MedWorm: Amenorrhea

Higher Ghrelin and Lower Leptin Secretion is Associated with Lower LH Secretion in Young Amenorrheic Athletes Compared with Eumenorrheic Athletes and Controls.

American Journal of Physiology. Endocrinology and Metabolism — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSION: Higher ghrelin and lower leptin secretion in AA related to lower fat mass may contribute to altered LH pulsatility and amenorrhea. PMID: 22252944 [PubMed - as supplied by publisher] (Source: American Journal of Physiology. Endocrinology and Metabolism)

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Caesarean section under local anaesthesia: back to basics.

Tropical Doctor — Tue, 17 Jan 2012 05:00:00 +0100

Authors: Shinde G, Sharma N, Jadhav B, Jaisal P Abstract Caesarean section under local anaesthesia (CSLA) was performed on a patient with a diagnosis of gravida 2 para 1 living 1, with eight months amenorrhea and uncontrolled, refractory, complicated eclampsia with intrauterine fetal demise and a previous lower segment Caesarean section. As she was at very high risk (ASA Grade III) for main stream anaesthesia, i.e. general/regional, lidocaine (0.5%) was used. CSLA should not be seen as a primitive/retrograde step. Instead, it should be considered to be a life-saving procedure, especially for women in rural India. Anaesthetists are not dispensable but with them on standby one can avoid mainstream anaesthesia complications in high-risk patients. PMID: 22253255 [PubMed - as suppli...

Evaluation of postural balance in postmenopausal women and its relationship with bone mineral density- a cross sectional study

BMC Musculoskeletal Disorders — Mon, 16 Jan 2012 05:00:00 +0100

Background: Low bone mineral density (BMD) and falls are common problems encountered in the postmenopausal women. The purpose was to evaluated the association between postural balance and BMD in postmenopausal women and its relation to risk for falls. Methods: In this cross-sectional study, 225 women in amenorrhea >12 months and age >/= 45 years were included and divided, according to BMD, in T-score values > -2.0 SD (n=140) and (Source: BMC Musculoskeletal Disorders)

Relationship between reproductive history, anthropometrics, lifestyle factors, and the likelihood of persistent chemotherapy-related amenorrhea in women with premenopausal breast cancer

Fertility and Sterility — Fri, 23 Dec 2011 05:44:12 +0100

Conclusion(s): Few identifiable factors contribute to the variability in CRA among premenopausal women after adjuvant chemotherapy for breast cancer. Further research to improve the prediction of CRA, premature menopause, and infertility in young breast cancer survivors is warranted. (Source: Fertility and Sterility)

A case of complete hydatidiform mole in a perimenopausal woman with diagnostic usefulness of p57(kip2) immunohistochemistry and HER2 fluorescent in situ hybridization.

Pathology, Research and Practice — Thu, 22 Dec 2011 05:00:00 +0100

Authors: Hatanaka K, Higashi M, Fujibayashi M, Hori S, Yoshioka T, Umekita Y, Tanimoto A Abstract Gestational trophoblastic disease in perimenopausal women is very rare. A 53-year-old perimenopausal woman complained about amenorrhea lasting over a period of 4months. Ultrasound showed enlargement of the uterus with a complex echogeneous area in the uterine cavity. Serum human chorionic gonadotropin was 67,611mIU/ml. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The uterus contained hemorrhagic and fragile tumor with grape-like vesicles in the enlarged endometrial cavity. Microscopic examination revealed hydropically degenerated villi with circumferential hyperplasia of atypical trophoblast and cistern formation. p57(kip2) immnostaining was negative...

Clinical and radiological findings in macroprolactinemia

Endocrine — Tue, 20 Dec 2011 16:46:56 +0100

Abstract Hyperprolactinemia is the most common abnormality of the hypothalamic–pituitary axis. The aim of this study was to investigate the clinical and radiological features of patients with macroprolactinemia. The study population consisted of patients with elevated serum prolactin (PRL) concentrations who presented to our Endocrinology outpatient clinic. Detection of macroprolactin (macroPRL) was performed using the polyethylene glycol precipitation method. Patients in which macroPRL made up more than 60% of total PRL levels were stratified into the macroPRL group, while the remaining patients were placed in the monomeric prolactin (monoPRL) group. A total of 337 patients were enrolled with a mean age of 33.8 ± 10.8 (16–66) years and a male/female ratio o...

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Bilateral dysgerminoma in a patient with a previous diagnosis of Swyer syndrome

Journal of Obstetrics and Gynaecology Research — Mon, 19 Dec 2011 05:00:00 +0100

AbstractA 16‐year‐old girl was referred to our center by her general physician because of primary amenorrhea. Her family history revealed an older sister with Swyer syndrome and gonadectomy at another institution. After thorough evaluation she received the same diagnosis, but unlike her sister, she refused gonadectomy. Four years later she presented with abdominal discomfort and a complex pelvic mass. She underwent exploratory laparotomy and histological examination revealed bilateral dysgerminoma without capsular invasion. The tumor was classified as stage IB. After surgery she underwent adjuvant chemotherapy with three cycles of BEP (bleomycin + etoposide + cisplatin). The present case emphasizes the importance of familial screening with a karyotype study in pure gonadal dysg...

Amenorrhea in women treated with thalidomide: Report of two cases and literature review

Inflammatory Bowel Diseases — Sun, 11 Dec 2011 05:00:00 +0100

(Source: Inflammatory Bowel Diseases)

Balanced autosomal translocation and double Robertsonian translocation in cases of primary amenorrhea in an Indian population

International Journal of Gynaecology and Obstetrics — Fri, 09 Dec 2011 05:00:00 +0100

Conclusion: Autosomal genes have a crucial role in reproductive development. More candidate genes need to be recognized for appropriate genetic counseling and clinical management. (Source: International Journal of Gynaecology and Obstetrics)

Hypogonadotropic hypogonadism in women.

Endokrynologia Polska — Wed, 07 Dec 2011 15:12:02 +0100

This article presents the role of the hypothalamus in reproduction, the definition of hypogonadotropic hypogonadism (HH), and the causes of acquired and syndromic HH and idiopathic HH (IHH). The authors present a short review of major causes of acquired HH, but most of the causes of IHH will not be discussed because they do not fall within the scope of the article. More attention is devoted to idiopathic HH, especially the genetic basis of IHH. Also presented in the article are clinical criteria of CHARGE syndrome. Later, the article discusses the clinical presentation, establishing the diagnosis, and management of IHH. The article ends with a brief overview of nutritional hypothalamic dysfunction and athletic amenorrhea. (Pol J Endocrinol 2011; 62 (6): 560-567). PMID: 22144224 [PubMed...

Effects of oestrogen deficiency on bone mineralisation in girls during "adolescent crisis".

Endokrynologia Polska — Wed, 07 Dec 2011 15:12:02 +0100

Effects of oestrogen deficiency on bone mineralisation in girls during "adolescent crisis". Endokrynol Pol. 2011;62(6):538-46 Authors: Sowińska-Przepiera E, Andrysiak-Mamos E, Jarząbek-Bielecka G, Friebe Z, Syrenicz A Abstract Puberty is a critical bone mineralisation period, and peak bone mass attained by adolescent girls is one of the most significant predictive factors for postmenopausal osteoporosis. Adolescent girls' peak bone mass depends on genetic factors as well as on general condition, nutritional status and body mass; lifestyle is also important, along with physical exercise and the use of prescription drugs. Additionally, hormones, including oestrogens, play an important role during pubertal accumulation of bone mass. Therefore, oestrogen deficiency during pub...

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Polymorphism of the vitamin D3 receptor gene and bone mineral density in girls with functional hypothalamic amenorrhea subjected to oestroprogestagen treatment.

Endokrynologia Polska — Wed, 07 Dec 2011 15:12:02 +0100

Conclusions: This study did not confirm that VDR polymorphism can modulate therapeutic outcome of FHA girls subjected to the hormonal treatment. Nonetheless, this study confirmed the effectiveness of EP therapy in the simultaneous treatment of menstrual disorders and the normalisation of bone mineral density in FHA patients. (Pol J Endocrinol 2011; 62 (6): 492-498). PMID: 22144214 [PubMed - in process] (Source: Endokrynologia Polska)

[Outcome of embryo vitrification compared to slow freezing process at early cleavage stages. Report of the first French birth.]

Gynecologie, Obstetrique et Fertilite — Wed, 07 Dec 2011 05:00:00 +0100

CONCLUSION: We experienced in our study that the post-thaw survival of vitrified embryos was significantly better than those of embryos resulting from SF. Then, a better CPR per thawed embryo cycle was observed following vitrification. PMID: 22154672 [PubMed - as supplied by publisher] (Source: Gynecologie, Obstetrique et Fertilite)

Acute kidney injury related to pregnancy in developing countries: etiology and risk factors in an intensive care unit.

Journal of Nephrology — Mon, 05 Dec 2011 05:00:00 +0100

Conclusion: The incidence of AKI in developing countries ranges from 4% to 36% depending on the study. In India and Pakistan, cases of pregnancy-related AKI occur mainly during the first trimester of pregnancy and are related to severe states of sepsis. In Morocco, AKI occurs mainly in the third trimester in a context of hypertensive disorders. Maternal mortality varies between 6% and 30% depending on the study. AKI is a frequently occurring complication in developing countries. It is reversible as shown by total recovery of renal function, but this depends on early and appropriate diagnosis and treatment. Nevertheless, the best treatment remains prevention. PMID: 22144377 [PubMed - as supplied by publisher] (Source: Journal of Nephrology)

Prolactin and autoimmunity.

Autoimmunity Reviews — Fri, 02 Dec 2011 05:00:00 +0100

Authors: Shelly S, Boaz M, Orbach H Abstract Sex hormones, especially estrogen and prolactin (PRL), have an important role in modulating the immune response. PRL is secreted from the pituitary gland as well as other organs and cells particularly lymphocytes. PRL has an immune stimulatory effect and promotes autoimmunity. PRL interferes specifically with B cell tolerance induction, enhances proliferative response to antigens and mitogens and increases the production of immune globulins, cytokines and autoantibodies. Hyperprolactinemia (HPRL) in women present with clinical manifestations of galactorrhea, primary or secondary amenorrhea, delayed menarche or a change in the menses either in the amount or in the regularity. Furthermore in the last 2 decades multi-organ and organ specifi...

Estriol administration modulates luteinizing hormone secretion in women with functional hypothalamic amenorrhea

Fertility and Sterility — Fri, 02 Dec 2011 05:00:00 +0100

Conclusion(s): Estriol administration induced the increase of LH plasma levels in FHA and improved GnRH-induced LH secretion. These findings suggest that estriol administration modulates the neuroendocrine control of the hypothalamus-pituitary unit and induces the recovery of LH synthesis and secretion in hypogonadotropic patients with FHA. (Source: Fertility and Sterility)

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Five-year follow-up after comparing bipolar endometrial ablation with hydrothermablation for menorrhagia.

Obstetrics and Gynecology — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION: : After treatment, bipolar radiofrequency endometrial ablation system is more effective at 5 years than hydrothermablation in the treatment of menorrhagia. LEVEL OF EVIDENCE: : II. PMID: 22105257 [PubMed - in process] (Source: Obstetrics and Gynecology)

[Adolescent with anorexia nervosa: Consequences on bone mineralization.]

