This discussion piece reflects on menstrual cycle research since the founding of the Society for Menstrual Cycle Research in the context of contemporary research presented in this special issue of Sex Roles. Although women researchers in the 19th century began documenting that normal menstruation is neither disabling nor dangerous, taboos, concealment and avoidance of menstruation persist. Feminist researchers have worked to find ways to support women’s health and wellbeing within a sociocultural milieu still reflecting largely negative views of menstrual cycle phenomena. The present collection of current menstrual cycle research offers useful contextual approaches to understanding why menstruation remains in the shadows, and how to resist negative characterizations, as well as encourage curiosity and body awareness. Alternatives to mainstream corporate and medical views of menstrual phenomena are discussed. Fruitful theoretical and methodological directions for research are identified to support advocacy, educational, and therapeutic interventions for menstrual health.

The first interdisciplinary research conference on the menstrual cycle and related topics was held in 1977, at the University of Illinois at Chicago (Dan, Graham, and Beecher 1980). In this paper, I offer some examples of what we have learned over the past 27 years as a society of feminist thinkers, researchers and women's health advocates. In particular, I reflect on some of the ways in which feminist attention to women's embodied experiences helps to illuminate and counteract the social and political forces that broadly affect women's lives and women's health. For, as women, we live, reproduce and mature in a society whose leadership, medical practice, media expertise, and influence remain largely in the hands of men, and reflect powerful financial and political interests

Objective: To determine use of botanical dietary supplements (BDS) in women between the ages of 40 and 60 years at the University of Illinois at Chicago (UIC) clinics, including information about commonly used BDS, the reason for use, information resources used, and the overall perception of safety and efficacy of BDS.Design: Five hundred female outpatients at UIC clinics were interviewed by healthcare practitioners using a botanical/drug history questionnaire. Respondents were 46.8% African American, 39.6% Caucasian, 11.7% Hispanic, and 1.5% Asian, with a mean age of 50.34 years.Results: BDS were used by 79% of respondents (n = 395), of which 36.5% used BDS daily. Of the positive respondents, 51.7% used one or two BDS, whereas 48.4% used three or more. Commonly used botanicals included soy (42%), green tea (34.68%), chamomile (20.76%), gingko (20.51%), ginseng (17.97%), Echinacea (15.44%), and St. John's wort (7.34%). Black cohosh, garlic, red clover, kava, valerian, evening primrose, and ephedra were used by less than 15% of respondents. Efficacy ratings were high for BDS, and 68% claimed to have no side effects. Only 3% of respondents obtained BDS information from healthcare professionals, and 70% of respondents were not informing their physician of BDS use.Conclusions: A high percentage of women at UIC clinics were using multiple BDS. The respondents believed that these products were both safe and effective for the treatment of common ailments. Concomitant BDS use with prescription and over-the-counter medications was commonplace, often without a physician's knowledge. Consumer education about the possible benefits and risks associated with BDS use is urgently needed.

A longitudinal study of 386 healthy Black and White women aged 35-60 years was conducted to determine the effects of physical activity and other related factors on lumbar bone mineral density over 24 months. Bone mineral density of the lumbar spine, L2-L4, was measured using dual energy x-ray (Hologic 1000). Physical activity levels in three dimensions (leisure, household, and occupational) from both a lifelong and current perspective were obtained by questionnaire. Body mass index was calculated from measured weight in kilograms divided by measured height in meters squared. Calcium, caffeine, and alcohol intake was estimated using a food frequency questionnaire. Age, race, and smoking were determined by self-report. Radioimmunoassays of follicle stimulating hormone (FSH) and estradiol were used to validate self-reports of menopausal status. Multiple regression analysis revealed that race, age, weight, FSH, calcium, and years of tobacco intake formed the best model at baseline ( r 2 = 0.32) and at 24 months ( r 2 = 0.303). Physical activity was not a significant predictor for bone mineral density at either time point. There were cross-sectional changes of bone mineral density with race, age, and menopausal status. Black women had significantly higher bone mineral density than White women. However, an age-related decline in bone mineral density was exhibited in both Black and White women. Perimenopausal women had significantly lower bone mineral density as compared with premenopausal women. Furthermore 37 (9.6%) women at baseline and 34 (11%) at 24 months were designated at risk for fracture.

While the number of women entering U.S. medical schools has risen substantially in the past 25 years, the number of women in leadership positions in academic medicine is disproportionately small. The traditional pathway to academic leadership is through research. Women's health research is an ideal venue to fill the pipeline with talented women physicians and scientists who may become academic leaders in positions where they can promote positive change in women's health as well as mentor other women. The Office on Women's Health (OWH) in the U.S. Department of Health and Human Services has contracted with 18 academic medical centers to develop National Centers of Excellence in Women's Health. Emphasizing the integral link between women's health and women leaders, each of the Centers of Excellence must develop a leadership plan for women in academic medicine as part of the contract requirements. This paper describes the training programs in women's health research that have developed at five of the academic medical centers: the University of Wisconsin, Magee Women's Hospital, the University of Maryland, Medical College of Pennsylvania Hahnemann University, and the University of Illinois at Chicago. We discuss some of the challenges faced for both initiation and future viability of these programs as well as criteria by which these programs will be evaluated for success.

Minority physicians provide care in a manner that promotes patient satisfaction and meets the needs of an increasingly diverse U.S. population. In addition, minority medical school faculty bring diverse perspectives to research and teach cross-cultural care. However, men and women of color remain underrepresented among medical school faculty, particularly in the higher ranks. National data show that although the numbers of women in medicine have increased, minority representation remains essentially static. Studying minority women faculty as a group may help to improve our understanding of barriers to diversification. Six National Centers of Excellence in Women's Health used a variety of approaches in addressing the needs of this group. Recommendations for other academic institutions include development of key diversity indicators with national benchmarks, creation of guidelines for mentoring and faculty development programs, and support for career development opportunities.

