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      Menstrual Cycle-Dependent Changes in Visual Field Analysis of Healthy Women

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          Abstract

          Purpose: To determine the effect of menstrual cycle phases on the visual field analysis of healthy females. Material and Methods: One randomly selected eye each of 59 healthy normally menstruating women, and of 54 men with no systemic and ocular problems, other than refractive error, were included in the study. Subjects underwent complete ocular examination, and standard achromatic perimetric (SAP) and short-wavelength automated perimetric (SWAP) analysis in both follicular (7th to 10th day of the cycle) and luteal phases (days 3–7 before the menstrual bleeding) of the menstrual cycle. Visual field analysis was performed using a Model 750 Humphrey Field Analyzer II (Humphrey Instruments Inc., San Leandro, Calif., USA) with full-threshold, central 30-2 program. Visual fields were divided into four regions as superior temporal, inferior temporal, superior nasal and inferior nasal, respectively. Results: The mean age of female (n = 59) and the male subjects (n = 54) were 34.6 ± 2.9 and 35.0 ± 2.7 years, respectively (p = 0.49). SWAP tests demonstrated a significantly decreased mean MS value in the luteal phase (p < 0.05). However, it did not change significantly with SAP tests. Regional MS values of both SAP and SWAP tests were not different in both phases of the menstrual cycle (all p values >0.05). Mean perimetric test durations obtained with both SAP and SWAP were not different throughout the menstrual cycle (both p values >0.05). Conclusion: Clinicians should verify menstrual status when evaluating a suspected loss of visual field sensitivity in menstruating women. The findings of the present study suggest that the SWAP test may be more sensitive to determine subtle sex hormone-dependent changes in visual field analysis of healthy women.

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          Most cited references 13

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          Effects of the menstrual cycle on medical disorders.

          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.
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            Hormonal status affects the reactivity of the cerebral vasculature.

            We compared the blood velocity and vascular resistance in the central retinal and ophthalmic arteries in healthy nonpregnant, pregnant, and postmenopausal women (before and after estrogen replacement therapy). Color flow Doppler ultrasonography was used to determine systolic, diastolic, and mean velocity, as well as the resistance index in the central retinal and ophthalmic arteries in 10 nonpregnant women, 10 third-trimester pregnant women, and 10 hypoestrogenic postmenopausal women. The postmenopausal patients were again studied 2 months after starting daily oral therapy with 2 mg of micronized 17 beta-estradiol. Pregnant women had a significantly (p < 0.05) higher diastolic blood velocity (4.2 +/- 0.8 cm/sec) and a lower resistance index (0.56 +/- 0.05) in the central retinal artery, when compared with nonpregnant women (diastolic velocity 2.8 +/- 0.8 cm/sec, resistance index 0.68 +/- 0.1), and hypoestrogenic postmenopausal women (diastolic velocity 2.6 +/- 0.9 cm/sec, resistance index 0.73 +/- 0.08). Significant differences were not seen in the ophthalmic artery. In the postmenopausal patients estradiol therapy was associated with an increase in diastolic velocity (2.6 +/- 0.9 cm/sec vs 4.1 +/- 1.6 cm/sec) and a decrease in the resistance index (0.73 +/- 0.08 vs 0.66 +/- 0.1) in the central retinal artery but not in the ophthalmic artery. The blood velocity and vascular resistance in the cerebral microcirculation appear to change according to the phases of a woman's reproductive life. This may be related, in part, to estrogen levels, because estradiol vasodilates small-diameter cerebral vessels in hypoestrogenic postmenopausal women.
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              The relationship between menstrual phase and the P3 component of ERPs.

               V Johnston,  X T Wang (1991)
              Event-related potentials (ERPs) and behavioral ratings were collected from 30 female subjects who were exposed to picture slides. The slides belonged to five affective categories whose content was babies, dermatological cases, ordinary people, male models, and female models. Based on the day of testing relative to their menstrual cycle, the subjects were grouped according to their expected levels of androgens, estrogen, or progesterone. The data were examined to determine whether any ERP component or behavioral rating (non-erotic/erotic, unpleasant/pleasant, simple/complex, and low arousal/high arousal) varied as a function of subjects' hormone defined menstrual phase. Only the P3 component was sensitive to menstrual phase. The P3 to babies and male models was largest when progesterone levels were high. High progesterone was also associated with a decrease in the complexity and eroticism of all slide categories. An increase in the pleasantness of all categories was evident when estrogen levels were high. The results are interpreted as support for an "adaptive context updating" theory of the P3 component of ERPs.
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                Author and article information

                Journal
                OPH
                Ophthalmologica
                10.1159/issn.0030-3755
                Ophthalmologica
                S. Karger AG
                0030-3755
                1423-0267
                2005
                February 2005
                06 January 2005
                : 219
                : 1
                : 30-35
                Affiliations
                Departments of aOphthalmology and bObstetrics and Gynaecology, Akdeniz University School of Medicine, Antalya, Turkey
                Article
                81780 Ophthalmologica 2005;219:30–35
                10.1159/000081780
                15627825
                © 2005 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 5, References: 27, Pages: 6
                Categories
                Original Paper

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