Injury Incidence Across the Menstrual Cycle in International Footballers

Objectives: This study aimed to assess how menstrual cycle phase and extended menstrual cycle length influence the incidence of injuries in international footballers.Methods: Over a 4-year period, injuries from England international footballers at training camps or matches were recorded, alongside self-reported information on menstrual cycle characteristics at the point of injury. Injuries in eumenorrheic players were categorized into early follicular, late follicular, or luteal phase. Frequencies were also compared between injuries recorded during the typical cycle and those that occurred after the cycle would be expected to have finished. Injury incidence rates (per 1,000 person days) and injury incidence rate ratios were calculated for each phase for all injuries and injuries stratified by type.Results: One hundred fifty-six injuries from 113 players were eligible for analysis. Injury incidence rates per 1,000 person-days were 31.9 in the follicular, 46.8 in the late follicular, and 35.4 in the luteal phase, resulting in injury incidence rate ratios of 1.47 (Late follicular:Follicular), 1.11 (Luteal:Follicular), and 0.76 (Luteal:Late follicular). Injury incident rate ratios showed that muscle and tendon injury rates were 88% greater in the late follicular phase compared to the follicular phase, with muscle rupture/tear/strain/cramps and tendon injuries/ruptures occurring over twice as often during the late follicular phase compared to other phases 20% of injuries were reported as occurring when athletes were “overdue” menses.Conclusion: Muscle and tendon injuries occurred almost twice as often in the late follicular phase compared to the early follicular or luteal phase. Injury risk may be elevated in typically eumenorrheic women in the days after their next menstruation was expected to start.

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Menstrual Cycle and Surgical Treatment of Breast Cancer: Findings From the NCCTG N9431 Study

Journal of Clinical Oncology ◽

10.1200/jco.2008.21.3603 ◽

2009 ◽

Vol 27 (22) ◽

pp. 3620-3626 ◽

Cited By ~ 17

Author(s):

Clive S. Grant ◽

James N. Ingle ◽

Vera J. Suman ◽

Daniel A. Dumesic ◽

D. Lawrence Wickerham ◽

...

Keyword(s):

Breast Cancer ◽

Menstrual Cycle ◽

Luteal Phase ◽

Follicular Phase ◽

Cycle Phase ◽

Adjuvant Radiation ◽

Menstrual Phase ◽

Menstrual Cycle Phase ◽

Hormone Levels ◽

Menstrual History

Purpose For nearly two decades, multiple retrospective reports, small prospective studies, and meta-analyses have arrived at conflicting results regarding the value of timing surgical intervention for breast cancer on the basis of menstrual cycle phase. We present the results of a multi–cooperative group, prospective, observational trial of menstrual cycle phase and outcome after breast cancer surgery, led by the North Central Cancer Treatment Group (NCCTG) in collaboration with the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the International Breast Cancer Study Group (IBCSG). Patients and Methods Premenopausal women age 18 to 55 years, who were interviewed for menstrual history and who were surgically treated for stages I to II breast cancer, had serum drawn within 1 day of surgery for estradiol, progesterone, and luteinizing hormone levels. Menstrual history and hormone levels were used to determine menstrual phase: luteal, follicular, and other. Disease-free survival (DFS) and overall survival (OS) rates were determined by Kaplan-Meier method and were compared by using the log-rank test and Cox proportional hazard modeling. Results Of 1,118 women initially enrolled, 834 women comprised the study cohort: 230 (28%) in luteal phase; 363 (44%) in follicular phase; and 241 grouped as other. During a median follow-up of 6.6 years, and in analysis that accounted for nodal disease, estrogen receptor status, adjuvant radiation therapy or chemotherapy, neither DFS nor OS differed with respect to menstrual phase. The 5-year DFS rates were 82.7%, 82.1%, and 79.2% for follicular, luteal, or other phases, respectively. Corresponding OS survival rates were 91.9%, 92.2%, and 91.8%, respectively. Conclusion When menstrual cycle phases were strictly defined, neither DFS nor OS differed between women who underwent surgery during the follicular phase versus the luteal phase. Nearly 30% of the patients did not meet criteria for either follicular- or luteal-phase categories.

