Category: Made For Science

The Luteal Lowdown: Hormones, Mood, and the Science of Cycles

Asmita Adya
March 2025

The time between ovulation and menstruation, known as the luteal phase, is often marked by emotional variability and instability in menstruating individuals. Feelings of negative affect, physical discomfort, and general malaise commonly plague individuals as the uterine lining thickens in preparation for pregnancy or, if fertilization does not occur, menstruation.

The Biological Basis

During ovulation, the hypothalamus secretes a surge of gonadotropin-releasing hormone (GnRH) to the pituitary gland. In response, the anterior pituitary gland releases luteinizing hormone (LH), which stimulates the gonads, leading to the luteal phase. During this phase, progesterone reaches its peak concentration. Prior to this, during the follicular phase, the anterior pituitary secretes follicle-stimulating hormone (FSH), which leads to a peak in estradiol levels. Estrogen, an ovarian hormone critical to well-being, plays a key role in mood regulation. Low estrogen levels have been implicated in increased vulnerability to depression and impaired emotional regulation. Thus, during the luteal phase, when estrogen levels decline, studies have shown that women exhibit more frequent negative affect and a heightened stress response [1]. Additionally, estradiol contributes to reward processing, as it has a stimulatory, activational effect and interacts with dopamine [2].

However, this raises the question: does the likelihood of experiencing negative affect stem solely from decreased estrogen, or does progesterone itself play a direct role? The lack of conclusive clinical evidence remains a significant barrier to answering this question.

The Implications of Hormonal Contraceptives

Hormonal contraceptives and their effects may serve as a clue. In the 1960s, ‘the pill’ revolutionized hormonal contraception in the United States. The pill typically contains ethinyl estradiol or mestranol (synthetic estrogen) and progestin (synthetic progesterone), though some formulations are progestin-only. The androgenic properties of different progestins vary, ranging from strongly anti-androgenic to strongly androgenic. The typical dose ranges from 0.1 to 3.0 mg per pill.

Although the exact mechanism of action is not fully understood, hormonal contraceptives are thought to “mimic pregnancy.” During pregnancy, endogenous estrogen and progesterone levels rise, exerting negative feedback on hypothalamic GnRH secretion. Similarly, contraceptives prevent pregnancy by mimicking these negative feedback effects. Exogenous hormones from the pill inhibit GnRH release, thereby suppressing FSH and LH secretion from the anterior pituitary. As a result, follicular development is inhibited due to reduced FSH, and ovulation does not occur due to the absence of an LH surge. While the extent of hormonal suppression varies by contraceptive formulation, this chronic suppression prevents pregnancy. Women using hormonal contraceptives typically have endogenous hormone concentrations equivalent to or lower than those observed in the early follicular phase of naturally cycling women. Although hormone levels usually return to baseline within months after discontinuation, some studies suggest lower levels persist for years [3].

Why does this matter? Women who use hormonal contraceptives often report negative side effects such as mood changes, diminished libido, and exacerbation of underlying psychiatric conditions [4]. Furthermore, contraceptives have been implicated in structural and functional changes in brain regions involved in affective and reward processing [5]. These effects highlight the profound impact of exogenous hormone manipulation. Since many contraceptive methods rely on progestin as a primary component, it is plausible that progesterone plays a key role in negative affect, though further research is needed to establish a definitive correlation.

Plausible Physical and Mental Effects

Possible physical and mental effects of elevated progesterone include fatigue, negative affect, and mood fluctuations [6]. These effects can impair emotional and physical functioning and exacerbate underlying psychiatric conditions. These hormonal fluctuations occur independently of individual control; menstruation follows its cyclical course, only ceasing at menopause. So, never dismiss a woman as “too hormonal”—she is simply functioning as nature intended.

References 

[1] Albert, K. M., & Newhouse, P. A. (2019). Estrogen, stress, and depression: Cognitive and biological interactions. Annual Review of Clinical Psychology, 15, 399–423. https://doi.org/10.1146/annurev-clinpsy-050718-095557.

[2] Beltz, A. M., & Moser, J. S. (Year). Ovarian hormones: A long overlooked but critical contributor to cognitive brain structures and function. Annals of the New York Academy of Sciences, Special Issue: The Year in Cognitive Neuroscience.

[3] Taylor, C. M., Pritschet, L., & Jacobs, E. G. (2021). The scientific body of knowledge – whose body does it serve? A spotlight on oral contraceptives and women’s health factors in neuroimaging. Frontiers in Neuroendocrinology, 60, 100874. https://doi.org/10.1016/j.yfrne.2020.100874

[4] Martell, S., Marini, C., Kondas, C. A., & Deutch, A. B. (2023). Psychological side effects of hormonal contraception: A disconnect between patients and providers. Journal of Women’s Health, 32(1), 45-53. https://doi.org/10.1089/jwh.2022.0467

[5] Brønnick, M. K., Økland, I., Graugaard, C., & Brønnick, K. K. (2020). The effects of hormonal contraceptives on the brain: A systematic review of neuroimaging studies. Frontiers in Psychology, 11, Article 556577. https://doi.org/10.3389/fpsyg.2020.556577

[6] Standeven, L. R., McEvoy, K. O., & Osborne, L. M. (2020). Progesterone, reproduction, and psychiatric illness. Best Practice & Research Clinical Obstetrics & Gynaecology, 69, 108–126. https://doi.org/10.1016/j.bpobgyn.2020.06.001

Does Menopause Occurring Later In Life Lead To Better Vascular Health?

