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

On the basis of 120 cases, the authors discuss the diagnostic problems of the Asherman's syndrome. They propose the accomplishment of hysterography in all cases when amenorrhea, hypomenorrhea, sterility or infertility develops after curettage during gestation period and puerperium. They describe the technical difficulties of X-ray examination, the appraisal of medicine certificates and the problems of differential diagnosis. The diagnosis of intrauterine synechia is usally based on the roentgen examination, but uterine sounding must also be performed, and these findings must be compared with the symptoms.
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PMID:[Diagnosis of Asherman's syndrome (intrauterine synechiae)]. 96 Dec 8

33 patients, 25 of whom were consulting for infertility problems and 8 for family planning, were evaluated as to the state of their endocrine systems. 38 ovarian biopsies were taken by culdoscopy, in 28 unilaterally and in the rest on both sides. They were done during the 2nd half of the cycle as a wedge resection. Both an endometrial biopsy and a salpingochromatoscopy were done at once. The histologic study found 30 normal ovaries, 1 case of diminished follicular tissue, and 2 cases without follicular tissue. The macroscopic examination found 20 normal ovaries, 2 hypoplastic, and 11 micropolycystic. A relationship was drawn between symptoms and macroscopic appearance of the ovary and histology of the follicular system. 93.9% of the patients were discharged in 24 hours. The biopsies gave a clearer indication of the total problem than the endocrine evaluation. 5 cases of amenorrhea were normalized and the other problems could be thoroughly considered. For example, the probability of pregnancy without follicular tissue is nil and with limited follicular tissue is unlikely.
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PMID:[Ovarian transculdoscopic biopsy, technic and clinical evaluation]. 101 Mar 44

A luteinizing hormone/follicle-stimulating hormone-releasing hormone (LH/FSH-RH) test was performed in 70 women with amenorrhoea or anovulatory infertility, or both, and a clomiphene stimulation test was also performed in 24 of these patients. Most patients responded to LH/FSH-RH with significant increases in LH and FSH. In women with gonadal dysgenesis or premature ovarian failure exaggerated responses were observed after LH/FSH-RH and there was no change in high basal LH levels after clomiphene. Patients with absent or impaired responses to LH/FSH-RH failed to respond to clomiphene. All patients with anovulatory menstrual cycles responded to both LH/FSH-RH and clomiphene, while seven out of 13 amenorrhoeic patients with a normal LH/FSH-RH response showed an early LH rise during clomiphene treatment and six were unresponsive. These results suggest a difference between the two groups at hypothalamic level with consequent therapeutic implications.
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PMID:Use of clomiphene and luteinizing hormone/follicle stimulating hormone-releasing hormone in investigation of ovulatory failure. 109 37

Serum prolactin and gonadotrophin concentrations were measured by radioimmunoassay in 106 women with amenorrhoea. Prolactin was normal in those with weight related disorders, primary ovarian failure, those with a variety of systemic diseases and in those in whom amenorrhoea followed treatment with the oral contraceptive and in unexplained primary amenorrhoea. Gonadotrophin concentrations in the above patients were normal except in those with primary ovarian failure. Prolactin was elevated in eight of forty patients (20%) with functional secondary amenorrhoea and was greatly raised in all but one of the thirteen women in this series with pituitary tumours (five of whom were studied only after treatment). Only three patients in each of the last two groups had galactorrhoea. Gonadotrophin levels were normal or slightly raised in all of the hyperprolactinaemic patients apart from those studied after hypophysectomy. Four hyperprolactinaemic patients (three with pituitary tumours and one with functional amenorrhoea) who did not have galactorrhoea have been treated with bromocriptine. Prolactin secretion was reduced in all patients and, in the two with normal gonadotrophins, ovulatory menstruation was resumed. One became pregnant in the second ovulation cycle after starting treatment. We conclude that, despite the rarity of galactorrhoea, hyperprolactinaemia is common in patients with functional amenorrhoea and in those with pituitary tumours. Treatment with bromocriptine in patients with normal gonadotrophins restores ovulation when the infertility is due to prolactin excess.
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PMID:Incidence and significance of hyperprolactinaemia in women with amenorrhea. 110 18