Physical activity in women has assumed increasing significance as a policy issue as a result of the release of the 1996 Surgeon General's Report on Physical Activity and Health. This report revealed that women in the United States were less likely than men to adhere to the recommended guidelines for physical activity. African American women are less likely than white women to participate in leisure time physical activity across age, occupational, and income groups. The purpose of this study was to use the Ecological Model of Health Promotion to explore policy, environmental, and individual factors influencing physical activity of middle- to older-aged African American women in a mixed income community in a large midwestern city. Focus group discussions were held with 3 groups of women -- administrators/community leaders, exercisers, and nonexercisers. Thirty-three women between the ages of 40 and 78 participated in the study. The women identified 6 themes influencing physical activity: perceptions of physical activity and exercise; perceived barriers to exercise; perceived benefits of and motivators to exercise; past and present opportunities for exercise; factors that enhance the successful delivery of an exercise program; and coalition building to deliver an exercise program to women in the community. The results of this study reveal that to successfully increase physical activity in an ethnic urban community, researchers and other concerned individuals need to collaborate at multiple ecological levels, with an initial emphasis on establishing coalitions between institutions, community groups, policy makers, and individuals.

The purpose of this descriptive study was to seek directly from college-educated African American women factors which they perceived influenced their individual weight control behavior, and those that influenced African American women collectively. Face-to-face, in-depth interviews were conducted, primarily in their homes, with 36 African American women. Thirteen major categories were identified. Six factors that influenced the women's individual weight control behavior were emotions/feelings, beliefs, life events, self-control, discipline, and commitment. Perceived benefits of the behavior and perceived barriers to the behavior were influential in determining the attractiveness, the type, and the extent of the weight control behavior. Five factors related to the African American culture were identified and described by the women. Recognition of psychosocial determinants of weight control behavior may enable health professionals to design unique interventions relevant to African American women.

Skeletal bone mass in women begins to decline at about the age of 30 years, and loss accelerates in the immediate postmenopausal years. A longitudinal study of 169 healthy women aged 35–62 years was conducted to determine the combined effects of physical activity and several other factors (age, menopause, race, body mass) on lumbar bone mineral density and change in lumbar bone over 24 months. Lumbar bone mineral content was assessed by dual-energy x-ray bone densitometry. Physical activity was quantified from both a fitness measure of predicted maximum oxygen intake and a retrospective 12-month self-report of time spent in aerobic weight-bearing activities. Fit midlife women, as measured by predicted maximum oxygen uptake, had significantly lower bone mineral density, partly associated with low body mass. On the other hand, the fit women and women with higher body mass had less bone loss over a 2-year period. These data suggest that increased levels of aerobic fitness as well as body mass may prevent some of the bone loss that occurs in healthy midlife women.

The Taylor Leisure Time Physical Activity Questionnaire and the Tecumseh Occupational Physical Activity Questionnaire were modified to measure energy expenditure in midlife women. A three-dimensional measure of female physical activity resulted which reflected leisure, occupational, and household activities. Total daily energy expenditure for the specific activities was calculated using established metabolic units and reported time spent performing the activities. Test-retest reliability was evaluated at two weeks for 15% (n = 59) of the sample of 375 midlife women. There was high agreement on participation in the various activities, but low agreement on the time spent doing the activities. Cardiorespiratory fitness, established with a Monarch bicycle ergometer, was used to test the validity of the energy expenditure measure. Correlations were significant between cardiorespiratory fitness and both leisure activity and household activity, but not between cardiorespiratory fitness and occupational activity.

The purposes of this study were to determine the prevalence of perimenstrual symptoms among a randomly selected group of Italian women by using a standardized menstrual symptom instrument and to compare them with those from a census-based sample of free-living American women in the study by Woods et al. (Am J Public Health 1982;72:1257-64). Italian menstrual symptom prevalence rates were obtained as part of a 1984 national health screening project using the Moos Menstrual Distress Questionnaire translated into Italian. A total of 306 of the 426 randomly invited women between ages 20 and 49 years participated (71.8% participation rate). After determination of ineligible participants (those who were postmenopausal, posthysterectomy, and pregnant), a total of 239 subjects were interviewed. Italian women reported the highest prevalence of symptoms during the menstrual phase and the lowest prevalence during the remainder of the cycle. The cross-cultural comparison indicates that, overall, Italian women reported higher prevalence of symptoms across the three phases of the cycle than did the American women, even though this difference was the smallest during the premenstrual phase. Prevalence rates of a number of classic premenstrual symptoms (e.g., breast tenderness) and affective symptoms (e.g., tension and avoid social activities) were found to be similar for the Italian and American samples. This study, while it identifies a sociocultural component to symptom reporting, indicates the presence of premenstrual distress symptoms in diverse cultural settings, even in women who are generally unaware of premenstrual syndrome. These findings lend support to the validity of the premenstrual phase distress experience and suggest the existence of the premenstrual syndrome across diverse cultures.

With the increased longevity of people in the United States, the incidence of vertebral and hip fractures continues to escalate. Thus, preventing bone loss is a major health care issue, particularly for women, who suffer more bone loss than men. This paper reviews studies on bone loss in mid-life women and considers factors of heredity, race, weight, hormone levels, and life-style (i.e., physical activity, calcium intake, caffeine and alcohol consumption, and smoking). Future studies should examine the interrelationships of these factors and follow women throughout life to better predict risk and identify age-appropriate interventions.