Fertility Awareness? What You Need to Learn Recognising the Signs of Fertility in a Woman’S • to Understand Your Menstrual Cycle Menstrual Cycle
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Fertility and Modernity*
Fertility and Modernity Enrico Spolaore Romain Wacziarg Tufts University and NBER UCLA and NBER May 2021 Abstract We investigate the determinants of the fertility decline in Europe from 1830 to 1970 using a newly constructed dataset of linguistic distances between European regions. We …nd that the fertility decline resulted from a gradual di¤usion of new fertility behavior from French-speaking regions to the rest of Europe. We observe that societies with higher education, lower infant mortality, higher urbanization, and higher population density had lower levels of fertility during the 19th and early 20th century. However, the fertility decline took place earlier and was initially larger in communities that were culturally closer to the French, while the fertility transition spread only later to societies that were more distant from the cultural frontier. This is consistent with a process of social in‡uence, whereby societies that were linguistically and culturally closer to the French faced lower barriers to learning new information and adopting new behavior and attitudes regarding fertility control. Spolaore: Department of Economics, Tufts University, Medford, MA 02155-6722, [email protected]. Wacziarg: UCLA Anderson School of Management, 110 Westwood Plaza, Los Angeles CA 90095, [email protected]. We thank Quamrul Ashraf, Guillaume Blanc, John Brown, Matteo Cervellati, David De La Croix, Gilles Duranton, Alan Fernihough, Raphael Franck, Oded Galor, Raphael Godefroy, Michael Huberman, Yannis Ioannides, Noel Johnson, David Le Bris, Monica Martinez-Bravo, Jacques Melitz, Deborah Menegotto, Omer Moav, Luigi Pascali, Andrés Rodríguez-Pose, Nico Voigtländer, Joachim Voth, Susan Watkins, David Yanagizawa-Drott as well as participants at numerous seminars and conferences for useful comments. -
American Society for Metabolic and Bariatric Surgery Position Statement
Surgery for Obesity and Related Diseases 13 (2017) 750–757 Review article American Society for Metabolic and Bariatric Surgery position statement on the impact of obesity and obesity treatment on fertility and fertility therapy Endorsed by the American College of Obstetricians and Gynecologists and the Obesity Society Michelle A. Kominiarek, M.D.a,1, Emily S. Jungheim, M.D.b,1, Kathleen M. Hoeger, M.D., M.P.H.c,1, Ann M. Rogers, M.D.d,2, Scott Kahan, M.D., M.P.H.e,f,3, Julie J. Kim, M.D.g,*,2 aDepartment of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois bDepartment of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri cDepartment of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York dPenn State Hershey Surgical Weight Loss Program, Hershey, Pennsylvania eGeorge Washington University; Washington D.C. fJohns Hopkins Bloomberg School of Public Health; Baltimore, MD gHarvard Medical School, Mount Auburn Weight Management, Mount Auburn Hospital, Cambridge, Massachusetts Received February 7, 2017; accepted February 8, 2017 Keywords: Obesity; Fertility; Fertility therapy; Bariatric surgery; Polycystic ovary syndrome; Contraception Preamble on fertility and fertility therapy. The statement may be revised in the future should additional evidence become available. The American Society for Metabolic and Bariatric Surgery issues the following position statement for the purpose of enhancing quality of care in metabolic and bariatric surgery. In Prevalence of obesity in reproductive-age women this statement, suggestions for management are presented that are The World Health Organization stratifies body mass index fi derived from available knowledge, peer-reviewed scienti c (BMI) into 6 categories to define underweight, normal literature, and expert opinion. -
Polycystic Ovary Syndrome.Pdf
Female reproductive system diseases Polycystic ovary syndrome Introduction: Polycystic ovary syndrome is one of the most common hormonal disorders among women. The name of this condition comes from the cysts that develop when ovulation vesicles get trapped under the surface of the ovaries preventing them from releasing the eggs. Cause: Normally, the pituitary gland in the brain secretes hormones (FSH) and (LH), that are responsible for controlling ovulation, while the ovary secretes estrogen and progesterone hormones, which prepare the uterus for the egg. The ovary also secretes the male hormone (androgen). However, in the case of polycystic ovary syndrome, the pituitary gland secretes excess amounts of (LH) and the ovary secretes excess amounts of the male hormone (androgen), resulting in irregular menstrual cycles and difficulties conceiving, as well as an increase facial hair and acne. There are many factors that may play a role in causing polycystic ovary syndrome: • Increased resistance to insulin (high blood glucose levels). • Heredity Symptoms: • Menstrual cycle abnormalities: The duration of the menstrual cycle may be prolonged to 35 days, or it could become less frequent occurring less than 8 times a year or it could be completely absent. • Increased body and facial hair • Acne • Obesity • Difficulty conceiving Diagnosis: • Medical history: Absence of the menstrual cycle - increased facial and body hair - acne - excess weight. • Ultrasound examination: of the uterus and ovaries • Blood test: To measure hormone levels, especially androgens and (LH). Treatment: Treatment depends on the symptoms regardless of whether the woman wants to conceive or not: • Lifestyle changes: This includes following a low-carb diet that is rich in grains, vegetables, fruits and small amounts of meat. -
