Flowing differently: exploratory characterization of menstrual effluent compared with peripheral blood

IF 1.9

F&S science Pub Date : 2026-09-01 Epub Date: 2026-06-18 DOI:10.1016/j.xfss.2026.06.002

Rachel Michel M.S.P.H., Ariadne Sinnis-Bourozikas B.A., Valentina Vanos M.S.P.H., Gregory W. Kirschen M.D., Ph.D., Laura A. St Clair Ph.D., Prasanthy Balasubramanian Sc.M., John Skinner B.S., Zachary Mulcare B.S., Anna Yin M.P.H., Andrew H. Karaba M.D., Ph.D., Jaiprasath Sachithanandham Ph.D., Malini Ramaiyer M.D., Malak El. Sabeh M.D., Jinxiao Liang M.D., Ph.D, Fiza Ali B.S., Andrew Pekosz Ph.D., Sabra L. Klein Ph.D., Andrea L. Cox M.D., Ph.D., Mostafa A. Borahay M.D., Ph.D.

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Abstract

Objective

To characterize the immune cell and hormonal profile of menstrual effluent compared with paired peripheral blood.

Design

This descriptive, cross-sectional study collected menstrual effluent and processed it to isolate cellular and soluble fractions; peripheral blood was processed in parallel. Steroid hormones were quantified using immunoassays, immune cell populations were assessed by multiparameter flow cytometry, and cytokines and chemokines were measured using multiplex assays.

Subjects

Menstrual effluent and peripheral blood were collected from 13 healthy participants (excluding those using NSAIDs or hormonal contraception) after informed consent.

Exposure

None

Main Outcome Measures

The immune cell and hormonal profiles of menstrual effluent and peripheral blood were the main outcome measures.

Results

Progesterone and cortisol concentrations were significantly decreased in menstrual effluent compared with peripheral blood. Menstrual effluent exhibited distinct immune and cytokine profiles, including increased plasmacytoid and myeloid dendritic cells, neutrophils, natural killer (NK) cells, and memory CD8⁺ T cells, alongside decreased regulatory T cells, natural killer T (NKT) cells, and multiple B cell subsets. Cytokine analysis revealed multiple elevated cytokines in menstrual effluent, even after false discovery rate correction.

Conclusions

Menstrual effluent is immunologically and hormonally distinct from peripheral blood, which may reflect inflammatory and tissue-repair activity. These findings contribute to the understanding of the normative baseline for menstrual effluent.

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流动不同：月经流出物与外周血的探索性表征。

目的：本研究旨在研究月经流出液与配对外周血的免疫细胞和激素特征。设计：这项描述性横断面研究收集月经流出物并对其进行处理以分离细胞和可溶性组分；同时处理外周血。使用免疫测定法定量类固醇激素，使用多参数流式细胞术评估免疫细胞群，使用多重测定法测量细胞因子和趋化因子。受试者：根据知情同意，收集13名健康受试者（不包括使用非甾体抗炎药或激素避孕的受试者）的月经流出物和外周血。主要结局指标：月经流出液和外周血的免疫细胞和激素谱是主要结局指标。结果：与外周血相比，月经流出液中孕酮和皮质醇浓度明显降低。月经流出物表现出不同的免疫和细胞因子特征，包括浆细胞样细胞和髓样树突状细胞、中性粒细胞、自然杀伤（NK）细胞和记忆性CD8+ T细胞增加，同时调节性T细胞、自然杀伤T细胞（NKT）细胞和多种B细胞亚群减少。细胞因子分析显示，即使在错误发现率校正后，月经流出物中也存在多种升高的细胞因子。结论：月经流出物在免疫和激素方面不同于外周血，这可能反映了炎症和组织修复活性。这些发现有助于理解月经流出物的规范基线。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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