Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifteen patients with infertility and hyperprolactinaemia have been investigated using tests of prolactin and LH secretion, and treated by prolactin suppression. In addition, 4 patients with hyperprolactinaemia not desiring fertility were also investigated. Of the total group, 16 had galactorrhoea and 15 had amenorrhoea. Pituitary tumours were present in 6 patients and 4 had pituitary microadenomas. Prolactin levels measured by both radioimmunoassay and radioreceptor assay were elevated before treatment and fell during therapy with bromoergocryptine (7.5 mg daily). Tests of prolactin release with TRH and chlorpromazine before treatment did not distinguish patients with functional hyperprolactinaemia from those with pituitary tumours. Basal plasma gonadotrophin concentrations were not elevated despite subnormal urinary oestrogen levels. The serum LH response to LRH was normal during hyperprolactinaemia, but LH release in response to oestrogen provocation was impaired in 14 of 17 patients. During prolactin suppression, mean oestrogen excretion rose significantly and the oestrogen provocation test became normal in all except 2 patients. Pregnancy occurred in all of the 15 patients desiring fertility. Abortion has occurred in 4 patients, all of whom are currently pregnant again. Nine pregnancies have reached term, with no complications from pituitary expansion. It appears that during hyperprolactinaemia there are defects in both positive and negative feedback of oestrogen on LH secretion, and that prolactin suppression in such patients is highly effective in restoring fertility.
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PMID:Investigation and management of symptomatic hyperprolactinaemia. 29 25

The results of 495 cycles of treatment with Cyclophenyl given to 286 women suffering from amenorrhea, oligomenorrhea or persistent anovulation are reported. In 61 cases the drug solved the problems of infertility, with a success rate of 43%. The over-all success rate was 58% (288 ovulatory cycles produced in 495 treatment cycles). In detail:--in cases of prolonged amenorrhea, with plasma estradiol levels lower than 50 pg/ml, the positive results were only 15%;--in cases of short-term amenorrhea, with plasma estradiol levels lower than 50 pg/ml, the success rate was only 18%;--in cases with prolonged amenorrhea but with plasma estradiol levels higher than 50 pg/ml, the success rate was 43%;--in cases of short-term amenorrhea with plasma estradiol levels higher than 50 pg/ml, the success rate was 68%;--in cases of oligomenorrhea and of persistent anovulation, the success rate was 72%.
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PMID:Induction of ovulation with cyclophenyl. 33 63

Because of the poor results and the morbidity associated with surgical and radiation treatment of pituitary adenomas, investigators continue to search for new pharmacologic tools to treat anterior pituitary hyperfunction. New drugs are being studied in the treatment of acromegaly, Cushing's disease, and galactorrhea-amenorrhea, infertility, and impotence associated with prolactin-secreting pituitary tumors.
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PMID:New drugs in the treatment of pituitary disorders. 33 37

Bromocriptine therapy was given to 42 amenorrheic women with hyperprolactinemia. Radiological signs of a pituitary tumor were seen in 24 women (57%). During treatment, the prolactin concentrations rapidly decreased towards normal in all the women and ovulation returned in all but 2 of the women after 5.5 weeks, on the average. 1 of the nonresponders had previously undergone transfrontal hypophysectomy. Defect luteal function was observed during the 1st ovulatory cycle in 51% of the women, while 90% had a normal luteal phase after the 2nd ovulation. 21 of 22 women who attempted to become pregnant conceived and experienced a total of 27 pregnancies, of which 6 ended in abortion. 11 of the 22 infertile women had radiological signs of a pituitary tumor. None of them was pretreated with irradiation or surgery. Clinical signs of tumor enlargement during pregnancy were seen in 2 of 11 women. Visual field defects developed during pregnancy in 1 woman, but reinstitution of bromocriptine improved the visual impairment and the pregnancy went to full term. Another tumor patient, who had an uneventful pregnancy, showed signs of tumor growth at the postpartum sellar x-ray. None of 10 women with normal pituitary radiology showed symptoms or signs of tumor enlargement during pregnancy, but postpartum, the pituitary fossa was found to have increased in size and become asymmetric in 1 woman. Prolonged bromocriptine therapy reversed estrogen deficiency symptoms in the nonfertile women by restoring normal gonadal function and improved libido and general well-being. Whether longterm bromocriptine therapy inhibits further growth or even causes regression of prolactin secreting pituitary tumors is still an open question. To sum up, bromocriptine is the drug of choice for treatment of amenorrhea and infertility due to hyperprolactinemia.
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PMID:Bromocriptine treatment of 42 hyperprolactinaemic women with secondary amenorrhoea. 35 99

The clinical use of bromocriptine (2.5 mg twice daily) was investigated in 40 women attending an infertility clinic and presenting with secondary amenorrhoea (18) or with ovarian dysfunction (22) which had failed to respond to anti-oestrogen therapy. Patients in each group were sub-divided into those with raised and those with normal prolactin levels, and re-examined at 3 and 12 months after the start of treatment. The results confirmed that bromocriptine is effective in the treatment of hyperprolactinaemic states whether there is amenorrhoea or not. Moreover, in cases of ovarian dysfunction as well as of amenorrhoea where the prolactin levels were within the normal range, there was evidence to suggest that bromocriptine can be associated with a return of ovulation, although the mechanism by which it might do so still needs evaluation.
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PMID:Bromocriptine in the treatment of secondary amenorrhoea and ovarian dysfunction in hyper- and normo-prolactinaemic patients. 36 17