Julia Palka
February 2025

Menopause is the dreaded cycle of hormonal imbalance, hot flashes, and discomfort. Women of all ages know it will manifest in various stages, with different symptoms and degrees of abruptness. However, first, we must all face the monthly gift of menstruation, but new findings show that if your body’s natural clock is a little late to the initial onset of menopausal symptoms (55 or older), you may have a significantly decreased risk of cardiovascular events!

According to newly published research from the University of Colorado at Boulder, Women who go through menopause at later ages in life have healthier blood vessels than women who go through it earlier. The research, published in the American Heart Association journal Circulation Research¹ arrived just in time for February, which is Women’s Heart Health Month. The findings can help pave the way to new research and advancements in therapies and treatments aimed at reducing heart disease, the leading cause of death in women.

The new insights show that females who stop menstruating at 55 or older are suggested to have a significantly lower risk of heart attacks and cardiovascular events during their postmenopausal years over women who stop menstruation below 55 years of age. To support this claim, studies write that women 55 or older are actually 20% less likely to develop ailments like heart disease than those 54 and younger. Sanna Darvish, a PhD candidate in the Department of Integrative Physiology at the University of Colorado at Boulder is part of a study assessing the vascular health of 92 women and how well their brachial artery dilates with increased blood flow. Darvish and her colleagues also measured the women’s mitochondrial health in relation to the cells lining the women’s blood vessels. The mitochondria, which is considered the powerhouse of energy in the human body, helped the researchers determine what molecules were present in the women’s blood streams.

The study proved that all the postmenopausal women had significantly worse function in their arteries than women who had not yet experienced menopause³. This is because, as women age, they produce less nitric oxide, a chemical compound that helps prevent plaque build up and stiffness as it dilates the blood vessels. The mitochondria in the cells lining the blood vessels also become more dysfunctional with age and generate free radicals; highly reactive and unstable molecules produced naturally by the human body. 

When women go through menopause, the age related decline in cardiovascular health is accelerated. However, the 10% of women who experience a late onset of menopausal symptoms are seemingly less affected by this predicament. Darvish’s study found that vascular function was only 24% worse in the women who experienced menopause later in life compared to the premenopausal women. In contrast those in the normal onset stage had a 51% decline in vascular health. The differences between the groups occurred 5 years or more after the women went through menopause, where remarkably the late onset group had a reported  44% better vascular function than the normal onset group. 

The success of maintaining better vascular health in the late onset group was linked to the women’s better functioning of mitochondria, which decreased the amount of free radicals produced. The circulating blood in the late onset group also generated more favorable levels of different lipid metabolites in their blood. Darvash and her team will next study how early onset menopause might impact heart health and how certain nutritional supplements marketed as targeting free radicals in the blood vessels may reduce heart disease in women at higher risks. Future research is still necessary to solidify the gaps between the studies currently published, and how and if all women will experience the same prognosis. John Hopkins Medicine says;  If cardiovascular disease runs strongly in the family, it’s also important that you see a cardiologist to further assess the likelihood of having cardiovascular disease and to optimize treatment. ² In summary, the important research provided from the University of Colorado at Boulder suggests that women who experience menopause at 55 or older have healthier blood vessels and a 20% lower risk of heart disease compared to those with earlier menopause. This is linked to better mitochondrial function, reduced free radicals, and improved vascular health, highlighting potential new avenues for cardiovascular disease prevention in women. 

References:

Darvish, S., et al. (2025). Preservation of vascular endothelial function in late-onset postmenopausal women. Circulation Research. https://doi.org/10.1161/circresaha.124.325639

Hopkins Medicine. (n.d.). Menopause and the cardiovascular system. Retrieved February 14, 2025, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/menopause-and-the-cardiovascular-system#:~:text=Plus%2C%20studies%20that%20have%20followed,normal%20age%20(around%2050)

News-Medical. (2025, February 4). Late menopause linked to better vascular health in women. News-Medical. Retrieved from https://www.news-medical.net/news/20250204/Late-menopause-linked-to-better-vascular-health-in-women.aspx

Understanding Organ Prolapse: Causes, Symptoms, and Treatment 

Steven Shin
February 2025

Pregnancy is thought of as a joyful experience, but for some women, it can bring life-threatening health challenges. One of the challenges is Peripartum Cardiomyopathy (PPCM), a form of heart failure that occurs during the final stages of pregnancy or in the postpartum period.¹ Recent research has revealed new information in the diagnosis, treatment, and management of PPCM to help women worldwide. 

What is PPCM? 

PPCM affects approximately 1 in 1,500 to 2,000 pregnancies globally with nonspecific symptoms like shortness of breath, exhaustion, and swelling¹. Crucial interventions or treatment are delayed because these symptoms are often dismissed as normal parts of pregnancy. In PPCM, the heart’s left ventricle weakens and impairs its function. While early treatment results in recovery, undiagnosed or untreated PPCM can lead to persistent heart failure or death³. 