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Descriptive Epidemiology of Injuries in Professional Ultimate Frisbee Athletes

Journal of Athletic Training ◽

10.4085/1062-6050-269-18 ◽

2020 ◽

Vol 55 (2) ◽

pp. 195-204 ◽

Cited By ~ 2

Author(s):

Matthew C. Hess ◽

David I. Swedler ◽

Christine S. Collins ◽

Brent A. Ponce ◽

Eugene W. Brabston

Keyword(s):

Incidence Rate ◽

Epidemiologic Study ◽

Incidence Rates ◽

Thigh Muscle ◽

Surveillance Program ◽

Injury Incidence ◽

Descriptive Epidemiology ◽

Injury Rates ◽

Ultimate Frisbee ◽

Rate Ratios

Context Injuries in professional ultimate Frisbee (ultimate) athletes have never been described. Objective To determine injury rates, profiles, and associated factors using the first injury-surveillance program for professional ultimate. Design Descriptive epidemiology study. Setting American Ultimate Disc League professional ultimate teams during the 2017 season. Patients or Other Participants Sixteen all-male teams. Main Outcome Measure(s) Injury incidence rates (IRs) were calculated as injuries per 1000 athlete-exposures (AEs). Incidence rate ratios were determined to compare IRs with 95% confidence intervals, which were used to calculate differences. Results We observed 299 injuries over 8963 AEs for a total IR of 33.36 per 1000 AEs. Most injuries affected the lower extremity (72%). The most common injuries were thigh-muscle strains (12.7%) and ankle-ligament sprains (11.4%). Running was the most frequent injury mechanism (32%). Twenty-nine percent of injuries involved collisions; however, the concussion rate was low (IR = 0.22 per 1000 AEs). Injuries were more likely to occur during competition and in the second half of games. An artificial turf playing surface did not affect overall injury rates (Mantel-Haenszel incidence rate ratio = 1.28; 95% confidence interval = 0.99, 1.67). Conclusions To our knowledge, this is the first epidemiologic study of professional ultimate injuries. Injury rates were comparable with those of similar collegiate- and professional-level sports.

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ADMA concentration changes across the menstrual cycle and during oral contraceptive use: the Cardiovascular Risk in Young Finns Study

Acta Endocrinologica ◽

10.1530/eje-09-0658 ◽

2010 ◽

Vol 162 (2) ◽

pp. 259-265 ◽

Cited By ~ 14

Author(s):

Pirjo Valtonen ◽

Kari Punnonen ◽

Heli Saarelainen ◽

Nonna Heiskanen ◽

Olli T Raitakari ◽

...

Keyword(s):

Oral Contraceptive ◽

Menstrual Cycle ◽

Brachial Artery ◽

Luteal Phase ◽

Follicular Phase ◽

Cycle Phase ◽

Adult Women ◽

Brachial Artery Diameter ◽

Concentration Changes ◽

Adma Concentration

ObjectiveThe aim of this study was to evaluate changes in the nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) levels during different menstrual cycle phases in young adult women with or without oral contraceptive (OC) use.Design and methodsThe subjects (n=1079) originated from a large population-based, prospective cohort study conducted in Finland. Plasma ADMA, symmetric dimethylarginine (SDMA), l-arginine, C-reactive protein, creatinine, and brachial artery flow-mediated dilatation (FMD) were measured. The use of OCs and menstrual cycle phase were determined from a questionnaire.ResultsIn non-OC users, ADMA (P=0.017), l-arginine (P=0.002), and ADMA/SDMA ratio (P<0.001) were significantly lower in the luteal phase than in the follicular phase of the menstrual cycle. Non-OC users also had significantly higher ADMA and SDMA concentrations (P<0.001) and lower l-arginine concentrations (P<0.001) compared to OC users of estrogen-containing pills. Progestin-only contraceptive pills (POPs) did not lower the ADMA level, but maintained it at the same level as in non-OC users. In OC users, there were no significant differences found in ADMA, FMD, or FMD% across menstrual cycle, whereas brachial artery diameter was significantly more decreased in the luteal phase (P=0.013) than in the follicular phase.ConclusionWe observed that the circulating ADMA concentration varies across the menstrual cycle in young women not using OCs, and women on OCs displayed significantly lower circulating ADMA concentrations than non-OC users, though this was not the case with POP contraception.

