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Sample records for amenorrhea

  1. Amenorrhea

    Science.gov (United States)

    ... a girl has not started having periods by age 15 (or within 5 years of the first signs of puberty) • Secondary amenorrhea: when a girl or woman has ... insufficiency, also called premature ovarian failure (menopause before age 40) • Abnormal ... Mental stress • Weight loss and low body weight • Eating ...

  2. Secondary amenorrhea (image)

    Science.gov (United States)

    Secondary amenorrhea is the cessation of menstrual flow for a period of 6 months or more in the absence ... as anxiety can be the root cause of amenorrhea. Treatment can range from behavior modification for excessive ...

  3. [Functional hypothalamic amenorrhea].

    Science.gov (United States)

    Stárka, Luboslav; Dušková, Michaela

    2015-10-01

    Functional hypothalamic amenorrhea (FHA) besides pregnancy and syndrome of polycystic ovary is one of the most common causes of secondary amenorrhea. FHA results from the aberrations in pulsatile gonadotropin-releasing hormone (GnRH) secretion, which in turn causes impairment of the gonadotropins (follicle-stimulating hormone and luteinizing hormone). FHA is a form of the defence of organism in situations where life functions are more important than reproductive function. FHA is reversible; it can be normalized after ceasing the stress situation. There are three types of FHA: weight loss related, stress-related, and exercise-related amenorrhea. The final consequences are complex hormonal changes manifested by profound hypoestrogenism. Additionally, these patients present mild hypercortisolemia, low serum insulin levels, low insulin-like growth factor 1 (IGF-1) and low total triiodothyronine. Women health in this disorder is disturbed in several aspects including the skeletal system, cardiovascular system, and mental problems. Patients manifest a decrease in bone mass density, which is related to an increase in fracture risk. Therefore, osteopenia and osteoporosis are the main long-term complications of FHA. Cardiovascular complications include endothelial dysfunction and abnormal changes in the lipid profile. FHA patients present significantly higher depression and anxiety and also sexual problems compared to healthy subjects.

  4. Primary amenorrhea: diagnosis and management.

    Science.gov (United States)

    Marsh, Courtney A; Grimstad, Frances W

    2014-10-01

    Puberty is a defining time of many adolescents' lives. It is a series of events that includes thelarche, pubarche, and menarche. Primary amenorrhea is the absence of menarche. There are numerous etiologies including outflow tract obstructions, gonadal dysgenesis, and anomalies of the hypothalamic axis. This review's aims are to define primary amenorrhea and describe the various causes, their workups, associated comorbidities, and treatment options. At the end, a generalist should be able to perform an assessment of an adolescent who presents with primary amenorrhea and, if warranted, begin initial treatment.

  5. Treating Athletic Amenorrhea: A Matter of Instinct?

    Science.gov (United States)

    Monahan, Terry

    1987-01-01

    Information is presented on the current status of research and treatment of athletic amenorrhea, including discussion of etiology, difficulties in research, study design, definition of amenorrhea, and future trends in research and treatment. (CB)

  6. Mullerian anomalies: a cause of primary amenorrhea

    OpenAIRE

    2013-01-01

    Background: The objectives of this study were to determine the etiologic causes of amenorrhea, the prevalence of mullerian anomalies as a cause of primary amenorrhea and the different varieties of mullerian anomalies causing primary amenorrhea. Methods: This study included all the women presenting with primary amenorrhea who presented to the department of obstetrics and gynecology, Sir T Hospital and Government Medical College, Bhavnagar from 1st January 2010 to 30th June 2012. Results: The c...

  7. Cytogenetic analysis of patients with amenorrhea

    Institute of Scientific and Technical Information of China (English)

    Zhang Ying; Zhang Xiu-ling; Li Yan

    2006-01-01

    Objective: To analyse the cytogenetic examination results and investigate the effect of chromosome abnormalities on amenorrhea.Methods: The routine cytogenetic analysis was performed, including the chromosome G band analysis and karyotype analysis of the cultured peripheral blood lymphocytes from the patients with primary amenorrhea or secondary amenorrhea.Results: One hundred and thirty-seven cases were found with chromosome abnormalities in 234 patients with primary amenorrhea. The incidence of chromosome abnormality was 58.6%. In 309 with secondary amenorrhea, the incidence of chromosome abnormality was 13.6%.The reported abnormalities included the numerical and structural abnormalities of X chromosome, 46,XY, 45,X0/46,XY,and the structural abnormality of autosome.Conclusions: Chromosome abnormality is one of the main causes of amenorrhea. Karyotype analysis of chromosome is absolutely necessary for the diagnosis and treatment of patient with amenorrhea.

  8. Amenorrhea: an approach to diagnosis and management.

    Science.gov (United States)

    Klein, David A; Poth, Merrily A

    2013-06-01

    Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Primary amenorrhea, which by definition is failure to reach menarche, is often the result of chromosomal irregularities leading to primary ovarian insufficiency (e.g., Turner syndrome) or anatomic abnormalities (e.g., Müllerian agenesis). Secondary amenorrhea is defined as the cessation of regular menses for three months or the cessation of irregular menses for six months. Most cases of secondary amenorrhea can be attributed to polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia, or primary ovarian insufficiency. Pregnancy should be excluded in all cases. Initial workup of primary and secondary amenorrhea includes a pregnancy test and serum levels of luteinizing hormone, follicle-stimulating hormone, prolactin, and thyroid-stimulating hormone. Patients with primary ovarian insufficiency can maintain unpredictable ovarian function and should not be presumed infertile. Patients with hypothalamic amenorrhea should be evaluated for eating disorders and are at risk for decreased bone density. Patients with polycystic ovary syndrome are at risk for glucose intolerance, dyslipidemia, and other aspects of metabolic syndrome. Patients with Turner syndrome (or variant) should be treated by a physician familiar with the appropriate screening and treatment measures. Treatment goals for patients with amenorrhea may vary considerably, and depend on the patient and the specific diagnosis.

  9. Secondary Amenorrhea among Female Athletes. Current Understandings.

    Science.gov (United States)

    Sasiene, Gwen Hagenbuch

    1983-01-01

    Research pertaining to female athletes' problems with secondary amenorrhea is reviewed. Studies point to stress, weight loss, anorexia nervosa, obesity, arduous athletic training, and age of onset of training as factors which may contribute to this disorder. (PP)

  10. Primary amenorrhea with bilateral endometriotic cysts.

    Science.gov (United States)

    Jabeen, Sadaqat; Raees, Mehnaz

    2015-05-01

    Primary amenorrhea is a common problem. Diagnosis is usually by going through systematic approach of history, examination and investigations. This case had bilateral large endometriotic cysts in the adnexal region. Uterus was normal sized with well-formed endometrium. She underwent laparotomy followed by drainage of endometriotic cysts, stripping and reconstruction of ovaries was performed. Patient was given a trial of combined oral contraceptive pills for two consecutive cycles to observe withdrawal bleeding, but it failed. Till now we are unable to find out such case in literature. Exact case of primary amenorrhea could not be found.

  11. Cytogenetic investigation of patients with primary amenorrhea

    Directory of Open Access Journals (Sweden)

    K Vijaya Laxmi

    2012-01-01

    Full Text Available Primary amenorrhea refers to absence of spontaneous menarche even after the age of 16. Cytogenetic analysis in two cases with primary amenorrhea, short stature, poorly developed secondary sexual characteristics, and growth retardation were studied. Routine GTG-band analysis of metaphases from peripheral blood leucocytes revealed female karyotype with a 15(ps+ and an isochromosome of X, i(Xq, in one patient and 46,X, i(Xq, in another patient. Ascertainment of the karyotype aided in confirmation of the provisional diagnosis, a better phenotype-genotype correlation to understand clinical heterogeneity in genetic counseling.

  12. [CYTOGENETIC ANALYSIS OF PATIENTS WITH PRIMARY AMENORRHEA].

    Science.gov (United States)

    Stoyanova, V; Linev, A; Ivanov, H; Vachev, T

    2015-01-01

    Primary amenorrhea is one of the common reproductive disorder affecting females. It leads to the absence of menarche in the reproductive age group in females and/or complete absence of reproductive organs. The physiology of menstruation and reproduction has a strong correlation with the expression of the X chromosome. Thus, the role of the clinical geneticists in terms of diagnosis, risk assessment, genetic counseling and management of patients with primary amenorrhea and their families is essential. The genetic contribution to amenorrhea is studied both at the cellular and molecular level aiming at chromosomal abnormalities and gene mutations. In the present study we aim to perform chromosomal analysis in 140 patients present with primary amenorrhea employing GTG banding technique. The resulting karyotype revealed 67.4% (n = 95) with normal chromosome composition and 32.6% (n = 46) showed chromosomal abnormalities. In patients with abnormal chromosome constituents, 20% (n = 9) exhibit numerical aberration, 22% (n = 10) showed structural abnormalities, 43% (n = 20) mosaic genotype and 15% (n = 7) of cases--male karyotype. Furthermore, the involvement of Y chromosome and the origin of marker chromosome was confirmed by applying fluorescent in situ hybridization (FISH) in four patients.

  13. The Six TCM Differential Treatments for Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Amenorrhea is a commonly encountered gynecolo- gical disorder in clinic. The causative factors are variant, and therefore the treatments should be different. In recent years, the author has adopted six TCM methods for the treatment based on syndrome differentiation. The results are satisfactory with illustrative cases introduced in the following.

  14. Treatment of Secondary Amenorrhea with Abdomen Acupuncture

    Institute of Scientific and Technical Information of China (English)

    韩燕

    2004-01-01

    @@ Abdomen acupuncture is a newly-emerged branch of body acupuncture, that has been used in clinic and gradually accepted by the patients. In recent years, the author has treated 33 cases of secondary amenorrhea with this art. The therapeutic results were satisfactory and reported as follows.

  15. Cortisol secretion in patients with normoprolactinemic amenorrhea

    DEFF Research Database (Denmark)

    Boesgaard, S; Hagen, C; Andersen, A N;

    1988-01-01

    Patients with functional amenorrhea have raised central dopaminergic activity and opioid-mediated GnRH inhibition leading to inhibition of hypothalamic-pituitary-ovarian function. In the present study, basal serum cortisol and ACTH levels were measured in normoprolactinemic amenorrheic patients...

  16. Cortisol secretion in patients with normoprolactinemic amenorrhea

    DEFF Research Database (Denmark)

    Boesgaard, S; Hagen, C; Andersen, A N

    1988-01-01

    Patients with functional amenorrhea have raised central dopaminergic activity and opioid-mediated GnRH inhibition leading to inhibition of hypothalamic-pituitary-ovarian function. In the present study, basal serum cortisol and ACTH levels were measured in normoprolactinemic amenorrheic patients...... with (N = 14) and without (N = 7) insulin-dependent diabetes mellitus. Basal serum cortisol levels was significantly (P less than 0.01) elevated in patients with normoprolactinemic amenorrhea compared with normal women. Basal serum cortisol was significantly (P less than 0.02) elevated in amenorrheic...... diabetic patients compared with menstruating diabetic women. In the amenorrheic groups both cortisol and ACTH levels increased significantly (P less than 0.01) after dopamine D-2 receptor blockade, whereas no hormonal changes occurred in the control groups. It is concluded that patients...

  17. Cytogenetic investigation of 468 patients with primary amenorrhea

    Institute of Scientific and Technical Information of China (English)

    Yu Hong; Bian Xu-min; Liu Jun-tao; Hao Na; Zhou Jing; Liu Shan-ying

    2010-01-01

    Objective: To analyze the relationship between karyotypes and clinic features of patients with primary amenorrhea. Method: G-banding was employed in karyotype analysis of patients with primary amenorrhea. Results: Karyotype analysis of 468 patients with primary amenorrhea revealed that 255 patients (54.49%) had normal female karyotypes and 213 patients (45.41%) had abnormal karyotypes, including 143 patients with abnormal X chromosome, 4 patients with mosaic X-Y chromosome, 57 patients with 46,XY karyotype, 8 patients with abnormal autosome and one patient with X-autosome translocation. All primary amenorrhea patients with deletion or break-up in Xp11.1-11.4 were short in stature. Conclusion: One of the main reasons of primary amenorrhea was chromosome abnormalities, especially sex chromosome abnormalities. Karyotype analysis should be routinely applied to detect primary amenorrhea patients. Xp11-12 may be critical to development of stature.

  18. Causes of amenorrhea in Korea: Experience of a single large center

    OpenAIRE

    2014-01-01

    Objective To investigate the causes of amenorrhea in Korean women. Methods Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea wer...

  19. A rare case of primary amenorrhea

    Directory of Open Access Journals (Sweden)

    Himadri Bal

    2016-01-01

    Full Text Available Crytomenorrhea arises usually due to the imperforate hymen, sometimes due to vaginal septum, rarely due to cervical agenesis. Here, we present a case of primary amenorrhea resulting from cervical agenesis in a 38-year-old woman. She presented with primary amenorrhea and cyclic lower abdominal pain. She had undergone some surgery 5 years back, details of which were not available. On examination secondary sexual characters were normal, per abdomen there was an 18 weeks size firm abdominopelvic mass. Local vaginal examination showed a blind vaginal pouch. A clinical diagnosis of hematometra due to transverse vaginal septum was made. However, magnetic resonance imaging pelvis suggested hematometra with cervical stenosis. The patient was taken up for examination under anaesthesia (EUA and exploratory laparotomy. On opening the abdomen uterus found to be enlarged with dense adhesions all around and signs of endometriosis. Extensive adhesiolysis revealed bilateral chocolate cysts of ovaries with hematosalpinges and peritubal adhesions. Hysterotomy and drainage of tarry contents were followed by an exploration of the uterine cavity. The lower pole ended blindly with no evidence of any cervix. Peroperative diagnosis of cervical agenesis leading to hematometra and endometriosis was made. A subtotal hysterectomy with bilateral salpingo-oophorectomy was done. Histopathological examination confirmed ovarian endometriosis and adenomyosis of uterus. Though reconstructive surgery for cervical dysgenesis has been successful in some cases, hysterectomy is generally recommended for cervical agenesis.

  20. [Diagnosis and management of amenorrhea in adolescent girls].

    Science.gov (United States)

    Laroche, E; Bricaire, L; Christin-Maitre, S

    2013-07-01

    Amenorrhea in adolescents can be primary, with or without breast development, or secondary. Whether amenorrhea is primary or secondary, height, body mass index, food intake, the level of physical activity per week, the presence of hirsutism or galactorrhea, pelvic pain and past history of intercourse need to be investigated. Initially, blood tests should include hCG, FSH, estradiol, testosterone and prolactin serum levels. This screening will discriminate between hypogonadotropic hypogonadism and amenorrhea from primary ovarian insufficiency (POI). In case of primary amenorrhea, hypogonadism may be due to congenital hypogonadotropic hypogonadism (HH) or more rarely acquired HH. If FSH is elevated, amenorrhea is due to primary ovarian failure, mainly related to Turner syndrome. If pubertal development is normal, a pelvic ultrasound should be performed. It may visualize a hindering of menses output or less frequently an absence of uterus, as in Rokitansky syndrome or androgen insentivity syndrome. The most frequent etiologies of secondary amenorrhea are polycystic ovarian syndrome (PCOS), functional hypothalamic amenorrhea and less frequently POI and hyperprolactinemia. The differential diagnoses of PCOS are late-onset 21-hydroxylase deficiency and very rare ovarian or adrenal tumors. When contraception is not necessary, hormonal replacement therapy, including estrogen and progestins should be administered in order to avoid hypoestrogenism. In case of PCOS, sequential progestins can be prescribed. A contraceptive pill can be considered when contraception is needed and/or when hyperandrogenism needs to be treated.

  1. Escitalopram-Induced Amenorrhea and False Positive Urine Pregnancy Test

    Science.gov (United States)

    Hour, Siv; Gunasekar, Palanikumar; Gray, Caron; Smith, James F.

    2017-01-01

    Escitalopram is a selective serotonin reuptake inhibitor antidepressant approved by the Food and Drug Administration for the treatment of major depressive disorder and generalized anxiety disorder. A 34-year-old female patient with major depressive disorder developed amenorrhea and had a false-positive urine pregnancy test after initiation of escitalopram treatment. To our knowledge, no published case report of amenorrhea and false-positive urine pregnancy tests in women taking escitalopram exists. This case report suggests that women of child-bearing age should be carefully monitored for amenorrhea while they are on an antidepressant treatment regimen. PMID:28197332

  2. Fingolimod-associated amenorrhea: a report of three cases.

    Science.gov (United States)

    Alroughani, R

    2014-10-01

    Amenorrhea has not been reported as an adverse event in fingolimod phase III clinical trials in patients with multiple sclerosis (MS) with either 0.5 mg or 1.25 mg dosages. Here we report three cases of young women with MS who developed amenorrhea within 6 months of initiation of fingolimod. They experienced irregularities in their menstrual cycles in the first 3 months, which progressed to amenorrhea by 5(th) or 6(th) month. Gynecology evaluations showed no other etiologies. Menses returned to baseline after discontinuation of fingolimod for 2-3 months. Amenorrhea could be associated with fingolimod in the first year. Future surveillance is advised to determine the incidence rate of this adverse event.

  3. [[The duration of postpartum amenorrhea in a Sundanese village

    Science.gov (United States)

    Takasaka, K

    1988-06-01

    "The duration of postpartum amenorrhea of women in a Sundanese agricultural village [in Indonesia] whose last pregnancy resulted in live birth in the past six years was studied. Data were collected from 197 women from September through November 1983....[The] results suggest that the duration of postpartum amenorrhea of women in a Sundanese agricultural village although relatively long, has recently become shorter." (SUMMARY IN ENG)

  4. Amenorrhea as a Diagnostic Criterion for Anorexia Nervosa

    OpenAIRE

    2012-01-01

    Amenorrhea is a current criterion for the diagnosis of anorexia nervosa (AN) according to the DSM-IV-TR. Nevertheless, when comparing groups of patients who fulfill all the criteria of this manual for AN and groups of women who show them all but amenorrhea, some studies did not find significant differences in the psychopathology typically associated with AN. The purpose of our study was to compare both groups in demographic, anthropometric, psychological and psychopathological variables. Ther...

  5. Ever intriguing and lsquo;Primary Amenorrhea'- an audit

    Directory of Open Access Journals (Sweden)

    Sapna Vinit Amin

    2014-08-01

    Full Text Available Background: Primary amenorrhea though its incidence is less than 0.1% often is a diagnostic challenge in establishing etiology and causes management dilemma to the gynecologist in the developing countries. Methods: A retrospective audit of all the cases of primary amenorrhea coming to our tertiary care teaching hospital in South India over 6 years, from January 2006 to December 2012. Results: Ninety-eight cases of primary amenorrhea were analyzed and it was found that the causes of primary amenorrhea were structural anomalies in 47.9%, endocrinological abnormality in 31.6%, and genetic factors in 20.5% of the patients. Mullerian anomalies were the most common cause for primary amenorrhea compared to gonadal dysgenesis in our study group; hence surgical correction formed an important mode of treatment following diagnosis. Conclusions: Primary amenorrhea work-up may seem to be complex, nevertheless a well elicited history, carefully conducted physical examination followed by use of imaging modalities and bio assays for endocrine abnormalities, permitted the clinician to narrow the diagnostic possibilities and reach an accurate diagnosis quickly that helped in choosing the appropriate management option. While managing, counselling of the patient and her near relatives was very essential for fruitful outcome. Among the surgical approaches for management, sigmoid vaginoplasty was found to be a promising alternative to MacIndoe's vaginoplasty in our series. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1090-1096

  6. A Rare Case of Primary Amenorrhea with Two Etiologies, Hypothalamic Amenorrhea, Transverse Vaginal Septum, and No Hematocolpos

    Directory of Open Access Journals (Sweden)

    Firouzeh Ghaffari

    2015-01-01

    Full Text Available We reported a rare case of hypothalamic amenorrhea and transverse vaginal septum. A 28-year-old woman presented with primary amenorrhea and no complaint of abdominal pain. Laparoscopy revealed a small rudimentary uterus with streak ovaries and a vaginal pouch. The patient with diagnosis of Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome was subjected to a vaginoplasty in another fertility center. In our institute, after two courses of estrogen and progesterone, sonography revealed hematocolpos, while, under anesthesia, transverse vaginal septum was resected. Hysteroscopy revealed normal uterine cavity. She became pregnant 5 months postoperatively with controlled ovarian stimulation (COS in conjunction with intrauterine insemination, and she has two healthy babies now. This case highlights the importance of careful evaluation of all primary amenorrheas. Clinicians should be aware of presence of more than one etiology which causes atypical presentations and accomplishes a systematic strategy for the evaluation of amenorrhea potential to avoid long-term side effects of a misdiagnosis.

  7. A Rare Case of Primary Amenorrhea with Two Etiologies, Hypothalamic Amenorrhea, Transverse Vaginal Septum, and No Hematocolpos

    OpenAIRE

    2015-01-01

    We reported a rare case of hypothalamic amenorrhea and transverse vaginal septum. A 28-year-old woman presented with primary amenorrhea and no complaint of abdominal pain. Laparoscopy revealed a small rudimentary uterus with streak ovaries and a vaginal pouch. The patient with diagnosis of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome was subjected to a vaginoplasty in another fertility center. In our institute, after two courses of estrogen and progesterone, sonography revealed hematocolpos...

  8. Using an algorithmic approach to secondary amenorrhea: Avoiding diagnostic error.

    Science.gov (United States)

    Roberts-Wilson, Tiffany K; Spencer, Jessica B; Fantz, Corinne R

    2013-08-23

    Secondary amenorrhea in women of reproductive age may be an indication of an undiagnosed, chronic condition and appropriate treatment is dependent upon accurate diagnosis of the underlying etiology. A thorough clinical assessment and a few common laboratory tests can easily identify the most frequent causes of secondary amenorrhea. However, once these have been ruled out, the more uncommon pathophysiologies can be difficult to diagnose due to similarities in presentation and appropriate laboratory testing and interpretation become critical. In these cases, misdiagnosis is unfortunately common and often the result of poor laboratory utilization in the form of a failure to employ indicated tests, the use of obsolete tests, or erroneous interpretation in the face of interfering factors or co-morbidities. Consequently, the algorithmic approach to laboratory evaluation in the context of secondary amenorrhea described in this review can minimize the risk of diagnostic error as well was decrease test volume, cost, and time to diagnosis.

  9. Postpartum Sexuality and the Lactational Amenorrhea Method for Contraception.

    Science.gov (United States)

    Labbok, Miriam H

    2015-12-01

    This chapter reviews the literature on postpartum coital behavior, anovulatory and ovulatory bleeding episodes, and the methodology and efficacy of Lactational Amenorrhea Method and progesterone-only oral contraceptives. Of interest is the finding that breastfeeding women may resume coital behavior earlier postpartum, but report increased discomfort over time. The high efficacy of the Lactational Amenorrhea Method is confirmed and data illustrating possible relaxation of some criteria are presented. The conflicting guidance of CDC and WHO concerning immediate postpartum use of progestin-only methods is presented. The dearth of recent studies calls for new research on these topics.

  10. Diagnostic pitfalls in the evaluation and management of amenorrhea in adolescents.

    Science.gov (United States)

    Azurah, Abdul Ghani Nur; Zainuddin, Ani Amelia; Jayasinghe, Yasmin

    2013-01-01

    Amenorrhea is a common menstrual problem seen in adolescents. Amenorrhea has been shown to have a negative impact on adolescents' quality of life. In this paper we discuss the various causes and investigations of amenorrhea in adolescents and address management dilemmas for specific conditions. Specific approaches in dealing with adolescents using the HEADSS (Home, Education, Activity, Drugs, Sexual activity, Suicidal) approach are discussed.

  11. Understanding the Female Athlete Triad: Eating Disorders, Amenorrhea, and Osteoporosis.

    Science.gov (United States)

    Beals, Katherine A.; Brey, Rebecca A.; Gonyou, Julianna B.

    1999-01-01

    Examines three disorders that can affect female athletes who focus on succeeding athletically and achieving a prescribed body weight: disordered eating, amenorrhea, and osteoporosis. The paper presents prevention and treatment suggestions for athletes with eating disorders, focusing on primary, secondary, and tertiary prevention. Recommends that…

  12. [Psychodiagnostic findings in anorexia nervosa and post-pill amenorrhea].

    Science.gov (United States)

    Ehle, G; Wahlstab, A; Ott, J

    1982-11-01

    Anorexia nervosa is originated from disturbances at various points of the cortico-hypothalamo-hypophyseal axis. 65 patients suffering from anorexia nervosa or post-pill-amenorrhea were classified by cluster-analysis with 174 marks of the social, psychodynamic and biological levels. The different psychodiagnostic characteristics (470-F-Test, Hamilton-Depression-Scale, Beck-Depression-Scale, Giessen-test) are discussed according to the 3 clusters.

  13. [Cytogenetic features of teenage girls with secondary amenorrhea].

    Science.gov (United States)

    Nachetova, T A; Nefidova, V E

    2014-11-01

    Some features of the chromosome apparatus status were studied in 25 adolescent girls, aged 14-18, with secondary amenorrhea and in 29 girls of the same age with a regular menstrual cycle. Materials for cytogenetic analysis were preparations of chromosomes at the stage of metaphase obtained from the culture of the peripheral blood lymphocytes. The technique of the culture preparation was carried out according to the standard method. 2225 metaphase plates were analyzed in girls with secondary amenorrhea, and 2603 plates were tested in their healthy age-mates. An increased total level of chromosomal aberrations and a rise in the frequency of disorders in the chromatid, chromosome and genome types of peripheral blood lymphocytes have been registered in the examined persons as compared with their healthy age-mates. We have shown, that polyploid cell registered in 15 times oftener in adolescent girls with SA as compared with healthy girls. It can be assumed that some marked changes in the frequency of chromosomal aberrations in patients with secondary amenorrhea and in their healthy age-mates may arise both as a result of exposure to the multiple environmental factors and disorders of rather complicated processes of DNA damages reparation.

  14. The -female athlete triad-: Eating disorders - amenorrhea- osteoporosis

    Directory of Open Access Journals (Sweden)

    Maria Polikandrioti

    2007-01-01

    Full Text Available The female athlete triad is a syndrome which consists of eating disorders, amenorrhea and osteoporosis. The syndrome is increasing in prevalence over the last thirty years, as more women are participating in sports at a competitive level. The aim of the present study was to review the research data regarding the female athlete triad in order to underline the significance of the problem. The method οf this study included search of international medical and nursing literature data-bases, for the reason that the female athlete triad has been extensively studied after 1990. The results from the review of relevant studies showed that female athletes who follow hard preparative athletic programmes in which body weight is critical for success, often manifest eating disorder patterns. These lead to dysregulation of the hypothalamic-pituitarian-ovarian axis (HPO and as a result to amenorrhea. Hypothalamic amenorrhea can lead to osteoporosis and increased fracture risk. Adolescents may particularly be at risk because it is during this crucial time that females attain their peak bone mass. Conclusively, a course of action that aims at preventing the occurrence of the syndrome is necessary. Prevention of the female athlete triad through education and identification of the athletes at risk may decrease the incidence of long-term catastrophic effects to health. Monitoring from a group of specialists should serve as a cornerstone when planning a program of training and preparation for high athletic performance

  15. Amenorrhea, ptosis and high insulin requirement in a young girl.

    Science.gov (United States)

    Hari Kumar, K V S; Kumar, Sandeep

    2016-01-01

    Lipodystrophy is an uncommon condition leading to excessive insulin requirement and menstrual abnormalities in young girls with diabetes. Neurological symptoms are uncommon in patients of generalized or partial lipodystrophy. We recently encountered a young girl, who presented with high insulin requirement, amenorrhea and neurological symptoms. Detailed evaluation led to the diagnosis of congenital lipodystrophy and we describe the same in this report. We also highlight the atypical features of the congenital lipodystrophy and the reasons for the excessive insulin requirement in patients with diabetes mellitus.

  16. Hormone profile in juvenile systemic lupus erythematosus with previous or current amenorrhea

    NARCIS (Netherlands)

    Silva, Clovis A.; Deen, Maria E. J.; Febronio, Marilia V.; Oliveira, Sheila K.; Terreri, Maria T.; Sacchetti, Silvana B.; Sztajnbok, Flavio R.; Marini, Roberto; Quintero, Maria V.; Bica, Blanca E.; Pereira, Rosa M.; Bonfa, Eloisa; Ferriani, Virginia P.; Robazzi, Teresa C.; Magalhaes, Claudia S.; Hilario, Maria O.

    2011-01-01

    To identify the underlying mechanism of amenorrhea in juvenile systemic lupus erythematosus (JSLE) patients, thirty-five (11.7%) JSLE patients with current or previous amenorrhea were consecutively selected among the 298 post-menarche patients followed in 12 Brazilian pediatric rheumatology centers.

  17. Switching to quetiapine for risperidone-induced amenorrhea: Report of two cases

    Directory of Open Access Journals (Sweden)

    P K Pardal

    2010-01-01

    Full Text Available Almost all the antipsychotics can cause hyperprolactinemia-related side-effects like amenorrhea. Quetiapine has been reported to have minimal propensity to cause hyperprolactinemia. We report here two cases of risperidone-induced amenorrhea, who resumed their normal cycle on switching over the medication to quetiapine.

  18. Chromosomal abnormalities and hormonal disorders of primary amenorrhea patients in Egypt

    Directory of Open Access Journals (Sweden)

    Faeza El-Dahtory

    2012-01-01

    Conclusion: The present study showed that karyotype and FISH are necessary to detect the causes of primary amenorrhea. This study also revealed the incidence of chromosomal abnormalities in women with primary amenorrhea in Egypt is similar to that reported in previous literatures.

  19. Primary amenorrhea in anorexia nervosa: impact on characteristic masculine and feminine traits.

    Science.gov (United States)

    Baker, Jessica H; Sisk, Cheryl L; Thornton, Laura M; Brandt, Harry; Crawford, Steven; Fichter, Manfred M; Halmi, Katherine A; Johnson, Craig; Jones, Ian; Kaplan, Allan S; Mitchell, James E; Strober, Michael; Treasure, Janet; Woodside, D Blake; Berrettini, Wade H; Kaye, Walter H; Bulik, Cynthia M; Klump, Kelly L

    2014-01-01

    Animal studies indicate that gonadal hormones at puberty have an effect on the development of masculine and feminine traits. However, it is unknown whether similar processes occur in humans. We examined whether women with anorexia nervosa (AN), who often experience primary amenorrhea, exhibit attenuated feminization in their psychological characteristics in adulthood due to the decrease/absence of gonadal hormones at puberty. Women with AN were compared on a number of psychological characteristics using general linear models on the basis of the presence/absence of primary amenorrhea. Although women with primary amenorrhea exhibited lower anxiety scores than those without primary amenorrhea, in general, results did not provide evidence of attenuated feminization in women with AN with primary amenorrhea. Future research should utilize novel techniques and direct hormone measurement to explore the effects of pubertal gonadal hormones on masculine and feminine traits.

  20. A Natural Method for Family Planning: Lactational Amenorrhea Method

    Directory of Open Access Journals (Sweden)

    Ayten Senturk Erenel

    2010-08-01

    Full Text Available Use of an family planning method during the postpartum period is important both to space births, and to prevent unwanted pregnancies. Under-utilization of family planning services during this period not only leads to adverse conditions caused by excessive fertility, but also has negative effects on both maternal and infant health. Women are in close contact with health care providers before, during, and after childbirth, when they are most likely to be impressed by the services they receive. Effective provision of health care services in these periods is therefore of great importance. Literature indicates high rates of success and compliance with family planning services provided during these periods. Many women neglect to use a modern contraceptive method in the postpartum period believing that breastfeeding alone ensures sufficient protection against pregnancy. Indeed, breastfeeding can be 98% effective as a contraceptive method; however, this is only true if certain criteria are observed. There are three basic criteria for the lactational amenorrhea method to be effective: the baby must be less than six months old, must be exclusively or almost exclusively breast-fed, and the mother must not be menstruating. In a conference held in Bellago in August 1988 by the World Health Organization and other international agencies, a consensus was developed for effective use of lactational amenorrhea method, and it was agreed to adopt breastfeeding as a potential family planning method in maternal and child health programs. [TAF Prev Med Bull 2010; 9(4.000: 383-390

  1. An overview of amenorrhea and respective remedies in Traditional Persian Medicine

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    Abdolmajid Elahi

    2016-03-01

    Full Text Available Amenorrhea is described as complete absence or cessation of menstruation. Besides conventional treatment approaches, traditional and complementary medical systems have suggested numerous natural medications for management of amenorrhea. Current study aimed to compile the pharmacological reports on amenorrhea from the standpoints of early Persian scholars. Medical and pharmaceutical manuscripts of Persian medicine from 9th to 18th centuries A.D. have been reviewed to extract the critical points and natural remedies. Based on Traditional Persian Medicine (TPM, impairment in uterus, brain and circulation are main causes of amenorrhea. Any obstruction, either anatomical or functional, in uterus and allied organs or tissues may lead the body to this disorder. Concerning herbal therapy of amenorrhea in TPM, 71 medicinal plants related to 35 families were found. The most prevalent families were Apiaceae, Asteraceae, Lamiaceae and Fabaceae, respectively. Usual routes of administration were oral, vaginal and topical. However, there was one report on a medicament, spoken to be effective nasally. Traditionally, emmenagogue medicines should possess diuretic activity to be effective for amenorrhea. All reported remedies were known as diuretic agents. However, this description is not corresponded with what is now accepted as diuretic. On the other hand, only Foeniculum vulgare showed therapeutic effects on amenorrhea in a randomized placebo-controlled trial. Despite lack of novel information on emmenagogue activity of these remedies, design and conducting evidence-based animal or human studies may be beneficial for new drug discovery from traditional knowledge.

  2. 经闭治验两则%Two Pieces of Amenorrhea Prescription

    Institute of Scientific and Technical Information of China (English)

    何运林

    2013-01-01

      根据祖国医学对闭经的治疗,结合笔者的临床经验,对两例闭经患者进行中医药治疗,疗效确切,以期丰富闭经的治疗经验。%According to the treatment of traditional Chinese medicine for amenorrhea, combined with the author's clinical experi-ence, two cases of patients with amenorrhea treating with traditional Chinese medicine was definite effective, which enriched clini-cal experience of amenorrhea.

  3. Computed tomographic scan of amenorrhea-galactorrhea syndrome

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    Nemoto, Yutaka; Inoue, Yuichi; Takemoto, Kazumasa; Oda, Atsuo; Yahata, Satoshi (Osaka City Univ. (Japan). Faculty of Medicine)

    1984-05-01

    Thin (2 mm) section CT scans of a pituitary gland of 30 amenorrhea-galactorrhea patients were reviewed. Eleven out of 30 patients were diagnosed as having a pituitary adenoma (tumor group); nine prolactionomas were verified by surgery. Tumor density compared with normal pituitary gland was low in five, low-mixed in three and isodense in four. The upper margin of a prolactinoma was convexed upward in seven, flat in two and concaved downward in two. Pituitary stalk was deviated in two and not visualized in four. Serum prolactine level (PRL) was more than 130 ng/ml in tumor group. There was a positive correlation between the size of a prolactinoma and PRL. Four prolactinomas invaded the cavernous sinus; three of them showed higher PRL than 1,000 ng/ml.

  4. Mosaic triple X syndrome in a female with primary amenorrhea

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    A Venkateshwari

    2012-01-01

    Full Text Available Background: Turner′s syndrome is the most common chromosomal abnormality in females, affecting 1 in 2,500 live female births. It is a result of absence of an X chromosome or the presence of a structurally abnormal X chromosome. Its most consistent clinical features are short stature and ovarian failure. Aim: The aim of the study was to report a rare case of mosaic triple X syndrome in a female with primary amenorrhea. Materials and Methods: The chromosomal analysis using GTG banding was carried out, which revealed a mosaicism with 45,XO/47,XXX chromosomal constitution. Fluorescent in situ hybridization was also carried out to further confirm the observation made in the study. Conclusion: The physical features presented by the female could be due to the 45,XO/47,XXX mosaicism and the karyotype analysis was consistent with the diagnosis and clinical symptoms. Triple X mosaicism was confirmed with conventional and molecular cytogenetic analysis.

  5. [Prevalence and etiology of secondary amenorrhea in a selected Mexican population].

    Science.gov (United States)

    Hernández, I; Cervera-Aguilar, R; Vergara, M D; Ayala, A R

    1999-08-01

    Studies performed upon american and european population indicate that secondary amenorrhea is associated to 3 months without menses, despite biases observed in age variation and intervals of apparition; nonetheless a 3 month lapse is the standard of reference to quality patients within mexican females. Hence, we investigated the prevalence of secondary amenorrhea among all females (n = 1099) that consulted in our clinic, grouped by age (15-50 yrs), time (months) of amenorrea and identifying the etiology when possible. The prevalence observed was 4.9% with major incidence of 4-12 months of amenorrhea duration (x 5.7 months) between 26-35 years of age. The three most common causes in order of frequency were: Hypothyroidism (14.8%); hiperandrogenism (12.9%) and pituitary adenoma (11.1%). It is concluded that the prevalence of secondary amenorrhea in our study resembled that found in the literature, although in this instance primary hyperthyroidism was the leading cause.

  6. [Primary amenorrhea by transverse vaginal septum: a case report and review of the literature].

    Science.gov (United States)

    González-Zárate, Alba Citlalli; Velásquez-Mamani, Jaime

    2014-09-01

    The transverse vaginal septum is one of the rarest anomalies of the reproductive tract classified depending on location. It is manifested by primary amenorrhea, cyclic pain and progressive mass growth at abdominopelvic level, ultrasound and magnetic resonance imaging provides the diagnosis, location and thickness of a transverse vaginal septum, treatment is surgical. We present a case of a teenage patient with primary amenorrhea due to lower transverse vaginal septum with surgical resection and satisfactory follow-up with successful vaginal patency.

  7. Contemporary issues in primary amenorrhea: An experience from a Tertiary Care Center

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    Ashok Krishna Bhuyan

    2012-01-01

    Full Text Available Introduction: Amenorrhea is classified as primary if menstrual bleeding has never occurred in the absence of hormonal treatment. The clinical significance of a lack of regular menstrual cycles extends beyond reproductive concerns. Episodes of amenorrhea as short as 90 day may have implications for bone and cardiovascular health. Aims and Objective: To evaluate all patients presenting with primary amenorrhea in the Endocrinology OPD of Gauhati Medical College and Hospital. Materials and Methods: A total of 14 patients presenting to the Endocrinology OPD from March 2010 to May 2012 with a history of primary amenorrhea were included in the study. All patients were subjected to a detailed history, a thorough clinical examination, and relevant biochemical, hormonal, and radiological investigations. Result: In our study, the average age of presentation was 17.23 ± 4.2 years. Out of the 14 patients presenting with primary amenorrhea, 5 patients (35.71% were found to have Turner′s syndrome, 2 (14.28% had XX (pure gonadal dysgenesis, 2 (14.28% patients had XY gonadal dysgenesis (Swyer syndrome, 2 (14.28% patients had Müllerian agenesis, 2 (14.28% patients had hypothalamic amenorrhea, and 1 (7.14% patient was found to have multiple pituitary hormone deficiency. Conclusion: In concordance with other studies, Turner′s syndrome, Müllerian agenesis, and gonadal dysgenesis are the commonest causes of primary amenorrhea in our study. However, in contrast to certain Western reports, primary amenorrhea rather than short stature remains the commonest cause for seeking medical evaluation in patients with Turner′s syndrome.

  8. The relation between athletic sports and prevalence of amenorrhea and oligomenorrhea in Iranian female athletes

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    Dadgostar Haleh

    2009-07-01

    Full Text Available Abstract Background In 1992, the concept of female athlete triad was introduced to describe the interrelated problems of amenorrhea, eating disorders and osteoporosis seen in female athletes. To gain a clearer picture of amenorrhea/oligomenorrhea in Iran, one of the main components of the female athlete triad, we therefore established this study on the prevalence of amenorrhea/oligomenorrhea in elite Iranian female athletes, also evaluating the risk factors of these disorders in the same population. Methods This study performed as a cross-sectional study. All elite Iranian female athletes of 34 sports federation, including female athletes in national teams and medalists of Tehran were invited to participate. A total of 788 (95% response rate returned the questionnaires and were examined. Younger athletes under the age of menarche were excluded. Each athlete completed a self-administered questionnaire, which covered the following questions about participant's demographic information, athletic history, history of injuries and menstrual pattern. In order to diagnose the causes of amenorrhea/Oligomenorrhea including polycystic ovary syndrome(PCOS, participants with amenorrhea/Oligomenorrhea underwent further investigation. They were evaluated by following Para clinic investigation, and an ultrasonographic study of ovary. Results The age ranged from 13–37 (mean = 21.1, SD = 4.5. Seventy one (9.0% individuals had amenorrhea/oligomenorrhea, among those, 11 (15.5% had PCOS. There was also a positive association between amenorrhea/oligomenorrhea and the following: age under 20 OR; 2.67, 95%CI(1.47 – 4.85, weight class sports OR; 2.09, 95%CI(1.15 – 3.82, endurance sports OR; 2.89, 95%CI(1.22 – 6.84, late onset of menarche OR; 3.32 95%CI(1.04–10.51, and use of oral contraceptive pills OR; 6.17, 95%CI(3.00 – 12.69. Intensity of training sport or BMI were not risk factors. Conclusion These findings support the previous findings in the literature

  9. Study on Correlation between Neuropeptide and Functional Hypothalamic Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    陈晓燕; 吕淑兰; 曹缵孙; 毛文军; 宋青

    2001-01-01

    Objective To explore the correlation between neuropeptide and functional hypothalam ic amenorrhea (FHA)Materials & Methods The basic and GnRH-stimulated levels of serum FSH, LH and plasma β-endorphin (β-EP), somatostatin (SS) in 33 patients with FHA and 17 women with normal menstrual cycles were tested by RIA.Results β-EP level in FHA group was significantly higher than that in control group and had a negative correlation with FSH and LH. The basic SS level in FHA group had no significant difference compared with the control group, but it had negative correlation with LH and no correlation with FSH. β-EP level in FHA group decreased after being stimulated with GnRH, and reached its minimum value after 15 min, then gradually rose back to the basic level. β-EP level in control group had no regular changes. SS level in both group did not change obviously.Conclusion The increased level of β-EP may play an important role in FHA. GnRH can inhibit β-EP level to some extent, while the effect of SS on FHA deserve further research.

  10. Low leptin levels predict amenorrhea in underweight and eating disordered females.

    Science.gov (United States)

    Köpp, W; Blum, W F; von Prittwitz, S; Ziegler, A; Lübbert, H; Emons, G; Herzog, W; Herpertz, S; Deter, H C; Remschmidt, H; Hebebrand, J

    1997-07-01

    Evidence that leptin plays an important role in reproductive function is accumulating rapidly. We hypothesized that low leptin synthesis is associated with amenorrhea. We therefore determined serum leptin levels in 43 underweight female students, who were screened for lifetime occurrence of amenorrhea. We assessed the predictive value of leptin, body mass index (BMI), fat mass and percent body fat, respectively, for lifetime occurrence of amenorrea. Factors predicting amenorrhea were tested for their capability to predict current amenorrhea in a second cohort of 63 inpatients with anorexia nervosa (AN) or bulimia nervosa (BN). Furthermore, the relationships between serum leptin levels and of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol and progesterone, respectively, were evaluated. Only leptin predicted lifetime occurrence of amenorrhea in the student cohort. The critical leptin level was in the range of 1.85 micrograms L-1. This level served to largely separate anorectic from bulimic patients. In patients with AN mean serum log10 leptin levels over the first 4 weeks of inpatient treatment were correlated with mean FSH, LH and estradiol levels, respectively. Evidently, a critical leptin level is needed to maintain menstruation. In affluent populations eating disorders are likely to be a major cause of a low leptin synthesis.

  11. Amenorrhea in the Female Athlete: What to Do and When to Worry.

    Science.gov (United States)

    Berz, Kate; McCambridge, Teri

    2016-03-01

    Functional hypothalamic amenorrhea is a diagnosis of exclusion that is common in female athletes, particularly those participating in aesthetic sports (ballet, other dance genres, figure skating, and gymnastics) and endurance sports (cross-country running). Although common, it should be considered abnormal even in the high-level elite athlete. Amenorrhea in combination with low energy availability and low bone density is labeled "the Female Athlete Triad." Studies have demonstrated numerous long-term consequences of athletes suffering from all or a portion of this triad, including increased rate of musculoskeletal injuries, stress fractures, abnormal lipid profiles, endothelial dysfunction, potential irreversible bone loss, depression, anxiety, low self- esteem, and increased mortality. This article provides the clinician with the tools to evaluate an athlete with secondary amenorrhea, reviews the recommended treatment options for affected athletes, and discusses when to return to the activity in an effort to facilitate "healthy" participation.

  12. The psychobiology and diagnostic significance of amenorrhea in patients with anorexia nervosa.

    Science.gov (United States)

    Gendall, Kelly A; Joyce, Peter R; Carter, Frances A; McIntosh, Virginia V; Jordan, Jennifer; Bulik, Cynthia M

    2006-05-01

    Amenorrhea is a diagnostic criterion for anorexia nervosa (AN), although menstrual cycles have been found to persist in some women with all the other features of AN. This study sought to determine factors that are associated with amenorrhea in 39 women with current primary spectrum AN. The use of exercise to control weight (odds ratio (OR) = 3.5; 95% confidence interval (CI) = 1.3-9.9; P = .02), low novelty seeking scores (OR = 0.7; 95% CI = 0.58-0.94; P = .02), and low systolic blood pressure (OR = 0.9; 95% CI = 0.84-0.99; P = .046) were predictors of amenorrhea independent of body mass index.

  13. Progress in Diagnosis of Amenorrhea%闭经的诊断进展

    Institute of Scientific and Technical Information of China (English)

    胡琳莉(综述); 孙莹璞(审校)

    2013-01-01

    The normal menstruation depends on the intercoordination between the hypothalamus-pituitary- ovary system and the endometrium induced by ovarian hormone. Dysfunction of any aspect will result in amenorrhea,and then affect fertility. There are many causes of amenorrhea. The key of successful treatment is the clarified diagnosis. The overall diagnosis of amenorrhea should combine history,physical examination,endocrine and auxiliary examination. The most common causes of amenorrhea are hypothalamic amenorrhea,polycystic ovary syndrome,hyperprolactinemia and premature ovarian failure. This review discussed the etiological diagnosis of amenorrhea.%女性正常月经依赖于下丘脑、垂体和卵巢及其激素诱导的子宫内膜之间的相互协调作用,其中任何一个方面出现功能障碍都可能导致闭经,影响生育。引起闭经的病因众多,明确诊断闭经的病因是治疗的关键。病史、体格检查、内分泌功能检查和辅助检查相结合可对闭经进行全面诊断。临床上最常见的闭经病因为下丘脑病变、多囊卵巢综合征、高催乳素血症和卵巢衰竭,综述临床常见闭经病因的诊断进展。

  14. Hormone profile in juvenile systemic lupus erythematosus with previous or current amenorrhea.

    Science.gov (United States)

    Silva, Clovis A; Deen, Maria E J; Febrônio, Marilia V; Oliveira, Sheila K; Terreri, Maria T; Sacchetti, Silvana B; Sztajnbok, Flavio R; Marini, Roberto; Quintero, Maria V; Bica, Blanca E; Pereira, Rosa M; Bonfá, Eloisa; Ferriani, Virginia P; Robazzi, Teresa C; Magalhães, Claudia S; Hilário, Maria O

    2011-08-01

    To identify the underlying mechanism of amenorrhea in juvenile systemic lupus erythematosus (JSLE) patients, thirty-five (11.7%) JSLE patients with current or previous amenorrhea were consecutively selected among the 298 post-menarche patients followed in 12 Brazilian pediatric rheumatology centers. Pituitary gonadotrophins [follicle-stimulating hormone (FSH) and luteinizing hormone (LH)] and estradiol were evaluated in 32/35 patients, and prolactin and total testosterone in 29/35 patients. Patient's medical records were carefully reviewed according to demographic, clinical and therapeutic findings. The mean duration of amenorrhea was 7.2 ± 3.6 months. Low FSH or LH was observed in 7/32 (22%) JSLE patients and normal FSH or LH in 25 (78%). Remarkably, low levels of FSH or LH were associated with higher frequency of current amenorrhea (57% vs. 0%, P = 0.001), higher median disease activity (SLEDAI) and damage (SLICC/ACR-DI) (18 vs. 4, P = 0.011; 2 vs. 0, P = 0.037, respectively) and higher median current dose of prednisone (60 vs. 10 mg/day, P = 0.0001) compared to normal FSH or LH JSLE patients. None of them had decreased ovarian reserve and premature ovarian failure. Six of 29 (21%) patients had high levels of prolactin, and none had current amenorrhea. No correlations were observed between levels of prolactin and SLEDAI, and levels of prolactin and SLICC/ACR-DI scores (Spearman's coefficient). We have identified that amenorrhea in JSLE is associated with high dose of corticosteroids indicated for active disease due to hypothalamic-pituitary-ovary axis suppression.

  15. Secondary amenorrhea in severe Asherman's syndrome: step by step fertility retrieval by Bettocchi's hysteroscope: some considerations.

    Science.gov (United States)

    Gizzo, Salvatore; Saccardi, Carlo; Di Gangi, Stefania; Bertocco, Anna; Vendemiati, Lucia; Righetto, Lara; Patrelli, Tito Silvio; D'antona, Donato; Nardelli, Giovanni Battista

    2014-03-01

    The aim of this report was to define the best diagnostic and therapeutic approach when secondary amenorrhea is related to undiagnosed Asherman syndrome. We present a single case of secondary amenorrhea with a previous diagnosis of alterated hypothalamic-hypophysary regulation, with a component of ovarian function in probable reduction, which was evaluated in our department and resulted affected by Asherman's syndrome IV stage. We describe step by step the diagnosis and treatment of a previously misdiagnosed case of severe Asherman's syndrome. An appropriate diagnosis and adequate treatment are mandatory to allow menses and fertility to be restored when severe Asherman's syndrome occurs.

  16. A case of primary amenorrhea with 46+XY genotype from Kashmir Valley

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    Shahid Mudassir Baba

    2013-01-01

    Full Text Available Primary amenorrhea is one of the common reproductive disorder affecting females. It leads to the absence of menarche in the reproductive age group in females and/or complete absence of reproductive organs. There are many causes which lead to PA, including genetic aberrations which are the leading factors.

  17. Exercise-Associated Amenorrhea: Are Altered Leptin Levels an Early Warning Sign?

    Science.gov (United States)

    Warren, Michelle P.; Ramos, Russalind H.; Bronson, Emily M.

    2002-01-01

    Although the exact cause of the female athlete triad (amenorrhea, disordered eating, and osteoporosis) is unknown, recent research implicates leptin, a hormone secreted by adipocytes. Leptin may be an important indicator of nutritional status and may play a role in reproductive function. Physicians who develop a plan for early recognition and…

  18. Clinical research of impulse GnRH infusion treatment to a patient with central secondary amenorrhea

    Institute of Scientific and Technical Information of China (English)

    孙首悦

    2014-01-01

    Objective To apply continuous subcutaneous pulse infusion of gonadotropin-releasing hormone(GnRH)to treat patients with central secondary amenorrhea,and to observe the induction of spontaneous ovulation and natural fertilization.Methods Using micro-pulse infusion pumps with each 90-minute infusion of LHRH 10μg daily,the serum LH,FSH,estrogen,and progesterone lev-

  19. Cytogenetic and Clinical Analysis of 340 Chinese Patients with Primary Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    Hong Yu; Xun-min Bian; Jun-tao Liu; Na Hao; Jing Zhou; Shan-ying Liu

    2011-01-01

    Objective To analyze the relationship between karyotypes and clinic features of patients with primary amenorrhea.Methods G banding was done for 340 patients with primary amenorrhea to facilitate individual chromosome identification, and if specific staining for certain portions of the chromosome was necessary, C banding was used. The clinical data were recorded by physical examination and ultrasound scanmng.Results Karyotype analysis of the 340 patients revealed that 180 (52.94%) patients had normal female karyotypes and 160 (47.06%) patients had abnormal karyotypes. The abnormal karyotyp es included abnormal X chromosome (150 patients), mosaic X-Y chromosome (4 patients), abnormal autosome (5 patients), and X-autosome translocation (1 patient). The main clinical manifestations in patients with primary amenorrhea were primordial or absent uterus (95.9%), invisible secondary sex features (68.8%), little or absent ovary (62.6%), and short stature (30.0%). The incidence of short stature in patients with X chromosome aberration (46%, 69/150) was significangly higher that in patients with 46, XX (9.44%, 17/180) as well as 46, XY (6.67%, 3/45;X2=146.25, P=0.000). All primary amenorrhea patients with deletion or break-point at Xp 11.1-11.4 were short statures.Conclusions One of the main reasons of primary amenorrhea is choromosome abnormality, especially heterosome abnormality. It implies the need to routinely screen chromosomal anomalies for such patients. There might be relationship between Xp 11.1-11.4 integrity and height improvement.

  20. Incidence of Chemotherapy-Induced Amenorrhea After Adjuvant Chemotherapy With Taxane and Anthracyclines in Young Patients With Breast Cancer

    OpenAIRE

    2013-01-01

    Background Chemotherapy-induced amenorrhea is one of long term side effects of adjuvant chemotherapy in patients with breast cancer which may interfere with their future reproductive function. Although amenorrhea is well recognized, the actual incidence following taxanes remains uncertain. Methods In a cross sectional study, we identified breast cancer patients aged 45 years or younger who were treated with adjuvant anthracycline and taxane-based regimens at three different oncology departmen...

  1. Amenorrhea as a rare drug-related adverse event associated with everolimus for pancreatic neuroendocrine tumors.

    Science.gov (United States)

    Kawaguchi, Yoshiaki; Maruno, Atsuko; Kawashima, Yohei; Ito, Hiroyuki; Ogawa, Masami; Mine, Tetsuya

    2014-11-14

    The patient was an asymptomatic 43-year-old woman. Abdominal ultrasonography and enhanced computed tomography showed a tumor lesion accompanied by multiple cystic changes in the liver and the pancreatic tail. Endoscopic ultrasound-fine needle aspiration was performed on the pancreatic tumor lesion and revealed pancreatic neuroendocrine tumor (PNET). As it was unresectable due to multiple liver metastases, the decision was made to initiate treatment with everolimus and transcatheter arterial chemoembolization. The patient ceased menstruating after the start of everolimus administration. When the administration was discontinued due to interstitial lung disease, menstruation resumed, but then again stopped with everolimus resumption. An association between everolimus and amenorrhea was highly suspected. Amenorrhea occurred as a rare adverse event of everolimus. As the younger women might be included in PNETs patients, we should put this adverse event into consideration.

  2. A case report of young hypertensive with primary amenorrhea: uncommon variant of congenital adrenal hyperplasia

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    Divendu Bhushan

    2015-10-01

    Full Text Available Hypertension in young should be evaluated in detail because secondary causes are more common in this subset of patients. As on one hand it help us in treating blood pressure and its complications including stroke , coronary artery disease and renal failure, other hand we should also treat the other complications like growth, puberty and electrolyte imbalance. Here we present a case who admitted in cardiology unit with accelerated HTN and hypokalaemia, and on detailed evaluation found to have primary amenorrhea. Identification of the cause not only leads to correct hypertension with minimal drugs but she got the reason of her amenorrhea. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1642-1644

  3. Chemotherapy-related amenorrhea after adjuvant paclitaxel-trastuzumab (APT trial).

    Science.gov (United States)

    Ruddy, Kathryn J; Guo, Hao; Barry, William; Dang, Chau T; Yardley, Denise A; Moy, Beverly; Marcom, P Kelly; Albain, Kathy S; Rugo, Hope S; Ellis, Matthew J; Shapira, Iuliana; Wolff, Antonio C; Carey, Lisa A; Overmoyer, Beth A; Hudis, Clifford; Krop, Ian E; Burstein, Harold J; Winer, Eric P; Partridge, Ann H; Tolaney, Sara M

    2015-06-01

    Chemotherapy-related amenorrhea (CRA) is associated with infertility and menopausal symptoms. Learning how frequently paclitaxel and trastuzumab cause amenorrhea is important. Most other adjuvant breast cancer therapies induce CRA in approximately 50 % of all premenopausal recipients [1]. 410 patients enrolled on the APT Trial, a single-arm phase 2 adjuvant study of 12 weeks of paclitaxel and trastuzumab followed by nine months of trastuzumab monotherapy. Eligible patients had ≤3 cm node-negative HER2 + breast cancers. Premenopausal enrollees were asked to complete menstrual surveys every 3-12 months for 72 months. Women who responded to at least one survey at least 15 months after chemotherapy initiation (and who did not undergo hysterectomy and/or bilateral oophorectomy or receive ovarian suppressing medications prior to 15 months) were included in this analysis. A participant was defined as having amenorrhea in follow-up if her self-reported last menstrual period at last follow-up was greater than 12 months prior to the survey. Among the 64 women in the evaluable population (median age at study entry 44 years, range 27-52 years), the median time between chemotherapy initiation and last menstrual survey was 51 months (range 16-79). 18 of 64 women (28 %, 95 % CI 18-41 %) were amenorrheic at that time point. Amenorrhea rates among premenopausal women treated with adjuvant paclitaxel and trastuzumab for early stage breast cancer appear lower than those seen historically with standard alkylator-based breast cancer regimens. Future studies are needed to understand the impact of this regimen on related issues of fertility and menopausal symptoms.

  4. Female patient with amenorrhea as complication of radiotherapy for Hodgkin's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kock, H.C.L.V. (St. Elisabeth en Mariaziekenhuis, Tilburg (Netherlands). Afdeling Gynaecologie en Obstetrie)

    1983-07-02

    A 25 year old woman was treated for Hodgkins disease with some surgery and radiotherapy directed to para-aortal, para-illiacal and inguinal lymph nodes. Half a year after remission she presented with secondary amenorrhea which was diagnosed as complication of the radiotherapy. She also became sterile. Genetic radiation effects are discussed and an improvement in the method of treatment to avoid sterility is proposed.

  5. Mentha longifolia syrup in secondary amenorrhea: a double-blind, placebo-controlled, randomized trials

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    Mokaberinejad Roshanak

    2012-12-01

    Full Text Available Abstract Background Amenorrhea is defined as the cessation of menses. Hormone therapy is the most common treatment. Due to the contraindications and side effects of it and the increasing demand for alternative medicine substitutes, Mentha longifolia L. was used in this study. Mentha longifolia L. is a known medication in Iranian traditional medicine to induce menstrual bleeding in women with secondary amenorrhea and oligomenorrhea. Methods A double-blind, randomized, placebo-controlled, multicenter study was conducted in 120 women with secondary amenorrhea and oligomenorrhea. Treatment consisted of sequential oral syrup, 45 ml (15 ml three times a day for 2 weeks. If the patients did not have menstruation after 2 weeks of taking the medication, we would wait for two more weeks. If the patients had menstruation at each stage of using the drug, we started it one week after the end of menstruation. But if the patients had not menstruate after four weeks (two-week using of drug and waiting for two more weeks, the previous steps were repeated. The drug and placebo were repeated in three cycles of menstruation. Bleeding was documented by the patient on diary cards. The primary outcome variable was the occurrence (yes/no of bleeding during the first treatment cycle. The secondary efficacy outcome was the regularity of bleeding pattern during the three cycles of the study. Results The number of women with bleeding during the first cycle were higher in the drug group as in the placebo group (68.3% vs. 13.6%; p Mentha longifolia L. syrup. Conclusion In conclusion, Mentha longifolia L. syrup is a safe, well-tolerated, and effective choice in inducing bleeding and maintaining regular bleeding in women with secondary amenorrhea and oligomenorrhea.

  6. Serum Levels of Tryptophan, 5-Hydroxytryptophan and Serotonin in Patients Affected with Different Forms of Amenorrhea

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    S. Comai

    2010-06-01

    Full Text Available Tryptophan (Trp is present in the serum, partly bound to albumine and in the free form. The unbound portion of circulating tryptophan has the property of crossing the hematoencephalic barrier and being converted within the brain into serotonin (5-HT through the enzymatic processes of hydroxylation and decarboxylation. The serotoninergic system plays an important role in neuroendocrine control of reproductive hormone secretion, and in particular, it may influence GnRH pulsatility, a function essential for reproductive processes. In this study, we analysed serum levels of tryptophan, serotonin and 5-hydroxytryptophan (5-HTP in women with three different forms of amenorrhea: 16 patients were diagnosed with anorexia nervosa, 60 patients with functional hypothalamic amenorrhea, and 14 patients with hyperprolactinemia. Data were compared with those of a group of 25 healthy women. Serum Trp levels were significantly (P ≤ 0.05 lower in the anorexic (11.64 ± 0.53 µg/ml, mean ± S.E. than in the control (12.98 ± 0.37 µg/ml groups. In addition, in the anorexic group a statistical dispersion of Trp values was shown indicating a bimodal data distribution suggesting the existence of two different subgroups of patients. Regarding 5-HTP, an increase of its serum level was observed in all the groups with amenorrhea with the highest value in hyperprolactinemic patients. On the contrary, no statistical differences in serum 5-HT levels among the four analyzed groups were observed. This study shows that women affected by various forms of amenorrhea present an altered metabolism of tryptophan via serotonin and, in particular, markedly high differences are observed between the two subgroups of anorexic patients.

  7. FEMALE GENITAL TUBERCULOSIS AS A CAUSE OF PRIMARY AMENORRHEA IN A YOUNG UNMARRIED WOMAN.

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    Zende Prashant

    2013-05-01

    Full Text Available ABSTRACT: Primary Amenorrhea is defined as 1No periods by ag e 14 in the absence of growth or development of secondary sexual character.2No peri ods by age 16 regardless of the presence of normal growth & development with the appearance of secondary sexual characters. Incidence of Extrapulmonary TB(EPTBis increasing i n young women throughout the world. We report a case of young woman apparently having n o sings & symptoms of Tuberculosis. CASE REPORT :-18 years young female patient was referred to us as a case of Primary Amenorrhea.She had Normal secondary sexual characte rs & normal Breast Development(Tanner staging of Breast-IV.She had negative Progesterone Challenge Test (PCT.Estrogen & Progesterone Challenge Test was negative. Diagnosis of End Organ Problem was done. Diagnosis of Genital Tuberculosis was confirmed by Hysterolaparoscopy. S he was given AKT for six months. Now she has positive Progestogen Challenge Test. DISCUSSION : Hysterolaparoscopy is important investigation in a case of Primary Amenorrhea with negative Estrogen & Progesterone Challenge Test. Counseling is necessary in unmarried young wo man for Minimally Invasive procedure like Hysterolaparoscopy. Short Chemotherapy has found to useful for FGTB.

  8. Disordered eating, amenorrhea, and substance use and misuse among professional ballet dancers: Preliminary analysis

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    Mia Peric

    2016-04-01

    Full Text Available Background: Substance use and misuse (SUM, eating disorders (ED and consequent amenorrhea (AM occur frequently in professional ballet dancing. The objective of this study has been to explore the prevalence and association between ED, AM and SUM in ballet. Material and Methods: The sample comprised 21 ballet dancers, 23.1±4.5 years old, members of the professional National Ballet Ensemble from Croatia. Variables were collected by questionnaires examining SUM, occurrence of amenorrhea, and corresponding ballet-specific and socio-demographic factors (Questionnaire on Substance Use – QSU and the level of ED (Brief Eating Disorder in Athletes Questionnaire – BEDA-Q. Results: Smoking is prevalent in 40% of dancers (25% smoke on a daily basis, 36% often use analgesics, and 25% engage in binge drinking at least once a month. Smoking and binge drinking are less frequent in ballerinas with a higher academic level (r = 0.60 and r = 0.54 for binge drinking and smoking, respectively; p < 0.05. Alcohol drinking is higher among dancers who consume analgesics more often and those with a higher BEDA-Q score (r = 0.53 and r = 0.54 for analgesics and BEDA-Q, respectively; p < 0.05. Amenorrhea is more prevalent among those dancers with a higher BEDA-Q score. Women who consume nutritional supplements are less likely to use analgesics (Mann Whitney U test = 2.11; p < 0.05. Conclusions: Efforts seeking to prevent ED in ballet should target dancers who consume alcohol to a greater extent. Future studies should specifically explore the less frequent consumption of analgesics among dancers who consume nutritional supplements. Med Pr 2016;67(1:21–27

  9. A case of dyskeratosis congenita with primary amenorrhea and adenocarcinoma of stomach

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    Nandini Chakrabarti

    2011-01-01

    Full Text Available Dyskeratosis congenita (DC is a rare disease characterized by hyperpigmentation, nail dystrophy and mucous membrane abnormality. Commonly occurring in males, the patients die young usually due to bone marrow suppression. Malignancies of various descriptions have been reported in this disease, the commonest being solid tumors of head/neck (squamous cell carcinoma. We report the case of a female patient with DC, who presented to us with severe wasting and primary amenorrhea and died of carcinoma stomach in our hospital 3 weeks later.

  10. Mentha Longifolia Syrup in Secondary Amenorrhea: a Double-blind, Placebo-Controlled, Randomized Trials

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    Roshanak Mokaberinejad

    2012-12-01

    Full Text Available Amenorrhea is defined as the cessation of menses. Hormone therapy is the most common treatment. Due to the contraindications and side effects of it and the increasing demand for alternative medicine substitutes, Mentha longifolia L. was used in this study. Mentha longifolia L. is a known medication in Iranian traditional medicine to induce menstrual bleeding in women with secondary amenorrhea and oligomenorrhea.Methods A double-blind, randomized, placebo-controlled, multicenter study was conducted in 120 women with secondary amenorrhea and oligomenorrhea. Treatment consisted of sequential oral syrup, 45 ml (15 ml three times a day for 2 weeks. If the patients did not have menstruation after 2 weeks of taking the medication, we would wait for two more weeks. If the patients had menstruation at each stage of using the drug, we started it one week after the end of menstruation. But if the patients had not menstruate after four weeks (two-week using of drug and waiting for two more weeks, the previous steps were repeated. The drug and placebo were repeated in three cycles of menstruation. Bleeding was documented by the patient on diary cards. The primary outcome variable was the occurrence (yes/no of bleeding during the first treatment cycle. The secondary efficacy outcome was the regularity of bleeding pattern during the three cycles of the study.Results The number of women with bleeding during the first cycle were higher in the drug group as in the placebo group (68.3% vs. 13.6%; p < 0.001. The regularity of bleeding throughout the study was markedly better in the drug group compared with those given placebo (33.3% vs. 3.3%; p < 0.001. No notable complication or side effect was reported in relation to Mentha longifolia L. syrup.ConclusionIn conclusion, Mentha longifolia L. syrup is a safe, well-tolerated, and effective choice in inducing bleeding and maintaining regular bleeding in women with secondary amenorrhea and oligomenorrhea.

  11. Mentha longifolia syrup in secondary amenorrhea: a double-blind, placebo-controlled, randomized trials

    Science.gov (United States)

    2012-01-01

    Background Amenorrhea is defined as the cessation of menses. Hormone therapy is the most common treatment. Due to the contraindications and side effects of it and the increasing demand for alternative medicine substitutes, Mentha longifolia L. was used in this study. Mentha longifolia L. is a known medication in Iranian traditional medicine to induce menstrual bleeding in women with secondary amenorrhea and oligomenorrhea. Methods A double-blind, randomized, placebo-controlled, multicenter study was conducted in 120 women with secondary amenorrhea and oligomenorrhea. Treatment consisted of sequential oral syrup, 45 ml (15 ml three times a day) for 2 weeks. If the patients did not have menstruation after 2 weeks of taking the medication, we would wait for two more weeks. If the patients had menstruation at each stage of using the drug, we started it one week after the end of menstruation. But if the patients had not menstruate after four weeks (two-week using of drug and waiting for two more weeks), the previous steps were repeated. The drug and placebo were repeated in three cycles of menstruation. Bleeding was documented by the patient on diary cards. The primary outcome variable was the occurrence (yes/no) of bleeding during the first treatment cycle. The secondary efficacy outcome was the regularity of bleeding pattern during the three cycles of the study. Results The number of women with bleeding during the first cycle were higher in the drug group as in the placebo group (68.3% vs. 13.6%; p < 0.001). The regularity of bleeding throughout the study was markedly better in the drug group compared with those given placebo (33.3% vs. 3.3%; p < 0.001). No notable complication or side effect was reported in relation to Mentha longifolia L. syrup. Conclusion In conclusion, Mentha longifolia L. syrup is a safe, well-tolerated, and effective choice in inducing bleeding and maintaining regular bleeding in women with secondary amenorrhea and oligomenorrhea. PMID

  12. Krukenberg tumor presenting with amenorrhea as the sole initial symptom: Case report and review of the literature.

    Science.gov (United States)

    Sahin, Suleyman; Karatas, Fatih; Hacioglu, B; Aytekin, A; Imamoglu, I; Koseoglu, N; Sari, E; Altinbas, M

    2015-01-01

    Krukenberg tumor (KT), mostly originates from gastric cancer, is the metastatic tumor of ovaries accounting for 1-2% of all ovarian cancer. Common presenting symptoms include abdominal pain, distension, and ascites. Rests of the patients have non-specific gastrointestinal symptoms including dyspepsia, weight loss, nausea and vomiting. Gynecologic symptoms such as virilization, menstrual bleeding or irregularity and amenorrhea are much less frequent in the literature cases. Here, we present an unusual case of KT presented with amenorrhea as the sole initial symptom.