Research showed that the hormone prolactin, commonly associated with breastfeeding, plays a significant role in PPCM. In affected women, prolactin is broken down into a harmful material that damages blood vessels and leads to heart failure. Researchers at the Hannover Medical  School found that the drug bromocriptine which is traditionally used to suppress lactation can block this harmful effect and promote heart recovery when used for heart failure therapy³. The safety and efficacy of bromocriptine showed that it can significantly improve maternal cardiac health without increasing the risk of complications such as blood clots². A study based on a global PPCM registry of 500+ patients supports bromocriptine as a recommended treatment for PPCM². 

New Hope for Subsequent Pregnancies 

Historically, women recovering from PPCM were advised against future pregnancies due to the high risk of relapse or worsening heart function. However, new research suggests a more optimistic outlook. A study based on data from the Global PPCM Registry found that even women with mild residual heart failure could safely carry another pregnancy under medical  supervision². 

This represents a major shift that allows women to expand their families without undue fear. Key to this success is interdisciplinary care by cardiologists, obstetricians, and maternal-fetal medicine specialists who ensure both mother and child are monitored closely¹.

PPCM’s impact is not uniform across the globe. A 20-year population study emphasized significant disparities in PPCM incidence and discussed higher rates reported in Black populations compared to White populations¹. These findings underscore the urgent need for targeted healthcare strategies and awareness campaigns in disproportionately affected communities. 

Access to specialized care also varies widely between high-income and low-income regions. In many low-resource settings, limited awareness means that PPCM often goes undetected until it progresses to a critical stage³. International registries and collaborations are vital in bridging this gap by providing data and resources to improve diagnosis and treatment worldwide³. 

Patient Outcomes and Future Directions 

A study published in the Journal of the American Heart Association reported that 6% of PPCM  patients die within six months of diagnosis, with 42% of these deaths attributed to heart failure and 30% to sudden cardiac arrest³. However, timely diagnosis and intervention can significantly reduce these figures. Advanced imaging techniques, the use of cardiac biomarkers, and continued research into genetic predispositions are important steps to improve outcomes¹. 

Additionally, researchers are exploring how to predict PPCM risk in future pregnancies more accurately. Early identification of at-risk women could allow for tailored monitoring and preventative therapies that potentially reduce the burden of this condition². Thanks to research and the dedication of specialized care teams, women diagnosed with PPCM now have access to better treatments and a brighter future. From innovative therapies like bromocriptine to improved management of subsequent pregnancies, advancements in PPCM care are empowering women to navigate motherhood against all odds. Despite the challenges, with early diagnosis and interdisciplinary care, affected women can embrace both recovery and the possibility of growing their families. 

Reference 

[1] Arany, Z., & Elkayam, U. (2016). Peripartum cardiomyopathy. Circulation, 133(14), 1397– 1409. https://doi.org/10.1161/CIRCULATIONAHA.116.018094 

[2] Sliwa, K., Bauersachs, J., van der Meer, P., Petrie, M. C., Hilfiker-Kleiner, D., Hamdan, R.,  & Seferovic, P. (2025). Pregnancies in women after peripartum cardiomyopathy: The global  European Society of Cardiology EuroObservational Research Programme Peri-Partum  Cardiomyopathy Registry. European Heart Journal. https://doi.org/10.1093/eurheartj/ehaf006

[3] Van der Meer, P., Sliwa, K., Bauersachs, J., Hilfiker-Kleiner, D., & Petrie, M. C. (2024).  Bromocriptine treatment and outcomes in peripartum cardiomyopathy: The EORP PPCM  registry. European Heart Journal. https://doi.org/10.1093/eurheartj/ehae559

Understanding the Gender Differences in Post-Traumatic Stress Disorder 

Helena Huynh
October 2024

Post-Traumatic Stress Disorder (PTSD) is a debilitating mental health condition typically following exposure to a traumatic event, with symptoms impacting day-to-day functioning, causing the person to re-experience their traumatic event, and affecting overall cognition and mood.^[1] According to the World Health Organization, over half of the global population–a shocking 70% of people–will experience a potentially traumatic event in their lives, with a minority of that population (5.6%) going on to develop PTSD.^[2] However, women are much more likely to develop PTSD, with lifetime prevalence rates being almost three times as frequent for women than for men.^[3] Why does this happen? 

Types of Trauma 

Women are much more likely to experience high-impact trauma, including sexual-related trauma and sexual assault. The CDC National Intimate Partner and Sexual Violence Survey conducted in 2010 found that 18.3% of women in the United States experienced rape at some point in their lives.^[3] That equates to an alarming rate of about 1 in 5 women. Exposure to sexual violence are associated with higher rates of PTSD.^[2] Additionally, women are also more likely to experience sexual abuse at younger ages compared to men.^[3] Trauma in early childhood has a strong impact on overall neurobiological development^[4] and also serves as a risk factor increasing the likelihood of developing PTSD.^[1] 