Archives de Pediatrie — Wed, 30 Nov 2011 05:00:00 +0100

CONCLUSION: Bone loss in anorexia nervosa is a complication that may be present as early as adolescence. It must be systematically searched for in all adolescents with severe malnutrition because, even if BMD correlated with nutritional parameters, no clinical predictor for osteoporosis or osteopenia could be identified in this study. PMID: 22137016 [PubMed - as supplied by publisher] (Source: Archives de Pediatrie)

A Single-Nucleotide Polymorphism in the EAP1 Gene Is Associated with Amenorrhea/Oligomenorrhea in Nonhuman Primates.

Endocrinology — Tue, 29 Nov 2011 05:00:00 +0100

Authors: Lomniczi A, Garcia-Rudaz C, Ramakrishnan R, Wilmot B, Khouangsathiene S, Ferguson B, Dissen GA, Ojeda SR Abstract Current evidence suggests that the acquisition of female reproductive capacity and the maintenance of mature reproductive function are related processes transcriptionally regulated by gene networks operating within the neuroendocrine brain. One of these genes, termed enhanced at puberty 1 (EAP1), encodes an upstream regulator of these processes. Selective inhibition of EAP1 expression in discrete regions of the rat and nonhuman primate (NHP) hypothalamus, via targeted delivery of RNA interference, either disrupts (rats) or abolishes (monkeys) reproductive cycles. The striking loss of menstrual cyclicity resulting from knocking down hypothalamic EAP1 expression ...

A pituitary adenoma secreting follicle-stimulating hormone with ovarian hyperstimulation: treatment using a gonadotropin-releasing hormone antagonist

Fertility and Sterility — Fri, 25 Nov 2011 05:00:00 +0100

Conclusion(s): The GnRH antagonist was found to be effective for the short-term treatment of ovarian hyperstimulation secondary to a pituitary adenoma secreting FSH, thus representing a therapeutic option that should be taken into consideration in such cases. (Source: Fertility and Sterility)

Early prenatal sonographic diagnosis of gastroschisis

Journal of Clinical Ultrasound — Mon, 21 Nov 2011 05:00:00 +0100

We report a case of gastroschisis that was suspected at sonography at 11 weeks + 3 days of amenorrhea. Although early detection does not alter prenatal management of this condition nor does it affect neonatal outcome, it allows early counseling ofthe parents.©2011 Wiley Periodicals, Inc. J Clin Ultrasound, 2011 (Source: Journal of Clinical Ultrasound)

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Triphasic versus monophasic oral contraceptives for contraception.

Cochrane Database of Systematic Reviews — Sun, 20 Nov 2011 22:06:03 +0100

CONCLUSIONS: The available evidence is insufficient to determine whether triphasic OCs differ from monophasic OCs in effectiveness, bleeding patterns or discontinuation rates. Therefore, we recommend monophasic pills as a first choice for women starting OC use. Large, high-quality RCTs that compare triphasic and monophasic OCs with identical progestogens are needed to determine whether triphasic pills differ from monophasic OCs. Future studies should follow the recommendations of Belsey or Mishell on recording menstrual bleeding patterns and the CONSORT reporting guidelines. PMID: 22071807 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Limited contribution of NR5A1 (SF-1) mutations in women with primary ovarian insufficiency (POI)

Fertility and Sterility — Thu, 17 Nov 2011 05:00:00 +0100

Conclusion(s): The current study demonstrates that mutations in the NR5A1 gene are rare in women with POI. Primary ovarian insufficiency remains unexplained in the great majority of patients; therefore, continued efforts are needed to elucidate its underlying genetic factors. (Source: Fertility and Sterility)

Comprehensive management of severe Asherman syndrome and amenorrhea

Fertility and Sterility — Thu, 17 Nov 2011 05:00:00 +0100

Conclusion(s): Comprehensive management provides the best possible outcomes in poor-prognosis women with severe Asherman syndrome. (Source: Fertility and Sterility)

[Role of embolization in the management of uterine fibroids.]

Journal de Gynecologie, Obstetrique et Biologie de la Reproduction — Tue, 15 Nov 2011 05:00:00 +0100

Authors: Kahn V, Fohlen A, Pelage JP Abstract Uterine artery embolization using non spherical PVA particles or calibrated tris-acryl microspheres above 500μm is effective to treat menorrhagia, bulk-related symptoms and pelvic pain in more than 90% of cases in the short-term. In the long-term, embolization is effective in 75% of cases at 5-7 years. At 6 months, uterine volume reduction and dominant fibroid volume reduction varies between 30-60% and 50-80% respectively. During hospital stay, the complication rate is 3%. Secondary hysterectomy for complication is less than 2% at 3 months. Definitive amenorrhea is reported in less than 5% of cases in women of less than 45 years of age. No significant impact of embolization on hormonal function has been reported in women less than 45 y...

The expression of activins, their type II receptors and follistatin in human Fallopian tube during the menstrual cycle and in pseudo-pregnancy

Human Reproduction — Thu, 10 Nov 2011 05:00:00 +0100

CONCLUSIONS We suggest that activins play a role in tubal physiology and early embryonic development. Additionally, exposure of the tubal epithelium to hCG modulates the expression of tubal activins. (Source: Human Reproduction)

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Amenorrhea, Abdominal Pain, and Weight Gain

New England Journal of Medicine — Wed, 09 Nov 2011 22:00:25 +0100

New England Journal of Medicine, Volume 365, Issue 19, November 2011. (Source: New England Journal of Medicine)

Causes of primary amenorrhea: A report of 295 cases in Thailand

Journal of Obstetrics and Gynaecology Research — Wed, 09 Nov 2011 05:00:00 +0100

Conclusions: The present study has currently been the largest case series of primary amenorrhea. Müllerian agenesis is the most prevalent cause in our study, while gonadal dysgenesis is the most common cause in the largest‐scale study in the USA. Hence, racial, genetic and environmental factors could play roles in the cause of primary amenorrhea. (Source: Journal of Obstetrics and Gynaecology Research)

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

Indian Journal of Dermatology — Fri, 04 Nov 2011 04:00:00 +0100

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. (Source: Indian Journal of Dermatology)

Bilateral Inguinal Hernia Containing Rudimentary Uteri in a Woman with Primary Amenorrhea

The Journal of Minimally Invasive Gynecology — Thu, 27 Oct 2011 03:35:28 +0100

You can discuss this article with its authors and with other AAGL members at http://www.AAGL.org/jmig-19-1-1622 (Source: The Journal of Minimally Invasive Gynecology)

Spinal Cord Injury Induced Arrest in Estrous Cycle of Rats Is Ameliorated by S‐nitrosoglutathione: Novel Therapeutic Agent to Treat Amenorrhea

The Journal of Sexual Medicine — Mon, 24 Oct 2011 04:00:00 +0100

Conclusion. SCI‐induced amenorrhea is accompanied by an increase in CX43 expression and a decrease in ERβ expression. SCI animals treated with GSNO resumed the estrous cycle significantly earlier. These results indicate a potential therapeutic value for GSNO in treating amenorrhea among SCI patients. Shunmugavel A, Khan M, Chou PC, and Singh I. Spinal cord injury induced arrest in estrous cycle of rats is ameliorated by S‐nitrosoglutathione: Novel therapeutic agent to treat amenorrhea. J Sex Med **;**:**–**. (Source: The Journal of Sexual Medicine)

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Placental site trophoblastic tumor with lung metastases as cause of death in a young patient: A case report

Placenta — Mon, 24 Oct 2011 04:00:00 +0100

We present the case of a 21-year old woman at first pregnancy without known previous abortion at 25 weeks of amenorrhea who was admitted to the hospital for hyperemesis, hepatic problems and important weight loss registered during the last few months. Few days after the admission, the patient suddenly died before the doctors can reach a diagnosis. A forensic investigation for medical malpractice was initiated. Samples collected from uterus at the autopsy revealed large trophoblastic cells with eosinophilic cytoplasm. Deposition of fibrinoid material was noticed between trophoblastic cells. Tumor cells dissected through the myometrium and invaded into the vascular spaces. Specimens of the lungs revealed numerous small neoplastic emboli into the vessels. We show autopsy and histological find...

Management of hematocolpos in adolescents with transverse vaginal septum

Archives of Gynecology and Obstetrics — Fri, 21 Oct 2011 16:00:25 +0100

Conclusion Physicians should be aware of transverse vaginal septum in the differential diagnosis of hematocolpos with abdominal pain and primary amenorrhea in the early adolescent years. Early diagnosis could be based on premenarcheal gynecological examination and could lead to correct management in order to avoid the complications of endometriosis (dysmenorrhea or infertility). Content Type Journal ArticleCategory General GynecologyPages 1-5DOI 10.1007/s00404-011-2114-4Authors E. Deligeoroglou, Division of Pediatric-Adolescent Gynecology and Reconstructive Surgery (Referal Centre of Greece), 2nd Department of Obstetrics and Gynecology, “Aretaieion” Hospital, University of Athens, 76, Vas. Sofias Av., 11528 Athens, GreeceC. Iavazzo, Division of Pediatric-Adolesc...

When Can Our Patient with Anorexia Go to the Psychiatry Unit?

PediatricEducation.org — Mon, 17 Oct 2011 00:49:23 +0100

Discussion Patients with anorexia nervosa refuse to maintain their body weight at or above a minimally normal weight for age and height (basically less than 85% of expected). They have an intense fear of gaining weight or becoming fat, even though they are underweight. They also have a distorted view of their own body weight or shape and often deny the seriousness of being underweight. For women who are postmenarchal, amenorrhea often occurs. Anorexia nervosa can have numerous complications which can be reviewed in the To Learn More section below. Cardiovascular problems include vascular instability with orthostasis, bradycardia and poor perfusion. Conduction abnormalities and repolarization abnormalities are potentially life-threatening requiring aggressive management. Myocardial dysfunc...

Lipid accumulation product (LAP) is related to androgenicity and cardiovascular risk factors in postmenopausal women

Maturitas — Thu, 13 Oct 2011 04:00:00 +0100

Abstract: Objectives: To investigate whether lipid accumulation product (LAP) is related to androgen and sex hormone binding globulin (SHBG) levels and to cardiovascular risk factors in postmenopausal women with no evidence of established cardiovascular disease.Study design: Cross-sectional study.Main outcome measures: LAP (waist-58×triglycerides [nmol/L]), LAP≥arbitrary cutoff point of 34.5, serum testosterone, SHBG, ultrasensitive C-reactive protein (us-CRP).Results: Forty-nine women (mean age 55±5years; median amenorrhea time 5.5years [3–8]) were studied: 14% had the metabolic syndrome and 24.5% were hypertensive. Compared with LAP (Source: Maturitas)

Resumption of Ovarian Function and Pregnancies in 358 Patients with Premature Ovarian Failure.