  13. Metformin, oral contraceptives or both to manage oligo-amenorrhea in adolescents with polycystic ovary syndrome? A clinical review.

    Science.gov (United States)

    Palomba, Stefano; Materazzo, Caterina; Falbo, Angela; Orio, Francesco; La Sala, Giovanni Battista; Sultan, Charles

    2014-05-01

    The management of oligo-amenorrhea in adolescent patients with polycystic ovary syndrome (PCOS) represents an important and difficult challenge. Metformin and/or oral contraceptives (OCs) are different strategies widely proposed in these patients. The objective of the current review was to provide an overview on the use of metformin and/or OCs for the management of oligo-amenorrhea in adolescents with PCOS underlining their potential risks and benefits in order to help the clinician to choose the best patients' tailored treatment.

  14. 浅谈闭经的中医辨证治疗%TCM Treatment of Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    李晓姝

    2015-01-01

    目的:对中医治疗闭经的疗法进行分析。方法随机选取我院2012年4月~2014年4月间收治的患有闭经的36例患者进行回顾分析。结果经过中医辨证分析及对症治疗,36例患者中有17例疗效显著,已痊愈,有16例患者有明显好转,其余3例治疗无效,总有效率为91.66%.结论采用中医疗法治疗闭经可取得良好的效果。%Objective To analyze TCM treatment for menopause therapy. Methods Our hospital between April 2012 to April 2014 in 36 patients suffering from amenorrhea were retrospectively analyzed. Results Analysis of TCM and symptomatic treatment,36 patients had a significant effect,17 cases have been recovered,16 patients had significantly improved,and three cases were ineffective,the total effective rate was 91.66%. Conclusion The use of traditional chinese medicine therapy amenorrhea can achieve good results.

  15. Deoxyribonucleic acid damage study in primary amenorrhea by comet assay and karyotyping

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    Sarah Ramamurthy

    2013-01-01

    Full Text Available Aim: This study aims at evaluating the chromosomal abnormalities and deoxyribonucleic acid (DNA damage in cases with primary amenorrhea by karyotyping and comet assay. Study Design: A total of 30 cases of primary amenorrhea were recruited. Secondary sexual characters were assessed by Tanner staging. Chromosomal analysis was performed by conventional phytohemagglutinin stimulated lymphocyte cell culture technique. Alkaline version of comet assay was used to evaluate DNA damage. Results: The chromosomal pattern of 20 subjects (66.7% was found to be normal (46,XX. Two subjects had 46,XY pattern and eight subjects had Turner syndrome (45,X or 45,X/46,XX. The comet parameters were found to be increased among subjects with 45,X monosomy, when compared to the rest of the study group and also in subjects with Tanner stage 1 when compared to stage 2. Conclusion: Comet assay revealed increased DNA damage in cases with 45,X monosomy, compared with subjects with 46,XX and 46,XY karyotype, which correlated with clinical features.

  16. [Psychogenic amenorrhea].

    Science.gov (United States)

    Lachowsky, M; Winaver, D

    2007-01-01

    Any amenorrhoea noticed outside pregnancy, lactation and menopause periods might be of organic or functional origin. Today, non organic amenorrhoea are either called hypothalamic amenorrhoea, more exactly supra hypothalamic amenorrhoea; functional amenorrhoea--this definition being characterized by its lack of any anatomic substratum; or, psychogenic amenorrhoea--an etiologic definition. Like any amenorrhoea, functional or psychogenic amenorrhoea is the consequence of either anovulation or endometrial hypotrophy. Neuroendocrine sciences do open new exciting research perspectives but other ways all the more promising since hormonal mechanics would not be the explanation. Work on the unconscious is indeed the other road leading to these psychogenic amenorrhoea. The term "psychogenic"--of psychological origin--does not mean of unknown origin, provided we recognize the strong link between psyche and soma. Treatment for this kind of amenorrhoea is twofold: medical and psychotherapeutic. Even though psychological etiology is obvious, clinical examination must be rigorous and completed by complementary exams which will guide the therapeutics. This is reassuring to the patient for the gynaecologist she chose to consult is implied, and not the psychotherapist. This reassures us too, because what we care for, as doctors, is first of all the body. Psychotherapeutic support can be provided by the general practitioner or the gynaecologist, both with psychosomatics training, but a multidisciplinary approach must often be worked out.

  17. Steroidogenic factor-1 (SF-1 gene mutation as a frequent cause of primary amenorrhea in 46,XY female adolescents with low testosterone concentration

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    Servant Nadège

    2010-03-01

    Full Text Available Abstract Background Primary amenorrhea due to 46,XY disorders of sex differentiation (DSD is a frequent reason for consultation in endocrine and gynecology clinics. Among the genetic causes of low-testosterone primary amenorrhea due to 46,XY DSD, SRY gene is reported to be frequently involved, but other genes, such as SF1 and WT1, have never been studied for their prevalence. Methods We directly sequenced SRY, SF1 and WT1 genes in 15 adolescent girls with primary amenorrhea, low testosterone concentration, and XY karyotype, to determine the prevalence of mutations. We also analyzed the LH receptor gene in patients with high LH and normal FSH concentrations. Results Among the 15 adolescents with primary amenorrhea and low testosterone concentration, we identified two new SRY mutations, five new SF1 mutations and one new LH receptor gene mutation. Our study confirms the 10-15% prevalence of SRY mutations and shows the high prevalence (33% of SF1 abnormalities in primary amenorrhea due to 46,XY DSD with low plasma testosterone concentration. Conclusions The genetic analysis of low-testosterone primary amenorrhea is complex as several factors may be involved. This work underlines the need to systematically analyze the SF1 sequence in girls with primary amenorrhea due to 46,XY DSD and low testosterone, as well as in newborns with 46,XY DSD.

  18. Amenorréia e osteoporose em adolescentes atletas Amenorrhea and osteosporosis in adolescents athletes

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    Graziela MANTOANELLI

    2002-09-01

    Full Text Available A participação feminina no esporte foi crescendo ao longo dos anos. Trabalhos científicos têm mostrado os benefícios trazidos por esta prática para a saúde da mulher, mas quando se trata de esporte competitivo podem surgir problemas. A complicação mais comum descrita pela literatura é a "tríade da atleta", a qual envolve três processos: o distúrbio alimentar, a amenorréia e a osteoporose. A amenorréia atinge, nos Estados Unidos, até 66% das atletas de competição, e algumas de suas possíveis causas são: perda de peso, excesso de treino, quantidade insuficiente de gordura corporal, perda de estoques específicos de gordura corporal e dieta inadequada. Como conseqüência da amenorréia, a esportista pode desenvolver osteoporose precoce. Não se sabe ao certo a porcentagem de atletas com osteopenia, mas há indícios de que a falta de estrógeno, a dieta inadequada e o consumo insuficiente de cálcio serem fatores que as predispõem a desenvolver a doença.The female participation in sports has been increasing over the years. Scientific studies have shown the benefits this practice brings to women's health, but, when it comes to competitive sports, problems may arise. The most common complication described by the literature is the "Female Athlete Triad", which involves three processes: the eating disorder, the amenorrhea, and the osteoporosis. In the United States, the amenorrhea afflicts up to 66% of the competition athletes, and some of its possible causes of are: weight loss, excessive training, insufficient quantity of body fat, loss of specific stores of body fat, and inadequate diet. As a consequence of the amenorrhea, the sportswoman may develop precocious osteoporosis. It is not known for sure the percentage of athletes with osteopenia, but there are indications that the lack of estrogen, the inadequate diet, and the insufficient consumption of calcium are factors predisposing them to develop the disease.

  19. [ROLE OF LEPTIN IN THE FORMATION OF SECONDARY AMENORRHEA IN ADOLESCENT GIRLS].

    Science.gov (United States)

    Levenets, S A; Nachotova, T A; Kashkalda, D A

    2015-01-01

    In order to understand the role of leptin in the formation of secondary amenorrhea (SA) during puberty, 78 girls aged from 13 to 17 years with SA and 74 girls of the same age with regular menstrual cycle have been examined with the estimation of body mass index (BMI) and hormonal/metabolic state. The obtained data show a strong connection between leptin level, BMI and parameters of energetic metabolic state (insulin; HOMA index); regression analysis results indicated the participation of leptin in steroidogenesis. Odds ratio (OR) values indicated an important role of leptin in the formation of SA during body weight deficit and normal BMI. It has been found that various clinical types of SA have different patterns of leptin influence.

  20. Hormone Use for Therapeutic Amenorrhea and Contraception During Hematopoietic Cell Transplantation.

    Science.gov (United States)

    Chang, Katherine; Merideth, Melissa A; Stratton, Pamela

    2015-10-01

    There is a growing population of women who have or will undergo hematopoietic stem cell transplant for a variety of malignant and benign conditions. Gynecologists play an important role in addressing the gynecologic and reproductive health concerns for these women throughout the transplant process. As women undergo cell transplantation, they should avoid becoming pregnant and are at risk of uterine bleeding. Thus, counseling about and implementing hormonal treatments such as gonadotropin-releasing hormone agonists, combined hormonal contraceptives, and progestin-only methods help to achieve therapeutic amenorrhea and can serve as contraception during the peritransplant period. In this commentary, we summarize the timing, risks, and benefits of the hormonal options just before, during, and for the year after hematopoietic stem cell transplantation.

  1. Heart rate variability in adolescents with functional hypothalamic amenorrhea and anorexia nervosa.

    Science.gov (United States)

    Bomba, Monica; Corbetta, Fabiola; Gambera, Alessandro; Nicosia, Franco; Bonini, Luisa; Neri, Francesca; Tremolizzo, Lucio; Nacinovich, Renata

    2014-02-28

    Aim of this study consisted in assessing the 24-h heart rate variability (HRV), a measure of autonomic nervous system (ANS) imbalance, in 21 adolescents with functional hypothalamic amenorrhea (FHA, 11 normogonadotropic, N-FHA, and 10 hypogonadotropic, Hy-FHA) compared to 21 patients with anorexia nervosa (AN) and 21 controls. As expected, subjects with AN showed a significant dysregulation in multiple HRV parameters, while Hy-FHA patients presented with a dysregulation in a few domains (SDNN, HFr), which was not present in girls with N-FHA, who showed values largely similar to controls. FHA might represent part of the AN biological spectrum, and a link between these two conditions might exist, possibly related to the degree of psychological and/or hormonal dysfunction.

  2. Amenorréia e anormalidades do cromossomo X Amenorrhea and X chromosome abnormalities

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    Rafael Fabiano Machado Rosa

    2008-10-01

    Full Text Available OBJETIVO: correlacionar as manifestações clínicas de pacientes com amenorréia e anormalidades do cromossomo X. MÉTODOS: realizou-se uma análise retrospectiva dos achados clínicos e laboratoriais das pacientes com amenorréia e anormalidades do cromossomo X, atendidas entre janeiro de 1975 e novembro de 2007. Suas medidas antropométricas foram avaliadas através de tabelas de crescimento padrão, sendo que, quando presentes, dismorfias menores e maiores foram anotadas. O estudo dos cromossomos foi realizado através do cariótipo com bandamento GTG. RESULTADOS: do total de 141 pacientes com amenorréia, 16% apresentavam anormalidades numéricas e 13% estruturais do cromossomo X. Destas pacientes com anormalidade do X (n=41, 35 possuíam descrição clínica completa. Todas elas apresentavam hipogonadismo hipergonadotrófico. Amenorréia primária foi observada em 24 pacientes, das quais 91,7% com fenótipo de síndrome de Turner. Com exceção de um caso com deleção Xq22-q28, todas as demais pacientes com este fenótipo apresentavam alterações envolvendo Xp (uma com uma linhagem 46,XY associada. Os dois casos restantes com apenas amenorréia primária possuíam deleções proximais de Xq. Entre as 11 pacientes com amenorréia secundária, 54,5% apresentavam fenótipo de Turner (todas com monossomia do X isolada ou em mosaico. Entre aquelas com fenótipo de falência ovariana isolada observaram-se somente deleções Xq e trissomia do X. CONCLUSÕES: a análise cromossômica deve sempre ser realizada em mulheres com falência ovariana de causa não conhecida, mesmo na ausência de achados dismórficos. Esta também é de extrema importância em pacientes sindrômicas, pois, além de confirmar o diagnóstico, é capaz de identificar pacientes em risco, como nos casos com uma linhagem 46,XY.PURPOSE: to correlate the clinical manifestations of patients with amenorrhea and X chromosome abnormalities. METHODS: a retrospective analysis of the

  3. 225例闭经患者染色体核型分析及临床意义%Chromosome karyotypte and clinical analyse in 225 amenorrheas

    Institute of Scientific and Technical Information of China (English)

    郑燕銮; 徐岚; 张新能

    2015-01-01

    目的:分析原发闭经和继发闭经患者的染色体异常情况并探讨其临床意义。方法抽取患者外周血培养,制备染色体,采用G显带分析。结果225例原发闭经和继发闭经患者,共检出异常核型63例,占28%。其中,原发闭经患者148例,异常核型55例,占37.16%。继发闭经患者77例,核型异常8例,占10.39%。结论染色体异常是导致原发闭经和继发闭经的主要原因,对闭经患者进行染色体检查,明确闭经原因,及早对症治疗有重要意义。%Objective To analyse the suffer′excrescent circumstance in chromosome who are primary amenorrhea or secondary amenorrhea and inquiry its clinical meaning .Methods Take out patients′peypheyal vein blood to cultuve ,the chromosome was pre‐pared ,G band was analysed .Results primary amenorrhea or secondary amenorrhea suffer totally 225 ,there were 63 with chromo‐som abnormal karyotyptes which occupies 28% ;Among 148 the patiens of primary amenorrhea ,chromosom abnormal karyotyptes were 55 examples which occupies 37 .16% ,secondary amenorrhea is 77 examples ,chromosom abnormal karyotyptes were 8 exam‐ples which occupies 10 .39% .Conclusion Chromosome abnormals are the main cause of primary amenorrhea and secondary amen‐orrhea .in patients with chromosom analyse ,to kncw the cause of amenorrhea ,early symptomatic treatment is important .

  4. Hyperandrogenism in female athletes with functional hypothalamic amenorrhea: a distinct phenotype

    Directory of Open Access Journals (Sweden)

    Javed A

    2015-01-01

    Full Text Available Asma Javed,1 Rahul Kashyap,2 Aida N Lteif1 1Pediatric and Adolescent Medicine, Division of Pediatric Endocrinology Mayo Clinic, Rochester, MN, USA; 2Department of Anesthesia and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA Objective: To compare the reproductive, metabolic, and skeletal profiles of young athletic women with functional hypothalamic amenorrhea (FHA as well as clinical or biochemical hyperandrogenism (FHA-EX+HA with body mass index matched women with FHA due to exercise (FHA-EX or anorexia nervosa (FHA-AN alone.Design: Retrospective cohort study.Setting: Tertiary care teaching hospital.Population: Adolescents and young women, 15–30 years of age, diagnosed with FHA along with concurrent signs of hyperandrogenism (n=22 and body mass index matched control groups consisting of 22 women in each group of FHA-EX and FHA-AN. Main outcomes: 1 Reproductive hormone profile: luteinizing hormone (LH, follicle stimulating hormone (FSH, total testosterone, pelvic ultrasound features. 2 Metabolic function and skeletal health markers: fasting glucose, cholesterol, number of stress fractures and bone mineral density as assessed by spine dual-energy X-ray absorptiometry z scores. Results: FHA-EX+HA group was older at diagnosis compared to the other groups with a median (interquartile range [IQR] age of 22 (18.75–25.25 years versus (vs 17.5 (15.75–19 for FHA-EX; (P<0.01 and 18 (16–22.25 years for FHA-AN (P=0.01. There were no differences among the groups based on number of hours of exercise per week, type of physical activity or duration of amenorrhea. Median (IQR LH/FSH ratio was higher in FHA-EX+HA than both other groups, 1.44 (1.03–1.77 vs 0.50 (0.20–0.94 for FHA-EX and 0.67 (0.51–0.87 for FHA-AN (P<0.01 for both. Total testosterone concentrations were not different among the groups. Median (IQR fasting serum glucose concentration was higher in FHA-EX+HA vs FHA-EX, 88.5 mg/dL (82.8–90 mg/dL vs 83.5 mg/dL (78.8–86.3 mg

  5. Age, anti-müllerian hormone, antral follicles count to predict amenorrhea or oligomenorrhea after chemotherapy with cyclophosphamide

    OpenAIRE

    2015-01-01

    Background A cohort study was performed to identify ovarian reserve markers (ORM) that predicts amenorrhea or oligomenorrhea 6 months after cyclophosphamide CTX in women with breast cancer. Methods 52 eumenorrheic patients with breast cancer were enrolled. FSH, anti-Müllerian hormone (AMH), antral follicles count (AFC) were measured before and 6 months after CTX. A logistic regression for independent samples and determination of the ROC curve were performed. Results The age of 32 years presen...

  6. Function and innervation of the locus ceruleus in a macaque model of Functional Hypothalamic Amenorrhea.

    Science.gov (United States)

    Bethea, Cynthia L; Kim, Aaron; Cameron, Judy L

    2013-02-01

    A body of knowledge implicates an increase in output from the locus ceruleus (LC) during stress. We questioned the innervation and function of the LC in our macaque model of Functional Hypothalamic Amenorrhea, also known as Stress-Induced Amenorrhea. Cohorts of macaques were initially characterized as highly stress resilient (HSR) or stress-sensitive (SS) based upon the presence or absence of ovulation during a protocol involving 2 menstrual cycles with psychosocial and metabolic stress. Afterwards, the animals were rested until normal menstrual cycles resumed and then euthanized on day 5 of a new menstrual cycle [a] in the absence of further stress; or [b] after 5 days of resumed psychosocial and metabolic stress. In this study, parameters of the LC were examined in HSR and SS animals in the presence and absence of stress (2×2 block design) using ICC and image analysis. Tyrosine hydroxylase (TH) is the rate-limiting enzyme for the synthesis of catecholamines; and the TH level was used to assess by inference, NE output. The pixel area of TH-positive dendrites extending outside the medial border of the LC was significantly increased by stress to a similar degree in both HSR and SS animals (p<0.0001). There is a significant CRF innervation of the LC. The positive pixel area of CRF boutons, lateral to the LC, was higher in SS than HSR animals in the absence of stress. Five days of moderate stress significantly increased the CRF-positive bouton pixel area in the HSR group (p<0.02), but not in the SS group. There is also a significant serotonin innervation of the LC. A marked increase in medial serotonin dendrite swelling and beading was observed in the SS+stress group, which may be a consequence of excitotoxicity. The dendrite beading interfered with analysis of axonal boutons. However, at one anatomical level, the serotonin-positive bouton area was obtained between the LC and the superior cerebellar peduncle. Serotonin-positive bouton pixel area was significantly

  7. Tripterygium glycosides-induced amenorrhea%雷公藤多苷致闭经

    Institute of Scientific and Technical Information of China (English)

    路敏; 周颖; 崔一民; 白文佩

    2014-01-01

    A 41-year-old female patient received tripterygium glycosides 20 mg thrice daily, prednisone 20 mg once daily,valsartan 80 mg once daily,amlodipine besylate 5 mg once daily,calcium carbonate 750 mg thrice daily and calcitriol 0. 25 μg once daily for glomerulonephritis and renal hypertension. Tripterygium glycosides and prednisone had to discontinue because the patients developed amenorrhea about one month after the therapy,and amenorrhea has lasted for five months. The sex hormone levels were measured as follows:luteinizing hormone 29 U/L,follicle-stimulating hormone 7 U/L,estradiol 1 168 pmol/L,prolactin 0. 02 nmol/L,testosterone 0. 12 nmol/L;progesterone 1. 5 nmol/L. Hormone replacement therapy with dydrogesterone 10 mg twice daily for 10 days was given. Her menstruation started on day 4 after dydrogesterone discontinuation and lasted for 5 days. The regular menstrual cycle has been restored.%1例41岁女性患者因肾小球肾炎、肾性高血压给予雷公藤多苷(20 mg,3次/d)、泼尼松(20 mg,1次/d)、缬沙坦(80 mg,1次/d)、苯磺酸氨氯地平(5 mg,1次/d)、碳酸钙(750 mg,3次/d)和骨化三醇(0.25μg,1次/d)口服。治疗1个多月后,患者因月经未来潮停用雷公藤多苷和泼尼松,但停药后月经仍未来潮,共闭经5个月。性激素检查:黄体生成激素29 U/L;卵泡刺激素7 U/L;雌二醇1168 pmol/L;催乳激素0.02 nmol/L;睾酮0.12 nmol/L;孕酮1.5 nmol/L。给予性激素地屈孕酮10 mg,2次/d口服治疗,连用10 d。停用地屈孕酮后第4天月经来潮,持续5 d。此后患者恢复正常月经周期。

  8. A 15-year-old female with amenorrhea, abdominal distention, and elevated human chorionic gonadotropin: pregnancy, right? Not so fast….

    Science.gov (United States)

    Aggarwal, Arun; Ocon, Anthony J; Nibhanipudi, Kumara

    2012-10-01

    Nongestational choriocarcinoma, a rare ovarian tumor, may present in young women with amenorrhea, abdominal distention, and elevated urine human chorionic gonadotropin (hCG), all of which may be mistaken for pregnancy. A 15-year-old Hispanic female, who reported no sexual activity, presented with 6 months of amenorrhea, abdominal pain, and progressive abdominal distension. Initially, suspicion of pregnancy was considered. Physical examination was significant for abdominal distension, but no uterine fundus or fetal anatomy could be palpated, and auscultation did not reveal any fetal heart sounds or bruits. Laboratory values showed elevated urine hCG, cancer antigen 125, and cancer antigen 19.9 levels but normal serum hCG level and was inconsistent with pregnancy. Computed tomographic scans revealed a large abdominal heterogeneous mass and pleural effusions. Salpingo-oophorectomy with total omentectomy and inversion appendectomy removed a 21 × 20.5 × 16.5-cm tumor. Pathological testing determined it to be a nongestational choriocarcinoma. This rare tumor is more common in the pediatric adolescent population than in adults. Surgical resection and chemotherapy often result in a positive prognosis. In female adolescent patients presenting with elevated hCG level, amenorrhea, and abdominal distention, choriocarcinoma should be considered, especially in those with no history of sexual activity or before menarche.

  9. The influence of estrogen therapies on bone mineral density in premenopausal women with anorexia nervosa and amenorrhea.

    Science.gov (United States)

    Lebow, Jocelyn; Sim, Leslie

    2013-01-01

    Low bone mineral density is one of the primary risks of chronic amenorrhea, and the effects of potentially long-term menstrual disruption on bone mass are serious concerns for individuals with a past or current anorexia nervosa (AN) diagnosis. As such, estrogen therapies are frequently used to address amenorrhea associated with AN. A systematic review of the literature was conducted to examine the effectiveness of estrogen therapies on bone mineral density in women with amenorrhea. Data regarding the effectiveness of oral contraceptives were of low quality and mixed, with the majority of studies finding no benefit of these treatments on bone mineral density. Hormone replacement therapy findings were also mixed, though promising results were found in a study comparing transdermal administration of physiologic estrogen, delivered in developmentally sensitive incremental doses to placebo controls. Though this study suggests a possible role for estrogen therapies in addressing bone density loss in women with AN, in general, more studies are needed. Clinical drawbacks of using these therapies in the treatment of AN, including the loss of menses resumption as a clinical marker for weight and nutritional rehabilitation, must be considered in the decision to use estrogen therapies, particularly given the uncertain effectiveness of most of these treatments.

  10. Multiple endocrine adenomatosis with Cushing's disease and the amenorrhea-galactorrhea syndrome responsive to proton beam irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Veseley, D.L.; Fass, F.H.

    1981-09-01

    Multiple endocrine adenomatosis (MEA) or neoplasia is a hereditary disorder consisting of tumors of hyperplasia of several endocrine glands. In MEA-1 the pituitary, parathyroids, and pancreatic islets are most frequently involved, while in MEA-2 the thyroid (medullary carcinoma of the thyroid), parathyroids,and adrenals (pheochromocytomas) are the endocrine glands most likely to be involved. Cushings's syndrome may occur in MEA-1 and has also been found in patients with MEA-2, where the cause of Cushing's syndrome is usually ectopic ACTH production from medullary carcinoma of the thyroid. Recently, there have been reports of amenorrhea-galactorrhea syndrome in patients with MEA-1, and confirmation that hyperprolactinemia is associated with this syndrom has been found in patients with MEA-1. The present report details a patient who has been followed up for 20 years since she first presented with amenorrhea and galactorrhea. Ten years after first being seen she was noted to have Cushing's syndrom and hyperparathyroidism due to parathyroid hyperplasia. Both the amenorrhea-galactorrhea syndrome and Cushing's sydrome disappeared with proton beam irradiation to the pituitary.

  11. 17-Alpha Hydroxylase Deficiency: A Rare Case of Primary Amenorrhea and Hypertension

    Directory of Open Access Journals (Sweden)

    Yasin Şimşek

    2014-12-01

    Full Text Available 17-alpha hydroxylase deficiency (17OHD is an uncommon cause of congenital adrenal hyperplasia (CAH resulting from mutation in the CYP17 gene. It is an autosomal recessive disease leading to the deficiency of enzyme activity which results in impaired synthesis of cortisol, androgen and sex steroids. A 35-year-old woman was admitted to the hospital with hypokalemia, weakness, and fatigue. Medical history revealed two attempts of in vitro fertilization (IVF without achieving pregnancy. Laboratory evaluation showed hypokalemia, hypocortisolemia, hypergonadotropic hypogonadism and increased levels of 11-deoxycorticosterone. Her karyotype was 46XX. The patient had no history of menarche. She had Tanner stage 2 breast development. Genotyping showed homozygous mutation located in exon 7 which abolishes both 17-alpha hydroxylase and 17,20 lyase activities of the CYP17A1 protein. After starting dexamethasone 0.5 mg/day, her potassium level was normalized, and blood pressure improved. In conclusion, a comprehensive evaluation should be performed before using assisted reproductive techniques, such as in vitro fertilization in hypertensive women with sexual infantilism, primary amenorrhea, and hypokalemia.

  12. Chemotherapy-induced amenorrhea: a prospective study of brain activation changes and neurocognitive correlates.

    Science.gov (United States)

    Conroy, Susan K; McDonald, Brenna C; Ahles, Tim A; West, John D; Saykin, Andrew J

    2013-12-01

    Chemotherapy-induced amenorrhea (CIA) often occurs in pre- and peri-menopausal BC patients, and while cancer/chemotherapy and abrupt estrogen loss have separately been shown to affect cognition and brain function, studies of the cognitive effects of CIA are equivocal, and its effects on brain function are unknown. Functional MRI (fMRI) during a working memory task was used to prospectively assess the pattern of brain activation and deactivation prior to and 1 month after chemotherapy in BC patients who experienced CIA (n = 9), post-menopausal BC patients undergoing chemotherapy (n = 9), and pre- and post-menopausal healthy controls (n = 6 each). Neurocognitive testing was also performed at both time points. Repeated measures general linear models were used to assess statistical significance, and age was a covariate in all analyses. We observed a group-by-time interaction in the combined magnitudes of brain activation and deactivation (p = 0.006): the CIA group increased in magnitude from baseline to post-treatment while other groups maintained similar levels over time. Further, the change in brain activity magnitude in CIA was strongly correlated with change in processing speed neurocognitive testing score (r = 0.837 p = 0.005), suggesting this increase in brain activity reflects effective cognitive compensation. Our results demonstrate prospectively that the pattern of change in brain activity from pre- to post-chemotherapy varies according to pre-treatment menopausal status. Cognitive correlates add to the potential clinical significance of these findings. These findings have implications for risk appraisal and development of prevention or treatment strategies for cognitive changes in CIA.

  13. 73 cases of primary amenorrhea etiology cytogenetic%73例原发性闭经患者细胞遗传学病因分析

    Institute of Scientific and Technical Information of China (English)

    史彩虹; 刘芳; 周友泉; 王厚照

    2011-01-01

    Objective: Xiamen patients with primary amenorrhea and the main features of cytogenetic abnormalities of the sex chromosomes influence gonad development. Methods: 73 patients with primary amenorrhea patients after routine gynecological examination, B - and endocrine function tests, the use of peripheral blood lymphocyte culture for cytogenetic analysis. Results; Of 73 cases detected in patients with primary amenorrhea, normal karyotype of chromosome 52 cases, accounting for 71. 2% , abnormal karyotypes in 21 cases, 28. 8% , including the number of sex chromosomes, structural abnormalities, and chimeras. Conclusion: Chromosomal abnormalities are the main causes of primary amenorrhea, and amenorrhea in patients with chromosome, a clear cause amenorrhea, early symptomatic treatment is important.%目的 探讨厦门地区原发性闭经患者细胞遗传学的主要特征及性染色体异常对性腺发育的影响.方法 73例原发性闭经患者经常规妇科检查、B超及内分泌功能检查后,采用外周血淋巴细胞培养进行细胞遗传学分析.结果 73例原发性闭经患者中检出染色体正常核型52例,占71.2%,异常核型21例,占28.8%,包括性染色体数目、结构异常及嵌合体.结论 染色体异常是导致原发性闭经的主要原因,对闭经患者进行染色体检查,明确闭经原因,及早对症治疗有重要意义.

  14. Deletion of 7q34-q36.2 in two siblings with mental retardation, language delay, primary amenorrhea, and dysmorphic features

    DEFF Research Database (Denmark)

    Sehested, Line T; Møller, Rikke S; Bache, Iben

    2010-01-01

    and neuropsychiatric disorders including mental retardation, language delay and epilepsy. The sister had primary amenorrhea. Array CGH revealed a 12.2¿Mb deletion at 7q34-q36.2 including more than 60 genes where CNTNAP2 and NOBOX are of special interest. Comparison of the clinical and cytogenetic findings of our...... patients with previously reported patients, supports that haploinsuffiency of CNTNAP2 can result in language delay and/or autism spectrum disorder. Furthermore, we report on the second women with a deletion involving NOBOX who is affected by primary amenorrhea....

  15. What lies behind chemotherapy-induced amenorrhea for breast cancer patients: a meta-analysis.

    Science.gov (United States)

    Zhao, Jianli; Liu, Jieqiong; Chen, Kai; Li, Shunrong; Wang, Ying; Yang, Yaping; Deng, Heran; Jia, Weijuan; Rao, Nanyan; Liu, Qiang; Su, Fengxi

    2014-05-01

    To evaluate the incidence of chemotherapy-induced amenorrhea (CIA) and its therapeutic impact in premenopausal breast cancer patients. A systematic search was performed to identify clinical studies that compared the incidence of CIA with different chemotherapy regimens and oncological outcomes with and without CIA. The fixed-effects and random-effects models were used to assess the pooled estimates. Heterogeneity and sensitivity analyses were performed to explore heterogeneity among studies and to assess the effects of study quality. A total of 15,916 premenopausal breast cancer patients from 46 studies were included. The cyclophosphamide-based regimens, taxane-based regimens, and anthracycline/epirubicin-based regimens all increased the incidence of CIA with pooled odds ratios of 2.25 (95 % CI 1.26-4.03, P = 0.006), 1.26 (95 % CI 1.11-1.43, P = 0.0003) and 1.39 (95 % CI 1.15-1.70, P = 0.0008), respectively. The three-drug combination regimens of cyclophosphamide,anthracycline/epirubicin, and taxanes (CAT/CET) caused the highest rate of CIA compared with the other three drug combinations (OR 1.41, 95 % CI 1.16-1.73, P = 0.0008). Tamoxifen therapy was also correlated with a higher incidence of CIA, with an OR of 1.48. Patients with CIA were found to exhibit better disease-free survival (DFS) and overall survival (OS) compared with patients without CIA. With respect to molecular subtype, this DFS advantage remained significant in hormone-sensitive patients (HR 0.61, 95 % CI 0.52-0.72, P < 0.00001). The current meta-analysis has demonstrated that anthracycline/epirubicin, taxanes, cyclophosphamide, and tamoxifen all contributed to elevated rates of CIA, and CIA was not merely a side effect of chemotherapy but was a better prognostic marker, particularly for ER-positive premenopausal early-stage breast cancer patients. However, this topic merits further randomized control studies to detect the associations between CIA and patient prognosis after adjusting for age, ER

  16. A rare case of ovarian granulosa cell tumour in an adolescent girl with secondary amenorrhea and virilisation

    Directory of Open Access Journals (Sweden)

    Arun Nayak

    2015-10-01

    Full Text Available Sex cord stromal ovarian tumors account for about 5-8% of all ovarian malignancies. Granulosa cell tumor is an estrogen secreting low grade malignant tumor and is seen in women of all ages with 2% bilaterality. Based upon histology, these neoplasms can be classified as adult and juvenile Granulosa cell tumors. Pre-pubertal lesions present clinically with sexual pseudo precocity whereas post-pubertal lesions present with menstrual irregularities or secondary amenorrhea or postmenopausal bleeding. This case report presents a rare case of Granulosa cell tumor with clinical presentation mimicking virilizing ovarian neoplasm in a 19 year old girl with history of abdominal swelling, secondary amenorrhea and virilization since one year duration. Clinical examination revealed a 20-22 weeks size abdominal mass, cystic in consistency, arising from pelvis and CT scan suggested presence of mucinous cystadenoma with solid areas with suspected malignancy. Exploratory laparotomy with right salpingo-oophorectomy was performed with staging as tumor was found confined to ovary with no involvement of other ovary or any other pelvic organ or peritoneum. Therefore, disease was staged as stage 1A. Histopathological examination confirmed the presence of Granulosa cell tumor with fibrothecomatous areas. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1653-1656

  17. MUSCULAR OXIDATIVE CAPACITY IN OVARIECTOMIZED RATS DISCUSSION ON THE ENDURANCE PERFORMANCE OF FEMALE ATHLETES WITH SPORTS-RELATED-AMENORRHEA

    Directory of Open Access Journals (Sweden)

    Natsuo Yasui

    2004-11-01

    Full Text Available The purpose of this study was to evaluate the effects of ovariectomy on intramuscular energy metabolism in adult rats. Based on the results, we discussed the skeletal muscle metabolism in female athlete with sports related amenorrhea. Twenty-five adult (20-week-old Sprague-Dawley female rats were used. Fifteen rats underwent ovariectomy (OVX group, and the other ten rats were sham-operated (Sham group. One and four weeks after surgery, muscular oxidative capacity was measured using 31P-MR spectra of the gastrocnemius-plantaris-soleus (GPS muscles group at rest and during electric stimulation. Wet weight and maximum tension of the whole GPS muscles group were also measured. From the MRS measurements, the muscle oxidative capacity in the OVX group was significantly lower than that in the Sham group (p < 0.05 at both one and four weeks after surgery. The muscle's wet weight one week after surgery in the OVX group was the same as the Sham group, while four weeks after surgery it was significantly greater than that in the Sham group (p < 0.05. There were no significant differences in maximum tension among the groups. In conclusion, in adult rats the oxidative capacity decreased due to ovariectomy despite the increase in muscle weight. It is suggested that the muscular endurance capacity in female adult athletes with sports related amenorrhea may deteriorate.

  18. Cytogenetics studies of 468 patients with primary amenorrhea%468例原发性闭经患者细胞遗传学分析

    Institute of Scientific and Technical Information of China (English)

    禹虹; 边旭明; 刘俊涛; 郝娜; 周京; 刘善英

    2011-01-01

    目的 分析原发性闭经患者染色体细胞核型与临床特征的关系.方法 原发闭经患者行外周血淋巴细胞培养,常规G显带染色体核型分析(必要时行C显带).结果 468例原发闭经患者中46,XX核型为255例(54.49%),41种异常核型213例(45.51%),包括X染色体异常143例、X-Y染色体异常4例、46,XY女性57例、常染色体异常8例、X-常染色体易位1例.75.52%身材矮小原发闭经患者X染色体异常,Xp11.1-11.4与Xp21-22缺失或断裂的患者均出现身材矮小.结论 人类细胞染色体异常是原发闭经的重要原因之一,应常规行细胞遗传学检查.临床表型与染色体特殊部位有一定关系,Xp11.1-11.4与Xp21-22可能与身高发育有关.%Objective To analyze the relationship between karyotypes and clinic features of patients with primary amenorrhea. Method Karyotype analysis of patients with primary amenorrhea was performed by using G-banding technique. Results Karyotype analysis of 468 patients with primary amenorrhea revealed that 255 patients (54. 49% ) had normal female karyotypes and 213 patients (45.51%) had abnormal karyotypes, including 143 patients with abnormal X chromosome, 4 patients with mosaic X -Y chromosome, 57 patients with 46, XY karyotype, 8 patients with abnormal autosome and one patient with Xautosome translocation. 75.52% primary amenorrhea patients with short stature had abnormal X chromosome, and all primary amenorrhea patients with deletion or break-up of Xp11. 1 - 11.4 and Xp21 - 22 were short statures. Conclusion One of the main reasons of primary amenorrhea was chromosome abnormity,especial heterosome abnormity. Karyotype analysis should be used to detect primary amenorrhea patients in regular. There might be relationship between height improvement and the abnormity of Xp11. 1 - 11.4 and Xp21 - 22.

  19. 浅谈针灸治疗运动性闭经%Discuss the Treatment of Athletic Secondary Amenorrhea by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    彭举华

    2013-01-01

      目的:对目前女性,尤其是年轻的女运动员出现的越来越多的运动性闭经现象进行调查与分析,根据其临床特点及诊治过程进行研究分析,为运动性闭经的治疗提供经验和方法。方法:我们可以使用中医针灸的治疗方法来治疗运动性闭经。结果:临床试验的经验表明,针灸疗法在治疗运动性闭经方面具有可观的效果。结论:我们了解到运动性闭经的症状主要会在女运动员中出现较多,她们参加较多的体育训练或者是各种比赛,在高强度大运动量的训练或比赛后,运动员容易出现精神过度紧张、内分泌失调等症状,这些都与运动性闭经的产生原因有关。因此,通过研究,我们可以运用针灸疗法来对运动性闭经进行有效的治疗。%Objective:To investigate and analyze the phenomenon of more and more athletic sec-ondary amenorrhea had happened in groups of young female athletes, and try to offer some experi-ence and methods of treatment of athletic secondary amenorrhea, according to the research on clini-cal features and diagnosis and treatment process. Methods: We can treat the athletic secondary amenorrhea using the acupuncture. Results:The clinical trial experience has shown that it would be effective by using the acupuncture therapy in treating the athletic secondary amenorrhea. Conclu-sion:We know that the symptoms of athletic secondary amenorrhea prefer to happen to groups of fe-male athletes, they ofter participate a variety of training or games, after the high-intensity training and games, athletes would more easily develop symptoms like excessive psychological stress and endocrine dyscrasia, which all related to the cause of athletic secondary amenorrhea. Therefore, through the research, we can use acupuncture therapy to treat athletic secondary amenorrhea.

  20. 人工流产术后闭经的病因学分析%Etiology of Artificial amenorrhea after abortion

    Institute of Scientific and Technical Information of China (English)

    杨家容; 刘敏; 龙文娟

    2015-01-01

    Objective To analyze the risk factors amenorrhea after abortion, and discuss abortion prevention countermeasure amenorrhea. Methods A hospital in April 2013 May 2014 patients undergoing artificial abortion after 94 cases of amenorrhea observation group, the election period selected lines into my clinical abortion complications did not occur in the control group of women to 120 cases retrospectively analyzed two groups of patients with general information for statistical analysis and comparison, laboratory tests comparing two groups of patients.Results The results showed that hysteroscopy half of the total test results of the cervix and cervical synechia,no abnormal cervical highest proportion. Observation group compared with the control group of patients, ovulation, E2 and FSH levels and LH levels were statistically significant. Conclusion Ovarian function, prolactin levels, levels of hypothalamic function can significantly affect the probability of amenorrhea after artificial abortion, and therefore need to adjust prolactin levels before and after surgery, to improve ovarian function, and hypothalamus state.%目的:对人工流产术后发生闭经的原因进行病因学分析,并探讨人工流产后预防闭经对策。方法选取我院2013年4月~2014年4月进行人工流产术后发生闭经的患者94例为观察组,选同期入我院行人工流产术未发生并发症女性120例为对照组,对其临床资料进行回顾性分析,对两组患者一般资料进行统计学分析,对比两组患者的实验室检查结果。结果宫腔镜检查结果表明宫颈内口和宫颈黏连的约占总检查结果的一半,宫颈内未见异常的所占比例最高。观察组与对照组相比,有无排卵,雌二醇(E2)和促卵泡生长激素(FSH)水平及黄体生成素(LH)的水平均有统计学差异。结论卵巢功能,催乳素水平,丘脑功能水平均能显著影响人工流产术后发生闭经的概率,因此

  1. New method for the induction of therapeutic amenorrhea: low dose endometrial afterloading irradiation. Clinical and hormonal studies

    Energy Technology Data Exchange (ETDEWEB)

    Gronroos, M.; Turunen, T.; Raekallio, J.; Ruotsalinen, P.; Salmi, T. (Turku Univ. (Finland). Dept. of Obstetrics and Gynecology)

    1982-08-01

    The authors present a new method for the induction of therapeutic amenorrhea: low dose endometrial afterloading irradiation. The problem with this method has been how to inactivate the endometrium while maintaining the physiological function of the ovaries. In 5/29 young patients regular or irregular bleedings occurred after an endometrial dose of 11+-1 Gy. These subjects were given a repeat low dose intrauterine irradiation. Thereafter no bleedings were found in four out of five patients. Two to 9 years after the repeat irradiation the plasma levels of E/sub 1/, E/sub 2/, FSH and LH corresponded closely to those of healthy women in reproductive age in three out of five patients; some high plasma P levels indicated ovulation. In two patients the E/sub 1/, E/sub 2/, and P values were more likely postmenopausal but, on the other hand, FSH and LH values reproductive ones. 19 refs.

  2. 穴位埋线疗法配合闭经汤治疗继发性闭经的临床疗效%The Clinical Curative Effect of Acupoint Catgut Embedding Therapy Combined With Amenorrhea Decoction in the Treatment of Secondary Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    陈丽; 武永飞

    2016-01-01

    Objective To delve into acupuncture points embedded wire with amenorrhea soup treatment the clinical effect of secondary amenorrhea. Methods 80 cases of secondary amenorrhea patients in our hospital from September 2014 to October 2015 were chosen as the research object, 80 patients were randomly divided into observation group and control group, 40 cases in each group, the control group using amenorrhea decoction treatment, the observation group combined with acupoint catgut embedding therapy.Results Compared with the control group the observation groupwas better than the control group (P<0.05), the difference was statistically significant.Conclusion In the treatment of patients with secondary amenorrhea, the use of acupuncture point bury line and amenorrhea soup combined treatment the overall effect is better.%目的:深入探讨穴位埋线配合闭经汤治疗继发性闭经的临床效果。方法选取我院2014年9月~2015年10月收治的80例继发性闭经患者为研究对象,随机将80例患者分为观察组和对照组,每组各40例;对照组采用闭经汤治疗,观察组联合穴位埋线治疗。结果治疗有效率比较,观察组优于对照组(P<0.05),差异有统计学意义。结论在继发性闭经患者的治疗中,采用穴位埋线和闭经汤联合治疗整体效果较好。

  3. The clinical features of patients with amenorrhea after induced abortion%人工流产术后闭经的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    曾华; 陈志

    2011-01-01

    目的:分析人工流产术后并发闭经患者的临床特点.方法:回顾性分析我院近5年来人工流产术后并发闭经患者的临床资料,记录性激素检查情况、宫腔镜检查结果、以及诊断性刮宫病理学检查结果,同时记录其治疗预后.结果:5年来我院共发生人流后闭经37例,占总人流患者的1.4%.发生距人流时间2-16个月,闭经时间2-5个月.人流次数越多,越易发生(x2=13.440,p=0.001);是否生产和术后闭经无关(x才=0.037,P=0.847).性激素检查显示卵巢早衰者或下丘脑功能失调性闭经共8例(21.6%).宫腔镜检查显示宫颈内口粘连11例(29.7%),宫腔粘连18例(48.6%).刮出物中有炎性细胞浸润者占64.0%.经过积极治疗,35例患者恢复周期,另2例效果不佳.结论:人工流产术可能导致一定的术后闭经并发症发生;宫颈内口和宫腔粘连以及性激素异常是造成术后闭经的主要原因,而炎症反应在其中也可能起到一定的作用;人工流产术后闭经治疗预后尚可.%Objective: To analyze the clinical characteristics of patients with amenorrhea after induced abortion. Methods: The patients with amenorrhea after induced abortion in our hospital of the past 5 years were analyzed retrospectively. Some characteristics of the patients were recorded, including sex hormone level, results of hysteroscopy, diagnostic curettage pathological Results ,as well as prognosis.Results: A total of 37 patients (1.4%) suffered amenorrhea 2 to 16 months after induced abortion, which sustained for 2 to 5 months. The occurrence of amenorrhea was positively related to the frequeney of induced abortion (x2 = 13.440, P = 0.001 ), but had nothing to do with delivery (x2 = 0.037, P = 0.847). Sex hormone level revealed premature ovarian failure or hypothalamic amenorrhea dysfunction in 8 patients (21.6%). Hysteroscopic examination revealed 11 patients had cervical adhesions (29.7%), and 18 patients had intrauterine adhesions (48.6

  4. A investigation in psychiatric outpatients with amenorrhea induced by antipsychotics%精神科门诊患者药源性闭经调查

    Institute of Scientific and Technical Information of China (English)

    罗维肖; 刘姝婷; 甘少兵; 覃宇; 谭健能

    2011-01-01

    Objective:To investigate the incidence of amenorrhea induced by antipsychotics and the related factors in female schizophrenia. Method :374 outpatients with schizophrenia taking antipsychotics were investigated by serf-made questionnaire. Results: Among the 374 outpatients, amenorrhea and galactorrhoea were reported by 99 and 31 patients, respectively, with amenorrhea incidence 26.5% and the incidence of amenorrhea companying with galactorrhoea 8.3%. The incidence of amenorrhea were 57.9% for combined antipsychotics use, which was the hi.est one and, 35.6% for sulpiride and 2.5.7% for risperidone which was the first and the second highest one for single antipaychotics use. The occurrence of amenorrhea induced by antipsychotics were not related to age, marriage, education level, illness course, time of medicine-taking, amounts of medicine-taking. The female schizophrenia who hadn't given birth to a child had the significantly higher incidence of amenorrhea compared with those female schizophrenia who had given birth to a child 69.7% vs 53.8% (P <0.01 ). Conclusion: Amenorrhea is very prevalent among patients with schizophrenia on antipaychotic medications. The therapeutic strategy for female schizophrenia is needed to avoid choosing sulpiride and risperidone in the long-term treatment; moreover, antipsychotic polypharmacy should be used as low as possible, espocially for those without reproduction.%目的:调查各种抗精神病药所致女性患者闭经的发生率及相关因素.方法:用自制调查表对门诊374例复诊的女性精神分裂症患者进行调查.结果:374例服用抗精神病药的女性患者中,99例出现闭经,发生率为26.5%;31例出现泌乳,闭经伴泌乳发生率为8.3%.闭经在联合用药中的发生率最高(57.9%),单一用药中闭经发生率最高的是舒必利(35.6%),其次是利培酮(25.7%).药源性闭经的发生与年龄、病程、服药时间、药量、学历、婚否等因素无关(P>0.05).

  5. 闭经患者细胞遗传学检查的临床意义%The analysis of cytogenetic abnormalities for patients with amenorrhea

    Institute of Scientific and Technical Information of China (English)

    杨瑞芳; 王明毅; 王济周

    2001-01-01

    目的:分析闭经患者细胞遗传学的检查结果及其临床意义。方法:对每例闭经患者进行常规妇科检查及细胞遗传学检查,包括外周血淋巴细胞培养制备染色体,G显带与C显带,必要时进行高分辨显带或银染处理,或同时用内分泌及超声检查。结果:233例闭经患者中,88例染色体异常,占37.78%,包括染色体数异常、缺失、倒位及嵌合。结论:染色体异常是闭经的主要原因之一,染色体核型分析对确诊闭经的病因、治疗及确定预后必不可少。%Objective: To analyse the cytogenetic examinations and their clinical significance for patients with amenorrhea. Methods: The routing gynecologic examination and cytogenetics were performed including pheripheral blood lymphocytes culture for chromosome, and G-banding, C-banding, or ifnecessary, high resolution banding and silver-staining were treated. In sometimes, endocrine and ultrasound examination were performed simultaneously. Results: There were 88 cases with chromosome abnormally in 233 cases of amenorrhea,account for 37.78%, including number abnormality, deletion, inversion andmosaic type. Conclusions: Chromosome abnormality is one of the main causes of amenorrhea. Karyotype analysis of chromosome are absolutely necessary methods for seeking the cause, therapy and prognosis of patients with amenorrhea.

  6. Molecular Cytogenetic Characterization of a Non-Robertsonian Dicentric Chromosome 14;19 Identified in a Girl with Short Stature and Amenorrhea

    OpenAIRE

    Dutta, Usha R.; Vijaya Kumar Pidugu; Ashwin Dalal

    2012-01-01

    We report a 16-year-old girl who presented with short stature and amenorrhea. Initially the cytogenetic analysis showed the presence of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19. Subsequent molecular cytogenetic analysis by fluorescence in situ hybridization (FISH) using whole chromosome paints, centromeric probes, as well as gene specific probes confirmed the dicentric nature of the derivative chromosome and indicated that the rearrangement involved the s...

  7. Literature analysis of diagnosis and treatment of acupuncture and moxibustion for amenorrhea%针灸治疗闭经诊疗特点的文献分析

    Institute of Scientific and Technical Information of China (English)

    王伟明; 刘志顺

    2012-01-01

    目的 探讨针灸治疗闭经的诊疗特点和规律.方法 电子检索中国知网(CNKI,1979~2012年)、中文科技期刊全文数据库(VIP,1989~2012年)、中国生物医学光盘数据库(CBM,1979~2012年)、PUBMED(1966~2012年)中针灸治疗闭经的文献,分析总结常用的针灸干预措施、闭经证型分布,针灸对其治疗时的辨证和选穴特点、针灸频次、疗程、疗效、随访、安全性.结果 纳入18篇文献中,体针治疗闭经占61.11%(11/18);针灸临床辨治闭经时常用的证型有气血不足(27.78%,5/18)、气滞血瘀(22.22%,4/18);入选的文献中使用辨病选穴的文献有8篇,占44.44%(8/18),出现频次较高的穴位是关元(8/18,44.44%)、三阴交(7/18,38.89%)、中极(5/18,27.78%)、气海(5/18,27.78%)、肾俞(5/18,27.78%)、中脘(5/18,27.78%),基于中医证型的取穴或配穴所选穴位集中来自于脾经、胃经、任脉;针灸治疗频次每天1次占55.56%(10/18);针灸治疗1个月经周期后观察疗效占38.89%(7/18);针灸治疗闭经的有效率随不同干预措施存在差异,在72.72%~100%之间;针灸治疗闭经的文献随访率不高,仅占5.56%(1/18).入选文献中未见到对针灸治疗闭经的不良反应的报道.结论 针灸临床治疗闭经以体针常见;针灸临床辨治闭经时常用的证型有气血不足、气滞血瘀;针灸治疗闭经取穴方式常见为辨病选穴,具体是关元、三阴交、中极、气海、肾俞、中脘;基于中医证型的取穴或配穴所选穴位多取自脾经、胃经、任脉;针灸每天1次,一般治疗1个月经周期后评价疗效,在临床上多被采用.针灸治疗闭经疗效肯定,安全性较好.%Objective To explore the diagnosis and treatment of acupuncture and moxibustion for amenorrhea. Methods we searched the literatures related to amenorrhea treated by acupuncture and moxibustion in CNKI( 1979 ~ 2012 ), VIP( 1989 ~ 2012 ), CBM( 1979 ~ 2012 ), PUBMED( 1966 ~ 2012 ), then summarized the

  8. Prognostic Effects of Adjuvant Chemotherapy-Induced Amenorrhea and Subsequent Resumption of Menstruation for Premenopausal Breast Cancer Patients.

    Science.gov (United States)

    Jeon, Se Jeong; Lee, Jae Il; Jeon, Myung Jae; Lee, Maria

    2016-04-01

    Chemotherapy-induced amenorrhea (CIA) is a side effect that occurs in patients with breast cancer (BC) as a result of chemotherapy. These patients require special treatments to avoid infertility and menopause. However, the factors controlling CIA, resumption of menstruation (RM), and persistence of menstruation after chemotherapy are unknown. The long-term prognosis for premenopausal patients with BC and the prognostic factors associated with CIA and RM are subject to debate. We performed a retrospective study by reviewing the medical records of 249 patients with BC (stage I to stage III) who were treated with cytotoxic chemotherapy. The median patient age was 43 (range, 26-55 years) and the median duration of follow-up was 64 months (range, 28-100 months). The medical records indicated that 219 patients (88.0%) scored as positive for the hormone receptor (HR); the majority of these patients completed chemotherapy and then received additional therapy of tamoxifen. Our analyses revealed that 88.0% (n = 219) of patients experienced CIA, and the percentage of RM during follow-up was 48.6% (n = 121). A total of 30 patients (12.0%) did not experience CIA. Disease-free survival (DFS) was affected by several factors, including tumour size ≥2 cm, node positivity, HR negative status, and body mass index ≥23 kg/m. Multivariate analysis indicated that tumour size ≥2 cm remained as a significant factor for DFS (hazard ratio = 3.3, P = 0.034). In summary, this study finds that the majority of premenopausal patients with BC (stage I to stage III) who receive chemotherapy experience CIA and subsequent RM. Although tumour size ≥2 cm is negatively associated with DFS, RM after CIA is not associated with poor prognosis.

  9. Biomarker prediction of chemotherapy-related amenorrhea in premenopausal women with breast cancer participating in E5103.

    Science.gov (United States)

    Ruddy, Kathryn J; O'Neill, Anne; Miller, Kathy D; Schneider, Bryan P; Baker, Emily; Sparano, Joseph A; Dang, Chau; Northfelt, Donald W; Sledge, George W; Partridge, Ann H

    2014-04-01

    This study aimed to investigate whether pre-chemotherapy anti-mullerian hormone (AMH) is a biomarker for chemotherapy-related amenorrhea (CRA) in breast cancer patients. A multicenter randomized controlled trial, ECOG5103, assigned patients with early stage breast cancer to standard doxorubicin-cyclophosphamide followed by paclitaxel with either placebo or one of two durations of bevacizumab therapy. Five hundred ninety-one patients were part of the decision-making/quality of life substudy, in which there were surveys from baseline through 18-month follow-up. One hundred twenty-four women were included in this analysis of menses data because they were premenopausal at enrollment, responded to the 12-month survey, had not undergone bilateral oophorectomy or ovarian function suppression before that survey, and had serum banked for research before chemotherapy. One hundred of the 124 also responded to the 18-month survey. Median age was 45 years (range 25-55), and median serum AMH level was 0.11 ng/mL (range 0.01-8.63) prior to treatment. Eighty-two percent had CRA at 12 months, and 81 % at 18 months. In multivariate analyses, older age (p = 0.0003) was the only statistically significant predictor of 12-month CRA, but at 18-months, lower pre-chemotherapy AMH (p = 0.04) and older age (p = 0.008) were both statistically significant predictors of CRA. Race, bevacizumab therapy, and tamoxifen use were not statistically significantly associated with CRA after adjustment for AMH and age. Pre-chemotherapy AMH level is a potential novel biomarker for CRA in premenopausal women with early stage breast cancer. Further research to evaluate the clinical utility of AMH testing is warranted.

  10. Analysis of professor ZHOU Ming-xin's treatment strategies about amenorrhea%周铭心教授辨治闭经方略分析

    Institute of Scientific and Technical Information of China (English)

    伍镝; 周铭心

    2013-01-01

    周铭心教授是国家级名老中医,中医临床经验丰富.周教授认识到闭经基本病机可分为血虚及血瘀两端,郁火积热也是闭经的另一重要病机,因病情的复杂性,临证需辨证认识虚瘀的关系;在治疗方法上通过“达冲”、“注冲”两种方法有层次的安排,观察病情“应”与“不应”,再采取相应的“达冲”与“注冲”的治疗方法;在用药方面,根据既往经验预先配伍治疗闭经有效的单元药组,临证时根据病情变化将这些单元药组联缀组方.策略得当,疗效满意.%Professor ZHOU Ming-xin is a prominent doctors of traditional Chinese medicine with rich clinical experience. Professor Zhou recognizes basic pathogenesis of amenorrhea can be divided into two sides: blood deficiency and blood stasis, in addition stagnated fire is also another important pathogenesis of amenorrhea. Due to complexity of disease, it is necessary to dialectical understand of the relationship of blood deficiency and blood stasis. Through the two treatment methods of ' Dredging Chong Vessel' and ' Irrigating Chong Vessel' with arrangement in sequence, disease improvement can be observed, then according to the result of observation, the two treatment methods above can be further used. Effective unit medicine groups, based on previous experience in treatment of amenorrhea, are connected and form TCM Prescription according to disease changes, the proper strategy curatives effect satisfaction.

  11. Significance of luteinizing hormone in the diagnosis of secondary amenorrhea%促黄体生成激素水平诊断继发性闭经的意义

    Institute of Scientific and Technical Information of China (English)

    刘菲; 王承伟

    2013-01-01

    Objective: To observe the differences of changes of luteinizing hormone (LH), follicle -stimulating hormone (FSH) and prolactin (PRL) levels in patients with secondary amenorrhea, normal women, women with amenorrhea during gestational period, and postmenopausal women, and analyze the relationship between changes of hormones and secondary amenorrhea. Methods: The normal women, women with amenorrhea during gestational period, patients with secondary amenorrhea, and postmenopausal women were selected as study objects, then the women in secondary amenorrhea group and postmenopausal group were divided into FSH >40 mIU/ml subgroup, FSH 25 mIU/ml subgroup, and LH 25 mTU/ml subgroup of secondary amenorrhea group were higher than those in postmenopausal group. Conclusion: Abnormal increase of LH is a pointcut to diagnose, study, and treat secondary amenorrhea.%目的:观察继发性闭经患者、正常对照人群、孕期闭经人群和绝经期人群促卯泡成熟激素(FSH)、促黄体生成激素(LH)和催乳素(PRL)水平变化的差异,分析激素变化与继发性闭经之间的关系.方法:以正常对照人群、孕期闭经人群、继发性闭经人群和绝经期人群为研究对象,将继发性闭经组和绝经组的FSH和LH激素水平按FSH> 40 mIU/ml、FSH<5 mIU/ml、LH> 25 mIU/ml和LH <5 mIU/ml分为4个亚组,分析其FSH和LH激素水平差异.结果:继发性闭经组和绝经组的FSH和LH激素水平显著高于正常对照组和孕期闭经组,而PRL激素水平与正常对照组无显著性差异.继发性闭经人群LH>25 mIU/ml亚组的激素水平显著高于绝经期人群.结论:LH异常升高是诊断、研究和治疗继发性闭经的切入点.

  12. Prevalence of X-aneuploidies, X-structural abnormalities and 46,XY sex reversal in Turkish women with primary amenorrhea or premature ovarian insufficiency.

    Science.gov (United States)

    Geckinli, B B; Toksoy, G; Sayar, C; Soylemez, M A; Yesil, G; Aydın, H; Karaman, A; Devranoglu, B

    2014-11-01

    Our objective was to identify the distribution of cytogenetic abnormalities of 175 Turkish women with primary amenorrhea (PA) or premature ovarian insufficiency (POI). A retrospective study was performed using medical records of 94 patients with PA and 81 patients with POI at the Genetics Department, Zeynep Kamil Women's and Children's Research and Training Hospital, Istanbul, Turkey. G-banded metaphase karyotype analysis were prepared and analyzed. Chromosomal abnormalities were present in 44 of 175 cases (25%). 15 were full blown or mosaic numerical X chromosome abnormalities (8.5%), 10 were full blown or mosaic X-chromosome structural anomalies (5.7%), one was X-autosome translocation (0.5%), 3 were autosomal anomalies (1.7%), 12 were XY karyotype (6.8%), one was 45,X/46,XY mosaic and 2 were full blown or mosaic structural anomalies of Y chromosome (1.7%). The prevalence of chromosomal abnormalities was 25% in this large series of Turkish women with primary amenorrhea or premature ovarian insufficiency, most cases involving X-aneuploidy or X-structural abnormalities or 46,XY karyotype. High prevalence of chromosomal abnormalities is associated with POI starting at an early age (average age: 26 years).

  13. Ovulation induction with pulsatile gonadotropin-releasing hormone (GnRH) or gonadotropins in a case of hypothalamic amenorrhea and diabetes insipidus.

    Science.gov (United States)

    Georgopoulos, N A; Markou, K B; Pappas, A P; Protonatariou, A; Vagenakis, G A; Sykiotis, G P; Dimopoulos, P A; Tzingounis, V A

    2001-12-01

    Hypothalamic amenorrhea is a treatable cause of infertility. Our patient was presented with secondary amenorrhea and diabetes insipidus. Cortisol and prolactin responded normally to a combined insulin tolerance test (ITT) and thyrotropin-releasing hormone (TRH) challenge, while thyroid-stimulating hormone (TSH) response to TRH was diminished, and no response of growth hormone to ITT was detected. Both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels increased following gonadotropin-releasing hormone (GnRH) challenge. No response of LH to clomiphene citrate challenge was detected. Magnetic resonance imaging findings demonstrated a midline mass occupying the inferior hypothalamus, with posterior lobe not visible and thickened pituitary stalk. Ovulation induction was carried out first with combined human menopausal gonadotropins (hMG/LH/FSH) (150 IU/day) and afterwards with pulsatile GnRH (150 ng/kg/pulse). Ovulation was achieved with both pulsatile GnRH and combine gonadotropin therapy. Slightly better results were achieved with the pulsatile GnRH treatment.

  14. Clinical manifestations of low bone mass in amenorrhea patients with elevated follicular stimulating hormone%高促卵泡激素闭经患者低骨量的临床表现

    Institute of Scientific and Technical Information of China (English)

    郁琦; 林守清; 何方方; 李包罗; 林元; 张涛; 张颖

    2002-01-01

    Objective To study the characteristics of low bone mass in amenorrhea patients with elevated follicular stimulating hormone (FSH). Methods Amenorrhea patients with elevated FSH: Primary amenorrhea 18 cases, secondary amenorrhea 171 cases and age matched controls with normal menstruation, 180 cases. The descriptive parameters were: estrogen, alkaline phosphatase, urinary excretion of calcium to creatine ratio, cortical bone mineral density at the right radius measured by single photon absorptiometry and trabecular bone mineral density at the lumbar vertebra body measured by quantitative computerized tomography. Results Average E2 levels in amenorrhea patients is under 150 pmol/L with significantly higher alkaline phosphatase and urine calcium to creatine ratio values than the normal menstruation group. Cortical bone mineral density in the secondary amenorrhea group (655±69 mg/cm2) was significantly lower than that of the normal menstruation group (677±56 mg/cm2, P<0.01). Trabecular bone mineral density in the secondary amenorrhea group (145±26 mg/cm3) was significantly lower than that of the NOR group (192±28 mg/cm3, P<0.001). The disparity with the normal menstruation group is even greater in the primary amenorrhea group. Bone mineral density of the amenorrhea patients was negatively correlated with duration of the menopause. Conclusions Serum estrodiol levels in amenorrhea patients was so low that bone turnover was accelerated. This led to insufficient bone accumulation and a dramatically drop in trabecular bone mineral density. The extent was closely related to age of onset of amenorrhea and the duration of ovarian failure.%目的了解高促卵泡激素(FSH)卵巢性闭经患者低骨量的特点.方法对18例高 FSH原发闭经(PA组)、171例高FSH继发闭经(SA组)患者,采用放射免疫法测定血清雌二醇(E2);生化法测定血清碱性磷酸酶(ALP)、尿钙/肌酐(Ca/Cr)比值;单光子吸收测量法测定右侧桡骨

  15. Chromosome analysis of 427 cases with primary amenorrhea%原发性闭经427例患者染色体核型分析

    Institute of Scientific and Technical Information of China (English)

    彭琳; 王楠; 邓东锐; 左伟; 程琛; 党静; 郝海燕; 周媛; 蒋敏; 凌霞珍

    2012-01-01

    目的 对原发性闭经患者进行细胞遗传学分析,探讨原发性闭经与染色体异常的关系,用以指导临床诊断及处理.方法 对427例原发性闭经患者进行外周血淋巴细胞培养、染色体制备及核型分析.结果 427例原发性闭经患者中共检出染色体异常核型118例,异常检出率为27.6℅﹙118∕427﹚.性染色体异常中,X染色体数目异常59例、结构异常25例、嵌合体24例,其中有单纯X染色体与常染色体平衡易位1例,合并X的部分缺失2例.常染色体结构异常10例,包括染色体倒位﹙4例﹚、平衡易位﹙4例﹚以及染色体大小异常﹙2例﹚,涉及到第6、7、9、14、15、16、22号常染色体.结论 结合临床表现、影像学检查以及染色体核型检查,可以为原发性闭经患者寻找病因提供理论依据,同时有利于处理措施的制定.%Objective To carry out chromosome analysis of patients with primary amenorrhea and investigate the relationship between primary amenorrhea and chromosome abnormalities, so as to guide clinical diagnosis and treatment. Methods Peripheral blood lymphocyte culture, chromosome preparation and karyotype analysis were done to 427 cases of patients with primary amenorrhea. Results There were 118 cases of abnormal chromosome karyotype with primary amenorrhea, and the anomaly detection rate was 27. 6% ( 118/427 ). In cases with sex chromosome abnormalities, there were 59 patients with numerical abnormalities of X chromosome, 25 patients with X chromosome structural abnormality, and 24 cases of mosaicism. Among them, there was one case of simple reciprocal translocation between X chromosome and autosome, and two cases of consolidation with terminal deletion of X chromosome. There were cases of autosomal structural abnormalities, including chromosomal inversion ( 4 cases ), balanced translocation ( 4 cases ) and abnormal chromosome size ( 2 cases ). Autosomal abnormalities happened on the sixth, seventh, ninth

  16. 原发闭经表型的细胞遗传学病因研究%Cytogenetic Investigation of Primary Amenorrhea Phenotype

    Institute of Scientific and Technical Information of China (English)

    曾寰; 周裕林; 陈小苑; 孔辉; 韩璐; 吴琼; 吴慧南; 沈艳艳; 陈佳燕; 江雨

    2011-01-01

    Objective: To investigate the cytogengetic etiology of primary amenorrhea phenotype.Methods: Regular G-banding karyotyping methods,fluorescence in situ hybridization(FISH), C-banding and Q-banding techniques were applied to analyze to verify the peripheral blood lymphocytes chromosomes and their abnormities of 25 primary amenorrhea patients. Results: Eighteen out of total 25 primary amenorrhea patients were karyotype abnormal. That was 72.0%. All the chromosome abnormalities patients included 8 cases of 45,X,2 cases of 46,XY, 1 case of i(X)(ql0), 1 case of X long arm terminal deletion, 2 cases of X-autosome balanced translocation, as well as 4 cases of mosaics, all were 45,X cell line and 46 cell lines with 4 diferent kinds of sex chromosomes structure abnormalities mosaicism. The rest 7 females with no uterus and no vagina in congenital,were detected karyotypely normal. Conclusion: X monosome, X structural anomalies, X monosome cell strain and structural anomalies cell strain mosaic, and 46,XY disorder of sex development (DSD), X-autosome reciprocal translocation are responsible for 18 patients' primary amenorrhea phenotype, individually. FISH, C-banding and, Q-banding techniques in addition to G-banding methods are very useful techniques in accurate diagnosis of the karyotypes of primary amenorrhea patients.%目的:探讨原发闭经表型的细胞遗传学病因.方法:运用常规的染色体核型分析技术及FISH、C-带和Q-带技术,分析25例原发闭经表型患者的染色体核型.结果:25例原发闭经表型病例中,18例核型异常,占72.0%.异常核型病例分别为:45,X 8例、46,XY 2例,等臂X1例、嵌合核型4例(分别为45,X细胞系与不同的结构异常性染色体细胞系的嵌合体)、X长臂末端缺失1例、X-常染色体平衡易位2例.除这18例异常核型患者外,尚有7例为先天性无子宫、无阴道的原发闭经患者未检出核型异常.结论:X染色体数目单体、X结构异常、X染色体数目单

  17. Treating 206 cases of amenorrhea galactorrhea syndrome infertility in the integrative medicine%中西医结合治疗闭经溢乳综合征之不孕206例

    Institute of Scientific and Technical Information of China (English)

    张华

    2013-01-01

    Objective: To investigate amenorrhea galactorrhea syndrome caused infertility in the integrative medicine treatment. Methods:Clinical admitted due to amenorrhea galactorrhea syndrome caused infertility patients in modern medicine treatment of 206 cases and analyze. Results: The cure rate and total efficiency of the integrative treatment due to amenorrhea galactorrhea syndrome caused infertility patients than purely modern medicine treatment group. Conclusion: Integrative medicine amenorrhea galactorrhea syndrome infertility treatment is worth promoting.%  目的:探讨闭经溢乳综合征引起的不孕症的中西医综合治疗方法。方法:通过临床收治的因闭经溢乳综合征引起的不孕症患者206例的中西医综合治疗并进行分析总结。结果:中西医综合治疗因闭经溢乳综合征引起的不孕症患者的治愈率及总有效率均高于单纯西医治疗组。结论:中西医结合治疗闭经溢乳综合征不孕症是值得推广的治疗方法。

  18. 无痛人流术后闭经的临床护理体会%The Clinical Nursing Experience of Amenorrhea Patients After Painless Abortion Operation

    Institute of Scientific and Technical Information of China (English)

    叶艳萍

    2015-01-01

    目的:分析无痛人流术后闭经的临床护理方法及效果。方法搜集2013年9月~2014年9月我院接收的无痛人流术后闭经39例患者,按照护理方法不同分为两组。给予对照组19例常规护理,给予实验组20例综合护理。观察对照组与实验组的护理效果,并比较分析。结果与对照组相比,实验组护理有效率和满意度较高,有明显差异,有统计学意义(P<0.05)。结论无痛人流术后闭经综合护理效果较好。%Objective The clinical nursing approach and its application efficacy in treatment of amenorrhea patients after painless abortion operation are to be investigated. Methods Choose 39 amenorrhea patients after painless abortion operation who are treated in hospital from September 2013 to September 2014 and separate them into two groups according to different nursing approaches,19 patients in control group are given conventional treatment,while 20 patients in study group are given comprehensive nursing,and then observe and compare nursing efficacy of the two groups. Results Compared to control group,the treatment efficacy and patients’ rate of satisfaction with nursing in study group are much higher; there is a treatment efficacy differential between the two groups,and such a differential has statistic value(P<0.05). Conclusion The comprehensive nursing is of efficiency in clinical treatment of amenorrhea patients after painless abortion operation;thus,it is quite worthwhile to be promoted.

