Menstrual Cycle Hormone Changes in Women Traversing Menopause: Study of Women's Health Across the Nation.

Context: Menstrual cycle hormone patterns in women approaching menopause are inadequately studied.

Objective: To describe day-to-day menstrual cycle hormones in women as they approach menopause from the Study of Women's Health Across the Nation Daily Hormone Study (DHS).

Design: DHS enrollees collected daily urine for one entire menstrual cycle or up to 50 days, whichever came first, annually, up to the final menstrual period (FMP) or for up to 10 years.

Recombinant human relaxin versus placebo for cervical ripening: a double-blind randomised trial in pregnant women scheduled for induction of labour.

Background: Nonclinical studies indicate that the hormone relaxin is a good candidate for a safe cervical ripening agent that does not cause uterine contractions.

Methods: This Phase II study (conducted November 2, 2005-October 20, 2006) was a randomised, double blind, placebo controlled trial testing 24-h intravenous infusion of serelaxin (recombinant human relaxin) or placebo for cervical ripening in 72 healthy, primiparous women. Eligible subjects had a singleton pregnancy ≥40 weeks, were planned for elective induction, had vertex presentation of the fetus, intact membranes and a Bishop score at screening ≤4.

Role of Medical Management for Uterine Leiomyomas.

Uterine leiomyomas, or fibroids, are the most common benign tumor in reproductive aged women. Affected women may remain asymptomatic or may report symptoms related to abnormal uterine bleeding, infertility, or pelvic pain and pressure. Depending on a patient's symptomatology and reproductive plans, treatment options include expectant management, medical management (hormonal and non-hormonal), or surgical management (myomectomy or hysterectomy).

Physical fitness, serum relaxin and duration of gestation.

Background: Women are recommended to perform regular exercise during pregnancy but the impact of physical fitness on duration of gestation and miscarriage is inconsistent. In addition, a dose-response relation between the amount of weekly exercise and increased risk of miscarriage in early pregnancy has been observed. Previous studies have mostly used an epidemiologic method.

Myometrial artery calcifications and aging.

Objective: This study aims to determine whether myometrial artery calcifications increase with age and whether uterine sections are an appropriate model for studying vascular aging.

Methods: An observational study of 172 women (aged 45 y or older) who underwent hysterectomy for benign indications at the University Hospital (Newark, NJ) between July 1, 2009 and June 1, 2012 was performed. Women with a history of malignancy, undocumented last menstrual period, or unavailable uterine tissue slides were excluded.

Does a diagnosis of atrophic vaginitis on Papanicolaou test signify the presence of inflammation?

Objective: Vaginal atrophy in menopause shows increased parabasal cells on cytology. This may be accompanied by abundant neutrophils. A shift in maturation index in the absence of significant inflammation is more accurately termed "atrophic pattern.

Effect of single embryo transfer on the risk of preterm birth associated with in vitro fertilization.

Purpose: To determine whether elective single embryo transfer (eSET) reduces the risk of preterm delivery associated with in vitro fertilization (IVF).

Methods: This is an observational study of 3125 eSET cycles performed from 2008 to 2009 and reported to the Society for Assisted Reproductive Technology (SART) database. Preterm delivery rates were compared to the overall preterm delivery rate among all patients undergoing IVF over the same time period.

Women's health research in the last four decades. Interview by Natasha Leeson.

Gerson Weiss speaks to Natasha Leeson, Assistant Commissioning Editor Gerson Weiss obtained his MD degree from New York University (NY, USA). After an internship in internal medicine at Baltimore City Hospital (MD, USA), he completed residency in obstetrics and gynecology at New York University. Further training in reproductive endocrinology was obtained as a postdoctoral research fellow in physiology at the University of Pittsburgh (PA, USA), in the laboratory of Dr Ernst Knobil.

Relaxin and the control of primate parturition.

In primate pregnancy, circulating relaxin, solely a product of the corpus luteum, peaks in the first trimester of pregnancy then declines and levels off for the remainder of pregnancy. Relaxin actions in pregnancy include increasing cervical pro-MMP-1 and pro-MMP-3 and decreasing TIMP-1, changes which soften the cervix. Relaxin, from early pregnancy, increases endometrial natural killer cells, macrophages and neutrophils, blood flow and arterial number.

Cardiovascular risk factor variation within a Hispanic cohort: SWAN, the Study of Women's Health Across the Nation.

Objectives: Hispanics have less favorable cardiovascular risk profiles relative to other groups, although little is known regarding variability in risk profiles according to country of origin. Our goal was to examine the association of cardiovascular risk factors with country of origin and acculturation in a cohort of middle-aged Hispanic women.

Setting: Baseline data for participants at the New Jersey Site of the Study of Women's Health Across the Nation (SWAN).

Negative attitudes and affect do not predict elective hysterectomy: a prospective analysis from the Study of Women's Health Across the Nation.

Objective: Cross-sectional studies suggest an association between hysterectomy and negative affect. Using prospective data, we examined the associations of negative affect, attitudes toward aging and menopause, premenstrual symptoms, and vasomotor symptoms with elective hysterectomy in midlife.

Methods: Data were from the Study of Women's Health Across the Nation, a multisite, community-based prospective cohort study of the menopausal transition (n = 2,818).

