%0 Journal Article
%T Fluid Retention over the Menstrual Cycle: 1-Year Data from the Prospective Ovulation Cohort
%A Colin P. White
%A Christine L. Hitchcock
%A Yvette M. Vigna
%A Jerilynn C. Prior
%J Obstetrics and Gynecology International
%D 2011
%I Hindawi Publishing Corporation
%R 10.1155/2011/138451
%X We report menstrual and mid-cycle patterns of self-reported ¡°fluid retention¡± in 765 menstrual cycles in 62 healthy women. Self-reported ¡°fluid retention,¡± commonly described as bloating, is one element of the clinical assessment and diagnosis of premenstrual symptoms. These daily diary data were collected as part of an observational prospective one-year study of bone changes in healthy women of differing exercise characteristics. Ovulation was documented by quantitative basal temperature analysis, and serum estradiol and progesterone levels were available from initial and final cycles. Fluid retention scores (on a 0¨C4 scale) peaked on the first day of menstrual flow (mean ¡À SE : ), were lowest during the mid-follicular period, and gradually increased from to over the 11 days surrounding ovulation. Mid-cycle, but not premenstrual, fluid scores tended to be lower in anovulatory cycles (ANOVA ), and scores were higher around menstruation than at midcycle ( ). Neither estradiol nor progesterone levels were significantly associated with fluid retention scores. The peak day of average fluid retention was the first day of flow. There were no significant differences in women's self-perceived fluid retention between ovulatory and anovulatory cycles. 1. Introduction Many women perceive changes in fluid retention or ¡°bloating¡± over the course of their menstrual cycle. As early as 1934, Sweeney [1] reported a pattern of ¡°menstrual edema,¡± premenstrual weight gain peaking at the onset of flow, in a subgroup of student nurses. Several prospective daily rating studies reported peak fluid retention at the onset of menstrual flow [2, 3], but the hormonal factors underlying these changes remain poorly understood. In particular, it is not clear whether ovulation is necessary, or whether similar changes also occur in anovulatory cycles of normal length. Although oligomenorrheic menstrual cycles are usually anovulatory, anovulation can also occur in clinically unremarkable menstrual cycles of normal length [4, 5]. In a normally ovulatory menstrual cycle, estradiol has two peaks, the higher mid-cycle peak before ovulation and the luteal peak after ovulation. Progesterone, by contrast, is low during the entire follicular phase but rises following ovulation and remains high during the luteal phase. Both estradiol and progesterone levels are low during the first few days of menstrual flow. During anovulatory cycles, estradiol levels may be variable or tonically high with anovulatory androgen excess (also called polycystic ovary syndrome) or variable but normal [6].
%U http://www.hindawi.com/journals/ogi/2011/138451/