  19. 傅友丰教授治疗闭经经验%Experience of FU You-feng Professor Treatment Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    周红光

    2012-01-01

    对傅友丰教授治疗闭经临床经验进行总结,介绍其治病特色.傅友丰教授治疗闭经强调辨证分虚实;补肾调周,采用中药建立人工周期;补肾填精,健脾和中贯穿始终等方法,取得很好的临床效果,值得临床推广应用.%This paper summarized FU You-feng professor of clinical experience in the treatment of amenorrhea, introduced her Cure characteristics. FUYou-feng professor emphasize that syndrome differentiation distinguish deficiency and exces; nourish kidney use of Chinese medicine build artificial cycle and nourish kidney replenishing essence. Acquired very good clinical effect and deserved clinical application.

  20. Molecular cytogenetic characterization of a non-robertsonian dicentric chromosome 14;19 identified in a girl with short stature and amenorrhea.

    Science.gov (United States)

    Dutta, Usha R; Pidugu, Vijaya Kumar; Dalal, Ashwin

    2012-01-01

    We report a 16-year-old girl who presented with short stature and amenorrhea. Initially the cytogenetic analysis showed the presence of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19. Subsequent molecular cytogenetic analysis by fluorescence in situ hybridization (FISH) using whole chromosome paints, centromeric probes, as well as gene specific probes confirmed the dicentric nature of the derivative chromosome and indicated that the rearrangement involved the short arms of both of these chromosomes. Furthermore, we also determined that the chromosome 19p13.3 breakpoint occurred within the terminal 1 Mb region. This is the first report of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19 with the karyotype determined as 45,XX,dic(14;19)(p11.2;p13.3)[35]/46,XX[15], and we suggest that the chromosome rearrangement could be the cause of clinical phenotype.

  1. Molecular Cytogenetic Characterization of a Non-Robertsonian Dicentric Chromosome 14;19 Identified in a Girl with Short Stature and Amenorrhea

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    Usha R. Dutta

    2012-01-01

    Full Text Available We report a 16-year-old girl who presented with short stature and amenorrhea. Initially the cytogenetic analysis showed the presence of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19. Subsequent molecular cytogenetic analysis by fluorescence in situ hybridization (FISH using whole chromosome paints, centromeric probes, as well as gene specific probes confirmed the dicentric nature of the derivative chromosome and indicated that the rearrangement involved the short arms of both of these chromosomes. Furthermore, we also determined that the chromosome 19p13.3 breakpoint occurred within the terminal 1 Mb region. This is the first report of a mosaic non-Robertsonian dicentric chromosome involving chromosomes 14 and 19 with the karyotype determined as 45,XX,dic(14;19(p11.2;p13.3[35]/46,XX[15], and we suggest that the chromosome rearrangement could be the cause of clinical phenotype.

  2. The risk of amenorrhea is related to chemotherapy-induced leucopenia in breast cancer patients receiving epirubicin and taxane based chemotherapy.

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    Wenbin Zhou

    Full Text Available BACKGROUND: Chemotherapy-induced amenorrhea (CIA is common in young breast cancer patients. The incidence of CIA associated with regimens involving epirubicin and taxane was not well known. Furthermore, previous studies suggested leucopenia and amenorrhea may reflect inter-individual variations in pharmacokinetics. The purpose of this study was to investigate the association between leucopenia after first cycle of chemotherapy and CIA in young breast cancer patients receiving epirubicin and taxane based chemotherapy. Furthermore, the incidence of CIA was also assessed. METHODOLOGY AND PRINCIPAL FINDINGS: Between October 2008 and March 2010, 186 consecutive premenopausal patients, treated with epirubicin and taxane based chemotherapy, were recruited. Information about CIA was collected by telephone and out-patient clinic. Of these 186 patients, data from 165 patients were included and analyzed. Of all 165 patients, CIA occurred in 72 patients (43.64%. In multivariate analysis, age older than 40 y (OR: 16.10, 95% CI: 6.34-40.88, P0.05. The rate of CIA in leucopenia group (52.56% was significantly higher than that in normal leukocyte group (34.62% (P = 0.024. In patients treated with a FEC regimen (cyclophosphamide, epirubicin and 5-fluorouracil, the rate of CIA in leucopenia group (59.57% was significantly higher than that in normal leukocyte group (36.84% (P = 0.037. CONCLUSIONS: Age at diagnosis and previous childbearing were both found to significantly increase the risk of CIA, whereas additional taxane was not associated with increased rate of CIA. Importantly, leucopenia after first cycle of chemotherapy was associated with increased risk of CIA, which suggested that leucopenia may be an early predictor of chemotherapy-induced infertility.

  3. 汉族女性精神分裂症首发患者利培酮治疗所致闭经的危险因素%Risk factors for medication-induced amenorrhea in first-episode female Chinese patients with schizophrenia treated with risperidone

    Institute of Scientific and Technical Information of China (English)

    陈海支; 任丽华; 沈仲夏; 钱敏才; 沈鑫华; 杨胜良; 杨剑虹; 宋娟芬; 费小聪; 陶百平; 宋宝华

    2013-01-01

    Background:Amenorrhea is a common adverse effect of treatment with antipsychotic medications that influences both fertility and adherence to medication regimens. Most research suggests that medication-induced prolactinemia is the main cause of amenorrhea but few prospective studies have assessed this hypothesis. Aim:Identify risk factors for amenorrhea following treatment with antipsychotic medication. Methods:The study used a prospective, nested case-control design. First-episode, drug naïve female patients with schizophrenia who were in the middle of their menstrual cycle at the time of admission were enrolled. Serum levels of six reproductive hormones were assessed before and after a 12-week course of treatment with risperidone:progesterone, estradiol, prolactin, follicular stimulating hormone, luteinizing hormone, and testosterone. The hormone levels of 31 patients who had no menstruation during the entire 12 weeks of treatment (the amenorrhea group) were compared to those of 31 age-matched subjects who had normal menstrual periods over the 12 weeks of treatment (the control group). Results:We found a dramatic 4-fold increase in prolactin levels in women of childbearing age treated with risperidone, but the pretreatment and posttreatment levels of prolactin were not different between patients who did and did not develop amenorrhea with treatment. However, there were significantly lower pretreatment levels of estradiol and progesterone in patients who subsequently developed amenorrhea with risperidone treatment than in patients who did not develop amenorrhea. A conditional logistic regression analysis found that pretreatment levels of estradiol remained significantly associated with the development of amenorrhea during treatment even when adjusting for the pretreatment levels of the other five reproductive hormones assessed. Conclusion:These findings do not support the suggestion that amenorrhea associated with the use of antipsychotic medication is the result

  4. 食疗与艾灸对女性继发性闭经疗效的探讨%Discussion on the Female Secondary Amenorrhea with Moxibustion and Diet Therapy

    Institute of Scientific and Technical Information of China (English)

    黄闯; 顾立众; 郇习高

    2014-01-01

    继发性闭经病因复杂,中医治疗有其独特之处,文章从继发性闭经的病因病机和艾灸以及自拟方治疗两个方面,论述治疗女性继发性闭经,从而用于指导保健康复工作。%Complex causes of secondary amenorrhea, Chinese medicine has its unique characteristics, this article from the secondary amenorrhea disease and its treatment of two aspects of Moxibustion and self Treating, which can be used to guide the Health Care and Rehabiliation.

  5. 闭经患者生存质量及其影响因素的相关研究%INVESTIGATION OF QUALITY OF LIFE AND CORRELATED FACTORS IN PATIENTS WITH AMENORRHEA

    Institute of Scientific and Technical Information of China (English)

    蔡林芮; 牟燕琳; 李宁秀; 徐克惠

    2011-01-01

    [目的]分析原发性闭经和继发性闭经患者的病因分布,评价闭经患者的生存质量.并探讨闭经患者生存质量的主要影响因素,为准确诊治闭经患者、改善病员生活质量提供理论依据.[方法]采用设计的问卷对2008年7~8月间在四川大学华西妇女儿童医院就诊的闭经患者进行相关调查,并用SF-36量表对调查对象进行生存质量评价.[结果]原发性闭经以下丘脑垂体病变最多,多囊卵巢综合征最少,而继发闭经多囊卵巢综合征最多见,最少的是子宫病变;闭经患者的生存质量比四川省常模低;精神压力是影响闭经患者生存质量的最主要因素.[结论]原发性闭经和继发性闭经的病因分布情况不同.在临床工作中,要关注闭经患者的生存质量,尤其是农村患者的生存质量;除了要治疗闭经患者的本身疾病,还应给予患者精神支持,减轻其精神压力,以全面提高其生存质量.%[Objective] To investigate for the etiological distribution of amenorrhea in Sichuan province and evaluate the quality of life in patients with amenorrhea and identify the correlated factors. [Methods] The survey was carried out using questionnaires in the conformed patients, who were recruited from Reproductive Endocrinological Clinic of Sichuan University Affiliated Hospital. [Results] The important reasons of primary amenorrhea were pituitary and hypothalamic diseases, but polycystic ovary syndrome (PCOS) played a key role in the secondary amenorrhea. The patients with amenorrhea had significantly lower scores of QOL than the norm of Sichuan province. Stress was the main factor that affected the quality of life in patients with amenorrhea. [Conclusion] The main etiological distributions of primary and secondary amenorrhea are different. Besides treating with the disease, doctors should manage some interventions to reduce the stress to improve the QOL of the patients with amenorrhea.

  6. Fifty-eight cases of amenorrhea treated mainly with Siguan points(四关穴)by acupuncture%针灸四关穴为主治疗闭经58例

    Institute of Scientific and Technical Information of China (English)

    孙朝辉; 许瑞华; 翟亚娟

    2010-01-01

    @@ The combination of Hégǔ(合谷LI 4)and Tàichōng(太冲LR 3)which is applied in the clinic is named as Siguan points(四关穴 Four-gate points).From January 1998 to April 2008,the authors had treated 5 8 cases of amenorrhea by puncturing on Siguan points(四关穴Four-gate points).The report is as follows.

  7. 吴克明教授治疗节食减肥后闭经经验介绍%Brief Introduction to Professor WU Keming′s Experience on Treatment of Amenorrhea after Losing Weight by Dieting

    Institute of Scientific and Technical Information of China (English)

    敖荣娜; 罗娟; 李晶晶; 吴克明

    2013-01-01

    从典型病例入手介绍吴克明教授运用中西医两法诊治减肥后闭经的临床经验,以期为相关临床研究提供参考.%We are discussing professor WU Keming's experience of treating amenorrhea after losing weight with western medicine and traditional Chinese medicine through analyzing classic cases, aiming to provide reference for associated clinical study.

  8. Clinical Observation of AcupunctureT reatment for Female Obesity in the Late Menstruation or Amenorrhea%针灸治疗女性肥胖症合并月经后期或闭经的临床研究

    Institute of Scientific and Technical Information of China (English)

    张安琪; 胡岚; 李熳

    2013-01-01

    目的:评价并比较针灸及药物疗法对女性肥胖合并月经后期或闭经患者的疗效。方法:选取女性肥胖症合并月经后期或闭经患者52例,随机分为针灸治疗组和药物治疗组,观察两组患者治疗前后的体重、腰围、臀围、腰臀比、月经周期、闭经情况。结果:针灸治疗组对肥胖、月经后期和闭经均有显著的改善作用(P<0.05),其临床疗效显著优于药物治疗组(P<0.05)。结论:针灸疗法治疗女性肥胖合并月经后期或闭经疗效显著,值得临床推广应用。%Objective:To evaluate and compare the effect of acupuncture and drug on obese women with late menstruation or amenorrhea .Mte hods:52 female patients were randomly divided into acupuncture treatment group and medication group .Body weight, waist circumference, hip circumference, waist-hip ratio, menstrual cycle , and amenorrhea were observed in two groups before and after treatment .Results:Acupuncture treatment had a significant effect on obesity , late menstruation and amenorrhea ( P<0.05 ) , and its clinical efficacy was better than that in the medication group ( P<0.05 ) .Conclusion:Acupuncture therapy can significantly im-prove obesity and irregular menstruation of obese women with late menstruation or amenorrhea , which is worthy of application in clinic .

  9. Secondary amenorrhea in a woman with spinocerebellar degeneration treated with thyrotropin-releasing hormone: a case report and in vitro analysis

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    Kanasaki Haruhiko

    2011-12-01

    Full Text Available Abstract Introduction While thyrotropin-releasing hormone is known to be a prolactin-release stimulating factor, thyrotropin-releasing hormone-tartrate and its derivative, taltirelin hydrate, are used for the treatment of spinocerebellar degeneration, a degenerative disease characterized mainly by motor ataxia. We report the case of a patient being treated with a thyrotropin-releasing hormone preparation for spinocerebellar degeneration who developed amenorrhea after a dose increase. Her hormonal background was analyzed and the effect of prolonged exposure to thyrotropin-releasing hormone on pituitary prolactin-producing cells was examined in vitro. Case presentation Our patient was a 36-year-old Japanese woman who experienced worsening of gait disturbance at around 23 years of age, and was subsequently diagnosed as having spinocerebellar degeneration. She had been treated with thyrotropin-releasing hormone-tartrate for four years. Taltirelin hydrate was added to the treatment seven months prior to her presentation, followed by an improvement in gait disturbance. Around the same period, she started lactating and subsequently developed amenorrhea three months later. Taltirelin hydrate was discontinued and she was referred to our hospital. She was found to have normal sex hormone levels. A thyrotropin-releasing hormone provocation test showed a normal response of thyroid-stimulating hormone level and an over-response of prolactin at 30 minutes (142.7 ng/mL. Resumption of menstruation was noted three months after dose reduction of thyrotropin-releasing hormone. In our in vitro study, following long-term exposure to thyrotropin-releasing hormone, cells from the rat pituitary prolactin-producing cell line GH3 exhibited an increased basal prolactin promoter activity but showed a marked decrease in responsiveness to thyrotropin-releasing hormone. Conclusions Physicians should be aware of hyperprolactinemia-associated side effects in patients receiving

  10. Transition from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh: barrier analysis and implications for behavior change communication program intervention design.

    Science.gov (United States)

    Kouyaté, Robin Anthony; Ahmed, Salahuddin; Haver, Jaime; McKaig, Catharine; Akter, Nargis; Nash-Mercado, Angela; Baqui, Abdullah

    2015-06-01

    The timely transition from Lactational Amenorrhea Method (LAM)(2) to another modern family planning method contributes to healthy spacing of pregnancies by increasing the adoption of family planning during the first year postpartum. Yet, literature suggests challenges in completing a timely LAM transition. To guide program implementation in Bangladesh, this study identified factors influencing women's transition decisions. Eighty postpartum women, comprising 40 who transitioned from LAM(3) and 40 who did not,(4) participated. Half of each group participated in in-depth interviews to explore the decision-making process. All participants responded to a "Barrier Analysis" questionnaire to identify differences in eight behavioral determinants. More than half of transitioners switched to another modern method before or within the same month that LAM ended. Of the 18 transitioners who delayed,(5) 15 waited for menses to return. For non-transitioners, key barriers included waiting for menses to return, misconceptions on return to fertility, and perceived lack of familial support. The LAM transition can help women prevent unintended pregnancy during the first year postpartum. Increased emphasis on counseling women about the risk of pregnancy, and misconceptions about personal fertility patterns are critical for facilitating the transition. Strategies should also include interventions that train health workers and improve social support.

  11. Amenorréia primária e cariótipo XY: identificando pacientes em risco Primary amenorrhea and XY karyotype: identifying patients in risk

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano Machado Rosa

    2008-11-01

    ser rotineiramente avaliados em indivíduos com amenorréia primária. Dessa forma, haveria um reconhecimento mais precoce das pacientes 46,XY e, conseqüentemente, um adequado manejo clínico das mesmas.PURPOSE: to verify the prevalence and clinical characteristics of patients with primary amenorrhea and XY caryotype, evaluated in our Service, aiming at identifying findings which could help their recognition. METHODS: from January 1975 to November 2007, 104 patients with amenorrhea were evaluated. All the cases were analyzed by the caryotype by GTG bands. Among them, 21 (20.2% presented a XY 46 constitution. Nevertheless, two of them were excluded from the study, because of incomplete data in their patient's chart. Most of the 19 patients who formed the sample had been referred to us by the gynecology clinics (63.2%. Their ages varied from 16 to 41 years old (an average of 22.1. Data were collected about their family and previous history, physical examination and results of complementary exams and the information was taken into consideration to determine the diagnosis. RESULTS: the predominant diagnosis was resistance to androgens syndrome (n=12; 63.2%; five patients (25.3% presented XY pure gonadal dysgenesis (XY PGD, one (5.3% 17 alpha-hydroxylase deficiency, and one (5.3%, 5 alpha-reductase deficiency. Clinical findings frequently found in these patients included abnormal development of secondary sexual characters (n=19, uterine agenesia with a blind vagina (n=14, family history of amenorrhea (n=8, and palpable gonads in the inguinal canal (n=5. Two of them presented a history of inguinal hernia. Systemic arterial hypertension was only diagnosed in the patient with 17 alpha-hydroxylase deficiency, and gonadal malignization, in the one with XY PGD. CONCLUSIONS: the rate of patients with XY caryotype (20% was higher than the one described in the literature (3 to 11%. It is believed that this fact is related to the way patients are usually referred to our service

  12. Magnetic resonance imaging of sella turcica: evaluation of patients with galactorrhea, amenorrhea and hyperprolactinemia; Ressonancia magnetica da sela turca: avaliacao de pacientes com galactorreia, amenorreia e hiperprolactinemia

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Alair Augusto Sarmet M.D. dos [Hospital Universitario Antonio Pedro, Niteroi, RJ (Brazil). Dept. de Radiologia; Moreira, Denise Madeira [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Andreiuolo, Pedro Angelo [Beneficencia Portuguesa de Niteroi, RJ (Brazil). Servico de Radiologia Santa Cruz Scan

    1999-08-01

    We have selected 135 cases of patients who have done magnetic resonance imaging of sella region, carried out from September, 1991 to August, 1996, who had galactorrhea (G), amenorrhea(A), and hyperprolactinemia (H), isolated or in association. The patients were divided in seven groups, according to the presence of these symptoms and signs. All examinations were made in a private clinic in the city of Rio de Janeiro, Brazil. Correlating these patients with the results of the magnetic resonance images, we found 57 micro adenomas, 31 normal examinations, 22 macro adenomas, 11 pituitary hyperplasias, 7 empty sella and 7 cases included in other aspects. The micro adenoma predominated in groups 1 (GAH), 2 (GH), 3 (HA) and 5 (H), that is, in all groups whose patients had hyperprolactinemia. In macro adenomas, a bright signal on T 1-weighted images indicates pituitary apoplexy with intratumoral hemorrhage. All in all, the magnetic resonance imaging is excellent method to be used in the evaluation of patients with changes in the hypothalamic-pituitary axis. (author)

  13. Clinical experience for treating secondary amenorrhea with the Yijing decoction according to astronomical calendar%结合天文历法服用益经汤治疗继发性闭经临床体会

    Institute of Scientific and Technical Information of China (English)

    刘亚琴; 孙得利

    2015-01-01

    Objective: Combination of astronomical calendar and the Yijing decoction was applied to treat secondary amenorrhea. Methods: 38 patients with secondary amenorrhea were included in the study, to summarize the clinical experience. Results: In one course, 21 cases were menstruation recovery of fancy. In two courses of treatment, 9 cases were menstruation recovery of fancy. In three courses of treatment, 3 cases were menstruation recovery of fancy; there are still 5 patients of fail menstruation; the total efifciency was 86.8%. Conclusion: Combination of astronomical calendar and the Yijing decoction has signiifcant effects on secondary amenorrhea.%目的:服用益经汤结合天文历法治疗继发性闭经。方法:选取38例继发性闭经患者,在满月(每月阴历十五)前一周开始服用益经汤,总结临床体会。结果:38例患者治疗一个疗程后,月经恢复来潮21例,治疗两个疗程后,月经恢复来潮9例,治疗三个疗程后,月经恢复来潮3例,仍然有5例患者月经未来潮,总有效率为86.8%。结论:结合天文历法服用益经汤治疗继发性闭经疗效显著。

  14. 调经1号治疗减肥引起闭经临床观察%Amenorrhea Which Caused by Losing Weight is Treated with TiaoJing 1th 7 Observation

    Institute of Scientific and Technical Information of China (English)

    喻佳

    2011-01-01

    闭经为妇科常见病、多发病,近些年来因减肥引发的闭经患者更是越来越多,治疗难度较大.导师梁学林教授承袭前人"经水出诸于肾"的观点,认为过度减肥脾胃功能低下,气血生化无源,日久累及肾脏,肾精亏虚,冲任失调,血海不能按时满溢而致闭经.在治疗上主张"补后天以养先天",自拟调经1号,随证加减.笔者有幸随师应诊,收集典型病例7例进行临床观察,分析如下.%For the department of gynecology common disease, frequently-occurring disease amenorrhea, in recent years for weight loss caused by the patient is more and more, which is difficult to cure.Professor LIANG Xue-lin approves the predecessor's viewpoint “the menstruation is from the kidney”,she thinks that amenorrhea because of losing weight are first with deficiency of the spleen, then inadequacy of Qi-blood supply and transference of the sickness from the spleen to kidney. Desfunction of Chong and Ren Channels, the bloodshed loses the department is he pathogenesis. In treatment she advocates “the acquiredness nourishing the innateness” and usually takes Tiao. Jing lth, increasing and decreasing some traditional medicine according symptoms. I have the pooprtunity to examine along with the teacher, collect 7cases of amenorrhea on the c1inical observation. Now, I will summarize my teacher's experience as follow.

  15. The Traditional Chinese Medicine Treatment Effect of 20 Cases of Patients With Second Amenorrhea%继发性闭经的20例中医治疗效果分析

    Institute of Scientific and Technical Information of China (English)

    贾立新

    2015-01-01

    目的:探讨继发性闭经的中医辨证治疗。方法选取2010年~2011年我院收治的20例继发性闭经患者为研究对象,回顾临床治疗情况,分析治疗效果。结果经过中医辨证分型治疗,治愈13例,好转6例,无效1例。总有效率95%。结论继发性闭经的治疗,要在中医辨证的基础上给予对症治疗,以利于患者的早日康复。%Objective The traditional Chinese medical and dialectical treatment of secondary amenorrhea to be investigated. Methods Reviewing the treatment data selected from 20 cases of patients with secondary amenorrhea who are treated in hospital from 2010 to 2011,and then analyzing the treatment effect. Results Because of the traditional Chinese medical and dialectical treatment,13 cases of patients are cured and 6 cases of patients show a sign of improvement in their health state,while one case is ineffective. The effectiveness is 95 percent in total. Conclusion The way to treat secondary amenorrhea is to provide patients with symptomatic treatment based on traditional Chinese medical and dialectical treatment,in order to help patients get recovery soon.

  16. Analysis of chromosomal karyotyp in 69 patients with primary amenorrhea in Xiamen%厦门地区69例原发闭经患者的染色体核型分析

    Institute of Scientific and Technical Information of China (English)

    刘芳; 史彩虹; 王厚照; 周友泉

    2012-01-01

    Objective To explore the distribution of abnormal chromosome karyotype in patients with primary amenorrhea in Xiamen area and its clinical signs and significance. Methods Karyotype analysis was performed by peripheral blood lymphocyte chromosomal culture techniques. Results In total 69 patients with primary amenorrhea, there were 28 cases of chromosomal abnormalities , abnormal detection rate was 40. 6% , of which the X chromosomes number abnormalities in 8 cases, accounting for 28. 6% ; number abnormalities and chimera in 6 cases, accounting for 21.4% ; structural abnormalities in 5 cases, accounting for 17.9% ; structural abnormalities and chimera in 3 cases, accounting for 10.7% ; chromosome inversion in 3 cases, accounting for 10.7% ; sex-reversed in 2 cases, accounting for 7.1 % ; autosomal translocation in 1 case, accounting for 3.6%. Conclusion Chromosomal abnormality is one of the major causes of primary amenorrhea, cytogenetic examination in primary amenorrhea patients is important to determine its causes and treatment options.%目的 探讨厦门地区原发性闭经患者各种异常染色体核型的分布情况及其有关临床体征和意义.方法 采用外周血淋巴细胞染色体培养技术进行染色体核型分析.结果 69例原发闭经患者共检出染色体异常28例,异常检出率为40.6%,其中X染色体数目异常8例,占28.6%;X染色体数目异常及嵌合体6例,占21.4%;X染色体结构异常5例,占17.9%;X染色体结构异常及嵌合体3例,占10.7%;染色体倒位3例,占10.7%;性反转2例,占7.1%;与常染色体易位1例,占3.6%.结论 染色体异常是导致原发性闭经的主要病因之一,对原发闭经患者进行细胞遗传学检查,对确定其病因及治疗方案具有重要意义.

  17. Two Medical Cases of Chinese Medicine in the Treatment of Amenorrhea Caused by Premature Ovarian Failure%中药治疗卵巢早衰所致闭经医案2则

    Institute of Scientific and Technical Information of China (English)

    任小梅; 杨丹丹; 桑海莉

    2016-01-01

    The premature ovarian failure refers to ovarian failure due to ovarian follicular depletion or due to iatrogenic injury occurred in women before the age of 40, with low estrogen and higher gonadal hormones ( FSH, LH ) features, and is mainly for the secondary amenorrhea associated with per menopausal symptoms.The “amenorrhea in young women” in theory of Fu Shan is the premature ovarian failure in modern medicine.There are many reasons that cause premature ovarian failure, the main factors that may be related to mental stress is too large for modern women.%卵巢早衰( Prematureovarian failure PoF),是指女性40岁前由于卵巢内卵泡耗竭或因医源性损伤而发生的卵巢功能衰竭,以低雌激素及高促性腺激素( FSH、LH)为特征,主要表现为继发性闭经,可伴有围绝经期症状,傅山所论的“年未老经水断”即为现代医学所说的卵巢早衰。引起卵巢早衰的原因有很多,最主要的因素可能是现代女性精神压力过大。

  18. 药物干预低促性腺激素性闭经致不孕的临床研究%Clinical Study of Drug Intervention for Hypogonadotropic Amenorrhea-induced Infertility

    Institute of Scientific and Technical Information of China (English)

    杨广; 罗汝琼

    2015-01-01

    OBJECTIVE:To explore the clinical efficacy of drug intervention on hypogonadotropic amenorrhea-induced infertili-ty. METHODS:33 patients with hypogonadotropic amenorrhea-induced infertility were included in study,and then received artifi-cial menstrual cycle+HMG+HCG. Therapeutic efficacy was observed. RESULTS:33 patients were included in the study,involving a total of 35 ovulation induction cycles. After treatment,there were 19 cases of pregnancy,5 cases of follicular development(more than 3 mature follicle,giving up HCG treatment and pregnancy plan),6 cases of follicular development(pregnancy failure)and 3 case of follicular development failure. CONCLUSIONS:Exogenous gonadotropin obtain relatively good results in the treatment of hypogonadotropic amenorrhea-induced infertility;but we must pay attention to drug dose so as not to affect the quality of folliculus.%目的:探讨药物干预对低促性腺激素性闭经所致不孕症的临床治疗作用。方法:将低促性腺激素性闭经所致不孕患者33例作为研究对象,采用人工月经周期+尿促性腺激素+人绒毛膜促性腺激素(HCG)进行治疗,观察临床疗效。结果:33例患者总计35个促排卵治疗周期。治疗后妊娠者有19例,卵泡发育超成熟者有5例(成熟卵泡>3个,放弃HCG治疗与妊娠计划),卵泡发育成熟者有6例(未能妊娠成功),剩余3例为促卵泡发育失败。结论:采用外源性促性腺激素治疗低促性腺激素性闭经所致不孕症可以取得良好的疗效,但需合理掌握用量,以避免对卵泡质量造成影响。

  19. Combine traditional Chinese and western medicine treatment of clinical research with amenorrhea after stream of people%中西医结合治疗40例人流术后闭经患者的临床研究

    Institute of Scientific and Technical Information of China (English)

    陈欢

    2015-01-01

    目的:探讨中西医结合治疗人流术后由宫腔粘连继发闭经的临床效果。方法:将80例人流术后由宫腔粘连继发闭经患者随机分对照组和观察组,每组40例,前者给予西医进行治疗,后者在西医的基础上结合中医进行治疗。结果:实验组治疗总有效率为97.50%,显著高于对照组(80.00%),且实验组IUA评分降低更为显著(分别为P<0.05和P<0.01)。结论:对于人流术后由宫腔粘连继发闭经患者来说,采取中西医结合疗法可显著提高治疗有效率,并显著降低宫腔粘连程度,具有重要的临床应用价值。%ObjectiveCombining traditional Chinese and western medicine treatment of stream of people surgery caused by intrauterine adhesions is addressed the clinical effect of secondary amenorrhea.Methods 80 cases of stream of people surgery by caused by intrauterine adhesions in patients with secondary amenorrhea random points in the control group and observation group, 40 cases in each group, the former gives the western medicine treatment, the latter on the basis of western medicine combined treatment of traditional Chinese medicine.Results Treatment group total effective rate was 97.50%, significantly higher than that of control group (80.00%), and the experimental group IUA score decreased significantly (P < 0.05 and P < 0.01).Conclusions For the stream of people surgery by caused by intrauterine adhesions in patients with secondary amenorrhea, to combine traditional Chinese and western medicine therapy can significantly improve the treatment efficiency, and significantly reduce caused by intrauterine adhesions degree, has the important clinical application value.

  20. Discussion of the Medication Characteristics for Amenorrhea Treated by Chen Zi-ming%陈自明治疗月水不通的用药特点探析

    Institute of Scientific and Technical Information of China (English)

    相宏杰; 闫石; 刘艳辉; 刘桂荣

    2013-01-01

    The treatment characteristics of amenorrhea by Master Chen was summarized in the paper by studying relevant herbal formulas in Fu Ren Da Quan Liang Fang. Concerning to etiology, Master Chen thought that injury of blood and qi results in weakness of body and wind and cold pathogens invade the uterus . Those internal and external factors damage the Thoroughfare Vessel and the Conception Vcssel,leading to obstruction of blood flow in the uterus,thus amenorrhea happens. This disease focuses on dciiciency of qi and blood and invasion of wind and cold in etiology. Regarding with treatment, Master Chen emphasized on tonifying and promoting treatment to regulate menstruation. Thirty — four formulas for the treatment of amenorrhea were analyzed statistically. It was discovered that those formulas emphasized on nourishing blood and activating blood circulation. The ingredients were warm and neutral in nature and bitter, pungent and sweet in flavor. Most ingredients were in the insect category with strong action on promoting circulation. Additionally the medication usage was flexible and various. All of those reflect the treating principles of tonifying and promoting in menstrual regulation.%文章通过研究中有关妇人月水不通的方剂,总结陈氏治疗月水不通的特点.病因方面,陈氏认为妇人常由"劳伤血气致令体虚""受风冷邪气客于胞内"内外两方面因素损伤冲任,使胞络内血绝不通而经闭,病因重视气血亏虚、风冷乘袭.治疗方面,陈氏重视"补通"以调经.通过统计分析陈氏治疗月水不通的34首方剂,发现其用药方面具有重视养血活血,药性偏温平,药味多苦辛甘,善用虫类药攻坚通络,服药方法灵活多样等特点,均体现了"补通"以调经的治疗原则.

  1. A first case of primary amenorrhea with i(X(qter---q10::---qter, rob(13;14(q10;q10, inv(9(p13q33 karyotype

    Directory of Open Access Journals (Sweden)

    Seema Korgaonkar

    2011-01-01

    Full Text Available Primary amenorrhea (PA refers to the absence of menarche by the age of 16-18 years although secondary sexual characters are developed. PA occurs in 1-3% of women in the reproductive age group. Various factors such as anatomical, genetic and hormonal factors reported to influence PA. We report triple chromosomal abnormalities of rob(13;14(q10;q10,inv(9(p13q33, i(Xq(qter---q10::---qter in a case of PA and short stature. Though proband has multiple chromosome aberrations, genotypic effect of only i(Xq is evident as proband has PA and short stature. The rob(13;14 and inv(9, which are paternally derived may have role in later reproductive age. Therefore, chromosomal analysis is essential in such cases for the accurate diagnosis and management of the disease.

  2. 中医治疗精神分裂症药源性闭经临床观察%Clinical observation of TCM treatment for schizophrenia with drug-induced amenorrhea

    Institute of Scientific and Technical Information of China (English)

    柯素梅; 周秀玉; 林建忠

    2015-01-01

    Objective To explore the efficacy of TCM treatment for schizophrenia with drug‐induced amenorrhea .Methods Sixty schizophrenics with drug‐induced amenorrhea were ran‐domly assigned to two groups of 30 ones each ,both groups maintained original antipsychotic treatment , research group was plus traditional Chinese drug of xuefu zhuyu tang for 12 weeks .Efficacies were assessed with the Clinical Global Impression (CGI) and adverse reactions with the Treatment Emergent Symptom Scale (TESS) before and after treatment ,menstruation recovery states recorded .Results After treatment the CGI scores of both groups lowered gradually ,there were no significant group differences in the corre‐sponding period (P>0 .05) .Both groups had no obvious adverse reactions ,the TESS score did no signifi‐cant group difference (P>0 .05) .At the end of the 12th week total effective rate of menstruation recovery was 93 .3% in research group ,amenorrhea status didn’t improve in control group ,the total effective rate was significantly higher in research than in control group (P<0 .01) .Conclusion TCM treatment has an evident effect and higher safety for schizophrenia with drug‐induced amenorrhea .%目的:探讨中医治疗精神分裂症药源性闭经的临床疗效。方法将60例精神分裂症药源性闭经患者随机分为两组,每组30例,均维持原用抗精神病药物治疗,研究组联合中药血府逐瘀汤加减治疗,观察12周。治疗前后采用临床总体疗效评定量表评定临床疗效,副反应量表评定不良反应,并记录月经恢复状况。结果治疗后两组临床总体疗效评定量表评分呈逐渐下降趋势,同期两组间评分比较差异无显著性(P>0.05);两组均未出现明显不良反应,副反应量表评分比较差异无显著性( P>0.05)。治疗12周末研究组月经恢复总有效率为93.3%,对照组闭经状况均无改善(未来月经),研究组总有效

  3. 功能性下丘脑性闭经患者生活事件、个性及激素水平%Life Events, Personality and Hormone Levels of Patients with Functional Hypothalamic Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    卢莉; 薛云珍; 彭梅

    2003-01-01

    @@ 功能性下丘脑性闭经(functional hypothalamic amenorrhea,FHA)是除外下丘脑、垂体器质性病变,由于促性腺激素功能不足而导致性腺功能低落的闭经,其发病率约占继发性闭经的55%[1].自Refeinstein(1946年)首次应用"精神性(心理性)闭经"[2]来描述应激诱发的月经紊乱以来,人们研究FHA时才开始考虑心理因素的作用.

  4. 超声检查在原发性闭经诊治中的应用价值%Role of ultrasonography in diagnosis and treatment of primary amenorrhea

    Institute of Scientific and Technical Information of China (English)

    顾燕; 茹彤; 戴晨燕; 杨燕; 徐燕

    2015-01-01

    Objective To investigate the clinical value of ultrasonography in the diagnosis and treatment of primary amenorrhea .Methods A total of 616 women with primary amenorrhea was examined by ultrasonography for the measurements of size of the uterus ,endometrial thickness ,size of two ovaries ,proportion of uterine body and uterine neck ,the number of ovarian follicle ,fluid in uterine cavity and vagina or pelvic cavity ,tumor in adnexa uteri and abnormalities in urinary system .Results The uterus dysplasia was diagnosed in 477 cases ,which included congenital absence of uterus in 72 cases ,primordial uterus in 110 cases and infantile uterus in 295 cases .The ovarian dysgenesis was diagnosed in 113 cases ,which included absence of two ovaries in 4 cases ,small size of two ovaries in 105 cases and single ovary in 4 cases .The vaginal dysplasia was diagnosed in 20 cases ,which included atresia of vagina in 15 cases ,transverse septum of vagina in 2 cases and oblique vaginal septum syndrome in 3 cases .The congenital imperforate hymen was diagnosed in 6 cases .The ectopic kidney was found in 9 cases .Conclusion Primary amenorrhea is associated with congenital defects of female genital organs .Ultrasound examination has a certain value in the diagnosis and treatment of primary amenorrhea .%目的:探讨超声检查在原发性闭经诊治中的应用价值。方法原发性闭经妇女616例,超声测量子宫大小、子宫内膜厚度、双侧卵巢大小,同时观察宫体与宫颈长度比例、卵巢内窦卵泡数目、有无宫腔积液、阴道积液、盆腔积液、附件包块和有无泌尿系统发育异常。结果616例中,子宫发育不良477例(先天性无子宫72例,始基子宫110例,幼稚子宫295例),卵巢发育不良113例(双侧卵巢未见4例,双侧卵巢偏小105例,仅见单侧卵巢4例),阴道发育异常20例(阴道闭锁15例,阴道横隔2例,阴道斜隔综合征3例),处女膜闭锁6

  5. Efifcacy of the integrative medicine on60 cases of secondary amenorrhea%中西医结合疗法治疗继发性痰湿阻滞型闭经的疗效观察60例

    Institute of Scientific and Technical Information of China (English)

    唐卓; 刘宇新

    2015-01-01

    目的:观察丹溪治湿痰方配合西药激素人工周期疗法治疗继发性痰湿阻滞型闭经的疗效。方法:将60例患者随机分为两组,治疗组30例,采用丹溪治湿痰方配合西药激素人工周期疗法治疗;对照组30例,采用西药激素人工周期疗法治疗。结果:治疗组、对照组总有效率分别为83.33%、70.00%,两组比较,差异有统计学意义(P<0.05)。结论:丹溪治湿痰方配合人工周期疗法治疗继发性痰湿阻滞型闭经疗效显著,可以明显改善临床症状。%Objective: To observe clinical efifcacy of the Danxi Zhi Shitan prescription plus hormone on secondary amenorrhea. Methods: 60 patients were randomly divided into two groups; the treatment group of 30 patients took the Danxi Zhi Shitan prescription plus hormone therapy; the control group of 30 patients took hormone therapy. Results: In the treatment group and the control group, the total effective rate was 83.33%, 70.00% respectively; the difference was statistically signiifcant (P<0.05). Conclusion: The Danxi Zhi Shitan prescription plus hormone on secondary amenorrhea showed a signiifcant effect, and can signiifcantly improve the clinical symptoms.

  6. The Risk of Sustained Amenorrhea in Patients with Systemic Lupus Erythematosus Receiving Intermittent Pulse Cyclophosphamide Therapy%大剂量环磷酰胺冲击治疗系统性红斑狼疮时的闭经危险

    Institute of Scientific and Technical Information of China (English)

    刘钢; 陈永涛; 王玲; 左川; 谢其冰; 王忠明; 林懋贤

    2001-01-01

    目的研究大剂量环磷酰胺冲击治疗系统性红斑狼疮时的闭经危险。方法前瞻性对比研究51例接受大剂量环磷酰胺冲击治疗的生育期女性患者与22例接受甲基强的松龙治疗的生育期女性患者的闭经发生率及其规律。结果大剂量环磷酰胺冲击治疗组闭经率19.6%,比甲基强的松龙治疗组的闭经率明显增高(P=0.025);大剂量环磷酰胺冲击治疗组中,年龄大于30岁组比30岁及30岁以下组闭经率高(P=0.0018)。结论大剂量环磷酰胺冲击治疗系统性红斑狼疮时,生育期女性患者闭经率升高。年龄愈大,闭经的危险愈高。%Objective To determine the risk of sustained amenorrhea in premenopausal women with systemic lupus erythematosus (SLE) receiving intermittent pulse cyclophosphamide (CTX) therapy. Methods Prospectively comparing the amenorrhea rate of 51 cases receiving intermittent pulse cyclophosphamide therapy versus that of 22 cases receiving intermittent pulse methylprednisolone (MP) therapy. Results The amenorrhea rate was higher in the CTX group (19.6%) than in the MP group (P=0.025).In the CTX group, the amenorrhea rate of patients aged over 30 was higher than that of patients aged 30 or below 30 (P=0.0018). Conclusion Pulse CTX therapy in fertile women with SLE is associated with increased rate of sustained amenorrhea, and the older the patient is, the higher risk for sustained amenorrhea the patient runs.

  7. Pro. Xu Xiaofeng’s Experience in Treating Primary Amenorrhea Combined with Infertility with Combination of TCM and Western Medicine (WM)%许小凤教授中西医联合治愈原发性闭经伴不孕1例

    Institute of Scientific and Technical Information of China (English)

    李成婷; 许小凤

    2014-01-01

    [Objective]Exploring from the specific case analysis of Chinese and western medicine treatment of primary amenorrhea with the clinical curative effect of infertility. [Method]In2013 January by Professor Xu Xiaofeng, doctor diagnosed primary amenorrhea with infertility and 1 patient of typicalcase, combined traditional Chinese medicine(TCM) and western medicine artificial menstrual cycle for 3 months, 3 months after the Chinese medicine Tiaozhou method combined with low dose of HMG with HCG inovulation induction treatment. [Result]After the treatment, the patients had pregnancy 70D, blood hormone and B Ultrasound examination were normal. [Conclusion]Combined treatment of TCM and western medicine is better than pure Chinese medicine or western medicine, suggesting that combination of TCM and western medicine is effective for the treatment of primary amenorrhea with infer-tility.%[目的]探究中西医联合治疗原发性闭经伴不孕的临床疗效。[方法]以许小凤教授2013年1月就诊的确诊为原发性闭经伴不孕的1患者为典型病例,先中药联合西药人工周期调经治疗3个月,3个月后中药调周法联合HMG小剂量递增配合HCG促排卵治疗。[结果]治疗后该患者成功妊娠,孕70d时,血激素及B超检查正常。[结论]中西医联合治疗优于单纯中医或西医治疗,提示中西医联合是治疗原发性闭经伴不孕的有效方法。

  8. 乌鸡白凤丸与阿立哌唑治疗利培酮所致闭经临床对比研究%Comparative clinical study on effect of Wuji Baifeng pills and aripiprazole in the treatment of risperidone induced amenorrhea

    Institute of Scientific and Technical Information of China (English)

    许勤伟; 刘向来; 黄胜; 黄兹高

    2013-01-01

    Objective:To explore clinical therapeutic effect and adverse reaction of Wuji Baifeng pills on risperidone induced amenorrhea.Methods:85 female schizophrenia patients with amenorrhea induced by risperidone were randomly divided into the treatment group of Wuji Baifeng pills (43 cases) and risperidone for aripiprazole contrast group (42 cases),90 days was a course.Results:Wuji Baifeng pills in the treatment of risperidone induced amenorrhea total clinical curative effect was obviously superior to risperidone,there was significant difference in effective rate between two groups (P < 0.05).Common adverse reactions were mild in two groups,and there was no significant difference in the score of TESS scale between the two groups (P > 0.05).Conclusion:Wuji Baifeng pills in the treatment of amenorrhea induced by risperidone has good clinical curative effect and adverse reaction is mild.%目的:探讨乌鸡白风丸治疗利培酮所致闭经的临床疗效及不良反应.方法:对85例利培酮治疗出现闭经的女性精神分裂症患者随机分为乌鸡白凤丸治疗组(43例)及停利培酮换用阿立哌唑的对比组(42例),以90天为一疗程.结果:乌鸡白凤丸治疗利培酮所致闭经的临床总疗效明显优于利培酮换用阿立哌唑的治疗,两治疗组有效率比较差异有统计学意义(P<0.05);两治疗组常见不良反应均较轻微,两组治疗不良反应采用TESS量表定期跟踪测评比较差异无统计学意义(P>0.05).结论:乌鸡白凤丸治疗利培酮所致闭经的临床疗效好,不良反应轻.

  9. An assessment of sex chromosome copy number in a phenotypic female patient with hypergonadtropic hypogonadism, primary amenorrhea and growth retardation by GTG-banding and FISH in peripheral blood and skin tissues

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, I.M.D.; DeMoranville, B.; Grollino, M.G. [Brown Univ. School of Medicine, Providence, RI (United States)] [and others

    1994-09-01

    The present report describes studies performed on an 18-year-old phenotypic female referred because of primary amenorrhea, hypergonadotropic hypoganadism and growth retardation. The clinical features raised the possibility of a gonadal dysgenesis. The ovaries were not identified on either side. Her testosterone was significantly elevated, with serum level at 48 ng/dl, and her free testosterone at 7 pg/ml. A GTG-banding analysis of 33 peripheral blood leukocytes revealed the modal number of chromosomes to be 46 per cell with a male sex constitution and normal appearing banding patterns (46,XY). In view of the clinical findings, additional cells were scored to rule out low percentage mosaicism. Out of 35 additional GTG-banded cells scored for the sex chromosomes, 4 cells (11.5%) were found to contain only one copy of the X chromosome. Fluorescent in situ hybridization (FISH) using dual color biotinylated X and Y probes (Imagenetics) was subsequently performed. Out of approximately 500 cells scored, 87% were found to be XY and 9% were found to be positive for the X signal only, versus 7% and 3% X signal only for 2 XY controls, aged 61 and 46, respectively. As loss of the Y chromosome has been reported in elderly males as well as certain males with leukemia, the age of the controls was important to note. To unequivocally establish the presence of mosaicism, a skin biopsy was obtained for fibroblast culture. Out of 388 total cells scored, 286 (74%) were found to be XY and 46 (12%) were found to be X, versus 99% XY and <1% X in controls. GTG-banding analysis of the same fibroblast culture is currently in progress. Preliminary data on this specimen thus far corroborate results of the FISH study. The presence of XY cells, along with an increased testosterone level, raises the distinct possibility of a gonadoblastoma. In view of this increased risk, arrangements are being made for the patient to have a laparoscopy and surgical removal of her presumptive streak gonads.

  10. 阿立哌唑治疗抗精神病药所致闭经的精神分裂症对照研究%A comparison study of aripiprazole in the treatment of schizophrenic patients with amenorrhea induced by antipsychotics

    Institute of Scientific and Technical Information of China (English)

    黄平; 廖彦浔; 叶慧; 虞晓兰

    2011-01-01

    目的:探讨阿立哌唑对抗精神病药所致闭经的精神分裂症患者的影响.方法:69例抗精神病药引起闭经的女性精神分裂症患者,随机分为A组(单用阿立哌唑治疗)34例和B组(用其他抗精神病药联合中药血府逐瘀汤治疗)35例,观察疗程3个月.于治疗前、治疗后1、2、3个月测定血清催乳素浓度,并评定闭经的疗效.结果:治疗后两组血清催乳素浓度均较治疗前降低;以A组血清催乳素浓度(15.21±6.17)μg/L显著低于B组(85.91±24.86)μg/L(t=-15.870,P=0.000);A组闭经治疗总有效率100%显著高于B组84.85%(χ2=67.00,P=0.000).结论:阿立哌唑治疗因抗精神病药所致闭经的精神分裂症患者安全、有效.%Objective:To study the clinical effect of aripiprazole in the treatment of schizophrenic patients with amenorrhea induced by antipsychotics.Method:69 female schizophrenic patients with amenorrhea induced by antipsychotics were randomly divided into two groups, group A (n =34, treated by aripiprazole) and group B (n = 35, treated by other antipsychotics combined with traditional Chinese medicine Xuefuzhuyu soup) ,for 3 months treatment.The serum level of prolactin was measured before and after 1,2 and 3 months treatment.The efficacy on amenorrhea was evaluated.Results:The serum level of prolactin decreased in both group after treatment, with significant decrease in group A compared with that in group B[(15.21 ± 6.17 ) μg/L vs.( 85.91 ± 24.86) μg/L( t = - 15.870, P = 0.000).The total treatment response rate for amenorrhea was 100% in patients of group A, significanfiy higher than that 84.85% in group B (x2 = 67.00, P=0.000).Conclusion:Aripiprazole can treat amenorrhea induced by antipsychotics in patients with schizophrenia efficaciously and safely.

  11. Riesgo Cardiovascular en la Anorexia Nerviosa y en otras formas de Amenorrea Hipotalámica Funcional Relacionadas con la Desnutrición Cardiovascular risk in anorexia nerviosa and other forms of functional hypothalamic amenorrhea related to undernutrition

    Directory of Open Access Journals (Sweden)

    Leán Fiszlejder

    2012-03-01

    ón auricular y la bradicardia, no es estadísticamente significativa, la presencia de estas arritmias aumentan el RCV y la posibidad de una eventual muerte súbita.The imbalance between energy intake and energy expenditure observed in malnourished or frankly under-nourished women with functional hypothalamic amenorrhea triggers an increased activity of hypothalamic hormones and peripheral neuropeptides, at facilitating the availability of endogenous energy metabolites. Osteoporosis, immune depression, hypothalamic amenorrhea and increased cardiovascular risk can be interpreted as secondary effects of the homeosthatic adaptation reactions by central and peripheral hormones. The extent of somatotropic axis deficiency, hypoestrogenism and time of evolution condition the nature of coronary circulation alterations and myocardial structural and functional involvement. An unfavorable lipid profile (normal LDL/ low HDL and hypertriglyceridemia, the rise in peripheral markers of fibrinolytic and inflammatory processes, results in a proatherosclerotic and prothrombotic environment. A premature presence of atheroma plaques in carotid walls, intima media thickness and subsequent artery stiffness may be frequently observed. This makes blood flow difficult, leading to coronary ischemia and predisposition to stroke. Echocardiographic studies show a decrease in the muscle mass of the left ventricle walls and the interventricular septum. These structural changes correlate with a volume reduction in the post-stress systolic ejection fraction, which subsequently occurs at rest at rest.The reduction in diastolic filling volume can be observed if the course of the disease is relatively long, showing, a serious compromise of cardiac performance. Even if the incidence of supraventricular extrasystoles, atrial fibrillation and bradycardia is not statistically significant, the presence of such arrhythmias increases CVR and the possibility of potential sudden death.

  12. Breastfeeding and Postpartum Amenorrhea in Rural Guatemala

    Directory of Open Access Journals (Sweden)

    Guido Pinto Aguirre

    2005-01-01

    Full Text Available La asociación entre los patrones de lactancia y el retorno de la menstruación de posparto es estudiada en mujeres rurales de Guatemala a partir del estudio longitudinal INCAP (1969-1977. En el estudio se distinguen entre mujeres que experimentaron la muerte de un infante antes del regreso de la menstruación, mujeres que quitaron la leche materna a sus hijos antes del regreso de la menstruación y mujeres que menstruaron mientras estaban lactando a sus hijos. Se encontró que el destete y mortalidad del infantil antes de la menstruación son factores de riesgo para el retorno de la menstruación. También se encontró que el bajo número de episodios de lactancia por día y una introducción temprana de alimentos sólidos en la dieta del infante son factores de riesgo significativos para el retorno de la menstruación de posparto.

  13. What Are the Treatments for Amenorrhea?

    Science.gov (United States)

    ... hot flashes and night sweats. ERT replaces the estrogen a woman's body should be making naturally for a normal menstrual cycle. In addition, ERT may help women with FXPOI lower their risk for the bone disease osteoporosis . 5 ERT can increase the risk for uterine ...

  14. [Hypercarotenemia, amenorrhea and a vegetarian diet].

    Science.gov (United States)

    Martin-Du Pan, R C; Hermann, W; Chardon, F

    1990-01-01

    In order to analyse the role of hypercarotenemia in amenorrhoea, we have studied the ovarian function of 20 patients presenting with hypercarotenemia (serum carotene greater than 5 mumol/l). 12 of these were complaining of secondary amenorrhoea (group I), 7 with a normal weight (group I A) and 5 with a weight below 85% of ideal weight (group I B). Another group of 8 patients had normal menstrual cycles and a body weight within normal limits (group II). Group I presented an ovarian insufficiency of hypothalamic origin with an increase in the FSH/LH ratio. The patients in group I A although of normal weight differed from group II by a history of important weight variations, strenuous sports activity and an essentially vegetarian diet, the most likely reason for their hypercarotenemia. The high carotene levels however do not seem to be directly responsible for the amenorrhoea, in view of the normal menstrual cycles of the patients in group II. Hypercarotenemia can be considered as a biologic marker of weight loss with fat mobilisation and low T3 levels. It can also be due to a vegetarian diet. The latter may be an aetiological factor in anovulation by increasing faecal excretion of oestrogens and thus decreasing blood levels of oestradiol particularly when associated with other compounding factors such as excessive physical activity, loss of weight or affective problems.

  15. Breastfeeding and Postpartum Amenorrhea in Rural Guatemala

    Directory of Open Access Journals (Sweden)

    Pinto Aguirre, Guido

    2005-07-01

    Full Text Available The association between breastfeeding patterns and resumption of postpartum menstruation was examined in rural Guatemalan women from the INCAP longitudinal study (1969-1977. It was distinguished among women who experienced infant mortality before menses resumed, women who weaned before menses resumed, and women who had return of menses while still breastfeeding. Weaning and infant mortality before menses resumes are significant risk factors for resumption of postpartum menstruation. Among those women whose menses resumed while still nursing or who remained amenorrheic and nursing at lose to follow-up or the end of the study, low number of nursing bouts per 24-hr day and the early introduction of supplements to the child were significant risk factors for the return of postpartum menstruation.

  16. Array CGH characterization of an unbalanced X-autosome translocation associated with Xq27.2-qter deletion, 11q24.3-qter duplication and Xq22.3-q27.1 duplication in a girl with primary amenorrhea and mental retardation.

    Science.gov (United States)

    Chen, Chih-Ping; Lin, Shuan-Pei; Chern, Schu-Rern; Kuo, Yu-Ling; Wu, Peih-Shan; Chen, Yu-Ting; Lee, Meng-Shan; Wang, Wayseen

    2014-02-01

    We present array comparative genomic hybridization (aCGH) characterization of an unbalanced X-autosome translocation with an Xq interstitial segmental duplication in a 16-year-old girl with primary ovarian failure, mental retardation, attention deficit disorder, learning difficulty and facial dysmorphism. aCGH analysis revealed an Xq27.2-q28 deletion, an 11q24.3-q25 duplication, and an inverted duplication of Xq22.3-q27.1. The karyotype was 46,X,der(X)t(X;11)(q27.2;q24.3) dup(X)(q27.1q22.3). We discuss the genotype-phenotype correlation in this case. Our case provides evidence for an association of primary amenorrhea and mental retardation with concomitant unbalanced X-autosome translocation and X chromosome rearrangement.

  17. lnteracciones de la respuesta del eje somatotrófco en la amenorrea hipotalámica funcional relacionada con la desnutrición The activity of the somatotrophic function in Functional Hypothalamic Amenorrhea (FHA related to undernourishmant

    Directory of Open Access Journals (Sweden)

    L Fiszlejder

    2011-03-01

    ólisis que aporta glucosa. No obstante, el aumento de los ácidos grasos libres y eventualmente la aparición de cuerpos cetónicos cuando la alimentación es muy restringida, sugieren la presencia de acidosis metabólica. Este estadio clínico implica un aumento del riesgo cardiovascular y la posibilidad de muerte prematura o súbita, una eventualidad latente en las pacientes con AHF y desnutridas. El autor declara no poseer conflictos de intereses.The activity of the somatotropic function in Functional Hypothalamic Amenorrhea (FHA is increased at the central level, and paradoxically, the peripheral hormonal behaviour, intermediate metabolism and several clinical aspects may be similar to those observed in somatotropic axis deficiency. Baseline and daily GH secretion levels are high, but its pulsatile profile is irregular. This results in resistance to GH, i.e., downregulation of hormone receptors, which, together with the decrease in GH binding protein (GHBP, impair GH ability to stimulate the synthesis of IGF-I, IGFBP-3 and the acid-labile subunit in the liver. This causes a decrease in the availability of free IGF-I in tissues. In addition, IGFBP-1 and IGF-BP2 significantly increase. Even if these peptides are regulated by GH, their inverse correlation with insulin activity (which is decreased in these patients and the low protein diet, respectively, appear to be more important factors. The increase in the serum levels of these peptides also contributes to the decrease in free IGF-I. Alterations in secretory patterns lead to a decrease in leptin concentration (an adipokine and to an increase in Ghrelin, which, in turn, facilitates GH secretion and has a remarkable incidence in intermediate metabolism in these undernourished patients. These hormonal changes can be interpreted as a mechanism of homeostatic adaptation tending to preserve availability of energetic nutrients. Thus, there is an initial predominance of lypolisis followed by proteolysis at muscle level. If

  18. PTP1B 、瘦素和脂联素在继发性闭经合并肥胖症患者外周血清中的表达及意义%Expression and Significance of Serum PTP1B,Leptin and Adiponectin in Obesity Patients with Secondary Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    宋丹; 石琨; 张晶鑫; 温菁

    2014-01-01

    [Objective]To explore the serum levels of protein tyrosine phosphatase 1B(PTP1B) ,leptin and adiponectin in patients with secondary amenorrhea .[Methods]A total of 60 patients diagnosed as secondary a-menorrhea in second affiliated hospital of Harbin medical university including 30 patients with obesity and 30 patients without obesity were selected as case group .Other 60 patients with normal menstrual including 30 pa-tients with obesity and 30 patients without obesity were selected as control group .Serum levels of PTP1B , leptin and adiponectin were measured by enzyme linked immunosorbent assay (ELISA) .[Results]Serum levels of PTP1B and leptin in amenorrhea with obesity group were (86 .24 ± 17 .58)ng/L and (16 .14 ± 2 .67)ng/L re-spectively ,which were obviously higher than those in patients with obesity in control group [(54 .66 ± 13 .27) ng/L and (10 .10 ± 1 .93)ng/L ,respectively)](all P 0 .05) ,while serum level of leptin was ob-viously increased[(6 .53 ± 3 .25) ng/L] and serum level of adiponectin was obviously decreased[(11 .76 ± 3 .58) mg/L](all P<0 .05) .Serum levels of leptin and adiponectin were related with obesity .PTP1B in amenorrhea with obesity patients was positively correlated with body mass index (BMI) and leptin ,but negatively correla-ted with adiponectin .[Conclusion] Serum levels of PTP1B ,leptin and adiponectin in obesity patients with a-menorrhea are of vital significance in promoting the occurrence and development of the disease .%【目的】探讨蛋白酪氨酸磷酸酶1B(PTP1B)和瘦素、脂联素在继发性闭经患者外周血清中的表达水平及意义。【方法】选取60例在哈尔滨医科大学附属第二医院诊断为继发性闭经的患者为观察组,其中30例闭经合并肥胖症,30例闭经无肥胖症;另选取60例体检月经正常者为对照组,其中30例合并肥胖症,30例无肥胖症。采用酶联免疫吸附实验(ELISA )检测两组患者血清中 PT P1B、瘦素和脂联

  19. 中药血府逐瘀汤辅助阿立哌唑治疗闭经的精神分裂症对照观察%Controlled observation of traditional Chinese medicine Xuefuzhuyu decoction combined with aripiprazole in treatment of schizophrenic patients with antipsychotic-induced amenorrhea

    Institute of Scientific and Technical Information of China (English)

    黄平; 杨泽云

    2011-01-01

    Objective To study the clinical effects of Xuefuzhuyu decoction (a traditional Chinese medicine) combined with aripiprazole in the treatment of schizophrenic patients with antipsychotic-induced amenorrhea. Methods Sixty-seven schizophrenic patients with antipsychotic-induced amenorrhea were randomly divided into group A (33 patients) treated with Xuefuzhuyu decoction combined with aripiprazole, and group B (34 patients) treated with aripiprazole alone. The treatment course was 3 months. The concentrations of prolactin (PRL) in serum were measured at the beginning of the study and at the end of each month, and the clinical effects on antipsychotic-induced amenorrhea were compared. The clinical effects on schizophrenosis were assessed using Positive and Negative Syndrome Scale (PANSS) at the beginning and the end of the study.Results The differences between PRL concentrations (base line and at the end of the 1st, 2nd, and 3rd months) of group A (113.88 ±40.84 μg/L, 43.59 ±17.35 μg/L, 16.88 ±8.42 μg/L and 15.53 ±6.28 μg/L)and group B (111.94±39.27 μg/L, 42.15 ±17.27 μg/L, 17.59 ±7.22 μg/L and 16.26 ±5.46 μg/L)had no statistical significance (t =0. 196 -0.600, P =0. 845 -0.550). The curative rate of antipsychotic-induced amenorrhea of group A ( 100.00% ) was not significantly different from that of group B (97.06%) (Chi square =0.956, P =0. 328). The total PANSS score of group A (45.69 ± 13.28) was significantly lower than that of group B (54.0318.52) at the end of the 3-month study (t= -2.091, P=0.040). Conclusion In the treatment of schizophrenic patients with antipsychotic-induced amenorrhea, Xuefuzhuyu decoction combined with aripiprazole can help to restore menstruation and improve the curative effect on schizophrenia.%目的 探讨中药血府逐瘀汤辅助阿立哌唑治疗闭经的精神分裂症患者临床疗效.方法 将67例抗精神病药引起闭经的精神分裂症患者按分层随机分为A组(n=33)、B组(n=34),A组中药血

  20. Effect of small dosage of estrogen on ovulation functional recovery of patients with weight-loss related amenorrhea%小剂量雌激素在跌重性闭经患者排卵功能恢复中的应用

    Institute of Scientific and Technical Information of China (English)

    李昕; 薛晓红; 徐晶晶; 林金芳

    2016-01-01

    Objective:To explore the effect of small dosage of estrogen on ovulation functional recovery of patients with weight‐loss related amenorrhea and clarify the variation of gonadotropin .Methods:The clinical data of 36 patients with weight loss‐related amenorrhea were collected and analyzed .The body mass index (BMI) before amenorrhea ,basic BMI (during amenorrhea) ,luteinizing hormone (LH)and luteinizing hormone‐releasing hormone (LHRH) provocation test data were collected .Clinical examination data of each period in estrogen treatment and LHRH provocation test data in each 6 months after treatment were collected .The basal body temperature was measured and serum progesterone was used to detect ovulation .The factors affecting the time of ovulation recovery were analyzed by statistic comparing .Results: Amone 36 patients ,20 cases were back to normal ovulation ,with the average time of (24 .1 ± 13 .6)months ,while the treatment period of estrogen replacement therapy in 16 non‐recovered cases was only (6 .65 ± 3 .36)months .Patients back to normal ovulation time was negatively correlated with former BMI (P<0 .01) and basal BMI (P=0 .04) .With the increasing of 1 kg/m2 of former BMI ,the treatment period can reduced 3 .6 months ,and the ovulation recovery time was reduced of 3 .1 months .In the 20 recovered patients ,arerage BMI of 17 patients increased (1 .92 ± 2 .11) kg/m2 ,2 patients did not change ,1 case was decreased of 0 .4 kg/m2 .The BMI variation of not recovered patients was not observed .The LH level was significantly increased of ([1 .2 ± 0 .4] mIU/mL vs [5 .6 ± 1 .6] mIU/mL , P= 0 .005) of patients back to normal ovulation .Area under the curve (AUC) of LH in LHRH provocation test was significantly increased (17 .1 ± 6 .3 vs 44 .6 ± 10 .1 ,P= 0 .027) .Conclusions:Weight loss‐related amenorrhea could restore ovulation by estrogen replacement therapy .L H self‐secretion level and reaction recovery of gonadotrophin releasing hormone are

  1. Clinical effect observation of exogenous gonadotropins in infertility patients caused by hypogonadotropic amenorrhea%外源性促性腺激素治疗低促性腺激素性闭经致不孕不育患者的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王霞; 蒋文友

    2016-01-01

    Objective To observe the clinical effect of exogenous gonadotropins in infertility patients caused by hy-pogonadotropic amenorrhea. Methods Selected 68 patients with infertility,caused by hypogonadotropic amenorrhea,they were in the hospital from January 2014 to January 2015 treated by estradiol valerate tablets and medroxyprogesterone acetate tablets. After treatment,compared the level of LH,FSH,P,E2 and PRL. Compared the related indicators of the uterus and pregnancy success rate. Results The level of LH、FSH、P、E2 and PRL after treatment were higher than that before treatment(P<0. 05). The uterine volume,ovarian volume,endometrial thickness after treatment were larger than that before treatment,the number of dominant follicle was more than that before treatment,the difference was statistically significant(P<0. 05). After treatment,52 cases was successful pregnancy,success rate of 76. 5%. Conclusion Exogenous gonadotropins in infertility patients caused by hypogonadotropic amenorrhea has an good effect,improve the patient′s chance of pregnancy,worthy of promotion.%目的:观察外源性促性腺激素治疗低促性腺激素性闭经致不孕不育患者的临床效果。方法收集2014年1月-2015年1月该院收治的低促性腺激素性闭经致不孕不育患者68例,采用外源性的促性腺激素(戊酸雌二醇片、醋酸甲羟孕酮片)进行治疗,对医治前后患者相关激素的水平进行检测比较,包括黄体生成素( LH)、卵泡刺激素( FSH)、孕酮( P)、雌二醇( E2)和催乳素( PRL),同时对医治前后子宫的变化进行对比,计算评估患者妊娠成功的概率。结果与治疗前相比,治疗后患者的LH、FSH、P、E2及PRL水平均显著升高(P<0.05)。治疗后患者子宫体积、卵巢休积及子宫内膜厚度大于治疗前,优势卵泡个数多于治疗前,差异均有统计学意义(P<0.05)。68例患者进行药物治疗后,有52例患者成功妊娠,成功率高达76.5%。

  2. The clinical significance of serum FSH,LH,PRL detection for amenorrhea women with atrophic urethritis%女性闭经后萎缩性尿道炎患者血清FSH、LH、PRL检验的临床意义研究

    Institute of Scientific and Technical Information of China (English)

    卢义娥; 朱中梁

    2015-01-01

    目的:探讨女性闭经后萎缩性尿道炎患者血清促卵泡素(FSH)、黄体生成素(LH)、垂体泌乳素(PRL)等性激素检验的临床方法及规律,为女性闭经后萎缩性尿道炎身心保健提供了理论支持。方法:选取40例闭经患者作为观察组,并选同期健康体检月经正常女性40例作为对照组。对象选取时间为2012年1月至2013年12月。采用放射免疫法分别对两组对象进行血清FSH、LH、PRL、E2、P、T水平检验,进行  对照研究。结果:观察组对象血清FSH、LH、PRL检验结果水平均明显高于对照组(P<0.05),E2检测水平低于对照组(P<0.05),P、T检测水平两组无差异(P>0.05)。结论:性激素水平检测可以有效反映女性闭经后萎缩性尿道炎的身体状况,有助于预防相关疾病,可作为临床诊治参考。%Objectives:To investigate the clinical methods and rules of serum FSH,LH,PRL detection for amenorrhea women with atrophic urethritis,to provide theoretical support for their physical and mental health. Methods:40 amenorrhea women were selected as the observation group,and correspondingly 40 healthy women with normal menstruation were selected as control group.All the objects were selected from January 201 2 to Decem-ber 201 3.Radioimmunoassay were adopted to study the serum FSH,LH,PRL,E2,P,T level of the two groups for control study.Results:The serum FSH,LH,PRL levels of control group were significantly higher than those of observation group (P0.05).Conclusion:The detection of sex hormone levels can effectively reflect the physical condition of amenorrhea women.As a reference in clinical treatment,it helps prevent related diseases.