Physiological Responses 

Prior research has found several differences when it comes to psychobiological reactions to PTSD^[4]. For one, hormonal responses can potentially play a role in regulating trauma responses. The hypothalamic-pituitary-adrenal (HPA) axis, a neuroendocrine system within the body that regulates responses to stress, has been found to be more sensitive to stress and trauma. Additionally, studies have found that testosterone may possibly work to reduce HPA reactivity.^[5] On top of that, studies have found that women with PTSD are more likely to experience a reduced fear-extinction during the mid-luteal phase of their menstrual cycle, when oestradiol and progesterone levels are lowest.^[5] These hormones are related to cognitive-emotional processes relating to PTSD, and in trauma-exposed women without PTSD, researchers actually found the opposite result.^[5]

Understanding PTSD Symptoms and Comorbidities 

When it comes to PTSD symptom expression, males and females tend to experience PTSD in a similar way.^[3] A study found that male and female veterans were about equally likely to report different PTSD symptoms on the PTSD Checklist^[3], a self-report measure looking at PTSD symptoms. However, when it comes to comorbidities, women are much more likely to experience internalizing disorders, including mood and anxiety-related disorders. Men, on the other hand, were much more likely to experience externalizing disorders, including substance abuse.^[3] 

Overall, previous research has established a number of differences in the development and prevalence of PTSD in males and females. Given that much of the early research surrounding our knowledge of PTSD revolves around male war veterans^[3], we must continue adding to the literature. Increasing our understanding of why these gender differences develop can inform targeted interventions to ultimately help those who need it. 

References 

[1] U.S. Department of Health and Human Services. (n.d.). Post-Traumatic Stress Disorder. National Institute of Mental Health. 

https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd

[2] World Health Organization. (2024, May 27). Post-traumatic stress disorder. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder 

[3] Vogt, D. (2007, January 1). Va.gov: Veterans Affairs. Research on Women, Trauma and PTSD. https://www.ptsd.va.gov/professional/treat/specific/ptsd_research_women.asp#four 

[4] Olff, M. (2017). Sex and gender differences in post-traumatic stress disorder: An update. European Journal of Psychotraumatology, 8(sup4). 

https://doi.org/10.1080/20008198.2017.1351204

[5] Christiansen, D. M., & Berke, E. T. (2020). Gender- and sex-based contributors to sex differences in PTSD. Current Psychiatry Reports, 22(4). 

https://doi.org/10.1007/s11920-020-1140-y

Understanding Pelvic Organ Prolapse: Causes, Symptoms, and Treatment 

Steven Shin
October 2024

Pelvic organ prolapse (POP) is a condition seen primarily in elder women. It occurs when the muscles and connective tissues that support the pelvic organs become weakened or damaged.  This weakening allows the organs to drop from their usual positions and cause discomfort that potentially affecting a woman’s quality of life. While pelvic organ prolapse can be distressing,  treatment options exist and this can be managed without surgery [1].

Cause of Pelvic Organ Prolapse 

The causes of pelvic organ prolapse are multifactorial, but pregnancy and childbirth remain the most significant risk factors. During childbirth, the pelvic floor undergoes extreme stress. The levator ani muscles and the connective tissue that secures the vagina to the sidewalls of the pelvis are both vital for maintaining pelvic stability. In a healthy individual, the vagina is positioned horizontally on top of the levator ani muscles, offering robust support to the pelvic organs [2]. However, the levator ani muscles can stretch beyond their normal limits that leads to injury. This overstretching causes the vaginal opening to widen and shifts the burden of support from the muscles to the connective tissues.  

Aging is the second most common cause of pelvic organ prolapse as muscle strength and tissue elasticity naturally decline over time. The lack of estrogen weakens the muscles and connective tissues of the pelvic floor, further exacerbating the risk. Other risk factors of Pelvic Organ  Prolapse include obesity, chronic conditions such as diabetes or constipation, and lifestyle habits  such as smoking [2].

Symptoms of Pelvic Organ Prolapse 

Many women with pelvic organ prolapse may not notice any symptoms. On the other hand,  women may experience a range of symptoms that affect their quality of life. The most common sign of prolapse is a feeling that something is “coming down” or a bulge protruding from the vaginal opening. Some women may feel or see a soft lump while washing themselves, while others might experience discomfort, pressure, or a dragging sensation in the pelvic area. Some may notice difficulty with bowel movements or find it challenging to keep tampons in place. 

Treatments of Pelvic Organ Prolapse

Not all cases of pelvic organ prolapse require medical treatment. Mostly, women with mild symptoms can manage their condition with lifestyle changes and conservative treatments.  However, certain situations, such as sores on the vaginal wall or bladder problems like ureteral kinking may require medical treatment. Regardless, please see your doctor the moment you notice symptoms.  

For women’s non-surgical options, Kegel exercises are often recommended. These exercises target the muscles that support the pelvic organs and can help strengthen them. Working with a pelvic floor therapist improves the effectiveness of these exercises. Pessaries, small silicone devices inserted into the vagina, can provide additional support to the pelvic organs [3]. These devices help relieve symptoms by holding the vaginal walls in place.  

Lifestyle modifications like avoiding heavy lifting, quitting smoking, and managing constipation can also reduce symptoms. Obesity and chronic health issues like diabetes and constipation aggravate prolapse, so managing these factors is crucial. 