The Journal of Clinical Endocrinology and Metabolism — Wed, 12 Oct 2011 04:00:00 +0100

Conclusion:Intermittent ovarian activity in patients with POF is not a rare phenomenon. The predictive score described in this study may help us to identify POF patients most likely to recover intermittent ovarian function. PMID: 21994953 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

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An adolescent patient with prolactinoma treated with cabergoline

Revista Paulista de Pediatria — Sun, 09 Oct 2011 17:48:24 +0100

OBJETIVO: Relatar um caso de macroprolactinoma diagnosticado em adolescente e tratado com cabergolina. DESCRIÇÃO DO CASO: Paciente do sexo feminino, 15 anos, iniciou quadro clínico aos dez anos, com cefaleia, obesidade e não havia apresentado menarca ao diagnóstico. A dosagem sérica inicial de prolactina foi de 2492ng/mL (valor de referência: 19-25ng/mL). A ressonância nuclear magnética de crânio evidenciou formação expansiva selar e suprasselar compatível com macroadenoma hipofisário sem compressão do quiasma óptico. Seis meses após o início do tratamento com cabergolina, houve queda significativa dos níveis séricos de prolactina para 87,7ng/mL, com redução de 76% no tamanho da lesão e melhora sintomática. COMENTÁRIOS: A ocorrência dos prolactinomas é rara na in...

Turner Syndrome: Contemporary Thoughts and Reproductive Issues

Seminars in Reproductive Medicine — Mon, 03 Oct 2011 04:00:00 +0100

Semin Reprod Med 2011; 29: 342-352DOI: 10.1055/s-0031-1280919ABSTRACTTurner syndrome is a common genetic disorder that has been classically associated with a 45,X karyotype. Several X-chromosomal abnormalities have been identified in these patients, many of which involve mosaicism. These patients have variable but predictable phenotypic findings and are at risk for development of endocrine, autoimmune, and structural abnormalities. As many as 1.5% of the population with Turner syndrome may develop dissection and rupture of the ascending aorta; the presence of abnormalities of the cardiac tree and hypertension increase this risk, but their absence does not preclude it. Rupture has occurred at aortic diameters smaller than previously reported for other patient populations. Five percent or mo...

Preadipocyte Factor-1 Levels Are Higher in Women with Hypothalamic Amenorrhea and Are Associated with Bone Mineral Content and Bone Mineral Density through a Mechanism Independent of Leptin.

The Journal of Clinical Endocrinology and Metabolism — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions: Pref-1 is higher in HA subjects than controls. Metreleptin administration at low physiological, supraphysiological, and pharmacological doses does not affect pref-1 levels, suggesting that hypoleptinemia is not responsible for higher pref-1 levels and that leptin does not regulate pref-1. PMID: 21795455 [PubMed - in process] (Source: The Journal of Clinical Endocrinology and Metabolism)

Cardiovascular Consequences of Ovarian Disruption: A Focus on Functional Hypothalamic Amenorrhea in Physically Active Women.

The Journal of Clinical Endocrinology and Metabolism — Wed, 28 Sep 2011 04:00:00 +0100

Conclusion:With the premenopausal years typically considered to be cardioprotective in association with normal ovarian function, ovarian disruption in women with EAA is of importance. Further investigation of the short-term, and potentially long-term, cardiovascular consequences of hypoestrogenemia in women with EAA is recommended. PMID: 21956422 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

Number of CGG repeats in the FMR1 gene of Japanese patients with primary ovarian insufficiency

Fertility and Sterility — Mon, 26 Sep 2011 04:00:00 +0100

Conclusion(s): More than 36 CGG repeats in the FMR1 might intensify the etiology of POI, at least up to the premutation range. (Source: Fertility and Sterility)

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Amenorrhea in Eating Disorders: poor stability of symptom after a one-year treatment.

Eating and weight disorders : EWD — Mon, 26 Sep 2011 04:00:00 +0100

Conclusion: Resumption of menses was not associated with a less severe eating symptomatology at the beginning of treatment nor with unequivocal psychopathological changes after treatment. It is important that clinicians consider not only the presence or absence of regular menses but also that they improve the ED screening and assessment in amenorrheic patients. Amenorrhea does not seem to represent a specific predictor of severity of illness or to have prognostic value. PMID: 22024566 [PubMed - as supplied by publisher] (Source: Eating and weight disorders : EWD)

Long-term results of International Breast Cancer Study Group Trial VIII: adjuvant chemotherapy plus goserelin compared with either therapy alone for premenopausal patients with node-negative breast cancer

Annals of Oncology — Fri, 23 Sep 2011 04:00:00 +0100

Conclusions: For pre/perimenopausal women with lymph-node-negative ER-positive breast cancer, CMF followed by goserelin improved DFS in comparison with either modality alone. The improvement was the most pronounced in those aged below 40, suggesting an endocrine effect of prolonged CMF-induced amenorrhea. (Source: Annals of Oncology)

Leptin in human physiology and pathophysiology

AJP: Endocrinology and Metabolism — Fri, 23 Sep 2011 04:00:00 +0100

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 lipoatro...

Hyperprolactinemia and Infertility

Endocrinology and Metabolism Clinics of North America — Fri, 23 Sep 2011 04:00:00 +0100

Prolactin-secreting pituitary tumors are a common cause of amenorrhea and infertility in premenopausal women. The goals of therapy are to normalize prolactin, restore gonadal function and fertility, and reduce tumor size, and dopamine agonists are the preferred therapy. Clinically significant tumor enlargement during pregnancy is uncommon and dependent on tumor size and prepregnancy treatment. (Source: Endocrinology and Metabolism Clinics of North America)

Dysgerminoma in a case of 46,XY Pure Gonadal Dysgenesis (Swyer syndrome): A Case Report

Diagnostic Pathology — Mon, 19 Sep 2011 04:00:00 +0100

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 Mullerian 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. (Source: Diagnostic Pathology)

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Body Composition Variables and Leptin Levels in Functional Hypothalamic Amenorrhea and Amenorrhea Related to Eating Disorders

Journal of Pediatric and Adolescent Gynecology — Mon, 12 Sep 2011 04:00:00 +0100

Abstract: The purpose of the study was to identify diagnostic criteria that can distinguish between subjects with functional hypothalamic amenorrhea largely related to minimal energy deficiency and those in whom failure of adaptive response to stress prevails. We studied 59 young women with secondary amenorrhea related to modest eating disorders and 58 who complained of stressful events in their history. We assessed anthropometric measurements, body composition using dual energy X-ray absorptiometry (DEXA) and bioelectrical impedance analysis (BIA), and basal endocrine profile. Subjects with disordered eating had lower body mass index (BMI), fat mass (FM) measured with both techniques, lumbar mineral density and direct and indirect measures of lean mass. Leptin and free tri-iodothyronine(F...

Hypothalamus Syndrome in Opticospinal Multiple Sclerosis [CASE REPORTS]

American Journal of Neuroradiology — Fri, 09 Sep 2011 04:00:00 +0100

This study describes a case of a patient with OSMS who presented with somnolence, periodic fever, memory impairment, and amenorrhea. Serum prolactin levels were found to be higher than normal. MR imaging showed a bilateral involvement of the hypothalamus. The clinical presentation, laboratory examination, and MR imaging findings suggested a diagnosis of hypothalamus syndrome in this patient. (Source: American Journal of Neuroradiology)

Reproductive capacity in iron overloaded women with thalassemia major

Blood — Thu, 08 Sep 2011 04:00:00 +0100

The pathophysiology of iron-induced compromised fertility in women with thalassemia major (TM) was evaluated in 26 adult TM females. Low gonadotropin secretion resulted in reduced ovarian antral follicle count and ovarian volume, but levels of anti-müllerian hormone (AMH), a sensitive marker for ovarian reserve independent of gonadotropin effect, were mostly normal. AMH correlated with non–transferrin-bound iron (NTBI), suggesting a role of labile iron in the pathogenesis of decreased reproductive capacity, possibly occurring in parallel to cardiac iron toxicity, as cardiac iron was associated with the presence of amenorrhea and with NTBI levels. AMH emerges as an important biomarker for assessment of reproductive capacity in TM, demonstrating that fertility is preserved in the ...

Comparison of high and low dose of cyclophosphamide in lupus nephritis patients: A long-term randomized controlled trial.

Saudi Journal of Kidney Diseases and Transplantation — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Mitwalli AH, Al Wakeel JS, Hurraib S, Aisha A, Al Suwaida A, Alam A, Hammad D, Sulimani F, Memon NA, Askar A, Al Tuwaijri A, Qudsi A Abstract To evaluate the outcome of low doses of cyclophosphamide (Cyclo) therapy in lupus nephritis (LN) patients, we studied 117 biopsy-proven, de novo LN WHO class IV patients double-blinded and randomized in December 1997 to receive Cyclo in different doses; Group I (n=73) received Cyclo 10 mg/kg monthly for six months then every two months for 12 months. Group II (n=44) received Cyclo 5 mg/kg monthly for six months then every two months for 36 months. The patients were followed-up till January 2007. Six months post-induction values for creatinine clearance were significantly higher in Group I (67.7 ± 28.6 mL/min) compared with Group II ...

Adjuvant hormonal therapy in perimenopausal patients.

Advances in Therapy — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Pinto Marín A, Ballesteros García AI, Izarzugaza Perón Y, Mansó Sánchez L, López-Tarruella Cobo S, Zamora Auñón P Abstract This section considers the treatment options for perimenopausal women with breast cancer. The perimenopause period begins in the so-called stage 2 of menopausal transition (early menopausal transition, where the length of the cycles changes by 7 days or more) and ends after 12 months of amenorrhea. It is characterized by an early increase in follicle-stimulating hormone and is associated with the presence of anovulatory cycles, irregular periods, and loss of menstrual cycles. The recommended treatment is tamoxifen (TAM) with or without ovarian ablation for 2 or 3 years followed by a re-evaluation. TAM should be maintained if the patient is prem...

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Bone and the Perimenopause

Obstetrics and Gynecology Clinics — Thu, 01 Sep 2011 04:00:00 +0100

The loss of ovarian function during the menopausal transition has a profound impact on female skeletal health. Currently, it is estimated that 1 in every 2 Caucasian women will experience an osteoporotic fracture during her lifetime, contributing to considerable morbidity and an enormous economic burden within the aging female population. However, most studies have been conducted in postmenopausal women, with fewer investigations focusing specifically on perimenopausal bone health. The Study of Women's Health Across the Nation (SWAN) is the largest prospective cohort to date where changes in bone mineral density (BMD) and bone turnover have been examined in relation to ovarian aging among women followed across the menopausal transition. As defined by bleeding pattern in SWAN, early perimen...

Menstruation and the Menopausal Transition

Obstetrics and Gynecology Clinics — Thu, 01 Sep 2011 04:00:00 +0100

In broad strokes, the nature of change in menstrual bleeding patterns as women approach and transition through the menopause were well defined more than 40 years ago by the classic menstrual calendar studies of Treloar and colleagues, Vollman, and others. Our current attribution of menopause, defined retrospectively after 12 months of amenorrhea have been observed and derived from the groundbreaking paper on the probability of natural menopause after age 40, is based on the Treloar data (now referred to as TREMIN). However, these early studies told us little about subpopulation differences in the menopausal experience, nor did they provide clear insights into the specific bleeding changes that mark the onset of the transition. Over the past 15 years, a more nuanced understanding of the ran...