  3. Application of array-based comparative genomic hybridization in primary amenorrhea women%基于微阵列芯片的比较基因组杂交技术在原发性闭经患者中的应用

    Institute of Scientific and Technical Information of China (English)

    冯琼; 符芳; 廖灿; 杨昕; 张亮; 田峰; 蔡斌; 刘帅

    2010-01-01

    目的 采用array-CGH技术对原发性闭经患者进行检测,探讨原发性闭经的分子生物学机制.方法 选取原发性闭经患者10例,另外选择10名具有规则月经周期的同龄女性自愿者作为健康对照者.分别采用常规细胞核型分析技术及array-CGH技术对10例原发性闭经患者和健康对照者进行分析.细胞核型分析技术采用常规G显带染色体核型分析技术,array-CGH技术采用美国Affymetrix公司Cytogenetic 2.7M微阵列芯片技术.结果 10例原发性闭经病例经常规G显带染色体核型分析未发现异常,所有病例和健康对照标本均为正常女性染色体核型:46,XX.Array-CGH 分析结果显示,有5例原发性闭经患者的X染色体短臂末端发生了约110000 bp的细小缺失,定位到染色体上的位置为:46,X,del(X)(p22.33).所有健康对照者经array-CGH分析均未见异常的DNA拷贝数改变.结论 Array-CGH技术在DNA水平上提高了染色体病的诊断水平,对于常规方法不能明确诊断的原发性闭经患者,有必要应用array-CGH技术进行更高分辨率的遗传学分析.%Objective To explore the molecular mechanisms of primary amenorrhea by using arrayCGH technology. Methods Ten patients with primary amenorrhea and 10 female volunteers with regular menstrual cycles as healthy controls were selected. All patients and control samples were analyzed by conventional chromosome analysis (G-banding technology) and array-CGH technology, respectively. ArrayCGH was performed using Affymetrix Cytogenetic 2. 7M arrays following the manufacturer's standard protocol. Results Both the patient group and control group analyzed by conventional G-banding karyotype technology showed a negative result with a normal female karyotype: 46, XX. The result of array-CGH analysis demonstrated a microdeletion of approximately 110 000 bp located at the end of the short arm of X chromosome [46, X, del (X) (p22. 33 )] were identified in 5 patients, which was

  4. Hypopituitarism and amenorrhea- galactorrhea syndrome caused by thrombosis of both internal carotid artery and giant intrasellar aneurysm: case report Hipopituitarismo e síndrome amenorreia-galactorreia causados por trombose de aneurisma carotídeo e da artéria carótida no pescoço: relato de caso

    Directory of Open Access Journals (Sweden)

    Jackson Gondim

    2004-03-01

    Full Text Available Giant intra and parasellar aneurysm with a spontaneous thrombosis of internal carotid artery is rare. We report the case of a 34 years old woman presenting a unique giant sellar and parasellar aneurysm associated with hypopituitarism and amenorrhea-galactorrhea syndrome. Computed tomographic scans and magnetic resonance images were suggestive of a sellar tumor with a cystic component. Digital cerebral angiography showed spontaneous thrombosis of a intrasellar and parasellar carotid artery aneurysm and left internal carotid artery in the neck. A transseptal endoscopic biopsy was done and confirmed a thrombosed aneurysm. No other surgical treatment was required in this patient but permanent endocrinological treatment was necessary.Aneurismas selares e paraselares gigantes com trombose da artéria carótida cervical e intracraniana são raros. Apresentamos o caso de mulher de 34 anos apresentando hipopituitarismo e síndrome amenorréia-galactorréia. A tomografia computadorizada craniana e a ressonância magnética foram sugestivas de tumor selar com componente cístico. Angiografia digital cerebral mostrou aneurisma único gigante selar e parasselar e trombose completa da artéria carótida comum esquerda no pescoço. A biopsia transeptal endoscópica da lesão mostrou tratar-se de aneurisma carotídeo trombosado. Não foi realizado nenhum outro tratamento cirúrgico na paciente, mas apenas tratamento endocrinológico de reposição.

  5. Treatment of Antipsychotic Drug-induced Phlegm Dampness Type Amenorrhea by Wuji Powder and a Small Dose Aripiprazole: a Clinical Study%五积散与小剂量阿立哌唑治疗抗精神病药物所致痰湿型闭经的临床研究

    Institute of Scientific and Technical Information of China (English)

    夏时炎; 张颖然; 虞洪; 孟旭; 张鹏; 刘军

    2014-01-01

    Objective To assess the efficacy and safety of Wuji Powder (WP) and a small dose aripiprazole in treatment of antipsychotic drug-induced phlegm dampness type amenorrhea.Methods Seventy female schizophrenic patients with antipsychotic drug-induced galactorrhea-amenorrhea syndrome (GAS) were recruited and randomly assigned to the treatment group and the control group,35 in each group.All patients received antipsychotic drug therapy.Patients in the treatment group additionally took WP,while those in the control group took aripiprazole (at the daily dose of 5 mg,once daily).The therapeutic course for all was 4 weeks.Prolactin levels and obesity indices [body weight、waist aircumstance、body mass index(BMI) and waist-hit ratio (WHR)] were determined before and after treatment.The efficacy was evaluated.Results The treatment course was completed in 95.71% of patients.The total effective rate of the 33 patients of the treatment group was 93.94% (31/33),while it was 91.18%(31/34) in the 34 patients of the control group.There was no difference in the total effective rate between the two groups (P >0.05).Prolactin levels in both group after treatment were significantly lower than those of the baseline (P <0.01).There was no significant difference in prolactin levels between the two groups after treatment (P >0.05).Compared with before treatment,body weight,BMI,waist circumstance,and waist-hip ratio obviously decreased after treatment,showing significant difference when compared with the control group (P <0.05).There was no significant difference in body weight,BMI,waist circumstance,and waist-hip ratio in the control group between before and after treatment (P >0.05).Conclusions Both WP and aripiprazole could lower high prolactin levels of schizophrenics with phlegm dampness type amenorrhea.They showed equivalent efficacy.But WP showed more obvious effect in reducing obesity indices.%目的 探讨五积散与小剂量阿立哌唑治疗抗精神病药物所

  6. Etiopatogenia de la amenorrea hipotalámica funcional: Interacción de las respuestas hormonales del sistema nervioso central y neuropéptidos periféricos Ethiopatogeniae of functional hypothalamic amenorrhea: Interactions of central nervous system and peripherical neuropeptides responses

    Directory of Open Access Journals (Sweden)

    L. Fiszlejder

    2008-06-01

    hipoestrogenismo es también uno de los factores de riesgo cardiovascular. No obstante, la administración de anticonceptivos que combinan estrógenos más progesterona, pueden aumentar significativamente los niveles de la proteína C reactiva, un reconocido y seguro marcador de riesgo cardiovascular. Ello induce a tomar precauciones en su utilización en estas amenorricas desnutridas. Asimismo, la administración de anticonceptivos no ha demostrado brindar un beneficio sustancial en el tratamiento de la osteosporosis de estas pacientes. El "circuito periférico", funcionalmente interrelacionado con el central, está principalmente compuesto por la leptina, adiponectina, ghrelin, insulina e IGF-1, péptidos provenientes del compartimiento graso ("adipocitokinas" tracto gastrointestinal superior, páncreas e hígado, respectivamente. Estos péptidos no sólo están involucrados en los mecanismos centrales del apetito y saciedad, sino que también participan en las respuestas de adaptación homeostática, tendientes a revertir los desvíos del metabolismo intermedio y fosfocálcico, que en grado variable afectan a estas pacientes. Conclusiones: la AHF relacionada en general con el estrés psicofísico prolongado y la mala nutrición, es un síndrome complejo, cuyas respuestas hormonales centrales y periféricas de adaptación, resultan primordiales en estas mujeres que padecen un cierto grado de compromiso nutritivometabólico general. Enfocando globalmente este abigarrado síndrome, estimamos que la AHF es, obviamente, un epifenómeno menos vital.Functional Hypothalamic Amenorrhea (FHA is a complex pathology produced by psicological stress, as observed in amenorrhea nervosa and bulimia or in intensive physical activity (athletas, competitions, classic dancing. Frequently, these factors are associated to quali-quantitative inadequated diets and therefore they induce alterations in the energetic balance (caloric intake, caloric expend and modification in body composition. These

  7. 闭经药膳方%Medicated diets for amenorrhea

    Institute of Scientific and Technical Information of China (English)

    赵怀德

    2009-01-01

    月经周期是正常的生理周期,如发生改变,说明体内发生了某些疾病。因此,不能忽视月经的各种变化。闭经,指少女年过18周岁而未行经,或有行经史而停经3个月以上,排除妊娠和更年期者。

  8. The Female Athlete Triad: Disordered Eating, Amenorrhea, and Osteoporosis.

    Science.gov (United States)

    Rust, Dawnella M.

    2002-01-01

    Describes the Female Athlete Triad, an interrelated combination of disorders that can occur in girls and women who are physically active. Presents nine resources for the Female Athlete Triad. Concludes that as more young females become physically active, school personnel need to be aware of the importance of promoting healthy eating and training…

  9. Fisiopatología de la disfunción gonadal en la Amenorrea Hipotalámica funcional (AHF y su relación con la activación del eje hipotálamo-hipófiso-adrenal Pathophysiology of gonadal dysfunction in functional Hypothalamic Amenorrhea (FHA and its relation to activation of the hypothalamic-pituitary-adrenal axis

    Directory of Open Access Journals (Sweden)

    León Fiszlejder

    2011-06-01

    cortisol sérico no son suprimidos por la administración de dexametasona y además la respuesta del ACTH postestímulo con CRH está atenuada. Estas observaciones sugieren una alteración de los mecanismos de "feedback" negativo del cortisol sobre la secreción del CRH-ACTH. Los mecanismos de esta resistencia al cortisol no están completamente dilucidados. Experiencias en animales sugieren que el estrés prolongado modifica la densidad y la relación de los receptores gluco/mineralocorticoideos y la actividad posreceptor. Por extrapolación se podría inferir que esta resistencia al cortisol en estas pacientes amenorreicas constituye un mecanismo tendiente a perpetuar la hiperactividad del eje adrenal. En adición, la activación del sistema simpático con el aumento de norepinefrina y epinefrina y su asociación con otros factores, produce un incremento en la liberación de glucosa y el aumento en la disponibilidad de NEFA, ácidos grasos libres y aminoácidos, mayor actividad cardíaca, estados de alerta y ansiedad. Estos aspectos pueden ser observados en estas pacientes con AHF, quienes frecuentemente presentan un importante componente psicosomático en su etiopatogenia. Conclusiones: la activación en el hipotálamo del NPY-CRH y sistemas opioide, serotoninérgico, GABAérgico, dopaminérgico y noradrenérgico, no solo afecta la función gonadal, sino que también puede estar involucrada en el desarrollo de osteoporosis y su riesgo de fracturas, inmunodepresión, aumento del riesgo cardiovascular y muerte súbita, una eventualidad latente en estas pacientes desnutridas con AHF.Functional Hypothalamic Amenorrhea (FHA is a secondary process to an adaptive response in women with inadequate diets and modified body composition. This process triggers hormonal reactions in the hypothalamus for preservation of metabolic homeostasis. It involves a "central circuit" made up of a network of hypothalamic hormones interrelated with a "peripheral circuit" made up of leptin and

  10. Lactação com amenorréia: experiência de enfermeiros e a promoção dessa opção contraceptiva Lactancia con amenorrea: experiencia de enfermeros y la promoción de esa opción anticonceptiva Lactational amenorrhea: nurses experience and the promotion of this alternative method of contraception

    Directory of Open Access Journals (Sweden)

    Escolástica Rejane Ferreira Moura

    2011-03-01

    varió de uno a seis meses, con media de 4,31 meses. Doce (19,6% usaron la LAM. El estudio demostró que la experiencia personal de enfermeros con la LAM no influenció en la promoción de este método a las pacientes atendidas por tales profesionales.This is a cross-sectional, field study that used a quantitative approach with the objectives to identify nurses' personal experiences with breastfeeding and with the Lactactional Amenorrhea Method (LAM; learn the reasons for not adhering to breastfeeding or adhering to mixed feeding; establish the relationship between nurses' personal experience with the LAM and their giving orientations about this contraceptive method to users of the Primary Health Care Center. Participants were 137 nurses with the Family Health Strategy in Fortaleza, Ceará, Brazil, and data collection was performed through interviews. Most participants were female; i.e., 121 participants (88.3%. The age range was 26 to 59 years, with an average of 38.3 years. Sixty-six participants (94.2% had a previous experience with breastfeeding, 61 (92.4% of which adhered to Exclusive Breastfeeding (EB, 5 (7.6% to Mixed Feeding (MF; and 4 (5.8% did not breastfeed. The time of EB ranged from one to six months, with an average 4.31 months. Twelve nurses (19.6% followed the LAM. The study showed that the nurses' personal experience with the LAM did not affect the promotion of this method to the clientele that they assist.

  11. Comparison and analysis of influencing factors of amenorrhea due to adjuvant chemotherapies of anthracycline-based and anthracycline followed by taxen in women with early breast cancer%含蒽环类和蒽环类序贯紫杉类方案辅助化疗对早期乳腺癌患者致闭经作用的比较及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    王佳玉; 李青; 张频; 袁芃; 马飞; 蔡锐刚; 罗扬; 樊英; 李俏

    2013-01-01

    前早期乳腺癌患者发生CIA,两组CIA的发生率及转归相似.年龄是CIA发生及其转归的重要影响因素.对于发生CIA的年轻患者,术后辅助化疗后的内分泌治疗选择应慎重.%Objective To determine the effect and influence factors of amenorrhea due to adjuvant chemotherapies of anthracycline-based and anthracycline followed by taxen in premenopausal patients with early breast cancer.Methods Case records of the patients who were premenopausal and estrogen receptor-positive with early breast cancer and received adjuvant chemotherapies of anthracycline-based and anthracycline followed by taxen in Cancer Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College from 2008 to 2010 were collected and retrospectively analysed.The chemotherapy regimens included anthracycline-based regimen 6EC (epirubicin 75 mg/m2 and cyclophosphamide 600 mg/m2 for 6 cycles and each cycle taking 21 days) and the anthracycline followed by taxen regimen 4EC-4T (epirubicin 90 mg/m2 and cyclophosphamide 600 mg/m2 for 4 cycles and each cycle taking 21 days,followed by paclitaxel 175 mg/n2 or docetaxel 75 mg/m2 for 4 cycles and each cycle taking 21 days).The patients were divided into two groups by the regiments.The incidence of chemotherapy-induced amenorrhea (CIA) was calculated and the recovery situation of menses and ovarian function in the patients with CIA during two years after the end of chemotherapy was recorded.The ovarian function was showed by luteinizing hormone,follicle-stimulating hormone,and estradiol levels.Influence factors of CIA was analysed in Logistic regression and x2 test methods.Results Ninety-six patients were enrolled in this study.Of them,45 patients were in the 6EC group with a media age of 43-year-old and 51 patients were in the 4EC-4T group with a media age of 42-year-old.Seventy-seven of ninety-six patients (80.2%) suffered from CIA during two years after the end of chemotherapy.Of the 77 patients with CIA,51

  12. Treatment of athletic amenorrhea with a diet and training intervention program.

    Science.gov (United States)

    Dueck, C A; Matt, K S; Manore, M M; Skinner, J S

    1996-03-01

    The purpose of this study was to determine the effect of a 15-week diet and exercise intervention program on energy balance, hormonal profiles, body composition, and menstrual function of an amenorrheic endurance athlete. The intervention program reduced training 1 day/week and included the use of a sport nutrition beverage providing 360 kcal/day. Three eumenorrheic athletes served as a comparison group and were monitored over the same 15-week period. The amenorrheic athlete experienced a transition from negative to positive energy balance, increased body fat from 8.2 to 14.4%, increased fasting luteinizing hormone (LH) from 3.9 to 7.3 mIU/ml, and decreased fasting cortisol from 41.2 to 33.2 micrograms/dl. The eumenorrheic subjects showed a 0.4% reduction in body fat, a decrease in follicular phase levels of LH from 7.9 to 6.5 mIU/ml, and no change in cortisol. These results suggest that nonpharmacological treatment can contribute to reestablishing normal hormonal profiles and menstrual cyclicity in amenorrheic athletes.

  13. Diagnosis and treatent of hypothalamic amenorrhea%下丘脑性闭经的诊治

    Institute of Scientific and Technical Information of China (English)

    白文佩

    2008-01-01

    下丘脑性闭经是闭经的常见类型,需在排除垂体、卵巢或子宫性闭经之后才能作出诊断。下丘脑性闭经分为功能性下丘脑性闭经(functional hypothalamic amenorrhea,FHA)和器质性下丘脑性闭经。

  14. 17-α-Hydroxylase deficiency: An unusual case with primary amenorrhea and hypertension

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Kota

    2011-01-01

    Full Text Available A 14-year-old girl presented with acute onset quadriparesis and newly detected hypertension. Parental consanguinity, delayed puberty with normal stature form the additional information. Hypokalemia with metabolic alkalosis, low cortisol, high ACTH and FSH pointed to the possibility of CAH with 17α hydroxylase deficiency. 46XX karyotype and high progesterone supported this. Normalization of hypokalemia and hypertension with glucocorticoid treatment confirmed the diagnosis. In summary, the possibility of 17 OHD should be suspected in patients with hypokalemic myopathy, Hypertension and hypogonadism so that appropriate therapy can be implemented.

  15. 闭经的中医治疗近况%Recent Progress in Research on TCM Treatment of Amenorrhea

    Institute of Scientific and Technical Information of China (English)

    李蕴茹

    2009-01-01

    闭经是妇科疾病的常见临床症状之一,其病因多样,病机繁杂,治疗棘手,中医对该病的治疗独具优势和潜力。现就2003年以来中医药治疗闭经的相关文献综述如下。

  16. Diagnosis and treatment of PCOS amenorrhea%多囊卵巢综合征性闭经的诊治

    Institute of Scientific and Technical Information of China (English)

    乔杰

    2008-01-01

    多囊卵巢综合征(PCOS)是育龄期妇女最常见的内分泌疾病,发病率约占育龄妇女的5%~10%,占无排卵性不孕的70%-80%。早在1935年Stein和Leventhal就将PCOS描述为月经稀发或闭经、多毛、肥胖和不孕为主要临床表现,后来的研究显示引起这些临床表现的主要病理生理基础是妇女血中雄激素水平升高,随后又发现胰岛素抵抗与高胰岛素血症也发挥着重要作用。

  17. La amenorrea como criterio diagnóstico de la anorexia nerviosa / Amenorrhea as a Diagnostic Criterion for Anorexia Nervosa

    OpenAIRE

    2013-01-01

    La amenorrea es un criterio para el diagnostico de la anorexia nerviosa (AN) según el DSM-IV-TR. Sin embargo, al comparar grupos de pacientes que cumplen todos los criterios de este manual para la AN con grupos de mujeres que los presentan todos salvo la amenorrea, algunos estudios no han encontrado diferencias significativas en la psicopatología típicamente asociadas con la AN. El propósito de nuestro estudio ha sido comparar variables demográficas, antropométricas, psicológicas y psicopatol...

  18. La amenorrea como criterio diagnóstico de la anorexia nerviosa / Amenorrhea as a Diagnostic Criterion for Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Santos Orejudo Hernández

    2013-06-01

    Full Text Available La amenorrea es un criterio para el diagnostico de la anorexia nerviosa (AN según el DSM-IV-TR. Sin embargo, al comparar grupos de pacientes que cumplen todos los criterios de este manual para la AN con grupos de mujeres que los presentan todos salvo la amenorrea, algunos estudios no han encontrado diferencias significativas en la psicopatología típicamente asociadas con la AN. El propósito de nuestro estudio ha sido comparar variables demográficas, antropométricas, psicológicas y psicopatológicas, en ambos grupos. No se observaron diferencias estadísticamente significativas entre ambos grupos en las variables evaluadas, pero el grupo con amenorrea tenía un índice de masa corporal significativamente más bajo. Nuestros datos apoyan la hipótesis de que la amenorrea podría no ser un criterio diagnóstico útil para la AN.

  19. The Health of Competitive Fitness Athletes

    Science.gov (United States)

    2017-03-24

    Resting Metabolic Rate; Bone Mineral Density, Low, Susceptibility to; Body Image; Perfectionism; Depression; Eating Disorder; Exercise-Related Amenorrhea; Exercise Addiction; Binge Eating; Dietary Amenorrhea; Dietary Deficiency

  20. 王少华善用消补兼施治疗闭经%Wang Shaohua's Experience in Treating Amenorrhea with Combined Treatment of Elimination and Tonification

    Institute of Scientific and Technical Information of China (English)

    王淑善

    2001-01-01

    @@ 家父王少华,在多年教学、科研、医疗工作中,取得了不少成就.我侍诊其侧,深知其在辨证上有过人见解,在论治上更具独到之处.现介绍其运用消补兼施法治疗闭经经验如下.

  1. Patient satisfaction and amenorrhea rate after endometrial ablation by ThermaChoice III or NovaSure: a retrospective cohort study

    NARCIS (Netherlands)

    Muller, I.; Palen, van der J.A.M.; Massop-Helmink, D.; Vos-de Bruin, R.; Sikkema, J.M.

    2015-01-01

    Heavy menstrual bleeding poses an important health problem, which can be managed, besides other treatments, with endometrial ablation. Nowadays, the bipolar radio frequency device (NovaSure) is the most commonly used device for endometrial ablation, followed by the thermal balloon device (ThermaChoi

  2. Amenorrhea Post-Induced Abortion:Analysis of 40 Cases%人工流产术后闭经40例原因分析

    Institute of Scientific and Technical Information of China (English)

    宋金荣

    2006-01-01

    闭经是妇科疾病的常见症状,可由各种不同的原因引起,人工流产术后发生闭经是由于子宫病变引起的闭经。现将我院2000年1月~2005年10诊治的人工流产术后闭经40例报告如下。

  3. Unique unbalanced X;X translocation (Xq22;p11.2) in a woman with primary amenorrhea but without Ullrich-Turner syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Letterie, G.S. [Virginia Mason Medical Center, Seattle, WA (United States)

    1995-12-04

    This is a report of a patient with delayed puberty and a previously unreported translocation 46,X,-X,+der(X),t(X;X) (q22;p11.2) without any manifestations of Ullrich-Turner syndrome. The relationship of this unbalanced translocation to the critical region hypothesis is discussed. 6 refs., 3 figs.

  4. Clinical investigation of bromocriptine treating in hypomenorrhea amenorrhea and galactorrhea%月经过少闭经溢乳症60例临床观察

    Institute of Scientific and Technical Information of China (English)

    黎秀琼; 林芸; 谭晓燕

    2004-01-01

    目的:探讨用溴隐亭治疗月经过少、闭经、溢乳症的临床效果,以及溴隐亭的治疗用量及疗程.方法:回顾分析总结1995~2000年诊治60例月经过少、闭经、溢乳症的临床资料,用溴隐亭治疗,先从小剂量1.25 mg/日治疗1周,第2周开始增加剂量至2.5 mg/日,第3周5 mg/日,症状改善后逐渐减量,至少量1.25 mg/日维持1~1.5月.结果:经用溴隐亭治疗后,3例垂体微腺瘤者症状消失,月经来潮;11例月经过少,3例治疗后2~8周月经量增多,3例治疗4~12周妊娠(其中2例为高PRL);51例溢乳患者,47例治疗后溢乳停止,4例明显减少;继发不孕10例,治疗期间妊娠6例(其中4例为高PRL),治疗后妊娠1例.结论:溴隐亭是药物治疗垂体泌乳素瘤的首选有效药物,对高PRL引起的月经量少、闭经及不孕治疗效果好,对某些不明原因的乳房溢乳、继发不孕可考虑使用溴隐亭治疗.

  5. Attach importance to the influence of amenorrhea on women's health and its treatment%重视闭经对女性健康的影响及其治疗

    Institute of Scientific and Technical Information of China (English)

    林金芳

    2008-01-01

    规律的月经是性成熟女性健康的标志,表明女性具有了周期性排卵的生殖功能及女性激素的周期性分泌。女性激素不仅促进女性性征发育,使生殖器官发生利于繁衍后代的变化,也是维持全身器官,包括眼、皮肤、心血管、骨骼等器官组织健康的重要激素。闭经(amenorrhea)对女性健康的影响不仅包括因排卵功能障碍而引起的不孕,还包括卵巢激素分泌失调或低雌激素的影响,以及引起闭经的疾病本身对健康的影响。

  6. 新兵训练后功能性闭经女兵的心身症状与激素水平%Psychosomatic Symptoms and Hormone Levels of Female Recruits with Functional Hypothalamic Amenorrhea after Physical Training

    Institute of Scientific and Technical Information of China (English)

    黄秀琴; 杨小柳; 张倩; 孙燕玲; 何晓冰; 骆利

    2005-01-01

    目的:探讨新人伍女兵功能性下丘脑性闭经(FHA)者与月经正常者激素水平及心理健康状况的差异.方法:在某部队新入伍女兵98人接受了为期近4个月的体能训练之后,有54人出现闭经,其中闭经3个月以上者有35人(研究组).训练后月经正常、在采血时月经周期处于第5~11天者有26人(对照组).分别测定她们血清中的促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)、泌乳素(PRL)、睾酮(T)、ACTH、T3、T4的水平,并用SCL-90分别评定她们的心理健康状况.结果:FHA者血清FSH值为4.96±1.73mIU/ml,LH值为2.63±1.78 mIU/m1,E2的值为7.23±5.37 pg/ml,对照组血清相应值为10.73±2.30mIU/ml、12.31±2.15mIU/ml、41.67±6.13pg/ml,差异有统计学意义(P<0.01),闭经组低于对照组.FHA组SCL-90的躯体化、人际敏感、抑郁、焦虑及其他因子分大于2的比率分别为:51.4%、42.9%、48.6%、51.4%及37.1%:而对照组这5项分值大于2的比率分别为15.4%、15.4%、19.2%、21.3%及11.5%,两组间这5个因子大于2的人数差异有统计学显著意义(P<0.05),闭经组高于对照组.结论:诊断为FHA的女兵与月经正常女兵的激素水平有差异,闭经组心身症状的发生率也高于对照组.

  7. Mechanism of Functional Hypothalamic Amenorrhea Caused by Anorexia Nervosa%神经性厌食引起功能性下丘脑闭经的作用机制

    Institute of Scientific and Technical Information of China (English)

    王晨曦

    2013-01-01

    神经性厌食症(AN)是一类发病早、病程长、病死率高的疾病,至今病因尚不完全清楚.AN发病的生物学基础是下丘脑的功能异常,伴随着能量消耗增加和(或)能量摄入的减少,以及一系列神经内分泌功能的紊乱症状.此种病征患者90% ~95%为女性,营养缺乏和内分辨代谢障碍导致促性腺激素功能不足,其特征为循环中低促性腺激素水平及低雌激素水平,对功能性下丘脑闭经(FHA)的发生和发展起重要作用.

  8. 中枢神经系统激素与功能性下丘脑性闭经%Functional Hypothalamic Amenorrhea and the Hormones of Central Nervous System

    Institute of Scientific and Technical Information of China (English)

    古芳; 徐艳文

    2009-01-01

    功能性下丘脑性闭经(FHA)是由于下丘脑促性腺激素释放激素(GnRH)的脉冲分泌受损导致的一种可逆性非器质性疾病.已发现中枢神经系统分泌的多种激素参与GnRH分泌的调控,并在功能性下丘脑性闭经的发病过程中起重要的作用.就目前认为与下丘脑性闭经相关的中枢神经系统激素进行综述,以探讨其治疗新策略.

  9. 二甲双胍治疗抗精神病药物所致闭经泌乳综合征的疗效观察%Effect of metformin on antipsychotic drug-induced galactorrhea-amenorrhea syndrome

    Institute of Scientific and Technical Information of China (English)

    梁春生

    2013-01-01

    目的 观察二甲双胍治疗药源性闭经泌乳综合征(GAS)的临床疗效.方法 选择本院116例GAS患者,在服用抗精神病药物的同时,给予二甲双胍治疗.在治疗前,治疗第4、8周时测定催乳素水平,进行疗效评定.结果 全部患者痊愈40例,显效42例,有效24例,无效10例,总有效率为91.4%.治疗后催乳素水平下降明显,与治疗前比较,差异有统计学意义(P<0.01).结论 二甲双胍治疗抗精神病药物所致GAS的疗效显著.

  10. 恶性颈动脉体瘤合并闭经和泌乳一例%A case of malignant tumor of carotid body complicated with amenorrhea and galactorrhea

    Institute of Scientific and Technical Information of China (English)

    高继东; 贾乃镛; 高芬; 李积德; 马立公; 鲍海华

    2001-01-01

    @@  患者女,36岁,右下颌肿物5年余伴低热1年。于1998年11月2日入院。5年前发现右下颌蚕豆大小的无痛肿块,3年前出现停经、溢乳。根据血清催乳素(PRL)水平及头颅MRI检查诊断泌乳—闭经症。口服溴隐亭治疗,月经恢复,催乳素降至正常水平,以后每日服溴隐亭2.5 mg维持治疗。2年前感右下颌肿物逐渐增大,行手术治疗,发现肿物呈椭圆形包绕颈内外动脉分叉部,因与颈动脉粘连紧密未能剥离。术后诊断:颈动脉体瘤。经CT检查示右侧颈内外动脉分叉处,45 mm×48 mm圆形低密度影,边界清,病灶将右侧颈内静脉向外推压,增强后病灶明显增强,同血管密度。1年来出现午后低热、盗汗、消瘦症状。X线片发现双肺结节样肿块数个、类园形(直径1~2 cm),密度均匀,边界清。CT检查诊断为肺转移瘤。肺组织活检免疫组化分析:神经原特异性烯醇化酶(neuron-specific enolase,NSE),嗜铬粒素(CgA)。既住无糖尿病及风湿病史,结婚10年,G1P1,月经14,(3-5)/(28-31),1998年5月7日。父母体健,家族中无遗传病史。体检:体温37.5℃,脉搏90次/分,呼吸20次/分,血压120/60 mm Hg(1 mm Hg=0.133 kPa),发育正常,精神差。右下颌角前下方可触及一约3 cm×5 cm大小的肿块,中等硬度、边界清、无触痛、活动度欠佳。甲状腺(-)、气管居中,双肺呼吸音略粗糙,心(-),肝脾未触及。神经系统病理反射(-)。住院期间实验室检查:血沉130~168 mm/h,血清总蛋白61~67 g/L、白蛋白20~31 g/L、球蛋白36~41 g/L。自身抗体:抗核抗体(ANA)+、抗核糖核酸蛋白抗体(32kd、29kd)+、A-SSB(47kd)+、A-SSA(52kd)±、抗核糖体蛋白抗体(38kd)+、口服葡萄糖耐量试验血糖水平:0h 12.9 mmol/L、0.5h 20.9 mmol/L、1h 24.6 mmol/L、2h 23.3 mmol/L。免疫反应性胰岛素:0h 5 mU/L、0.5h 20 mU/L、1h 26 mU/L、2h 10 mU/L。血清甲状腺激素:T3 0~0.3 nmol/L(正常值0.8~2.94 nmol/L)、T4 50~72 nmol/L(正常值43~183 nmol/L)、FT3 0.05~0.9 pmol/L(正常值3.18~9.22 pmol/L)、FT4 4.68~17.00 pmol/L(正常值8.6~25.6 pmol/L)、促甲状腺激素(TSH)0 mU/L(正常值0~8 mU/L)、皮质醇157~224 μg/L(正常值50~250 μg/L)、促生长素(GH)1.0~1.2 μg/L(正常值<5 μg/L)、促性腺激素FSH 0.0~1.5 IU/L(正常值3~30 IU/L)、LH 0 IU/L(正常值3~16.8 IU/L),催乳素29 μg/L(正常值2~25 μg/L)。住院半年,终因病情恶化未能救治。

  11. The Effects of Yangjingzhingyu Decoction in the Treatment of 12 Cases of Amenorrhea-galactorrhea Syndrome%养精种玉汤加减治疗闭经溢乳综合征12例

    Institute of Scientific and Technical Information of China (English)

    唐同秀; 张烨; 萧咏良

    1999-01-01

    @@ 闭经溢乳综合征属妇科疑难病,其发病多与垂体病变、某些药物影响、原发性甲低、外界刺激等因素有关,因其治疗疗程长,副作用大,复发率高,目前尚无确切疗法.笔者运用中药治疗本病12例,收到较好疗效,现分析报告如下.

  12. Nutrition for Women Athletes. Commonly Asked Questions.

    Science.gov (United States)

    Burke, N. Peggy

    1987-01-01

    Information on the nutritional needs of female athletes is presented. Among the topics discussed are proper eating habits, carbohydrate loading, amenorrhea, osteoporosis, anemia, vitamins, and minerals. (MT)

  13. Cardiometabolic abnormalities in the polycystic ovary syndrome : Pharmacotherapeutic insights

    NARCIS (Netherlands)

    Westerveld, H. E.; Hoogendoorn, M.; de Jong, A. W. F.; Goverde, A. J.; Fauser, B. C. J. M.; Dallinga-Thie, G. M.

    2008-01-01

    The polycystic ovary syndrome (PCOS) affects 5-10% of all premenopausal women. It is diagnosed by a combination of oligo-amenorrhea and hyperandrogenism (NIH criteria) or by the presence of two out of three of: oligo-amenorrhea, hyperandrogenism, polycystic ovaries on ultrasound (Rotterdam criteria)

  14. Fisiopatología de la disfunción gonadal en la Amenorrea Hipotalámica funcional (AHF) y su relación con la activación del eje hipotálamo-hipófiso-adrenal Pathophysiology of gonadal dysfunction in functional Hypothalamic Amenorrhea (FHA) and its relation to activation of the hypothalamic-pituitary-adrenal axis

    OpenAIRE

    León Fiszlejder

    2011-01-01

    La amenorrea hipotalámica funcional (AHF) constituye un proceso secundario de una respuesta de adaptación en mujeres que consumen dietas inadecuadas y presentan modificaciones en la composición corporal de su organismo. Ello origina reacciones hormonales en el hipotálamo destinadas a preservar la homeostasis metabólica. En este proceso de adaptación intervienen un "circuito central" constituido por una red de hormonas hipotalámicas que se interrelacionan con un "circuito periférico" integrado...

  15. Etiopatogenia de la amenorrea hipotalámica funcional: Interacción de las respuestas hormonales del sistema nervioso central y neuropéptidos periféricos Ethiopatogeniae of functional hypothalamic amenorrhea: Interactions of central nervous system and peripherical neuropeptides responses

    OpenAIRE

    2008-01-01

    La amenorrea hipotalámica funcional (AHF) es una patología compleja provocada generalmente por el estrés psicológico, o por alteraciones psicógenas como la depresión en otras entidades como la amenorrea nerviosa y bulimia o en la excesiva actividad física (atletas competitivas, bailarinas clásicas) entre las causas más frecuentes. Habitualmente, estos factores se presentan asociados a dietas cuali y cuantitativamente inadecuadas, originando alteraciones en el balance energético (consumo /gast...

  16. Efficacy of TVT-AbbrevoTM system in amenorrhea hole without tension urethra middle tension slings%TVT-AbbrevoTM系统在经闭孔无张力尿道中段无张力悬吊带术中的应用疗效研究

    Institute of Scientific and Technical Information of China (English)

    彭御冰; 李文吉; 刘冲; 王忠; 蔡志康

    2015-01-01

    目的 探讨使用TVT-AbbrevoTM系统改良TVT-O手术治疗女性压力性尿失禁(SUI)的疗效及安全性;方法 2014年9~11月随机分配入组38例SUI患者,分为TVT-O及TVTA组各19例,分别使用传统TVT-O吊带及TVT-AbbrevoTM系统行手术.术前评估年龄、病程、分娩、体质指数(BMI)、valsalva漏尿点压力(VLPP)、尿流率Qmax,各项两组差异无统计学意义.记录术中手术时间、出血量、术后1月内治愈率、并发症等并比较两组区别;结果 38例手术均获得治愈或改善,手术时间及手术中出血量TVT-O组较TVTA组差异无统计学意义,术后TVT-O组有2例术后尿频,TVTA组3例,经药物治疗1~2w后缓解.术后TVT-O组有单侧或双侧大腿根部疼痛4例,TVTA组有1例.两组比较差异有统计学意义(P<0.05).两组均无急迫性尿失禁及尿储留表现.结论 TVT-AbbrevoTM系统改良TVT-O手术,可以减少并发症的发生,长期疗效需要观察.

  17. Effect of Tongdatang Serial Recipe on Antipsychotic Drug-induced Galactorrhea-amenorrhea Syndrome%通达汤系列方治疗抗精神病药所致药源性闭经泌乳综合征的临床观察

    Institute of Scientific and Technical Information of China (English)

    丁瑛; 钱惠忠; 王义强; 沈鉴清; 朱长江; 刘军云; 张丽娜; 许子明

    2008-01-01

    目的 观察自拟通达汤系列方治疗药源性闭经泌乳综合征的临床疗效.方法 选用因服抗精神病药物引起药源性闭经和(或)泌乳的女性精神分裂症患者100例,随机分为两组(各50例),两组患者在服用抗精神病药物的同时,治疗组给予通达汤系列方治疗,对照组给予安慰剂治疗.并在治疗前,治疗4、8周时测定催乳素水平进行疗效评定.结果 两组总完成率为96%;治疗组49例,痊愈31例(63.3%),显效11例(22.4%),有效4例(8.2%),无效3例(6.1%),总有效率为93.9%.对照组47例,痊愈0例,显效3例(6.4%),有效7例(14.9%),无效37例(78.7%),总有效率为21.3%.催乳素水平:两组治疗前比较差异无统计学意义,治疗后治疗组下降(P<0.01),且治疗组下降幅度优于对照组(P<0.05);对照组治疗前后比较差异无统计学意义.结论 通达汤系列方治疗抗精神病药物引起药源性闭经泌乳综合征效果满意.

  18. Research of clinical effect by integrated traditional Chinese and Western medicine in the treatment of amenorrhea-galactorrhea syndrome%中西医结合治疗闭经泌乳综合征临床疗效的研究

    Institute of Scientific and Technical Information of China (English)

    孙玉

    2016-01-01

    目的 观察中西医结合治疗闭经泌乳综合征的临床疗效.方法 138例闭经泌乳综合征患者依就诊先后顺序分西医、中医、中西医结合三组,各46例,均进行相应的治疗,对各自临床疗效进行比较.结果 西医组总有效率76.09%(35/46)、中医组总有效率86.43%(37/46)、中西医结合组总有效率95.65%(44/46),中西医结合组临床疗效优于其他两组(P<0.05).结论 中西医结合治疗闭经泌乳综合征临床疗效优于单纯西医或中医治疗,值得推广应用.

  19. «Unsex Me Here»: Bodies and Femininity in the Performance History of Lady Macbeth

    OpenAIRE

    2013-01-01

    Jenijoy La Belle argued that Lady Macbeth’s “unsex me here” speech expresses Lady Macbeth’s desire to be made more masculine through amenorrhea. This amenorrhea enables Duncan’s murder, but leaves her barren. La Belle’s essay is predicated on Lady Macbeth’s female and initially fertile body, which is rendered barren by her actions in the first act. This paper considers alternative readings of Lady Macbeth’s femininity and amenorrhea codified by two historical bodies: the mal...

  20. Prolactin blood test

    Science.gov (United States)

    ... test; Amenorrhea - prolactin test; Breast leakage - prolactin test; Prolactinoma - prolactin test; Pituitary tumor - prolactin test ... hypothyroidism ) Kidney disease Pituitary tumor that makes prolactin (prolactinoma) Other pituitary tumors and diseases in the area ...

  1. Progesterone Test

    Science.gov (United States)

    ... not rise normally during an early pregnancy, the pregnancy may be ectopic and/or may be failing. If serial measurements ... Decreased function of ovaries Lack of menstruation ( amenorrhea ) Ectopic pregnancy Fetal death/miscarriage ^ Back to top Is there ...

  2. Serum progesterone

    Science.gov (United States)

    ... more commonly) Determine the risk of miscarriage or ectopic pregnancy early in pregnancy Normal Results Progesterone levels vary ... levels may be due to: Amenorrhea (no periods) Ectopic pregnancy Failure to ovulate Fetal death Possible miscarriage Alternative ...

  3. Risiko for øget sygelighed hos kvindelige idraetsudøvere

    DEFF Research Database (Denmark)

    Olesen, Anette Grønning; Clausen, Helle Vibeke; Skouby, Sven Olaf

    2010-01-01

    The female athlete triad refers to the interrelationships among energy availability, menstrual function and bone mineral density which may have clinical manifestations including eating disorders, functional hypothalamic amenorrhea and osteoporosis. The potentially irreversible consequences...

  4. Leptin levels in patients with anorexia nervosa are reduced in the acute stage and elevated upon short-term weight restoration

    DEFF Research Database (Denmark)

    Hebebrand, J; Blum, W F; Barth, N;

    1997-01-01

    Circulating leptin concentrations are known to be low in acute anorexia nervosa (AN), which is characterized by low weight, amenorrhea and specific psychopathological features. In this study plasma leptin concentrations were determined during inpatient treatment of 23 adolescent females...

  5. How I Manage Exercise-Related Menstrual Disturbances.

    Science.gov (United States)

    Shangold, Mona M.

    1986-01-01

    Amenorrhea and oligomenorrhea are often related to heavy exercise, but these conditions can signal a serious pathologic condition. Tests to pinpoint causes of menstrual dysfunctions are listed, and treatments to establish a proper hormone balance are described. (MT)

  6. Polycystic ovary syndrome: from phenotype to genetype

    NARCIS (Netherlands)

    Y.V. Louwers (Yvonne)

    2014-01-01

    markdownabstract__Abstract__ oligomenorrhea or amenorrhea, hirsutism or hyperandrogenism and polycystic ovarian morphology. Later in life, adverse metabolic implications, such as obesity, insulin resistance, type 2 diabetes and cardiovascular disease, become more prominent. In this thesis, we aimed

  7. Government Ideology, Economic Pressure, and Risk Privatization. How Economic Worldviews Shape Social Policy in Times of Crisis

    DEFF Research Database (Denmark)

    Horn, Alexander

    2017-01-01

    presented with symptoms of hypercortisolism such as progressive weight gain, Cushingoid appearance, proximal myopathy, easy bruising, and amenorrhea. Blood testing including inferior petrosal sinus sampling uncovered an ACTH-producing microadenoma in the right aspect of the anterior pituitary gland...

  8. Overproductive ovaries (image)

    Science.gov (United States)

    ... imbalance can be caused by tumors in the ovaries or adrenal glands, or by polycystic ovarian syndrome. Hyperandrogenism may include growth of excess body and facial hair, acne, amenorrhea (loss of menstrual periods), and changes in ...

  9. Autoimmune oophoritis: A rarely encountered ovarian lesion

    Directory of Open Access Journals (Sweden)

    Sunitha Jacob

    2015-01-01

    Full Text Available Autoimmune oophoritis is a rare disorder causing ovarian failure clinically characterized by amenorrhea and infertility. It often occurs in a setting of autoimmune polyendocrine syndromes. A 38-year-old female presented with a 3 years history of secondary amenorrhea. She was on treatment for Hashimoto′s thyroiditis and Addison′s disease. The ovaries were cystic and histologically featured by folliculotropic lymphoplasmacytic inflammatory infiltrate concentrated in the theca interna layer of developing follicles, but sparing the primordial follicles.

  10. High Serum 25-hydroxyvitamin D is Associated with Low Incidence of Stress Fractures

    Science.gov (United States)

    2011-06-01

    of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California 3 Osteoporosis Research Center...group (p 0.01) (9). Amenorrhea and age older than 25 years were also predictors of increased risk of stress fracture, while history of exercise was... exercise were independently associated with risk of fractures (9). In this study, it was not possible to include amenorrhea and exercise history (prior to

  11. Leptin levels in patients with anorexia nervosa are reduced in the acute stage and elevated upon short-term weight restoration

    DEFF Research Database (Denmark)

    Hebebrand, J; Blum, W F; Barth, N

    1997-01-01

    Circulating leptin concentrations are known to be low in acute anorexia nervosa (AN), which is characterized by low weight, amenorrhea and specific psychopathological features. In this study plasma leptin concentrations were determined during inpatient treatment of 23 adolescent females with AN u......Circulating leptin concentrations are known to be low in acute anorexia nervosa (AN), which is characterized by low weight, amenorrhea and specific psychopathological features. In this study plasma leptin concentrations were determined during inpatient treatment of 23 adolescent females...

  12. Prevalence of the female athlete triad in edirne, Turkey.

    Science.gov (United States)

    Vardar, Selma Arzu; Vardar, Erdal; Altun, Gülay Durmus; Kurt, Cem; Oztürk, Levent

    2005-12-01

    The aim of this study was to determine the prevalence of the female athlete triad, which is a clinical condition defined as the simultaneous occurrence of disordered eating, amenorrhea, and osteopenia and/or osteoporosis in female athletes. A total number of 224 female athletes from Edirne city participated in our study. Eating attitudes test (EAT 40) and a self-administered questionnaire were used to assess disordered eating behavior and menstrual status respectively. The participants having both disordered eating and amenorrhea were performed dual energy x-ray absorptiometry to evaluate bone mineral density. Thirty seven subjects (16.8%) had disordered eating behavior and 22 subjects (9.8%) were reported to have amenorrhea. Six athletes (2.7%) met two criteria (disordered eating and amenorrhea) of the triad. Of these, only three athletes met all components of the triad. We have found that the prevalence rate of female athlete triad was 1.36% among young Turkish female athletes. Female athletes have under considerable risk for the disordered eating and amenorrhea components of the triad. Key PointsThe prevalence rate of the occurrence of whole criteria of the female athlete triad was 1.36 % in young Turkish athletes in Edirne.Female athletes who met whole criteria of female athlete triad are more prone to the eating disorders.The occurrence of disordered eating behavior was higher in female athletes according to general population.Amenorrhea prevalence was significantly higher in female athletes who had disordered eating.

  13. PREVALENCE OF THE FEMALE ATHLETE TRIAD IN EDIRNE, TURKEY

    Directory of Open Access Journals (Sweden)

    Selma Arzu Vardar

    2005-12-01

    Full Text Available The aim of this study was to determine the prevalence of the female athlete triad, which is a clinical condition defined as the simultaneous occurrence of disordered eating, amenorrhea, and osteopenia and/or osteoporosis in female athletes. A total number of 224 female athletes from Edirne city participated in our study. Eating attitudes test (EAT 40 and a self-administered questionnaire were used to assess disordered eating behavior and menstrual status respectively. The participants having both disordered eating and amenorrhea were performed dual energy x-ray absorptiometry to evaluate bone mineral density. Thirty seven subjects (16.8% had disordered eating behavior and 22 subjects (9.8% were reported to have amenorrhea. Six athletes (2.7% met two criteria (disordered eating and amenorrhea of the triad. Of these, only three athletes met all components of the triad. We have found that the prevalence rate of female athlete triad was 1.36% among young Turkish female athletes. Female athletes have under considerable risk for the disordered eating and amenorrhea components of the triad

  14. Pathophysiology of bone loss in the female athlete.

    Science.gov (United States)

    Lambrinoudaki, Irene; Papadimitriou, Dimitra

    2010-09-01

    Low bone mass is frequent among female athletes. The "female athlete triad" is a term that describes the interaction among energy availability, menstrual function, and bone metabolism that may lead to amenorrhea and osteopenia or osteoporosis. The main pathophysiologic mechanisms that lead to low bone mass in female athletes are low energy availability and functional hypothalamic amenorrhea. Increased energy expenditure and/or decreased energy intake, as well as the presence of eating disorders, are associated with low bone mass. In addition, menstrual dysfunction is quite common, especially among athletes competing in sports favoring leanness, and also associates with low bone mass. Screening for bone loss in female athletes should take place in the presence of amenorrhea or body mass index <18 kg/m(2) . Management of low bone mass aims to restore normal energy availability and nutritional habits. Hormone replacement therapy has no effect in abnormally underweight patients unless normal eating behaviors are restored.

  15. A Case of Primary Hypogonadism with Features of Albright’s Syndrome

    Science.gov (United States)

    Lodh, Moushumi; Mukhopadhyay, Rajarshi

    2016-01-01

    Background: McCune Albright syndrome is rare with an estimated prevalence of 1 in 100,000 to 1 in 1,000,000 persons. The classical clinical triad consists of fibrous dysplasia of the bone, café-au-lait skin spots and precocious puberty. However, in rare cases, there may be primary hypogonadism and amenorrhea. Case Presentation: An eighteen-year-old female presented with amenorrhea. She had a short stature, round face, thick neck, and short fourth metacarpals and metatarsals. The secondary sexual characters were absent. Serum calcium, phosphorus and parathyroid concentrations were normal, but gonadotropin hormones were very low. X-ray examination revealed short fourth and fifth metacarpals, short left metatarsal, and short fibula. Conclusion: These local bony abnormalities along with the biochemical findings helped us to diagnose this case as an unusual presentation of primary hypogonadism with features of McCune Albright’s syndrome where there was amenorrhea rather than preocious puberty. PMID:27478774

  16. A Case of Primary Hypogonadism with Features of Albright’s Syndrome

    OpenAIRE

    Lodh, Moushumi; Mukhopadhyay, Rajarshi

    2016-01-01

    Background: McCune Albright syndrome is rare with an estimated prevalence of 1 in 100,000 to 1 in 1,000,000 persons. The classical clinical triad consists of fibrous dysplasia of the bone, café-au-lait skin spots and precocious puberty. However, in rare cases, there may be primary hypogonadism and amenorrhea. Case Presentation: An eighteen-year-old female presented with amenorrhea. She had a short stature, round face, thick neck, and short fourth metacarpals and metatarsals. The secondary sex...

  17. Eating disorders

    Science.gov (United States)

    The incidence of eating disorders is increasing, and health care professionals are faced with the difficult task of treating these refractory conditions. The first clinical description of anorexia nervosa (AN) was reported in 1694 and included symptoms such as decreased appetite, amenorrhea, food av...

  18. Post Repeat Lower Segment Caesarean Section Cervicovesical Fistula

    Directory of Open Access Journals (Sweden)

    Vidya A.Thobbi

    2008-12-01

    Full Text Available A 35 year old female patient G2P1L1 with previous LSCS with 9 months amenorrhea with labor pains was admitted and caesarean section was done for cephalo – pelvic disproportion with foetal distress. Patient developed cervico-vesical fistula which was successfully repaired by total abdominal hysterectomy and fistula was repaired using peritoneal flap .

  19. Heterotropic pregnancy following induction of ovulation with clomiphene

    Directory of Open Access Journals (Sweden)

    Sangeeta Raman Jogi

    2015-08-01

    A case of 36 years old G3P2 had received Clomiphen Citrate for three cycles for ovulation induction presented with amenorrhea for two months with severe pain in abdomen and bleeding. She was diagnosed as a case of right ectopic with 8 weeks of intrauterine pregnancy. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1241-1243

  20. The impact of gastric bypass surgery on sex hormones and menstrual cycles in premenopausal women

    DEFF Research Database (Denmark)

    Kjær, Mette Mandrup; Madsbad, Sten; Hougaard, David M;

    2016-01-01

    postoperative months. SHBG increased progressively and was doubled after 12 months. In contrast, total and free androgens and DHEA declined about 50% during the first three postoperative months and remained fairly constant hereafter. One year after surgery, 85% (11/13) of the women with oligo-/amenorrhea gained...

  1. Myo-inositol, glucose and zinc concentrations determined in the preconceptional period, during and after pregnancy.

    NARCIS (Netherlands)

    Groenen, P.M.; Roes, E.M.; Peer, P.G.M.; Merkus, H.M.; Steegers, E.A.P.; Steegers-Theunissen, R.P.M.

    2006-01-01

    OBJECTIVE: To determine the blood concentrations of myo-inositol, glucose and zinc before, during and after normal pregnancy. STUDY DESIGN: Preconceptionally, at 6, 10, 20, 30 and 37 weeks amenorrhea, and 6 weeks after delivery, blood samples of 18 nulliparae and 19 multiparae were obtained and conc

  2. The Effects of Lei Gong Teng on Reproductive Hormones

    Institute of Scientific and Technical Information of China (English)

    顾江红; 朱彩凤; 王蔚; 王联欢

    2001-01-01

    The serum reproductive hormone levels were examined with radioimmunoassay in women of child-bearing age before and after treatment with the prescriptions containing Lei Gong Teng (雷公藤Radix Tripterygii Wilfordii). The results showed that Lei Gong Teng could induce amenorrhea, but it was reversible.

  3. Neuroprotection via Reduction in Stress: Altered Menstrual Patterns as a Marker for Stress and Implications for Long-Term Neurologic Health in Women

    Science.gov (United States)

    Prokai, David; Berga, Sarah L.

    2016-01-01

    Individuals under chronic psychological stress can be difficult to identify clinically. There is often no outwardly visible phenotype. Chronic stress of sufficient magnitude not only impacts reproductive function, but also concomitantly elicits a constellation of neuroendocrine changes that may accelerate aging in general and brain aging in particular. Functional hypothalamic amenorrhea, a phenotypically recognizable form of stress, is due to stress-induced suppression of endogenous gonadotropin-releasing hormone secretion. Reversal of functional hypothalamic amenorrhea includes restoration of ovulatory ovarian function and fertility and amelioration of hypercortisolism and hypothyroidism. Taken together, recovery from functional hypothalamic amenorrhea putatively offers neuroprotection and ameliorates stress-induced premature brain aging and possibly syndromic Alzheimer’s disease. Amenorrhea may be viewed as a sentinel indicator of stress. Hypothalamic hypogonadism is less clinically evident in men and the diagnosis is difficult to establish. Whether there are other sex differences in the impact of stress on brain aging remains to be better investigated, but it is likely that both low estradiol from stress-induced anovulation and low testosterone from stress-induced hypogonadism compromise brain health. PMID:27999413

  4. Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Akcan AB.

    2013-06-01

    Full Text Available Turner syndrome is an important cause of short stature in girls and primer amenorrhea in young women that is usually caused by loss of part or all of an X chromosome. This topic will review the clinical manifestations, diagnosis and management of Turner syndrome.

  5. Galactorrhea and hyperprolactinemia associated with chest wall injury.

    Science.gov (United States)

    Morley, J E; Dawson, M; Hodgkinson, H; Kalk, W J

    1977-11-01

    A 48 year old premenopausal woman presented with galactorrhea and amenorrhea associated with chest wall burns. Basal serum prolactin levels were raised, and were further elevated by the administration of L-dopa, chlorpromazine and TRH. Intercostal nerve block and bromocryptine treatment reduced prolactin levels to normal, but did not noticably reduce milk secretion.

  6. Effect of hyperprolactinemia during development in children and adolescents.

    Science.gov (United States)

    Correll, Christoph U

    2008-08-01

    Increased levels of prolactin associated with some antipsychotic treatment can potentially lead to serious adverse events including gynecomastia, galactorrhea, oligomenorrhea, amenorrhea, and pituitary tumors. Clinicians may need to employ pharmacotherapeutic interventions such as reducing dosage, switching antipsychotics, or prescribing adjunctive agents to minimize or prevent these negative side effects and improve patients' outcomes.

  7. Meatless Diets in Female Athletes: A Red Flag.

    Science.gov (United States)

    Loosli, Alvin R.; Ruud, Jaime S.

    1998-01-01

    Physically active adolescent girls and young women who eliminate meat from their diets risk developing protein, iron, and zinc deficiencies. Meatless diets signal the possibility of amenorrhea and/or disordered eating, with the attendant risk of osteoporosis. Physicians must educate young women, parents, and coaches about the risks of meatless…

  8. Use of the Preparticipation Physical Exam in Screening for the Female Athlete Triad among High School Athletes

    Science.gov (United States)

    De La Torre, Dena M.; Snell, B. J.

    2005-01-01

    The female athlete triad comprises 3 individual but interrelated conditions associated with athletic training: disordered eating, amenorrhea, and osteoporosis. Each condition is of medical concern, but when found within the triad, they can have serious medical consequences. The purpose of this study was to evaluate the effectiveness of…

  9. The Female Athlete Triad. Managing an Acute Risk to Long-Term Health.

    Science.gov (United States)

    Nattiv, Aurelia; Lynch, Linda

    1994-01-01

    Amenorrhea, disordered eating, and osteoporosis form an interconnected, potentially fatal triad that is not widely understood. Physician vigilance when treating young female athletes can lead to early recognition and prevention of serious consequences. Physicians must help athletic young women participate in their sports in the healthiest, safest…

  10. The Female Athlete Triad

    Science.gov (United States)

    Sherman, Roberta Trattner; Thompson, Ron A.

    2004-01-01

    The Female Athlete Triad is a syndrome of the interrelated components of disordered eating, amenorrhea, and osteoporosis. Sometimes inadvertently, but more often by willful dietary restriction, many female athletes do not ingest sufficient calories to adequately fuel their physical or sport activities, which can disrupt menstrual functioning,…

  11. Characteristics of the Female Athlete Triad in Collegiate Cross-Country Runners

    Science.gov (United States)

    Thompson, Sharon H.

    2007-01-01

    The Female Athlete Triad is a life-threatening syndrome defined by disordered eating, amenorrhea, and osteoporosis. Objective and Participants: The author's purpose in this study was to examine female cross-country runners' (N = 300) calcium consumption, along with the prevalence of 2 components of the triad: disordered eating and menstrual…

  12. Helping Teenage Girls Avoid the Female Athlete Triad.

    Science.gov (United States)

    Ilardi, Deb

    2002-01-01

    Describes how school nurses can advocate for adolescent female students and help them avoid the female athlete triad that includes disordered eating, amenorrhea, and osteoporosis. The article focuses on consequences of the triad, how to uncover the symptoms, working to improve public support, and creating a successful program through partnership.…

  13. Effects of Inactivity and Exercise on Bone.

    Science.gov (United States)

    Smith, Everett L.; Gilligan, Catherine

    1987-01-01

    Research has shown that bone tissue responds to the forces of gravity and muscle contraction. The benefits of weight-bearing exercise in preventing or reversing bone mass loss related to osteoporosis is reviewed. The effects of weightlessness and immobilization, and the possible effects of athletic amenorrhea, on bone mineral density are…

  14. EARLY PREGNANCY TERMINATION WITH RU 486 ALONE AND IN COMBINATION WITH ONO 802

    Institute of Scientific and Technical Information of China (English)

    DUMing-Kun; HUANGZi-Yun; ZHENGHuai-Mei

    1989-01-01

    One hundred and eighty seven pregnant women with less than 49 days of amenorrhea were treated with RU 486, an antiprogestin, at a single oral dose of 600 mg alone (group 1, 28 cases ) and in combination with a vaginal suppository Containing 1 mg of ONO 802

  15. A PRELIMINARY CLINICAL STUDY OF TAMOXIFEN PRIOR TO PROSTAGLANDIN FOR TERMINATION OF EARLY PREGNANCY

    Institute of Scientific and Technical Information of China (English)

    CHENGLi-Nan; ZHOUYu-Fen; CHUYun-Hong; JINzhao-Ying

    1989-01-01

    Thirty four healthy women with amenorrhea of less than 49 daya applied for legal abortion. Each patient received tamoxifen ( Tara ) tablets 20 mg twioe a day for 4 consecutive days orally. In the morning of the Frith day they were given a vaginal sponge con-taining

  16. Copy number variants on the X chromosome in women with primary ovarian insufficiency

    NARCIS (Netherlands)

    Knauff, Erik A. H.; Blauw, Hylke M.; Pearson, Peter L.; Kok, Klaas; Wijmenga, Cisca; Veldink, Jan H.; van den Berg, Leonard H.; Bouchard, Philippe; Fauser, Bart C. J. M.; Franke, Lude

    2011-01-01

    Objective: To investigate whether submicroscopic copy number variants (CNVs) on the X chromosome can be identified in women with primary ovarian insufficiency (POI), defined as spontaneous secondary amenorrhea before 40 years of age accompanied by follicle-stimulating hormone levels above 40 IU/L on

  17. Successful Advanced Maternal Age Pregnancy with Mosaic Turner Syndrome Conceived after Ovulation Induction with Clomiphene Citrate: A Case Report

    Directory of Open Access Journals (Sweden)

    Masahiro Murakami

    2014-01-01

    Full Text Available Turner women typically experience gonadal dysfunction that results in amenorrhea and sterility. We encountered a case of mosaic Turner syndrome where conception was possible after ovulation induction with clomiphene citrate (CC. The patient’s ovaries were overresponsive to induction with CC. The challenges and successful outcome are reported.

  18. Successful advanced maternal age pregnancy with mosaic turner syndrome conceived after ovulation induction with clomiphene citrate: a case report.

    Science.gov (United States)

    Murakami, Masahiro; Hinokio, Kenji; Kiyokawa, Machiko; Morine, Mikio; Iwasa, Takeshi

    2014-01-01

    Turner women typically experience gonadal dysfunction that results in amenorrhea and sterility. We encountered a case of mosaic Turner syndrome where conception was possible after ovulation induction with clomiphene citrate (CC). The patient's ovaries were overresponsive to induction with CC. The challenges and successful outcome are reported.

  19. 21 CFR 862.1275 - Estrogens (total, nonpregnancy) test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Estrogens (total, nonpregnancy) test system. 862.1275 Section 862.1275 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... infertility, amenorrhea (absence of menses) differentiation of primary and secondary ovarian...

  20. Similar phenotype characteristics comparing familial and sporadic premature ovarian failure.

    NARCIS (Netherlands)

    Janse, F.; Knauff, E.A.; Niermeijer, M.F.; Eijkemans, M.J.; Laven, J.S.E.; Lambalk, C.B.; Fauser, B.C.J.M.; Goverde, A.J.

    2010-01-01

    OBJECTIVE: Premature ovarian failure (POF) is characterized by secondary amenorrhea before the age of 40 years, along with repeated increased follicle-stimulating hormone and low estrogen concentrations. POF is considered a complex genetic disease with a familial presentation in 12% to 50% of cases.

  1. Similar phenotype characteristics comparing familial and sporadic premature ovarian failure

    NARCIS (Netherlands)

    Janse, Femi; Knauff, Erik A. H.; Niermeijer, Martinus F.; Eijkemans, Marinus J.; Laven, Joop S. E.; Lambalk, Cornelius B.; Fauser, Bart C. J. M.; Goverde, Angelique J.; Hoek, Annemieke

    2010-01-01

    Objective: Premature ovarian failure (POF) is characterized by secondary amenorrhea before the age of 40 years, along with repeated increased follicle-stimulating hormone and low estrogen concentrations. POF is considered a complex genetic disease with a familial presentation in 12% to 50% of cases.

  2. Hyperprolactinemia in Women of Reproductive Age: Etiology, diagnosis, and management

    OpenAIRE

    Yuen, Basil Ho

    1992-01-01

    Galactorrhea-amenorrhea syndrome and infertility are manifestations of elevated prolactin levels. Numerous functional and tumorous conditions can cause hyperprolactinemia; prolactinoma is the most common tumor. The dopamine agonist agent bromocriptine controls hypersecretion, shrinks prolactinomas, and will restore menstruation and alleviate galactorrhea in most patients.

  3. Complementary Therapy in Polycystic Ovary Syndrome

    OpenAIRE

    Aquino, Carmen Imma; Nori, Stefania Lucia

    2014-01-01

    Polycystic Ovary Syndrome (PCOS) is an endocrine disease. PCOS afflicts 5 to 10 % of women of reproductive age. The symptoms are: amenorrhea, oligomenorrhea, hirsutism, obesity, infertility, chronic hyperandrogenic anovulation and acne. Other risk factors aggravate this condition: insulin resistance, obesity, hypertension, dyslipidemia, inflammation and subclinical cardiovascular disease. Anxiety, depression and reduced quality of life are also common. This review highlights the mechanisms an...

  4. Testicular Feminization or Androgen Insensitivity Syndrome (AIS in Iran: a Retrospective Analysis of 30-Year Data

    Directory of Open Access Journals (Sweden)

    Dariush. D FARHUD

    2016-02-01

    Full Text Available Background: Androgen insensitivity syndrome (AIS or testicular feminization is a partial or complete inability of cell response to androgen. The cause is enzymatic defect in synthesis of testosterone, resulting sexually immature phenotypically female, with primary amenorrhea. There are three categories of AIS, complete, partial and mild, depending on the degree of external genital masculinization. The aim of this study was to find out chromosomal abnormalities, and correlation between AIS and maternal/paternal age, parents' consanguineous marriage, family history and clinical observation, in Iranian AIS patients.  Method: This study includes a retrospective data analysis of 72,000 families' medical records in the Genetic Clinic in Tehran, during a 30-yr period (1984-2014. The essential basis for the patients' referral to the clinic by gynecologists was primary amenorrhea. Cytogenetic abnormalities has been confirmed by chromosome G-banding and conventional staining methods.Results: Seventy AIS female patients with 46XY pattern were cytogenetically diagnosed and the frequency of AIS syndrome was estimated about 0.05% (~70/140000. The results showed no association between AIS and maternal or paternal age nor were the marital pattern of the parents. The clinical findings illustrated that primary amenorrhea had the highest indication for referral of AIS patients for genetic counseling and cytogenetic study.Conclusion: No correlation was observed between AIS and maternal or paternal age or consanguineous marriages. Amenorrhea is the most clinically observed sign of AIS patients.  Keywords: Androgen insensitivity syndrome (AIS, Testicular feminization, Human androgen receptor (HAR, Amenorrhea, Iran

  5. Use of hormonal contraceptives to control menstrual bleeding: attitudes and practice of Brazilian gynecologists

    Science.gov (United States)

    Makuch, María Y; D Osis, Maria José; de Pádua, Karla Simonia; Bahamondes, Luis

    2013-01-01

    Background The purpose of this study was to assess the attitudes and prescribing practices of Brazilian obstetricians and gynecologists regarding use of contraceptive methods to interfere with menstruation and/or induce amenorrhea. Methods We undertook a nationwide survey of Brazilian obstetricians and gynecologists selected using a computer-generated randomization system. Participants completed a questionnaire on prescription of contraceptives and extended/continuous regimens of combined oral contraceptives (COCs). Results In total, 79.2% of Brazilian obstetricians and gynecologists reported that 20%–40% of their patients consulted them for menstrual-related complaints and 26%–34% of the gynecologists reported that 21%–40% of their patients consulted them for reduction in the intensity, frequency, and/or duration of menstrual bleeding. Overall, 93% stated that medically induced amenorrhea represents no risk to women’s health and 82.5% said that they prescribed contraceptives to control menstruation or induce amenorrhea. The contraceptives most commonly prescribed were extended-cycle 24/4 or 26/2 COC regimens and the levonorgestrel-releasing intrauterine system. Poisson regression analysis showed that Brazilian obstetricians and gynecologists prescribing contraceptives to control menstruation or induce amenorrhea consider extended-use or continuous-use COC regimens to be effective for both indications (prevalence ratio 1.23 [95% confidence interval 1.09–1.40] and prevalence ratio 1.28 [95% confidence interval 1.13–1.46], respectively). They also prescribed COCs with an interval of 24/4 or 26/2 to control bleeding patterns (prevalence ratio 1.10 [95% confidence interval 1.01–1.21]). Conclusion Brazilian obstetricians and gynecologists were favorably disposed toward prescribing extended-use or continuous-use COC regimens for control of menstrual bleeding or to induce amenorrhea on patient demand. PMID:24399887

  6. 透明质酸钠对预防人工流产术后闭经的作用研究

    Institute of Scientific and Technical Information of China (English)

    范睿嘉; 裘雅芬; 裘琳; 倪娟; 俞波

    2014-01-01

    目的:探讨透明质酸钠在人工流产手术后对预防闭经的实际疗效及价值。方法对400例人工流产术后使用透明质酸钠者进行跟踪调查,观察术后6个月内月经是否正常,有无白带增多、腹痛等症状,统计闭经出现的概率,并调查其年龄、孕次数与闭经之间的关系。随机选择400例进行人工流产术且未使用透明质酸钠等防粘连产品者,作为对照组,同样观察以上指标。结果人工流产术后使用透明质酸钠者仅1例出现闭经,闭经概率为0.26%,未使用防粘连产品者有19例闭经,闭经概率为5.35%,差异有统计学意义。结论透明质酸钠在人工流产术中对预防闭经有显著效果。%Objective To explore the value of sodium hyaluronate in preventing amenorrhea after induced abortion. Methods We Investigated 400 patients of induced abortion with the use of sodium hyaluronate byobserving whether they had regular menses,or any increased leucorrhea,abdominal pain and other symptoms Within half a year,collecting the rate of amenorrhea,and the relationship of the age and time span of mother pregnancy with amenorrhea. Another 400 patients of induced abortion without the use of sodium hyaluronate and were as a control. Results Only 1 patient suffered from amenorrhea with the use of sodium hyaluronate, the rate was 0.26%,while 19 patients suffered from amenorrhea without the use of sodium hyaluronate,the differencewas Significant. Conclusions Sodium hyaluronate has a significant effect on prevention of amenorrhea after induced abortion operation.