For women with more severe prolapse that significantly affects their quality of life, surgery may be necessary. Surgical procedures aim to repair and reinforce the damaged tissues, restoring the organs to their proper positions. Surgery can be performed either through the abdomen or the vagina [3]. In cases where the prolapse causes more serious complications, such as difficulty emptying the bladder or bowel, surgery may be the best option to restore normal function. However, about 25% of women may require additional surgeries later due to the recurrence of prolapse [3].  

Pelvic organ prolapse is a common condition that affects many women. It is often treatable, and many women can manage their symptoms without surgery. Non-surgical treatments, such as pelvic floor exercises and pessaries, can be highly effective. For those with more severe cases,  surgery is an option to improve quality of life. If you suspect you have pelvic organ prolapse, it’s important to consult your healthcare provider to explore the best treatment options for your individual needs.

Reference 

[1] Iglesia, C. B., & Smithling, K. R. (2017). Pelvic organ prolapse. American family physician,  96(3), 179-185. 

[2] Collins, S., & Lewicky-Gaupp, C. (2022). Pelvic organ prolapse. Gastroenterology Clinics,  51(1), 177-193. 

[3] American College of Obstetricians and Gynecologists. (2019). Pelvic organ prolapse.  Urogynecology, 25(6), 397-408.

Polycystic Ovarian Syndrome: Understanding your Symptoms and Knowing your Treatment Options 

Chaimaa Riad
October 2024

Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that affects around 5-10% of women of reproductive age.^[4]While its prevalence is high, scientists are unsure of the cause of this disorder. Symptoms can often be overlooked, as PCOS can present in a variety of ways with very general symptoms. It is specifically challenging to diagnose PCOS in young girls because symptoms can often be seen as normal signs of puberty.^{[2] [4]}It is important to recognize any signs and symptoms of hyperandrogenism and express concerns to your primary care provider to get the tests necessary to diagnose PCOS. 

Signs and Symptoms to Consider 

Family history is important to consider: 

• Let your doctor know if there is a history of PCOS in the family, or a family history of acne, hirsutism, or obesity.^[2] 

PCOS is strongly associated with metabolic dysfunction: 

• Women should be aware of recent weight gain. While girls going through puberty are likely to gain weight, there should be a discussion of the progression of the weight gain. ^[2] 
• Signs of insulin resistance are also associated with PCOS. The increase in fat associated with hyperandrogenism is likely to cause your body to not be able to respond properly to the insulin created in your body, leading to an increase in sugar levels, leading to type 2 diabetes.^[2] 

Irregular menstrual cycles: 

• Oligomenorrhea (infrequent menstrual periods)^[1] 
• Menorrhagia (heavy bleeding)^[1] 
• Primary amenorrhea (failure to get a first period by 15 years old)^[1] 
• Secondary amenorrhea (not having a period for at least three months)^[1] ○ Infertility^[1] 

Skin changes 

• Hirsutism (excess hair growth on the face or body) ^[2] 
• Abnormal acne or oily skin ^{[1] [2]} 
• Acanthosis nigricans (hyperpigmentation usually in the axilla, groin, and neck secondary to diabetes).^[2][3] 

Cardiovascular concerns

• Although unclear, there have been concerns about atherosclerosis forming in young women who have PCOS. This can increase risk of stroke as well as heart attacks. More studies need to be done to properly assess this risk in women with PCOS.^[1] 

Diagnosis 

According to the World Health Organization, diagnosis of PCOS includes at least two out of three of the following: 

1. Symptoms that suggest high androgens (hirsutism, acne, high testosterone levels on lab testing) with no explanation of why there are high androgen levels ^[5] 
2. Irregular menstrual cycles, as explained above in greater detail ^[5] 
3. Ultrasound imaging showing polycystic ovaries ^[5] 

Laboratory studies are especially important to ensure that other endocrine disorders are ruled out, including: 

• Hypothyroidism: TSH levels ^[3] 
• Hyperprolactinemia: Prolactin levels ^[3] 
• Congenital Adrenal Hyperplasia: 17-hydroxyprogesterone levels ^[3] 

Treatment Options 

After a diagnosis of PCOS is made, there are various methods of management:

• Lifestyle modifications – a healthy diet and increased physical activity are ways that can help manage the comorbidities of PCOS including diabetes and obesity. In addition to this, women should follow up with their PCP to assess for any worsening of diabetes or any development of cardiovascular changes such as hypertension.^[1] 
• Medical management: As discussed, diabetic management can vary, and can be managed with medication, as well as hypertension.^[1] Additionally, oral contraceptives can help with irregular menstrual cycles.^[1] Specific types of medication vary based on the presentation and severity of the specific symptoms. 