Forearm bone mineral density changes during postpartum and the effects of breastfeeding, amenorrhea, body mass index and contraceptive use

Osteoporosis International — Wed, 31 Aug 2011 15:54:01 +0100

Conclusions There was a trend in bone loss during the first 6 months postpartum with posterior recovery. Also, hormonal contraceptive methods provided protection of bone loss. However, the long duration of breastfeeding and the follow-up were not sufficient to draw definitive conclusions on postweaning BMD conditions. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00198-011-1767-yAuthors M. L. Costa, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, BrazilF. G. Krupa, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, BrazilP. M. Rehder, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, C...

Effect of Lifestyle Intervention on Features of Polycystic Ovarian Syndrome, Metabolic Syndrome, and Intima-Media Thickness in Obese Adolescent Girls.

The Journal of Clinical Endocrinology and Metabolism — Tue, 30 Aug 2011 23:00:00 +0100

Conclusions:Weight loss due to lifestyle intervention is effective to treat menses irregularities, normalize androgens, and improve CRF and IMT in obese adolescent girls with PCOS. PMID: 21880803 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

Female Adolescent Athletes’ Awareness of the Connection between Menstrual Status and Bone Health

Journal of Pediatric and Adolescent Gynecology — Mon, 29 Aug 2011 19:35:17 +0100

Conclusions: The prevalence of irregular menses is high among adolescent track athletes and a larger-scale inquiry to clarify adolescent athletes’ knowledge of and attitudes about the link between menstrual patterns and BMD is indicated. Education may provide one key to improved health behavior among this at-risk population. (Source: Journal of Pediatric and Adolescent Gynecology)

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

Clinical and Developmental Immunology — Sun, 28 Aug 2011 13:09:05 +0100

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. (Source: Clinical and Developmental Immunology)

The Impact Of Chemotherapy On Female Fertility

Health News from Medical News Today — Sun, 28 Aug 2011 07:00:00 +0100

Current estimates of the impact of chemotherapy on women's reproductive health are too low, according to a University of California, San Francisco (UCSF) study. The researchers say their analysis of the age-specific, long-term effects of chemotherapy provides new insights that will help patients and clinicians make more informed decisions about future reproductive options, such as egg harvesting. Previous studies largely have focused on amenorrhea, or the lack of menstruation shortly after treatment, as the primary reproductive side effect of chemotherapy... (Source: Health News from Medical News Today)

Uterine Preservation and Vaginal Reconstruction in a Patient with Congenital Vaginal Agenesis Presenting With Cyclic Menouria

The Journal of Minimally Invasive Gynecology — Sat, 27 Aug 2011 19:31:02 +0100

Abstract: Herein we report the case of a patient with primary amenorrhea and cyclic menouria. The patient was a 20-year-old woman with primary amenorrhea and inability to achieve sexual intercourse. Clinical examination revealed normally developed labia majora and minora, clitoris, and external urethral orifice, but no vaginal opening. A mature female pubic hair pattern was present, and axillary hair development was normal. Breasts were normally developed. Abdominopelvic magnetic resonance imaging demonstrated a remnant upper vagina and unicornuate uterus filled with fluid, and left-sided renal agenesis. Intraoperatively, a congenital vesicouterine fistulous tract was observed. The fistulous tract was completely resected. Vaginal reconstruction using a sigmoid colon pedicled flap was perfo...

Reply of the Authors

Fertility and Sterility — Mon, 22 Aug 2011 04:00:00 +0100

We would like to thank Balkenede et al. for their interest in our article. We are aware of the potential methodologic weakness of the included trials, especially the trial published by Badawy et al. that favored intervention. In the Badawy et al. trial, at the end of the observation period, almost 44% more patients were ovulating in the GnRH agonist group than control subjects. We mentioned clearly in our discussion that this study generated a great deal of controversy . We mentioned in our discussion that the reported amenorrhea rates were twice as high as other groups with even more gonadotoxic chemotherapy and older study populations . Even so, because this was a systematic review of the evidence, rather than a narrative review, we were obliged to include all trials that fulfilled th...

First assessment of menstrual cycle function and reproductive endocrine status in Samoan women

Human Reproduction — Tue, 16 Aug 2011 23:00:00 +0100

CONCLUSIONS Self-reported OM/AM was associated with an elevated BMI, abdominal adiposity and serum insulin, and with reduced adiponectin levels. These findings support a high rate of metabolic syndrome, and perhaps PCOS and reproductive dysfunction, among Samoan women. (Source: Human Reproduction)

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What do Ovaries have to do with Sleeping?

The Journal of Pediatrics — Tue, 16 Aug 2011 04:00:00 +0100

Polycystic ovarian syndrome (PCOS), a disorder of androgen excess, affects 5% to 10% of women of reproductive age. The onset of symptoms, which include oligo or amenorrhea or irregular menstrual cycles, hirsutism, and acne, often first present in adolescence. Although unnecessary for diagnosis, the prevalence of obesity in patients affected by PCOS is quite high, affecting up to 75% of individuals. The presence of obesity may exacerbate the PCOS phenotype in individuals previously with no symptoms and amplify the severity of PCOS in individuals known to be affected. This may, in part, be caused by increased abdominal adiposity with concurrent increases in visceral fat and heightened insulin resistance. However, at least to some degree, insulin resistance in PCOS is independent of body weig...

Full length visfatin levels are associated with inflammation in PCOS patients

European Journal of Clinical Investigation — Sun, 07 Aug 2011 23:00:00 +0100

Conclusion: Our results suggest that circulating visfatin levels correlate with WBC and CRP but are not associated with PCOS, obesity or metabolic markers, suggesting that visfatin may act as a proinflammatory cytokine. (Source: European Journal of Clinical Investigation)

Different effects on bone strength and cell differentiation in pre pubertal caloric restriction versus hypothalamic suppression

Bone — Sun, 07 Aug 2011 23:00:00 +0100

Abstract: Hypothalamic amenorrhea and energy restriction during puberty affect peak bone mass accrual. One hypothesis suggests energy restriction alters hypothalamic function resulting in suppressed estradiol levels leading to bone loss. However, both positive and negative results have been reported regarding energy restriction and bone strength. Therefore, the purpose of this study was to investigate energy restriction and hypothalamic suppression during pubertal onset on bone mechanical strength and the osteogenic capacity of bone marrow-derived cells in two models: female rats treated with gonadotropin releasing hormone antagonists (GnRH-a) or 30% energy restriction. At 23days of age, female Sprague Dawley rats were assigned to three groups: control group (C, n=10), GnRH-a group (n=10),...

An unusual association of neuroendocrine tumors in MEN 1A

Pituitary — Thu, 04 Aug 2011 15:33:08 +0100

This report represents an unusual case of MEN 1A with association of insulinomas, gastrinomas glucagonomas and somatostatinomas in the same patient. Content Type Journal ArticlePages 1-5DOI 10.1007/s11102-011-0334-zAuthors Mariela Varsavsky, Bone Metabolic Unit, Endocrinology Department, Hospital Universitario San Cecilio, Av. Dr. Oloriz 16, 18012 Granada, SpainRebeca Reyes-García, Bone Metabolic Unit, Endocrinology Department, Hospital Universitario San Cecilio, Av. Dr. Oloriz 16, 18012 Granada, SpainGuillermo Alonso García, Bone Metabolic Unit, Endocrinology Department, Hospital Universitario San Cecilio, Av. Dr. Oloriz 16, 18012 Granada, SpainManuel Muñoz-Torres, Bone Metabolic Unit, Endocrinology Department, Hospital Universitario San Cecilio, Av. Dr. Oloriz 16, 18012 Granad...

Endocrine and Metabolic Characteristics of Polycystic Ovary Syndrome in Chinese Women with Different Phenotypes

Clinical Endocrinology — Wed, 03 Aug 2011 23:00:00 +0100

Conclusions: The amenorrhea group had severe endocrine and metabolic abnormalities, which appeared to be related to latent long‐term complications and higher morbidity. The degree of dysbolism was positively associated with the change in BMI. (Source: Clinical Endocrinology)

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Serum Anti-Müllerian hormone (AMH) levels are differentially modulated by both serum gonadotropins and not only by serum Follicle Stimulating Hormone (FSH) levels

Medical Hypotheses — Tue, 02 Aug 2011 04:00:00 +0100

Abstract: It is generally accepted that serum AMH levels are thought to reflect the size of the ovarian follicle pool. Therefore, an inverse correlation between serum AMH and Follicle Stimulating Hormone (FSH) levels has been noted in older women with abnormal or exhausted follicular development, such as menopause, leading to the use of serum AMH as a marker of ovarian reserve. In clinical practice the use of serum AMH for the assessment of ovarian reserve has been expanding to women irrespective of age, such as women in early menopause or women undergoing ovarian stimulation for in vitro fertilization (IVF).To our knowledge, this opinion article aims to show that serum AMH levels are differentially modulated by both serum gonadotropins, depending on the degree of ovarian reserve. For inst...

Successful tubal blastocyst transfer after laparoscopic cervical cerclage: cesarean delivery of a live very low-birth-weight infant and later hysterectomy for uterine rupture

Fertility and Sterility — Mon, 01 Aug 2011 04:00:00 +0100

Conclusion(s): This first report of a blastocyst intrafallopian transfer was associated with an intrauterine pregnancy; however, when the indication for blastocyst tubal transfer of an obstructed cervix is associated with a foreshortened cervix requiring cervical cerclage, there can be major health risks for infant and mother. (Source: Fertility and Sterility)

The association of a high drive for thinness with energy deficiency and severe menstrual disturbances: confirmation in a large population of exercising women.

International Journal of Sport Nutrition and Exercise Metabolism — Sun, 31 Jul 2011 23:00:00 +0100

Authors: Gibbs JC, Williams NI, Scheid JL, Toombs RJ, De Souza MJ A high drive-for-thinness (DT) score obtained from the Eating Disorder Inventory-2 is associated with surrogate markers of energy deficiency in exercising women. The purposes of this study were to confirm the association between DT and energy deficiency in a larger population of exercising women that was previously published and to compare the distribution of menstrual status in exercising women when categorized as high vs. normal DT. A high DT was defined as a score ≥7, corresponding to the 75th percentile for college-age women. Exercising women age 22.9 ± 4.3 yr with a BMI of 21.2 ± 2.2 kg/m2 were retrospectively grouped as high DT (n = 27) or normal DT (n = 90) to compare psychometric, energetic, and reproductive ...

Misdiagnosed cervical pregnancy following a pregnancy with cotyledonoid leiomyoma

European Journal of Obstetrics, Gynecology, and Reproductive Biology — Fri, 29 Jul 2011 04:00:00 +0100

We would like to report a case of cervical missed abortion, a G5P4 presented with history of 11 weeks amenorrhea and on and off mild vaginal bleeding for a week. She had three spontaneous vaginal deliveries followed by a cesarean section in her last pregnancy which was complicated by cotyledonoid leiomyoma removal at 5th month.. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)

Leptin in human physiology and pathophysiology.

American Journal of Physiology. Endocrinology and Metabolism — Mon, 25 Jul 2011 23:00:00 +0100

Authors: Mantzoros CS, Magkos F, Brinkoetter M, Sienkiewicz E, Dardeno TA, Kim SY, Hamnvik OP 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 congen...