  7. Use of hormonal contraceptives to control menstrual bleeding: attitudes and practice of Brazilian gynecologists

    Directory of Open Access Journals (Sweden)

    Makuch MY

    2013-11-01

    Full Text Available María Y Makuch,1 Maria José D Osis,1 Karla Simonia de Pádua,1,2 Luis Bahamondes3 1Center for Research in Reproductive Health (CEMICAMP, 2Prof Dr José Aristodemo Pinotti Women's Hospital, University of Campinas, 3Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas, and National Institute of Hormones and Women's Health, Campinas, São Paulo, Brazil Background: The purpose of this study was to assess the attitudes and prescribing practices of Brazilian obstetricians and gynecologists regarding use of contraceptive methods to interfere with menstruation and/or induce amenorrhea. Methods: We undertook a nationwide survey of Brazilian obstetricians and gynecologists selected using a computer-generated randomization system. Participants completed a questionnaire on prescription of contraceptives and extended/continuous regimens of combined oral contraceptives (COCs. Results: In total, 79.2% of Brazilian obstetricians and gynecologists reported that 20%–40% of their patients consulted them for menstrual-related complaints and 26%–34% of the gynecologists reported that 21%–40% of their patients consulted them for reduction in the intensity, frequency, and/or duration of menstrual bleeding. Overall, 93% stated that medically induced amenorrhea represents no risk to women's health and 82.5% said that they prescribed contraceptives to control menstruation or induce amenorrhea. The contraceptives most commonly prescribed were extended-cycle 24/4 or 26/2 COC regimens and the levonorgestrel-releasing intrauterine system. Poisson regression analysis showed that Brazilian obstetricians and gynecologists prescribing contraceptives to control menstruation or induce amenorrhea consider extended-use or continuous-use COC regimens to be effective for both indications (prevalence ratio 1.23 [95% confidence interval 1.09–1.40] and prevalence ratio 1.28 [95% confidence interval 1.13–1.46], respectively. They also

  8. Sheehan's Syndrome with Edema in Optical Neural Sheaths: A Case Report

    Directory of Open Access Journals (Sweden)

    Mehtap Evran

    2013-04-01

    Full Text Available Sheehan syndrome is partial or complete hypophyseal insufficiency due to hypophyseal necrosis secondary to postpartum hemorrhage and hypovolemia. Clinical findings are cessation of lactation, secondary amenorrhea, loss of libido and hypophyseal reserve loss. Treatment is hormone replacement. Forty-four years old women admitted with somnolence, malaise, edema and blurred vision. Physical examination revealed edema and hypotension. She had massive bleeding during her birth 11 years old ago; therefore she had received blood transfusion and could not breast-feed then. She had amenorrhea when she admitted. She was diagnosed to be Sheehan syndrome while glucocorticoid and levothyroxine replacement was started. Hypophyseal and orbital magnetic resonance imaging revealed empty sella and edema in bilateral optical neural sheaths respectively. Empty sella may cause edema in optical neural sheaths by increasing pressure in subarachnoidal space. We present this case to point out this coincidence. [Cukurova Med J 2013; 38(2.000: 299-304

  9. Sheehan's syndrome with reversible dilated cardiomyopathy: A case report and brief overview.

    Science.gov (United States)

    Islam, A K M Monwarul; Hasnat, Mohammad A; Doza, Fatema; Jesmin, Humayra

    2014-04-01

    Sheehan's syndrome is a rare condition characterized by post-partal panhypopituitarism due to necrosis of adenohypophysis resulting from severe post-partum hemorrhage. Lethargy, amenorrhea and failure of lactation are the usual presenting features. Cardiac involvement in Sheehan's syndrome is rare. The case presented here describes dilated cardiomyopathy in a 36-year-old lady who failed to respond adequately to the standard anti-failure treatment. Further investigation revealed the diagnosis of Sheehan's syndrome. Besides other manifestations, cardiac function reverted to normal after giving replacement therapy with glucocorticoid, levothyroxine and sex hormone. Physicians, specially those in developing countries, should have high index of suspicion for the diagnosis of Sheehan's syndrome while dealing with a case of 'peripartal dilated cardiomyopathy'. Persistent amenorrhea and failure of lactation may be important clues in this context. Timely diagnosis and appropriate treatment can lessen the sufferings of the patients.

  10. Sheehan’s syndrome with reversible dilated cardiomyopathy: A case report and brief overview

    Science.gov (United States)

    Islam, A.K.M. Monwarul; Hasnat, Mohammad A.; Doza, Fatema; Jesmin, Humayra

    2014-01-01

    Sheehan’s syndrome is a rare condition characterized by post-partal panhypopituitarism due to necrosis of adenohypophysis resulting from severe post-partum hemorrhage. Lethargy, amenorrhea and failure of lactation are the usual presenting features. Cardiac involvement in Sheehan’s syndrome is rare. The case presented here describes dilated cardiomyopathy in a 36-year-old lady who failed to respond adequately to the standard anti-failure treatment. Further investigation revealed the diagnosis of Sheehan’s syndrome. Besides other manifestations, cardiac function reverted to normal after giving replacement therapy with glucocorticoid, levothyroxine and sex hormone. Physicians, specially those in developing countries, should have high index of suspicion for the diagnosis of Sheehan’s syndrome while dealing with a case of ‘peripartal dilated cardiomyopathy’. Persistent amenorrhea and failure of lactation may be important clues in this context. Timely diagnosis and appropriate treatment can lessen the sufferings of the patients. PMID:24719543

  11. Galactorrhea: a complication of spinal cord injury.

    Science.gov (United States)

    Yarkony, G M; Novick, A K; Roth, E J; Kirschner, K L; Rayner, S; Betts, H B

    1992-09-01

    Galactorrhea, a secretion of milk or milk-like products from the breast in the absence of parturition, has been reported to occur in women with spinal cord injuries in association with amenorrhea and hyperprolactinemia. Four cases of galactorrhea in association with spinal cord injury are reported. Galactorrhea developed in four spinal cord injured women who had thoracic paraplegia. The onset of galactorrhea was from one month to five months after injury. Although the onset of galactorrhea may have been related to prescribed medications in all four cases, insufficient data exist to draw conclusions. The three women whose galactorrhea persisted declined treatment and galactorrhea continuing for more than two years in one instance. We conclude that galactorrhea with or without amenorrhea may develop after a spinal cord injury and that spinal cord injured women may have an enhanced sensitivity to medication-induced galactorrhea.

  12. Women with anorexia nervosa should not be treated with estrogen or birth control pills in a bone-sparing effect.

    Science.gov (United States)

    Bergström, Ingrid; Crisby, Milita; Engström, Anne-May; Hölcke, Mats; Fored, Monika; Jakobsson Kruse, Pia; Of Sandberg, Ann-Marie

    2013-08-01

    Eating disorders are prevalent, serious conditions that affect mainly young women. An early and enduring sign of anorexia is amenorrhea. There is no evidence for benefits of hormone therapy in patients with anorexia; however, hormone medication and oral contraceptives are frequently prescribed for young women with anorexia as a prevention against and treatment for low bone mineral density. The use of estrogens may create a false picture indicating that the skeleton is being protected against osteoporosis. Thus the motivation to regain weight, and adhere to treatment of the eating disorder in itself, may be reduced. The most important intervention is to restore the menstrual periods through increased nutrition. Hormone and oral contraceptive therapy should not be prescribed for young women with amenorrhea and concurrent eating disorders.

  13. Neuroendokrine forstyrrelser ved anorexia nervosa - primoere eller sekundoere?

    DEFF Research Database (Denmark)

    Støving, R K; Hansen-Nord, M; Hangaard, J

    1996-01-01

    Anorexia nervosa is associated with multiple endocrine abnormalities. Hypothalamic neuropeptides and monoamines are involved in the regulation of human appetite, and they are changed in several ways in anorexia nervosa. But it remains to be clarified whether these alterations are secondary...... or etiologic. Feeding behaviour in anorexia nervosa is characterised by a strong ambivalence and not by loss of appetite. Hypothalamic amenorrhea is a diagnostic criterion, and is not only secondary as it often precedes the weight loss and persists for a long time after weight and motor activity have returned...... to normal. Hypersecretion of corticotropin releasing hormone seems to be secondary to starvation, but at the same time it may keep up and intensify the anorexia, physical hyperactivity and amenorrhea. Low production of insulinlike growth factor-I and high growth hormone secretion reflects the nutritional...

  14. A review of endocrine changes in anorexia nervosa

    DEFF Research Database (Denmark)

    Støving, R K; Hangaard, J; Hansen-Nord, M

    1999-01-01

    Anorexia nervosa is a syndrome of unknown etiology. It is associated with multiple endocrine abnormalities. Hypothalamic monoamines (especially serotonin), neuropeptides (especially neuropeptide Y and cholecystokinin) and leptin are involved in the regulation of human appetite, and in several ways...... they are changed in anorexia nervosa. However, it remains to be clarified whether the altered appetite regulation is secondary or etiologic. Increased secretion of corticotropin-releasing hormone and proopiomelanocortin seems to be secondary to starvation, however, there is evidence that it may maintain...... and intensify anorexia, excessive physical activity and amenorrhea. Hypothalamic amenorrhea, which is a diagnostic criterion in anorexia nervosa, is not solely related to the low body weight and exercise. Growth hormone resistance with low production of insulin-like growth factor I and high growth hormone...

  15. Isolated adrenocorticotropin deficiency presenting as primary infertility.

    Science.gov (United States)

    Atkin, S L; Masson, E A; White, M C

    1995-06-01

    A 31 year old female presented with primary infertility and gave a two year history of amenorrhea without symptoms or signs of endocrine dysfunction. Examination was normal and investigation showed low oestradiol and progesterone levels with decreased LH pulsatility. The cortisol responses were impaired following hypoglycaemic stress and a short synacthen test, but the cortisol response to a prolonged synacthen test was normal. An inadequate ACTH response to CRF testing confirmed the diagnosis of isolated ACTH deficiency. Hydrocortisone therapy was followed by an ovulatory menstrual cycle. Amenorrhea again ensued following the reduction of the steroid dose and normal menses resumed on normal steroid replacement therapy. Six hourly gonadotrophin pulsatility showed a significant increase in both pulse amplitude and mean LH and FSH levels following steroid treatment. Isolated ACTH deficiency is a rare but treatable cause of hypogonadism and infertility, and this case gives further insight on the role of cortisol on the hypothalamo-pituitary gonadal axis.

  16. Genetically modified mouse models for premature ovarian failure (POF).

    Science.gov (United States)

    Jagarlamudi, Krishna; Reddy, Pradeep; Adhikari, Deepak; Liu, Kui

    2010-02-01

    Premature ovarian failure (POF) is a complex disorder that affects approximately 1% of women. POF is characterized by the depletion of functional ovarian follicles before the age of 40 years, and clinically, patients may present with primary amenorrhea or secondary amenorrhea. Although some genes have been hypothesized to be candidates responsible for POF, the etiology of most of the cases is idiopathic, with the underlying causes still unidentified because of the heterogeneity of the disease. In this review, we consider some mutant mouse models that exhibit phenotypes which are comparable to human POF, and we suggest that the use of these mouse models may help us to gain a better understanding of the molecular mechanisms underlying POF in humans.

  17. Team management of the female athlete triad: part 1: what to look for, what to ask.

    Science.gov (United States)

    Joy, E; Clark, N; Ireland, M L; Martire, J; Nattiv, A; Varechok, S

    1997-03-01

    The female athlete triad of disordered eating, amenorrhea, and osteoporosis affects many active women and girls, especially those in sports that emphasize appearance or leanness. Because of the athlete's psychological defense mechanisms and the stigma surrounding disordered eating, physicians may need to ask targeted questions about nutrition habits when assessing a patient who has a stress fracture or amenorrhea, or during preparticipation exams. Carefully worded questions can help. Physical signs and symptoms include unexplained recurrent or stress fracture, dry hair, low body temperature, lanugo, and fatigue. Targeted lab tests to assess nutritional and hormonal status are essential in making a diagnosis that will steer treatment, as are optimal radiologic tests like dual-energy x-ray absorptiometry for assessing bone density.

  18. Youssef’s Syndrome following Cesarean Section

    Directory of Open Access Journals (Sweden)

    Ozer Birge

    2015-01-01

    Full Text Available Youssef’s syndrome is characterized by cyclic hematuria (menouria, absence of vaginal bleeding (amenorrhea, and urinary incontinence due to vesicouterine fistula (VUF, the least common of the urogynecological fistulas. Youssef’s syndrome has a variable clinical presentation. A vesicouterine fistula is an abnormal pathway between the bladder and the uterus. The most common cause is lower segment Cesarean section. Conservative treatment may be appropriate in some cases, but surgery is the definitive treatment. Vesicouterine fistula should be suspected in cases presenting with urinary incontinence even years after Cesarean section. Diagnostic tests as well as necessary appropriate surgery should be performed on cases with suspected vesicouterine fistula. We present a 40-year-old multiparous woman with vesicouterine fistula after primary Cesarean section; she presented with urinary incontinence, hematuria, and amenorrhea 1 year after the birth. Here, we discuss our case with the help of previously published studies found in the literature.

  19. ECTOPIC CHORIOCARCINOMA IN A PRETEEN IN OGBOMOSO, SOUTH-WEST NIGERIA. A CASE REPORT

    OpenAIRE

    Olumuyiwa Ogunlaja A; Gbemi Ano-Edward H.; Akintunde Fehintola O; Michael Alao A; Olufemi Awotunde T; Idowu Ogunlaja P; Olurotimi Aaron; Ajibola Idowu; Funmito Fehintola O; Matthew Bojuwoye O; Sunday Oladeji A; Matthew Lasisi E

    2016-01-01

    Ectopic Choriocarcinoma is an extremely rare occurrence. The case of ectopic choriocarcinoma discussed here involved a 12 year old girl who presented with lower abdominal pain and dizziness following a short period of amenorrhea after attaining menarche. Aprovisional diagnosis of ruptured ectopic gestation was made based on the clinical evaluation and patient had emergency laparotomy. Histopathology report revealed a choriocarcinoma of the ovary. Patient defaulted on subsequent follow up care...

  20. Ethnobotany, phytochemistry and pharmacology of Biophytum sensitivum DC

    OpenAIRE

    Bharati, Abinash C.; Sahu, Alakh N.

    2012-01-01

    Medicinal plants are widely being used by the traditional medical practitioners for curing various diseases in their day-to-day practice. Biophytum sensitivum DC (Oxalidaceae) is used as a traditional folk medicine in ailments such as inflammation, arthritis, wounds, tumors and burns, gonorrhea, stomach ache, asthma, cough, degenerative joint disease, urinary calculi, diabetes, snake bite, amenorrhea and dysmenorrhea. It is a small, flowering, annual herb with sensitive leaves. It grows throu...

  1. Phenolic profile of wild Achillea millefolium L. obtained by HPLC-DADESI/MS.

    OpenAIRE

    Dias, Maria Inês; Barros, Lillian; Dueñas, Montserrat; Carvalho, Ana Maria; Oliveira, M.B.P.P.; Santos-Buelga, Celestino; FERREIRA, ISABEL C.F.R.

    2013-01-01

    Achillea millefolium L., commonly known as yarrow, belongs to Asteraceae family and it is very common in mountain meadows, pathways, crop fields and homegardens. It is widely used in Europe as an herbal remedy to treat digestive problems, diabetes, hepato-biliary diseases and amenorrhea, being also consumed for its antitumor, antimicrobial, anti-inflammatory and antioxidant properties [1,2]. Some studies related A. millefolium medicinal properties to the presence of phenolic compo...

  2. 下丘脑性闭经14例分析

    Institute of Scientific and Technical Information of China (English)

    陆湘; 汪玉宝; 高敏芝

    2004-01-01

    下丘脑性闭经(hypothalamic amenorrhea,HA)是最常见的一种闭经形式,约占继发性闭经的48%。其病因复杂,本文即是对14例HA患者的病因和内分泌表现进行分析。

  3. Ovarian mucinous cystadenocarcinoma in 17-year-old girl : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Koo; Ko, Jae Kook; Moon, Hee Jung; Kim, Mi Young; Yu, Hyun; Shin, Hyun Ja; Seo, Kung Yong; Kim, Jeong Rye [Korea Veterans' Hospital, Seoul (Korea, Republic of)

    1997-08-01

    Malignant epithelial neoplasm usually occurs in postmenopausal women, with less than 10% of cases occurring in women under the age of 20. In patients below this age, the majority of ovarian tumors are of germ cell origin and malignant ovarian epithelial tumors are uncommon. We report US and CT imaging in a case of mucinous cystadenocarcinoma in a 17-year-old nullipara who complained of amenorrhea for 45 days and a palpable mass.

  4. Preparation and clinical application of the Bawei Huayu mixture%八味化瘀合剂的制备与临床应用

    Institute of Scientific and Technical Information of China (English)

    马永明; 陈淑萍; 刘秋鹤

    2013-01-01

      目的:探讨八味化瘀合剂的制备与治疗产后胎盘、胎膜残留、痛经、闭经的临床疗效。方法:建立该制剂的质量控制方法;观察其治疗产后胎盘、胎膜残留、痛经、闭经的的疗效。结果:处方配伍及制备过程合理,治疗观察103例病例,胎盘、胎膜残留治愈率87.3%,显效98.2%。痛经有效率90.0%,闭经有效率66.6%。临床疗效显著。结论:八味化瘀合剂治疗产后胎盘、胎膜残留、痛经、闭经疗效确切,有临床推广应用价值。%Objective:To investigate the preparation of the Bawei Huayu mixture and the efficacy for treating postpartum residual placental membranes, dysmenorrhea, amenorrhea. Methods: Establishing quality control methods of the formulations, the efficacy was observed for treating postpartum residual placental membranes, dysmenorrhea, amenorrhea. Results: Prescription compatibility and preparation process was reasonable, 103 cases were observed and treated, the cure rate of postpartum residual placental membranes was 87.3%, and the markedly efficiency was 98.2%. The efficiency was 90.0% for treating dysmenorrhea, and was 66.6% for treating amenorrhea, clinical efficacy was significant. Conclusion:The Bawei Huayu mixture is effective in treating postpartum residual placental membranes, dysmenorrhea, amenorrhea, worthy of clinical application.

  5. Hemoperitoneum: a diagnostic dilemma. A solid ovarian tumour mimicking ruptured ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Wills G. Sheelaa

    2013-04-01

    Full Text Available 39 year old sterilized women presented like ruptured ectopic pregnancy with 40 days amenorrhea, pain, and shock Urine Pregnancy Test negative. Culdocentesis was positive. Ultra sonogram confirmed hemoperitoneum and TO mass. Laparotomy revealed left solid ovarian tumour with tumour mass protruding from perforated site and hemoperitoneum. Histological diagnosis was granulosa cell (GC tumour Stage 1c. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 254-256

  6. Injury Reduction Effectiveness of Prescribing Running Shoes Based on Plantar Shape in Marine Corps Basic Training San Diego, CA and Parris Island, SC

    Science.gov (United States)

    2009-05-01

    amenorrhea results in hormonal changes, especially lower estrogen levels, which leads to a reduction in bone mineral density and increasing likelihood...Stegman M.R., and Recker R.R. 2001. The impact of lifestyle factors on stress fractures in female Army recruits. Osteoporosis International, 12...stages. Osteoporosis International, 16:552- 561. 166. Valimaki M.J., Karkkainen M., Lamberg-Allardt C., Laitinen K., Alhava E., Heikkinen J

  7. Hyperprolactinemia with normal serum prolactin: Its clinical significance

    Directory of Open Access Journals (Sweden)

    Manika Agarwal

    2010-01-01

    Full Text Available Amenorrhea and infertility with an added feature of galactorrhea makes a provisional diagnosis of hyperprolactinemia. But again, normal serum prolactin with all clinical features of hyperprolactinemia might question the diagnosis and further management. The answer lies in the heterogeneity of the peptide hormone - the immunoactive and the bioactive forms. This has been further illustrated with the help of a case which had been treated with cabergoline.

  8. A case of Cushing s syndrome in pregnancy secondary to an adrenal cortical adenoma.

    OpenAIRE

    Kim, Hwi Gon; Lee, Kwang Hyun; Je, Goo Hwa; Han, Myoung Seok

    2003-01-01

    Cushing s syndrome in pregnant women is rare and difficult to be diagnosed because of the syndrome's association with oligomenorrhea or amenorrhea and the changes in cortisol metabolism during normal pregnancy. Cushing syndrome in pregnancy is usually confused with complicated pregnancy, such as preeclampsia or gestational diabetes, and its rarity leads to a low degree of clinical suspicion, often delaying diagnosis. We experienced a case of Cushing s syndrome in pregnancy, which had been con...

  9. A Case of Ullrich-Turner Syndrome with 45,X/46,XY Karyotype

    OpenAIRE

    Yüce, Hüseyin; AKIN, Haluk; ETEM, Ebru; DEVECİ, Şükriye DERYA

    2004-01-01

    The presence of mosaic 45,X/46,XY is a very rare chromosomal anomaly, with an incidence of about 1.5 per 10.000 in newborn infants and in midtrimester amniocentesis. The phenotype can vary from a normal male to a classical Ullrich-Turner syndrome (UTS). This patients are often infertile. The proposita presented at short stature, primary amenorrhea and hypoplasic uterus. Clinical examination revealed multiple Turner syndrome stigmata. Proposita karyotype was determined as 45,X/46,XY by cytogen...

  10. Treating symptomatic hyperprolactinemia in women with schizophrenia: presentation of the ongoing DAAMSEL clinical trial (Dopamine partial Agonist, Aripiprazole, for the Management of Symptomatic ELevated prolactin)

    OpenAIRE

    Kelly, Deanna L; Wehring, Heidi J.; Earl, Amber K; Sullivan, Kelli M; Dickerson, Faith B.; Feldman, Stephanie; McMahon, Robert P.; Buchanan, Robert W.; Warfel, Dale; Keller, William R.; Fischer, Bernard A.; Shim, Joo-Cheol

    2013-01-01

    Prolactin elevations occur in people treated with antipsychotic medications and are often much higher in women than in men. Hyperprolactinemia is known to cause amenorrhea, oligomenorrhea, galactorrhea and gynecomastia in females and is also associated with sexual dysfunction and bone loss. These side effects increase risk of antipsychotic nonadherence and suicide and pose significant problems in the long term management of women with schizophrenia. In this manuscript, we review the literatur...

  11. Gonadotropin Pulsatllity in FemaIe Long Distance Runners

    Science.gov (United States)

    1986-10-24

    Luteinizing action on the induction of LH receptors by FSH. hormone in turn stimulates the synthesis of androgen precursors. During the late follicular...gonadotrope . for subsequent GnRH mediated gonadotropin release. In addition, ’ both GnRH and estradiol promote gonadotropin synthesis . However...such as heroin or methadone is associated with drugs ~e development of amenorrhea or other menstrual disturbances (Santen, 1973). Recently

  12. Prevalence of the Female Athlete Triad in Edirne, Turkey

    OpenAIRE

    Selma Arzu Vardar; Erdal Vardar; Gülay Durmus Altun; Cem Kurt; Levent Öztürk

    2005-01-01

    The aim of this study was to determine the prevalence of the female athlete triad, which is a clinical condition defined as the simultaneous occurrence of disordered eating, amenorrhea, and osteopenia and/or osteoporosis in female athletes. A total number of 224 female athletes from Edirne city participated in our study. Eating attitudes test (EAT 40) and a self-administered questionnaire were used to assess disordered eating behavior and menstrual status respectively. The participants having...

  13. The dependence [correction of dependance] between the mineral content in skeletal bones and the state of periodontium in women in case of hypoestrogenemia.

    Science.gov (United States)

    Volozhin, A I; Khokhlova EYu; Novikov, V E

    1996-09-01

    Women with hypoestrogenemia either through secondary amenorrhea of unknown etiology, post-menopausal period or removed ovaries due to benign tumor were studied to determine if there is a relationship between the hormone state of women and their skeletal and periodontal tissues. Results indicated that women with hypoestrogenemia showed more pronounced changes in periodontium tissue as compared to normal women. These women also showed evidence of periodontium injury. These results are discussed along with implications for treatment and preventive measures.

  14. Endocrine evaluation of reproductive function in girls during infancy, childhood and adolescence

    DEFF Research Database (Denmark)

    Juul, Anders; Hagen, Casper P; Aksglaede, Lise

    2012-01-01

    a spectrum of disorders such as premature thelarche, premature adrenarche, central and peripheral precocious puberty, adolescent polycystic ovarian syndrome, functional ovarian hyperandrogenism, late-onset congenital adrenal hyperplasia, primary and secondary amenorrhea, and premature ovarian insufficiency....... Diagnosis of these reproductive disorders includes biochemical as well as clinical evaluation. The biochemical evaluation of reproductive function includes measurement of basal reproductive hormone levels and dynamic pituitary or adrenal hormone testing. Correct interpretation of such test results requires...

  15. [Abdominal migration of a levonorgestrel-releasing intrauterine device. Case report and review of the literature].

    Science.gov (United States)

    Pont, M; Lantheaume, S

    2009-04-01

    We report the case of a 27-year-old woman in amenorrhea after the installation of a levonorgestrel releasing intra-uterine device, 3 years previously. In front of pelvic continuing pains, paraclinic explorations diagnosed the DIU-LNG in intra-abdominal situation. An exploratory laparoscopy was realized and allowed its ablation. The authors discuss the systemic distribution of the levonorgestrel and the impact of the DIU-LNG in intra-abdominal situation by a review of the literature.

  16. Polycystic ovary syndrome and hirsutism

    OpenAIRE

    Evliyaoğlu, Olcay

    2011-01-01

    Polycystic ovary syndrome is a multi factorial heterogenous disorder characterized by chronic anovulation and hyperandrogenism Diagnosis is based on clinical or laboratory evidence of nbsp; hyperandrogenism nbsp; For diagnosis at least two of the three Rotterdam criteria oligo anovulation clinical or biochemical signs of hyperandrogenism polycystic ovaries nbsp; should be ensured Clinical symptoms usually begin around menarche nbsp; Oligomenorrhea amenorrhea hirsutism acne alopecia can be ass...

  17. Fraser syndrome.

    Directory of Open Access Journals (Sweden)

    Chattopadhyay A

    1993-10-01

    Full Text Available Fraser Syndrome is a rare disorder with only a few cases having been described in Indian literature. We report here a case of a patient aged 16 yr present with primary amenorrhea which is a very unusual mode of presentation. Multiple associated anomalies were present including those of eyelids, eyebrow, face, fingers and genitalia. Chromosome analysis revealed a normal female karyotype. Pituitary gonadotropins were within normal range.

  18. The pineal gland - Its possible roles in human reproduction

    Science.gov (United States)

    Brzezinski, Amnon; Wurtman, Richard J.

    1988-01-01

    The paper discusses the role of the pineal gland in controlling mammalian reproduction, with particular attention given to the role of melatonin in polyestrus mammals, like humans and laboratory rodents. Evidence is cited indicating the influence of melatonin production and blood content on the age of puberty, the timing of the ovulatory cycle, gonadal steriodogenesis, and patterns of reproductive behavior. It is suggested that abnormal patterns of melatonin might be associated with amenorrhea, anovulation, unexplained infertility, premature menopause, and habitual abortions.

  19. Present Concepts in Internal Medicine. Volume 13, Number 1. Endocrinology Research Symposium,

    Science.gov (United States)

    1980-01-01

    BM Nylund (First Authors) plus co-autho s S. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASK Department of Medicine...have at least partial deficiencies of one or more pituitary hormones at the time of diagnosis. These deficiencies most commonly affect FSI! and LH...Erhardt F, Fahlbusch R, Pickardt CR, v Werder K, Scriba PC: Recurrent goiter , hyperthyroidism, galactorrhea and amenorrhea due to a thyrotropin and

  20. The genetics of premature ovarian failure: current perspectives

    OpenAIRE

    2015-01-01

    Chevy Chapman, Lynsey Cree, Andrew N Shelling Department of Obstetrics and Gynecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand Abstract: Premature ovarian failure (POF) is a common cause of infertility in women, characterized by amenorrhea, hypoestrogenism, and elevated gonadotropin levels in women under the age of 40. Many genes have been identified over the past few years that contribute to the development of POF. However, few genes have been ...

  1. The genetic basis of premature ovarian failure.

    Science.gov (United States)

    Woad, Kathryn J; Watkins, Wendy J; Prendergast, Deborah; Shelling, Andrew N

    2006-06-01

    Premature ovarian failure (POF) is a common condition, affecting approximately 1:100 women. It is characterised by amenorrhea, hypoestrogenism, and elevated gonadotrophin levels in women under the age of 40. It is often an unexpected and distressing diagnosis, which coincides with infertility and menopausal symptoms. There is a well recognised genetic basis to the development of POF. Our laboratory has identified several candidate genes associated with POF.

  2. Symptoms of hyperprolactinemia with normal serum prolactin: is treatment required?

    Directory of Open Access Journals (Sweden)

    Deepti Verma

    2016-06-01

    Full Text Available Galactorrhea with menstrual abnormalities like oligomenorrhea or amenorrhea point towards a provisional diagnosis of increased serum prolactin levels or hyperprolactinemia. However, as the prolactin hormone is heterogeneous with two forms- the bioactive and the immunoactive forms, patients can have all the features of hyperprolactinemia with normal serum prolactin levels. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 2041-2042

  3. Appendectomy during the third trimester of pregnancy in a 27-year old patient: case report of a "near miss" complication

    OpenAIRE

    Holzer Thomas; Pellegrinelli Gianmaria; Morel Philippe; Toso Christian

    2011-01-01

    Abstract The management of acute appendicitis during pregnancy is not fully established, especially regarding the choice between open and laparoscopic surgery during the third trimester. We report herein the case of a major uterine variecele hemorrhage during a laparoscopic appendectomy in a 27-year old pregnant patient at 33 weeks of amenorrhea. After conversion to a Pfannenstiel incision, the baby was delivered, the bleeding stopped and the appendectomy completed. While both mother and chil...

  4. Health-related Quality of Life in Women with Polycystic Ovary Syndrome

    OpenAIRE

    Belén Carazo Hernández; Olivia Lafalla Bernad; Raquel García Simón; Elena Gascón Mas; Esther Moreno Romea; Beatriz Rojas Pérez-Ezquerra

    2014-01-01

    Polycystic ovary syndrome is the most frequent endocrine and metabolic disorder in women of reproductive age. Its characteristic signs and symptoms are menstrual irregularities, amenorrhea, acne, hirsutism, obesity and infertility. Polycystic ovary syndrome has major effects on long-term health, which can lead to psychological morbidity and decreased quality of life. This paper reviews the current literature on polycystic ovary syndrome and health-related quality of life; in addition, it asse...

  5. Sheehan's syndrome co-existing with Graves' disease.

    Science.gov (United States)

    Arpaci, D; Cuhaci, N; Saglam, F; Ersoy, R; Cakir, B

    2014-01-01

    Sheehan's syndrome (SS), which is an important cause of hypopituitarism, is common in developing countries. The most common presentation is the absence of lactation and amenorrhea. Hypothyroidism rather than hyperthyroidism is the usual expected phenomenon in SS. Postpartum hyperthyroidism is also common and Graves' disease (GD) is an important cause of postpartum hyperthyroidism. Here we report a case of a 22-year-old female patient in our clinic presented symptoms of amenorrhea, lack of lactation, palpitations and sweating. Her physical examination revealed goiter, moist skin and proptosis. Her laboratory evaluation showed suppressed thyroid stimulating hormone, elevated levels of free thyroxine and free triiodothyronine. Thyroid antibodies were positive. Tec 99m thyroid scintigraphy results were gland hyperplasia and increased uptake consistent with GD. She gave birth 7 months ago; after delivery she had a history of prolonged bleeding, amenorrhea and inability to lactate. She had hypogonadotropic hypogonadism, hyperprolactinemia and growth hormone deficiency. Serum cortisol and adrenocorticotropic hormone levels were normal. Her magnetic resonance imaging was empty sella. Our diagnosis was GD co-existing with SS. GD with concomitant hypopituitarism is rare but has been described previously, but there are no reports of GD occurring with SS. In this case study, we report a patient with GD associated with SS.

  6. [Hypertension during pregnancy: Epidemiology, definition].

    Science.gov (United States)

    Fauvel, Jean-Pierre

    2016-01-01

    Hypertension in pregnancy has several forms that differ by their mechanisms and their consequences for mothers and fetus. Chronic hypertension is defined by SBP≥140mm Hg or DBP≥90mm Hg before pregnancy or before the 20th week of amenorrhea. Gestational hypertension is defined by SBP≥140mm Hg or DBP≥90mm Hg during or after the 20th week of amenorrhea. Preeclampsia is the occurrence of hypertension and proteinuria after 20weeks of amenorrhea. Severe preeclampsia is accompanied by clinical signs and symptoms indicating visceral pain. The HELLP syndrome is a severe preeclampsia accompanied by intravascular hemolysis and hepatic cytolysis. Eclampsia is characterized by seizures of the tonic-clonic type. A chronic hypertension is observed in 1-5% of pregnancies. Gestational hypertension without proteinuria appears in 5-6% of pregnancies. A preeclampsia develops in 1-2% of pregnancies, but much more frequently (up 34%) in the presence of risk factors. High blood pressure during pregnancy remains, by its complications, the leading cause of maternal morbidity and mortality.

  7. Anorexia, bulimia, and the athletic triad: evaluation and management.

    Science.gov (United States)

    Fenichel, Rebecca M; Warren, Michelle P

    2007-12-01

    Caloric restriction caused by undernutrition or over-exercise is increasingly common and has significant health consequences such as hypothalamic amenorrhea, infertility, attainment of low peak bone mass, and bone loss leading to fracture. In these patients, the pathophysiology of amenorrhea and bone loss is multifactorial, involving hormones that integrate the nutritional state with the hypothalamic-pituitary-ovarian axis, including leptin and possibly ghrelin. The pathophysiology of bone loss includes nutritional deficiencies, possibly estrogen deficiency, and direct and indirect effects of leptin on bone. Identifying patients at risk for low bone mineral density and fracture is important, as is screening with dual energy radiograph absorptiometry. Treatment has focused on oral contraceptive use, yet improved bone mineral density is marked by nutritional recovery and anovulation reversal. Therefore, resolving the nutrition deficiency should be the cornerstone of treatment. Cognitive-behavioral therapy aims for weight recovery, which can lead to reversal of amenorrhea and improvement in other associated metabolic abnormalities. During treatment, estradiol levels can be followed to assess hypothalamic-pituitary-ovarian recovery because estradiol secretion may increase well before ovulation occurs. In patients failing the above interventions, hormone replacement should be considered, but bone mineral density should be followed because patients may continue to lose bone despite treatment with oral contraceptives if nutrition is not improved.

  8. Analysis of Chinese women with primary ovarian insufficiency by high resolution array-comparative genomic hybridization

    Institute of Scientific and Technical Information of China (English)

    LIAO Can; FU Fang; YANG Xin; SUN Yi-min; LI Dong-zhi

    2011-01-01

    Background Primary ovarian insufficiency (POI) is defined as a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years. The etiology of primary ovarian insufficiency in human female patients is still unclear. The purpose of this study is to investigate the potential genetic causes in primary amenorrhea patients by high resolution array based comparative genomic hybridization (array-CGH) analysis.Methods Following the standard karyotyping analysis, genomic DNA from whole blood of 15 primary amenorrhea patients and 15 normal control women was hybridized with Affymetrix cytogenetic 2.7M arrays following the standard protocol. Copy number variations identified by array-CGH were confirmed by real time polymerase chain reaction.Results All the 30 samples were negative by conventional karyotyping analysis. Microdeletions on chromosome 17q21.31-q21.32 with approximately 1.3 Mb were identified in four patients by high resolution array-CGH analysis. This included the female reproductive secretory pathway related factor N-ethylmaleimide-sensitive factor (NSF) gene.Conclusions The results of the present study suggest that there may be critical regions regulating primary ovarian insufficiency in women with a 17q21.31-q21.32 microdeletion. This effect might be due to the loss of function of the NSF gene/genes within the deleted region or to effects on contiguous genes.

  9. ASHERMAN’S SYNDROME FOLLOWING THERMAL ABLATION OF THE ENDOMETRIUM

    Directory of Open Access Journals (Sweden)

    Sheila K.

    2014-02-01

    Full Text Available Intrauterine adhesions develop as a result of varying degrees of intrauterine trauma. The extent of intrauterine adhesion formation and the impact of the adhesions on the contour of the uterine cavity vary widely. Extensive intrauterine adhesions with amenorrhea and hematometra can develop following endometrial ablation. Thirty one year old parous lady with history of thermal endometrial ablation for menorrhagia presented with complaints of amenorrhea and pain abdomen for two years. Hormonal assays were normal. Transvaginal scan showed absent endometrial stripe with patchy fluid collections in cavity suggestive of adhesions. The findings were corroborated by sonohysterogram and MRI pelvis. Patient did not respond to gonadotrophins. In view of persistent symptoms she was counseled for adhesiolysis under hysteroscopic guidance. Patient opted for hysterectomy. An atrophic uterus was noted intraoperatively and cut section revealed obliterated cavity with adhesive bands and mucoid collections supporting the diagnosis which was later confirmed on histopathological evaluation Extensive intrauterine adhesions with amenorrhea and hematometra can develop following endometrial ablation. Hysteroscopic adhesiolysis with cervical dilatation is the treatment of choice, but hysterectomy can be beneficial in a small subset of patients.

  10. 抗精神病药物所致闭经的治疗策略

    Institute of Scientific and Technical Information of China (English)

    彭向芸

    2012-01-01

      Objective Explore the clinical features and treatment of antipsychotic- induced amenorrhea. Methods Patients taking antipsychotic induced amenorrhea gynecology outpatient clinic in our hospital from January 2006 to December 2011 were retrospectively analyzed. Results Antipsychotic-induced amenorrhea can occur in patients without endometrial thickening, galactorrhea, increased serum prolactin clinical manifestations, treatment should be carried out before the necessary physical examination and various laboratory examinations, and given the appropriate weight depending on the clinical manifestationsprocessing, in order to achieve the best clinical results. Conclusion Antipsychotic-induced amenorrhea is reversible clinical manifestations, withdrawal or dressing after the resumption of menstruation, hormone replacement therapy due to clinical needs need to continue the medication can be given according to the patient's request. Keywords: antipsychotics; amenorrhea; clinical manifestations; treatment strategies; clinical effect.%  目的探讨抗精神病药物所致闭经的临床特点和治疗方法。方法对2006年1月至2011年12月在我院妇科门诊就诊的因服用抗精神病药物所致闭经的患者作回顾性分析。结果抗精神病药物所致闭经患者可出现无子宫内膜增厚,溢乳,血清泌乳素增高等临床表现,治疗前应进行必要的体格检查及各种辅助检查,并根据不同的临床表现给以相应的处理,以达到最好的临床效果。结论抗精神病药物所致闭经是可逆性临床表现,停药或换药后可恢复月经,若因临床需要需继续用药可根据患者的要求给予激素替代治疗。

  11. Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Objective. To obtain pilot data on the endometrial histology of Depomedroxyprogesterone acetate (Depo-Provera, DMPA users experiencing breakthrough bleeding (BTB versus users with amenorrhea. To compare the endometrial histology of patients who used DMPA continuously for 3–12 months versus those who used it for 13 months or more. Methods. Cross-sectional study. Endometrial biopsy was obtained from all consenting patients who used DMPA for at least 3 months. Patients were divided into those with BTB in the last 3 months versus those with amenorrhea for at least 3 months. Histology results and duration of therapy were compared. Results. The proportion of women with chronic endometritis, uterine polyps, atrophic, proliferative, or progesterone-dominant endometrium did not differ between those DMPA users with BTB versus those with amenorrhea. Duration of therapy did not correlate with symptoms of BTB or endometrial histology. Chronic endometritis was the most common histologic finding (10/40, 25% and occurred more often in women experiencing BTB (35% versus 15% (RR 1.62 CI 0.91–2.87. Moreover, 45% of women with BTB had received DMPA for more than 12 months. Conclusions. BTB was more common than previously reported in women using DMPA for more than 12 months. Chronic endometritis, which may indicate an underlying infectious or intracavitary anatomic etiology, has not been previously reported as a frequent finding in DMPA users, and may be related to ethnic or other sociodemographic characteristics of our patient population. Further study to elucidate the etiology of chronic endometritis in these patients is warranted.

  12. Higher ghrelin and lower leptin secretion are associated with lower LH secretion in young amenorrheic athletes compared with eumenorrheic athletes and controls.

    Science.gov (United States)

    Ackerman, Kathryn E; Slusarz, Katherine; Guereca, Gabriela; Pierce, Lisa; Slattery, Meghan; Mendes, Nara; Herzog, David B; Misra, Madhusmita

    2012-04-01

    Amenorrhea is common in young athletes and is associated with low fat mass. However, hormonal factors that link decreased fat mass with altered gonadotropin pulsatility and amenorrhea are unclear. Low levels of leptin (an adipokine) and increased ghrelin (an orexigenic hormone that increases as fat mass decreases) impact gonadotropin pulsatility. Studies have not examined luteinizing hormone (LH) secretory dynamics in relation to leptin or ghrelin secretory dynamics in adolescent and young adult athletes. We hypothesized that 1) young amenorrheic athletes (AA) would have lower LH and leptin and higher ghrelin secretion than eumenorrheic athletes (EA) and nonathletes and 2) higher ghrelin and lower leptin would be associated with lower LH secretion. This was a cross-sectional study. We examined ghrelin and leptin secretory patterns (over 8 h, from 11 PM to 7 AM) in relation to LH secretory patterns in AA, EA, and nonathletes aged 14-21 yr. Ghrelin and leptin were assessed every 20 min and LH every 10 min. Groups did not differ for age, bone age, or BMI. However, fat mass was lower in AA than in EA and nonathletes. AA had lower LH and higher ghrelin pulsatile secretion and AUC than nonathletes and lower leptin pulsatile secretion and AUC than EA and nonathletes. Percent body fat was associated positively with LH and leptin secretion and inversely with ghrelin. In a regression model, ghrelin and leptin secretory parameters were associated independently with LH secretory parameters. We conclude that higher ghrelin and lower leptin secretion in AA related to lower fat mass may contribute to altered LH pulsatility and amenorrhea.

  13. Tamoxifen and ovarian function.

    Directory of Open Access Journals (Sweden)

    Martine Berliere

    Full Text Available BACKGROUND: Some studies suggest that the clinical parameter "amenorrhea" is insufficient to define the menopausal status of women treated with chemotherapy or tamoxifen. In this study, we investigated and compared the ovarian function defined either by clinical or biological parameters in pre-menopausal breast cancer patients treated with tamoxifen administered as adjuvant therapy. MATERIALS AND METHODS: Between 1999 and 2003, 138 premenopausal patients consecutively treated for early breast cancer were included. Sixty-eight received tamoxifen in monotherapy as the only adjuvant systemic treatment (Group I and 70 were treated with tamoxifen after adjuvant chemotherapy (Group II. All patients had a confirmed premenopausal status based on clinical parameters and hormonal values at study entry. They were followed prospectively every 3 months for 3 years: menses data, physical examination and blood tests (LH, FSH, 17-beta-estradiol. Vaginal ultrasonography was carried out every 6 months. After 3 years, prospective evaluation was completed and monitoring of ovarian function was performed as usual in our institution (1x/year. All data were retrospectively evaluated in 2011. RESULTS: Three patients were excluded from the study in group I and 2 were excluded in group II. Patients were divided into 4 subgroups according to clinical data, i.e. menses patterns. These patterns were assessed by questionnaires. a: Regular menses (>10 cycles/year b: Oligomenorrhea (5 to 9 cycles/year c: Severe oligomenorrhea (1 to 4 cycles/year d: Complete amenorrhea Estrogen levels did not appear to have any impact on disease-free survival rates after 3 or 8 years. FSH values were also documented and analyzed. They exhibited the same profile as estradiol values. CONCLUSIONS: Amenorrhea is an insufficient parameter to define menopausal status in patients receiving tamoxifen. Low estradiol levels must be coupled with other biological parameters to characterize endocrine status

  14. Ten-year literature review of global endometrial ablation with the NovaSure® device

    Directory of Open Access Journals (Sweden)

    Gimpelson RJ

    2014-03-01

    Full Text Available Richard J Gimpelson Mercy Clinic, Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Mercy Hospital St Louis, St Louis, MO, USA Abstract: This review examines the peer-reviewed literature describing prospective studies that report amenorrhea rates, patient satisfaction, and surgical reintervention rates following the NovaSure® endometrial ablation procedure. A search of the English-language literature published from 2000 to 2011 was conducted using PubMed. Ten prospective studies, six single-arm NovaSure trials, and four randomized controlled trials comparing the NovaSure procedure with other global endometrial ablation modalities met the inclusion criteria and were reviewed. The follow-up periods ranged from 6 to 60 months. Amenorrhea rates for the NovaSure procedure ranged from 30.0% to 75.0%. Patients who reported being satisfied with the NovaSure procedure ranged from 85.0% to 94.0%. In randomized controlled trials with other global endometrial ablation modalities, amenorrhea rates at 12 months with the NovaSure procedure ranged from 43.0% to 56.0%, while other modalities ranged from 8% to 24%. In addition, this manuscript reviews the following: the NovaSure technology; use of the NovaSure procedure in the office setting; intraoperative and postoperative pain; effects on premenstrual syndrome (PMS; dysmenorrhea; special circumstances, including presence of uterine disease, history of cesarean delivery, coagulopathy, or use of anticoagulant medication; post-procedure uterine cavity assessment and cancer risk; contraception and pregnancy; and safety. Keywords: abnormal uterine bleeding, menorrhagia, endometrial ablation, NovaSure®

  15. [Endocrino-gynecologic problems of the female adolescent].

    Science.gov (United States)

    Sirpresi, S; Antoniazzi, F; Costantini, E; Zamboni, G; Tatò, L

    1996-01-01

    Adolescence is usually defined as the period of rapid physical and psychological growth and development occurring during the second decade of life. After the introduction about the physiology of puberty and menstrual cycle, the major problems in female adolescents are discussed: delayed puberty, hypo and hypergonadotropic hypogonadism, causes of primary and secondary amenorrhea, menstrual irregularity, dysfunctional uterine bleeding, dysmenorrhea, breast disorders, hirsutism, acne. Finally, adolescent pregnancy prevention and contraception are discussed. The Authors want to stress the importance of the endocrinological and gynaecological disorders in female adolescents and their impact on the psychological and emotional development at this very delicate age.

  16. Major depressive disorder induced by prolactinoma--a case report.

    Science.gov (United States)

    Liao, Wei-Ting; Bai, Ya-Mei

    2014-01-01

    Prolactinomas, the most common type of pituitary tumor, can induce hyperprolactinemia and cause some psychiatric symptoms, such as anxiety, depression and even psychotic symptoms. However, in previous case reports, no information about estrogen levels was mentioned. Here, we present a 48-year-old female patient who had a recurrent episode of major depressive disorder (MDD) and amenorrhea. Hyperprolactinemia (167 ng/ml), low estrogen (15.31 pg/ml) and a pituitary prolactinoma were found by MRI. After a dopamine agonist (Dostinex) and aripiprazole were prescribed, the patient's depressed mood remitted and her menstruation normalized. The possible mechanism of MDD induced by prolactinoma is discussed.

  17. Lack of tumor reduction in hyperprolactinemic women with extrasellar macroadenomas treated with bromocriptine

    Energy Technology Data Exchange (ETDEWEB)

    Boulanger, C.M.; Mashchak, C.A.; Chang, R.J.

    1985-10-01

    Three patients with hyperprolactinemia and large extrasellar pituitary macroadenomas were treated with bromocriptine, 10 mg daily, for 8 weeks. In spite of correction of their amenorrhea, galactorrhea, and hyperprolactinemia, radiologic evaluation by CT scan failed to show evidence of tumor shrinkage. After surgical resection, histologic examination revealed that PRL-secreting cells comprised only a small portion of the tumor cell population in two patients and in the third patient were completely absent. These cases illustrate that large nonfunctional pituitary tumors may mimic signs and symptoms of a prolactinoma and stress the importance of adequate radiologic evaluation during medical management. 8 references, 3 figures.

  18. CT studies in hyperprolactinemia; Badania KT w hiperprolaktynemii

    Energy Technology Data Exchange (ETDEWEB)

    Gradzki, J.; Paprzycki, W.; Krzyzagorska, E.; Wasko, R.; Warenik-Szymankiewicz, A. [Akademia Medyczna, Poznan (Poland)

    1993-12-31

    Computerized tomography studies in 62 patients (55 females and 7 males) with hyperprolactinemia are presented. The female patients had secondary amenorrhea and galactorrhea, whereas the male patients suffered from impotency, gynaecomastia and very rarely galactorrhea. In 39 cases CT revealed a pituitary adenoma (prolactinoma), in 14 cases of them microadenoma, as the cause of hormonal and clinical disturbances. In 21 cases an empty sella with rudimentary pituitary surrounded by cerebrospinal fluid or lack of pituitary mass were found. In one case suprasellar and intrasellar calcifications were present. (author). 17 refs, 4 figs.

  19. A Study on the Changes of Prolaction Levels of Female Patients with Schizophrenia after the Treatment of Aripiprazone, Ziprasidone and Risperidone%阿立哌唑、齐拉西酮、利培酮治疗女性精神分裂症患者后催乳素的变化研究

    Institute of Scientific and Technical Information of China (English)

    李文学; 孔德荣; 殷晓; 李猛; 赵青霞; 赵中健

    2014-01-01

    Objective To study the changes of prolaction levels of female patients with schizophrenia after the treatment of arip-iprazone, ziprasidone and risperidone and the causes of amenorrhea. Methods A double-blind randomized-controlled study was adopted. 180 cases of first-episode female schizophrenic patients diagnosed in our hospital from July, 2012 to September, 2013, were selected and they were divided into aripiprazone group and risperidone group, ziprasidone group, 60 cases in each group. They were treated for 6 months. The prolaction level and the number of cases of amenorrhea before and 1, 3, 6 months after treat-ment were detected. Results The prolactin levels of risperidone group were elevated significantly after treatment ( P0.05), the cases of amenorrhea were less. Conclusion Prolactin elevation, amenorrhea and other symptoms easily occur in the patients who take risperidone, but seldom occur in the patients who take aripiprazole and ziprasidone, and the efficacy of aripiprazole and ziprasidone is better, so they are recommended to use.%目的:探讨女性精神分裂症患者在用阿立哌唑、齐拉西酮、利培酮治疗后催乳素水平变化及闭经原因分析。方法采用随机双盲对照研究,收集本院2012年7月—2013年9月首发确诊女性精神分裂症患者180例,分为阿立哌唑组、利培酮组,齐拉西酮组,每组各60例,疗程6个月,治疗前及治疗后1个月、3个月及3个月分别检测催乳素水平及闭经例数。结果利培酮组治疗后催乳素水平显著升高(P0.05),出现闭经例数比较少。结论利培酮用药的患者容易出现催乳素升高、闭经等现象,而阿立哌唑及齐拉西酮却很少出现这种情况,疗效也比较好,建议使用。

  20. 针灸对大鼠运动性闭经E2、P水平调节作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    李莉; 唐纯志; 卢咏梅; 赖秋媛; 王静; 罗伟君; 余瑾

    2011-01-01

    运动性闭经(Athletic Secondary Amenorrhea,简称ASA)是女运动员过度疲劳的一种特殊征象,属于运动性月经失调(Athletic Menstrual cycle Irregu-larities,简称AMI)的严重类型。随着竞技体育的不断发展,越来越多的女性参加激烈的训练和比赛,ASA的发生率也相应提高。某些田径项目甚至高达57%,

  1. 妇科常用中药介绍%Introducing common gynecological medicine

    Institute of Scientific and Technical Information of China (English)

    刘宏

    2013-01-01

    对用于治疗痛经、闭经、癥瘕,治疗崩漏证,治疗产后瘀阻腹痛及恶露不绝证,治疗产后虚热证等妇科疾病的中药归纳介绍。%The TCM was summarized and introduced, which for treating dysmenorrhea, amenorrhea, Zhengjia, metrorrhagia, postpartum blood stagnation abdominal pain, lochia must not, postpartum hot syndrome and other gynecological diseases.

  2. Dysgerminoma in a case of 46, XY pure gonadal dysgenesis (swyer syndrome: a case report

    Directory of Open Access Journals (Sweden)

    He Anguang

    2011-09-01

    Full Text Available Abstract Simple 46, XY gonadal dysgenesis syndrome, also called Swyer syndrome, is known as pure gonadal dysgenesis. Individuals with the syndrome are characterized by 46, XY karyotype and phenotypically female with female genital appearance, normal Müllerian structures and absent testicular tissue. The condition usually first becomes apparent in adolescence with delayed puberty and primary amenorrhea due to the gonads have no hormonal or reproductive potential. Herein, we report a case of dysgerminoma diagnosed in a dysgenetic gonad of a 21-year-old patient with Swyer syndrome.

  3. Primary squamous cell carcinoma of the fallopian tube masquerading inflammatory mass

    Directory of Open Access Journals (Sweden)

    Indu Chawla

    2016-10-01

    Full Text Available Ovarian pregnancy is rare and a conspicuous variant of ectopic pregnancy and an accurate preoperative diagnosis is very challenging various advances in diagnostic modalities like Transvaginal ultrasonography has evolved in identifying an ovarian pregnancy. We report here one such case of 30 years old with severe lower abdominal pain and bleeding per vaginum following six weeks of amenorrhea confirmed as ovarian ectopic pregnancy consistent with Speigelberg's criteria on ultrasonography. This case highlights the significance of 3D ultrasonography in the diagnosis. Histopathological report concluded it to be an ovarian ectopic pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3609-3612

  4. Heterophilic antibodies interfering with radioimmunoassay. A false-positive pregnancy test

    Energy Technology Data Exchange (ETDEWEB)

    Vladutiu, A.O.; Sulewski, J.M.; Pudlak, K.A.; Stull, C.G.

    1982-11-19

    A young woman with amenorrhea had a consistently positive pregnancy test result (serum radioimmunoassay measurement of ..beta..-human chorionic gonadotropin hormone). No fetal or placental tissue was found after uterine curettage and exploratory laparotomy. The false-positive pregnancy test result was due to heterophilic antibovine and antigoat antibodies in the patient's serum. These antibodies interfered with radioimmunoassays using goat antibodies. This case shows that serum heterophilic antibodies can interfere with immunoassays and result in unnecessary diagnostic procedures and/or unnecessary treatment.

  5. A Case with 46,XX,dup(X(q21.3q24 karyotype

    Directory of Open Access Journals (Sweden)

    Selda Şimşek

    2010-03-01

    Full Text Available The relationship between phenotype and Xq duplicationsin females remains unclear. Some females are normal;some have short stature; and others have features suchas microcephaly, developmental delay/mental retardation,body asymmetries, and gonadal dysgenesis. Somefeatures in these females resemble those in Turner syndrome.We, herein, presented a 15 years-old girl withshort stature and primary amenorrhea, who was referredto cytogenetic laboratory. Through karyotipe analysis performedby Giemsa banding technique, the patient wasdetermined to have positive Barr body and 46,XX,dup(X(q21.3q24 chromosomal constitution. Case was discussedaccording to information of present literatures.

  6. Temporary ovarian failure in thyroid cancer patients after thyroid remnant ablation with radioactive iodine

    Energy Technology Data Exchange (ETDEWEB)

    Raymond, J.P.; Izembart, M.; Marliac, V.; Dagousset, F.; Merceron, R.E.; Vulpillat, M.; Vallee, G.

    1989-07-01

    We studied ovarian function retrospectively in 66 women who had regular menstrual cycles before undergoing complete thyroidectomy for differentiated thyroid cancer and subsequent thyroid remnant ablation with /sup 131/I. Eighteen women developed temporary amenorrhea accompanied by increased serum gonadotropin concentrations during the first year after /sup 131/I therapy. No correlation was found between the radioactive iodine dose absorbed, thyroid uptake before treatment, oral contraceptive use, or thyroid autoimmunity. Only age was a determining factor, with the older women being the most affected. We conclude that radioiodine ablation therapy is followed by transient ovarian failure, especially in older women.

  7. Marvelon治疗高促性腺激素闭经38例

    Institute of Scientific and Technical Information of China (English)

    文娜; 武泽; 章晓梅

    2002-01-01

    @@ 高促性腺激素闭经(Hypergonadotropic Amenorrhea HGA)的临床特点为40岁前闭经,常伴有不同程度的更年期症状,如烘热、多汗、面部潮红、性激素测定Gn常高于正常,尤以FSH升高显著,E_2降低,部分病例可因此不孕,临床上常采用人工周期治疗。我们对38例HGA患者试用……

  8. Radiological and orthopedic abnormalities in Satoyoshi syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Haymon, M.L. [Children`s Hospital, New Orleans, LA (United States). Dept. of Radiology; Willis, R.B. [Children`s Hospital, New Orleans, LA (United States). Dept. of Orthopedics; Ehlayel, M.S. [Div. of Genetics, Dept. of Pediatrics, Louisiana State Univ. Medical Center, Orleans, LA (United States)]|[Louisiana State Medical Center, New Orleans, LA (United States). Center for Molecular and Human Genetics; Lacassie, Y. [Div. of Genetics, Dept. of Pediatrics, Louisiana State Univ. Medical Center, Orleans, LA (United States)]|[Louisiana State Medical Center, New Orleans, LA (United States). Center for Molecular and Human Genetics]|[Children`s Hospital, New Orleans, LA (United States). Dept. of Pediatrics

    1997-05-01

    Satoyoshi syndrome is a are disorder on unknown etiology characterized by progressive, painful intermittent muscle spasms, serve skeletal abnormalities mimicking a skeletal dyplasia, malabsorption, alopecia, and amenorrhea. We further report on a 20{sup 1}/{sub 2}-year-old Caucasian woman whith characteristic manifestation of the syndrome. Since the establishment of the diagnostic 1 year ago, she has been treated with prednisone with good response. However, treatment of the multiple deformities and fractures has been difficult and challenging. The early recognition and treatment of this disorder is of utmost importance, as the skeletal deformities and fractures seem to be secondary to the muscular spasms, as suggested by Satoyoshi.

  9. 病理性闭经的诊治(二)

    Institute of Scientific and Technical Information of China (English)

    葛秦生

    2001-01-01

    @@下丘脑性闭经 垂体以上,下丘脑部位引起闭经的疾病称为下丘脑性闭经(hypothalamic amenorrhea, HA)。下丘脑是促性腺激素释放激素(GnRH)的合成部位。当下丘脑不分泌GnRH或分泌不足时,将影响垂体与卵巢一系列生殖功能的调节而出现闭经,三种生理性闭经均属HA。

  10. Radiation Therapy of Pituitary Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Park, Moon Baik; Hong, Seong Eong [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    Radiation treatment results were analyzed in a retrospective analysis of 47 patients with pituitary adenoma treated with radiation alone or combined with surgery from 1974 through 1987 at the Department of Therapeutic Radiology of Kyung Hee University. The 5-year overall survival rates for all patients was 80.4%. Radiation therapy was effective for improving visual symptoms and headache, but could not normalize amenorrhea and galactorrhoea. There was no difference of survival rate between radiation alone and combination with surgery. Prognostic factors such as age, sex, disease type, visual field, headache and surgical treatment were statistically no significant in survival rates of these patients.

  11. Experimental and clinical studies with radiofrequency-induced thermal endometrial ablation for functional menorrhagia

    Energy Technology Data Exchange (ETDEWEB)

    Phipps, J.H.; Lewis, B.V.; Prior, M.V.; Roberts, T. (Watford General Hospital, Herts (England))

    1990-11-01

    A method of ablating the endometrium has been introduced into clinical practice that uses radiofrequency electromagnetic energy to heat the endometrium, using a probe inserted through the cervix. Preliminary studies suggest that over 80% of patients treated will develop either amenorrhea or a significant reduction in flow. The advantages of radiofrequency endometrial ablation over laser ablation or resection are the avoidance of intravascular fluid absorption, simplicity (no special operative hysteroscopic skills are required), speed of operation, and reduced cost compared with the Nd:YAG laser. In this paper, we describe the experimental studies performed during development of this new technique.

  12. Trimegestone in a low-dose, continuous-combined hormone therapy regimen prevents bone loss in osteopenic postmenopausal women

    DEFF Research Database (Denmark)

    Warming, Lise; Ravn, Pernille; Spielman, Danièle

    2004-01-01

    OBJECTIVE: To determine the efficacy of estrogen + progestogen therapy with 1 mg 17beta-estradiol and 0.125 mg trimegestone in the prevention of postmenopausal osteoporosis. DESIGN: For this study, 360 healthy, postmenopausal women with osteopenia [lumbar spine bone mineral density (BMD) between -1...... bone-specific alkaline phosphatase revealed a more retarded decrease of 40% and 33%, respectively. Of the women receiving hormone therapy, 75% had amenorrhea from the first cycle, and 5% withdrew prematurely due to metrorrhagia or mastalgia. CONCLUSION: This new estrogen + progestogen therapy...

  13. Severe Hemoperitoneum Following Rupture of Uterine Diverticulum due to Pregnancy: a Case Report

    Directory of Open Access Journals (Sweden)

    Yaghmaei Minoo

    2009-06-01

    Full Text Available Uterovaginal malformations, occur in 0.16% of women and contribute to the problems of infertility, recurrent pregnancy loss, dysmenorrhea, dyspareunia, amenorrhea and a poor outcome in pregnancy. True diverticulum is an exceedingly rare anomaly and is like a tubular formation connected to uterine cavity that ends in a cul-de sac and It is not classified as any of mullerian duct anomalies. In this article a case of uterine diverticulum rupture due to pregnancy in a 19 years old woman with nausea, vomiting and abdominal pain is reported. Although rare, in complicated pregnancy we should think to genital tract anomalies.

  14. [XX 'pure' gonadal dysgenesis and XYY syndrome].

    Science.gov (United States)

    Itoh, Naoki; Tsukamoto, Taiji

    2004-02-01

    XX 'pure' gonadal dysgenesis is a disease related to Turner's syndrome. Patients of this disease are characterized by normal female external genitalia, bilateral streak gonads, amenorrhea and sexual infantilism. Recently, it has been reported that point mutations of the FSH receptor gene may be one of cause of this disease. The relationship between criminal behavior and XYY syndrome is still controversial. Increased incidence of disomic sperm in 47,XYY males has been reported by fluorescent in situ hybridization(FISH). Genetic counseling should be done when they undergo intracytoplasmic sperm injection.

  15. A displaced stress fracture of the femoral neck in an adolescent female distance runner with female athlete triad: A case report.

    Science.gov (United States)

    Okamoto, Shinichi; Arai, Yuji; Hara, Kunio; Tsuzihara, Takashi; Kubo, Toshikazu

    2010-03-05

    This report presents a case of a displaced stress fracture of the femoral neck in an adolescent female distance runner with amenorrhea. Both reduction and internal fixation were performed early after the injury. At 24 months postoperatively, magnetic resonance imaging and bone scintigraphy showed no positive signs of femoral head necrosis and bone union was confirmed on plain X-ray. A medical examination for the presence of the signs of the female athlete triad by checking weight, calorie intake and menstrual cycles is most important to prevent such stress fractures. Athletes as well as their coaches or parents therefore need to understand female athlete triad.

  16. The female athlete triad and endothelial dysfunction.

    Science.gov (United States)

    Lanser, Erica M; Zach, Karie N; Hoch, Anne Z

    2011-05-01

    A tremendous increase in the number of female athletes of all ages and abilities has occurred in the past 35 years. In general, sports and athletic competition produce healthier and happier women. However, explosion in participation has revealed clear gender-specific injuries and medical conditions unique to the female athlete. This article focuses on the latest advances in our knowledge of the female athlete triad and the relationship between athletic-associated amenorrhea and endothelial dysfunction. Treatment of vascular dysfunction with folic acid is also discussed.

  17. Anorexia, bulimia, and the female athlete triad: evaluation and management.

    Science.gov (United States)

    Mendelsohn, Felicia A; Warren, Michelle P

    2010-03-01

    The female athlete triad is an increasingly prevalent condition involving disordered eating, amenorrhea, and osteoporosis. An athlete can suffer from all 3 components of the triad, or just 1 or 2 of the individual conditions. The main element underlying all the aspects of the triad is an adaptation to a negative caloric balance. Screening for these disorders should be an important component of an athlete's care. Prevention and treatment should involve a team approach, including a physician, a nutritionist, and a mental health provider.

  18. A displaced stress fracture of the femoral neck in an adolescent female distance runner with female athlete triad: A case report

    Directory of Open Access Journals (Sweden)

    Okamoto Shinichi

    2010-03-01

    Full Text Available Abstract This report presents a case of a displaced stress fracture of the femoral neck in an adolescent female distance runner with amenorrhea. Both reduction and internal fixation were performed early after the injury. At 24 months postoperatively, magnetic resonance imaging and bone scintigraphy showed no positive signs of femoral head necrosis and bone union was confirmed on plain X-ray. A medical examination for the presence of the signs of the female athlete triad by checking weight, calorie intake and menstrual cycles is most important to prevent such stress fractures. Athletes as well as their coaches or parents therefore need to understand female athlete triad.

  19. Advances in management of the female athlete triad and eating disorders.

    Science.gov (United States)

    Zach, Karie N; Smith Machin, Ariane L; Hoch, Anne Z

    2011-07-01

    Although there are numerous benefits to women from athletic participation, a complex combination of endocrine and metabolic factors exaggerates risk for a serious health concern: the female athlete triad. The purpose of this article is to provide updates on new issues related to the triad, specifically the relationship between athletic-associated amenorrhea and endothelial dysfunction-a potential fourth component to the triad that is a concern for future cardiovascular risk, public health issues, and athletic performance. Folic acid should be considered a potential safe and inexpensive therapeutic treatment to restore endothelial-dependent vasodilation.

  20. Successful triplet pregnancy in an African with pure gonadal dysgenesis:A plus for assisted reproduction

    Institute of Scientific and Technical Information of China (English)

    Aziken M; Osaikhuwuomwan J; Osemwenkha A; Iribhogbe O; Orhue A

    2015-01-01

    Gonadal dysgenesis represents a congenital developmental disorder of the reproductive system, with its main gynaecologic manifestations being amenorrhea and infertility. We present a unique case of pure gonadal dysgenesis in an ‘about to be’ married lady resident in a society where high premium and success in marriage is dependent on childbirth. With astute evaluation and counseling, assisted reproductive technology (ART) was safely and successfully used in this case with eventual triplet pregnancy and delivery. Our index experience shows that situations with compromised fertility the availability and access to ART aids effective treatment planning and births a re-invigorated hope for family life.

  1. Karotinaemi hos patient med excessivt betakarotinfødeindtag og dysreguleret diabetes mellitus

    DEFF Research Database (Denmark)

    Mikkelsen, Carsten Sauer; Mikkelsen, Dorthe Bisgaard; Lindegaard, Hanne Merete

    2009-01-01

    A case of carotinaemia in a patient with excessive beta-carotene food-intake, diabetes mellitus and physiological amenorrhea is reported. The patient developed yellow discolouration in the palms and the soles of her feet. Blood samples showed a significantly increased lever of serum beta......-carotene, but normal vitamine A value and liver enzymes. The patient reported an excessive intake of carrots (approximately 1 kg per day). The status of physiological amenorrhoea and dysregulated diabetes mellitus may have deteriorated the yellow discolouration of the skin. Udgivelsesdato: 2009-Jan-26...

  2. Complete androgen insensitivity syndrome or testicular feminization: review of literature based on a case report

    Science.gov (United States)

    Souhail, Regragui; Amine, Slaoui; Nadia, Abounouh; Tarik, Karmouni; Khalid, El Khader; Abdellatif, Koutani; Ahmed, Ibn Attya

    2016-01-01

    Testicular feminization, or the androgen insensitivity syndrome, is a rare disease. Because of various abnormalities of the X chromosome, a male, genetically XY, has some physical characteristics of a woman or a full female phenotype. Indeed the androgen insensitivity syndrome occurs because of a resistance to the actions of the androgen hormones, which in turn switches the development towards the aspect of a woman. We report a case of complete androgen insensitivity syndrome in a 30 years old woman who presented primary amenorrhea. We aim to improve our knowledge of this illness from the data that provides us this study, and a review of the literature.

  3. Successful Pregnancy and Delivery in a Patient with Chronic Myeloid Leukemia while on Dasatinib Therapy

    OpenAIRE

    2010-01-01

    Here we report the case of an 18-year-old woman with chronic myeloid leukemia (CML) who became pregnant while undergoing treatment with dasatinib. Before pregnancy, she received imatinib mesylate therapy but could not tolerate the treatment. The regimen was then changed to dasatinib at a dose of 70 mg b.i.d. While she was in hematological remission and on dasatinib therapy, she became pregnant. The unplanned pregnancy was identified after the patient had experienced four weeks of amenorrhea. ...

  4. Successful triplet pregnancy in an African with pure gonadal dysgenesis: A plus for assisted reproduction

    Directory of Open Access Journals (Sweden)

    M Aziken

    2015-06-01

    Full Text Available Gonadal dysgenesis represents a congenital developmental disorder of the reproductive system, with its main gynaecologic manifestations being amenorrhea and infertility. We present a unique case of pure gonadal dysgenesis in an ‘about to be’ married lady resident in a society where high premium and success in marriage is dependent on childbirth. With astute evaluation and counseling, assisted reproductive technology (ART was safely and successfully used in this case with eventual triplet pregnancy and delivery. Our index experience shows that situations with compromised fertility the availability and access to ART aids effective treatment planning and births a re-invigorated hope for family life.