There is no specific management for PCOS, but rather symptom-based intervention to help prevent serious complications. It is important to discuss with your PCP to know which specific intervention is right for you based on your symptoms. ^[1][4] 

References 

[1] Hoeger, K. M., Dokras, A., & Piltonen, T. (2020, November 19). Update on PCOS: Consequences, challenges, and guiding treatment. OUP Academic. 

https://academic.oup.com/jcem/article/106/3/e1071/5992309?login=false

[2] Screening and management of the hyperandrogenic adolescent. ACOG. (2024). https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/10/screening-an d-management-of-the-hyperandrogenic-adolescent 

[3] Teede, H. J., Piltonen, T., Costello, M. F., & Misso, M. L. (2018, August). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. American Society for Reproductive Medicine. https://www.fertstert.org/article/S0015-0282(18)30400-X/fulltext 

[4] Why polycystic ovarian syndrome is often misdiagnosed. Why Polycystic Ovarian Syndrome Is Often Misdiagnosed: Women’s Healthcare of Princeton: Gynecologists. (n.d.). https://www.princetongyn.com/blog/why-polycystic-ovarian-syndrome-is-often-misdiagnosed [5] World Health Organization. (2023, June). Polycystic ovary syndrome. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome

Debunking the Myth: No Link Between Cellphone Use and Cancer?

Steven Shin
September 2024

The rapid increase in cellphone usage over the past few decades has sparked significant public concern about potential health risks, especially the risk of developing brain cancer. Considering the usage of cell phones, even a slight increase in cancer risk could have significant public health implications. This concern has been particularly serious regarding brain and central nervous system cancers, as phones are often used close to the head. However, recent research offers stunning news: there is no conclusive link between cellphone use and brain cancer (Karipidis,  2024, p.33-39). 

The potential danger of cellphone radiation originates from the fact that these devices emit radiofrequency energy, a type of nonionizing radiation. Nonionizing radiation is low-frequency and low-energy, so it is known to damage DNA and increase cancer risk, unlike ionizing radiation such as X-rays and cosmic rays. 

The research suggests that energy from cellphone radiation is too weak to cause DNA damage,  which is a key mechanism through which cancers can develop. The biological effect of radiofrequency radiation on the human body is a slight heating of the tissue in the area where the phone is held, but this heating is minimal and not sufficient to increase core body temperature or cause harm. Additionally, no increase in the incidence of leukemia or brain cancer was observed in children exposed to radio or TV transmitters or cellphone towers (Karipidis, 2024).  

These findings are significant in of the fears that have lingered since 2011 when the International  Agency for Research on Cancer (IARC) classified radiofrequency electromagnetic fields as a possible factor that causes cancer. This past result is thought to be a bias that arose from distorted result analysis when individuals with brain cancer compared to those without. Nowadays, the newer generation of cellphone networks like 3G and 4G plays a role in reducing potential risks because they emit significantly lower levels of radiofrequency radiation compared to older networks (Karipidis, 2024, p.45). Moreover, the presence of more cellphone towers shows a decrease in the amount of radiation emitted from individual cell phones. 

Over the years, cohort studies and case-control studies have been the primary methods used to conduct the experiment. Case-control studies compare cellphone use between individuals with tumors and those without, while cohort studies follow large groups of people over time to observe tumor development among cellphone users and non-users. 

Another important aspect of the research is its consideration of the lack of evidence regarding the health effects of 5G networks. While no major studies have specifically examined the long-term effects of 5G, existing research on radar technology, which operates at similar frequencies, has not shown an increased risk of cancer (Safari Variani, A, 2019, p.7-9). This comparison provides additional reassurance to the public as new technologies continue to emerge and spread rapidly. 

These findings emphasize a trend that the introduction of new technologies often initiates public fears about potential health danger. The most recent example of this phenomenon was the widespread but unproven belief during the COVID-19 pandemic that 5G cellphone towers were spreading the virus. This once led to attacks on cell towers in a few regions. Long-term research about new technologies can change the rapidly created fear and bias of crowds.  

In conclusion, concerns about the potential link between cellphone use and cancer due to the widespread use of these devices arose, but recent research shows that this is not true. The WHO commissioned research including epidemiological studies has found no conclusive evidence that cellphone use increases the risk of cancer. The radiofrequency radiation emitted by cell phones is nonionizing and too weak to damage DNA. Plus, advances in cellphone technology, such as lower emissions from newer networks and the increased presence of cellphone towers, decrease any potential risks. As new technologies like 5G continue to appear, further research is essential to monitor long-term health effects.

References 

[1] Karipidis, K., Baaken, D., Loney, T., Blettner, M., Brzozek, C., Elwood, M., … & Lagorio, S.  (2024). The effect of exposure to radiofrequency fields on cancer risk in the general and working population: A systematic review of human observational studies–Part I: Most researched outcomes. Environment International, 108983. 

[2] Safari Variani, A., Saboori, S., Shahsavari, S., Yari, S., & Zaroushani, V. (2019). Effect of  Occupational Exposure to Radar Radiation on Cancer Risk: A Systematic Review and Meta Analysis. Asian Pacific Journal of Cancer Prevention, 20(11), 3211-3219. doi:  10.31557/APJCP.2019.20.11.3211

Balancing Minds and Hormones: Unraveling the Impact of Contraceptives on Young Girls’ Mental Health

The growing association between mental health and hormonal contraceptive use is becoming an issue of rising concern for young girls. Due to the wide scope of benefits provided from hormonal birth control, ranging from acne management to pregnancy prevention, the utilization of this medicine has become more prevalent among adolescents. As a consequence, the mental health implications of these medications have come under growing inspection. This article focuses on the relationship between hormonal contraceptives and mental health disorders in young adolescents, further highlighting the significance of well-informed decisions for the betterment of young girl’s healthcare. 

