EFFECTS OF THE MENSTRUAL-CYCLE ON MEDICAL DISORDERS

Exacerbation of certain medical conditions at specific phases of the m enstrual cycle is a well-recognized phenomenon. We review the effects of the menstrual cycle on medical conditions, including menstrual migr aine, epilepsy, asthma, rheumatoid arthritis, irritable bowel syndrome , and diabetes. We discuss the role of medical suppression of ovulatio n 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 t herapy of menstrual cycle-related exacerbations of disease processes. Abrupt changes in the concentrations of circulating ovarian steroids a t ovulation and premenstrually may account for menstrual cycle-related changes in these chronic conditions. Accurate documentation of sympto ms on a menstrual calendar allows identification of women with cyclic alterations in disease activity. Medical suppression of ovulation usin g gonadotropin-releasing hormone agonists can be useful for both diagn osis and treatment of any severe, recurrent menstrual cycle-related di sease exacerbations.