  5. Dysgerminoma in a female with turner syndrome and Y chromosome material: A case-based review of literature

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Kota

    2012-01-01

    Full Text Available We report a 17-year-old girl evaluated for primary amenorrhea. Cytogenetic analysis of the peripheral blood lymphocytes revealed normal autosomes with 46X inv (Y confirming the diagnosis of Turner′s syndrome with Y cell line. Treatment was initiated with conjugated estrogen while recommending bilateral prophylactic oophorectomy to the patient. One year later the patient presented with abdominal mass, biopsy of the specimen following resection confirmed dysgerminoma originating from right ovary with no invasion or metastasis. The literature is reviewed with regard to the various pathogenetic mechanisms proposed for the development of germ cell tumors in ovary, the cytogenetic findings and recommendations to handle such scenario.

  6. Ectopic Intrauterine Device in the Bladder of a Pregnant Woman

    Directory of Open Access Journals (Sweden)

    Zehra Kurdoglu

    2010-01-01

    Full Text Available Background. Uterine perforation and transvesical migration of an intrauterine device are rare complications. Case. A 28-year-old woman who had an intrauterine device was admitted to our outpatient clinic with complaints of amenorrhea lasting 5 weeks and pelvic pain lasting a year. Transvaginal ultrasonography revealed embedding of the intrauterine device in the bladder. The misplaced device was removed by laparotomy. Conclusion. The followup of intrauterine device localization with transvaginal ultrasonography is essential for early detection of possible serious complications.

  7. Microchimérisme et prédiction des complications de la grossesse chez les femmes primigestes

    OpenAIRE

    Vigorito, Érika

    2016-01-01

    Objective: To compare fetal microchimerism levels in serum from primigravid women at 12 weeks of amenorrhea (WA), with or without pathological pregnancies. To show that high levels of fetal microchimerism could predict emergence of preeclampsia in women, and/or intra-uterine fetal growth restriction (IUGR) and/or a small of gestational age (SGA) in newborns as early as 12 WA.Methods: Selection of serum from primigravid women with a male or female offspring and with a healthy or pathological p...

  8. Hypopituitarism as unusual sequelae to central nervous system tuberculosis

    Directory of Open Access Journals (Sweden)

    S Mageshkumar

    2011-01-01

    Full Text Available Neurological tuberculosis can very rarely involve the hypophysis cerebri. We report a case of an eighteen year old female who presented with five months duration of generalised apathy, secondary amenorrhea and weight gain. She was on irregular treatment for tuberculosis of the central nervous system for the last five months. Neuroimaging revealed sellar and suprasellar tuberculomas and communicating hydrocephalus requiring emergency decompression. Endocrinological investigation showed hypopituitarism manifesting as pituitary hypothyroidism, hypocortisolism, hypogonadotropic hypogonadism, and hyperprolactinemia. Restarting anti-tuberculosis treatment, hormone replacement therapy, and a ventriculo-peritoneal shunt surgery led to remarkable improvement in the general condition of the patient.

  9. Team management of the female athlete triad part 2: optimal treatment and prevention tactics.

    Science.gov (United States)

    Joy, E; Clark, N; Ireland, M L; Martire, J; Nattiv, A; Varechok, S

    1997-04-01

    Multidisciplinary management of the female athlete triad (disordered eating, amenorrhea, and osteoporosis) is optimal, but what exactly does it entail? With the primary care physician as the point person, the healthcare team addresses the underlying causes of disordered eating through such measures as drawing up a contract for returning to play, resolving nutrition issues, exploring psychotherapy options, and, sometimes, prescribing antidepressants. Hormone replacement therapy and conservative or orthopedic intervention for stress fractures may also be required. Communication among the members of the treatment team is crucial, and athletic trainers especially can provide valuable input. Prevention strategies need to involve education of coaches, teachers, trainers, parents, and others who work closely with female athletes.

  10. Intracranial germ cell tumor mimicking anorexia nervosa.

    Science.gov (United States)

    Andreu Martínez, F J; Martínez Mateu, J M

    2006-12-01

    We report on a case of a 23 year-old female diagnosed as having a germ-cell tumour located in the sellar region. The patient referred anorexia, psychic disorders, weight loss of 15 kilograms and secondary amenorrhea during the previous three years. This is the reason why the patient was diagnosed as having anorexia nervosa. Subsequently, the patient presented some endocrine dysfunction. MRI revealed the existence of a lesion located in suprasellar and hypothalamic regions. This case shows that the presence of intracranial tumours next to the hypothalamus must be borne in mind as a rare but real possibility in cases of anorexia nervosa, specially in those non-typical cases.

  11. Diabetic ketoacidosis in a patient with acromegaly, a case report

    OpenAIRE

    O. Akha; R Rajabian; R. Aboutorabi; S. Teymouri

    2007-01-01

    Abstract Although impaired glucose tolerance affects 36% and overt diabetes mellitus can be seen in 30% of cases with acromegaly, diabetic ketoacidosis is rarely reported in patients with this disease. We present an unusual complication of acromegaly: a 22 year old woman with amenorrhea (6 month ago) and blurred vision of left eye (4 month ago) referred to Ghaem neurology clinic in Mashhad. With a growth hormone (GH) level of =100ng/ml, Insulin like growth factor-1 (IGF-1) =1560 ng/ml and pit...

  12. Chronic dihydroergotoxine treatment affects the number of dopamine recognition sites in rat striatum

    Energy Technology Data Exchange (ETDEWEB)

    Battaini, F.; Govoni, S.; Rius, R.A.; Spano, P.F.; Trabucchi, M.

    1984-06-01

    Ergot derivatives have been proposed to have ameliorative effects in various pathological conditions where dopaminergic transmission is believed to be impaired, namely Parkinson's disease, amenorrhea-galactorrhea syndrome, and in the treatment of behavioural disturbances of the elderly. To get more insight into a possible involvement of a direct action of ergot derivatives on dopamine receptors we studied the effect of acute and chronic dihydroergotoxine (DHT) treatment on 3H-Spiroperidol and 3H-N-Propylnorapomorphine (3H-NPA) binding to rat striatal membrane preparations. The results are in favor of an interaction of ergot derivatives with dopamine recognition sites both after acute and chronic treatment.

  13. Le don de lait personnalisé chez le grand prématuré : facteurs associés et accompagnement des mères à la maternité de Port Royal

    OpenAIRE

    Remani-Rafa, Souad

    2015-01-01

    Background and aim: Personalized Breast Milk Gift (PBMG) from a mother to her premature infant, is a way to restore the link between mother and child in the technological environment of the Neonatal Intensive Care Unit. Despite the benefits of mother’s milk for premature infants, breastfeeding rate is very low in this category. In 2013, at Port-Royal Maternity, only 54% of premature newborn fewer than 32 weeks of amenorrhea received milk from their own mothers at least once during hospitaliza...

  14. Health-related Quality of Life in Women with Polycystic Ovary Syndrome

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    Belén Carazo Hernández

    2014-04-01

    Full Text Available Polycystic ovary syndrome is the most frequent endocrine and metabolic disorder in women of reproductive age. Its characteristic signs and symptoms are menstrual irregularities, amenorrhea, acne, hirsutism, obesity and infertility. Polycystic ovary syndrome has major effects on long-term health, which can lead to psychological morbidity and decreased quality of life. This paper reviews the current literature on polycystic ovary syndrome and health-related quality of life; in addition, it assesses how some clinical manifestations of polycystic ovary syndrome affect the quality of life of women who suffer this disorder.

  15. Appendectomy during the third trimester of pregnancy in a 27-year old patient: case report of a "near miss" complication

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    Holzer Thomas

    2011-05-01

    Full Text Available Abstract The management of acute appendicitis during pregnancy is not fully established, especially regarding the choice between open and laparoscopic surgery during the third trimester. We report herein the case of a major uterine variecele hemorrhage during a laparoscopic appendectomy in a 27-year old pregnant patient at 33 weeks of amenorrhea. After conversion to a Pfannenstiel incision, the baby was delivered, the bleeding stopped and the appendectomy completed. While both mother and child fully recovered, this «near miss» complication underlines the challenges linked to the management of acute appendicitis during pregnancy. Based on a literature review, we propose an algorithm favoring the laparoscopic approach during the first and second trimesters, and the open approach during the third trimester (especially after the 26th week of amenorrhea. In case of unclear pre-operative diagnosis, a laparoscopy should be conducted even during the third trimester with a Mc Burney conversion when the diagnosis of appendicitis is confirmed.

  16. Genetics of primary ovarian insufficiency.

    Science.gov (United States)

    Rossetti, R; Ferrari, I; Bonomi, M; Persani, L

    2017-02-01

    Primary ovarian insufficiency (POI) is characterized by a loss of ovarian function before the age of 40 and account for one major cause of female infertility. POI relevance is continuously growing because of the increasing number of women desiring conception beyond 30 years of age, when POI prevalence is >1%. POI is highly heterogeneous and can present with ovarian dysgenesis and primary amenorrhea, or with secondary amenorrhea, and it can be associated with other congenital or acquired abnormalities. In most cases POI remains classified as idiopathic. However, the age of menopause is an inheritable trait and POI has a strong genetic component. This is confirmed by the existence of several candidate genes, experimental and natural models. The variable expressivity of POI defect may indicate that, this disease may frequently be considered as a multifactorial or oligogenic defect. The most common genetic contributors to POI are the X chromosome-linked defects. Here, we review the principal X-linked and autosomal genes involved in syndromic and non-syndromic forms of POI with the expectation that this list will soon be upgraded, thus allowing the possibility to predict the risk of an early age at menopause in families with POI.

  17. Rare case of leiomyoma in Mayer-Rokitansky-Kuster-Hauser syndrome

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    Sonal A. Bhuyar

    2014-04-01

    Full Text Available Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome is a cause for primary amenorrhea. It is characterized by the presence of XX karyotype, normal ovarian function and blind vaginal pouch. The uterus is usually represented by bilateral rudimentary primordia. Presence of functioning endometrial tissue may lead to development of hematometra in one or both primordia. Rarely myomas, neoplasms and adenomyosis can develop in the rudimentary bulbs. MRKH syndrome is frequently associated with urologic and skeletal abnormalities. In this case, a 45 year old patient presented with primary amenorrhea and lower abdominal pain. On examination, she had a blind vaginal pouch and a pelvic mass. She was investigated and taken for laparotomy with a provisional diagnosis of hematometra or ovarian tumor. The mass turned out to be leiomyoma in one of the rudimentary bulbs which was confirmed on histopathology. Our patient had vertebral abnormalities too. The incidence of MRKH syndrome is less and its association with pelvic tumor is even rarer. Hence this case is reported. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 488-490

  18. Discussion on Traditional Chinese Medicine With Artificial Cycle on Treating Irregular Menstruation Due to Polycystic Ovarian Syndrome%疏肝解郁配中药人工周期治疗多囊卵巢综合征引起月经不调初探

    Institute of Scientific and Technical Information of China (English)

    贾绍燕

    2012-01-01

    Polycystic ovarian syndrome is characteristed with hypomenorrhea, secondary amenorrhea, anovulation, infertility, hirsutism, obesity and enlarged Polycystic ovarian. It belongs to delayed menstruation, amenorrhea, metrorrhagia and metrostaxix, infertility, abdominal mass, and so on. This article explained the mechanism and clinical curative effect of traditional Chinese medicine with artificial cycle treating polycystic ovarian syndrome causing irregular menstruation based on the production mechanism of menstruation and its relationship between the liver.%多囊卵巢综合征是一种多以月经稀发、月经过少、继发闭经、无排卵、不孕、多毛、肥胖、卵巢多囊性增大为特征的综合征,属中医“月经后期”、“闭经”、“崩漏”、“不孕”、“癥瘕”等范畴,文章从月经产生的机理、与肝脏的关系,阐述疏肝解郁配中药人工周期治疗多囊卵巢综合征引起月经不调的机理及临床疗效.

  19. Electroacupuncture Modulates Reproductive Hormone Levels in Patients with Primary Ovarian Insufficiency: Results from a Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Kehua Zhou

    2013-01-01

    Full Text Available To investigate the effects of electroacupuncture (EA on serum FSH, E2, and LH levels, women with primary ovarian insufficiency (POI were treated with EA once a day, five times a week for the first four weeks and once every other day, three times a week, for the following two months, and then were followed up for three months. Serum E2, FSH, and LH levels were measured at baseline, at the end of treatment, and during followup. A total of 11 women with POI were included in this prospective consecutive case series study. Compared with baseline, patients’ serum E2 increased, FSH decreased, and LH decreased (P=0.002, 0.001, and 0.002, resp. after EA treatment, and these effects persisted during followup. With treatment, 10 patients resumed menstruation (10/11, 90.91%, whereas one patient remained amenorrhea. During followup, two patients, including the one with amenorrhea during treatment, reported absence of menstruation. Temporary pain occurred occasionally, and no other adverse events were found during treatment. The results suggest that EA could decrease serum FSH and LH levels and increase serum E2 level in women with POI with little or no side effects; however, further randomized control trials are needed.

  20. "ACUTE FATTY LIVER OF PREGNANCY AND PREECLAMPSIA IN A TRIPLET GESTATION "

    Directory of Open Access Journals (Sweden)

    M. Ghaffarnejad

    2007-06-01

    Full Text Available Acute fatty liver of pregnancy (AFLP is a rare entity and a potentially fatal disorder. It is reported to be more common in multiple than singleton pregnancies. Sometimes it coincides with preeclampsia but the exact etiology is not yet understood. A 31-year-old G2 P1 patient admitted at 33 weeks of pregnancy with signs and symptoms of jaundice, gastroenteritis, hypertension, malaise, urinary incontinence and preterm contractions. She had history of idiopathic hypothalamic amenorrhea and by a recent trial with gonadotropins, she had got triplet gestation. After admission her general condition deteriorated. She underwent Cesarean section at once and all fetuses survived. She had severe postpartum hemorrhage. The results of laboratory tests indicated coagulopathy and liver function abnormalities. The AFLP was diagnosed on the third day of hospital stay. She was discharged one week later. Again she returned with complaint of severe sustained headache. Computed tomography showed subdural hemorrhage and drainage of hematoma was performed immediately. Finally the patient recovered from all of these critical conditions. This is the first report of AFLP in a patient with history of idiopathic hypothalamic amenorrhea. AFLP should be suspected in every pregnant patient with preeclampsia and gastroenteritis symptoms in the third trimester of pregnancy.

  1. Cytogenetic evaluation of patients with clinical spectrum of Turner syndrome

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    Rajasekhar Moka

    2013-01-01

    Full Text Available Aim: The objective of this study was to correlate the genotype, of female patients, withshort stature and primary amenorrhea. Materials and Methods: One hundred and forty-six subjects were recruited during 2005-2012. Microscopic and automated karyotyping analyses were done by using chromosomes isolated from the lymphocytes using Giemsa banding (GTG to identify chromosome abnormalities. Results: A total of 146 clinically suspected Turner syndrome (TS subjects were recruited for the study, of which, 61 patients were identified to have chromosome abnormalities. The chromosomal abnormalities detected were as follows: Monosomy X (n = 19, 13.01%, triple X syndrome (n = 4, 2.7%, mosaic TS (n = 12, 8.21%, XY gonadal dysgenesis (n = 13, 8.9%, and structural abnormalities including X chromosome (n = 15, 10.27% and one patient each with autosomal changes involving 9qh inversion and translocation of chromosomes 12 and 14. Conclusion: Karyotype abnormalities accounting for 46% in this study emphasize the need for karyotype testing in cases of short stature with primary amenorrhea.

  2. Gynecologic and obstetric findings related to nutritional status and adherence to a gluten-free diet in Brazilian patients with celiac disease.

    Science.gov (United States)

    Kotze, L M S

    2004-08-01

    This study shows a broad analysis of gynaecological and obstetrical disturbances in patients with celiac disease in relation to their nutritional status and adherence to a gluten-free diet. Seventy-six adult celiac patients were analyzed according to nutritional status and 18 children/adolescents to gluten-free diet adherence. As controls, 84 adults and 22 adolescents with irritable bowel syndrome were used The significant findings were observed as follow: adult celiac patients, irrespective of the nutritional status, were younger than controls, presented delayed menarche, secondary amenorrhea, a higher percentage of spontaneous abortions, anemia and hypoalbuminemia. No differences were observed regarding the number of pregnancies, age at menopause and duration of the reproductive period. After treatment, patients presented with normal pregnancies and one patient presented spontaneous abortion. The adolescents who were not adherent to gluten-free diet presented delayed menarche and secondary amenorrhea. In conclusion, gluten per se could explain the disturbances and malnutrition would worsen the disease in a consequent vicious cycle. Therefore, celiac disease should be included in the screening of reproductive disorders.

  3. [Application of TB type thermal balloon endometrial ablation for the treatment of abnormal uterine bleeding].

    Science.gov (United States)

    Wang, W; Zhai, Y; Zhang, Z H; Li, Y; Zhang, Z Y

    2016-11-08

    Objective: To investigate the clinical efficacy, safety and promotion value of TB type thermal balloon endometrial ablation in the treatment of abnormal uterine bleeding. Methods: Fourty three patients who had received TB type endometrial ablation system for treatment of abnormal uterine bleeding from January, 2015 to January, 2016 in theDepartment of gynecology, Beijing Chaoyang Hospital were enrolled in this study. The intra-operative and post-operative complications and improvement of abnormal uterine bleeding and dysmenorrhea were observed. Results: There were nointra-operative complication occurred, such as uterine perforation, massive hemorrhage or surrounding organ damage. At 6 months after operation, 32 patients developed amenorrhea, 6 developed menstrual spotting, 3 developed menstruation with a small volume and 1 had a normal menstruation. No menstruation with an increased volume occurred. The occurrence of amenorrhea was 76.19% and the response rate was 97.62%.At 6 months after operation, 1 case had no response, 2 cases had partial response and 11 cases had complete response among the 14 cases of pre-operative dysmenorrhea; only 3 cases still had anemia among the 23 cases of pre-operative anemia. Compared with before treatment, patients with dysmenorrhea and anemia both significantly reduced with a statistically significant difference(P<0.01). Conclusion: TB type thermal balloon endometrial ablation has a significant efficacy with high safety for the treatment of abnormal uterine bleeding, which could have clinical promotion practice.

  4. The young female athlete.

    Science.gov (United States)

    Hurvitz, Michal; Weiss, Ram

    2009-12-01

    Participation of adolescents and young women in strenuous sports activity may lead to various metabolic and psychological derangements of clinical relevance to the endocrinologist. The most common manifestations encountered in practice are primary and secondary amenorrhea, reduced bone mineral density and eating disorders. The occurrence of all three together has been named "the athletic triad". The underlying hormonal drivers that lead to some of these manifestations are the reduced leptin level as well as the persistent low grade stress response commonly observed in such females. "Exercise-related female reproductive dysfunction" (ERFRD), can possibly include short-term (infertility) and long-term (osteoporosis) consequences. Functional hypothalamic amenorrhea, a manifestation of ERFRD in adolescence, is an integrated response to the combination of excessive physical and emotional stress, exercise, and/or reduced food intake characterized by decreased endogenous GNRH secretion. The primary aim of treating these athletes should be the prevention of the development of any component of the triad as well as the whole complex by educating athletes, trainers, parents and health care professionals about proper nutrition and safe training. The long term prognosis is good. However, significant long term morbidity may affect these young women later in life.

  5. RECOVERY OF BONE MINERAL DENSITY AND FERTILITY IN A FORMER AMENORRHEIC ATHLETE

    Directory of Open Access Journals (Sweden)

    Karen Hind

    2008-09-01

    Full Text Available Inadequate dietary intake and prolonged amenorrhea in women athletes can lead to bone loss, particularly at the spine, which may be irreversible. This report presents the case of a woman endurance runner, followed prospectively over 6 years after presenting with the female athlete triad. Bone mineral density (BMD and body composition were assessed by dual-energy X-ray absorptiometry. At baseline, lumbar spine (LS, total hip and total body (TB BMD Z-scores were -2.2, -0.5 and -0.3 respectively. At 6 years, following a recovery plan of cognitive behavioural therapy (CBT, weight gain, improved dietary intake and reduced training load, the athlete regained menstrual function and BMD. LS, TB and hip BMD Z-scores improved to -0.6, -0.1 and 0.1 respectively. Restoration of fertility was indicated by pregnancy, following only 4 months of regular menstruation. This case report suggests that bone density and fertility may not be completely jeopardised in formerly amenorrheic and osteopenic athletes, providing recovery through diet, weight gain, and return of menstruation is achieved within the third decade. Longitudinal studies tracking bone changes in women with amenorrhea and low BMD are required and would have important implications for the treatment of the female athlete triad

  6. Homozygous Inactivating Mutation in NANOS3 in Two Sisters with Primary Ovarian Insufficiency

    Directory of Open Access Journals (Sweden)

    Mariza G. Santos

    2014-01-01

    Full Text Available Despite the increasing understanding of female reproduction, the molecular diagnosis of primary ovarian insufficiency (POI is seldom obtained. The RNA-binding protein NANOS3 poses as an interesting candidate gene for POI since members of the Nanos family have an evolutionarily conserved function in germ cell development and maintenance by repressing apoptosis. We performed mutational analysis of NANOS3 in a cohort of 85 Brazilian women with familial or isolated POI, presenting with primary or secondary amenorrhea, and in ethnically-matched control women. A homozygous p.Glu120Lys mutation in NANOS3 was identified in two sisters with primary amenorrhea. The substituted amino acid is located within the second C2HC motif in the conserved zinc finger domain of NANOS3 and in silico molecular modelling suggests destabilization of protein-RNA interaction. In vitro analyses of apoptosis through flow cytometry and confocal microscopy show that NANOS3 capacity to prevent apoptosis was impaired by this mutation. The identification of an inactivating missense mutation in NANOS3 suggests a mechanism for POI involving increased primordial germ cells (PGCs apoptosis during embryonic cell migration and highlights the importance of NANOS proteins in human ovarian biology.

  7. A Muhicentered Clinical Trial of the Long-acting Injectable Contraceptive Depo Provera in Chinese Women

    Institute of Scientific and Technical Information of China (English)

    SunDan-li; ShaoQing-xiang; SangGuo-wei

    2005-01-01

    This study was an open trial where 1994 subjects each received Depo Provera injectable contraceptive every three months for one year and were observed a total of 20,294.3 woman months.At the time of observation,only one accidental pregnancy had occurred giving a use-effectiveness rate of 99.94% and a cumulative continuation rate of 72.8%.There were no significant adverse effects on weight and bolld pressure.The main side effects were spotting,prolonged bleeding,and amenorrhea and these were alsothe main reasons of discontinuation.Complaints related to bleeding problems gradually decreased and complaints of amenorrhea increased with continued use. In lactating women,side effects occurrence rate was lower and continuation rate was higher in comparison with non-lactating women.Users did not report any effect on milk secretion.The results of this study confirm that Depo Provera is a very effective contraceptive method.With appropriate counseling and medical support,high acceptability and continuation rate can be achieved. Depo Provera is especially suitable for lactating women and could become a popular contraceptive method for lactating Chinese women.

  8. Narrative review: the role of leptin in human physiology: emerging clinical applications.

    Science.gov (United States)

    Kelesidis, Theodore; Kelesidis, Iosif; Chou, Sharon; Mantzoros, Christos S

    2010-01-19

    Leptin is a hormone secreted by adipose tissue in direct proportion to amount of body fat. The circulating leptin levels serve as a gauge of energy stores, thereby directing the regulation of energy homeostasis, neuroendocrine function, and metabolism. Persons with congenital deficiency are obese, and treatment with leptin results in dramatic weight loss through decreased food intake and possible increased energy expenditure. However, most obese persons are resistant to the weight-reducing effects of leptin. Recent studies suggest that leptin is physiologically more important as an indicator of energy deficiency, rather than energy excess, and may mediate adaptation by driving increased food intake and directing neuroendocrine function to converse energy, such as inducing hypothalamic hypogonadism to prevent fertilization. Current studies investigate the role of leptin in weight-loss management because persons who have recently lost weight have relative leptin deficiency that may drive them to regain weight. Leptin deficiency is also evident in patients with diet- or exercise-induced hypothalamic amenorrhea and lipoatrophy. Replacement of leptin in physiologic doses restores ovulatory menstruation in women with hypothalamic amenorrhea and improves metabolic dysfunction in patients with lipoatrophy, including lipoatrophy associated with HIV or highly active antiretroviral therapy. The applications of leptin continue to grow and will hopefully soon be used therapeutically.

  9. Leptin in human physiology and therapeutics.

    Science.gov (United States)

    Dardeno, Tina A; Chou, Sharon H; Moon, Hyun-Seuk; Chamberland, John P; Fiorenza, Christina G; Mantzoros, Christos S

    2010-07-01

    Leptin regulates energy homeostasis and reproductive, neuroendocrine, immune, and metabolic functions. In this review, we describe the role of leptin in human physiology and review evidence from recent "proof of concept" clinical trials using recombinant human leptin in subjects with congenital leptin deficiency, hypoleptinemia associated with energy-deficient states, and hyperleptinemia associated with garden-variety obesity. Since most obese individuals are largely leptin-tolerant or -resistant, therapeutic uses of leptin are currently limited to patients with complete or partial leptin deficiency, including hypothalamic amenorrhea and lipoatrophy. Leptin administration in these energy-deficient states may help restore associated neuroendocrine, metabolic, and immune function and bone metabolism. Leptin treatment is currently available for individuals with congenital leptin deficiency and congenital lipoatrophy. The long-term efficacy and safety of leptin treatment in hypothalamic amenorrhea and acquired lipoatrophy are currently under investigation. Whether combination therapy with leptin and potential leptin sensitizers will prove effective in the treatment of garden-variety obesity and whether leptin may have a role in weight loss maintenance is being greatly anticipated.

  10. 黄可佳教授从肝论治多囊卵巢综合征之经验总结%Professor HUANG Kejia's Experience in Treating Polycystic Ovary Syndrome from Liver

    Institute of Scientific and Technical Information of China (English)

    刘英蕾; 黄可佳

    2013-01-01

    Polycystic ovary syndrome ( PCOS ) is a common endocrine and metabolic abnormalities disease of the women of growth period, and the main features are rare menstruation, amenorrhea, hairy, obesity and so on. It can be classified in late menstruation, less menstruation, amenorrhea and infertility and so on. The author talks about the etiology and pathogenesis and professor HUANG Kejia's experience in treating PCOS from liver.%多囊卵巢综合征是生育期妇女常见的内分泌代谢异常所致的疾病,以月经稀发甚或闭经、不孕、多毛、肥胖等为主要症状,可归属于中医学“月经后期”“经量过少”“闭经”“不孕”等疾病的某些证型.作者总结黄可佳教授对多囊卵巢综合征病因病机的认识,及从肝论治多囊卵巢综合征之经验.

  11. Uterine morphology and peristalsis in women with polycystic ovary syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Leonhardt, Henrik; Hellstroem, Mikael [Department of Radiology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden)], E-mail: henrik.leonhardt@vgregion.se; Gull, Berit; Nilsson, Lars; Janson, Per O. [Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Kishimoto, Keiko [Department of Radiology, St Marianna University School of Medicine, Kanagawa (Japan); Kataoka, Masako [Department of Radiology, Kyoto University Hospital, Kyoto (Japan); Stener-Victorin, Elisabet [Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Sweden)

    2012-12-15

    Background. Polycystic ovary syndrome (PCOS) is associated with chronic oligo-anovulation and high circulating sex hormone levels. Women with PCOS have an increased risk of developing endometrial cancer. In anovulatory women with PCOS a positive relationship between endometrial thickness and endometrial hyperplasia has been observed. Uterine peristalsis, which has been suggested to be of importance for female fertility, has not previously been studied in PCOS. Purpose. To assess whether women with PCOS have altered endometrial thickness, uterine wall morphology, and peristalsis. Material and Methods. In this prospective case-control study 55 women with PCOS (mean age, 29.5 years {+-} 4.5 SD) and 28 controls (27.6 {+-} 3.2) were examined using magnetic resonance imaging (MRI), assessing thickness of endometrium, junctional zone (JZ), and myometrium, and evaluating the occurrence, frequency (waves/min), strength (amplitude), pattern, and direction of peristalsis. Uterine morphology was also assessed by transvaginal ultrasonography (TVUS). Results. The endometrium was thinner in PCOS with oligo-amenorrhea compared to controls, also after adjustments for age and BMI (adjusted P = 0.043). There was no difference in thickness of the JZ or the myometrium in cases versus controls. Uterine peristalsis was less commonly observed in women with PCOS than in controls (adjusted P = 0.014). Conclusion. There were no differences in myometrial morphology between PCOS and controls, but the endometrium was thinner in PCOS with oligo-amenorrhea. Based on cine MRI, uterine peristalsis was less common in PCOS than in controls.

  12. Collagen type I alpha 1 gene polymorphism in premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Vujović Svetlana

    2013-01-01

    Full Text Available Introduction. Premature ovarian failure (POF is characterized by amenorrhea, hypergonadotropism and hypoestrogenism in women bellow 40 years. Osteoporosis is one of the late complications of POF. Objective. To correlate collagen type I alpha1 (COLIA1 gene polymorphism with bone mineral density (BMD in women with POF. Methods. We determined the COLIA1 genotypes SS, Ss, ss in 66 women with POF. Single nucleotide polymorphism (G to T substitution within the Sp 1-binding site in the first intron of the COLIA1 gene was assessed by polymerase chain reaction (PCR followed by single-stranded conformation polymorphism (SSCP analysis. Bone mineral density (BMD was measured at the lumbar spine region by dual X-ray absorptiometry. Statistics: Kruskal-Wallis ANOVA, Chisquare test, Spearman correlation test. Results. The relative distribution of COLIA1 genotype alleles was SS - 54.4%, Ss - 41.0% and ss - 4.5%. No significant differences were found between genotype groups in body mass index, age, duration of amenorrhea or BMD. A significant positive correlation was observed between BMI and parity. Conclusion. The COLIA1 gene is just one of many genes influencing bone characteristics. It may act as a marker for differences in bone quantity and quality, bone fragility and accelerated bone loss in older women. However, in young women with POF, COLIA1 cannot identify those at higher risk for osteoporosis. [Projekat Ministarstva nauke Republike Srbije, br. ON 173056

  13. Williams Syndrome and 15q Duplication: Coincidence versus Association.

    Science.gov (United States)

    Khokhar, Aditi; Agarwal, Swashti; Perez-Colon, Sheila

    2017-01-01

    Williams syndrome is a multisystem disorder caused by contiguous gene deletion in 7q11.23, commonly associated with distinctive facial features, supravalvular aortic stenosis, short stature, idiopathic hypercalcemia, developmental delay, joint laxity, and a friendly personality. The clinical features of 15q11q13 duplication syndrome include autism, mental retardation, ataxia, seizures, developmental delay, and behavioral problems. We report a rare case of a girl with genetically confirmed Williams syndrome and coexisting 15q duplication syndrome. The patient underwent treatment for central precocious puberty and later presented with primary amenorrhea. The karyotype revealed 47,XX,+mar. FISH analysis for the marker chromosome showed partial trisomy/tetrasomy for proximal chromosome 15q (15p13q13). FISH using an ELN-specific probe demonstrated a deletion in the Williams syndrome critical region in 7q11.23. To our knowledge, a coexistence of Williams syndrome and 15q duplication syndrome has not been reported in the literature. Our patient had early pubertal development, which has been described in some patients with Williams syndrome. However, years later after discontinuing gonadotropin-releasing hormone analogue treatment, she developed primary amenorrhea.

  14. Clinical and metabolic aspects of the continuous use of a contraceptive association of ethinyl estradiol (30 microg) and gestodene (75 microg).

    Science.gov (United States)

    Machado, Rogério Bonassi; Fabrini, Paula; Cruz, Achilles Machado; Maia, Edna; da Cunha Bastos, Alvaro

    2004-11-01

    This open, prospective, noncomparative study evaluated clinical and metabolic aspects of the use of a contraceptive combination of ethinyl estradiol (30 microg) and gestodene (75 microg) continuously for 24 weeks in 45 women aged 25 +/- 3.7 years. No alterations in weight or blood pressure were observed. Few side effects were recorded. Amenorrhea rates increased from the fourth month of observation onwards, reaching 81.2% by week 24. A reduction in the levels of cholesterol and LDL and an increase in HDL and triglycerides were observed. Insulin levels increased but not significantly, while levels of glycemia remained unchanged. Levels of antithrombin III, fibrinogen and plasminogen activator inhibitor-1 (PAI-1) increased, whereas a reduction was observed in proteins C and S and in prothrombin time (PT). Activated partial thromboplastin time (APTT) remained unchanged. The treatment was associated with satisfactory clinical effects, high rates of amenorrhea after the third treatment cycle, and resulted in metabolic changes similar to those encountered during the classic use of contraceptive pills with monthly interruption for withdrawal bleeding.

  15. Ultra-low-dose continuous combined estradiol and norethisterone acetate: improved bleeding profile in postmenopausal women

    DEFF Research Database (Denmark)

    Sturdee, D.W.; Archer, D.F.; Rakov, V.;

    2008-01-01

    OBJECTIVE: To evaluate the effect of two ultra-low-dose hormone treatments containing estradiol (E2) 0.5 mg and norethisterone acetate (NETA) 0.1 or 0.25 mg on the endometrium and bleeding. METHODS: A prospective, randomized, placebo-controlled trial of 6 months. Local Ethics Committee approval...... at baseline and on completion. An endometrial biopsy was obtained when indicated clinically. RESULTS: In months 1-6, the amenorrhea rates with E2/NETA 0.1 were 89%, 89%, 86%, 85%, 89% and 89%, respectively and the no-bleeding rates were correspondingly high: 95%, 94%, 93%, 90%, 95% and 95%. The amenorrhea...... and spotting-only rates were similar with both ultra-low-dose combinations. The withdrawal rates due to bleeding were very low and the same in all three treatment arms (n = 1; 1%). There was a slight increase in the mean endometrial thickness in all three groups, which remained less than 5 mm. CONCLUSIONS...

  16. Cytogenetic evaluation of patients with clinical spectrum of Turner syndrome

    Science.gov (United States)

    Moka, Rajasekhar; Sreelakshmi, Kodandapani; Gopinath, Puthiya Mundyat; Satyamoorthy, Kapettu

    2013-01-01

    AIM: The objective of this study was to correlate the genotype, of female patients, withshort stature and primary amenorrhea. MATERIALS AND METHODS: One hundred and forty-six subjects were recruited during 2005-2012. Microscopic and automated karyotyping analyses were done by using chromosomes isolated from the lymphocytes using Giemsa banding (GTG) to identify chromosome abnormalities. RESULTS: A total of 146 clinically suspected Turner syndrome (TS) subjects were recruited for the study, of which, 61 patients were identified to have chromosome abnormalities. The chromosomal abnormalities detected were as follows: Monosomy X (n = 19, 13.01%), triple X syndrome (n = 4, 2.7%), mosaic TS (n = 12, 8.21%), XY gonadal dysgenesis (n = 13, 8.9%), and structural abnormalities including X chromosome (n = 15, 10.27%) and one patient each with autosomal changes involving 9qh inversion and translocation of chromosomes 12 and 14. CONCLUSION: Karyotype abnormalities accounting for 46% in this study emphasize the need for karyotype testing in cases of short stature with primary amenorrhea. PMID:24082654

  17. Mycophenolate mofetil in the treatment of lupus nephritis

    Directory of Open Access Journals (Sweden)

    Patrick FK Yong

    2008-06-01

    Full Text Available Patrick FK Yong1,2, David P D’Cruz21Department of Clinical Immunology, Kings College Hospital; 2The Lupus Research Unit, St Thomas’ Hospital, London, UKAbstract: Lupus nephritis is a complication of systemic lupus erythematosus, which has significant morbidity and mortality. The accepted standard of treatment for severe lupus nephritis is cyclophosphamide for induction of remission. This has significant adverse effects including severe infection and amenorrhea. In addition, although cyclophosphamide induces remission, long-term mortality does not seem to be altered. Mycophenolate mofetil (MMF is an immunosuppressive agent originally used in solid organ transplantation, which has been compared with cyclophosphamide in trials for lupus nephritis. Randomized trials with MMF have been relatively small, although pooled data seem to suggest that it is at least as effective as cyclophosphamide in inducing remission. In addition, MMF has also been associated with a reduced risk of infection and amenorrhea, although this finding is not universal. MMF appears to be associated with more diarrhea compared with cyclophosphamide. MMF is likely to be a useful treatment for lupus nephritis, although available trial data are limited due to the small size of previous studies. A large trial (the Aspreva Lupus Management Study is currently underway to attempt to establish the place of MMF in treatment of lupus nephritis.Keywords: mycophenolate mofetil, lupus nephritis, systemic lupus erythematosus

  18. Chromosome territories, X;Y translocation and Premature Ovarian Failure: is there a relationship?

    Directory of Open Access Journals (Sweden)

    Betri Enrico

    2009-09-01

    Full Text Available Abstract Background Premature ovarian failure (POF is a secondary hypergonadotrophic amenorrhea occurring before the age of 40 and affecting 1-3% of females. Chromosome anomalies account for 6-8% of POF cases, but only few cases are associated with translocations involving X and Y chromosomes. This study shows the cytogenetic and molecular analysis of a POF patient came to our attention as she developed a left ovary choriocarcinoma at the age of 10 and at 14 years of age she presented secondary amenorrhea with elevated levels of gonadotropins. Results Breakpoint position on X and Y chromosomes was investigated using Fluorescent In Situ Hybridisation (FISH with a panel of specific BAC probes, microsatellite analysis and evaluation of copy number changes and loss of heterozigosity by Affymetrix® GeneChip platform (Santa Clara, CA, USA. Patient's karyotype resulted 46, X, der(Yt(X;Y(q13.1;q11.223. X inactivation study was assessed by RBA banding and showed preferential inactivation of derivative chromosome. The reciprocal spatial disposition of sexual chromosome territories was investigated using whole chromosome painting and centromeres probes: patient's results didn't show a significant difference in comparison to normal controls. Conclusion The peculiar clinical case come to our attention highlighted the complexity of POF aetiology and of the translocation event, even if our results seem to exclude any effect on nuclear organisation. POF phenotype could be partially explained by skewed X chromosome inactivation that influences gene expression.

  19. Hyperprolactinemia

    Directory of Open Access Journals (Sweden)

    Abha Majumdar

    2013-01-01

    Full Text Available Prolactin (PRL is an anterior pituitary hormone which has its principle physiological action in initiation and maintenance of lactation. In human reproduction, pathological hyperprolactinemia most commonly presents as an ovulatory disorder and is often associated with secondary amenorrhea or oligomenorrhea. Galactorrhea, a typical symptom of hyperprolactinemia, occurs in less than half the cases. Out of the causes of hyperprolactinemia, pituitary tumors may be responsible for almost 50% of cases and need to be investigated especially in the absence of history of drug induced hyperprolactinemia. In women with hyperprolactinemic amenorrhea one important consequence of estrogen deficiency is osteoporosis, which deserves specific therapeutic consideration. Problem in diagnosing and treating hyperprolactinemia is the occurrence of the ′big big molecule of prolactin′ that is biologically inactive (called macroprolactinemia, but detected by the same radioimmunoassay as the biologically active prolactin. This may explain many cases of very high prolactin levels sometimes found in normally ovulating women and do not require any treatment. Dopamine agonist is the mainstay of treatment. However, presence of a pituitary macroadenoma may require surgical or radiological management.

  20. Clinical effect of conservative drug treatment for ectopic pregnancy and the influencing factors%异位妊娠药物保守治疗效果及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    李婵娟; 凌斌

    2013-01-01

    目的 分析影响异位妊娠药物保守治疗效果的因素.方法 对我院妇产科2008年6月至2011年6月收治的100例异位妊娠患者进行药物保守治疗,将所有患者根据药物治疗是否成功分为成功组与失败组,比较两组患者的停经时间、腹痛天数、血HCG水平、血孕酮水平、彩超结果,并用Logistic回归分析影响异位妊娠药物治疗成功率的因素.结果 单因素分析显示,停经时间、血HCG水平、血孕酮水平、彩超显示包块大小影响药物保守治疗的成功率,停经时间越短、血HCG水平与孕酮水平越低,包块直径越小成功率越高(P<0.05);腹痛时间、盆腔积液量对药物治疗成功率影响不明显(P>0.05).Logistic多因素分析显示,血HCG水平、包块大小是影响药物保守治疗成功率的因素.结论 患者血HCG水平、停经天数、包块大小是影响药物保守治疗成功与否的关键因素,停经时间也是因素之一,治疗时应根据患者临床表现及辅助检查结果选择治疗方案,提高成功率,以免给患者造成不必要的负担.%Objective To analyze the factors influencing the clinical effect of conservative drug treatment for ectopic pregnancy. Methods One hundred patients with ectopic pregnancy admitted in our hospital from June, 2008 to June, 2011 received conservative drug treatment, which were divided into the success group and the fail group according to the outcome of treatment The days of amenorrhea, days of pain, levels of human chorionic gonadotrophin (HCG) and blood progesterone, as well as the sonographic results were compared between the two groups. The factors influencing the clinical effect of the treatment were analyzed by logistic regression analysis. Results Single factor analysis showed mat days of amenorrhea, HCG level, mass diameter, progesterone level were the factors that influence the outcome of die treatment The success of the treatment was correlated with shorter

  1. Relationships between serum estradiol,prolactin and bone density in women with hyperprolactinemia%从“肾主骨”谈高泌乳素血症妇女血清雌二醇及泌乳素水平与骨密度关系

    Institute of Scientific and Technical Information of China (English)

    马霞; 吴国光; 潘艳丽; 焦宏官; 张晶; 储戟农; 朱玲

    2012-01-01

    目的:理解我国高PRL血症妇女BD变化并探讨引起BD变化的原因.方法:采取BMD-4型骨密度分析仪对88例高泌乳素血症妇女进行骨密度(BD)测定,同时测定血清雌二醇(E2)、泌乳素(PRL)和睾(T)水平,以30例月经正常妇女及40例正常闭经妇女作为对照.结果:高PRL血症闭经妇女和高PRL正常闭经妇女BD均明显低于正常对照组(分别为P<0.05,<0.01),其二者血清E2水平亦明显低于正常对照组(均为P<0.01).而高PRL血症妇女月经正常妇女BD和血清E2水平与正常对照组均无明显差异.结论:雌激素水平不足是高PRL血症闭经妇女BD减低的主要原因,绝经前妇女月经正常与否是有否异常骨丢失的客观指标.%Objection: To study the bone density ( BD) in women with hyperprolactnemia and to clarify the cause of changes in BD. Methods:The BD in 48 women with hyperprolactinemia a were measured by BMD-4 bone density analyzer, at the same time, we determined serum estrdiol( E2 ) prolactin( PRL) and testosterone( T). 25 healthy women with normal menopause and 40 amenorrhea women with normal PRL were control. Result;The BD were lower in amenorrhea women with hyperprolactinmia and with normal PRL than those in the healthy controls ( P < 0. 05, < 0. 01 ) and the E2 levsls were significantly lower than those of the healthy (P < 0. 01, < 0. 01). The levels of BD and E2 were not different between the normal menstruation women with hyperprolactinemia and healthy controls. Conciutoin: The insufficiency of estrin was the main cause of reduction in BD of amenorrhea women with hyperprolactinema. Whether the menstruation of premeopausal women were normal or not was an objective index on judging loss in bone metabolism.

  2. [Changes of menstruation patterns and adverse effects during the treatment of LNG-IUS for symptomatic adenomyosis].

    Science.gov (United States)

    Li, L; Leng, J H; Zhang, J J; Jia, S Z; Li, X Y; Shi, J H; Dai, Y; Zhang, J R; Li, T; Xu, X X; Liu, Z Z; You, S S; Chang, X Y; Lang, J H

    2016-09-25

    Objective: To investigate the changes of mestruation patterns and adverse effects during the treatment of levonorgestrel-releasing intrauterine system(LNG-IUS)for symptomatic adenomyosis in a prospective cohort study. Methods: From December, 2006 to December, 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in Peking Union Medical College Hospital were given LNG-IUS. Before and after placement of IUS, all patients' parameters were recorded, including carrying status of IUS, symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Risk factors for changes of menstruation patterns and adverse effects, and their impact on treatment effects were analyzed. Results: Totally 1 100 cases met inclusion criteria, with median age 36 years(range 20-44 years), median follow-up 35 months(range 1 -108 months). During follow-up changes of menstruation patterns increased significantly with amenorrhea and shortened-menstruation being the most common manifestations. On 3, 6, 12, 24, 36, 48 and 60 months after the placement of LNG-IUS, 0, 5.8%(43/744), 6.9%(47/682), 10.1%(60/595), 17.3%(87/502), 27.2%(104/383)and 29.6%(82/277)patients achieved amenorrhea respectively(P12 months after placement, abdominal pain and body weight increasing ≥5 kg/year were the most common adverse effects. Changes of menstruation patterns, total and subclassifications of adverse effects were neither dependent on patient parameters, treatment modes and treatment effects, nor could predict future LNG-IUS carrying status(all P> 0.05). After taking out of LNG-IUS, most changes of menstruation and adverse effects disappeared. Conclusions: During the treatment of LNG-IUS for symptomatic adenomyosis, changes of menstruation patterns increase gradually with amenorrhea and shortened-menstruation being the most common manifestations, while adverse effects decrease significantly. Changes of

  3. Stein and Leventhal: 80 years on.

    Science.gov (United States)

    Azziz, Ricardo; Adashi, Eli Y

    2016-02-01

    Eighty years ago a publication in the Journal proved to be seminal and transformative. The report by Irving Freiler Stein and Michael Leventhal titled, "Amenorrhea associated with polycystic ovaries," has proven to be a remarkably lasting and influential publication. The growth in related literature has been increasing exponentially: the 50 years between 1950 and 2000 saw a little more than 8000 publications on the topic, whereas the 15 year period between 2001 and 2015 (so far) has seen more than 20,000 related publications, a greater than 8-fold increase in the publication rate after 2000. As we commemorate the 80th anniversary year of the publication of the report by Stein and Leventhal, it is important to ask ourselves, "Was this publication truly as seminal as it is generally assumed to be? And why did it gain such a strong foothold on the medical psyche?" To the first question, a review of the antecedent medical literature makes it clear that the report of Drs Stein and Leventhal in 1935, although not flawless, was both seminal and transformative. In fact, it was the first report to describe a series of patients, rather than isolated cases, who demonstrated the triad of polycystic ovaries, hirsutism, and oligo/amenorrhea, connecting what had previously been disparate features of polycystic ovaries and menorrhagia, and hirsutism and oligo/amenorrhea. Second, the facts that Dr Stein and his collaborators were relatively prolific writers, consistent and clear in their message and descriptions; that a possible therapy (bilateral ovarian wedge resection) had been conveniently included in the report; and that the disorder was (is) relatively prevalent, permitted what would eventually be called the Stein-Leventhal syndrome to gain a strong foothold in contemporary medical practice. Overall, we in the field of medicine have much to celebrate, as we commemorate the 80th anniversary of the publication of the report by Stein and Leventhal in 1935, for a new disorder was

  4. Hubungan Resistensi Insulin dengan Gambaran Klinis Sindrom Ovarium Polikistik

    Directory of Open Access Journals (Sweden)

    Meliza Wahyuni

    2015-09-01

    Full Text Available Abstrak Sindrom Ovarium Polikistik (SOPK merupakan kelainan endokrin dan metabolik pada wanita usia reproduksi. SOPK merupakan kumpulan gejala dari amenore, oligomenore, infertilitas, obesitas, hirsutisme, acne, alopesia, dan akantosis nigrikan. Resistensi insulin diyakini sebagai salah satu penyebab tersering dari SOPK melalui berbagai mekanisme. Tujuan penelitian ini adalah untuk mengetahui hubungan resistensi insulindengan gambaran klinis SOPK. Penelitian ini dilakukan pada pasien SOPK dengan menggunakan studi cross sectional dengan pendekatan retrospektif, yaitu mengumpulkan kejadian masa lalu dari tahun 2009 - 2011, jumlah sampel 105 orang. Analisis statistik yang digunakan adalah uji chi-square. Hasil penelitian didapatkan 33,3% penderita SOPK mengalami resistensi insulin. Berdasarkan gambaran klinis 35,23% amenore, 64,77% oligomenore, 72,04% infertilitas, 50,5% obesitas, 0,95% hirsutisme, acne 20%, alopesia dan akantosis nigrikan0%. Dari 33,3% SOPK dengan resistensi insulin 40% amenore, 60% oligomenore, 71,9% infertilitas, 77,14% obesitas, dan 0% hirsutisme. Berdasarkan hasil uji statistik ditemukan hubungan bermakna antara resistensi insulin dengan obesitas (p<0,05 dan tidak ditemukan hubungan bermakna antara resistensi insulin dengan infertilitas, hirsutisme, dan acne (p>0,05.Kata Kunci: SOPK, resistensi insulin, gambaran klinisAbstract Polycystic Ovary Syndrome (PCOS is an endocrine and metabolic disorders that is common in reproductive-aged women. PCOS is a group of symptoms, such as amenorrhea, oligomenorrhea, infertility, obesity, hirsutism, acne, alopecia, and achanthosis nigricans. Insulin resistance is believed to be one of the most common causes of PCOS through a various mechanisms. The objective of this study was to find out the relationship between insulin resistance and clinical manifestation of PCOS. This research was done in patients with PCOS using cross sectional study with retrospective approach. Data was collected from

  5. ECTOPIC CHORIOCARCINOMA IN A PRETEEN IN OGBOMOSO, SOUTH-WEST NIGERIA. A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Olumuyiwa Ogunlaja A

    2016-12-01

    Full Text Available Ectopic Choriocarcinoma is an extremely rare occurrence. The case of ectopic choriocarcinoma discussed here involved a 12 year old girl who presented with lower abdominal pain and dizziness following a short period of amenorrhea after attaining menarche. Aprovisional diagnosis of ruptured ectopic gestation was made based on the clinical evaluation and patient had emergency laparotomy. Histopathology report revealed a choriocarcinoma of the ovary. Patient defaulted on subsequent follow up care. This case is presented as an eye opener on the need to also focus on the reproductive health challenges, early sex education in preteen and rare occurrence of the disease amongst the Pre-teenage groups. It is also important to deal with the possibility of a non gestational choriocarcinoma of the ovary which has a worse prognosis.

  6. Role of inflammation and aromatase expression in the eutopic endometrium and its relationship with the development of endometriosis.

    Science.gov (United States)

    Maia, Hugo; Haddad, Clarice; Coelho, Genevieve; Casoy, Julio

    2012-11-01

    Epigenetic changes favoring the transcription of the aromatase gene in the endometrium allow endometrial cells to survive in ectopic locations by producing estrogens that spare them from destruction through activated macrophages. Local estrogen production hastens prostaglandin synthesis by stimulating COX-2 activity, thus creating a self-perpetuating sequence of augmented estrogen formation and enhanced inflammation. Repetitive retrograde menstruation reintroduces aromatase-positive endometrial cells endowed with the capacity to implant and invade the peritoneum. In order to control endometriosis, an effective medication must inhibit aromatase, block COX-2, decrease fibrosis and induce amenorrhea. Within this framework, progestins, either alone or in the form of oral contraceptives, appear as first-line treatment for endometriosis owing to their capacity to block enzymes such as aromatase and COX-2.

  7. High fetal irradiation: about one pregnant woman receiving infra diaphragmatic radiotherapy for Hodgkin lymphoma; Irradiation foetale elevee: a propos d'une femme dont la grossesse etait meconnue irradiee en sous-diaphragmatique pour un lymphome hodgkinien

    Energy Technology Data Exchange (ETDEWEB)

    Moreau, M.V.; Brunaud, C.; Marchesi, V.; Hoffstetter, S.; Peiffert, D. [Centre Alexis-Vautrin, Service de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Bologna, S. [Centre Hospitalier Universitaire Nancy-Brabois, Service d' Hematologie, 54 - Vandoeuvre-les-Nancy (France)

    2007-12-15

    We report the case of a 19-year-old young woman for whom was discovered a pregnancy at the end of the irradiation for a Hodgkin lymphoma (stage IV bone Bb), initially treated by chemotherapy. The radiotherapy delivered 36 Gy in infra-diaphragmatic volumes (lumbo-aortic, spleen, L5), beginning in a pregnant patient for less than 4 amenorrhea weeks. The calculated received fetal dose (literature data, measurement with software T.P.S., measurement on phantom) is high: it's between 2.8 and 5 Gy. With a current follow-up of 4 years since the radiotherapy's end, the patient is in complete remission and her child presents with a normal development for the age, in spite of the infra diaphragmatic irradiation. (authors)

  8. Ethnobotany, phytochemistry and pharmacology of Biophytum sensitivum DC.

    Science.gov (United States)

    Bharati, Abinash C; Sahu, Alakh N

    2012-01-01

    Medicinal plants are widely being used by the traditional medical practitioners for curing various diseases in their day-to-day practice. Biophytum sensitivum DC (Oxalidaceae) is used as a traditional folk medicine in ailments such as inflammation, arthritis, wounds, tumors and burns, gonorrhea, stomach ache, asthma, cough, degenerative joint disease, urinary calculi, diabetes, snake bite, amenorrhea and dysmenorrhea. It is a small, flowering, annual herb with sensitive leaves. It grows throughout tropical Africa and Asia, especially in Philippines and the hotter parts of India and Nepal. Phytochemical studies have shown that the major pharmacologically active constituents are amentoflavone and a polysaccharide fraction, BP100 III. Recent pharmacological study shows that it has antioxidant, immunomodulatory, anticancer, anti-inflammatory, chemoprotective, antidiabetic and wound healing potential. This review attempts to describe the ethnobotany, pharmacognosy, traditional uses, chemical constituents, and various pharmacologic activities and other aspects of B. sensitivum.

  9. Polycystic Ovarian Syndrome: A Diagnostic and Therapeutic Challenge

    Directory of Open Access Journals (Sweden)

    Manmohan K Kamboj

    2010-01-01

    Full Text Available Polycystic ovarian syndrome (PCOS is the commonest endocrinopathy in women with a multi-factorial etiology, and presents not just a diagnostic dilemma but also a therapeutic challenge as well. The clinical features of the syndrome in adolescents result from hyperandrogenemia and oligo/anovulation. Most women presenting with non-pregnancy related secondary amenorrhea, oligomenorrhoea, acne, hirsutism, and infertility have PCOS. Consensus diagnostic criteria have been developed by the United States National Institutes of Health (NIH, and the European Society of Human Reproduction and Embryology and American Society of Reproduction (Rotterdam criteria. PCOS needs to be suspected, recognized, and treated to prevent some long term complications. Treatment modalities need to be individualized to address the specific concerns of each female presenting with this entity. This article reviews the diagnosis and principles of management of PCOS.

  10. 月经不调的中医护理

    Institute of Scientific and Technical Information of China (English)

    马庆彤; 李增云

    2015-01-01

    Menstrual disease syndrome refers to the menstrual period, quantity, color, quality is abnormal, and accompanied by menstrual cycle symptoms is a kind of disease characteristics. Clinical common disease and syndrome have menstruation irregular menstruation, dysmenorrhea, amenorrhea, uterine bleeding, by the line before and after the menstrual period syndromes, the syndrome etc..%月经病证是指月经的期、量、色、质发生异常,以及伴随月经周期出现明显症状为特点的一类疾病。临床常见的月经病证有月经不调、痛经、闭经、崩漏、经行前后诸证、经期前后诸证等。

  11. Complete vaginal outlet stenosis in a patient with Sheehan’s syndrome

    Science.gov (United States)

    Choo, Minji; Park, Hana

    2016-01-01

    We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan’s syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety. PMID:27896263

  12. Complete vaginal outlet stenosis in a patient with Sheehan's syndrome.

    Science.gov (United States)

    Choo, Minji; Park, Hana; Yi, Kyong Wook

    2016-11-01

    We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan's syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety.

  13. Sheehan syndrome with reversible dilated cardiomyopathy.

    Science.gov (United States)

    Laway, Bashir A; Alai, Mohammad S; Gojwari, Tariq; Ganie, Mohd A; Zargar, Abdul Hamid

    2010-01-01

    Cardiac abnormalities in patients with Sheehan syndrome are uncommon. A case of Sheehan syndrome with dilated cardiomyopathy is presented in whom hormone replacement with levothyroxine and prednisolone resulted in complete recovery of cardiomyopathy. A 25-year-old woman presented with lactation failure, secondary amenorrhea, features of hypothyroidism and a hypocortisol state following severe postpartum hemorrhage after her last child birth. She also had smear positive pulmonary tuberculosis. After starting antitubercular treatment, she developed shock, suggestive of hypocortisol crisis. Hormonal investigations revealed evidence of panhypopitutarism and magnetic resonance imaging revealed partial empty sella. Meanwhile echocardiography revealed evidence of dilated cardiomyopathy (DCM). The patient was given replacement therapy in the form of glucocorticoids and levothyroxine in addition to antitubercular treatment. She improved and on follow-up over a period of 7 months, the DCM completely reversed. To our knowledge this is the first report of reversible DCM in a patient with Sheehan syndrome.

  14. Cloning and Expression of Luteinizing Hormone Subunits in Chinese Hamster Ovary Cell Line

    Directory of Open Access Journals (Sweden)

    Zeinab Soleimanifar

    2016-10-01

    Full Text Available Background: Luteinizing hormone (LH was secreted by the stimulating cells of the testes and ovaries in the anterior pituitary gland. The application of this hormone is in the treatment of men and women with infertility and amenorrhea respectively.Materials and Methods: In the present study the alpha and beta subunits of human LH gene were cloned into the pEGFP-N1 expression vector and produced the recombinant LH hormone in Chinese hamster ovary (CHO eukaryotic system.Results: Alpha and beta subunits of LH hormone were cloned between NheI and BamHI cut sites of pEGFP_N1 expression plasmid and confirmed by PCR.  Hormone expression was evaluated in CHO cell line by Western blotting using the specific antibody.Conclusion: Alpha and beta subunits of LH hormone were expressed in CHO cell line perfectly.

  15. 雌孕激素替代疗法配合中药治疗卵巢早衰34例%Hormone Replacement Therapy Cooperating with Traditional Chinese Medicine in Women with Premature Ovarian Failure(with 34 cases reported)

    Institute of Scientific and Technical Information of China (English)

    陈蔚

    2003-01-01

    Premature ovarian failure (POF) is secondary amenorrhea with elevated gonadotrophins oc-curring under the age of 40,affects 1-3% women in the general population with myriad ramificationsfrom psychological devastation to multi-system implications of estrogen deprivation and its sequelae. Sev-eral therapeutic approaches have been tried.The Objective of the paper is to evaluate the clinical thera-peutic effectiveness to these patients.34 women with POF who were treated with traditional Chinesemedicine and hormone replacement therapy were included in the study.Some women experiencing theapproach obtained improvement, even pregnancy, and two newborn were gained. The treatment conceptsand pathogeny for women with POF are discussed in this paper.

  16. Uterine conserving surgery in a case of cervicovaginal agenesis with unicornuate uterus

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    Vineet Mishra

    2016-01-01

    Full Text Available The presence of cervicovaginal agenesis with unicornuate uterus is a very rare mullerian anomaly. Its true incidence is still unknown. The presence of functioning unicornuate uterus poses a great challenge for a gynecologist because a successful repair could restore normal menses and may preserve a patient′s fertility. Hence, we report a case of 16-year-old unmarried female who presented with chief complaints of primary amenorrhea with cyclical lower abdominal pain. On clinical and radiological evaluation, she was diagnosed with complete cervicovaginal agenesis with right unicornuate uterus (hematometra and hematosalpinx. She underwent vaginoplasty (McIndoes method along with uterovaginal anastomosis by neocervix formation, in order to preserve her uterus. On follow-up, her vagina was completely healed, and she was menstruating normally.

  17. ACUTE RESPIRATORY DISTRESS SYNDROME IN PREGNANCY

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    Madhumala

    2015-04-01

    Full Text Available Acute respiratory distress syndrome (ARDS is a clinical syndrome of severe dyspnea of rapid onset, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure. ARDS occurs in pregnancy and may have unique causes. Overall mortality for both the mother and the fetus is high and significant morbidity can persist even after initial recovery. ARDS is associated with obstetric causes such as amniotic fluid embolism, preeclampsia, septic abortion, and retained products of conception or non - obstetr ic causes that include sepsis, aspiration pneumonitis, influenza pneumonia, blood transfusions, and trauma. Here is a 24 years old female admitted with 7months of amenorrhea, who presented with respiratory failure, she was intubated and ventilated for 47da ys. She recovered, and a live baby was delivered. She was discharged after 73days.

  18. 补肾调周法对继发性闭经患者FSH及FSH/LH的影响

    Institute of Scientific and Technical Information of China (English)

    陆颖仪

    2012-01-01

    闭经(amenorrhea)是妇科临床一种常见的症状,继发性闭经指月经来潮后再出现停经3~6个月以上者。发病机制主要为肾虚,变化在气血,肾的阴阳亏虚是主要病机,但与天癸、冲任、胞宫有关。现代西医治疗方面对不同病因继发性闭经都应用激素替代疗法替代卵巢的内分泌功能。但关于性激素使

  19. Intra-Abdominal Testicular Seminoma in a Woman with Testicular Feminization Syndrome

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    Darshana D. Rasalkar

    2011-01-01

    Full Text Available We report a case of intra-abdominal testicular tumor in a 36-year-old married lady presenting with chief complaints of primary amenorrhea. The patient was later diagnosed with testicular feminization syndrome, a form of male pseudohermaphroditism. This testicular tumor was histologically proven as seminoma. Due to rarity, imaging findings in patients with testicular feminization syndrome and intraabdominal testicular tumor have been poorly documented. So far, only one case report had described the combined role of CT and MR imaging in intraabdominal testicular sex-cord stromal tumor. To our knowledge, this case is first to document USG and MR imaging in addition to MR spectroscopy features in intraabdominal testicular seminoma.

  20. Successful Vaginal Delivery despite a Huge Ovarian Mucinous Cystadenoma Complicating Pregnancy: A Case Report

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    Dipak Mandi

    2013-12-01

    Full Text Available A 22-year-old patient with 9 months of amenorrhea and a huge abdominal swelling was admitted to our institution with an ultrasonography report of a multiloculated cystic space-occupying lesion, almost taking up the whole abdomen (probably of ovarian origin, along with a single live intrauterine fetus. She delivered vaginally a boy baby within 4 hours of admission without any maternal complication, but the baby had features of intrauterine growth restriction along with low birth weight. On the 8th postpartum day, the multiloculated cystic mass, which arose from the right ovary and weighed about 11 kg, was removed via laparotomy. A mucinous cystadenoma with no malignant cells in peritoneal washing was detected in histopathology examination. This report describes a rare case of a successful vaginal delivery despite a huge cystadenoma of the right ovary complicating the pregnancy.

  1. Bilateral Gonadal Cysts and Late Diagnosis of Androgen Insensitivity Syndrome Treated by Laparoscopic Gonadectomy

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    D. Tourlakis

    2011-01-01

    Full Text Available Background. Complete androgen insensitivity syndrome is a rare syndrome in which the uterus is absent and testes rather than ovaries are present. Patients usually visit a gynecologist due to primary amenorrhea. Case. A forty-eight-year-old woman with lower abdominal pain and anamnesis of uterus agenesis was operated on due to bilateral cystic masses. A 5 × 3 × 1.2 cm left adnexal cyst revealed the presence of a serous cyst with a hypoplastic ductus deferens. A smaller cyst of the right adnexa revealed immature testis tissue with Leydig-cell hyperplasia. After karyotype and hormonal examinations, laparoscopic gonadectomy was performed. Conclusion. Attention should be paid in all cyst-removing operations in cases of uterus agenesis, due to the high incidence of malignancy. Not of less importance is the issue of informing the patient in the most appropriate way.

  2. Role of Imaging in the Diagnosis and Management of Complete Androgen Insensitivity Syndrome in Adults

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    Marco Nezzo

    2013-01-01

    Full Text Available Complete androgen insensitivity syndrome is an X-linked recessive androgen receptor disorder characterized by a female phenotype with an XY karyotype. Individuals affected by this syndrome have normal female external genitalia but agenesis of the Müllerian duct derivatives, that is, absence of the Fallopian tubes, uterus, cervix, and the proximal part of the vagina, with presence of endoabdominal, labial, or inguinal testes. The estimated prevalence is between 1 and 5 in 100,000 genetic males. Complete androgen insensitivity syndrome can be diagnosed as a result of mismatch between the prenatal sex prediction and the phenotype at birth, can be detected by chance, or remain undetected until investigations for primary amenorrhea. Imaging can be important both to diagnose the pathology and to localize gonads prior to surgical treatment. In this paper, we present three cases of complete androgen insensitivity syndrome in adult women of 34, 22, and 38 years old.

  3. Case report of clival tuberculoma. Difficult to diagnose by means of a CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Ichikawa, F.; Tachibana, S.; Miyasaka, Y.; Suwa, T.; Iida, H.; Kan, S.; Matsuda, Y.

    1987-02-01

    A patient with tuberculoma at the skull base was reported. Twenty-two years old, she had complained for ten years of amenorrhea, headache, and visual disturbance. On neurological examination, bitemporal hemianopsia, bilateral sixth nerve palsy, and recent right-side facial palsy were demonstrated. On radiological examination, a destructive lesion was found at the clivus. CT and MRI demonstrated, a space-taking lesion expanding to the floor of the third ventricle anteriorly, to the cerebello-pontine angle superiorly, and to the epipharynx inferiorly, and a marked swelling of the cerebellum, though no confirmative diagnosis could be obtained without a biopsy of the epipharyngeal tumor. The histological examination revealed that the tumor was tuberculoma. Medical treatment with INH, RFP, and steroids was effective. Although tuberculoma involving the skull base is very rare and rather difficult to diagnose, the authors would like to stress that early accurate diagnosis is very important because the lesion is curable with appropriate medical treatment.

  4. 早期绝经的病因诊断和处理

    Institute of Scientific and Technical Information of China (English)

    杨帆; 邵敬於

    2001-01-01

    @@ 所谓早期绝经系指40岁以前月经停闭者,可因卵巢功能自然衰退,又称为卵巢早衰(premature ovarian failure,POF),表现为闭经、潮热、盗汗、阴道干涩和性欲减退等,FSH和LH值≥40IU/L,E2值<20ng/L,而PRL正常;亦可因疾病行卵巢切除术、放疗或化疗后产生上述临床表现,常称为去势(castration),近年来有称为高促性腺激素性闭经( hypergonadotropic amenorrhea)或高促性腺激素性性腺功能低下症( hypergonadotropic hypogonadism)。

  5. Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman

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    K. H. Odubamowo

    2014-01-01

    Full Text Available Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days’ duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide. Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation.

  6. Krukenberg tumor in a young woman: A rare presentation

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    Deepa Hatwal

    2014-01-01

    Full Text Available Krukenberg tumors mostly occur after 40 years. Metastatic ovarian tumors in young age are very rare and reported to be 2% of all the cases. Thirty percent of all ovarian neoplasms occurring during childhood and adolescence are malignant. A 25-year-old woman, parity- 2, presented with abdominal distension, pain in abdomen and amenorrhea. On examination, 18 weeks lump was palpable, firm to hard in consistency, non-tender and mobile. On ultrasonography bilateral ovarian tumors were reported, without any peritoneal free fluid. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Microscopic examination revealed signet ring cells with glandular differentiation, diffusely invading the ovarian parenchyma. Tumor cells exhibited strong, diffuse immunopositivity for CEA with focal strong immunopositivity for CK7 and CK20 and immunonegativity for SATB2. Diagnosis of Krukenberg tumor was made. Endoscopic biopsy confirmed the diagnosis of adenocarcinoma stomach. This case is reported because of its rarity in younger age group.

  7. Congenital absence of uterine cervix

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    Selvaraj Ravi Lakshmy

    2016-10-01

    Full Text Available Cervical agenesis or dysgenesis is an extremely rare congenital anomaly. Patients with congenital absence of the cervix present with primary amenorrhea and infertility. Though it poses a diagnostic challenge to the clinician, correct diagnosis prior to surgery is possible with the help of ultrasound. Early diagnosis offers significant advantages in patient care and effective presurgical planning. This case report reviews two cases of cervical agenesis diagnosed with the help of ultrasound and later confirmed with the help of MRI. Ultrasonography is the modality of choice to define the internal genital anatomy and helps us to classify the level of obstruction or aplasia in obstructive uterine anomalies. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3634-3636

  8. Autosomal Recessive Polycystic Kidney Disease: Antenatal Diagnosis and Histopathological Correlation

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    Dayananda Kumar Rajanna

    2013-01-01

    Full Text Available Autosomal recessive polycystic kidney disease (ARPKD is one of the most common inheritable disease manifesting in infancy and childhood with a frequency of 1:6,000 to 1:55,000 births. The patient in her second trimester presented with a history of amenorrhea. Ultrasound examination revealed bilateral, enlarged, hyperechogenic kidneys, placentomegaly, and severe oligohydramnios. The pregnancy was terminated. An autopsy was performed on the fetus. Both the kidneys were found to be enlarged and the cut surface showed numerous cysts. The liver sections showed changes due to fibrosis. The final diagnosis of autosomal recessive polycystic kidney disease was made based on these findings. In this article, we correlate the ante-natal ultrasound and histopathological findings in autosomal recessive polycystic kidney disease.