The Discovery of Different Types of Cervical Mucus and the Billings Ovulation Method
The Discovery of Different Types of Cervical Mucus and the Billings Ovulation Method Erik Odeblad Emeritus Professor, Dept. of Medical Biophysics, University of Umeå, Sweden Published with permission from the Bulletin of the Ovulation Method Research and Reference Centre of Australia, 27 Alexandra Parade, North Fitzroy, Victoria 3068, Australia, Volume 21, Number 3, pages 3-35, September 1994. Copyright © Ovulation Method Research and Reference Centre of Australia 1. Abstract 2. Introduction 3. Anatomy and Physiology 4. What is Mucus? 5. The Commencement of my Research 6. The Existence of Different Types of Crypts and of Mucus 7. Identification and Description of G, L, and S Mucus 8. G- and G+ Mucus 9. Age, Pregnancy, the Pill and Microsurgery 10. P Mucus 11. F Mucus 12. The Role of the Vagina 13. The Different Types of Secretions and the Billings Ovulation Method 14. Early Infertile Days 15. The Days of Possible Fertility 16. Late Infertile Days 17. Anovulatory Cycles 18. Lactation 19. Diseases and the Billings Ovulation Method 20. The Future 21. Acknowledgements 22. Author's Note 23. References 24. Appendix Abstract An introduction to and some new anatomical and physiological aspects of the cervix and vagina are presented and also an explanation of the biosynthesis and molecular structure of mucus. The history of my discoveries of the different types of cervical mucus is given. In considering my microbiological investigations I suspected the existence of different types of crypts and cervical mucus and in 1959 1 proved the existence of these different types. The method of examining viscosity by nuclear magnetic resonance was applied to microsamples of mucus extracted 1 outside of several crypts. -
Women's Menstrual Cycles
1 Women’s Menstrual Cycles About once each month during her reproductive years, a woman has a few days when a bloody fluid leaves her womb and passes through her vagina and out of her body. This normal monthly bleeding is called menstruation, or a menstrual period. Because the same pattern happens each month, it is called the menstrual cycle. Most women bleed every 28 days. But some bleed as often as every 20 days or as seldom as every 45 days. Uterus (womb) A woman’s ovaries release an egg once a month. If it is Ovary fertilized she may become pregnant. If not, her monthly bleeding will happen. Vagina Menstruation is a normal part of women’s lives. Knowing how the menstrual cycle affects the body and the ways menstruation changes over a woman’s lifetime can let you know when you are pregnant, and help you detect and prevent health problems. Also, many family planning methods work best when women and men know more about the menstrual cycle (see Family Planning). 17 December 2015 NEW WHERE THERE IS NO DOCTOR: ADVANCE CHAPTERS 2 CHAPTER 24: WOMEN’S MENSTRUAL CYCLES Hormones and the menstrual cycle In women, the hormones estrogen and progesterone are produced mostly in the ovaries, and the amount of each one changes throughout the monthly cycle. During the first half of the cycle, the ovaries make mostly estrogen, which causes the lining of the womb to thicken with blood and tissue. The body makes the lining so a baby would have a soft nest to grow in if the woman became pregnant that month. -
Menstrual Health Glossary Key Words and Acronyms in the Field, from UNICEF + WHO
Menstrual Health Glossary Key words and acronyms in the field, from UNICEF + WHO Menstruation or menses is the natural bodily process of releasing blood and associated matter from the uterus through the vagina as part of the menstrual cycle.¹ A menstruator is a person who menstruates and therefore has menstrual health and hygiene needs – including girls, women, transgender and non-binary persons.¹ Menarche is the onset of menstruation, the time when a girl has her first menstrual period.¹ Menstrual hygiene materials are the products used to catch menstrual flow, such as pads, cloths, tampons or cups. These may also be referred to as menstrual materials or period products.¹ Menstrual Health Glossary Key words and acronyms in the field, from UNICEF + WHO Menstrual supplies are other supportive items needed for MHH, such as body and laundry soap, underwear and pain relief items.¹ Menstrual Hygiene Management (MHM) refers to management of hygiene associated with the menstrual process.¹ Adequate MHM involves: Knowledge and awareness about the menstrual process. Menstrual hygiene materials such as washable pads, disposable pads, tampons, and cups,WASH infrastructure such as Safe, clean, convenient, and private spaces for changing, washing, and/or disposing of menstrual hygiene materials. Adequate amounts of clean water and soap. Supportive social environments that enable menstruators to manage their periods with dignity and confidence. Policies and systems that create positive norms and dismantle limitations associated with menstruation.² Menstrual -