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Thermal balloon ablation versus laparoscopic supracervical hysterectomy for the surgical treatment of heavy menstrual bleeding: A randomized study

Journal of Obstetrics and Gynaecology Research — Sun, 24 Jul 2011 23:00:00 +0100

Conclusion: The effectiveness of TBA as a possible treatment of HMB is confirmed. However, LSH showed a definitive improvement of the symptoms, and a better life quality profile. Further controlled prospective studies are required for identifying the best surgical approach in women with HMB. (Source: Journal of Obstetrics and Gynaecology Research)

Successful pregnancy in a Swyer syndrome patient with preexisting hypertension

Fertility and Sterility — Thu, 21 Jul 2011 22:47:29 +0100

Conclusion(s): A woman with Swyer syndrome, hypoplastic uterus, and chronic hypertension delivered a healthy newborn. (Source: Fertility and Sterility)

Mayer-Rokitansky-Kuster-Hauser syndrome: a case report and literature review

Radiologia Brasileira — Sun, 17 Jul 2011 14:03:09 +0100

Os autores descrevem o caso de uma paciente jovem com amenorreia primária e caracteres sexuais secundários normais. A investigação diagnóstica constatou a ocorrência da síndrome de Mayer-Rokitansky-Kuster-Hauser.The authors describe the case of a young female patient with primary amenorrhea and normal secondary sexual characteristics. The diagnostic investigation demonstrated the occurrence of Mayer-Rokitansky-Kuster-Hauser's syndrome. (Source: Radiologia Brasileira)

Health-related quality of life changes among users of depot medroxyprogesterone acetate for contraception

Contraception — Fri, 15 Jul 2011 04:00:00 +0100

Conclusion: Besides its contraceptive efficacy, DMPA is associated with an improvement in perceived physical health with no apparent adverse effect on mental health and sexual function. (Source: Contraception)

Uterine artery embolization for symptomatic fibroids: long-term changes in disease-specific symptoms and quality of life

Human Reproduction — Thu, 14 Jul 2011 23:00:00 +0100

CONCLUSIONS UAE leads to durable relief of fibroid-related symptoms and sustained improvement in HRQOL. After 6 years, clinical failure can be expected in 17%, and most of these patients require secondary invasive treatment. (Source: Human Reproduction)

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Idiopathic primary ovarian insufficiency: a study of serial hormonal profiles to assess ovarian follicular activity

Human Reproduction — Thu, 14 Jul 2011 23:00:00 +0100

CONCLUSION Endogenous ovarian follicular function is intermittently present in only 11.1% of Asian Indian women with POI. However, the 95% CI (1.4–34.7%) was large due to a small sample size. (Source: Human Reproduction)

Bilateral Gonadal Cysts and Late Diagnosis of Androgen Insensitivity Syndrome Treated by Laparoscopic Gonadectomy

Anesthesiology Research and Practice — Wed, 13 Jul 2011 14:30:56 +0100

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. (Source: Anesthesiology Research and Practice)

The prevalence of polycystic ovary syndrome in Iranian women based on different diagnostic criteria.

Endokrynologia Polska — Tue, 12 Jul 2011 13:00:02 +0100

Conclusion: The Rotterdam prevalence estimates were double those obtained with the NIH criteria. This study can be used for international comparisons because it was conducted on a representative sample of females using different criteria for the definition of PCOS. (Pol J Endocrinol 2011; 62 (3): 238-242). PMID: 21717406 [PubMed - in process] (Source: Endokrynologia Polska)

Efficacy and safety of global endometrial ablation after cesarean delivery: a cohort study

American Journal of Obstetrics and Gynecology — Mon, 11 Jul 2011 04:00:00 +0100

Conclusion: The efficacy and safety of endometrial ablation are comparable in women with or without a history of cesarean delivery. (Source: American Journal of Obstetrics and Gynecology)

Leptin and the skeleton—where is the fat?

Metabolism - Clinical and Experimental — Sun, 10 Jul 2011 23:00:00 +0100

Despite years of active research, there is still debate over the skeletal effects of leptin. Leptin is a hormone well known for its importance in the regulation of food intake and energy expenditure, as well as neuroendocrine function and both glucose and fat metabolism. However, its effects on bone turnover and bone density are still under investigation. Two articles in this month's edition of Metabolism afford insight into the effects of leptin replacement therapy in two unique clinical models: hypothalamic amenorrhea (a state of leptin deficiency) and obesity (a state of leptin tolerance or resistance) . In these studies, the efficacy of leptin replacement appeared to vary depending on the body composition and accompanying hormonal profile of the individuals studied. The differing effec...

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Long-term metreleptin treatment increases bone mineral density and content at the lumbar spine of lean hypoleptinemic women

Metabolism - Clinical and Experimental — Thu, 07 Jul 2011 23:00:00 +0100

Abstract: Strenuously exercising young women with hypothalamic amenorrhea are hypoleptinemic and have low bone mineral density (BMD) and content (BMC), which predispose them to increased fracture risk. Short-term leptin replacement in these women corrects many neuroendocrine abnormalities and increases circulating levels of bone formation markers. Whether treatment with recombinant methionyl human leptin (metreleptin) for a long period improves BMD and BMC remains unknown. We studied 20 strenuously exercising young women with hypoleptinemia (leptin concentration (Source: Metabolism - Clinical and Experimental)

Increased Difficulties and Complications Encountered During Hysteroscopy in Women with Genital Tuberculosis

The Journal of Minimally Invasive Gynecology — Tue, 05 Jul 2011 23:00:00 +0100

Conclusion: Hysteroscopy in women with genital TB is associated with difficulty in performing the procedure and with higher rates of complications. (Source: The Journal of Minimally Invasive Gynecology)

Successful canalization of a noncommunicating uterine horn by horn-vaginal anastomosis: preliminary findings of a novel approach for an unclassified anomaly

Journal of Pediatric Surgery — Thu, 30 Jun 2011 23:00:00 +0100

Conclusions: Communication between a well-developed noncommunicating uterine horn and vagina was accomplished with successful establishment of the menstrual outflow tract. Regular menstrual pattern was successfully reestablished for 15 consecutive menstrual periods. (Source: Journal of Pediatric Surgery)

The reproductive and metabolic effect of rosiglitazone on Chinese women with polycystic ovarian syndrome—a double-blind randomized placebo-controlled study

Fertility and Sterility — Thu, 30 Jun 2011 23:00:00 +0100

Conclusion(s): We found a possible benefit in menstrual cyclicity but a lack of improvement in hyperandrogenism in our Chinese population.Clinical Trial Registration Number: ChiCTR-TRC-09000670 (Chinese Clinical Trial Registry). (Source: Fertility and Sterility)

Diagnosis of a variant of Mayer–Rokitansky–Kuster–Hauser syndrome: useful MRI findings

Abdominal Imaging — Wed, 29 Jun 2011 10:52:42 +0100

Abstract Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome consists of vaginal aplasia associated with other müllerian duct abnormalities. Its penetrance varies, as does the involvement of other organ systems. Type I MRKU syndrome is characterized by an isolated absence of the proximal two thirds of the vagina, whereas type II is marked by other malformations which include vertebral, cardiac, urologic (upper tract), and otologic anomalies. In both types, the extent of vaginal aplasia varies, ranging from virtually absent to a length much more inferior than the normal one (2–5 cm). MRKU syndrome usually remains undetected until the patient presents with primary amenorrhea despite normal female sexual development. It is important to underline the fact that this sy...

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MRKH syndrome with endometriosis: case report and literature review

European Journal of Obstetrics, Gynecology, and Reproductive Biology — Mon, 27 Jun 2011 04:00:00 +0100

We would like to report a case of endometriosis in a patient with complete uterine agenesis. A 23-year-old girl was admitted to hospital with primary amenorrhea post puberty. On pelvic examination, the uterus could not be touched clearly. Trans-abdominal ultrasound showed a 2.3cm×1.9cm×1.0cm hypoechoic nodules (single uterine bud) with no functional endometrium line resonance, no vaginal gas line resonance was found and the ovaries were in normal size. She was diagnosed with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome by clinical symptoms, followed up with endorectal exploration and abdominal ultrasound. Pelvic MRI was not routinely used in China for the diagnosis of MRKH at that time. During trans-abdominal sigmoid transplantation for vaginal reconstruction, a purple and brown nodule...

Athletic Amenorrhea (Chad T Carlson MD)

Family Medicine Digital Resources Library (FMDRL) Recently Uploaded — Fri, 24 Jun 2011 23:00:00 +0100

Grand rounds talk on athletic amenorrhea (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Long-term safety profile of mitoxantrone in a French cohort of 802 multiple sclerosis patients: a 5-year prospective study

Multiple Sclerosis — Sun, 19 Jun 2011 23:00:00 +0100

Conclusion: This large cohort with at least 5 years of follow-up provided good insights into the long-term safety profile of MITOX in MS. (Source: Multiple Sclerosis)

Field evaluation of the intermittent preventive treatment of malaria during pregnancy (IPTp) in Benin: evolution of the coverage rate since its implementation

Parasites and Vectors — Wed, 15 Jun 2011 23:00:00 +0100

Conclusions: In total, application of IPT-SP 2-doses has rapidly evolved since 2005, but the objective of 80% IPT coverage has not yet been achieved throughout the country. Moreover, problems of drug shortage recurring in the field (reported by health staff) remain to be resolved. (Source: Parasites and Vectors)

Female Sexual Dysfunction in Iranian Postmenopausal Women: Prevalence and Correlation with Hormonal Profile

The Journal of Sexual Medicine — Tue, 14 Jun 2011 23:00:00 +0100

Conclusion. In Iranian postmenopausal women, Desire and Arousal are the most prevalent menopausal sexual dysfunctions, and Female Sexual Dysfunction is much more than just a hormonal problem. Moghassemi S, Ziaei S, and Haidari Z. Female sexual dysfunction in Iranian postmenopausal women: Prevalence and correlation with hormonal profile. J Sex Med **;**:**–**. (Source: The Journal of Sexual Medicine)

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What Are Indications for Pelvic Examinations in Adolescents?

PediatricEducation.org — Mon, 13 Jun 2011 00:27:11 +0100

Discussion In 2010, the American College of Obstetricians and Gynecologists changed the recommendations for Papanicolaou (Pap) testing. The first Pap test is at 21 years of age regardless of the onset of sexual activity unless the patient has HIV or is immune suppressed and patients are then followed yearly after initiation of sexual activity. The reasons for this change are that although about 50% of high school students are sexually active, and about 50% of young women will have a positive test for human papilloma virus (HPV) within 36 months of initiating sexual activity, over 90% of the HPV infections will resolve within 24 months in patients with intact immune systems. HPV is the most common STI worldwide. Adolescent patients who have previously been screened and have cervical atypia...

Advances in Management of the Female Athlete Triad and Eating Disorders

Clinics in Sports Medicine — Fri, 10 Jun 2011 23:03:46 +0100

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. (Source: Clinics in Sports Medicine)

Association between low-dose pulsed intravenous cyclophosphamide therapy and amenorrhea in patients with systemic lupus erythematosus: A case-control study

BMC Women's Health - Latest articles — Thu, 09 Jun 2011 23:00:00 +0100

Background: The risk for amenorrhea following treatment of systemic lupus erythematosus (SLE) patients with low-dose intravenous cyclophosphamide (IVCY) has not been fully explored. Our objective was to ascertain the incidence of amenorrhea following treatment with low-dose IVCY and the association between amenorrhea and the clinical parameters of SLE. Methods: A case-control retrospective study of premenopausal women [less than or equal to]45 years old who had been treated for SLE with low-dose IVCY (500 mg/body/pulse) plus high-dose glucocorticoids (0.8-1.0 mg/kg/day of prednisolone; IVCY group) or glucocorticoids alone (0.8-1.0 mg/kg/day of prednisolone; steroid group) in our hospital from 2000 through 2009 was conducted using a questionnaire survey and medical record review. Results: T...