The Impact of Hormonal Contraceptives on Mental Health

Hormonal contraceptives, including birth control pills, injections, and implants, are put into effect by changing the body’s natural hormone levels in attempts to avoid accidental pregnancies. These methods, despite having a high efficiency rate, have the potential to affect the brain’s chemistry. This could cause alterations in the adolescents mood as well and negatively impact their mental health. The two main hormones that are influenced by contraceptives are estrogen and progesterone, which are responsible for inflicting changes to the mental health of the individual. 

A study published in JAMA Psychiatry led to the conclusion that young girls that utilize hormonal contraceptives were 80% more likely and in greater risk of being diagnosed with depression in comparison to those who did not use these methods. ^[1] In addition, a separate study brought awareness to the unfavorable consequences that resulted from the usage of these medications by highlighting that young adolescents who used combined oral contraceptives had a 70% increased risk of developing symptoms of anxiety compared to those who did not. ^[2]

Risk Factors Involved 

Various factors can increase the risk of experiencing mental health issues from hormonal contraceptives. This includes pre-existing mental health conditions, such as a previous experience or history with depression or anxiety. In addition, genetic proneness, such as a family history of mental health disorders, can also influence the extent to which a girl’s body reacts in a negative manner to these hormones.

Research that was conducted by the University of Copenhagen found that teenage girls who possessed a history of mental health issues had almost double the risk of experiencing worsening symptoms after starting hormonal contraceptives. ^[3] To expand, a longitudinal study expressed that those with a family history of depression had a higher likelihood of developing symptoms related to depression following the introduction of hormonal birth control into their system. ^[4]

Conclusion

The correlation between mental health disorders and hormonal contraceptives for adolescent girls is a complex and highly prevalent issue in today’s society. Despite the benefits that result from taking these medications, the potential negative consequences on mental health for those who take them cannot be overlooked. It is important to understand that great consideration must  go into deciding whether or not hormonal contraceptives are the best route for young girls. 

References

[1] Skovlund, C. W., Morch, L. S., Kessing, L. V., & Lidegaard, Ø. (2016). Association of hormonal contraception with depression. JAMA Psychiatry, 73(11), 1154-1162.

[2] Zettermark, S., Perez Vicente, R., & Merlo, J. (2018). Hormonal contraceptive use among adolescent girls and subsequent depression: A nationwide population-based cohort study. BMJ Open, 8(11), e024813.

[3] University of Copenhagen. (2017). Impact of hormonal contraception on mental health in young women. Scandinavian Journal of Public Health, 45(5), 483-491.

[4] Bratke, S., & Sundström, A. (2020). Hormonal contraception and the risk of mental health disorders: A systematic review. Journal of Psychiatric Research, 126, 75-85.

The Silent Toll: How Workplace Stress Disrupts Women’s Menstrual Health in High-Pressure Careers

The workplaces in today’s modern society stand responsible for stimulating high stresses and intense pressures in their employees. Despite the shared experiences of tension among both men and women, demanding professions inflict unique challenges particularly for females in regard to their menstrual health. Research depicts a strong correlation between workplace stress and menstrual irregularities that are highly prevalent in female employees who are placed in demanding positions in their field of labor. This article delves into the specifics of these consequences while simultaneously highlighting the need for better support systems for women placed in these high-pressure environments. 

The Connection Between Stress and Menstruation

Stress can be responsible for a variety of hormonal changes that occur within the body. This can be initially stimulated by the release of cortisol, which can be otherwise referred to as the “stress hormone”. As the levels of cortisol rises, it impedes a region of the brain primarily known for its regulation of the menstrual cycle: the hypothalamus. Disruptions to this section can stimulate imbalances in hormones including estrogen and progesterone. This further links to menstrual inconsistencies, such as missed periods, unpredictable cycles, and intensified symptoms.^[1]

A study conducted by the American Psychological Association illustrated that women who are involved in work atmospheres with intense pressure are more likely to experience menstrual irregularities. The research further reported an approximation of 40% claiming to have pissed periods and 25% possessing an experience with significantly heavier menstrual bleeding during periods of high stress. ^[2] In addition, another study put forth the notion that women participating in high-pressure areas of work, such as medicine and law, had a 33% higher chance of experiencing extreme menstrual cramps in comparison to women who were involved in fields that were less demanding. ^[3]

Nurturing a Healthier Work Environment 

In order to alleviate the stress that the workplace imposes on menstruation for women in high stress jobs, employers must take measures to create a healthy atmosphere. This may include promoting flexible work policies, such as remote work positions, which can assist women in managing their stress with greater care. A study published in the Journal of Occupational Health Psychology further explored how flexible work patterns diminished menstrual interferences in 60% of women participants. [4]

Conclusion

Workplace stress is difficult to avoid in modern life and fields of work, however its impact on women’s menstrual health should not be left unnoticed. Through efforts to understand the association between stress and menstruation as well as fostering supportive work environments, employers can help reduce some of the burdens placed on women active in high-stress jobs. 