Genetic Regulation of Physiological Reproductive Lifespan and Female Fertility
International Journal of Molecular Sciences Review Genetic Regulation of Physiological Reproductive Lifespan and Female Fertility Isabelle M. McGrath , Sally Mortlock and Grant W. Montgomery * Institute for Molecular Bioscience, The University of Queensland, 306 Carmody Road, St Lucia, QLD 4072, Australia; [email protected] (I.M.M.); [email protected] (S.M.) * Correspondence: [email protected] Abstract: There is substantial genetic variation for common traits associated with reproductive lifes- pan and for common diseases influencing female fertility. Progress in high-throughput sequencing and genome-wide association studies (GWAS) have transformed our understanding of common genetic risk factors for complex traits and diseases influencing reproductive lifespan and fertility. The data emerging from GWAS demonstrate the utility of genetics to explain epidemiological obser- vations, revealing shared biological pathways linking puberty timing, fertility, reproductive ageing and health outcomes. The observations also identify unique genetic risk factors specific to different reproductive diseases impacting on female fertility. Sequencing in patients with primary ovarian insufficiency (POI) have identified mutations in a large number of genes while GWAS have revealed shared genetic risk factors for POI and ovarian ageing. Studies on age at menopause implicate DNA damage/repair genes with implications for follicle health and ageing. In addition to the discov- ery of individual genes and pathways, the increasingly powerful studies on common genetic risk factors help interpret the underlying relationships and direction of causation in the regulation of reproductive lifespan, fertility and related traits. Citation: McGrath, I.M.; Mortlock, S.; Montgomery, G.W. Genetic Keywords: reproductive lifespan; fertility; genetic variation; FSH; AMH; menopause; review Regulation of Physiological Reproductive Lifespan and Female Fertility. -
The Evolutionary Ecology of Age at Natural Menopause
1 The Evolutionary Ecology of Age at Natural 2 Menopause: Implications for Public Health 3 4 Abigail Fraser1,3, Cathy Johnman1, Elise Whitley1, Alexandra Alvergne2,3,4 5 6 7 1 Institute of Health and Wellbeing, University of Glasgow, UK 8 2 ISEM, Université de Montpellier, CNRS, IRD, EPHE, Montpellier, France 9 3 School of Anthropology & Museum Ethnography, University of Oxford, UK 10 4 Harris Manchester College, University of Oxford, UK 11 12 13 14 15 16 17 18 19 Author for correspondence: 20 [email protected] 21 22 23 Word count: 24 Illustrations: 2 boxes; 3 figures; 1 table 25 26 27 Key words: reproductive cessation, life-history, biocultural, somatic ageing, age at 28 menopause, ovarian ageing. 29 1 30 31 Abstract 32 33 Evolutionary perspectives on menopause have focused on explaining why early 34 reproductive cessation in females has emerged and why it is rare throughout the 35 animal kingdom, but less attention has been given to exploring patterns of diversity in 36 age at natural menopause. In this paper, we aim to generate new hypotheses for 37 understanding human patterns of diversity in this trait, defined as age at final menstrual 38 period. To do so, we develop a multi-level, inter-disciplinary framework, combining 39 proximate, physiological understandings of ovarian ageing with ultimate, evolutionary 40 perspectives on ageing. We begin by reviewing known patterns of diversity in age at 41 natural menopause in humans, and highlight issues in how menopause is currently 42 defined and measured. Second, we consider together ultimate explanations of 43 menopause timing and proximate understandings of ovarian ageing. -
Understanding Your Menstrual Cycle If You're Trying to Conceive
IS MY PERIOD NORMAL? Understanding Your Menstrual Cycle If You’re Trying to Conceive More than 70% 11% 95% of women have or more of of U.S. women start irregular menstrual American women their periods by cycles as menopause suffer from age 16. approaches. endometriosis.1 10% 12% of U.S. women are of women have affected by PCOS trouble getting or (polycystic ovary staying pregnant.3 syndrome).2 Fortunately, your menstrual cycle can tell you a lot about your fertility if you know what to look for. TYPES OF MENSTRUAL CYCLES Only 15% of About Normal = women have 30% of women are fertile only during 21 to 35 days the “perfect” the “normal” fertility 28-day cycle. window—between days 10 and 17 of the menstrual cycle. Day 1 Period starts (aka menses) 27 28 1 2 26 3 25 4 24 5 Day 15-28 23 6 Day 2-14 Luteal phase; Follicular phase; progesterone** 22 WHAT’S NORMAL? 7 FSH released, (follicle- uterine lining 21 8 stimulating matures Give or take a few days, hormone) and a normal cycle looks like this: estrogen released, 20 9 ovulation* begins 19 10 18 11 17 12 16 15 14 13 *ovulation: the process of an ovum (egg) being released from the ovary; occurs 10-14 days before menses. **progesterone: a steroid hormone that tells the uterus to prepare for pregnancy At least 30% of women have an “irregular” cycle either short, long or inconsistent. Short = Long = < 21 days > 35 days May be a sign of: May be a sign of: Hormonal imbalance Hormonal imbalance Ovaries with fewer eggs Lack of ovulation Approach of menopause Other fertility issues Reduced fertility4 Increased risk of miscarriage SIGNS TO WATCH FOR Your menstrual cycle provides valuable clues about your body’s reproductive health. -