  9. Synchrotron radiation X-ray microtomography and histomorphometry for evaluation of chemotherapy effects in trabecular bone structure

    Science.gov (United States)

    Alessio, R.; Nogueira, L. P.; Almeida, A. P.; Colaço, M. V.; Braz, D.; Andrade, C. B. V.; Salata, C.; Ferreira-Machado, S. C.; de Almeida, C. E.; Tromba, G.; Barroso, R. C.

    2014-04-01

    Three-dimensional microtomography has the potential to examine complete bones of small laboratory animals with very high resolution in a non-invasive way. One of the side effects caused by some chemotherapy drugs is the induction of amenorrhea, temporary or not, in premenopausal women, with a consequent decrease in estrogen production, which can lead to bone changes. In the present work, the femur heads of rats treated with chemotherapy drugs were evaluated by 3D histomorphometry using synchrotron radiation microcomputed tomography. Control animals were also evaluated for comparison. The 3D tomographic images were obtained at the SYRMEP (SYnchrotron Radiation for MEdical Physics) beamline at the Elettra Synchrotron Laboratory in Trieste, Italy. Results showed significant differences in morphometric parameters measured from the 3D images of femur heads of rats in both analyzed groups.

  10. Analysis of cortical bone porosity using synchrotron radiation microtomography to evaluate the effects of chemotherapy

    Science.gov (United States)

    Alessio, R.; Nogueira, L. P.; Salata, C.; Mantuano, A.; Almeida, A. P.; Braz, D.; de Almeida, C. E.; Tromba, G.; Barroso, R. C.

    2015-11-01

    Microporosities play important biologic and mechanical roles on health. One of the side effects caused by some chemotherapy drugs is the induction of amenorrhea, temporary or not, in premenopausal women, with a consequent decrease in estrogen production, which can lead to cortical bone changes. In the present work, the femur diaphysis of rats treated with chemotherapy drugs were evaluated by 3D morphometric parameters using synchrotron radiation microtomography. Control animals were also evaluated for comparison. The 3D tomographic images were obtained at the SYRMEP (SYnchrotron Radiation for MEdical Physics) beamline at the ELETTRA Synchrotron Laboratory in Trieste, Italy. Results showed significant differences in morphometric parameters measured from the 3D images of femur diaphysis of rats.

  11. Spontaneous Unruptured Bilateral Tubal Pregnancy: A Case Report

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    Nayereh Ghomian

    2015-11-01

    Full Text Available Bilateral spontaneous tubal ectopic pregnancy is the rarest form of extra uterine pregnancy. The diagnosis is usually made intraoperatively and levels of serum BHCG and ultrasound has not been useful in the diagnosis of bilateral tubal ectopic pregnancy. A 33-year-old woman with 8 weeks amenorrhea and sever lower abdominal pain was admitted. A transvaginal pelvic ultrasound revealed left adnexal mass and massive fluid collection in the pelvis and abdomen. The serum BHCG was 5,700 mIU/ml and in laparotomy bilateral unruptured tubal pregnancy was noted. Left salpingectomy and right salpingostomy were performed. The diagnosis of bilateral spontaneous tubal ectopic pregnancy is usually made intraoperatively. Both tubes at the time of surgery should be closely examined in order to prevent maternal morbidity and mortality.

  12. Ruptured Heterotopic Tubal Pregnancy for a Patient with a History of Segmental Salpingectomy from Ectopic Pregnancy: A Case Report

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    Nam, Kyung Bum; Namkung, Sook; Hong, Myung Sun; Kim, Heung Cheol; Cho, Young; Choi, Young Hee [Chuncheon Sacred Heart Hospital, Chyncheon (Korea, Republic of)

    2012-06-15

    Heterotopic pregnancy refers to the simultaneous development of an intrauterine pregnancy and an extrauterine pregnancy. We experienced a case of a ruptured heterotopic pregnancy for a patient with a history of a right segmental salpingectomy from an ectopic pregnancy. The 30-year-old patient with amenorrhea for six weeks complained of lower abdominal pain with hypovolemic shock. Transabdominal ultrasonography showed diffuse hemoperitoneum with a structure similar to an ectatic tube or a deformed cyst with no echogenic double ring or peripheral hypervascularity in the right adnexa and an intrauterine gestational sac. We considered a ruptured corpus luteum cyst as an ultrasonographic finding and found a ruptured tubal mass in the right salpinx and hemoperitoneum through an emergency laparotomy. We performed a right salpingectomy, and the histopathologic report confirmed ectopic pregnancy.

  13. [Ectopic pregnancy: Its current interest in Primary Health Care].

    Science.gov (United States)

    López-Luque, P R; Bergal-Mateo, G J; López-Olivares, M C

    2014-01-01

    An ectopic pregnancy is the implantation and development of the ovum fertilized outside the endometrial cavity. Its incidence has increased in the last 30 years, and although its morbimortality has decreased, it is still the first cause of mortality in the first trimester of the pregnancy. Early suspicion is important, particularly in women of fertile age and with risk factors indicative of an extrauterine gestation. The symptomatology is usually amenorrhea, abdominal pain, metrorrhagia, general pregnancy symptoms, and even syncope and shock. The diagnosis of ectopic pregnancy is based on the clinical information, analytical results on mother blood and urine, ultrasound examination, transvaginal culdocentesis, laparoscopic or laparotomic inspection, and a histological study. The treatment can be surgical (salpingostomy or salpingectomy), medical (methotrexate) or expectant, depending on the factors of the ectopic pregnancy: early diagnosis, presence of acute complications, clinical condition of the patient, etc.

  14. The use of an anterior abdominal wall peritoneal flap in the laparoscopic repair of vesicouterine fistula.

    Science.gov (United States)

    Tasdemir, Nicel; Abali, Remzi; Celik, Cem; Yazici, Cenk Murat; Akkus, Didem

    2014-01-01

    Vesicouterine fistula (VUF) is a rare type of genitourinary fistula. Lower-segment cesarean section is the leading cause of VUF. Patients mostly present with the classical triad of menouria, amenorrhea, and urinary incontinence, with the history of a previous cesarean section. Conservative management with catheterization and open, laparoscopic, and robotic surgeries are the prescribed treatment options. We present the case of a 35-year-old woman who presented with cyclical menouria and urinary incontinence. After diagnosis of VUF by cystoscopy, the laparoscopic approach was chosen. During the procedure, we used anterior abdominal wall peritoneum and adjacent adipose tissue interposition for the first time, instead of omental interposition, because of the unavailability of omentum. The postoperative period was uneventful, and the procedure was successful. In conclusion, the laparoscopic approach is feasible and the anterior abdominal wall peritoneal flap can be used instead of omentum for tissue interposition when the omentum is not available.

  15. Reversible thyrotroph hyperplasia with hyperprolactinemia: A rare presenting manifestation of primary hypothyroidism

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    Rajesh Rajput

    2012-01-01

    Full Text Available Pituitary thyrotroph hyperplasia with hyperprolactinemia has been described as a rare presentation of primary hypothyroidism. Premenopausal females with this disorder can present with features of hypothyroidism, menstrual disturbances, galactorrhea, and visual field defects because of enlarged pituitary. Here we describe a 32-year-old female presenting to her gynecologist primarily with galactorrhea and secondary amenorrhea. She was found to have raised serum prolactin, and MRI brain showed enlarged pituitary. She was referred for pituitary surgery when she came to us. Clinical examination and biochemistry were suggestive of primary hypothyroidism. She was prescribed levothyroxine replacement. At 6 weeks follow-up, serum prolactin came down to normal, galactorrhea subsided, and spontaneous menstrual cycles resumed. In 12 weeks, pituitary enlargement completely regressed and in another month after that, she conceived. Hence, primary hypothyroidism can present with thyrotroph hyperplasia, where correct diagnosis and levothyroxine therapy can prevent unnecessary pituitary surgery. Hyperprolactinemia in this setting is of no clinical significance.

  16. Immunoreactive prolactin in breast milk and plasma of women with hyperprolactinemia, galactorrhea and menstrual dysfunction.

    Science.gov (United States)

    Yuen, B H

    1986-01-01

    Prolactin levels were measured by radioimmunoassay in paired breast milk and plasma samples of 11 hyperprolactinemic women with galactorrhea and various menstrual disorders (amenorrhea, n = 8; oligomenorrhea, n = 2; luteal phase defect, n = 1) before and during treatment with bromocriptine (Parlodel, Sandoz). Pretreatment levels of prolactin in the milk and plasma were 80 +/- 13 ng/mL (mean +/- SEM) and 47 +/- 7 ng/mL (P less than 0.05), respectively. While on treatment, the concentration gradient for prolactin remained in favour of the milk, with values for milk and plasma 59 +/- 11 and 29 +/- 3 ng/mL (P less than 0.01), respectively. Thus, bromocriptine lowered the prolactin concentrations in both breast milk and plasma. Since prolactin in milk is biologically active, these findings may be relevant to the initiation and maintenance of lactation in women with abnormal lactogenesis.

  17. Acne tarda and male-pattern baldness unmasking primary ovarian insufficiency: a case and review.

    Science.gov (United States)

    Zouboulis, Christos C; Achenbach, Alexander; Makrantonaki, Eugenia

    2014-01-01

    A 30-year-old woman presented with recurrent acne lesions and progressing male-pattern baldness. Furthermore, she reported amenorrhea, weight loss, mucosal xerosis and dyspareunia since discontinuation of hormonal contraception 6 months earlier in order to conceive. Acne tarda and androgenetic alopecia of female pattern were diagnosed. Hormonal and immunologic serological and ultrasound examinations revealed an autoimmune hypergonadotropic primary ovarian insufficiency (POI) with no ovarian cysts but ovarian fibrosis with marked reduced follicle pool. Immediate ovarian stimulation and in vitro fertilization led to pregnancy and the patient gave birth to a healthy child. Though presenting with clinical findings similar to menopause, 50% of patients with POI exhibit varying and unpredictable ovarian function, and only 5-10% are able to accomplish pregnancy. Genetic disorders affect the X chromosome. In 14-30% of cases POI has been associated with autoimmunity. POI may occur after discontinuation of hormonal contraception, like in our case.

  18. Uterine conserving surgery in a case of cervicovaginal agenesis with unicornuate uterus

    Science.gov (United States)

    Mishra, Vineet; Saini, Suwa Ram; Nanda, Sakshi; Choudhary, Sumesh; Roy, Priyankur; Singh, Tanvir

    2016-01-01

    The presence of cervicovaginal agenesis with unicornuate uterus is a very rare mullerian anomaly. Its true incidence is still unknown. The presence of functioning unicornuate uterus poses a great challenge for a gynecologist because a successful repair could restore normal menses and may preserve a patient's fertility. Hence, we report a case of 16-year-old unmarried female who presented with chief complaints of primary amenorrhea with cyclical lower abdominal pain. On clinical and radiological evaluation, she was diagnosed with complete cervicovaginal agenesis with right unicornuate uterus (hematometra and hematosalpinx). She underwent vaginoplasty (McIndoes method) along with uterovaginal anastomosis by neocervix formation, in order to preserve her uterus. On follow-up, her vagina was completely healed, and she was menstruating normally. PMID:28216917

  19. Clinical evaluation of 413 Thalassemic patients

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    Korosdari Gh.H

    2000-08-01

    Full Text Available Thalassemia is the most prevalent genetic disorder in Iran and around the world and these patients need regular careful care. The present study reports results of routine examination of patients visited Thalassemia clinic of Tehran. Data about clinical and laboratory examinations of 413 Thalassemic were extracted and analyzed. The prevalence of heart complications, diabetes, growth retardation, delayed puberty and primary and secondary amenorrhea was 9%, 8%, 21.3%, 3.1% and 6.3%, respectively. 44% didn't have secondary sex characteristics. Splenectomy had been done for 67.2% of cases. HBsAg, HBsAb and HBcAb were positive in 1.9%, 57.4% and 43%, respectively. We concluded that blood transfusion standards in this clinic was acceptable, whereas because of poor knowledge, iron chelating is unfavorable.

  20. A rare case of type 1 diabetes mellitus with pituitary hypoplasia.

    Science.gov (United States)

    Pinto, Jostol; Sudeep, K; Venkatesha, B M

    2014-01-01

    Growth failure and pubertal abnormalities are not uncommon in chronic uncontrolled metabolic diseases like diabetes mellitus. We present a young girl with uncontrolled type 1 diabetes mellitus, who presented with short stature and primary amenorrhea, and on evaluation was found to have anterior pituitary hypoplasia. In addition to uncontrolled diabetes mellitus, she presented with early onset growth failure and lack of spontaneous secondary sexual characteristics. She had central hypothyroidism and inappropriately normal gonadotropin levels. However her serum cortisol levels were normal. MRI of the sellar-suprasellar region revealed a small anterior pituitary gland with thinning of the pituitary stalk consistent with pituitary hypoplasia. While uncontrolled type 1 diabetes itself may cause growth retardation and pubertal abnormalities, this girl had coexisting pituitary maldevelopment - a rare co-existence of two major illnesses of unrelated etiologies. The partial pituitary hormonal deficiency, which spared the hypothalamo-pituitary-adrenal axis, may be due to a transcription factor defect.

  1. Is the pterygopalatomaxillary suture (sutura sphenomaxillaris) a growing suture in the fetus?

    Science.gov (United States)

    Vacher, C; Onolfo, J P; Barbet, J P

    2010-08-01

    The pterygopalatomaxillary suture is considered as having an important role in the posteroanterior growing of the maxilla. To determine whether this suture is a growing suture in the fetus, we performed a histological study of this suture in a fetus aged of 16 weeks of amenorrhea. Serial sections (5 microm) of the pterygopalatomaxillary suture area have been performed. Fibrous sutures are separating four pieces of ossification (maxilla, palatine bone, lateral and medial plates of the pterygoid process). A fibroblastic growing site has been observed on the dorsal aspect of the pterygopalatomaxillary suture, in contact to the anterior border of the lateral plate of the pterygoid process. The posteroanterior growing of maxilla is dependent on a growing suture located on the anterior border of the pterygoid process. The pterygoid process (via its lateral plate) makes the junction between the maxilla and both the cranial base and the condylar mandibular site of growth.

  2. Switch to quetiapine in antipsychotic agent-related hyperprolactinemia.

    Science.gov (United States)

    Keller, R; Mongini, F

    2002-12-01

    Novel antipsychotics (clozapine, risperidone, olanzapine, quetiapine) are effective in treating psychotic symptoms, also in neurological disease. Hyperprolactinemia is a side effect related to antipsychotics that can cause galactorrhea, gynecomastia, amenorrhea, anovulation, impaired spermatogenesis, decreased libido and sexual arousal, impotence, and anorgasmia, consequent to removal of tonic dopaminergic inhibition of prolactin secretion via hypothalamic dopaminergic receptor blockade in the tuberoinfundibolar tract. Hyperprolactinemia occurs more frequently during treatment with risperidone and olanzapine compared with clozapine and quetiapine. The therapeutic algorithm to antipsychotic-relatedhyperprolactinemia is the following: reduction in antipsychotic dose, addition of cabergoline, bromocriptine, amantadine, and/or switch to another antipsychotic. We propose switching to quetiapine in symptomatic hyperprolactinemia related to antipsychotics and describe five cases.

  3. Treating symptomatic hyperprolactinemia in women with schizophrenia: presentation of the ongoing DAAMSEL clinical trial (Dopamine partial Agonist, Aripiprazole, for the Management of Symptomatic ELevated prolactin).

    Science.gov (United States)

    Kelly, Deanna L; Wehring, Heidi J; Earl, Amber K; Sullivan, Kelli M; Dickerson, Faith B; Feldman, Stephanie; McMahon, Robert P; Buchanan, Robert W; Warfel, Dale; Keller, William R; Fischer, Bernard A; Shim, Joo-Cheol

    2013-08-22

    Prolactin elevations occur in people treated with antipsychotic medications and are often much higher in women than in men. Hyperprolactinemia is known to cause amenorrhea, oligomenorrhea, galactorrhea and gynecomastia in females and is also associated with sexual dysfunction and bone loss. These side effects increase risk of antipsychotic nonadherence and suicide and pose significant problems in the long term management of women with schizophrenia. In this manuscript, we review the literature on prolactin; its physiology, plasma levels, side effects and strategies for treatment. We also present the rationale and protocol for an ongoing clinical trial to treat symptomatic hyperprolactinemia in premenopausal women with schizophrenia. More attention and focus are needed to address these significant side effects and help the field better personalize the treatment of women with schizophrenia.

  4. Amantadine in the treatment of neuroendocrine side effects of neuroleptics.

    Science.gov (United States)

    Correa, N; Opler, L A; Kay, S R; Birmaher, B

    1987-04-01

    An open-label reversal drug study was undertaken on 10 neuroleptic-treated schizophrenic inpatients to assess the impact of amantadine hydrochloride on presumed prolactin-mediated neuroendocrine side effects. Measures were conducted across 7 weeks, including a 2-week neuroleptic baseline, a 3-week neuroleptic-plus-amantadine phase, and a 2-week return to the baseline regimen. Significant reduction with amantadine was observed on all six indices of neuroendocrine side effects: serum prolactin levels, body weight, gynecomastia/galactorrhea, breast tenderness, decreased libido, and amenorrhea. Improvement on these parameters was noted for as many as nine or all 10 patients, while in no cases was there worsening. In terms of motor and clinical effects, significant diminution of extrapyramidal and psycho-pathological symptoms was also achieved during this phase. The results suggested that amantadine may be beneficial for the treatment of neuro-endocrine side effects of antipsychotic medication owing to its ability to reverse neuroleptic-induced hyperprolactinemia.

  5. Hyperprolactinemia with antipsychotic drugs in children and adolescents.

    Science.gov (United States)

    Rosenbloom, Arlan L

    2010-01-01

    There is increasing use of antipsychotic drugs in pediatric and psychiatry practice for a wide range of behavioral and affective disorders. These drugs have prominent side effects of interest to pediatric endocrinologists, including weight gain and associated metabolic risk factors and hyperprolactinemia. The drugs block dopamine action, thus disinhibiting prolactin secretion. Hyperprolactinemia is especially prominent with first-generation antipsychotics such as haloperidol and the second-generation drugs, most commonly risperidone, with some patients developing gynecomastia or galactorrhea or, as a result of prolactin inhibition of gonadotropin releasing hormone from the hypothalamus, amenorrhea. With concern about the long-term effects of antipsychotics on bone mass and pituitary tumor formation, it is prudent to monitor serum prolactin levels in antipsychotic drug-treated pediatric patients and consider treatment with an agent less likely to induce hyperprolactinemia.

  6. Pituitary stalk lesion in a 13-year-old female

    Science.gov (United States)

    Zilbermint, Mihail; Ramnitz, Mary S.; Lodish, Maya B.; Kanaka-Gantenbein, Christina; Kattamis, Antonis; Lyssikatos, Charalampos; Patronas, Nicholas J.; Quezado, Martha M.

    2016-01-01

    Germinomas presenting with a pituitary stalk lesion and panhypopituitarism are rare in children, and their definite diagnosis is challenging. An invasive diagnostic approach, such as a transsphenoidal biopsy, is often required prior to establishing a treatment regimen. A 13-year-old female presented with 1 year of secondary amenorrhea, fatigue, and progressive thirst with polyuria. Laboratory work-up revealed panhypopituitarism (central hypothyroidism, hypogonadotropic hypogonadism, adrenal insufficiency and central diabetes insipidus). α-Fetoprotein and β-human chorionic gonadotropin were not elevated in serum nor in cerebrospinal fluid. The magnetic resonance imaging (MRI) of the pituitary region showed an enhancing infundibular lesion, extending into the hypothalamus, and infiltrating the pituitary gland. A transsphenoidal biopsy of the infundibular lesion confirmed the diagnosis of germinoma (germ-cell tumor). After appropriate hormone replacement therapy, chemotherapy and low-dose radiation therapy, the patient achieved complete resolution of the pituitary stalk lesion on the MRI. PMID:24129100

  7. Primary pigmented nodular adrenocortical disease associated with Carney complex: case report and literature review

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    Fabrícia Torres Gonçalves

    Full Text Available CONTEXT: Carney complex (CNC, a familial multiple neoplasm syndrome with dominant autosomal transmission, is characterized by tumors of the heart, skin, endocrine and peripheral nervous system, and also cutaneous lentiginosis. This is a rare syndrome and its main endocrine manifestation, primary pigmented nodular adrenal disease (PPNAD, is an uncommon cause of adrenocorticotropic hormone-independent Cushing's syndrome. CASE REPORT: We report the case of a 20-year-old patient with a history of weight gain, hirsutism, acne, secondary amenorrhea and facial lentiginosis. Following the diagnosing of CNC and PPNAD, the patient underwent laparoscopic bilateral adrenalectomy, and she evolved with decreasing hypercortisolism. Screening was also performed for other tumors related to this syndrome. The diagnostic criteria, screening and follow-up for patients and affected family members are discussed.

  8. [Female athlete triad].

    Science.gov (United States)

    Portmann, Luc; Giusti, Vittorio

    2009-08-05

    The practitioner, as well as specialist such as gynecologist and endocrinologist, may face in their office women with eating disorders, abnormalities of menstrual cycles and low bone mass, which may be the first hints of the female athlete triad. In these situations, the practitioner may search other findings of these triad by looking at some particular physical findings and by using appropriate questionnaire. In some advanced forms of this triad specific abnormalities of eating disorders (anorexia and boulimia) may be present as well as amenorrhea and osteoporosis, which may disturb the well-being and cause health damages of women practising sport either as amateur or in a elite setting. An appropriate handling of such disorders has to be proposed to these women.

  9. Female athletes and health

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    Malara Marzena

    2016-06-01

    Full Text Available It is well documented that regular physical activity has a beneficial effect on human health by affecting the metabolic processes that are of fundamental importance in the body’s functions, such as insulin sensitivity and glucose disposal, as well as lipid and lipoprotein turnover. On the other hand, there is a wealth of studies which indicate that strenuous, regular physical activity, such as that performed by high performance athletes, may be detrimental for the athletes’ health especially in women. This review focuses on the factors that contribute to health problems in female athletes, named the female athlete triad, which includes excessive dieting, menstrual dysfunctions (anovulatory menstrual cycles, oligomenorrhea, amenorrhea and a low bone mineral density (BMD. As a result of these factors, women who participate in sports, especially those focused on leanness, need special attention and education from health professionals, coaches and the athletes themselves to prevent the detrimental effects of an inadequate energy supply against high energy demands.

  10. Female Athlete Triad: Past, Present, and Future.

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    Matzkin, Elizabeth; Curry, Emily J; Whitlock, Kaitlyn

    2015-07-01

    After the passage of Title IX in 1972, female sports participation skyrocketed. In 1992, the female athlete triad was first defined; diagnosis required the presence of an eating disorder, amenorrhea, and osteoporosis. However, many athletes remained undiagnosed because they did not meet all three of these criteria. In 2007, the definition was modified to a spectrum disorder involving low energy availability (with or without disordered eating), menstrual dysfunction, and low bone mineral density. With the new definition, all three components need not be present for a diagnosis of female athlete triad. Studies using the 1992 definition of the disorder demonstrated a prevalence of 1% to 4% in athletes. However, in certain sports, many female athletes may meet at least one of these criteria. The actual prevalence of athletes who fall under the "umbrella" diagnosis of the female athlete triad remains unknown.

  11. Female athlete triad and stress fractures.

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    Feingold, David; Hame, Sharon L

    2006-10-01

    Stress fractures are a common occurrence in athletes, and the incidence of stress fractures in female Division 1 collegiate athletes is double that of men. Hormonal influences on bone and bone morphology may influence the risk for fracture. A high level of suspicion and special imaging procedures allow for accurate diagnosis of these fractures. In stress fractures that are associated with the female athlete triad, addressing the three aspects of the triad--eating disorders, amenorrhea, and osteoporosis--are critical for successful treatment. Preparticipation screening for the presence of signs of the female athlete triad by monitoring weight, energy level, menstrual cycles, and bone mineral density may help to prevent the occurrence of stress fractures in this population.

  12. Common injuries and ailments of the female athlete; pathophysiology, treatment and prevention.

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    Hilibrand, Miryl J; Hammoud, Sommer; Bishop, Meghan; Woods, Daniel; Fredrick, Robert W; Dodson, Christopher C

    2015-11-01

    With increasing numbers of women competing in high school and collegiate athletics, it is important that physicians become familiar with injury patterns and medical conditions unique to the female athlete. Observations and clinical data have elucidated unique biomechanical, anatomic and hormonal factors that predispose skeletally mature female athletes to anterior cruciate ligament (ACL) injuries, patellofemoral disorders and lower extremity stress fractures. Additionally, younger female athletes are particularly at risk of developing components of the "Female Athlete Triad" (more recently included under the syndrome of "Relative Energy Deficiency in Sport" [RED-S]): disordered eating, amenorrhea and osteoporosis. An understanding of the pathophysiology of these conditions has led to the development of programs that can treat their underlying causes, decrease susceptibility to injury, and improve the long-term health of the female athlete. This paper is intended to provide physicians with a review of the sex-specific etiology, prevention and treatment of injuries common to the female athlete.

  13. Fine-needle aspiration cytology of ovarian steroid cell tumor: A rare case report

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    Nidhi Agrawal

    2015-01-01

    Full Text Available Steroid cell tumors (SCTs of the ovary are a rare subgroup of sex cord tumors that account for less than 0.1% of all ovarian tumors. These tumors can produce steroids, especially testosterone, which produces symptoms such as hirsutism, amenorrhea/oligomenorrhea, and male patterned voice. For evaluation of the androgen excess, testosterone and dehydroepiandrosterone sulfate (DHEA-S are the first laboratory tests to be measured. Abdominal ultrasound and magnetic resonance imaging (MRI are useful radiologic imaging techniques. Although SCTs are generally benign, the risk of malignant transformation is always present. Surgical excision of tumor is the most important and hallmark treatment. The present case signifies the early preoperative diagnosis of a virilizing SCT, based on cytological features and its careful correlation with clinicopathological and radiological findings.

  14. Different types of menstrual cycle and their significance in Chinese women diagnosed with polycystic ovary syndrome according to the Rotterdam consensus criteria%基于鹿特丹标准诊断的多囊卵巢综合征患者月经类型及其意义

    Institute of Scientific and Technical Information of China (English)

    徐兴华; 谭迎春; 石玉华; 王斌; 鞠秀清; 郑庆梅; 郝翠芳; 陈子江

    2009-01-01

    目的 分析基于鹿特丹标准诊断的中国人多囊卵巢综合征(PCOS)患者不同月经类型的临床资料及内分泌代谢指标,以指导临床治疗.方法 将符合鹿特丹标准的2100例PCOS患者按闭经、月经稀发、月经规律进行分组,分别进行代谢及内分泌等指标的比较.结果 (1)闭经组多毛、多囊卵巢发生率均高于月经稀发组(P<0.01).(2)闭经组的血清搞睾酮最高,月经稀发组最低(P<0.01);黄体生成素(LH)在闭经组最高(P<0.01),在月经稀发组和月经规律组问差异无统计学意义(P>0.05);黄体生成素/卵泡刺激素(LH/FSH)在月经规律组增高明显(P<0.01).(3)口服葡萄糖后2 h血糖在闭经组显著增高(P<0.01).结论 符合鹿特丹标准的不同月经类型的PCOS患者具有不同的临床表现及代谢、内分泌特点,对于不同月经类型PCOS患者的治疗也应该个体化.%Objective To analyze the clinical and metabolic characteristics of Chinese women with different menstrual types.All the women were diagnosed with polycystic ovary syndrome according to the Rotterdam consensus criteria.Methods A total of 2100 patients were divided into three groups:amenorrhea,oligomenorrhea and regular menstruation.The metabolism and endocrine indices were determined and compared among three groups.Results (1)The incidences of hirsutism and PCO were obviously higher in the amenorrhea group than in the oligomenorrhea roup(P<0.01).(2)The amenorrhea group had the highest level of serum testosterone while the oligomenorrhea group had the lowest.Moreover,the level of luteinizing hormone(LH)was higher in the amenorrhea group than in the other two groups(P<0.01).However the ratio of LH/FSH increased significantly in the regular menstruation group (P<0.01).(3)The value of 2 h blood glucose was the highest in the amenorrhea group(P<0.01).Conclusion PCOS patients with diverse types of menstrual cycle show difierent clinical manifestations and

  15. Steroid Cell Tumor of the Ovary in an Adolescent: A Rare Case Report

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    Gokhan Boyraz

    2013-01-01

    Full Text Available Steroid cell tumors (SCTs of the ovary are a rare subgroup of sex cord tumors, account for less than 0.1% of all ovarian tumors, and also will present at any age. These tumors can produce steroids, especially testosterone, and may give symptoms like hirsutism, hair loss, amenorrhea, or oligomenorrhea. For the evaluation of androgen excess, testosterone and dehydroepiandrosterone sulfate (DHEA-S are the first laboratory tests to be measured. A pelvic ultrasound and a magnetic resonance imaging are useful radiologic imaging techniques. Although steroid cell tumors are generally benign, there is a risk of malignant transformation and clinical malignant formation. Surgery is the most important and hallmark treatment.

  16. Antipsychotic-induced Hyperprolactinemia

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    Suheyla Dogan Bulut

    2015-06-01

    Full Text Available Prolactin provides the growth of the mammary gland during pregnancy and synthesis and preparation of breast milk for lactation. Antipsychotics and antidepressants that are frequently used in psychiatry, cause hyperprolactinemia. The prevalent opinion is that especially typical antipsychotics increase prolactin levels primarily by blocking D2 receptors in the anterior pituitary. The effects of atypical antipsychotics on hyperprolactinemia vary. Hyperprolactinemia causes galactorrhea, gynecomastia, sexual dysfunction, infertility, acne, hirsutism in women, weight gain, obesity and mood changes in addition to menstrual irregularities such as oligomenorrhea, polymenorrhea and amenorrhea. In the long term, hyperprolactinemia may cause reduction in bone density and osteoporosis. Hyperprolactinemia as a side effect of antipsychotics drugs and its treatment will be reviewed in this article. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2: 109-124

  17. Ethnobotany, phytochemistry and pharmacology of Biophytum sensitivum DC

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    Abinash C Bharati

    2012-01-01

    Full Text Available Medicinal plants are widely being used by the traditional medical practitioners for curing various diseases in their day-to-day practice. Biophytum sensitivum DC (Oxalidaceae is used as a traditional folk medicine in ailments such as inflammation, arthritis, wounds, tumors and burns, gonorrhea, stomach ache, asthma, cough, degenerative joint disease, urinary calculi, diabetes, snake bite, amenorrhea and dysmenorrhea. It is a small, flowering, annual herb with sensitive leaves. It grows throughout tropical Africa and Asia, especially in Philippines and the hotter parts of India and Nepal. Phytochemical studies have shown that the major pharmacologically active constituents are amentoflavone and a polysaccharide fraction, BP100 III. Recent pharmacological study shows that it has antioxidant, immunomodulatory, anticancer, anti-inflammatory, chemoprotective, antidiabetic and wound healing potential. This review attempts to describe the ethnobotany, pharmacognosy, traditional uses, chemical constituents, and various pharmacologic activities and other aspects of B. sensitivum.

  18. [Hematometra & Listeria monocytogenes].

    Science.gov (United States)

    Gómez Arzapalo, E; Pérez Mendizábal, A; Herrera Avalos, I; Gorozpe Calvillo, J I

    2001-05-01

    The hematometra is a nosological entity that may not always be attributed to an embryonic defect of the paramesonefros; cervical-vaginal infections such as etiological possibilities due to Listeria monocytogenes (Lm), cervix malignant neoplasias, iatrogenias due to endometrial ablation with Lasser, traumatic bloody uterine curetage and because of cervical cryocoagulation or electrocoagulation are also mentioned. The case to be reported is from a woman in reproductive stage, who is 32 years old, and had menarca at the age of 13, starting her sexual life at 31, not using any method to control her fertility. When having an eight-week amenorrhea after 8 months of marriage, she visited the doctor for assumed pregnancy, within the prenatal analysis a pelvic echographic study was requested, finding out images that we concluded as hematometra, having been drained and demonstrated the presence of LM by anti-Lm antibodies, being administered Azitromicina and Espiramicina.

  19. Endometrioid Endometrial Carcinoma Indirectly Caused by Pituitary Prolactinoma:A Case Report

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    Kimihiro Nishino

    2013-01-01

    Full Text Available We present the case of a 44-year-old nulliparous woman who experienced irregular menstrual cycles for about 10 years and developed both pituitary prolactinoma and endometrioid endometrial carcinoma. In premenopausal women, hyperprolactinemia causes hypogonadism by inhibiting secretion of gonadotropin-releasing hormone and thus suppressing luteinizing hormone levels, which can cause menstrual disorders ranging from amenorrhea, oligomenorrhea and chronic anovulatory cycle to short luteal phase of the menstrual cycle. A chronic anovulatory menstrual cycle is the most common cause of long-term exposure of the endometrium to endogenous estrogen without adequate opposition from progestins, which can lead to endometrioid endometrial carcinoma. In this case, pituitary prolactinoma may have caused the chronic anovulatory cycle and indirectly led to the endometrioid endometrial carcinoma. In patients for whom the cause of irregular menstruation and chronic anovulatory cycle is suspected to be hyperprolactinemia, explorations of both the hypophysis and endometrium are essential.

  20. Endometrioid endometrial carcinoma indirectly caused by pituitary prolactinoma: a case report.

    Science.gov (United States)

    Nishino, Kimihiro; Niwa, Yuri; Mizutani, Teruyuki; Shimizu, Ken; Hayashi, Kazumasa; Chaya, Jyunya; Kato, Noriko; Yamamuro, Osamu

    2013-01-01

    We present the case of a 44-year-old nulliparous woman who experienced irregular menstrual cycles for about 10 years and developed both pituitary prolactinoma and endometrioid endometrial carcinoma. In premenopausal women, hyperprolactinemia causes hypogonadism by inhibiting secretion of gonadotropin-releasing hormone and thus suppressing luteinizing hormone levels, which can cause menstrual disorders ranging from amenorrhea, oligomenorrhea and chronic anovulatory cycle to short luteal phase of the menstrual cycle. A chronic anovulatory menstrual cycle is the most common cause of long-term exposure of the endometrium to endogenous estrogen without adequate opposition from progestins, which can lead to endometrioid endometrial carcinoma. In this case, pituitary prolactinoma may have caused the chronic anovulatory cycle and indirectly led to the endometrioid endometrial carcinoma. In patients for whom the cause of irregular menstruation and chronic anovulatory cycle is suspected to be hyperprolactinemia, explorations of both the hypophysis and endometrium are essential.

  1. Factors related to variation in premenopausal bone mineral status: a health promotion approach.

    Science.gov (United States)

    Tudor-Locke, C; McColl, R S

    2000-01-01

    Bone loss prior to menopause may contribute to later risk of fracture due to osteoporosis. Women may be able to optimize premenopausal bone mass and/or prevent losses. Heredity, and possibly age at menarche (retrospectively determined), are unmodifiable risk factors and attention should therefore be directed to more amenable factors. Amenorrhea, low body weight, disordered eating, and smoking are modifiable risk factors. Vitamin D is not a factor for premenopausal women who receive incidental sun exposure and consume fortified foods, but supplementation should be considered for others, especially during the winter months. Protective factors include a higher body weight (especially due to increased muscularity), calcium supplementation, and purposeful load-bearing exercise. Positive effects of oral contraceptives are most apparent in women with menstrual irregularities. Reproductive history (parity), lactation, moderate intakes of alcohol and caffeine, and the appropriate treatment of endometriosis have no apparent effect on premenopausal bone.

  2. Pituitary stalk lesion in a 13-year-old female.

    Science.gov (United States)

    Zilbermint, Mihail; Ramnitz, Mary S; Lodish, Maya B; Kanaka-Gantenbein, Christina; Kattamis, Antonis; Lyssikatos, Charalampos; Patronas, Nicholas J; Quezado, Martha M; Stratakis, Constantine A

    2014-03-01

    Germinomas presenting with a pituitary stalk lesion and panhypopituitarism are rare in children, and their definite diagnosis is challenging. An invasive diagnostic approach, such as a transsphenoidal biopsy, is often required prior to establishing a treatment regimen. A 13-year-old female presented with 1 year of secondary amenorrhea, fatigue, and progressive thirst with polyuria. Laboratory work-up revealed panhypopituitarism (central hypothyroidism, hypogonadotropic hypogonadism, adrenal insufficiency and central diabetes insipidus). α-Fetoprotein and β-human chorionic gonadotropin were not elevated in serum nor in cerebrospinal fluid. The magnetic resonance imaging (MRI) of the pituitary region showed an enhancing infundibular lesion, extending into the hypothalamus, and infiltrating the pituitary gland. A transsphenoidal biopsy of the infundibular lesion confirmed the diagnosis of germinoma (germ-cell tumor). After appropriate hormone replacement therapy, chemotherapy and low-dose radiation therapy, the patient achieved complete resolution of the pituitary stalk lesion on the MRI.

  3. Deciduoma of the ovary complicating pregnancy

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    Rangaswamy Vedavalli

    2014-03-01

    Full Text Available A 24 yr old Primigravida who conceived spontaneously came with two months amenorrhea for confirmation of pregnancy and routine checkup. Her 1st trimester scan, showed a single intra – uterine viable pregnancy of 8-9 weeks, with a right adnexal mass of about 10.7x7.7x10.3 cm with solid and cystic areas with internal echoes. In view of the size of the tumor and its varying echogenicity, pathological condition of the ovary was suspected. She reported at 24 weeks with abdominal pain. Partial torsion was suspected and Laprotomy was done. Right ovary was enlarged to 10 cm with varying consistency. Right ovariotomy was done. Postoperative period was uneventful. Histopathological examination showed extensive decidual changes in the ovary, forming tumor like lesions in the cystic areas. The pregnancy progressed without any complication. At term, she delivered a healthy female baby. The case is being presented for its extreme rarity.

  4. Theoretical discussion of Treatment Polycystic ovary syndrome by Bushen Huayu in TCM%补肾化瘀法治疗多囊卵巢综合征探讨

    Institute of Scientific and Technical Information of China (English)

    王晓静

    2015-01-01

    Polycystic Ovary Syndrome (PCOS) is a common endocrine diseases of women, its morbidity is about 5~10% of the infertile women, accounting for anovulatory women 75%~80% of, return belongs to Chinese medicine "late period", "menstrual quantity is little," amenorrhea "" bleeding "" infertility "category.In this paper, the research on the disease from the perspective of kidney deficiency and blood stasis, the report is as follows.%多囊卵巢综合征(PCOS)是女性常见的内分泌疾病,其发病率占不孕妇女的5%~10%,占不排卵妇女的75%~80%,多归属于中医学"月经后期""月经量少""闭经""崩漏""不孕"等范畴.本文从肾虚血瘀角度对本病进行研究探讨探讨,报告如下.

  5. [The fate of very early premature babies. Mortality, morbidity and 2-year follow-up in a population of 96 very early premature babies].

    Science.gov (United States)

    Lenclen, R; Paupe, A; Carbajal, R; Blanc, P; Hoenn, E; Olivier-Martin, M

    1992-11-01

    The neonatal fate, and outcome at 2 years in a population of 96 premature babies born after no more than 28 weeks of amenorrhea is described. Mortality was directly influenced by the gestational age ( or = 26 WA = 21.1%, p 1,000 g = 20%, p < 0.05). Two other factors with a harmful impact were identified: retarded growth (neonatal mortality doubled) and fetal multiplicity (increased fourfold). Investigation of the neonatal morbidity highlights the importance of respiratory, neurological and digestive problems. Assessment of the longer-term outcome has shown an 11.3 p. cent incidence of handicap. An estimation of the prognosis on the basis of gestational age is proposed.

  6. Polycystic ovary syndrome: update on diagnosis and treatment.

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    Setji, Tracy L; Brown, Ann J

    2014-10-01

    Polycystic ovary syndrome is now a well-recognized condition affecting 6%-25% of reproductive-aged women, depending on the definition. Over the past 3 decades, research has launched it from relative medical obscurity to a condition increasingly recognized as common in internal medicine practices. It affects multiple systems, and requires a comprehensive perspective on health care for effective treatment. Metabolic derangements and associated complications include insulin resistance and diabetes, hyperlipidemia, hypertension, fatty liver, metabolic syndrome, and sleep apnea. Reproductive complications include oligo-/amenorrhea, sub-fertility, endometrial hyperplasia, and cancer. Associated psychosocial concerns include depression and disordered eating. Additionally, cosmetic issues include hirsutism, androgenic alopecia, and acne. This review organizes this multi-system approach around the mnemonic "MY PCOS" and discusses evaluation and treatment options for the reproductive, cosmetic, and metabolic complications of this condition.

  7. Successful Pregnancy and Delivery After Radiation With Ovarian Shielding for Acute Lymphocytic Leukemia Before Menarche.

    Science.gov (United States)

    Ishibashi, Naoya; Maebayashi, Toshiya; Aizawa, Takuya; Sakaguchi, Masakuni; Abe, Osamu; Saito, Tsutomu; Tanaka, Yoshiaki; Chin, Motoaki; Mugishima, Hideo

    2015-07-01

    Total body irradiation is performed as a preconditioning regimen to inhibit graft-versus-host disease after bone marrow transplantation and to eradicate remaining tumor cells. However, these regimens result in delayed secondary sex characteristics and failure of ovarian function recovery, leading to amenorrhea and infertility. Herein, we report a case of an 11-year-old girl diagnosed with acute lymphocytic leukemia who received induction chemotherapy and prophylactic cranial irradiation. For bone marrow transplantation, she received total body irradiation of 12 Gy with uterine and ovarian shielding at 13 years of age. The patient remained in remission and menarche began at 14 years of age. At 23, she became pregnant and delivered a baby naturally with no abnormalities.

  8. Papillary tumor of the pineal region-report of three cases with literature review

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    Debajyoti Chatterjee

    2015-01-01

    Full Text Available Papillary tumor of the pineal region (PTPR is a rare tumor of the pineal region. Not much is known about the pathogenesis, prognosis, and treatment protocol of this uncommon entity. We present three cases of PTPR with follow-up from 8 months to 98 months. All patients presented with headache and visual disturbance. One patient also had amenorrhea. Radiology revealed an heterogeneously enhancing mass arising from the pineal region with associated hydrocephalus. Histopathologically, all cases showed the papillary architecture, strong pan cytokeratin and cytokeratin 18 positivity, and faint positivity for synaptophysin and neuron-specific enolase. All cases received postoperative radiotherapy. One case showed tumor recurrence after 7 years. Other two cases did not show any recurrence till the last follow-up.

  9. The pharmacological effects of Salvia species on the central nervous system.

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    Imanshahidi, Mohsen; Hosseinzadeh, Hossein

    2006-06-01

    Salvia is an important genus consisting of about 900 species in the family Lamiaceae. Some species of Salvia have been cultivated world wide for use in folk medicine and for culinary purposes. The dried root of Salvia miltiorrhiza, for example, has been used extensively for the treatment of coronary and cerebrovascular disease, sleep disorders, hepatitis, hepatocirrhosis, chronic renal failure, dysmenorrhea, amenorrhea, carbuncles and ulcers. S. officinalis, S. leriifolia, S. haematodes, S. triloba and S. divinorum are other species with important pharmacological effects. In this review, the pharmacological effects of Salvia species on the central nervous system will be reviewed. These include sedative and hypnotic, hallucinogenic, skeletal muscle relaxant, analgesic, memory enhancing, anticonvulsant, neuroprotective and antiparkinsonian activity, as well as the inhibition of ethanol and morphine withdrawal syndrome.

  10. A rare case of Turner′s syndrome presenting with Mullerian agenesis

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    Suresh Vaddadi

    2013-01-01

    Full Text Available Turner′s syndrome also called as Ullrich Turner′s syndrome, is a disease of unclear pathogenesis characterized by complete or partial absence of one sex chromosome, with or without cell line mosaicism in a phenotypic female with short stature. Various anomalies result in a constellation of features, of which the most disturbing is primary amenorrhea due to gonadal dysgenesis. Hormone therapy in these patients can often result in successful menstruation, and scope for subsequent pregnancy because of anatomically normal uterus and vagina. Coexisting Mullerian agenesis in these patients can jeopardize the chances of future pregnancy as they have associated structural abnormalities of the uterus and vagina. We report a rare case of middle-aged female with Turner′s syndrome and Mullerian agenesis having absent secondary sexual characters and missing uterus with incompletely formed vagina.

  11. Report of a case of Turner′s syndrome with localized aggressive periodontitis

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    Suresh Kumar Kasagani

    2011-01-01

    Full Text Available Turner′s syndrome is a disorder in females characterized by the absence of all or part of a normal second sex chromosome. It is typically characterized by the combination of physical features and cytogenetics in females. Physical features include short stature, primary amenorrhea, hypogonadism, low hair line at the back of the neck, and digital anomalies. Most affected patients have a 45XO monosomy, but the presence of an abnormal chromosome or mosaicism of 45X with another cell line can also fulfill the criteria. Features seen in the oral cavity of patients diagnosed with Turner′s syndrome include high palatal vault, hypoplastic mandible, prematurely erupting teeth, and orthodontic anomalies. A case of Turner′s syndrome with localized aggressive periodontitis has been reported here.

  12. Perfil hormonal sexual de mulheres em programa crônico de diálise em tratamento com eritropoetina humana recombinante Sex hormones in women on dialysis

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    Rosina Conceição Graçaplena Dal Maso

    2003-01-01

    evaluate the pattern of follicle stimulating hormone (FSH, luteinizing hormone (LH, prolactin (PRL and estradiol (E2 in 47 women with end stage renal disease (ESRD, on regular dialysis and receiving recombinant human erythropoietin (r-HuEPO. METHODS: One patient was on intermitent peritoneal dialysis, 4 on continuous ambulatory peritoneal dialysis and 42 on maintenance haemodialysis. They were divided into: Group I consisted of 10 women with regular menses, aged lesser than 48 years; Group II consisted of 15 women with amenorrhea, aged lesser than 48 years and; Group III, consisted of 22 women with amenorrhea, aged 48 years or more. Levels of FSH, LH, PRL e E2 were obtained by ELISA. RESULTS: All groups showed FSH, LH and E2 levels in the normal range for normal women without renal failure, and there was no statistical significance in the levels of these hormones between women with regular menses or women with amenorrhea aged lesser than 48 years. The serum concentrations of PRL were above the normal range in all groups. The patients aged 48 or more showed hormonal profile consistent with post-menopausal (i.e. high FSH, high LH and low estradiol. CONCLUSIONS: We conclude that ovarian function is intact on ESRD and we have to search for other causes for amenorrhea in women that do not have na abnormal hormonal sex profile.

  13. Xanthomatous Hypophysitis Mimicking a Pituitary Adenoma: Case Report and Review of the Literature

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    Laura Aste

    2010-01-01

    Full Text Available Background. Hypophysitis is an inflammatory disease of the pituitary gland that may mimic pituitary tumors clinically and radiologically. Case Description. We report a case of a xanthomatous hypophysitis initially diagnosed as pituitary adenoma. A 31-year-old woman presented with headache, diabetes insipidus, and amenorrhea. A head CT scan showed no intrasellar changes, while an MRI scan showed a sellar cystic mass. An endocrinological work up revealed mild hypocortisolism and diabetes insipidus (DI. Transsphenoidal surgery was performed. The intraoperative histological examination suggested a pituitary adenoma. The removed tissue showed central necrosis surrounded by accumulation of foamy cells and xanthomatous epithelioid cells. The patient made an uneventful postoperative recovery, Nevertheless, DI persisted and the adenohypophysis hypofunction did not recover. Conclusion. We describe an unusual inflammatory lesion of the pituitary gland mimicking an adenoma. A high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.

  14. Two Adult Patients with Ectopic Neurohypophysis and Panhypopituitarism Due to Absent Pituitary Stalk

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    Fettah Acıbucu

    2014-12-01

    Full Text Available We report two cases of 27-year-old and 19-year-old female patients with ectopic neurohypophysis and panhypopituitarism due to absent pituitary stalk. They were admitted to the endocrinology clinic with short stature, growth retardation and primary amenorrhea. Basal hormones revealed secondary hypothyroidism, adrenal insufficiency, hypogonadism and growth hormone insufficiency. Peak cortisol response to the short synacthen test (SST was normal but was inadequate to insulin tolerance test. The other dynamic pituitary function tests showed panhypopituitarism. Magnetic resonance imaging of the pituitary gland revealed an ectopic posterior pituitary tissue and absent pituitary stalk. We administered hormone replacement therapy. As this disorder is usually encountered in the pediatric age group, we report here two adult patients with ectopic posterior pituitary tissue, absent pituitary stalk and panhypopituitarism.

  15. Constitutional thinness and anorexia nervosa: a possible misdiagnosis?

    Science.gov (United States)

    Estour, Bruno; Galusca, Bogdan; Germain, Natacha

    2014-01-01

    Clinical and biological aspects of restrictive anorexia nervosa (R-AN) are well documented. More than 10,000 articles since 1911 and more than 600 in 2013 have addressed R-AN psychiatric, somatic, and biological aspects. Genetic background, ineffectiveness of appetite regulating hormones on refeeding process, bone loss, and place of amenorrhea in the definition are widely discussed and reviewed. Oppositely, constitutional thinness (CT) is an almost unknown entity. Only 32 articles have been published on this topic since 1953. Similar symptoms associating low body mass index, low fat, and bone mass are reported in both CT and R-AN subjects. Conversely, menses are preserved in CT women and almost the entire hormonal profile is normal, except for leptin and PYY. The aim of the present review is to alert the clinician on the confusing clinical presentation of these two situations, a potential source of misdiagnosis, especially since R-AN definition has changed in DSM5.

  16. Constitutional thinness and anorexia nervosa: a possible misdiagnosis?

    Directory of Open Access Journals (Sweden)

    Bruno eEstour

    2014-10-01

    Full Text Available Clinical and biological aspects of restrictive anorexia nervosa (R-AN are well documented. More than ten thousand articles since 1911 and more than six hundred in 2013 have addressed R-AN psychiatric, somatic and biological aspects. Genetic background, ineffectiveness of appetite regulating hormones on refeeding process, bone loss and place of amenorrhea in the definition are widely discussed and reviewed. Oppositely, constitutional thinness (CT is an almost unknown entity. Only 32 articles have been published on this topic since 1953. Similar symptoms associating low BMI, low fat and bone mass are reported in both CT and R-AN subjects. Conversely, menses are preserved in CT women and almost the entire hormonal profile is normal, except for leptin and PYY. The aim of the present review is to alert the clinician on the confusing clinical presentation of these two situations, a potential source of misdiagnosis, especially since R-AN definition has changed in DSM-5.

  17. Stress and Eating Disorder Behavior in Anorexia Nervosa as a Function of Menstrual Cycle Status

    Science.gov (United States)

    Jappe, Leah M.; Cao, Li; Crosby, Ross D.; Crow, Scott J.; Peterson, Carol B.; Le Grange, Daniel; Engel, Scott G.; Wonderlich, Stephen A.

    2013-01-01

    Objective Fluctuations in ovarian hormones during the menstrual cycle and psychosocial stress contribute to eating disorder (ED) behavior. Methods Using ecological momentary assessment techniques, this study examined relationships between stress and binge eating, self-induced vomiting, and dietary restriction based on menstrual cycle status in anorexia nervosa (AN). 109 females with full and subthreshold AN (17–45 years old) recorded ED behavior and stress ratings over two weeks. Using hierarchical linear modeling, individuals with eumenorrhea and those with amenorrhea or oligomenorrhea were compared. Results Following episodes of meal skipping, momentary stress decreased in individuals with normal menstrual cycles and increased in those with irregular menstrual cycles. Discussion Results suggest that changes in stress severity in response to food restriction may differ based on ovarian hormonal status and may be a mechanism by which AN is maintained in individuals without menstrual disturbance. PMID:24222529

  18. An idic(15) associated with POF (premature ovarian failure): molecular cytogenetic definition of a case and review of the literature.

    Science.gov (United States)

    Bertini, Veronica; Viola, David; Vitti, Paolo; Simi, Paolo; Valetto, Angelo

    2012-07-15

    We report on a 36-year-old infertile woman, presenting a premature ovarian failure with an otherwise normal female phenotype. Cytogenetic analyses showed the presence of a supernumerary marker chromosome, that was characterized by FISH (fluorescent in situ hybridization) and array CGH (comparative genomic hybridization). This marker chromosome was derived from chromosome 15, and contained only heterochromatic material. The Prader Willi/Angelman region was not present. No duplications of the 15q regions were detected by array CGH. Supernumerary markers of chromosome 15 have been reported in cases of infertility and amenorrhea, that is also described in cases with marker derived by other acrocentric chromosomes. The case here presented constitutes a further example that etiology of POF is not always associated with a defective gene, but in some cases oocytes atresia can be the consequence of the abnormal meiotic pairing of chromosomes.

  19. A susceptibility gene for premature ovarian failure (POF) maps to proximal Xq28.

    Science.gov (United States)

    Rossetti, Francesca; Rizzolio, Flavio; Pramparo, Tiziano; Sala, Cinzia; Bione, Silvia; Bernardi, Franca; Goegan, Mara; Zuffardi, Orsetta; Toniolo, Daniela

    2004-10-01

    Terminal deletions of the long arm of the human X chromosome have been described in women with premature ovarian failure (POF). We report here the molecular characterization of an inherited deletion in two affected women and in their mother. The two daughters presented secondary amenorrhea at 17 or 22 years respectively, while the mother was fertile. She had four children, but she eventually had premature menopause at 43 years of age. The fine molecular analysis of the deletion showed that the three women carried an identical deletion. We conclude that the phenotypic difference within the family must be attributed to genetic or environmental factors and not to the presence of different extent deletions. By comparison with other deletions in the region, we map a susceptibility gene for POF to 4.5 Mb, in the distal part of Xq.

  20. Reproductive Function in Patients with Non-functioning Pituitary Adenoma According to the Register of the Republic of Uzbekistan

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    Dinara A. Alieva

    2016-06-01

    Full Text Available The main aim of our study was to evaluate the reproductive system status and gonadotropic pituitary function in patients with non-functioning pituitary adenoma (NFPA according to the register data. Depending on the state of the reproductive system at the time of NFPA diagnosis, men and women can be classified into three groups: secondary hypogonadism (40.7%; normal state of the sexual system (22.0%; and PCOS in women (36.5% and reduced testicular size in men (11.2%. Menstrual irregularities took place in 77.8% NFPA women of reproductive age (41.3% of them had galactorea-oligo/amenorrhea combined with moderate hyperprolactinemia, and sexual dysfunction occurred in 42.0% of male patients with NFPA.

  1. Modern Approach in Premature Ovarian Failure

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    Pacu Irina

    2014-09-01

    Full Text Available Premature ovarian failure (POF is a condition affecting 1-2% of women younger than 40 years of age, characterized by amenorrhea, hypoestrogenism and elevated gonadotropin levels. In the last years it became a problem of social health interest as the frequency increased due to environmental factors and new, efficient methods for cancer treatment in young women. Few genes have beed identified to explain cases of POF but there are also autoimmune associated conditions and an increasing number of iatrogenic cases (chemotherapy, surgery, radiotherapy. Modern approach in POF means not only a precise etiological diagnosis, but also a correct counseling for these patients who often want to become parents, and a chance for a healthy life without the long term consequences of estrogen deprivation from an early age. In vitro fertilization (IVF techniques can be useful for certain cases but research is needed on strategies to improve fertility for women who have follicles remaining in the ovaries.

  2. Smooth muscle relaxant activity of Crocus sativus (saffron) and its constituents: possible mechanisms.

    Science.gov (United States)

    Mokhtari-Zaer, Amin; Khazdair, Mohammad Reza; Boskabady, Mohammad Hossein

    2015-01-01

    Saffron, Crocus sativus L. (C. sativus) is rich in carotenoids and used in traditional medicine for treatment of various conditions such as coughs, stomach disorders, amenorrhea, asthma and cardiovascular disorders. These therapeutic effects of the plant are suggested to be due to its relaxant effect on smooth muscles. The effect of C. sativus and its constituents on different smooth muscles and the underlying mechanisms have been studied. Several studies have shown the relaxant effects of C. sativus and its constituents including safranal, crocin, crocetin and kaempferol on blood vessels. In addition, it was reported that saffron stigma lowers systolic blood pressure. The present review highlights the relaxant effects of C. sativus and its constituents on various smooth muscles. The possible mechanisms of this relaxing effect including activation of ß2-adrenoceptors, inhibition of histamine H1 and muscarinic receptors and calcium channels and modulation of nitric oxide (NO) are also reviewed.

  3. Smooth muscle relaxant activity of Crocus sativus (saffron and its constituents: possible mechanisms

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    Amin Mokhtari-Zaer

    2015-08-01

    Full Text Available Saffron, Crocus sativus L. (C. sativus is rich in carotenoids and used in traditional medicine for treatment of various conditions such as coughs, stomach disorders, amenorrhea, asthma and cardiovascular disorders. These therapeutic effects of the plant are suggested to be due to its relaxant effect on smooth muscles. The effect of C. sativus and its constituents on different smooth muscles and the underlying mechanisms have been studied. Several studies have shown the relaxant effects of C. sativus and its constituents including safranal, crocin, crocetin and kaempferol on blood vessels. In addition, it was reported that saffron stigma lowers systolic blood pressure. The present review highlights the relaxant effects of C. sativus and its constituents on various smooth muscles. The possible mechanisms of this relaxing effect including activation of ß2-adrenoceptors, inhibition of histamine H1 and muscarinic receptors and calcium channels and modulation of nitric oxide (NO are also reviewed.

  4. Pure Androgen-Secreting Adrenal Adenoma Associated with Resistant Hypertension

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    René Rodríguez-Gutiérrez

    2013-01-01

    Full Text Available Pure androgen-secreting adrenal adenoma is very rare, and its diagnosis remains a clinical challenge. Its association with resistant hypertension is uncommon and not well understood. We present an 18-year-old female with a 10-year history of hirsutism that was accidentally diagnosed with an adrenal mass during the evaluation of a hypertensive crisis. She had a long-standing history of hirsutism, clitorimegaly, deepening of the voice, and primary amenorrhea. She was phenotypically and socially a male. FSH, LH, prolactin, estradiol, 17-hydroxyprogesterone, and progesterone were normal. Total testosterone and DHEA-S were elevated. Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonclassic congenital adrenal hyperplasia were ruled out. She underwent adrenalectomy and pathology reported an adenoma. At 2-month followup, hirsutism and virilizing symptoms clearly improved and blood pressure normalized without antihypertensive medications, current literature of this unusual illness and it association with hypertension is presented and discussed.

  5. Ovarian failure and cancer treatment: Incidence and interventions for premenopausal women

    Energy Technology Data Exchange (ETDEWEB)

    Feldman, J.E.

    1989-09-01

    Ovarian failure may be a long-term consequence of cancer treatment for premenopausal women. Caused by several treatments, including radiation therapy and the alkylating agents, it produces signs and symptoms associated with menopause: hot flashes, amenorrhea, dyspareunia, loss of libido, and irritability. Critical factors that determine ovarian functioning after treatment for cancer are the patient's age at the time of therapy, the amount of radiation that the ovaries received, and the dose of the antineoplastic agent(s). Medical interventions, such as hormonal therapy and surgical repositioning of the ovaries, may maintain ovarian function for some women. Nursing intervention includes assessment, education, and counseling. Counseling focuses on how the prematurely menopausal patient feels about herself as indicated by self-esteem, body image, and sexuality.

  6. [Primary empty sella. Clinico-radiologic considerations in 18 cases].

    Science.gov (United States)

    Pompili, A; Jachetti, M; Carapella, C M; Crecco, M; Gaudino, G; Isabella, F; Mastrostefano, R

    1985-01-28

    18 patients with "primary empty sella" were reviewed for this study. In 3 of them the sellar enlargement was discovered occasionally by performing skull radiographs for other reasons. The galattorrhea-dismenorrhea or amenorrhea syndrome and obesity were the most common clinical features. Endocrinological tests were normal in ten patients and abnormal in eight. Slight elevation of serum PRL was the most common record. 12 patients had enlarging of the sella turcica; in 4, only the floor was asymmetric and in 2 the sella was quite normal. In 5 patients C.T. without intra-thecal contrast was sufficient to discover the E.S. In 13 patients we performed C.T. cysternography by injecting in the lumbar subarachnoid space 8-10 ml of Iopamidolo 200. This is an excellent and safe technique to perform C.T. cysternography.

  7. Menstrual disturbance and galactorrhea in people taking conventional antipsychotic medications.

    Science.gov (United States)

    Thangavelu, Karthik; Geetanjali, S

    2006-11-01

    Endocrine disturbances are emerging as major side effects of antipsychotic medications. Of particular note is the profile of menstrual disturbance and galactorrhea as a consequence of hyperprolactinemia (A. Weick & P. M. Haddad, 2003), a sequela of antidopaminergic action at the hypothalamopituitary axis. Research into the clinical aspects of this sensitive issue is sparse. The authors completed a cross-sectional descriptive study of 50 patients on conventional antipsychotic medications. The prevalence of menstrual disturbance was 54%, and the prevalence of amenorrhea was 12%. Symptoms of galactorrhea were present in 32% of patients. A history of pregnancy and childbirth was noted to be significantly associated with the development of galactorrhea (p = .01). The authors hypothesized that pregnancy and lactation might sensitize the hypothalamopituitary axis for further development of hyperprolactinemia due to medications.

  8. Radioimmunoassay of human homologous prolactin in serum with commercially available reagents. [/sup 125/I tracer technique

    Energy Technology Data Exchange (ETDEWEB)

    Kao, P.C.; Jiang, N.S.; Abboud, C.F.

    1977-09-01

    A clinically useful and reproducible radioimmunoassay for human homologous prolactin, established with commercially available reagents, was studied and validated. We present detailed conditions for iodination and purification of labeled prolactin and the optimal conditions for the assay. By the method, we found values (..mu..g/liter) as follows for serum prolactin: normal men, 8.9 +- 5.2 (mean +- SD); normal women, 11.8 +- 5.5; normal women taking contraceptive pills, 9.2 +- 5.0; pregnant women in the third trimester, 188 +- 69.5; patients with various diseases other than of the hypothalamic-pituitary axis, 9.3 +- 6.3; in some patients with amenorrhea and galactorrhea of diverse origin, 78.2 +- 87.4; and in some patients with surgically proven pituitary tumor, 1414 +- 1980. Results under provocative testing are also presented for a patient with normal hypothalamic-pituitary function.

  9. Hyperprolactinemia with Antipsychotic Drugs in Children and Adolescents

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    Arlan L. Rosenbloom

    2010-01-01

    Full Text Available There is increasing use of antipsychotic drugs in pediatric and psychiatry practice for a wide range of behavioral and affective disorders. These drugs have prominent side effects of interest to pediatric endocrinologists, including weight gain and associated metabolic risk factors and hyperprolactinemia. The drugs block dopamine action, thus disinhibiting prolactin secretion. Hyperprolactinemia is especially prominent with first-generation antipsychotics such as haloperidol and the second-generation drugs, most commonly risperidone, with some patients developing gynecomastia or galactorrhea or, as a result of prolactin inhibition of gonadotropin releasing hormone from the hypothalamus, amenorrhea. With concern about the long-term effects of antipsychotics on bone mass and pituitary tumor formation, it is prudent to monitor serum prolactin levels in antipsychotic drug-treated pediatric patients and consider treatment with an agent less likely to induce hyperprolactinemia.

  10. Hyperprolactinemia with Antipsychotic Drugs in Children and Adolescents

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    Rosenbloom ArlanL

    2010-08-01

    Full Text Available There is increasing use of antipsychotic drugs in pediatric and psychiatry practice for a wide range of behavioral and affective disorders. These drugs have prominent side effects of interest to pediatric endocrinologists, including weight gain and associated metabolic risk factors and hyperprolactinemia. The drugs block dopamine action, thus disinhibiting prolactin secretion. Hyperprolactinemia is especially prominent with first-generation antipsychotics such as haloperidol and the second-generation drugs, most commonly risperidone, with some patients developing gynecomastia or galactorrhea or, as a result of prolactin inhibition of gonadotropin releasing hormone from the hypothalamus, amenorrhea. With concern about the long-term effects of antipsychotics on bone mass and pituitary tumor formation, it is prudent to monitor serum prolactin levels in antipsychotic drug-treated pediatric patients and consider treatment with an agent less likely to induce hyperprolactinemia.

  11. [Interest in prolactin levels in galactorrhea].

    Science.gov (United States)

    Bessioud, Moncef; Mamlouk, Lilia; Djait, Riadh; Ben Aïssa, Rim; Gueddana, Nésiha

    2004-02-01

    The action of prolactin (PRL) in supra-physiological levels on the ovaries or on the hypothalamic-pituitary axis for the release of gonadotropins leads to a reversible inhibition of the cyclic functioning of the pituitary gland and of the ovaries. The consequences are either the production of immature follicles marked by anovulatory or dysovulatory cycles, or the absence of follicle production marked by amenorrhea. Thus, prolactin plays a major role in the productive system by its lactotropic and antigonadotropic effects. Through this study we intend to try to determine the diagnostic value of the association of the cyclic dysfunctions with galactorrhea by measuring the prolactin levels in 2236 patients complaining of galactorrhea. Measurements of FSH and LH levels were also performed in 236 women among those consulting for infertility associated with galactorrhea. The results obtained showed that galactorrhea was associated with prolactenemia in only 17% of cases and of the ovaries was proportional to the prolactin in blood.

  12. [Mayer-Rokitansky-Küster-Hauser syndrome: two cases report].

    Science.gov (United States)

    Ávila-Vergara, Marco Antonio; León-Álvarez, Damián Alfredo; López-Villegas, Miriam Nayeli; Quintero-Medrano, Samantha Melissa; Angulo-Bueno, Gladys Fabiola; Vadillo-Ortega, Felipe

    2015-03-01

    Agenesia of the Müllerian ducts is a low-frequency congenital disease but with devastating effects on women's reproductive health. In this paper we present two cases of women affected by Mayer-Rokitansky-Küster-Hauser syndrome (MRKH). First case was a 17-year-old woman with aplasia of the upper vagina and absence of uterus. No other defects were found and was classified as type 1-MRKH. Second case was 18-year-old woman with absence of uterus, escoliosis and polycystic ovary syndrome, classified as type II-MRKH. Patients were seen at the Hospital with primary amenorrhea and fully developed secondary sexual characteristics. A clinical follow-up protocol, including the use of high-resolution image studies was used for diagnosis. Diagnostic procedures and current medical approaches to the treatment of MRKH are discussed, including psychological advisory, surgical procedures and new tissue-engineering techniques.

  13. The prevalence and features of the polycystic ovary syndrome in young South Indian women from Pondicherry

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    Willis G. Sheelaa

    2014-04-01

    Full Text Available Background: Aim of current study was to correlate clinical presentation of menstrual irregularity with ultrasound ovarian morphology and assess prevalence of occult PCO. Methods: Fifty women in the age group of 15-25 years attending gynaecology OPD with the complaints of menstrual irregularity were selected for the study. Fifty women within the same age group without any of these complaints were enrolled as control. Results: Past In study group 80% were obese, 50% had acne, 26% had hirsutism, 94% had oligomenorrhea, 80% had ovarian morphological changes and 6% had amenorrhea. In the control group 48% were obese and 46% had ovarian changes. Conclusions: Occult PCOD category need follow up and laboratory assays, as they have risk of PCOD and long term implications like diabetes, hypertension, dyslipidemia and cardiovascular disease. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 344-346

  14. Androgen dependence of hirsutism, acne, and alopecia in women: retrospective analysis of 228 patients investigated for hyperandrogenism.