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Indirect Markers of Muscle Damage Throughout the Menstrual Cycle

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2019-0727 ◽

2020 ◽

pp. 1-9

Author(s):

Nuria Romero-Parra ◽

Victor Manuel Alfaro-Magallanes ◽

Beatriz Rael ◽

Rocío Cupeiro ◽

Miguel A. Rojo-Tirado ◽

...

Keyword(s):

Menstrual Cycle ◽

Range Of Motion ◽

Muscle Damage ◽

Sex Hormones ◽

Muscle Soreness ◽

Perceived Exertion ◽

Follicular Phase ◽

Cycle Phase ◽

Countermovement Jump ◽

Late Follicular Phase

Context: The indirect markers of muscle damage have been previously studied in females. However, inconclusive results have been found, possibly explained by the heterogeneity regarding monitoring and verification of menstrual-cycle phase. Purpose: To determine whether the fluctuations in sex hormones during the menstrual cycle influence muscle damage. Methods: A total of 19 well-trained eumenorrheic women (age 28.6 [5.9] y; height 163.4 [6.1] cm; weight 59.6 [5.8] kg body mass) performed an eccentric-based resistance protocol consisting of 10 × 10 back squats at 60% of their 1-repetition maximum on the early follicular phase (EFP), late follicular phase, and midluteal phase of the menstrual cycle. Range of motion, muscle soreness, countermovement jump, and limb circumferences were evaluated prior to 24 and 48 hours postexercise. Perceived exertion was evaluated after each set. Results: Differences in sex hormones indicated that tests were adequately performed in the different menstrual-cycle phases. Prior to exercise, muscle soreness was higher in the EFP (4.7 [7.7]) than in the late follicular phase (1.1 [3.2]; P = .045). No other variables showed significant differences between phases. Time-point differences (baseline, 24, and 48 h) were observed in knee range of motion (P = .02), muscle soreness, countermovement jump, and between sets for perceived exertion (P < .001). Conclusion: Although the protocol elicited muscle damage, hormonal fluctuations over the menstrual cycle did not seem to affect indirect markers of muscle damage, except for perceived muscle soreness. Muscle soreness was perceived to be more severe before exercise performed in EFP, when estrogen concentrations are relatively low. This may impair women’s predisposition to perform strenuous exercise during EFP.

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Peak gamma frequency and cortical laminar processing are modified across the healthy menstrual cycle

10.1101/219196 ◽

2017 ◽

Author(s):

R.L. Sumner ◽

R.L. McMilllan ◽

A. D. Shaw ◽

K.D. Singh ◽

F. Sundram ◽

...

Keyword(s):

Menstrual Cycle ◽

Luteal Phase ◽

Pyramidal Cells ◽

Gamma Oscillations ◽

Gonadal Hormones ◽

Follicular Phase ◽

Cycle Phase ◽

Functional Changes ◽

Gamma Frequency ◽

Cortical Laminar

AbstractFluctuations in gonadal hormones over the course of the menstrual cycle are known to cause functional brain changes and are thought to modulate changes in the balance of cortical excitation and inhibition. Animal research has shown this occurs primarily via the major metabolite of progesterone, allopregnanolone, and its action as a positive allosteric modulator of the GABAA receptor. Our study used EEG to record gamma oscillations induced in the visual cortex using stationary and moving gratings. Recordings took place during twenty females’ mid-luteal phase when progesterone and oestradiol are highest, and early follicular phase when progesterone and oestradiol are lowest. Significantly higher (~5 Hz) gamma frequency was recorded during the luteal compared to the follicular phase for both stimuli types. Using dynamic causal modelling these changes were linked to stronger self-inhibition of superficial pyramidal cells in the luteal compared to the follicular phase. In addition the connection from inhibitory interneurons to deep pyramidal cells was found to be stronger in the follicular compared to the luteal phase. These findings show that complex functional changes in synaptic microcircuitry occur across the menstrual cycle and that menstrual cycle phase should be taken into consideration when including female participants in research into gamma-band oscillations.