References

[1] Chandraratna, S., & Harlow, S. D. (2022). Stress and menstrual cycle irregularity: A prospective study of the effect of workplace stress. Journal of Women’s Health, 31(3), 300-306.

[2] American Psychological Association. (2023). Stress and menstrual health: How workplace pressure affects women’s cycles. APA Research, 45(2), 112-119.

[3] Cousins, S., & Maguire, K. (2021). The impact of occupational stress on menstrual health among women in high-stress professions: A review. Women’s Health Issues, 31(6), 452-460.

[4] Allen, R., & Parker, J. (2022). The effect of flexible work policies on women’s health outcomes in high-stress jobs. Journal of Occupational Health Psychology, 27(3), 205-213.

Amenorrhea: How The Absence of Menstruation Can Be a Problem

Gabriela Castro
May 2024

If you have a uterus, there’s a chance your period has not always come on a regular monthly basis. The chronic absence of a period can be indicative of a medical condition called amenorrhea. There are two types of amenorrhea–primary and secondary.^[4] Primary amenorrhea refers to those with uteruses who have not had their first period (also known as “menarche”) by age 15.^[3] Secondary amenorrhea is the absence of 3 or more consecutive periods by someone who has begun to menstruate previously.^[3] 

Symptoms

The central feature of amenorrhea is a lack of menstruation. Other symptoms associated with amenorrhea can vary in part due to its causes, including::

• Milky nipple discharge^[3]
• Hair loss^[3]
• Headache^[3]
• Vision changes^[3]
• Excess facial hair^[3]
• Pelvic pain^[3]
• Acne^[3]

Primary Amenorrhea Causes

• Primary amenorrhea is caused primarily by hormonal imbalances and genetic abnormalities.^[5] 
• Having hypothalamic issues can prevent the onset of menstruation.^[5] 
• Issues with the pituitary gland such as pituitary tumors can inhibit menstruation.^[5] 
• Low body weight, excessive exercise, and eating disorders can cause stress which affects hormone production (particularly in the pituitary gland or hypothalamus leading to amenorrhea).^[3]
• Genetic abnormalities such as a lack of reproductive organs or a structural abnormality obstructing the vagina can block visible bleeding.^[3] Chromosomal issues such as Turner syndrome–which is caused by a missing or partly missing X chromosome–or genetic disorders like androgen insensitivity syndrome–often characterized by high testosterone levels–may affect menstruation.^[5]

Secondary Amenorrhea Causes

Secondary amenorrhea has a wider variety of causes. 

• It can be brought on naturally through pregnancy, breastfeeding, or menopause.^[5] This type of amenorrhea can be brought on by hormone imbalance in ways similar to primary amenorrhea. 
• Hypothalamic amenorrhea–associated with low body weight, body fat, high stress, extreme exercise–can result in secondary amenorrhea.^[5] Other hormonal imbalances that result in amenorrhea can be overactive or underactive thyroid, or pituitary tumors.^[5][3] 
  • Gynecological issues such as polycystic ovarian syndrome (PCOS) as well as premature menopause (which is associated with fragile X-associated primary ovarian insufficiency (FXPOI)) are tied to amenorrhea. ^[5][3][4]
• Uterine scarring as a result of various medical interventions (including dilation and curettage (D&C), cesarean section, or treatment for uterine fibroids) may cause amenorrhea.^[5][3]
  • Medications such as contraceptives, antipsychotics, antidepressants, blood pressure medications, chemotherapy radiation, and allergy medications are also known to cause secondary amenorrhea.^[5][3]

Prevalence

With the wide array of underlying causes, you might be wondering, how common is amenhorrea? When focusing on women who menstruate, the American College of Obstetricians and Gynecologists estimated that 1 in 25 women who are not pregnant, breastfeeding, or going through menopause experience amenorrhea at some point in their lives.^[1] If you struggle with amenorrhea, you should know you are not alone. 

Treatments

If you or someone you know is struggling with amenorrhea, it can be a sign of a deeper issue especially if it is not because of natural causes like pregnancy or menopause. That is why it is important to discuss your menstrual cycle with your healthcare provider, including any other symptoms you’ve been experiencing. Depending on the root cause of amenorrhea, treatment can vary from psychological therapy, stress management, eating disorder treatment, changing medications, surgery, chemotherapy, or radiation.^[2] Whatever the cause is, you do not have to endure amenorrhea without help or guidance. Taking the first step by sharing your concern with your health care provider and a trusted loved one will ensure you are in good hands and supported in your recovery.

References

[1] Amenorrhea: Absence of periods. (2020, October). https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods

[2] Amenorrhea—Diagnosis & treatment. (2023, February 9). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/amenorrhea/diagnosis-treatment/drc-20369304

[3] Amenorrhea—Symptoms and causes. (2023, February 9). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/amenorrhea/symptoms-causes/syc-20369299 

[4] Fragile x-associated primary ovarian insufficiency (Fxpoi) | nichd—Eunice kennedy shriver national institute of child health and human development. (2021, August 19). https://www.nichd.nih.gov/health/topics/fxpoi

[5] What causes amenorrhea? | nichd – eunice kennedy shriver national institute of child health and human development. (2017, January 31). https://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/causes