Effect of Luteinizing Hormone-Releasing Hormone Agonist on Ovarian Function After Modern Adjuvant Breast Cancer Chemotherapy: The GBG 37 ZORO Study [Breast Cancer]

Journal of Clinical Oncology — Tue, 07 Jun 2011 23:00:00 +0100

Conclusion Premenopausal patients with breast cancer receiving goserelin simultaneously with modern neoadjuvant chemotherapy did not experience statistically significantly less amenorrhea 6 months after end of chemotherapy compared with those receiving chemotherapy alone. (Source: Journal of Clinical Oncology)

Cesarean scar pregnancy: A rare cause of uterine arteriovenous malformation

Journal of Clinical Ultrasound — Sun, 05 Jun 2011 23:00:00 +0100

AbstractA 38‐year‐old gravida 4, para 2 woman with a history of two Cesarean sections and one curettage was referred to our hospital, because of painless vaginal bleeding and 6 weeks + 2 days of amenorrhea. The first diagnosis was Cesarean scar pregnancy, managed with methotrexate. Subsequently, an arteriovenous malformation developed, which was diagnosed with color Doppler imaging. The diagnosis was confirmed with angiography. Successful bilateral uterine artery embolization was performed with ethylene vinyl alcohol copolymer (Onyx), n‐butyl‐2‐cyanoacrylate (Histoacryl), and gelfoam. © 2011 Wiley Periodicals, Inc. J Clin Ultrasound, 2011 (Source: Journal of Clinical Ultrasound)

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A woman with premature ovarian failure induced by Tripterygium wilfordii Hook.f. gives birth to a healthy child

Fertility and Sterility — Wed, 01 Jun 2011 23:00:00 +0100

Conclusion(s): This is a real-life manifestation of reproductive damage of TW. The medicamentous amenorrhea, hormone levels and AFC decline induced by TW are reversible, but oocyte and granulosa cell damage may be irreversible. This will help clinicians to avoid using TW for nulligravida. (Source: Fertility and Sterility)

24. The incidence of polycystic ovary syndrome in women with epilepsy treated with valproate versus lamotrigine

Clinical Neurophysiology — Wed, 01 Jun 2011 02:39:39 +0100

Purpose: To evaluate the incidence of polycystic ovary syndrome (PCOS) in women with epilepsy (WWE) on valproate or lamotrigine monotherapy. Method: The prospective study included 60 WWE aged 18–40years. Patients were treated with valproate or lamotrigine. Patients were followed-up for 6months. PCOS was defined as hyperandrogenism combined with oligomenorrhea (cycle length>35days) or amenorrhea. All patients were given a clinical examinations and pelvic ultrasonography. (Source: Clinical Neurophysiology)

A combination of transcriptome and methylation analyses reveals embryologically-relevant candidate genes in MRKH patients

BioMed Central — Fri, 27 May 2011 23:00:00 +0100

Conclusion: Our study used, for the first time, a combined whole-genome expression and methylation approach to reveal the etiology of the MRKH syndrome. The findings suggest that either deficient estrogen receptors or the ectopic expression of certain HOXA genes might lead to abnormal development of the female reproductive tract. In utero exposure to endocrine disruptors or abnormally high maternal hormone levels might cause ectopic expression or anterior transformation of HOXA genes. It is, however, also possible that different factors influence the anti-Mullerian hormone promoter activity during embryological development causing regression of the Mullerian ducts. Thus, our data stimulate new research directions to decipher the pathogenic basis of MRKH syndrome. (Source: BioMed Central)

Effects of oral contraceptives on natriuretic peptide levels in women with hypothalamic amenorrhea: a pilot study

Fertility and Sterility — Wed, 25 May 2011 23:00:00 +0100

Natriuretic peptides, which are important regulators of salt handling and blood pressure, are 60%–75% higher in healthy young women than in men, consistent with a gender dimorphism. In this randomized, placebo-controlled study in women with functional hypothalamic amenorrhea, we show that administration of oral contraceptives (OC) increases natriuretic peptide levels and that end-of-study free T levels are inversely associated with amino-terminal pro-B-type natriuretic peptide levels, consistent with the hypothesis that natriuretic peptide levels may be mediated by differences in gonadal steroid concentrations—estrogens (E) or androgens. (Source: Fertility and Sterility)

Estrogen, PYY affect BMD in active premenopausal women

MedWire News - Bone Health — Tue, 24 May 2011 00:00:00 +0100

Raised levels of peptide YY and suppressed estrogen concentrations are associated with, and could directly contribute to, low bone mineral density in exercising women with amenorrhea, US researchers report. (Source: MedWire News - Bone Health)

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Resumption of menses after 32 years in anorexia nervosa.

Eating and weight disorders : EWD — Sun, 22 May 2011 23:00:00 +0100

We report a case of a 53 years old female patient affected with AN since the age of 17 years when also amenorrhea started. During the subsequent 31 years she refused to modify her body weight she always remained with a BMI below 17, and amenorrhea persisted throughout all the period. In November 2005 when she was 48 years old (BMI 15.6 kg/m2), she came in the Eating Disorder Unit Niguarda Hospital, to treat surgical complication of lower limb wound persisting after two operation, she also presented a marked reduction bone density. After 6 months of intensive day hospital treatment she got a normal body weight and resumption of menses, in the following four years she is still well and with normal menses, and bone density showed an improvement. PMID: 21606666 [PubMed - as supplied by pub...

Optimal adjuvant therapy for very young breast cancer patients.

Breast — Fri, 20 May 2011 23:00:00 +0100

Authors: Francis PA Approximately one in forty women diagnosed with early breast cancer is very young (<35 years) and this age group has a worse prognosis. The inferior prognosis in very young women appears to have two aspects. Very young women present more frequently with tumors with adverse histo-pathologic features. However, even when the histo-pathologic features appear favorable (ie. endocrine responsive tumors), analyses suggest that very young women with hormone receptor positive tumors are a sub-group at particular risk for adverse outcomes, compared to older premenopausal women with similar tumors. Chemotherapy induced amenorrhea has been shown to be associated with better outcomes and very young women are less likely to develop amenorrhea. Trials to determine the optimal a...

[Clinical features of women with idiopathic premature ovarian failure.]

Journal of Southern Medical University — Thu, 19 May 2011 23:00:00 +0100

CONCLUSION: Patients with menstrual disturbance, polymenorrhea and oligomenonrrhea are at risk of developing POF, in which case regular detection of the mean uterine volume, ovarian volume and AFC by vaginal ultrasound may help in early POF detection. Close monitoring can be necessary in the course of hormone replacement therapy, and timely intervention with assisted reproductive techniques may increase the chance of pregnancy. PMID: 21602150 [PubMed - as supplied by publisher] (Source: Journal of Southern Medical University)

Prevalence of Polycystic Ovarian Syndrome in Indian Adolescents

Journal of Pediatric and Adolescent Gynecology — Thu, 19 May 2011 23:00:00 +0100

Conclusion: Prevalence of PCOS in Indian adolescents is 9.13%.This draws attention to the issue of early diagnosis in adolescent girls. (Source: Journal of Pediatric and Adolescent Gynecology)

Identification of novel SRY mutations and SF1 (NR5A1) changes in patients with pure gonadal dysgenesis and 46,XY karyotype

Molecular Human Reproduction — Tue, 17 May 2011 23:00:00 +0100

Primary amenorrhea due to 46,XY disorders of sexual development (DSD) is complex with the involvement of several genes. Karyotyping of such patients is important as they may develop dysgerminoma and molecular analysis is important to identify the underlying mechanism and explore the cascade of events occurring during sexual development. The present study was undertaken for the genetic analysis in seven patients from five families presenting with primary amenorrhea and diagnosed with pure gonadal dysgenesis. Karyotyping was done and the patients were screened for underlying changes in SRY, desert hedgehog (DHH), DAX1 (NR0B1) and SF1 (NR5A1) genes, mutations in which are implicated in DSD. All the patients had 46,XY karyotype and two novel SRY mutations were found. In Family 1 (Patient S1.1)...

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Effects of Vitamin A or Beta Carotene Supplementation on Pregnancy-Related Mortality and Infant Mortality in Rural Bangladesh: A Cluster Randomized Trial [Original Contribution]

JAMA — Mon, 16 May 2011 23:00:00 +0100

Conclusion Use of weekly vitamin A or beta carotene in pregnant women in Bangladesh, compared with placebo, did not reduce all-cause maternal, fetal, or infant mortality. Trial Registration clinicaltrials.gov Identifier: NCT00198822 (Source: JAMA)

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

Patient Safety in Surgery — Mon, 16 May 2011 23:00:00 +0100

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...

Estrogen and peptide YY are associated with bone mineral density in premenopausal exercising women

Bone — Tue, 10 May 2011 23:00:00 +0100

Conclusion: PYY, mean E1G and body weight are associated with BMD in premenopausal exercising women. Thus, elevated PYY and suppressed estrogen concentrations are associated with, and could be directly contributing to, low BMD in exercising women with amenorrhea, despite regular physical activity.Research highlights: ► Fasting total PYY concentrations are negatively associated with total body BMD and total hip BMD. ► Estrogen is positively associated with total body BMD and lumbar spine BMD. ► PYY, estrogen and body mass are associated with BMD in premenopausal exercising women. ► Elevated PYY and suppressed estrogen concentrations could be directly contributing to low BMD in exercising women with amenorrhea. (Source: Bone)

Mosaic pentasomy x/tetrasomy x syndrome and premature ovarian failure.

Indian Pediatrics — Fri, 06 May 2011 23:00:00 +0100

Authors: Wood A, Kleis L, Toriello H, Cemeroglu AP A 16 year-old girl with pentasomy X mosaicism (47,XXX(1) 48,XXXX(12)/49,XXXXX) presented with primary amenorrhea. She had epicanthal folds, long philtrum, high-arched palate, facial asymmetry, short webbed neck, low posterior hairline, mild scoliosis, cubitus valgus, mental retardation and clinodactily. She was diagnosed with osteoporosis and premature ovarian failure. PMID: 21654007 [PubMed - in process] (Source: Indian Pediatrics)

Menstrual bleeding: perspective of Brazilian women

Contraception — Thu, 05 May 2011 04:00:00 +0100

The objective of the study was to describe perspectives and attitudes of Brazilian women regarding menstruation and its interference in daily activities.Study Design: A semistructured questionnaire was applied to nonpregnant, nonlactating women between 18 and 45 years old, who were menstruating, consulting at public health services for other complaints than gynecological or reproductive health care, and staff members and teachers of public universities in one city of each geographic region of Brazil and the Federal District.Results: Of the 885 women interviewed, 51.5% were aged 20–29 years, almost 60% reported normal frequency of bleeding, 22% and 43% reported interference of menstruation in their school activities and in the relationship with their partner, respectively. The value attri...