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PSYCHOPHYSIOLOGICAL CHARACTERISTICS OF WOMEN IN DEPENDENCE ON THE OVARIOHORMONAL CYCLE PHASE AND PROGESTERONE ACTIVITY (PART 2)

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2013-2-257-265 ◽

2013 ◽

Vol 12 (2) ◽

pp. 257-265

Author(s):

K. B. Muravlyova ◽

O. I. Kuzminova ◽

S. I. Petrova ◽

M. V. Skoraya ◽

O. M. Bazanova

Keyword(s):

Menstrual Cycle ◽

Luteal Phase ◽

Peak Frequency ◽

Follicular Phase ◽

Progesterone Level ◽

Cycle Phase ◽

Alpha Band ◽

Menstrual Cycle Phase ◽

Subject Design ◽

Alpha Peak

With the aim to identify the effects of menstrual cycle phase on the alpha EEG characteristics the 78 women aged 18–27 years were studied in a within-subject design Half the subjects began investigation at their follicular phase and half at their luteal phase (LP). The alpha peak frequency, alpha band width and power inalpha-2 range are highest, but power in alpha 1 and activation are lowest in LP that is associated with the highest saliva progesterone level.

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PSYCHOPHYSIOLOGICAL CHARACTERISTICS OF WOMEN IN DEPENDENCE ON THE OVARIOHORMONAL CYCLE PHASE AND PROGESTERONE ACTIVITY (PART 1)

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2013-2-247-256 ◽

2013 ◽

Vol 12 (2) ◽

pp. 247-256 ◽

Cited By ~ 1

Author(s):

K. B. Muravlyova ◽

O. I. Kuzminova ◽

S. E. Petrova ◽

M. V. Skoraya ◽

O. M. Bazanova

Keyword(s):

Menstrual Cycle ◽

Cognitive Performance ◽

Luteal Phase ◽

Follicular Phase ◽

Progesterone Level ◽

Cycle Phase ◽

Menstrual Cycle Phase ◽

Emotional Tension ◽

Subject Design

With the aim to identify the effects of menstrual cycle phase on the cognitive and psycho-emotional characteristics in 78 women aged 18–27 years were studied in a within-subject design Half the subjects began during their follicular phase and half began during their luteal phase (LP). The level of psycho-emotional tension was lowest, but cognitive performance efficiency is a highest in LP that is associated with the highest saliva progesterone level.

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THE SEQUENCE OF PITUITARY RESPONSES TO SYNTHETIC LUTEINIZING HORMONE RELEASING HORMONE (LH-RH) THROUGHOUT THE NORMAL MENSTRUAL CYCLE

Acta Endocrinologica ◽

10.1530/acta.0.0790625 ◽

1975 ◽

Vol 79 (4) ◽

pp. 625-634 ◽

Cited By ~ 4

Author(s):

Elwyn M. Grimes ◽

Irwin E. Thompson ◽

Melvin L. Taymor

Keyword(s):

Menstrual Cycle ◽

Luteal Phase ◽

Follicular Phase ◽

Lh Surge ◽

Luteinizing Hormone Releasing Hormone ◽

Late Luteal Phase ◽

Normal Menstrual Cycle ◽

Early Follicular Phase ◽

Lh Rh ◽

Late Follicular Phase

ABSTRACT Thirty-one ovulatory women between 20 and 33 years of age were given 150 μg of synthetic LH-RH during different phases of the menstrual cycle. Five patients were studied during the early follicular phase (days 4–7); 10 patients during the late follicular phase (days 9–12); 6 patients during the "LH Surge"; 5 patients during the early luteal phase (days 14–16); 3 patients during mid-luteal phase (days 17–21); and 2 patients during late luteal phase (days 22–27). Oestrogen, progesterone, FSH and LH levels were determined from 30 min prior to LH-RH administration to 90 min thereafter in all cases. LH response to LH-RH increased progressively during the follicular phase. Enhanced pituitary responsiveness to LH-RH occurred at mid-cycle for both LH and FSH and maximum LH responses occurred during the "LH Surge" and early luteal phase. LH responses during the mid and late luteal phases were similar to late follicular phase responses. There were no significant differences between FSH responses during the early follicular, late follicular, mid-luteal and late luteal phases. Maximum pituitary responsiveness appears to occur in a gonadal steroid milieu of high oestrogen levels in association with rising but low progesterone levels. Progesterone or a crucial oestrogen: progesterone ratio may in fact potentiate pituitary release of LH during the early stages of corpus luteum formation. Pituitary responsiveness to LH-RH correlates positively with basal LH and oestrogen levels during the menstrual cycle and with the oestrogen:progesterone ratio during the luteal phase.

