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Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Microbiopsy of the fimbrial end of the fallopian tube may prove to be a valuable method for investigating the tubal pick-up and transport mechanism in infertility patients. Counting of the percentage of ciliated cells on semithin sections shows that in normal fertile women a percentage of such cells is present that is higher than in abnormal conditions such as peritubal adhesions, ectopic pregnancy and amenorrhoea following prolonged progestogen treatment. It is also suggested that ultrastructural examination of the biopsy may provide additional valuable information.
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PMID:Microbiopsy of the fallopian tube as a method for clinical investigation of tubal function in infertility. 0 88

356 15-35 year old patients with secondary amenorrhea were studied. In all cases amenorrhea had persisted for 12 months or more. The best prognosis was found in patients with postpill amenorrhea with 95% recovery in 6 years. Lowest recovery rates, 56-61%, were seen in patients with anorexia nervosa and idiopathic functional amenorrhea. Of those with an organic etiology, ovarian failure was diagnosed in 22 patients who showed no follicular response after large doses of human menopausal gonadotropin (HMG). Relative ovarian failure was diagnosed in 5 patients who responded to HMG, the Stein-Leventhal syndrome was found in 9 patients, an adrenal adenoma was present in 1 patient; a pituitary tumor was diagnosed in 1 patient, 3 patients had organic brain lesions, and intrauterine synechiae were present in 3 patients. 93 of the 308 patients with functional amenorrhea gave a history of self-induced weight loss. In 56 patients, amenorrhea began after oral contraceptives ceased. 17 of 22 patients with anorexia nervosa were in the recovery stage. Psychogenic factors were present in 55 cases. 18 patients had galactorrhea and amenorrhea. In 5 of these the symptoms appeared after contraceptive treatment was stopped; they were classified as functional. No known etiological factor was found in 62 patients. The principal treatment was estrogen-progesterone substitution. Clomiphene, 100 mg/day for 5 days, was given to 105 patients with functional amenorrhea. Patients with infertility should be treated 1st with clomiphene-human chorionic gonadotropin or tamoxifen. If no response is obtained, bromocriptine with clomiphene are recommended. Induction of ovulation with exogenous gonadotropin was carried out for patients who did not respond to clomiphene. 27 healthy children were born after gonadotropin-induced ovulation.
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PMID:Etiology, clinical features and prognosis in secondary amenorrhea. 2 Apr 14

Twelve patients with primary infertility due to a defective luteal phase associated with hyperprolactinemia and galactorrhea are reported. All were treated with 2-bromoergocryptine. During the first cycle of therapy, the serum prolactin level decreased in all cases, and galactorrhea disappeared during the second cycle of therapy. Seven women responded to 2-bromoergocryptine, as was reflected in their endometrial biopsies. The remaining five were given clomiphene citrate on the second and sixth days of the next 2-bromoergocryptine cycle. Three of these patients responded favorably to this combined therapy. Six pregnancies were reported during therapy. The results of follow-up after labor or abortion suggested that these cases represent a latent stage of the amenorrhea-galactorrhea syndrome.
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PMID:Galactorrhea and the defective luteal phase of the menstrual cycle. 3 6

18 women (6 healthy women with regular menstrual cycles and 12 women with anovulatory infertility or amenorrhea being treated with clomiphene citrate) were initially studied to evaluate a new method for the determination of SHBG (sex-hormone-binding globulin-binding capacity. The anovulatory group had been suffering from amenorrhea for 1 to 3 years, but none of the women were hirsute or hypothroid. Blood samples were collected on days 7, 14, and 21, of spontaneous cycles; for amenorrheic women, blood samples were collected at the start of the clomiphene treatment and 1 and 2 weeks later. Plasma-SHBG, estradiol, and, plasma progesterone were measured. A significant increase in SHBG from day 7 to day 21 was observed among the spontaneous ovulatory cycles; patients who ovulated in response to clomiphene also exhibited a significant rise (59+ or -7.9) at day 21, while those who did not ovulate in response to clomiphene and in whom there was no increase in plasma-estradiol did not exhibit any change in SHBG. These findings show a significant increase in SHBG during spontaneous and induced ovulatory cycles but not in anovulatory cycles. This binding protein can be used to assess ovulatory function in infertile women, particularly those on clomiphene therapy.
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PMID:Sex-hormone-binding globulin: an additional test for ovulatory function. 8 61

Twenty-one young female patients are described who presented with amenorrhoea, galactorrhoea or infertility, and were treated by 90Y pituitary implantation of 20,000 rads. There was no morbidity. In all patients serum prolactin values were elevated and radiographs of the pituitary fossa were abnormal. Observations are available for 1--76 months (mean 27) after implantation. The median fall in prolactin values was 60 per cent while there was no deterioration in pituitary function if normal pre-operatively. Luteinizing hormone values, both basally and following gonadotrophin-releasing hormone, rose to normal after operation; several instances of sellar remodelling were observed radiologically, and no instance of relapse was found radiologically, biochemically or clinically. Thirteen patients desiring fertility have been observed since implantation; so far nine have become pregnant, in three instances without any additional therapy; since four patients became pregnant twice, a total of 13 pregnancies have occurred. No case of tumour expansion was observed during pregnancy. 90Y implantation can be considered as a therapeutic procedure in young female patients requiring fertility which is competitive with surgical methods, and together with a short course of bromocriptine if needed, could prove to be the treatment of choice.
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PMID:Treatment of prolactin-secreting pituitary tumours in young women by needle implantation of radioactive yttrium. 10 59