A Fixed Formula to Define the Fertile Window of the Menstrual Cycle As the Basis of a Simple Method of Natural Family Planning
ORIGINAL RESEARCH ARTICLE A Fixed Formula to Define the Fertile Window of the Menstrual Cycle as the Basis of a Simple Method of Natural Family Planning Marcos Are´valo,* Irit Sinai,* and Victoria Jennings* A significant number of women worldwide use periodic basis of the proposed Standard Days method, a simple abstinence as their method of family planning. Many of method of natural family planning (NFP). Survey data them use some type of calendar-based approach to deter- from a number of countries around the world show mine when they should abstain from unprotected inter- that a substantial number of women worldwide use course to avoid pregnancy; yet they often lack correct periodic abstinence as their method of family plan- knowledge of when during their menstrual cycle they are ning.1 Many of these women use calendar-based ap- most likely to become pregnant. A simple method of proaches to determine when they should abstain from natural family planning (NFP) based on a fixed formula to unprotected intercourse to avoid pregnancy. How- define the fertile window could be useful to these women. ever, research also indicates that a significant per- This article reports the results of an analysis of the appli- centage of women who claim to use periodic absti- cation of a fixed formula to define the fertile window. A nence lack correct knowledge of when during their large existing data set from a World Health Organization menstrual cycle they are most likely to become study of the Ovulation Method was used to estimate the pregnant.a Most of these women simply abstain from theoretical probability of pregnancy using this formula. -
Natural Family Planning Fact Sheet
Natural Family Planning Fact Sheet ____________________________________________________________________________ 24-hour Emergency Number/Location WHAT’S INSIDE: SOURCES: What is the natural family planning? Office on Women’s Health Basal body temperature method Calendar Method Birth Control Methods: Frequently Cervical Mucus Method Asked Questions How effective are natural family Fertility Awareness planning methods? Advantages of natural family Centers for Disease Control and planning Prevention Drawbacks of natural family planning Unintended Pregnancy Prevention: Contraception U.S. Department of Health & Human Services 200 Independence Avenue, S.W. Washington, D.C. Oklahoma State Department of Health ODH Form 337 MCH/Perinatal & Reproductive Health Division/Family Planning Program Revised Oct 2014 Office of Population Affairs Natural Family Planning Fact Sheet How effective is natural family planning? Of 100 couples who use natural family planning methods each year, anywhere from 1 to 25 will become pregnant. Natural family planning can be an effective type of birth control if all three methods are used and if all are always used correctly. What is natural family planning? A woman with a normal menstrual cycle has about 8 days a month when she can get pregnant. These include the five days before she ovulates (when an egg is released), the day she ovulates, and about one to two days after ovulation. Natural family planning (sometimes known as fertility awareness or the rhythm method) is an approach to birth control some couples use to predict when these fertile days happen. It involves paying close attention to the menstrual cycle by using methods that include: Basal Body Temperature Method Calendar Method Cervical Mucus Method When all three methods are used together, it is known as the symptothermal method. -
Age and Fertility: a Guide for Patients
Age and Fertility A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the Patient Education Committee and the Publications Committee. No portion herein may be reproduced in any form without written permission. This booklet is in no way intended to replace, dictate or fully define evaluation and treatment by a qualified physician. It is intended solely as an aid for patients seeking general information on issues in reproductive medicine. Copyright © 2012 by the American Society for Reproductive Medicine AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Age and Fertility A Guide for Patients Revised 2012 A glossary of italicized words is located at the end of this booklet. INTRODUCTION Fertility changes with age. Both males and females become fertile in their teens following puberty. For girls, the beginning of their reproductive years is marked by the onset of ovulation and menstruation. It is commonly understood that after menopause women are no longer able to become pregnant. Generally, reproductive potential decreases as women get older, and fertility can be expected to end 5 to 10 years before menopause. In today’s society, age-related infertility is becoming more common because, for a variety of reasons, many women wait until their 30s to begin their families. Even though women today are healthier and taking better care of themselves than ever before, improved health in later life does not offset the natural age-related decline in fertility. It is important to understand that fertility declines as a woman ages due to the normal age- related decrease in the number of eggs that remain in her ovaries.