    Science.gov (United States)

    Karrer-Voegeli, Sandra; Rey, François; Reymond, Marianne J; Meuwly, Jean-Yves; Gaillard, Rolf C; Gomez, Fulgencio

    2009-01-01

    Hirsutism, acne, alopecia, and oligo-amenorrhea are clinical expressions of hyperandrogenism, one of the most frequent endocrine disorders in women of reproductive age. Women referred to our endocrine clinics for skin symptoms of hyperandrogenism underwent a laboratory workup to evaluate hormone measurements and received antiandrogen therapy. We retrospectively analyzed the outcome of 228 consecutive patients investigated over 6 years.Patients with hirsutism had higher levels of androstenedione, dehydroepiandrosterone sulfate (DHEAS), and salivary testosterone; lower levels of sex hormone-binding globulin (SHBG); and a higher prevalence of oligo-amenorrhea than patients with alopecia, while patients with acne showed intermediate values. Hirsutism score correlated positively with androstenedione, DHEAS, and salivary testosterone, and correlated negatively with SHBG; salivary testosterone showed the highest correlation coefficient. Total testosterone was not significantly different among patients with hirsutism, alopecia, or acne, and did not significantly correlate with hirsutism score. Hirsutism and oligo-amenorrhea were the most sensitive symptoms of hyperandrogenism, and no androgenic parameter alone allowed us to identify all cases of hyperandrogenism.Patients of central European origin sought consultation with milder hirsutism scores than patients of southern European origin. There was, however, no difference in the clinical-biological correlation between these groups, arguing against differences in skin sensitivity to androgens.Polycystic ovary syndrome, defined as hyperandrogenism (hirsutism or elevated androgens) and oligo-amenorrhea, was diagnosed in 63 patients (27.6%), an underestimate compared with other reports that include systematic ovarian ultrasound studies. Neither pelvic ultrasound, used in a limited number of cases, nor the luteinizing hormone/follicle-stimulating hormone ratio helped to distinguish patients with polycystic ovary syndrome from

  15. Endemic disease, nutrition and fertility in developing countries.

    Science.gov (United States)

    Mascie-Taylor, C G

    1992-07-01

    Subfecundity is caused by disease and nutrition as well as by genetic, environmental, and psychological components. Sexually transmitted diseases (STDs) are caused by 21 different pathogens of which syphilis, gonorrhea, and chlamydia are the most important. Syphilis is caused by the bacterium Treponema pallidum with incidence of 10% in Thailand. 20% in Papua New Guinea, and 40% in Ethiopia. Stillbirths in infected mothers range from 66% to 80%. Gonorrhea is caused by the bacterium Neisseria gonorrhoea and its incidence was 18% in female patients in Ugandan clinic. 20% of women in Africa with cervical gonorrhea develop salpingitis. The risk of pelvic inflammatory disease is several times higher in IUD users. The bacterium Chlamydia trachomatis caused infertility in 15.4% of men in a 1991 study. Herpes simplex virus 2 infects 15-30% of sexually active adults, and the chance of fetal transmission is 40% when maternal lesions are present. Diseases other than STDs include tuberculosis (TB) whose development is aided by conditions such as malnutrition, malaria, leprosy, syphilis, and African sleeping sickness. Genital TB causes a 5-50% rate of menstrual disorders including amenorrhea and a 55-85% rate of sterility in women. Malaria is caused by Plasmodium protozoa, and the feverish state included by it can lead to oligospermia. Severe malarial anemia can lead to fetal and maternal mortality. The protozoa Trypanosoma causes African sleeping sickness that produces azoospermia and impairs the pituitary gland and ovaries. Schistosomiasis (bilharzia) and filariasis have less direct effect on fecundity but they negatively impact nutritional status. Maternal nutrition substantially impacts fetal and infant survival. During the Dutch famine of 1944-45 there was a 50% decrease in births 9 months subsequently. A 10-15% weight loss results in amenorrhea.

  16. A Multicentre Study of CLa Implant and Sino-implant Expanded Application (two-year follow-up)

    Institute of Scientific and Technical Information of China (English)

    方可娟; 关艳敏; 范慧民; 高尔生; 杨丹; 薜丽; 韩耀玲; 刘宝

    1997-01-01

    A multicentre comparative clinical study of CLa implant and Sino-implant was carried out at 100 subcentres in 11 provinces, and a total of 19673 subjects were recruited. Two year follow up has been finished. The follow-up rate at the end of two years was 94,29%. Two-year cumulative continuation rate per 100 women for Sino-implant(89.93) was significantly higher than that for CLa implant (88.89). Two-year cumulative pregnancy rates per 100 women were 0.0462(CLa implant) and 0.281(Sino-implant) respectively; there was statistically significant difference between them. No ectopic pregnancy was recorded among CLa implant users and three ectopic pregnancies were reported among Sino implant users,resulting in an ectopic pregnancy rate of 0.163 per 1000 women years. The incidence of side-effects appeared to diminish with time. The major side effects were the menstrual disturbances, which accounted for more than 90% of the total sideeffects, and the incidence of frequent menstruation, irregular bleeding and spotring was higher than that of infrequentjscanty menstruation and amenorrhea. Use of CLa implant had higher incidence of amenorrhea and infrequentjscanty menstruation than that of Sin-imptant. During two-year follow-up, the number of discontinuation due to menstrual problems contributed 78% of the total number of discontinuation; two year menstrual-related cumulative discontinuation rates were 8.96 per 100 women for CLa implant and 7.84 for Sino-implant; there was statistically significant difference(P< 0.01). Two-year study shows that the two types of implant are similar to Norplant in the incidence of side-effects and contraceptive efficacy as well as two year continuation rates.

  17. Reduced placental telomere length during pregnancies complicated by intrauterine growth restriction.

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    Jérôme Toutain

    Full Text Available OBJECTIVES: Recent studies have shown that telomere length was significantly reduced in placentas collected at delivery from pregnancies complicated by intrauterine growth restriction secondary to placental insufficiency. Placental telomere length measurement during ongoing pregnancies complicated by intrauterine growth restriction has never been reported. This was the main objective of our study. METHODS: In our center, late chorionic villus samplings were performed between 18 and 37 weeks of amenorrhea in 24 subjects with severe intrauterine growth restriction (cases and in 28 subjects with other indications for prenatal diagnosis (controls. Placental insufficiency was assessed by histo-pathological examination. Relative measurement of telomere length was carried out prospectively by quantitative Fluorescent In Situ Hybridization using fluorescent Peptide Nucleic Acid probes on interphase nuclei obtained from long-term cultured villi and with an automated epifluorescent microscope. A quantitative Polymerase Chain Reaction technique was performed to confirm the quantitative Fluorescent In Situ Hybridization results. The number of copies of gene loci encoding the RNA template (hTERC and the catalytic subunit (hTERT of the enzyme complex telomerase were also estimated in these placentas by Fluorescent In Situ Hybridization. RESULTS: Mean fluorescence intensity of telomere probes estimated by quantitative Fluorescent In Situ Hybridization was significantly less for cases compared to controls (p<0.001. This result indicated that mean telomere length was significantly reduced in placentas during pregnancies complicated by intrauterine growth restriction. Reduced telomere length was confirmed by the quantitative Polymerase Chain Reaction technique. No copy number variation of the hTERC and hTERT loci was noticed for cases, or for controls. CONCLUSION: This study clearly demonstrates a reduction of placental telomere length in ongoing pregnancies

  18. Genetic and environmental determinants of menstrual characteristics

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    Shayesteh Jahanfar

    2012-01-01

    Full Text Available Background: The impact of women′s menstrual cycle on her quality of life, health, work, and community is substantial. Menstrual disturbance is linked with general ill conditions such as migraine, asthma, and endocrinopathies. The clinical significance of medical interventions to prevent these conditions becomes clear if the role of genetic or environment is clarified. Aims: To identify the genetic and environmental contribution on menstrual characteristics. Setting and Design: This was a cross-sectional study in 2 Asian countries. Materials and Methods: 2 cohorts of monozygotic and dizygotic twins born between (1945-1988, n = 122 and (1951-1993, n = 71 were taken. A standard questionnaire was designed inclusive of socio- demographic characteristics of subjects as well as menstrual history (duration, interval, amount, irregularity. Subjects were interviewed by phone. Statistical Analysis: Quantitative variables were analyzed using Falconars′ formula as well as maximum likelihood analysis. Structural modeling was then applied to twin correlations to provide estimates of the relative genetic and/or environmental factors contribution in determining the measured trait. Results: Menstrual characteristics were found to be under environmental influence where the best fitting model for menstrual interval and duration was common environment. CDF plotting confirmed the results for both variables. Proband-wise concordance analysis for amount of menstruation, amenorrhea, and irregular menstruation revealed no genetic influence. The best fitting model for menstrual irregularity was CE (C73%, E27%. The same model was defined for amenorrhea (C48%, E52%. Conclusions: Environmental factors are most likely responsible to determine the menstrual flow, its integrity, and regularity. These factors need to be studied further.

  19. Female athlete triad and its components: toward improved screening and management.

    Science.gov (United States)

    Javed, Asma; Tebben, Peter J; Fischer, Philip R; Lteif, Aida N

    2013-09-01

    As female athletic participation has increased, the positive effects of exercise on health have become evident. However, with this growth in sports activity, a set of health problems unique to the female athlete has emerged. The female athlete triad as first described in 1992 by the American College of Sports Medicine consisted of disordered eating, amenorrhea, and osteoporosis; the definition was updated in 2007 to include a spectrum of dysfunction related to energy availability, menstrual function, and bone mineral density. For this review, a comprehensive search of databases-MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Scopus, from earliest inclusive dates to January 2013-was conducted by an experienced librarian with input from the authors. Controlled vocabulary supplemented with keywords such as female athlete triad, amenorrhea, oligomenorrhea, fracture, osteopenia, osteoporosis, bone disease, anorexia, bulimia, disordered eating, low energy availability was used to search for articles on female athlete triad. Articles addressing the prevalence, screening, and management of the female athlete triad were selected for inclusion in the review. This article reviews the current definitions of the triad components, epidemiology, pathophysiology, and recommended screening and management guidelines. The lack of efficacy of current screening of athletes is highlighted. Low energy availablity, from either dietary restriction or increased expenditure, plays a pivotal role in development of the triad. Athletes involved in "lean sports" (those that emphasize weight categories or aesthetics, such as ballet, gymnastics, or endurance running) are at highest risk. Treatment is centered on restoring energy availability to reverse adverse changes in the metabolic milieu. Prevention and early recognition of triad disorders are crucial to ensure timely intervention

  20. Leptin in human physiology and pathophysiology.

    Science.gov (United States)

    Mantzoros, Christos S; Magkos, Faidon; Brinkoetter, Mary; Sienkiewicz, Elizabeth; Dardeno, Tina A; Kim, Sang-Yong; Hamnvik, Ole-Petter R; Koniaris, Anastasia

    2011-10-01

    Leptin, discovered through positional cloning 15 years ago, is an adipocyte-secreted hormone with pleiotropic effects in the physiology and pathophysiology of energy homeostasis, endocrinology, and metabolism. Studies in vitro and in animal models highlight the potential for leptin to regulate a number of physiological functions. Available evidence from human studies indicates that leptin has a mainly permissive role, with leptin administration being effective in states of leptin deficiency, less effective in states of leptin adequacy, and largely ineffective in states of leptin excess. Results from interventional studies in humans demonstrate that leptin administration in subjects with congenital complete leptin deficiency or subjects with partial leptin deficiency (subjects with lipoatrophy, congenital or related to HIV infection, and women with hypothalamic amenorrhea) reverses the energy homeostasis and neuroendocrine and metabolic abnormalities associated with these conditions. More specifically, in women with hypothalamic amenorrhea, leptin helps restore abnormalities in hypothalamic-pituitary-peripheral axes including the gonadal, thyroid, growth hormone, and to a lesser extent adrenal axes. Furthermore, leptin results in resumption of menses in the majority of these subjects and, in the long term, may increase bone mineral content and density, especially at the lumbar spine. In patients with congenital or HIV-related lipoatrophy, leptin treatment is also associated with improvements in insulin sensitivity and lipid profile, concomitant with reduced visceral and ectopic fat deposition. In contrast, leptin's effects are largely absent in the obese hyperleptinemic state, probably due to leptin resistance or tolerance. Hence, another emerging area of research pertains to the discovery and/or usefulness of leptin sensitizers. Results from ongoing studies are expected to further increase our understanding of the role of leptin and the potential clinical

  1. Acute changes in the composition of milk during the ovulatory menstrual cycle in lactating women.

    Science.gov (United States)

    Hartmann, P E; Prosser, C G

    1982-03-01

    1. Breast milk composition was followed for a period of 28 days in five women during lactational amenorrhea and in another two who were taking oral contraceptives. The milk composition was also studied in two women during an anovulatory menstrual cycle and in six women during an ovulatory menstrual cycle. Samples of milk were collected from each breast at each feed for each day of the study. 2. Two acute changes, the first 5-6 days before and the second 6-7 days after ovulation, occurred in the milk composition during the ovulatory menstrual cycle. At both times there was an increase in Na and Cl concentrations from (mean +/- S.E. of mean) 4.6 +/- 0.2 mM and 11.1 +/- 0.2 mM to 10.1 +/- 0.9 mM and 22.0 +/- 0.9 mM respectively and a decrease in lactose and K concentrations from 7.8 +/- 0.2 g/100 ml. and 13.6 +/- 0.4 mM to 6.0 +/- 0.2 g/100 ml. and 10.2 +/- 0.5 mM respectively. The mean duration of the first change was 28 hr and the second was 32 hr. The concentrations of lactose, Cl, K and Na remained relatively constant during lactational amenorrhea, anovulatory menstrual cycles and for those women taking oral contraceptives. 3. These observations indicate that an increase in the permeability of the mammary epithelium was elicited by changes related to ovulation. It is suggested that the first acute change in the breast milk composition may be associated with the final stages of follicle maturation and the second with the regression of the corpus luteum during the ovulatory menstrual cycle.

  2. [Health care personnel's opinion on the breast-feeding pattern in the Mexican rural area].

    Science.gov (United States)

    Potter, J E; Mojarro Dávila, O; Hernández, D

    1991-01-01

    This paper surveys the health care personnel's knowledge and opinion about the physiology of the mother milk production and the issues that occur when it is stopped at an earlier moment. From an inquire carried out in 1984 on 155 doctors and nurses and 48 midwives that render their services to the rural population of Mexico, it was found that the majority of the health care personnel recognized breast-feeding as the best nurture for the child. Nevertheless, this personnel is against having a long breast-feeding period. More than half of the doctors and nurses commented that the breast-feeding period must be stopped when the child has diarrhea, which is contrary to the international health agencies opinion. The majority of the health care personnel recommends the introduction of complementary food to children under three months old and suggests a quick stop of the breast-feeding period. From these data it is shown that the health care personnel has little knowledge about the breast-feeding role as an element that increases the period of amenorrhea and its value as a natural contraceptive. The relation between breast-feeding and amenorrhea and infertility is inaccurate, that is why it is concluded that it is necessary to have training for the health care personnel in some physiological aspects of breast-feeding that are of prime importance. If the health care personnel has a better knowledge about breast-feeding, these influencing agents to decrease the incidence and value of breast-feeding will turn into strong promoters of such a healthy practice.

  3. Application of CAO Lingxian's Characteristic Couplet Medicinals in Treatment of Gynecological Diseases%曹玲仙应用特色药对治疗妇科疾病经验

    Institute of Scientific and Technical Information of China (English)

    曾薇薇; 殷岫绮

    2016-01-01

    总结妇科名医曹玲仙教授临床运用特色药对治疗妇科疾病经验,分别有茜草配乌贼骨,主治月经量少、月经后期及闭经;葛根配知母,治疗卵巢早衰或卵巢储备功能下降患者;炒酸枣仁配茯神,治疗肝血亏虚之失眠患者;半夏配北秫米,治疗不寐伴有胃不和、大便欠畅患者;地骨皮配桑白皮,瓜蒌配石斛,分别治疗多囊卵巢综合征有高雄激素临床表现及胰岛素抵抗患者;石菖蒲配远志,主治低促性腺激素性闭经.并举案例加以说明.%Professor CAO Lingxian's experience in treating gynecological diseases with characteristic couplet medicinals is summarized as follows:madder root combined with cuttlefish bone for treatment of hypomenorrhea,delayed menstrual cycle and amenorrhea,kudzuvine root combined with common anemarrhena rhizome for treatment of premature ovarian failure and diminished ovarian reserve,spine date seed combined with poria with hostwood for treatment of insomnia caused by deficiency of liver blood,pinellia combined with north husked sorghum for treatment of insomnia accompanied by symptoms like stomach disharmony and inhibited defecation,wolfberry bark combined with white mulberry root-bark and snakegourd fruit combined with dendrobium respectively for treatment of polycystic ovary syndrome patients with high androgen and insulin resistance,grassleaf sweetflag rhizome combined with polygala root for treatment of hypogonadotropic amenorrhea.To illustrate the experience,some examples are given.

  4. Ovarian structural disturbances in epilectic patients treated with Sodium valproate

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    Yousefi N.

    2008-03-01

    Full Text Available Background: Recent studies have raised the issue of an increased incidence of polycystic ovaries (PCO and menstrual disturbances in women with epilepsy treated with valproate (VPA. It seems that antiepileptic drugs, especially valproate, may have a functional role in altering the endocrine system of child-bearing women with epilepsy. We conducted this study to investigate the association of VPA and ovarian structural/menstrual disorders in epileptic women.Methods: In this cross-sectional study, we compared a total of 64 epileptic patients, aged 16-45 years, 32 of whom had been taking VPA alone and 32 were on other antiepileptic drugs for a minimum duration of six months. Ovarian sonography was performed and body mass index (BMI calculated for all subjects. We also recorded the presence of menstrual disturbances in both groups.Results: Fifteen (46% of the VPA subjects had PCO compared to 7 (21.9% of the other group. In the VPA group, four (12.5% had oligomenorrhea, one (3.1% amenorrhea and 13 (40.6% had irregular menstrual cycles. However, from the other group, two (6.3% subjects had oligomenorrhea and seven (21.9% had irregular menstrual cycles; amenorrhea was not present in the non-VPA treated patients. Mean BMI was 22.5 kg/m2 among the VPA subjects and 20.1 kg/m2 in the non-VPA subjects.Conclusions: This study supports the association of PCO and high BMI with VPA treatment. The frequency of menstrual disturbances did not differ significantly between the two groups.

  5. Clinical analysis of gynecopathia among female college students:report of 236 cases%女大学生妇科疾病236例临床分析

    Institute of Scientific and Technical Information of China (English)

    郭虹

    2011-01-01

    目的:探讨女大学生这一特殊群体生殖健康状态,为高校构建全面、系统的性与生殖健康服务体系及制定保健干预措施提供理论依据.方法:整理近3年来诊治的236例女大学生妇科疾病的临床资料,并进行统计学分析.结果:女大学生妇科疾病的发病率最高为月经失调(39.8%),其次为痛经(20.3%),妇科炎症为17.79%占第3位,闭经发病率最低.结论:月经失调、痛经、妇科炎症、闭经是困扰女大学生的主要妇科疾病,加强生殖健康知识教育,有助于提高女大学生生理健康.%Objective:To investigate the state of reproductive health in frmale college students, and to provide the theory evidence about building a sexual and reproductive health service system and health care interventions. Methods : Retrospective analysis the clinic data of female college students (n= 236) in recent three years. Results: The incidence rate of menstruation disorder was 39. 8%, dysmenorrheal was 20. 3%,gynecological inflammation was 17. 79% and amenorrhea was rare in the study. Conclusion: The common gynecologic disease in female college students were menstruation disorder, dysmenorrheal, gynecological inflammation and amenorrhea. The education about reproductive knowledge was helpful in promote reproductive health in college students.

  6. Bone Parameters in Relation to Attitudes and Feelings Associated with Disordered Eating in Oligo-Amenorrheic Athletes, Eumenorrheic Athletes, and Nonathletes

    Science.gov (United States)

    Sokoloff, Natalia Cano; Eguiguren, Maria L.; Wargo, Katherine; Ackerman, Kathryn E.; Baskaran, Charumathi; Singhal, Vibha; Clarke, Hannah; Slattery, Meghan; Lee, Hang; Eddy, Kamryn T.; Misra, Madhusmita

    2016-01-01

    Objectives Disordered eating may negatively impact bone in athletes. However, it is not known whether this effect is independent of the associated amenorrhea and relative hypercortisolemia. We aimed to compare attitudes, feelings, and cognitions associated with disordered eating using the Three-Factor Eating Questionnaire (TFEQ) and Eating Disorder Inventory-2 (EDI-2) in normal-weight oligomenorrheic athletes (OA), eumenorrheic athletes (EA), and nonathletes, and determine the associations with bone independent of confounders. Method 109 OA, 39 EA, and 36 nonathletes (14–25 years) completed the TFEQ and EDI-2. Dual-energy X-ray absorptiometry was used to assess spine bone mineral density (BMD), and high-resolution pQCT to assess radius microarchitecture. We measured integrated cortisol (q 20’, 11 PM–7 AM), bone formation (procollagen Type 1 N-terminal propeptide, P1NP), and resorption (C-telopeptide, CTX) markers in a subset. Results OA had lower spine BMD Z-scores than EA. Cognitive eating restraint (CER), drive for thinness (DT), ineffectiveness, and interoceptive awareness (IA) were higher in OA than EA (p < 0.05); CER was higher in OA versus nonathletes (p = 0.03). Pulsatile cortisol was positively associated with DT, ineffectiveness, and IA (p < 0.03). CER was inversely associated with BMD Z-scores and P1NP, and ineffectiveness with radius cross-sectional area even after controlling for age, BMI, amenorrhea duration, and cortisol (p < 0.03). Discussion Higher CER in athletes independently predicts lower BMD. PMID:25823597

  7. BIRTH INTERVAL AMONG NOMAD WOMEN

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    E.Keyvan

    1976-06-01

    Full Text Available To have an, idea about the relation between the length of birth interval and lactation, and birth control program this study have been done. The material for such analysis was nomad women's fertility history that was in their reproductive period (15-44. The material itself was gathered through a health survey. The main sample was composed of 2,165 qualified women, of whom 49 due to previous or presently using contraceptive methods and 10 for the lack of enough data were excluded from 'this study. Purpose of analysis was to find a relation between No. of live births and pregnancies with total duration of married life (in other word, total months which the women were at risk of pregnancy. 2,106 women which their fertility history was analyzed had a totally of272, 502 months married life. During this time 8,520 live births did occurred which gave a birth interval of 32 months. As pregnancy termination could be through either live birth, still birth or abortion (induced or spontaneous, bringing all together will give No. of pregnancies which have occurred during this period (8,520 + 124 + 328 = 8,972 with an average of interpregnancy interval of 30.3 months. Considering the length of components of birth interval: Post partum amenorrhea which depends upon lactation. - Anovulatory cycles (2 month - Ooulatory exposure, in the absence of contraceptive methods (5 months - Pregnancy (9 months.Difference between the length, of birth interval from the sum of the mentioned period (except the first component, (2 + 5+ 9 = 16 will be duration of post partum amenorrhea (32 - 16 = 16, or in other word duration of breast feeding among nomad women. In this study it was found that, in order to reduce birth by 50% a contraceptive method with 87% effectiveness is needed.

  8. Turner Syndrome Genotype and phenotype and their effect on presenting features and timing of Diagnosis

    Science.gov (United States)

    Al Alwan, I; M, Khadora; Amir; G, Nasrat; A, Omair; L, Brown; M, Al Dubayee; M, Badri

    2014-01-01

    Background Turner syndrome (TS) is a common genetic disorder caused by abnormalities of the X chromosome. We aimed to describe the phenotypic characteristics of TS patients and evaluate their association with presenting clinical characteristics and time at diagnosis. Methods We studied females diagnosed with TS at King Abdul Aziz Medical City (KAMC), Riyadh between 1983 and 2010. Patients were classified based upon karyotype into females with classical monosomy 45,X (group A) and females with other X chromosome abnormalities (mosaic 45,X/46,XX, Xqisochromosomes, Xp or Xq deletion) (group B). Clinical features of the two groups were analyzed. Results Of the 52 patients included in the study, 16(30.8%) were diagnosed with classical monosomy 45,X and the rest with other X chromosome abnormalities. Only 19(36.5%) patients were diagnosed in infancy and the remaining during childhood or later (odds ratio (OR) = 4.5,95%CI 1.27–15.90, p=0.02). Short stature was universal in group A versus 77.8% in group B. All patients in group A had primary amenorrhea compared with 63.2% of those in group B (P = 0.04); the rest of group B had secondary amenorrhea. Cardiovascular abnormalities were higher in group A (OR=3.50, 95%CI 0.99–12.29, p-value =0.05). Renal defects and recurrent otitis media were similar in both groups. Conclusion This study suggests that karyotype variations might affect the phenotype of TS; however, it may not reliably predict the clinical presentation. Chromosomal analysis for all suspected cases of TS should be promptly done at childhood in order to design an appropriate management plan early in life. PMID:25246887

  9. Pituitary hyperplasia: an uncommon presentation of a common disease

    Science.gov (United States)

    Massolt, E T; Peeters, R P; Neggers, S J; de Herder, W W

    2015-01-01

    Summary A 21-year-old woman presented with amenorrhea, bilateral galactorrhea and fatigue. Visual acuity and visual fields were normal. Laboratory examination demonstrated hyperprolactinemia. Magnetic resonance imaging (MRI) of the pituitary showed a 19×17×12-mm sellar mass with supra- and parasellar extension, causing compression of the pituitary stalk and optic chiasm. Further examinations confirmed mild hyperprolactinemia, strongly elevated TSH (>500 mU/l), low free thyroxine (FT4), hypogonadotropic hypogonadism and secondary adrenal insufficiency. Hydrocortisone and l-T4 replacement therapy was started. Three months later, the galactorrhea had disappeared, thyroid function was normalized and MRI revealed regression of the pituitary enlargement, confirming the diagnosis of pituitary hyperplasia (PH) due to primary hypothyroidism. Subsequently, the menstrual cycle returned and the hypocortisolism normalized. This case demonstrates that severe primary hypothyroidism may have an unusual presentation and should be considered in the differential diagnosis of pituitary enlargement associated with moderate hyperprolactinemia. Learning points One should always try to find one etiology as the common cause of all the clinical findings in a pathologic process.Amenorrhea, galactorrhea and fatigue may be the only presenting clinical manifestations of primary hypothyroidism.Not every patient with galactorrhea, hyperprolactinemia and a pituitary mass has a prolactinoma.Primary hypothyroidism should always be considered in the differential diagnosis of hyperprolactinemia associated with pituitary enlargement and pituitary hormone(s) deficiency(ies).When PH due to primary hypothyroidism is suspected, thyroid hormone replacement should be started and only regression of pituitary enlargement on MRI follow-up can confirm the diagnosis.Examination of thyroid function in patients with a pituitary mass may avoid unnecessary surgery. PMID:26279852

  10. Treatment of hyperprolactinemia: a systematic review and meta-analysis

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    Wang Amy T

    2012-07-01

    Full Text Available Abstract Background Hyperprolactinemia is a common endocrine disorder that can be associated with significant morbidity. We conducted a systematic review and meta-analyses of outcomes of hyperprolactinemic patients, including microadenomas and macroadenomas, to provide evidence-based recommendations for practitioners. Through this review, we aimed to compare efficacy and adverse effects of medications, surgery and radiotherapy in the treatment of hyperprolactinemia. Methods We searched electronic databases, reviewed bibliographies of included articles, and contacted experts in the field. Eligible studies provided longitudinal follow-up of patients with hyperprolactinemia and evaluated outcomes of interest. We collected descriptive, quality and outcome data (tumor growth, visual field defects, infertility, sexual dysfunction, amenorrhea/oligomenorrhea and prolactin levels. Results After review, 8 randomized and 178 nonrandomized studies (over 3,000 patients met inclusion criteria. Compared to no treatment, dopamine agonists significantly reduced prolactin level (weighted mean difference, -45; 95% confidence interval, -77 to −11 and the likelihood of persistent hyperprolactinemia (relative risk, 0.90; 95% confidence interval, 0.81 to 0.99. Cabergoline was more effective than bromocriptine in reducing persistent hyperprolactinemia, amenorrhea/oligomenorrhea, and galactorrhea. A large body of noncomparative literature showed dopamine agonists improved other patient-important outcomes. Low-to-moderate quality evidence supports improved outcomes with surgery and radiotherapy compared to no treatment in patients who were resistant to or intolerant of dopamine agonists. Conclusion Our results provide evidence to support the use of dopamine agonists in reducing prolactin levels and persistent hyperprolactinemia, with cabergoline proving more efficacious than bromocriptine. Radiotherapy and surgery are useful in patients with resistance or intolerance

  11. Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives

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    Giuseppe Benagiano

    2009-04-01

    empirically utilized various continuous administration regimens. The first extended-cycle oral contraceptive regimen introduced in clinical practice is an 84-day regimen that results in bleeding only 4 times a year. A commercial product specifically packed for continuous use is now available in Europe and contains 30 µg EE and 150 µg LNG. In a variation of this regimen, after administration of the same combination for 84 days, women are given 7 pills containing 10 µg EE. A 6-monthly regimen has also been tested in a small study using EE 20 µg plus LNG 100 µg taken with and without a hormone-free interval. Women in the continuous group reported significantly fewer bleeding days requiring protection and were more likely to have amenorrhea; in addition they also reported significantly fewer days of bloating and menstrual pain. A yearly regimen is now being developed. Each pill of this novel formulation contains EE 20 µg and LNG 90 µg to be taken continuously for 364 days (13 cycles per year. A phase III trial has now evaluated safety, efficacy and menses inhibition. At the end of the 1-year trial amenorrhea was present in 58.7% of the women and a complete absence of bleeding in 79.0%. Overall, the number of bleeding and spotting days per pill pack declined with time and adverse events and discontinuations were comparable to those reported for cyclic oral contraceptive regimens.Keywords: levonorgestrel, oral contraceptive, continuous administration, menstruation, amenorrhea

  12. 抗精神病药物致高泌乳素血症对女性精神病患者卵巢功能的影响%Effect of Antipsychotic-induced Hyperprolactinemia on Ovarian Function in the Young Women Psychiatric Patients

    Institute of Scientific and Technical Information of China (English)

    余云香; 吕那; 李宇晨; 李雪梅; 蒋美宏

    2016-01-01

    Objective To investigate the changes of serum sex hormones and correlation in the young women psychiatric patients with Antipsychotic-induced hyperprolacti-nemia(HPRL).Methods 158 cases of young women patients wirh Antipsychotic- induced HPRL were selected in this study, the serum levels of prolacin(PRL), folicular stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2) were measured and analyzed, which were divided into four groups according to the difference level of PRL. GroupⅠ (PRL100 ng/mL; 40 cases; age mean: (29.65±6.96)yesas; GroupⅣ (PRL>100 ng/mL; amenorrhea patients ; 38 cases; age mean: (36.72±7.85)years.Results GroupⅠ, groupⅡ and groupⅢ was no significantly difference between PRL and age, FSH, LH, E2(P>0.05); GroupⅠ and groupⅣ was the negative correlation between PRL and LH (P<0.05).Conclusions When the level of PRL was lower of 100 ng/mL; Antipsychotic-induced hyperprolactinemia(HPRL) didn't affect the level of sexual hormone in the female psychiatric patients. it is obvious that the abnormal menstruation patients increase with the higher level of PRL. When the level of PRL was higher of 100 ng/mL, no correlation between PRL and FSH, LH, E2, in no amenorrhea patients, but the negative correlation between PRL and LH in amenorrhea patients.%目的:抗精神病药物致高泌乳素血症对育龄女性精神病患者的卵巢功能的影响。方法选择158例育龄女性精神病患者,年龄18~40岁,在服用抗精神病药物期间测定PRL、FSH、LH、E2水平,根据其泌乳素水平及月经情况分为四组,组Ⅰ:PRL<25 ng/mL,40例;平均年龄(33.76.±8.03)岁;组Ⅱ:30 ng/mL<PRL<100 ng/mL,40例;平均年龄(32.00±7.19)岁;组Ⅲ:PRL>100 ng/mL,40例;平均年龄(29.65±6.96)岁;组Ⅳ:PRL>100 ng/mL,患者出现闭经,38例;平均年龄(36.72±7.85)岁。结果组Ⅰ与组Ⅱ、组Ⅲ相比,PRL与FSH、LH、E2无相关性;组Ⅰ与组Ⅳ相比

  13. THALASSAEMIA AND ABERRATIONS OF GROWTH AND PUBERTY

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    Andreas Kyriakou

    2009-07-01

    Full Text Available Endocrine dysfunction in Thalassaemia major (TM is a common and disturbing complication, which requires prompt recognition and treatment. The contribution of the underlying molecular defect in TM to the development of endocrinopathies is significant because the patients with the more severe genetic defects have a greater rate of iron loading through higher red cell consumption. TM patients frequently present delay of growth and puberty with reduction of final height. The pathogenesis of growth failure is multifactorial and is mainly due to chronic anemia and hypoxia, chronic liver disease, zinc and folic acid deficiency, iron overload, intensive use of chelating agents, emotional factors, and endocrinopathies (hypogonadism, delayed puberty, hypothyroidism and GH-IGF-1 axis dysregulation. Although appropriate iron chelation therapy can improve growth and development, TM children and adolescents treated intensively with desferrioxamine remain short as well, showing body disproportion between the upper and lower body segment. Body disproportion is independent of prepubertal or pubertal period of greater height gain. Treatment with recombinant GH (rhGH is recommended when GH deficiency is established, and even so, the therapeutic response is often non satisfactory. Growth acceleration is mostly promoted with sex steroids in children with associated pubertal delay. Sexual complications in TM, which include Delayed Puberty, Arrested Puberty and Hypogonadism, present the commonest endocrine complication. Iron deposition on gonadotroph cells of the pituitary leads to disruption of gonadotrophin production which is proven by the poor response of FSH and LH to GnRH stimulation. In the majority of patients gonadal function is normal as most women with Amenorrhea are capable of achieving pregnancy with hormonal treatment and similarly men with azoospermia become fathers. Secondary Hypogonadism appears later in life,    and is manifested in women as

  14. Breast-feeding, return of menses, sexual activity and contraceptive practices among mothers in the first six months of lactation in Onitsha, South Eastern Nigeria.

    Science.gov (United States)

    Egbuonu, I; Ezechukwu, C C; Chukwuka, J O; Ikechebelu, J I

    2005-07-01

    The objective of this study was to determine the exclusive breast-feeding practices, return of menstruation, sexual activity and contraceptive practices among breast-feeding mothers in the first six months of lactation. The study was based in Onitsha, South Eastern Nigeria. A structured questionnaire was used to obtain data from breast-feeding mothers on their age, educational attainment, breast-feeding practices, return of menstruation, sexual activity and contraceptive practices within the first six months of lactation at intervals of 6 weeks, 10 weeks 14 weeks and 6 months post delivery. Analysis of the information obtained showed that out of the 178 mothers who participated in the study 81% of the mothers were within the ages of 20 - 34 years. While all the mothers had formal education, the majority (59%) had secondary education. Seventy-three percent initiated breast-feeding within one hour of delivery. On discharge from hospital, all of them had already established breast-feeding which continued up to six weeks and dropped to 97.8% at six months. Exclusive breast-feeding which was practised by 100% on discharge dropped to 3.9% at six months. The feeding regimen was on demand as practised by 98.9% of the mothers. Menstrual flow had returned in 33.8% of the mothers by 6 weeks of lactation, and had risen to 70.2% at six months. There was more prolonged lactational amenorrheoa in exclusively breast-feeding mothers than in those who were not. By 6 weeks post delivery 31.6% of the mothers had resumed sexual activity and this rose to 93.6% at six months. With the resumption of sexual activity only 5% of the mothers resorted to contraceptive practices other than lactational amenorrhea and this increased to 54% at six months. There was no pregnancy in any of these women during the six months period. While appreciating the role of lactational amenorrhea in child spacing and considering the early return of sexual activity among the mothers the practice of introducing

  15. [Hypertension and pregnancy. Diagnosis, physiopathology and treatment].

    Science.gov (United States)

    Fournier, A; Fievet, P; el Esper, I; el Esper, N; Vaillant, P; Gondry, J

    1995-11-25

    preeclampsia (> 8-10%). In multiparas the selection of such a high risk population is relatively easy when at least 2 (or 1?) previous pregnancies were complicated with early preeclampsia and/or intrauterine growth retardation. In nulliparas the selection of the high-risk population is still a subject of research. The 2 most promising criteria are abnormal Doppler velocimetry of the uterine arteries at around 20 weeks of amenorrhea, and abnormally high plasma levels of beta HCG at 17 weeks of amenorrhea.

  16. American College of Sports Medicine position stand. The female athlete triad.

    Science.gov (United States)

    Nattiv, Aurelia; Loucks, Anne B; Manore, Melinda M; Sanborn, Charlotte F; Sundgot-Borgen, Jorunn; Warren, Michelle P

    2007-10-01

    The female athlete triad (Triad) refers to the interrelationships among energy availability, menstrual function, and bone mineral density, which may have clinical manifestations including eating disorders, functional hypothalamic amenorrhea, and osteoporosis. With proper nutrition, these same relationships promote robust health. Athletes are distributed along a spectrum between health and disease, and those at the pathological end may not exhibit all these clinical conditions simultaneously. Energy availability is defined as dietary energy intake minus exercise energy expenditure. Low energy availability appears to be the factor that impairs reproductive and skeletal health in the Triad, and it may be inadvertent, intentional, or psychopathological. Most effects appear to occur below an energy availability of 30 kcal.kg(-1) of fat-free mass per day. Restrictive eating behaviors practiced by girls and women in sports or physical activities that emphasize leanness are of special concern. For prevention and early intervention, education of athletes, parents, coaches, trainers, judges, and administrators is a priority. Athletes should be assessed for the Triad at the preparticipation physical and/or annual health screening exam, and whenever an athlete presents with any of the Triad's clinical conditions. Sport administrators should also consider rule changes to discourage unhealthy weight loss practices. A multidisciplinary treatment team should include a physician or other health-care professional, a registered dietitian, and, for athletes with eating disorders, a mental health practitioner. Additional valuable team members may include a certified athletic trainer, an exercise physiologist, and the athlete's coach, parents and other family members. The first aim of treatment for any Triad component is to increase energy availability by increasing energy intake and/or reducing exercise energy expenditure. Nutrition counseling and monitoring are sufficient

  17. Effect of Chronic Athletic Activity on Brown Fat in Young Women.

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    Vibha Singhal

    Full Text Available The effect of chronic exercise activity on brown adipose tissue (BAT is not clear, with some studies showing positive and others showing negative associations. Chronic exercise is associated with increased resting energy expenditure (REE secondary to increased lean mass and a probable increase in BAT. Many athletes are in a state of relative energy deficit suggested by lower fat mass and hypothalamic amenorrhea. States of severe energy deficit such as anorexia nervosa are associated with reduced BAT. There are no data regarding the impact of chronic exercise activity on BAT volume or activity in young women and it is unclear whether relative energy deficiency modifies the effects of exercise on BAT.We assessed cold induced BAT volume and activity in young female athletes compared with non-athletes, and further evaluated associations of BAT with measures of REE, body composition and menstrual status.The protocol was approved by our Institutional Review Board. Written informed consent was obtained from all participants prior to study initiation. This was a cross-sectional study of 24 women (16 athletes and8 non-athletes between 18-25 years of age. Athletes were either oligo-amenorrheic (n = 8 or eumenorrheic (n = 8.We used PET/CT scans to determine cold induced BAT activity, VMAX Encore 29 metabolic cart to obtain measures of REE, and DXA for body composition.Athletes and non-athletes did not differ for age or BMI. Compared with non-athletes, athletes had lower percent body fat (p = 0.002, higher percent lean mass (p = 0.01 and trended higher in REE (p = 0.09. BAT volume and activity in athletes trended lower than in non-athletes (p = 0.06; p = 0.07, respectively. We found negative associations of BAT activity with duration of amenorrhea (r = -0.46, p = 0.02.BAT volume correlated inversely with lean mass (r = -0.46, p = 0.02, and positively with percent body fat, irisin and thyroid hormones.Our study shows a trend for lower BAT in young female

  18. Radiotherapy for pituitary adenomas: long-term outcome and complications

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    Rim, Chai Hong; Yang, Dae Sik; Park, Young Je; Yoon, Won Sup; Lee, Jung AE; Kim, Chul Yong [Korea University Medical Center, Seoul (Korea, Republic of)

    2011-09-15

    To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-fi ve patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing

  19. Clinical study of two kinds of endometrial ablation in the treatment of abnormal uterine bleeding%两种子宫内膜祛除术治疗异常子宫出血的临床研究

    Institute of Scientific and Technical Information of China (English)

    刘海绒

    2016-01-01

    Objective:To study the clinical effect of two kinds of endometrial ablation in the treatment of abnormal uterine bleeding.Methods:65 patients with abnormal uterine bleeding were selected.They were divided into two groups Hysteroscopy in the treatment of endometrial resection;the NovaSure group with NovaSure endometrial ablation.Clinical effect was compared. Results:The NovaSure group 1 year amenorrhea rate was significantly higher than that of hysteroscopy group;electrolyte disorder was lower than that of hysteroscopy group(P<0.05).Conclusion:The NovaSure endometrial removal surgery and hysteroscopic endometrial resection in treatment of abnormal uterine bleeding all have certain effect,but the NovaSure endometrial removal surgery can decrease the trauma,reduce interfere with the body,increase the rate of amenorrhea,combined with actual choice suitable operation.%目的:研究两种子宫内膜祛除术治疗异常子宫出血的临床效果。方法:收治异常子宫出血患者65例,分两组。宫腔镜组以宫腔镜子宫内膜切除术治疗;诺舒组以诺舒子宫内膜祛除术治疗。比较临床效果。结果:诺舒组1年闭经率明显高于宫腔镜组,电解质紊乱率低于宫腔镜组(P<0.05)。结论:诺舒子宫内膜祛除术和宫腔镜子宫内膜切除术治疗异常子宫出血均有一定效果,但诺舒子宫内膜祛除术可减轻创伤,减轻机体干扰,提高闭经率,需结合患者实际选择合适术式。

  20. Bone mineral density in female high school athletes: interactions of menstrual function and type of mechanical loading.

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    Nichols, Jeanne F; Rauh, Mitchell J; Barrack, Michelle T; Barkai, Hava-Shoshana

    2007-09-01

    During adolescence, skeletal integrity of girls is largely dependent on menstrual function and impact exercise, yet currently there is limited research regarding the interaction between menstrual status and type of mechanical loading associated with various high school sports. Our purpose was to examine associations of menstrual status, type of mechanical loading, and bone mineral density (BMD) in female high school athletes participating in high/odd impact or repetitive/non-impact sport. Participants were 161 female high school athletes (15.7+/-1.3 years; 165.3+/-6.9 cm; 59.4+/-8.7 kg) representing high/odd impact (n=93, including soccer, softball, volleyball, tennis, lacrosse, and track sprinters and jumpers), or repetitive/non-impact sports (n=68, including swimmers, cross-country and track distance runners who participated in events>or=800 m). Areal BMD was measured by DXA at the spine (L1-L4), proximal femur, and total body. Menstrual status was determined by self-report. Athletes with primary, secondary or oligomenorrhea were combined into a single group (oligo/amenorrheic) and compared to eumenorrheic athletes. Analysis of covariance (ANCOVA) with Bonferroni post hoc comparisons adjusted for age, BMI, and gynecological age were used to compare BMD of athletes in combined mechanical loading and menstrual status groups. We found significantly greater total hip (p=0.04) and trochanter (p=0.02) BMD (g cm(-2)) among eumenorrheic high/odd impact compared to eumenorrheic repetitive/non-impact athletes, and greater spine (p=0.01) and trochanter (p=0.04) BMD among high/odd impact eumenorrheic athletes compared to repetitive/non-impact oligo/amenorrheic athletes. Chi-squared analysis of BMD Z-scores adjusted for gynecological age showed a significantly greater percentage of repetitive/non-impact athletes (33.9%) compared to high/odd impact athletes (11.8%) with low spine BMD for their age (BMD Z-scoresports, and especially those with oligo/amenorrhea, may not be

  1. Breast-feeding behavioral patterns among La Leche League mothers: a descriptive survey.

    Science.gov (United States)

    Cable, T A; Rothenberger, L A

    1984-06-01

    Many studies have documented the behavioral patterns of unrestricted breast-feeding among Third World mothers, but knowledge of this behavior among Western women is lacking. La Leche League International is a strong advocate of unrestricted breast-feeding, a feeding behavior more characteristic of women in developing countries than in Western society. To investigate the breast-feeding patterns of La Leche League mothers, a pilot study of 24 active members was undertaken. Utilizing a home diary, a 2-month record of suckling frequency, vaginal bleeding, sexual intercourse, solid food supplements, and six-hour intervals without a suckling episode was maintained. The results show the La Leche League mother in this sample to be an average of 29 years old, white, and well-educated. She fed an infant an average of 15 times per day and frequently slept with her child. Frequency of mother and child sleeping together was inversely related to the frequency of marital intercourse. Prolonged lactational amenorrhea was also found, as 92% of the mothers nursing infants 5 to 16 months old had not regained their normal menstrual flow. La Leche League mothers represent a subset of nursing mothers who have a life-style of which the primary care physician must be aware in order to provide optimal maternal-infant care.

  2. MISPLACED AND MIGRATED IUCD: A CASE REPORT

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    Sankareswari

    2015-12-01

    Full Text Available Misplaced IUCD is the condition when the tail of IUCD is not seen through the cervical os. IUCD migration subsequent to uterine perforation is an uncommon but serious complication. Incidence of perforation varies from 1-3 per 1000 insertions. 4 24 years old female, P3L2A0 with the complaints of severe dysmenorrhea for 4years and abdominal pain with low back pain for 2years. She had 2FTND and IUCD inserted 6months after last delivery in April 2007. 5months later, with 2months amenorrhea, diagnosed as pregnancy with expulsion of IUCD, as there was no thread seen through external cervical os. USG was not done. This pregnancy was terminated at 7th month due to Anencephaly in February 2008. Interval laparoscopic sterilisation done in July 2010. USG on 28/09/2013 revealed IUCD in right ovary when she went for ovum donation and advised removal. After 7.5 years, on 11/10/2013 laparoscopic removal of IUCD done from right ovary which was surrounded by adhesions and pus. Perforated site seen in the fundus of uterus as depression. Appropriate antibiotics given. Post-operative period was uneventful. On follow up, the patient is free of abdominal pain and back pain. This case report highlights the need for vigilance in misplaced IUCD. Plain X ray abdomen and pelvis can pick up the diagnosis and exclude the perforation and migration. So that further complications and morbidity are prevented

  3. Reproduction in women with end-stage renal disease and effect of kidney transplantation.

    Science.gov (United States)

    Ghazizadeh, Shirin; Lessan-Pezeshki, Mahboob

    2007-07-01

    Menstrual problem is common among women with chronic kidney disease, and patients with end-stage renal disease usually have amenorrhea. The rate of pregnancy in women on dialysis is low. Fetal survival in this population has improved, with half of such pregnancies resulting in delivery of a live infant. However, prematurity remains common and accounts for the low-birth weight of these infants. Intensifying hemodialysis by increasing the frequency of treatments is associated with longer gestation and increased likelihood of a successful pregnancy. Intense hemodialysis also improves the control of maternal intravascular volume and reduces the risk of hypotension due to excessive ultrafiltration. Women with chronic kidney disease tend to experience decreased libido and reduced ability to reach orgasm. Sexual difficulties in uremic patients are often worsened by hemodialysis, with a lowered frequency of intercourse, reduced sexual desire, and an increased incidence of sexual failure. There have been ongoing improvements in survival and quality of life after kidney transplantation. In most patients, sexual desire increases significantly after successful transplantation; however, improvement in the frequency of sexual activity and the overall sexual satisfaction is not as high as that in sexual desire. These have been accompanied by an improvement in reproductive function. Pregnancy success rate exceeds 90% after the first trimester in women with kidney transplant. Contraceptive counseling should be provided before transplantation, because ovulatory cycles may begin within 1 to 2 months after transplantation in women with functioning grafts. Breastfeeding is discouraged for patients taking any immunosuppressive drugs.

  4. [Morbidity in the ghettos during the Holocaust].

    Science.gov (United States)

    Shasha, Shaul M

    2002-04-01

    The environmental conditions and daily life in the ghettos of Europe during the holocaust are reviewed, and their effect on morbidity in different ghettos is scrutinized in an attempt to construct a typical morbidity profile. The outstanding characteristics were: crowding, shortage of basic necessities (such as food, clothing and medications), harsh environmental and sanitary conditions, inclement weather, poor personal hygiene, chronic undernutrition and malnutrition, physical and mental exhaustion. Morbidity was mainly due to infectious diseases, both endemic and epidemic outbreaks with high mortality, and high infestation rates of lice and other parasites. The dominant feature was "hunger disease" with its protean clinical expressions, endocine pathology, growth and development retardation in children, and amenorrhea and infertility among women of child-bearing age. Polyuria, nocturia and increased frequency of bowel movement were common. The typical presentation of a ghetto dweller was of extreme emaciation (a loss of up to 50% body weight); muscle weakness and skeletal abnormalities; pale, dry skin with excoriations; pedal edema; anxiety and nervousness; often goiter in children. Most of the inhabitants had some, or all, of those signs and symptoms (there were times when more than half the population was sick). This syndrome complex was termed "Ghetto Sickness" or "Ghetto Fatigue" (ghetto schwachkeit).

  5. Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review.

    Science.gov (United States)

    Teles, Kaian Amorim; Medeiros-Souza, Patrícia; Lima, Francisco Aires Correa; Araújo, Bruno Gedeon de; Lima, Rodrigo Aires Correa

    2016-09-17

    Cyclophosphamide (CPM) is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy (pre-ChT), administration of cyclophosphamide, and post-chemotherapy (post-ChT), taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare-but serious-side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.

  6. Menstrual and oral contraceptive use patterns among deployed military women by race and ethnicity.

    Science.gov (United States)

    Deuster, Patricia A; Powell-Dunford, Nicole; Crago, Mark S; Cuda, Amanda S

    2011-01-01

    Menstrual cycle patterns and concerns and oral contraceptive use in the combat environment were examined in Caucasian, Asian, Hispanic, and African American women to guide the development of educational resources for women soldiers. An anonymous, questionnaire was completed by 455 U.S. Army women-Caucasian (CA: n = 141); Asian (AS: n = 67); Hispanic (HIS: n = 67); and African American (AA: n = 184) to compare menstrual patterns and concerns, dysmenorrhea, and oral contraceptive patterns. Total menstrual concerns were significantly lower among African Americans relative to Caucasians, Asians, or Hispanics; Asians and Hispanics reported the greatest concern. Overall, secondary amenorrhea was noted by 14.9% of women. Severe dysmenorrhea rates were significantly lower in African American (6.1%) compared to Caucasian (11.6%), Asian (20.9%) and Hispanic (19.7%) women. Asian women reported missing less work-only 9.3% with moderate to severe dysmenorrhea missed work compared to 25.1% of all other women. Only 9.2% of women with mild, compared to 25.8% with moderate to severe (OR = 3.44; p ≤ 0.0001) dysmenorrhea sought health care. Less than 50% of women took oral contraceptive, and less than half of those women took oral contraceptive continuously. African Americans seemed to experience menstruation as less bothersome than others, despite no difference in the proportion with menstrual irregularities, mean duration of menses, and/or mean time between cycles.

  7. EPIDEMIOLOGICAL CORRELATES OF POSTMENOPAUSAL BLEEDING IN A TERTIARY CARE HOSPITAL

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    Sonia Arora

    2012-07-01

    Full Text Available Background: A woman is considered menopausal after 12 months of amenorrhea. The most feared symptom during menopause is postmenopausal bleeding which unless proved otherwise indicates genital malignancy. Objectives: To study Socio-demographic factors related to postmenopausal bleeding and to find time lapse between bleeding and reporting of these cases. Material and Methods: This cross sectional was done in the Department of Obstetrics & Gynecology, Pt. J. N. M. Medical College & DR. B. R. Ambedkar Memorial, Hospital, Raipur (C. G. The participants were 146 women who came with the complaint of postmenopausal bleeding. A detailed, preceded, pre-tested, structured, close ended questionnaire was used to collect the data. By interviewing these women, information was collected about different demographic factors like age, socio-economic status, parity etc. The collected data was put in the master chart and analyzed. Results: The proportion of postmenopausal bleeding cases was 3.5% .Maximum cases(50% with postmenopausal bleeding were found in the age group of 45-54yrs . 60 % of patients were from rural areas and 62% were illiterate. 65% of the patients were grand multipara (Parity4. Most of the patients belonged to lower socioeconomic strata. Almost half (48% of patients presented after, more than 6 months since the first episode of bleeding . Conclusions: The proportion of postmenopausal bleeding is high, requiring immediate investigation. Lack of awareness led to very late presentation of most of the patients, so education at community level is required to reduce this time lapse for earlier diagnosis and management

  8. Pituitary injury and persistent hypofunction resulting from a peripartum non-hemorrhagic, vaso-occlusive event

    Science.gov (United States)

    Kuriya, Anita; Morris, David V

    2015-01-01

    Summary Cerebral vascular accidents are caused by vasospasm when induced by preeclampsia or by dopamine agonists. However, six arteries nourish the pituitary and prevent against vasospasm-induced damage, which up until now has not been thought to occur. Bromocriptine was used to arrest lactation in a 31-year-old with secondary amenorrhea following preeclampsia and fetal demise at 28 weeks gestation. Tests and history revealed panhypopituitarism not associated with hemorrhage or mass infarction but instead caused by vasospasm. The present study is the first report of pituitary damage from a non-hemorrhagic, vaso-occlusive event in the literature. In keeping with Sheehan's and Simon's syndromes, we have named pituitary damage resulting from vaso-occlusion as Dahan's syndrome, and a literature review suggests that it may be a common and previously overlooked disorder. Learning points Vasospasm can cause damage to the pituitary gland, although it was not previously believed to do so.Preeclampsia and the use of a dopamine agonist, particularly in the peripartum state, may trigger vasospasm.Vasospasm resulting from dopamine agonists may be a common cause of injury to the pituitary gland, and it may have been overlooked in the past. PMID:26038692

  9. Sheehan's syndrome: a single centre experience

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    E. Sunil

    2013-01-01

    Full Text Available Background: Sheehan's syndrome (SS occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. It is one of the most common causes of hypopituitarism in developing countries. Objective: To study the clinical profile of patients with SS presenting to the Endocrinology Department at a tertiary care teaching hospital in South India. Methods: All patients diagnosed as SS during the study period of 2007-2012 were identified. Their clinical, biochemical, hormonal, radiological and bone mineral density (BMD data were collected. Results: Eighteen patients were identified. Median age of diagnosis was 40 years [interquartile range (IQR = 32-51 years; median (IQR diagnostic delay was 11 (5-17 years]. Failure to resume menstruation and lactation failure was the most common clinical presentation. The median total tetraiodothyronine (T4, peak stimulated cortisol, stimulated growth hormone (GH, and prolactin (PRL levels were low. The gonadotropins [follicle stimulating hormone (FSH and luteinizing hormone (LH] were inappropriately normal in the presence of amenorrhea. Hyponatremia was the most common electrolyte abnormality seen in 14 patients. Seven patients had anaemia and five of them had normocytic normochromic anaemia. BMD assessment (n = 9 was suggestive of low bone mass. Conclusion: SS resulted in multiple pituitary hormone deficiencies in all the patients. Hyponatremia, anaemia, and low bone mass were frequently seen in patients with SS.

  10. [Atypical and rare cardiac revelation about Sheehan's syndrome: A report of three cases].

    Science.gov (United States)

    Bouznad, N; Mghari, G El; Hattaoui, M El; Ansari, N El

    2017-01-24

    Sheehan syndrome is a potentially serious complication in the postpartum period corresponding to ischemic necrosis of the anterior pituitary related to postpartum haemorrhage. We report three original observations showing an unusual mode of revelation of this syndrome. The first observation is that of a 46-year-old patient admitted initially to resuscitation for a recovered cardiorespiratory arrest, severe hypoglycemia and profound hyponatremia. The second is that of a 45-year-old patient, admitted for recurrent cardiac tamponade after pericardial and pleural puncture and pericardial drainage; clinical survey found signs of slight panhypopituitarism. The latest case is that of a patient of 44 years, admitted to pericardial effusion average abundance revealed by dyspnea and tachypnea with hypotension. The interrogation of all patients revealed the concept of an old hemorrhagic syndrome, absence of lactation and secondary amenorrhea thereafter. Laboratory tests showed insufficient thyroid-stimulating, low cortisol, a hypogonadism hypogonadism. The pituitary magnetic resonance imaging showed an empty sella in the three cases. Patients were placed under replacement therapy with L-thyroxine and hydrocortisone with good clinical, biological and echocardiographic evolution. The three cases illustrate a rare heart atypical presentation for Sheehan's syndrome and underline the importance of early diagnosis and suitable replacement therapy of this syndrome to avoid this complication that can be life threatening.

  11. [Psychotic Disorder and Sheehan's Syndrome: Etiology or Comorbidity?: A Case Report].

    Science.gov (United States)

    Tıkır, Baise; Göka, Erol; Aydemir, Makbule Çiğdem; Gürkan, Şahin

    2015-01-01

    Sheehan's Syndrome -also called postpartum hypopituitarism- is a syndrome which characterized by lots of bleeding during or after delivery and necrosis of pituitary gland due to hypovolemic shock. It appears with not only agalactorrhea, amenorrhea, hypoythyroidism and hypoglycemia but also psychiatric disorders like psychosis. In this study, we reported a case presented with psychotic disorder and diagnosed as Sheehan's Syndrome at the same time. 44 year-old, female patient, married. She was admitted for withdrawal, irritability, insomnia, hearing voices -especially insult her- thoughts about that her husband was cheating on her and people would do evil. She was diagnosed as psychotic disorder and she was treated with olanzapine 20 mg/day. She had hypopituitarism symptoms so hormone tests and cranial MRI are done. Sheehan's syndrome was also diagnosed and prednisolone and tyroxine were added to the treatment. Her symptoms were disappeared one months later Olanzapine was stopped after 4 months and her treatment continued with prednisolone and tyroxine. Studies about etiology of psychotic symptoms refer to endocrine and autoimmune systems. In this study, we discussed a case that diagnosed as psychotic disorder and Sheehan's Syndrome -diagnosed 24 years later and etiological aspect with the follow-up period and treatment.

  12. Deep vein thrombosis in a patient of Sheehan′s syndrome: Autoimmunity or hypercoagulabilty

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    Shahnaz Ahmad Mir

    2013-01-01

    Full Text Available Introduction: Literature is inconsistent whether patients with hypopituitarism have increased risk of thrombosis. Recent data has shown problems with the coagulation system in Sheehan′s syndrome (SS. Here, we describe a case of SS which presented with deep vein thrombosis. Objective: To describe a case of SS presenting as deep vein thrombosis. Case Report: A 30-year-old female was admitted to the general medicine ward with 1 month history of gradual onset swelling and pain in the left leg. The left calf diameter was 5 cm greater than the right. Doppler of the lower limbs revealed thrombosis in the left popliteal vein. Patient′s coagulation profile revealed a normal prothrombin time of 12 sec, activated partial thromboplastin time of 30 sec, positive D-dimer, negative protein C and protein S and normal titres of antinuclear antibodies. Echocardiography showed an ejection fraction of 52 percent. Endocrinology consultation was sought in view of clinical suspicion of hypothyroidism. Endocrinology review revealed a significant past history of primary postpartum hemorrhage, lactation failure and secondary amenorrhea since the delivery of the last child 6 years back. She had clinical features of growth hormone, thyroid hormone and adrenocorticotropic hormone deficiency. Hormonal analysis showed features of central hypothyroidism, secondary adrenal insufficiency and growth hormone deficiency which was subsequently confirmed by insulin tolerance test. Conclusion: SS patients may have increased risk of thrombosis

  13. Functional Evaluation of TSH Secretory Reserve Capacity in Hypothalamo pituitary Disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Yong; Choi, Kyoo Ok; Park, Chang Yun; Huh, Kab Bum; Ryu, Kyung Ja [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1979-03-15

    The TRH stimulation test was known as a highly diagnostic method in hypothalamo pituitary disorders. To evaluate the location and the extension of the lesion, we estimated TSH response to TRH test in 27 patients. Correlation between volume of sella and TSH response was also studied. The results obtained were 25 follows: 1) In Sheehan's syndrome, TSH response after TRH test were not observed in all of 12 patients. 2) All 2 acromegaly patients showed normal TSH response. 3) In 4 cases of chromophobe adenoma, 2 cases showed no TSH response. In 2 responded cases, one patient whose tumor mass extended to suprasella region was hypothyroid state. 4) In craniopharyingioma 3 cases, the tumor which extended to intrasella showed hypothyroid and no TSH response. 5) Correlation between volume of sella and TSH response were valuable in 2 cases, but no diagnostic significance. 6) In diabetes inspidus, TSH response were all absent. 7) In primary amenorrhea, TSH response observed in 1 case, which conformed with isolated FSH deficiency.

  14. Determinants of puberty health among female adolescents residing in boarding welfare centers in Tehran: An application of health belief model.

    Science.gov (United States)

    Shirzadi, Shayesteh; Asghari Jafarabadi, Mohammad; Nadrian, Haidar; Mahmoodi, Hassan

    2016-01-01

    Background: Adolescence is a critical stage of growth and development. That is associated with changes in body shape and appearance. Issues such as irregular menstrual periods, amenorrhea, and menstrual cycle are major issues in women's health. The purpose of this study was to examine the determinants of physical puberty health based on the Health Belief Model (HBM) among female adolescents. Methods: This analytical cross sectional study was conducted in welfare boarding centers in Tehran, Iran. Data were collected in 2011 by a structured and valid questionnaire. Total 61 female adolescents (age range: 12-19 yrs) participated in this study from welfare boarding centers in Iran, Tehran, by using convenience sampling method. The questionnaire consisted of demographic characteristics, health belief model constructs and physical puberty health behaviors gathered by using interview. A series of univariate general linear models were used to assess the relationship between puberty health and health belief model constructs. Results: According to the results of this study there were positive significant relationships between perceived susceptibility, perceived benefits, perceived barriers, cues to action and increased puberty health in female adolescents (phealth behaviors. Conclusion: Based on the results of the study to improve the physical Puberty health behaviors of female adolescents should make them aware of the benefits of health behaviors, and remove or reform the perceived barriers of health behaviors. Also, the appropriate information resources should be introduced for obtaining information about puberty health.

  15. A Review of the Pharmacological Effects of the Dried Root of Polygonum cuspidatum (Hu Zhang and Its Constituents

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    Huan Zhang

    2013-01-01

    Full Text Available Traditional Chinese medicine (TCM has been widely used in China for thousands of years to treat and prevent diseases. TCM has been proven safe and effective, and it is being considered as one of the important types of complementary and alternative medicine and receives increasing attention worldwide. The dried root of Polygonum cuspidatum Sieb. et Zucc. (also known as “Hu Zhang” in Chinese is one of the medicinal herbs listed in the Pharmacopoeia of the People's Republic of China. Hu Zhang is widely distributed in the world. It can be found in Asia and North America and is used as folk medicine in countries such as Japan and Korea. In China, Hu Zhang is usually used in combination with other TCM herbs. The therapeutic uses of those Hu Zhang-containing TCM prescriptions or formulations are for treating cough, hepatitis, jaundice, amenorrhea, leucorrhea, arthralgia, burns and snake bites. Recent pharmacological and clinical studies have indicated that Hu Zhang has antiviral, antimicrobial, anti-inflammatory, neuroprotective, and cardioprotective functions. This review gives a summary of the reported therapeutic effects of the active compounds and the different extracts of Hu Zhang.

  16. Macroprolactinemia in a Patient with Invasive Macroprolactinoma: A Case Report and Minireview

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    Atanaska Elenkova

    2013-01-01

    Full Text Available Background. Macroprolactin, the high-molecular prolactin isoform, is considered to be an inactive in vivo product with extrapituitary origin. Patients with macroprolactinemia are usually asymptomatic, with negative pituitary imaging. Based on these data, most authors do not recommend treatment and long-term followup in subjects with macroprolactinemia. However, there is evidence for overlapping clinical features among subjects with hyperprolactinemia due to monomeric or “big big” PRL isoform. Case Presentation. We present a 35-year-old female patient with secondary amenorrhea, mild obesity, hirsutism, headache and blurred vision. Hormonal evaluation revealed an extreme hyperprolactinemia (PRL = 10 610 mIU/L almost exclusively due to macroprolactin isoform (MPRL = 10 107 mIU/L; recovery after PEG precipitation 4.7% and hypogonadotropic hypogonadism. An invasive pituitary macroadenoma was visualized on MRI, and cabergoline therapy was initiated. Disappearance of clinical signs and symptoms, normalization of gonadotropin levels, and restoration of regular ovulatory menstrual cycles after 1 year of treatment are arguments in favor of preserved-macroprolactin bioactivity in this case. The significant decrease in MPRL levels and tumor volume in response to dopamine agonist therapy is suggestive for the tumoral origin of this isoform. Conclusions. Although macroprolactinemia is considered to be a benign condition, pituitary imaging, dopamine agonist treatment, and prolonged followup should be recommended in some particular cases.

  17. Discrimination of prolactinoma from hyperprolactinemic non-functioning adenoma.

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    Hong, Jae Won; Lee, Mi Kyung; Kim, Sun Ho; Lee, Eun Jig

    2010-02-01

    The objective of this study was to evaluate characteristics that discriminate prolactinoma from non-functioning pituitary macroadenoma with hyperprolactinemia. We included 117 patients with hyperprolactinemic pituitary macroadenomas. Patients were divided into three groups according to treatment outcomes and pathologic results: (A) prolactinoma that responded to dopamine agonist (DA) treatment (PRDA); (B) prolactinoma requiring surgical treatment (PRS); and (C) non-functioning pituitary adenoma with hyperprolactinemia (NFPAH). Old age, low serum prolactin levels, and extrasellar extension were associated with NFPAH. Most patients with NFPAH had serum prolactin levels less than 100 ng/ml. Visual defects and GH deficiency were more common in patients with NFPAH compared with patients with PRS and PRDA, without difference of tumor size. Galactorrhea and amenorrhea were less frequent in patients with NFPAH than in patients with PRS and PRDA. Post-operative remission of hyperprolactinemia was achieved in 100% of patients with NFPAH and in 72.5% of patients with PRS. DA administration was required in 25.5% of patients with PRS; however, no patients with NFPAH required DA administration. In conclusion, old age, extrasellar tumor extension with relatively low prolactin levels, visual defect, and GH deficiency were considered suggestive of non-functioning pituitary adenoma rather than prolactinoma in hyperprolactinemic pituitary macroadenoma.

  18. [Prolactinoma].

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    Glezer, Andrea; Bronstein, Marcello D

    2014-03-01

    Prolactinomas are the most common pituitary adenomas that affect young women at fertile age. Hyperprolactinemia causes hypogonadism, menstrual irregularities or amenorrhea in women, low serum testosterone levels in men, and infertility and sexual dysfunction in both men and women. Macroprolactinomas may cause cephalea, visual disturbance, and hypopituitarism. Clinical treatment with dopamine agonists is the gold standard, with cabergoline as the first choice due to its greater efficiency and tolerability. In about 20% of the cases, treatment is partially or completely ineffective, a situation in which surgery, in general by transsphenoidal route, is indicated. Radiotherapy is indicated only in the control of tumor growth in invasive/aggressive cases. In invasive macroprolactinoma, the necessary approach, in general, is the combination of several therapeutic modalities, including debulking and recently-approved drugs, such as temozolamide. As for pregnancy, the drug of choice to induce ovulation still is bromocriptine. In the cases of microprolactinomas and intrasselar macroprolactinomas, the treatment with dopaminergic agonists may be suspended after pregnancy is confirmed. In macroprolactinomas, management should be individualized.

  19. Management of resistant prolactinoma in infertile lady with successful maternal and perinatal outcome

    Directory of Open Access Journals (Sweden)

    Niroopama Pushpagiri

    2015-10-01

    Full Text Available Mrs. X of 28 years presented to the gynaecology department with primary infertility for 4 years, secondary amenorrhea for 6 months and galactorrhea for 3 months. She was investigated and diagnosed to have macroprolactinoma. Medical treatment with cabergoline was started. Patient became symptomatically free in 6 months with gradual reduction in serum prolactin levels as well as tumour size. After 2 years of therapy, failure of normalisation of prolactin levels and failure of significant tumour reduction observed and diagnosed it as resistant prolactinoma. Considering her infertility and future complications associated with resistant macroadenoma, she was treated with stereotactic radiosurgery using cyber knife radiation. Tumour regression in MRI with significant decrease in serum prolactin levels were observed in the post radiation period and monthly follow up done. She conceived spontaneously after 2 months of radiotherapy. She has been followed up with visual field testing during antenatal period. Her antenatal, intranatal period was uneventful with successful maternal and perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1659-1662

  20. A case of an ectopic prolactinoma.

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    Simsir, Ilgin Yildirim; Kocabas, Gokcen Unal; Sahin, Serap Baydur; Erdogan, Mehmet; Cetinkalp, Sevki; Saygili, Fusun; Yilmaz, Candeger; Ozgen, Ahmet Gokhan

    2012-02-01

    A 34-year-old female presented to our clinic with a 1.5 year history of secondary amenorrhea and galactorrhea. Prolactin (PRL) level was found to be 151.89 ng/ml. Pituitary imaging was reported to be normal. An examination of the patient revealed that PRL level was still high so the dose of cabergoline was further increased and subsequently, bromocriptine was added to the treatment. There was no reduction in PRL levels in controls. A scanning was performed to look for an ectopic focus. Abdominal computerized tomography revealed a heterogenous mass lesion originating from the uterus. Octreotide scintigraphy was performed and we observed an involvement consistent with the mass in the uterus. The patient underwent abdominal total hysterectomy. PRL dropped to 0.4 ng/ml the next day after the operation. The pathology result was a low-grade malignant mesenchymal tumor. Prolactin was found to be immunohistochemically negative. However, galactorrhea disappeared postoperative and PRL levels are still low. Elevated levels of PRL, resistant to bromocriptine and cabergoline, rapidly returned to normal after hysterectomy, which obviously indicates that hyperprolactinemia was associated with the myoma of the uterus.