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Computed tomography contrast enhancement pattern of the uterus in premenopausal women in relation to menstrual cycle and hormonal contraception

Acta Radiologica ◽

10.1177/0284185120958404 ◽

2020 ◽

pp. 028418512095840

Author(s):

Konstantinos Angelopoulos ◽

Magnus Palmér ◽

Berit Gull ◽

Niklas Lundqvist ◽

Linda Kopelia ◽

...

Keyword(s):

Computed Tomography ◽

Menstrual Cycle ◽

Contrast Enhancement ◽

Luteal Phase ◽

Hormonal Contraception ◽

Premenopausal Women ◽

Follicular Phase ◽

Cycle Phase ◽

Homogeneous Type ◽

Menstrual Cycle Phase

Background There are different types of computed tomography (CT) contrast enhancement patterns of the uterus. It is not known whether these are hormonally dependent. Purpose To assess the relationship between these patterns and the menstrual cycle in non-users of hormonal contraception, and the possible impact of hormonal contraception. Material and Methods Prospective observational study of abdominal CT scans of 53 premenopausal women of whom 28 were non-users and 25 users of hormonal contraception. The non-users were divided according to menstrual cycle phase: follicular (n = 12); ovulatory (n = 1); and luteal (n = 12). The pattern and intensity of contrast enhancement of the uterine myometrium were assessed. Results The dominant pattern of contrast enhancement of the myometrium was the diffuse homogeneous type in both non-users and users. The intensity of the enhancement measured in Hounsfield units (HU) was higher in the follicular phase (median 102, range 73–130) compared to the luteal phase in non-users (median 92, range 57–130); however this was not statistically significant ( P = 0.2). The HU values observed in users (median 95, range 45–160) were at the same levels compared to those of the luteal phase in non-users. Conclusion The dominant pattern of contrast enhancement in the portal venous phase of the myometrium in fertile ages is the diffuse homogeneous type and is independent of menstrual cycle phase or the use of hormonal contraception. However, these factors seem to play a role in the intensity of contrast enhancement, with a tendency of higher HU values in the follicular phase of non-users.

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The menstrual cycle affects recognition of emotional expressions: an event-related potential study

F1000Research ◽

10.12688/f1000research.11563.1 ◽

2017 ◽

Vol 6 ◽

pp. 853 ◽

Cited By ~ 2

Author(s):

Madoka Yamazaki ◽

Kyoko Tamura

Keyword(s):

Menstrual Cycle ◽

Facial Expressions ◽

Cognitive Processing ◽

Luteal Phase ◽

Follicular Phase ◽

Event Related Potential ◽

Reproductive Age ◽

Cycle Phase ◽

Late Luteal Phase ◽

The Relationship

Background: Several studies have investigated the relationship between behavioral changes and the menstrual cycle in female subjects at a reproductive age. The present study investigated the relationship between the menstrual cycle and emotional face recognition by measuring the N170 component of ERPs. Methods: We measured N170 of twelve women in both follicular phase and late luteal phase who were presented with human facial expressions as stimuli (happy and angry). Results: In the follicular phase, participants showed a significantly larger response to happy male facial expressions. In the late luteal phase, participants had longer reaction times to all emotional stimuli, and a significantly reduced response to happy faces, especially happy male facial expressions (P<0.001). Conclusions: Our findings suggest that the menstrual cycle modulates early visual cognitive processing, and highlight the importance of considering the menstrual cycle phase in studies that investigate emotion and cognition.

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