Endometrial expression of relaxin and relaxin receptor in endometriosis.

Our studies demonstrate significantly lower expression of relaxin and its receptor in ectopic endometriotic tissues than their expression in eutopic endometrium and in endometrium from normal controls. These data suggest that in normal and eutopic endometrium, relaxin may exert a protective effect against endometriosis.

Maternal obesity and associated reproductive consequences.

The prevalence of obesity is continuing to increase among women. Women who are in their reproductive years are disproportionately affected by obesity. The link between obesity and increased morbidity from various conditions, including cardiovascular disease, Type 2 diabetes, osteoarthritis and malignancies, is well established.

Qualifications of Physicians Performing Hysterectomy: The Study of Women's Health Across the Nation.

The objective of this study was to evaluate whether physicians performing hysterectomy on participants of the Study of Women's Health Across the Nation (SWAN) are adequately trained to perform this procedure. A multicenter longitudinal study of 3302 women aged 42 to 52 was conducted over 9 years of follow-up. Of the 238 women reporting hysterectomy within the United States, 165 were verified via medical record review.

Circulating relaxin and cervical length in midpregnancy are independently associated with spontaneous preterm birth.

Objective: We sought to examine associations among serum relaxin levels, cervical length, and spontaneous preterm birth (sPTB).

Study Design: We conducted a case-control study within a cohort of 1080 singleton pregnant women. In all, 38 women (3.

Circulating dehydroepiandrosterone sulfate concentrations during the menopausal transition.

Context: A previous report from the Study of Women Across the Nation indicated a rise in dehydroepiandrosterone sulfate (DHEAS) during the menopausal transition using data from three annual visits.

Objective: Our objective was to examine changes in DHEAS with chronological and ovarian aging, expanding the original analyses to include 10 yr of annual data.

Design: A longitudinal observational study and cross-sectional analyses of baseline data were conducted.

Racial differences in women who have a hysterectomy for benign conditions.

Objective: To evaluate if there are racial differences between African-American and Caucasian women who have hysterectomy for benign conditions in terms of (1) presenting symptoms (prolapse, vaginal bleeding, pain, and known history of leiomyomas), (2) serum estradiol and testosterone levels at the visit before hysterectomy, and (3) uterine weight.

Methods: A multi-ethnic, multisite, community-based longitudinal cohort study of 3,302 women ages 42-52 at enrollment was conducted. During 9 years of follow-up, 203 African-American and Caucasian women reported a hysterectomy, 90 with evidence of uterine leiomyomas.

A randomized, double-blind, placebo-controlled trial of relaxin for cervical ripening in post-delivery date pregnancies.

Recombinant human relaxin was used to attempt cervical ripening in post-delivery date pregnancies. High doses of relaxin were safe but did not advance cervical ripening or induce labor.

Expression of LGR7 in the primate corpus luteum implicates the corpus luteum as a relaxin target organ.

In women, the corpus luteum is the source of circulating relaxin. No previous studies have addressed whether the corpus luteum is also a relaxin target organ. We determined relaxin receptor LGR7 mRNA expression in human term pregnancy corpora lutea and nonhuman primate corpora lutea obtained during the menstrual cycle.

Relaxin in endometriosis.

Endometriosis is an important contributing factor to chronic pelvic pain and infertility. Matrix metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) have each been implicated in the establishment of endometriotic lesions. Since relaxin regulates the expression of MMPs and VEGF in the endometrium, we tested the hypothesis that relaxin plays a role in endometriosis by comparing the expression of relaxin mRNA and its LGR7 (RXFP1) receptor mRNA in normal human endometrium to those in samples from patients with endometriosis.

Relaxin in human pregnancy.

Relaxin has beneficial effects upon the endometrium which are responsible for establishment of pregnancy. We have demonstrated that relaxin stimulates endometrial decidualization, the structural and biochemical changes in endometrial parenchymal cells, and the accompanying angiogenesis, modulation of matrix metalloproteinase activity, and increased concentrations in local immune cells which are required for implantation. Our recent data also demonstrate that either too much or too little relaxin can be detrimental.

Relaxin receptor LGR7 (RXFP1) is regulated by estrogen.

Estrogen regulates LGR7 (RXFP1) mRNA expression in an in vitro model of human term pregnancy cervix that utilizes lower uterine segment fibroblasts. LGR7 mRNA levels were increased by estradiol to mean levels of 152%+/- 5.9% above those in untreated control cells.

Inflammation in reproductive disorders.

Inflammatory disorders account for a significant percentage of gynecologic disease, particularly in reproductive age women. Inflammation is a basic method by which we respond to infection, irritation, or injury. Inflammation is now recognized as a type of nonspecific immune response, either acute or chronic.

Longitudinal changes in hypothalamic and ovarian function in perimenopausal women with anovulatory cycles: relationship with vasomotor symptoms.

Objective: To determine whether the transition to menopausal status is unidirectional and predictable with aging.

Design: Longitudinal evaluation of the menstrual cycle hormone patterns and experience of vasomotor symptoms in an anovulatory, perimenopausal cohort, during cycles that occurred 1 and 2 years after an anovulatory cycle.

Setting: Academic center.