected side kidney. Conservative operation including six cases of salpingo-oophorectomy and 10 cases of ovarian cystectomy were chosen followed by danazol treatment. One year to seven years after surgical treatment, two patients required subsequent conservative operation for recurrence of endometriosis and two other patients resumed dysmenorrhea. Two married women became pregnant 5 and 10 months after surgical and medical therapy respectively. In conclusion, adolescent endometriosis may occur around five years after menarche and an obstructive uterine anomaly, enhancing retrograde menstruation, increases the occurrence rate. The symptoms and treatment of endometriosis in teenage group do not really differ from that in the older women. In the treatment of endometriosis and for the prevention of recurrence, it is recommended to give three to six months of danazol after surgical treatment.     

Fiber type composition of abdominal muscles in Japanese macaques (Macaca fuscata)

The muscle fiber composition and cross-sectional area of muscle fiber types were investigated histochemically in the abdominal muscles (rectus abdominis muscle, obliquus externus abdominis muscle, obliquus internus abdominis muscle and transversus abdominis muscle) of three Japanese macaques (Macaca fuscata). Muscle fibers were classified into three fiber types (Type I, II A and II B) by myosin ATPase activity and succinate dehydrogenase activity. Each abdominal muscle in Japanese macaques contained high proportion of Type II B fibers and there were no large differences in the fiber type composition between the abdominal muscles. The range of mean fiber type percent was 26-32% Type I, 21-22% Type II A, and 46-52% Type II B fibers. Thus, based on the histochemical fiber type composition, the separate abdominal muscles appear to have a similar functional capacity. The cross-sectional area was larger for Type II than for Type I fibers, and the areas were similar in Type II A and Type II B fibers in each muscle. The rectus abdominis showed larger fibers of each type compared to the lateral abdominal muscles. The high proportion of Type II B fibers and large fiber size for Type II B fibers suggest that the abdominal muscles of Japanese macaques have properties similar to the propulsive and locomotory muscles in the limbs.     

Analgesic effects induced by TENS and electroacupuncture with different types of stimulating electrodes on deep tissues in human subjects

Effects of conditioning peripheral nerve stimulation with different types of stimulating electrodes on pain thresholds in various deep tissues were measured in human subjects. Cone-shaped metal (phi 13 mm), rubber (phi 13 mm), and large soft surface electrodes (50 x 150 mm) were used for transcutaneous electrical nerve stimulation (TENS), and insulated and non-insulated acupuncture needles (diameter: 240 microns) were used for electroacupuncture (EA). Two pairs of electrodes were placed around the point of deep pain measurement. Symmetrical positive and negative square pulses (0.1 msec at 100 Hz) of just below the pain tolerance intensity were used for both TENS and EA. Deep pain thresholds were measured at the center of the thigh with a pulse algometer and insulated needle electrodes. Pain thresholds of deep tissues were in the order periosteum < fascia < skin (including subcutaneous tissues) < muscle. TENS with surface electrodes significantly increased pain thresholds of skin and fascia but not those of muscle or periosteum. The shape, material and size of the surface electrodes hardly affected the degree of analgesic effect, except in the fascia by large soft electrodes. In contrast, EA with non-insulated needles induced a greater increase in pain threshold in skin, fascia and muscle, although statistically significant results were obtained in only the first two tissues. EA with insulated needle electrodes was the only technique with which we obtained a significant increase in pain threshold in muscle and periosteum. These results suggest that the choice of electrode and stimulus parameters is important for the production of sufficient analgesic effects in different somatic tissues and that insulated needle electrodes are useful for pain relief in deeper tissues such as muscle and periosteum.     

Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the abdominal muscle structural adaptations and functional capabilities during pregnancy and the postbirth period. SUBJECTS: Six primigravid subjects, aged 28 to 33 years, participated in nine test sessions from 14 weeks of gestation to 8 weeks postbirth. METHODS: At each test session, three-dimensional photography of abdominal skin markers was used to determine the gross morphology of a representative abdominal muscle, the rectus abdominis muscle. The functional capability of the abdominal muscle group was assessed on the ability of the muscle group to stabilize the pelvis against resistance. RESULTS: Increases were found in rectus abdominis muscle separation width, length, and angles of insertion as pregnancy progressed. Reversal in rectus abdominis muscle separation was found by 4 weeks postbirth. The ability to stabilize the pelvis against resistance was shown to be decreased as pregnancy progressed and remained compromised postbirth. Decrements in abdominal muscle function paralleled in time the structural adaptations as pregnancy progressed. Continued functional deficits were found in parallel with incomplete resolution of structural adaptations postbirth. CONCLUSION AND DISCUSSION: Abdominal muscle function is affected by structural adaptations that occur during pregnancy. Because our results showed that the ability to stabilize the pelvis against resistance is decreased during pregnancy and at least 8 weeks postbirth, abdominal muscle exercises should be chosen with care. [Gilleard WL, Brown JMM. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period.     

Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis

STUDY DESIGN: The contribution of transversus abdominis to spinal stabilization was evaluated indirectly in people with and without low back pain using an experimental model identifying the coordination of trunk muscles in response to a disturbances to the spine produced by arm movement. OBJECTIVES: To evaluate the temporal sequence of trunk muscle activity associated with arm movement, and to determine if dysfunction of this parameter was present in patients with low back pain. SUMMARY OF BACKGROUND DATA: Few studies have evaluated the motor control of trunk muscles or the potential for dysfunction of this system in patients with low back pain. Evaluation of the response of trunk muscles to limb movement provides a suitable model to evaluate this system. Recent evidence indicates that this evaluation should include transversus abdominis. METHODS: While standing, 15 patients with low back pain and 15 matched control subjects performed rapid shoulder flexion, abduction, and extension in response to a visual stimulus. Electromyographic activity of the abdominal muscles, lumbar multifidus, and the surface electrodes. RESULTS: Movement in each direction resulted in contraction of trunk muscles before or shortly after the deltoid in control subjects. The transversus abdominis was invariably the first muscle active and was not influenced by movement direction, supporting the hypothesized role of this muscle in spinal stiffness generation. Contraction of transversus abdominis was significantly delayed in patients with low back pain with all movements. Isolated differences were noted in the other muscles. CONCLUSIONS: The delayed onset of contraction of transversus abdominis indicates a deficit of motor control and is hypothesized to result in inefficient muscular stabilization of the spine.     

Differences in urologist and patient assessments of health related quality of life in men with prostate cancer: results of the CaPSURE database

Premenstrual syndrome (PMS) is characterized by distressing somatic and behavioral symptoms that develop after ovulation, reach a maximum during the premenstrual days, and disappear within 4 days after the onset of menstruation. Corpus luteum formation is necessary for the presence of symptoms, but the role of luteal hormones is unclear. The aim of this work was to investigate the relationship between sex hormone serum concentrations and premenstrual symptom severity in patients with PMS. Mental and physical symptoms were marked on a validated visual analog scale by 30 PMS patients every evening. Daily blood samples were taken in the luteal phase and in most of the follicular phase. Estradiol, progesterone, FSH, and LH were analyzed. Symptom severity was calculated as the number of negative symptoms expressed per day and as summarized scores of negative ratings. Based on premenstrual hormone concentrations and using the median split method, patients were divided into groups with high and low hormone levels. The pattern of expressed symptoms and summarized scores during the menstrual cycle was similar for the 2 groups. High concentration of luteal-phase estradiol and LH were related to the severity of negative premenstrual symptoms.