Influence of the Menstrual Cycle on Raynaud's Phenomenon and on Cold Tolerance in Normal Women

Digital strain gauge plethysmography during a controlled cycle of hand warming and cooling was performed at weekly intervals through a single menstrual cycle in 10 normal women and 6 patients with idiopathic Raynaud's phenomenon (RP). Results were compared to those in 16 additional RP patients and 5 normal males. Maximum digital arterial flow at finger temperature 38 degrees C and reactive hyperemia following three minute arterial occlusion at 30 degrees C was comparable for all groups and did not vary with menstrual status. During cooling, normal women manifested plethysmographic loss of digital arterial flow at finger temperatures (18.1 degrees C +/- 7.9) intermediate between those of normal men (13.7 degrees C +/- 4.3, P less than 0.05) and RP patients (26.0 degrees C +/- 6.1, P less than 0.001). RP patients showed no change in cold tolerance in relation to menstrual status. However, normal women had variable responses to cooling and were found least cold tolerant at the time of menstruation with RP-like responses in all 10 cases although digital color changes were absent. These data support the hypothesis that RP in the premenopausal woman is physiologic and thus, in the majority of cases, not likely to evolve into a definable connective tissue disease.