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Buprenorphine versus methadone in pregnant opioid-dependent women: a prospective multicenter study

European Journal of Clinical Pharmacology — Tue, 03 May 2011 05:52:59 +0100

Conclusions We did not observe more frequent malformations or cases of withdrawal syndrome in the buprenorphine group than in the methadone-treated group. Buprenorphine appears to be as safe as the currently approved substitute methadone considered to date as the reference treatment for pregnant opioid-dependent women. Content Type Journal ArticlePages 1-7DOI 10.1007/s00228-011-1049-9Authors Isabelle Lacroix, Centre Hospitalier Universitaire de Toulouse, Laboratoire de Pharmacologie Médicale et Clinique, Centre d’Evaluation et d’Information sur la Pharmacodépendance et d’Addictovigilance, INSERM U1027, Université de Toulouse, Toulouse, FranceAlain Berrebi, Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de Toulouse, Toulouse, FranceDa...

Index of Suspicion * Case 1: Abdominal Pain and Coffee Ground Emesis in a 9-year-old Boy * Case 2: Vomiting, Headache, and Seizures in a 7-year-old Boy * Case 3: Primary Amenorrhea in a 15-year-old Girl

Pediatrics in Review — Sun, 01 May 2011 23:00:00 +0100

(Source: Pediatrics in Review)

The Female Athlete Triad and Endothelial Dysfunction

PM and R — Sat, 30 Apr 2011 23:00:00 +0100

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. (Source: PM and R)

Amenorrhea.

The Journal of Clinical Endocrinology and Metabolism — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Pinkerton JV, Stuenkel CA PMID: 21543433 [PubMed - in process] (Source: The Journal of Clinical Endocrinology and Metabolism)

Endometrial ablation with the NovaSure system in Iran

International Journal of Gynaecology and Obstetrics — Tue, 19 Apr 2011 23:00:00 +0100

Abstract: Objective: To evaluate the rate of response to treatment with the NovaSure endometrial ablation device among Iranian women with menorrhagia.Methods: Twenty 35–50-year-old women with menorrhagia who were referred to Arash Hospital, Tehran, Iran, in 2008 were enrolled. They underwent endometrial ablation via the NovaSure system and were followed-up for 2years.Results: The incidence of amenorrhea was 30.0% at the end of the 2-year follow-up period. Hypomenorrhea was reported by 40.0% of women. The mean number of days of bleeding per month decreased significantly, from 30.0±6.4days before treatment to 3.1±2.6days after 2years (P (Source: International Journal of Gynaecology and Obstetrics)

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Leptin is an effective treatment for hypothalamic amenorrhea [Medical Sciences]

Proceedings of the National Academy of Sciences — Mon, 18 Apr 2011 23:00:00 +0100

Hypothalamic amenorrhea (HA) is associated with dysfunction of the hypothalamic-pituitary-peripheral endocrine axes, leading to infertility and bone loss, and usually is caused by chronic energy deficiency secondary to strenuous exercise and/or decreased food intake. Energy deficiency also leads to hypoleptinemia, which has been proposed, on the basis of observational studies as well as an open-label study, to mediate the neuroendocrine abnormalities associated with this condition. To prove definitively a causal role of leptin in the pathogenesis of HA, we performed a randomized, double-blinded, placebo-controlled trial of human recombinant leptin (metreleptin) in replacement doses over 36 wk in women with HA. We assessed its effects on reproductive outcomes, neuroendocrine function, and b...

Leptin may restore fertility to women with hypothalamic amenorrhea

MedWire News - Ob/Gyn — Mon, 18 Apr 2011 00:00:00 +0100

Treatment with the hormone leptin could restore fertility in women with hypothalamic amenorrhea brought on by chronic energy deficiency, say researchers. (Source: MedWire News - Ob/Gyn)

Physician attitude is main factor in uptake of extended-use OC regimens

MedWire News - Ob/Gyn — Mon, 11 Apr 2011 00:00:00 +0100

An improvement in attitudes towards medically induced amenorrhea could positively impact on the uptake of extended-use oral contraceptive regimens, show US study findings. (Source: MedWire News - Ob/Gyn)

Leptin Restores Fertility, May Improve Bone Health In Lean Women

Health News from Medical News Today — Tue, 05 Apr 2011 10:00:00 +0100

Women with extremely low body fat, including runners and dancers, as well as women with eating disorders, are prone to develop hypothalamic amenorrhea, a condition in which their menstrual periods cease, triggering such serious problems as infertility and osteoporosis. Now, a study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) offers the first definitive proof that a lack of leptin contributes to hypothalamic amenorrhea (HA) and that treatment with a synthetic form of the hormone can restore fertility and reduce the risk of bone fractures in this group of patients... (Source: Health News from Medical News Today)

Leptin restores fertility, may improve bone health in lean women; Treatment could help athletes, women with eating disorders

ScienceDaily Headlines — Mon, 04 Apr 2011 19:13:13 +0100

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Study finds leptin restores fertility, may improve bone health in lean women

EurekAlert! - Social and Behavioral Science — Mon, 04 Apr 2011 04:00:00 +0100

(Beth Israel Deaconess Medical Center) Women with extremely low body fat, including runners and dancers, as well as women with eating disorders, are prone to develop hypothalamic amenorrhea, a condition in which their menstrual periods cease, triggering such serious problems as infertility and osteoporosis. (Source: EurekAlert! - Social and Behavioral Science)

Pharmacological review on Centella asiatica: A potential herbal cure-all

Indian Journal of Pharmaceutical Sciences — Wed, 30 Mar 2011 23:00:00 +0100

Kashmira J Gohil, Jagruti A Patel, Anuradha K GajjarIndian Journal of Pharmaceutical Sciences 2010 72(5):546-556In recent times, focus on plant research has increased all over the world. Centella asiatica is an important medicinal herb that is widely used in the orient and is becoming popular in the West. Triterpenoid, saponins, the primary constituents of Centella asiatica are manly believed to be responsible for its wide therapeutic actions. Apart from wound healing, the herb is recommended for the treatment of various skin conditions such as leprosy, lupus, varicose ulcers, eczema, psoriasis, diarrhoea, fever, amenorrhea, diseases of the female genitourinary tract and also for relieving anxiety and improving cognition. The present review attempts to provide comprehensive information on ...

Lactational amenorrhea: nurses experience and the promotion of this alternative method of contraception

Revista da Escola de Enfermagem da USP — Tue, 29 Mar 2011 20:24:20 +0100

Estudo transversal, de campo, com abordagem quantitativa. Objetivou-se identificar experiências pessoais de enfermeiros com aleitamento materno e com o método da Lactação com Amenorréia (LAM); conhecer motivos para a não adoção do aleitamento materno ou adoção do aleitamento misto; estabelecer a relação entre a experiência pessoal de enfermeiros com a LAM e a orientação desta forma de anticoncepção à clientela da UBS. Estudo realizado com 137 enfermeiros da Estratégia Saúde da Família de Fortaleza-CE, por meio de entrevista. Houve predominância do sexo feminino, com 121 participantes (88,3%). A faixa etária variou de 26 a 59 anos, com média de 38,3. 66 entrevistados (94,2%) tiveram experiência com aleitamento e destes 61 (92,4%) realizaram Aleitamento Materno Exclu...

Extended-use oral contraceptives and medically induced amenorrhea: attitudes, knowledge and prescribing habits of physicians

Contraception — Thu, 24 Mar 2011 04:00:00 +0100

Conclusion: Physicians' attitudes regarding medically induced amenorrhea influence the use of extended-cycle OC more than any other characteristic. (Source: Contraception)

Asherman's Syndrome

Seminars in Reproductive Medicine — Thu, 24 Mar 2011 00:00:00 +0100

Semin Reprod Med 2011; 29: 083-094DOI: 10.1055/s-0031-1272470ABSTRACTAsherman's syndrome is being diagnosed with increasing frequency. Although it usually occurs following curettage of the pregnant or recently pregnant uterus, any uterine surgery can lead to intrauterine adhesions (IUA). Most women with IUA have amenorrhea or hypomenorrhea, but up to a fourth have painless menses of normal flow and duration. Those who have amenorrhea may also have cyclic pelvic pain caused by outflow obstruction. The accompanying retrograde menstruation may lead to endometriosis. In addition to abnormal menses, infertility and recurrent spontaneous abortion are common complaints. Hysteroscopy is the standard method to both diagnose and treat this condition. Various techniques for adhesiolysis and for preve...

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Systemic bevacizumab (Avastin) for exudative retinal detachment secondary to choroidal melanoma.

European Journal of Ophthalmology — Wed, 23 Mar 2011 00:00:00 +0100

Conclusions. This pilot study suggests that systemic bevacizumab was associated with transient systemic effects as well as resolution of choroidal melanoma-related exudative retinal detachment. PMID: 21445839 [PubMed - as supplied by publisher] (Source: European Journal of Ophthalmology)

Circulating vaspin and visfatin are not affected by acute or chronic energy deficiency or leptin administration in humans.

European Journal of Endocrinology — Mon, 21 Mar 2011 00:00:00 +0100

Conclusions: Circulating vaspin and visfatin are not affected by acute or chronic energy deficiency leading to hypoleptinemia and are not regulated by leptin in human subjects, indicating that these adipocyte-secreted hormonal regulators of metabolism are independently regulated in humans. PMID: 21422197 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Success rate, quality of life, and descriptive analysis after generalized endometrial ablation in an obese population

International Journal of Gynaecology and Obstetrics — Mon, 21 Mar 2011 00:00:00 +0100

Conclusion: Global endometrial ablation improved quality of life for obese women with menorrhagia and had a high rate of satisfaction, even for patients not achieving amenorrhea. Patients with a BMI of more than 34 showed a trend toward failure and a higher rate of hysterectomy. (Source: International Journal of Gynaecology and Obstetrics)

Menstrual Psychosis: A Bipolar Disorder with a Link to the Hypothalamus

Current Psychiatry Reports — Sat, 19 Mar 2011 02:53:11 +0100

Abstract The literature on menstrual psychosis is briefly reviewed in this article. There are about 80 cases with substantial evidence, and about 200 other possible cases. The clinical features are generally those of manic depressive (bipolar) disorder. The diagnosis requires the accurate dating of the onsets of episodes and of menstrual bleeding. Obtaining a baseline of several carefully dated episodes is also important in finding the best way to arrest the periodic illness. Although conventional psychotropic drugs can shorten episodes, they do not prevent recurrences. For this, unconventional treatments appear to be more effective, especially thyroid hormone and clomiphene. Patients with menstrual psychosis usually have abnormal menstruation, such as anovulatory cycles, ...

