Menstrual cycle luteal phase

Follicular phase of menstrual cycle Luteal phase of menstrual cycle... 

The female menstrual cycle is divided into four functional phases follicular, ovulatory, luteal, and menstrual.6 The follicular phase starts the cycle, and ovulation generally occurs on day 14. The luteal phase then begins and continues until menstruation occurs.6 The menstrual cycle is regulated by a negative-feedback hormone loop between the hypothalamus, anterior pituitary gland, and ovaries6 (Fig. 45-1). 

Progesterone therapy either during the luteal phase of the menstrual cycle or for 21 days starting on day 5 after the onset of menses results in a 32% to 50% reduction in menstrual blood loss.29 Its use has not been shown to be superior to other medical treatments, including NSAIDs.29 In addition, it is not associated with any contraceptive benefit.33... 

The first-line therapeutic options for PMDD include the selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, fluvoxamine, sertraline, paroxetine, and citalopram. These agents can be given either continuously or only during the luteal phase of the menstrual cycle, i.e., initiated at the time of ovulation and discontinued on the first day of menses. 

The median length of the menstrual cycle is 28 days (range 21 to 40). The first day of menses is day 1 of the follicular phase. Ovulation usually occurs on day 14 of the menstrual cycle. After ovulation, the luteal phase lasts until the beginning of the next cycle. 

The results 68% of the women treated with extracts from the follicular phase of the menstrual cycle shortened their own current cycle by an average of 1.7 days. A different 68% of the women treated with extracts from the ovarian phase of the menstrual cycle lengthened their own current cycle by an average of 1.4 days. Finally, underarm extracts taken following ovulation, in the luteal phase, had no effect on the... 

Figure 19.6 A 28-day menstrual cycle. The approximate number of days for menstruation, ovulation and the follicular and luteal phases are shown.

Figure 19.12 Representation of changes in hormone levels during the menstrual cycle. Note that LH peaks about one day before ovulation. Oestrogen has two peaks one in the Luteal phase prior to LH surge and a smaller one in the follicular phase. Progesterone peaks in the follicular phase to stimulate development of endometrium.

Initial 12.5 mg/day. Paroxetine CR may be administered either daily throughout the menstrual cycle or limited to the luteal phase of the menstrual cycle. Usual range is 12.5 mg/day and 25 mg/day. 

During the follicular phase of the menstrual cycle, one or more follicles are prepared for ovulation. FSH and estrogens are the most important hormones for this developmental process. Complete follicular maturation cannot occur in the absence of LH. Rupture of a mature follicle follows the midcycle peak of LH and FSH by about 24 hours. In humans, usually one mature ovum is released per cycle. During the luteal phase of the menstrual cycle and under the influence of LH, the ovarian granulosa cells of the corpus luteum become vacuolated and accumulate a yellow pigment called lutein. 

Concentrations of plasma testosterone and other androgens vary throughout the day in both sexes whether such variation is simply random or fits a repeatable diurnal pattern is a matter of debate. Compared with the diurnal variation seen with cortisol, plasma testosterone concentrations are reasonably constant. Plasma androgen concentrations also vary greatly in women through the menstrual cycle, with peak levels seen in the luteal phase. 

Prolactin inhibition. The dried leaves, smoked by healthy female volunteers at a dose of 1 g/person, produced a decrease in plasma prolactin levels during the luteal phase of the menstrual cycle but not during... 

Gastric acidity will also affect the absorption of medication. An acidic environment increases the absorption of weak acids, whereas the absorption of weak bases is facilitated by a less acidic environment. Many psychotropic agents such as tricyclic antidepressants (TCAs] and benzodiazepines are weak bases. Older studies of gastric acid secretion found that women have approximately 33%-40% lower basal gastric acid secretion than do men [Yonkers and Hamilton 1995]. Gastric acid secretion may be further decreased in the luteal phase of the menstrual cycle (Booth et al. 1957]. 

Wikander I, Sundblad C, Andersch B, et al Citalopram in premenstrual dysphoria is intermittent treatment during luteal phases more effective than continuous medication throughout the menstrual cycle J Clin Psycho-pharmacol 18 390-398, 1998... 

Furthermore, these symptoms have a significant impact on a woman s interpersonal relations and general lifestyle and usually require the help of a mental health professional. Typically, at least five symptoms have been present in most menstrual cycles within the previous year, usually during the last week of the luteal phase, begin to remit within a few days after the onset of the follicular phase, and are absent during the week after menses ( 20). 

Allergic bronchospasm occurs very rarely with estrogens (17), but has been reported several times in women with an existing allergic tendency or a history of asthma some asthmatic women have worse symptoms during the luteal phase of the menstrual cycle. In affected cases, the link with estrogens can be demonstrated by rechallenge. 

Melatonin affects reproduction in seasonally breeding animals. In humans, findings of increased endogenous melatonin in hypogonadism and low concentrations in precocious puberty imply an interaction between melatonin and gonadotropins however, data on the effects of exogenous melatonin are limited (1). In a randomized study in 16 women, melatonin enhanced LH and FSH responses to submaximal GnRH stimuli in the follicular but not the luteal phase of the menstrual cycle (24). 

Vaginal immunization experiments with a cholera vaccine containing killed vibrios and CTB have been conducted in both the follicular (V-FPimm) and luteal (V-LPimm) menstrual cycle phase. With both producing comparable cervical CTB-specific IgA responses, however, only the V-FPimm induced cervical IgA2-restricted Ab to the bacterial lipopolysaccharide (LPS) vaccine component and induced CTB-specific IgA in rectal secretions. 

The vagina demonstrates a relatively high permeability to many drags, particularly during the late luteal and early follicular phases of the menstrual cycle. 

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