A young patient with secondary amenorrhea and primary infertility is described. After a gynecological-endocrinological exploration including laparoscopy, the diagnosis indicates secondary hypergonadotropic, hypo-estrogenic normo-androgenic amenorrhea. The anatomopathological examination of an ovarian biopsy revealed an intact follicular apparatus, thus disproving the suspected diagnosis of climacterium praecox. Since very high gonadotropin doses could not induce an ovulation, it was concluded that the rare combination of secondary amenorrhea and the gonadotropin-resistant ovary syndrome must be present. The pathogenesis of this syndrome is discussed.
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PMID:The gonadotropin-resistant ovary syndrome in association with secondary amenorrhea. 12 35

The primary use of laparoscopy is as a surgical tool, with sterilizations being the overwhelming indication. The laparoscope is used less frequently as a non-surgical tool, with the major indication being for diagnosing infertility and/or amenorrhea, and for evaluation of obscure pelvic pain. There would seem to be several indications for laparoscopy that have been neglected, these being in confirming the diagnosis of acute pelvic inflammatory disease; in the evaluation of malignancies and abdominal-pelvic trauma; and the surgical treatment of pelvic pain. Lapar-The majority of these contraindications are relative, and depend soley on the laparoscopist's ability and his clinical judgment. The problems of hernias seem to have been over-emphasized. The laparoscopist should be aware of potential problems with umbilical hernia, and he probably can ignore hiatal hernias except when they are large and quite symptomatic. However, generalized abdominal peritonitis, significant hemoperitoneum with intestinal obstruction are felt by most authors to be absolute contraindications. The most frequent complications of laparoscopy involve the physoperitoneum. Except for cardiac arrest the most serious complications involve electrical burns to small bowel.
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PMID:Indications, contraindications and complications of laparoscopy. 12 9

The article presents a review of the evolution of indications for laparosocpy during the years 1973-1977. Laparoscopy is always indicated in case of chronic pelvic pains, ovarian malignant tumors, tubal infertility, adnexitis or ectopic pregnancy. In such cases the accurate inspection of the pelvic cavity can allow precise diagnosis and therapy. Laparoscopy can also be repeated to control the effectiveness of therapy, especially in the surveillance of ovarian cancers. On the other hand, laparoscopy should not be systematically performed in cases of isolated pelvic pains, in case of ovarian cyst or fibroma, or in case of amenorrhea, where clinical examinations and biological explorations are sufficient to determine diagnosis and therapy. Laparoscopy should be used only when there are contraindications among biological findings, or in cases of therapeutic failures.
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PMID:[The evolution of the indications for laparoscopy between 1973 and 1977. 1,758 cases (author's transl)]. 16 66

The effect of bromocriptine administration was studied in 34 patients, whose presenting symptoms included amenorrhoea, galactorrhoea, infertility, dyspareunia, delayed puberty, and impotence. Two patients were found to have raised plasma prolactin values during investigation for acromegaly. With the exception of three individuals all patients had hyperprolactinaemia. Pituitary fossa enlargement or asymmetry was reported in 16 patients and one patient had primary hypothyroidism. Virtually all patients complained of side effects when first starting bromocriptine but only two patients were unable to tolerate prolonged therapy with doses which ranged from 5--40 mg daily. A single oral dose of 2.5 mg resulted in a greater than 50% reduction in plasma prolactin within five hours in 22 of 26 patients. Over the course of one month, five patients with significant pituitary fossa enlargement appeared to show less rapid suppression of plasma prolactin than five patients without fossa enlargement. At two months this trend was still evident but eventually all patients showed acceptable control of plasma prolactin, with the exception of one patient who required pituitary surgery. Galactorrhoea ceased in 13 of 15 patients, menstrual periods resumed in ten of 13 patients, two patients becoming pregnant first. Potency returned and puberty proceeded in two hypogonadal males. Six of the nine patients requesting treatment for infertility became pregnant. It is concluded that bromocriptine provides effective treatment for galactorrhoea, amenorrhoea or gonadal disorders when there is associated hyperprolactinaemia.
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PMID:Treatment of amenorrhoea, galactorrhoea and hypogonadism with bromocriptine. 27 21

To ensure infertility whilst breast feeding many mothers ingest steroidal contraceptives. Animal experiments have shown how sexual differentiation of the brain occurs during perinatal life and can be affected by exogenous steroids. The amount of sex steroid secreted in the milk of lactating mothers is very small and dependent on the type of steroid chosen. "On demand" breast feeding is associated with a longer period of lactational amenorrhoea, obviating the necessity for early usage of contraceptives. In view of the possibility that sexual differentiation may be disturbed, it is suggested that, where steroidal contraception is required, the progesterone with the minimal amount of oestrogenic metabolite be used.
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PMID:Factors influencing the time of introduction of steroidal contraception in the breast-feeding mother. 29 24


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