Journal List > Ewha Med J > v.41(1) > 1058720

Lee, Lee, Kim, Kim, Woo, Kim, and Jeong: Influence of the Phase of Menstrual Cycle on Postoperative Nausea and Vomiting after Breast Cancer Surgery



The phase of the menstrual cycle was demonstrated to have an influence on the incidence of postoperative nausea and vomiting (PONV) after gynecologic laparoscopic surgery, but little was known for breast surgery, which was shown to have relatively higher incidence of PONV, >60%. We performed this study to investigate the influence of the phase of menstrual cycle on PONV after breast cancer surgery.


A total of 103 patients, who were scheduled for breast cancer surgery under general anesthesia, were recruited, and patients with irregular menstrual cycles, history of previous history of PONV were excluded. Groups were divided in two ways as follows: 1) gynecologic classification: premenstrual and menstrual (days 25 to 6), follicular (days 8 to 12), ovulation (days 13 to 15), and luteal phase (days 20 to 24); 2) menstrual classification: menstrual (days 1 to 8) and non-menstrual (days 9 to 28). PONV were recorded using Rhodes index of nausea, vomiting and retching at postoperative 6 and 24 hours.


The overall incidence of PONV during postoperative 24 hours was 35.4%. At the menstrual classification, the incidence of PONV at postoperative 24 hours was higher in the menstrual group than that in the non-menstrual group (16.7% vs. 4.2%, P=0.057). The severity of PONV, measured with Rhodes index of nausea, vomiting and retching was significantly different between menstrual and non-menstrual groups (P=0.034).


The duration and severity of the PONV after breast cancer surgery were demonstrated to be prolonged and aggravated during menstruation, respectively. Therefore, consideration of menstrual cycle for scheduling breast cancer surgery could effectively prevent the PONV and reduce medical cost.

Figures and Tables

Fig. 1

The incidence and degree of postoperative nausea and vomiting at 6 and 24 hours after surgery. *P<0.05 compared to non-menstrual group.

Table 1

Rhodes index of nausea, vomiting and retching

Table 2

Patient characteristics


Values are presented as mean±standard deviation.

Table 3

Overall incidence of PONV in different phases of the menstrual cycle


Values are presented as number or number (%).

PONV, postoperative nausea and vomiting.

Table 4

Overall incidence of PONV in different types of surgery


Values are presented as number (%), or mean±standard deviation.

PONV, postoperative nausea and vomiting.


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