Menstrual History and Quality-of-Life Outcomes in Women With Node-Positive Breast Cancer Treated With Adjuvant Therapy on the NSABP B-30 Trial [Breast Cancer]

Journal of Clinical Oncology — Thu, 17 Mar 2011 00:00:00 +0100

Conclusion Amenorrhea rates differed significantly by treatment arm, with the AT arm having the lowest rate. Patients treated with longer duration therapy (AC->T) had greater symptom severity and poorer QOL at 6 months, but did not differ from shorter duration treatments at 12 months. (Source: Journal of Clinical Oncology)

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Health management of adults with Turner Syndrome: An attempt at multidisciplinary medical care by gynecologists in cooperation with specialists from other fields

Journal of Obstetrics and Gynaecology Research — Wed, 16 Mar 2011 00:00:00 +0100

Conclusion: Multidisciplinary health management in our Reproductive Health Clinic improved the status of medical care for TS adults. (Source: Journal of Obstetrics and Gynaecology Research)

Treatment for partial vaginal agenesis, bicornuate uterus and rudimentary cervical

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

The lack of exteriorization of the menstrual flow after menarche causes cryptomenorrhea and blood accumulation in the vagina causes hematocolpus. The imaging diagnosis for hematosalpinx or hematometra, associated or not to hematocolpus has great importance. The test must be extended for other organs, especially of the urinary tract, for the research of associated malformations. The transperineal ultrassound must be taken in consideration for the differencial diagnosis for primary amenorrhea, when the access through the vagina is not possible. It might be used for the detection of cervical or vaginal atresia, and transverse vaginal septum. CT and RMI have great value evaluating specific images of the genital tract, showing the kind of annomaly present in the müllerian ducts. (Source: Journ...

Physiological and Behavioral Predictors of Amenorrhea in Normal-Weight Adolescents With Eating Disorders

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:53 +0100

This study compares clinical and behavioral characteristics of low and normal-weight amenorrheic adolescents with EDs in treatmentat presentation and at return of menses (ROM) or at the last clinic date (LCD) if menses did not return. (Source: Journal of Pediatric and Adolescent Gynecology)

Pituitary Origin as the Cause of Persistently Elevated Human Chorionic Gonadotropin in an Adolescent With Primary Amenorrhea Secondary to Frasier Syndrome

Journal of Pediatric and Adolescent Gynecology — Tue, 15 Mar 2011 17:06:50 +0100

We report a female adolescent with Frasier syndrome (46 XY gonadal dysgenesis with focal segmental glomerulosclerosis-FSGS) who presented with primary amenorrhea and was found to have persistently elevated levels of hCG, status post bilateral gonadectomy, beyond ranges reported in postmenopausal women (beta hCG < 14 mIU/ml). The purpose of this case report is to alert clinicians to include a pituitary source of hCG in the differential diagnosis within this patient population. (Source: Journal of Pediatric and Adolescent Gynecology)

Post‐cesarean vesicouterine fistula (Youssef syndrome): Report of two cases

Journal of Obstetrics and Gynaecology Research — Sun, 13 Mar 2011 00:00:00 +0100

We present two cases of VUF that were successfully managed by transperitoneal surgical repair. The first case presented with the Youssef classical triad: cyclical hematuria (menouria), amenorrhea and urinary continence, while the second case presented with total urinary incontinence with normal menstruation. In both cases, diagnosis was confirmed by hysterogram and both were managed by transperitoneal surgical repair. The clinical features, etiologic factors, diagnostic procedures and treatment modalities are discussed in relation to the case and others as reported in the literature. (Source: Journal of Obstetrics and Gynaecology Research)

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Incidence of chemotherapy-induced amenorrhea in premenopausal patients with breast cancer following adjuvant anthracycline and taxane.

Breast Cancer — Fri, 11 Mar 2011 00:00:00 +0100

CONCLUSION: Age was the strongest predictor of the incidence of amenorrhea during chemotherapy. It is unclear whether additional taxane may contribute to amenorrhea. This information could be useful in deciding whether to use adjuvant chemotherapy. PMID: 21394515 [PubMed - as supplied by publisher] (Source: Breast Cancer)

Use of the levonorgestrel-releasing intrauterine system, quality of life and sexuality. Experience in an Italian family planning center

Contraception — Thu, 10 Mar 2011 05:00:00 +0100

Conclusions: Although in Italy intrauterine contraception is poorly accepted, once started on LNG-IUS, women found that the device represents a safe and effective contraceptive modality, with valuable noncontraceptive benefits, especially in the presence of heavy or prolonged bleeding. (Source: Contraception)

Menopausal Status in Breast Cancer Patients with Past Chemotherapy Determines Long‐Term Hypoactive Sexual Desire Disorder

The Journal of Sexual Medicine — Wed, 02 Mar 2011 00:00:00 +0100

Conclusions. Cancer treatment that leads to long‐term ovarian failure in breast cancer patients has a negative impact on sexual desire. Patients with menopause induced by chemotherapy or GnRH agonists show significantly reduced sexual desire as compared to menstruating patients with past chemotherapy. Ochsenkühn R, Hermelink K, Clayton AH, von Schönfeldt V, Gallwas J, Ditsch N, Rogenhofer N, and Kahlert S. Menopausal status in breast cancer patients with past chemotherapy determines long‐term hypoactive sexual desire disorder. J Sex Med **;**:**–**. (Source: The Journal of Sexual Medicine)

Osteoporosis in anorexia nervosa.

Eating Disorders — Tue, 01 Mar 2011 00:00:00 +0100

Authors: Mehler PS, Cleary BS, Gaudiani JL Osteoporosis is common in anorexia nervosa. It places these patients at increased lifetime risk for fractures. Bone loss may never recover completely even once weight is restored. The strongest predictors of osteoporosis include low body weight and amenorrhea. Loss of bone density can occur rapidly and very early in the course of anorexia nervosa. The etiology of bone loss in the patient with anorexia nervosa is multifactorial. In addition to reduced estrogen and progesterone, excess cortisol levels and low levels of insulin growth factor (IGF-1), a correlate for bone formation, are observed. Dual energy x-ray absorptiometry screening is important to assess bone density. However, successful treatments to reverse bone loss, in those with anorex...

Ectopic Ovary at Ectopic Pregnancy

The Journal of Minimally Invasive Gynecology — Tue, 01 Mar 2011 00:00:00 +0100

A 33-year-old woman presented at the emergency department with a 3-day history of abdominal pain and mild vaginal bleeding at 7 weeks amenorrhea. She was anxious but with stable vital signs (blood pressure 115/78 mmHg, pulse rate 86). The serum β-human chorionic gonadotropin level was 1226 IU/mL, and transvaginal ultrasonography, done with moderate discomfort, revealed hemoperitoneum, an empty uterus, and an adnexal mass adjacent to the left ovary suggestive of a tubal ectopic pregnancy. (Source: The Journal of Minimally Invasive Gynecology)

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Intussusception and Incarceration of a Fallopian Tube: Report of 2 Atypical Cases, with Differential Considerations, Clinical Evaluation, and Current Management Strategies

The Journal of Minimally Invasive Gynecology — Tue, 01 Mar 2011 00:00:00 +0100

Abstract: Herein are presented 2 cases from the last 5 years. In case 1, a fallopian tube intussusception without perforation, misdiagnosed as a myoma, was observed at hysteroscopy of the uterine cavity18 months after last vacuum aspiration. In case 2, a fallopian tube incarceration, misdiagnosed as a placental polyp, was observed 3 months after last suction curettage. Although uterine perforation caused by suction curettage after abortion or of afterbirth occurs rarely, it is a complication that must be taken into account because after this procedure there may be painful symptoms such as the typical triad of abdominal pain, vaginal discharge, and dyspareunia. In some situations, as in case 2, amenorrhea occurs alone, without other distressing symptoms. In both cases, a hysteroscopic appro...

Pregnancy in a patient with adrenocortical carcinoma during treatment with Mitotane - a case report.

Endokrynologia Polska — Tue, 01 Mar 2011 00:00:00 +0100

We present the case of a female patient with virilising adrenocortical carcinoma treated surgically who conceived during adjuvant treatment with mitotane. We discuss the frequently erroneous routine treatment with oral hormonal contraception without thorough differential diagnosis in female patients with oligo-/amenorrhea and subsequent delay in the proper diagnosis of adrenocortical carcinoma. (Pol J Endocrinol 2011; 62 (2): 186-188). PMID: 21528483 [PubMed - in process] (Source: Endokrynologia Polska)

Medical vs. surgical abortion: the importance of women's choice

Contraception — Mon, 28 Feb 2011 00:00:00 +0100

Conclusion: In this sample of French women who participated in a national survey on abortion, those who were involved in the decision-making process as to whether to have a medical or surgical procedure showed a strong preference for the medical procedure. (Source: Contraception)

Acute misoprostol toxicity during the first trimester of pregnancy

International Journal of Gynaecology and Obstetrics — Mon, 21 Feb 2011 00:00:00 +0100

A previously healthy 29-year-old woman (gravida 4, para 1) presented to the emergency unit of Santa Maria Hospital, Lisbon, Portugal, following 6weeks of amenorrhea, with shaking chills, fever, and confusion—after having self-administered 8mg of misoprostol (1mg orally and 7mg intravaginally) in an attempt to induce abortion. (Source: International Journal of Gynaecology and Obstetrics)

Effects of I-131 therapy on gonads and pregnancy outcome in patients with thyroid cancer

NeLM - News — Thu, 17 Feb 2011 00:00:00 +0100

Source: Fertil Steril Area: News In this review, the authors discuss the published reports concerning the effects of I131 therapy on female and male gonads and pregnancy and offspring outcome. They analysed data on the following: . I-131 and testicular function . I-131 and pregnancy outcome . I-131 and lactation The following findings were reported: . Therapeutic administration of I-131 may reduce long-term morbidity and possibly improve survival in patients with differentiated thyroid cancer. . Transient amenorrhea or menstrual irregularities, which usually resolve within 1 year, can be expected in ~30% of patients that have received therapeutic I131. . Male patients demonstrate transient impairment ...

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

Fertility and Sterility — Mon, 14 Feb 2011 00:00:00 +0100

Conclusion(s): X chromosomal submicroscopic CNVs do not play a major role in Caucasian POI patients. We provide guidelines on how submicroscopic cytogenetic POI research should be conducted. (Source: Fertility and Sterility)

Circulating leptin concentrations do not distinguish menstrual status in exercising women

Human Reproduction — Fri, 11 Feb 2011 00:00:00 +0100

CONCLUSIONS These data suggest that leptin concentrations per se are not associated with FHA in exercising women, but the modulation of leptin concentrations may differ depending on reproductive status. (Source: Human Reproduction)

Cyclophosphamide Regimens Tied to Duration of Amenorrhea

Medscape Medical News Headlines — Tue, 08 Feb 2011 20:51:27 +0100

The longer women stay on cyclophosphamide (Cytoxan), the higher their risk of prolonged amenorrhea, according to results of a national breast cancer trial. Reuters Health Information (Source: Medscape Medical News Headlines)

One patient, two uteri, two endometrial ablations: case report of thermal balloon ablation in uterine didelphys

Fertility and Sterility — Mon, 07 Feb 2011 00:00:00 +0100

Objective: To describe the clinical application and outcomes after endometrial ablation with ThermachoiceIII (Ethicon, Somerville, NJ) in a patient with uterine didelphys with heavy menstrual bleeding.Design: Case report.Setting: Inner-city community obstetrics and gynecology clinic.Patient(s): A 44-year-old Hispanic woman, gravida 3, para 0, with three spontaneous abortions.Intervention(s): The patient underwent diagnostic hysteroscopy, gynecologic dilation and curettage, and endometrial ablation with ThermachoiceIII.Main Outcome Measure(s): Menstrual pattern at 3 months postoperatively, as either amenorrhea (complete lack of menstrual flow), hypomenorrhea (scant or minimal flow lasting (Source: Fertility and Sterility)