European Journal of Cardiovascular Medicine

Females have higher age-standardized rates of acute conditions, chronic conditions, and disability due to acute conditions, compared to males according to National Health Interview Survey for 1957-72 ¹. Excess female morbidity is primarily due to social and psychological factors. Menstrual dysfunction, like other aspects of sexual and reproductive health, is not included in the Global Burden of Disease estimates ^2,3 and, even as reproductive health programs expand their focus to address gynecologic morbidity, the utility of evaluating and treating menstrual problems is not generally considered. Available data from developing countries on the frequency of menstrual disorders and their impact on women's health status, quality of life and social integration suggest that evaluation and treatment of menstrual complaints should be given a higher priority in primary care programs ⁴.

The menstrual cycle is a window into the general health and well-being of women, and not just a reproductive event. The hormonal changes occurring during menstrual cycle not only affect oocyte maturation and the endometrial and vaginal environment but can also have an effect on anthropometric changes. Apart from it being physiological there are various disorders associated with menstrual cycle which cause morbidity & mortality.

The menstrual cycle is characterized by cyclical fluctuations in the levels of FSH, LH, oestrogen and progesterone. These hormones are known to have an effect on oxygen carrying capacity, immune response, bleeding and also changes in serum electrolytes which may be responsible for variable physical, psychological symptoms and autonomic changes.

               Up to 18 % of women have severe PMS and 3–8 % qualify for a diagnosis of premenstrual dysphonic disorder (PMDD)^5,6. Two to ten percent of women have significant premenstrual symptoms that are different from the normal discomfort associated with menstruation in healthy women^7,8 . Low levels of certain vitamins and minerals, particularly magnesium, manganese, Vitamin E , Vitamin D⁹ and pyridoxine  are associated with PMS. Although exact etiology of PMS is not known but low progesterone levels, high estrogen levels, increased aldosterone activity,increased rennin-angiotensin activity have been implicated¹⁰. Estrogen like aldosterone and some other adrenocortical hormones causes sodium  and water retention by kidney tubules¹¹. Whereas progesterone is a competitive inhibitor of aldosterone at the kidney,it has natriuretic action¹². It is likely that an exaggerated response to hormonal changes may be responsible for variable physical and psychological symptoms¹³.

Serum proteins bind sex steroids and regulate activity of menstrual cycle. The sex steroids have an anabolic effect. Oestrogen causes positive nitrogen balance due to growth promoting effect which causes slight increase in the total body proteins¹⁴.Progesterone exerts anabolic effect & this partly accounts for some of the weight gain¹⁵.

Numerous scientific studies have been undertaken on Body Mass Index(BMI) changes during menstrual cycle but the results are often contradictory & variable. So, the present study was undertaken to re-examine the findings and thus provide a screening tool to avoid morbidity and mortality related to menstrual cycle.

Source of Data: Apparently healthy 100 female medical students aged between 18-23 years of Mahadevappa. Rampure Medical College were taken for the study after obtaining their informed consent. Ethical clearance was obtained from the instituition.

Inclusion criteria:

1. Apparently healthy 100 female medical students aged between 18-23 years were selected for the study.
2. Normal regular menstrual cycles of 27-33 days.
3. Ovulatory cycles.

Exclusion criteria:

1. Subjects below 18yrs and above 23yrs of age.
2. Subjects with endocrinal & gynecological disorders, chronic diseases, allergic conditions.
3. Presence of infection at the time of sampling.
4. Subjects with Diabetes.
5. Pregnant subjects.
6. Subjects with irregular menstrual cycle.
7. H/O drugs intake affecting menstrual cycle.
8. Subjects performing regular exercise.

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Weight was recorded by using standard weighing machine and height was measured by stadiometer. BMI was calculated. Body mass index (BMI):- This was calculated as weight (in Kg) divided by height in (meters )².

Statistical analysis was done using SPSS 17.0 Software. To compare means of two independent groups, student’s t- test for independent samples was used.

Height (cms) i.e. 156.85 ± 6.27. Mean ± S.D of weight in Menstrual Phase, Proliferative Phase, Secretory Phase were (53.73 ±9.49), (53.47 ±9.40), (53.633 ±9.44) respectively. Mean ± S.D of Body Mass Index were (21.79±3.37), (21.89±4.52), (21.75±3.37) in Menstrual Phase, Proliferative Phase and Secretary Phase respectively. No statistically significant values in weight and BMI were noted i.e. MP Vs PP, MP Vs SP, PP Vs SP.Figure 1 & 2 also gave same idea without statistical significance.

Table 1: Anthropometric changes in menstrual cycle

P VALUE < 0.05 – Significant

Figure 1: Anthropometric measurement: (Weight)

Figure 2: Anthropometric measurement: (BMI)

The human menstrual cycle involves physiological, biochemical, and anthropometric changes. It is under the control of Hypothalamo- Pituitary- Ovarian (HPO) axis. Steroid hormones, estrogen and progesterone which play a major role in menstrual cycle are controlled by an integrated HPO axis through release of FSH and LH.

Age, height, weight, Body Mass Index (BMI) are within normal range suggesting that females under study were normal and healthy. Non- alteration of the BMI in different phases of menstrual cycle clearly reflects no gross physiological changes. Having a high or low BMI may cause an absence of menstruation, irregular menstruation and painful menstruation¹ Present study and several other studies showed that mean body weight did not show any significant changes in different phases of menstrual cycle.^{16, 17, 18, 19}

BMI did not show significant changes indicating maintainence of homeostasis.Further study has to be conducted with large sample size along with hormonal assay.

ACKNOWLEDGEMENT:   I thank all the authors whose articles are cited in my work                                                                                                                                                

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