Bromocriptine has been successfully used to treat hyperprolactinaemic disorders of ovulation; treatment with 5.0 to 7.5 mg daily results in normalisation of serum prolactin concentration and restoration of ovulatory menstruation in most patients with hyperprolactinaemic amenorrhoea or oligomenorrhoea. It is equally effective in hyperprolactinaemic patients with pituitary tumours as in those with normal pituitary x-rays, but the choice of bromocriptine as primary treatment in the former group (especially in those patients who desire pregnancy) is a matter of some controversy and requires careful judgement. Bromocriptine has also been used, with reported success, in infertility associated with luteal insufficiency, the polycystic ovary syndrome, normoprolactinaemic amenorhoea and ovulatory infertility. However, its role in the treatment of these disorders will remain uncertain until more extensive, adequately controlled clinical trials are availabe.
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PMID:Use of bromocriptine in hyperprolactinaemic anovulation and related disorders. 37 49

A review of our current knowledge of the mechanism underlying lactation amenorrhoea suggests that there is a causal relationship between high prolactin levels and the absence of ovarian activity. During pregnancy, blood levels of prolactin continually increase. After delivery, among those women who breastfeed, the level remains; however, when breastfeeding is reduced to 3 or less episodes/day, prolactin levels quickly return to normal. The follicle stimulating hormone (FSH) is suppressed during pregnancy but increases after birth. For lactating women, FSH in the 1st year is in the high normal range and in the 2nd year it is in the normal range of the follicular phase. The luteinizing hormone (LH) remains low during lactation but at weaning, LH concentrations increase as prolactin levels decrease. Apparently this low level of LH during lactation is not due to pituitary inability to respond to the gonadotrophin-releasing hormone, but instead, is due to the increased sensitivity of the hypothalamo-pituitary axis to the negative feedback effects of estrogen. In lactating women estradiol levels remain low as long as prolactin levels remain high. Despite an adequate store of releasable FSH and LH in the pituitary, estrogen secretion does not occur and the ovaries remain inactive. In pathological hyperprolactinemia, the high levels of prolactin also appear to be related to the absence of ovarian function. Many studies have shown that in some societies prolonged breast feeding, accompanied by lactational infertility, increases the birth interval and thus serves as a form of contraception. Other studies indicate that lactation is not associated with infertility for all women and that the number of suckling episodes introduces variation in the lactational maintenance of infertility. Further studies are needed concerning the relationship between suckling frequency and prolactin level. In addition there is a need to develop a reliable method for detecting the resumption of ovulation.
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PMID:Effects of lactation on fertility. 38 62

Thirteen women with infertility thought due to anovulation were treated with LRH. Etiologic diagnoses of amenorrhea included hypothalamic or "idiopathic" and PCOD. All patients had normal gonadotropins and otherwise normal endocrinologic and infertility evaluations; none had ovulated with clomiphene. Patients were studied for six 35 day cycles, single blind, and received LRH or placebo by subcutaneous injections for 28 days/cycle (LRH dosage 1.0 mg 2 or 3 times each day). Frequent assessments of physical status, cervical mucus, vaginal cytology, and serum LH, FSH, estrogen, and progesterone were performed. Ovulation was documented by basal temperature, serum progesterone and, on occasion, endometrial biopsy. Follow-up was continued for 6 months after therapy. Of the 13 patients treated, eight have ovulated and five have conceived. There were no complications of therapy.
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PMID:Ovulation induction with luteinizing hormone--releasing hormone in amenorrheic, infertile women. 38 50

Plasma testosterone levels were measured in the female partners of 146 consecutive infertile couples. The incidence of hyperandrogenism in the woman was correlated with ovarian function, incidence of pregnancy, male factor, and response of plasma testosterone levels to prednisone treatment. Over 70 per cent of the patients had pretreatment testosterone levels above 40 ng. per 100 ml. while after a minimum of two months of therapy approximately 80 per cent had levels below 40 ng. per 100 ml. High levels of plasma testosterone were associated with significant prolongation of the follicular phase of the cycle and increased incidence of amenorrhea or anovulation. An over-all pregnancy rate of 50.4 per cent resulted from the treatment. A direct relationship between pregnancy rates and sperm density as well as between pregnancy rates and degree of suppression of plasma testosterone after therapy was observed. These results demonstrate a high incidence of hyperandrogenism in female partners of infertile couples. The effectiveness of glucocorticoid treatment appears to be related to suppression of excessive androgen levels. The data also suggest that infertility is a relative state related to the fertility potential of each member of the couple. Improvement of the fertility potential of either member may result in conception.
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PMID:Testosterone levels in female partners of infertile couples. Relationship between androgen levels in the woman, the male factor, and the incidence of pregnancy. 42 Feb 68

With the advent of the prolactin radioimmunoassay and more sensitive methods of roentgenologic examination, prolactin-secreting pituitary tumors are now being diagnosed with much greater frequency. Definitive treatment has been considered to involve transphenoidal hypophysectomy. The symptoms of hyperprolactinemia including amenorrhea, galactorrhea and infertility can usually be controlled without difficulty by bromergocryptine therapy, but little is known regarding continued tumor growth. Bromergocryptine and other ergot alkaloids have been shown to decrease the production of prolactin and to inhibit the rate of pituitary tumor growth in animal studies. In man, evidence for a similar effect is not as clear. The present study demonstrates tumor regression associated with bromergocryptine therapy in two patients.
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PMID:Regression of pituitary tumors, a possible effect of bromergocryptine. 43 74


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