In an effort to diminish the incidence of multiple pregnancy, ovarian hyper-stimulation syndrome, and the excessive cost of human menopausal gonadotropin (HMG) administration, a sequence of Clomid-HMG-human chorionic gonadotropin (HCG) was used in 80 patients with infertility due to prolonged amenorrhea. Criteria for this therapeutic regimen were: (1) normal seminal fluid analysis and postcoital test; (2) lack of withdrawal bleeding from progesterone following amenorrhea of more than 6 months' duration; (3) normal x-ray of the sella turcica and visual fields; (4) low serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels; (5) normal endoscopic examination; and (6) lack of response to clomiphene in excessive dose (200 mg daily for 5 days) or prolonged dose (100 mg daily for 10 days) with or without HCG, or apparent ovulatory response to the above sequence for five or six consecutive cycles without pregnancy. Clomiphene was administered in a dose of 100 mg daily for 7 days. HMG was then given in the following manner: two ampules daily for 4 days, then one ampule daily for 2 days (75 IU of FSH and 75 IU of LH/ampule). After a 24-hour interval without treatment, 10,000 IU of HCG were given and 2000 IU of HCG 4 days later. Twenty-three pregnancies occurred in 80 patients. However, 15 of the first 25 patients became pregnant--in these patients the only abnormality noted was lack of ovulation. Six additional pregnancies occurred subsequent to one or more unsuccessful cycles. Multiple pregnancies occurred in only two patients (twins delivered at 32 weeks in one and an abortion of five fetuses at 20 weeks in another). However, multiple pregnancy did not occur in any patient whose urinary estrogen level was monitored and in whom the level was 100 mug or less when the HCG was given. The ovarian hyperstimulation syndrome did not occur in any patient.
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PMID:Sequential use of clomiphene citrate and human menopausal gonadotropin in ovulation induction. 124 45

This article reviews current knowledge about the effects of anorexia nervosa, bulimia nervosa and partial syndromes on ovulation, menstruation, sexuality, fertility, pregnancy and fetal-infant health. Eating disorders may result in failure to ovulate, oligomenorrhea, amenorrhea, reduced sex drive, infertility, hyperemesis gravidarum, low maternal weight gain in pregnancy, small babies for gestational date, low birth weight infants, increased neonatal morbidity and problems in infant feeding. The available information suggests that clinicians should inquire about nutritional intake, a history of eating disorders and weight reducing behaviours as part of the routine assessment of patients with the disorders of reproductive function listed above. If an eating disorder is discovered before conception, the woman should be encouraged to delay pregnancy until the eating disorder is treated and effectively under control. If the woman is pregnant, early diagnosis and treatment are essential to reduce maternal and fetal complications. The infants of eating-disordered women should be carefully followed to ensure adequate nutritional intake. Problems in reproductive function related to eating disorders offer rich opportunities for multispecialty collaboration in primary and secondary prevention programmes directed toward both mother and infant.
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PMID:Reproductive functions in eating disorders. 138 91

The authors examined five children with the non-classical form of adrenal hyperplasia. The clinical symptoms of the disease comprise: early congenital pubic hair, small stature, accelerated bone maturation, infertility, in girls hirsutism, acne, menstrual disorders, amenorrhoea, in boys oligospermia, acne. Laboratory examination reveals slightly elevated 17-OH progesterone values during the synactene loading test. It is an autosomal recessively hereditary disease. It is due to an allelic variant of the gene for 21 hydroxylase. The authors revealed a link with antigen B14. Even in the small group examined antigen B14 was present in 40%, although the prevalence in our population is 2.9%.
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PMID:[A non-classic form of congenital adrenal hyperplasia]. 139 39

In Kenya, researchers compared data on 377 25-34 year old women in rural Kisa with data on 338 such women in rural Ena to determine changes in contraceptive adoption, method switching, and method discontinuation and to examine the effects of contraceptive use of fertility in relation to other determinants of fertility. Contraceptive prevalence rose between 1987 and 1990 in both areas. It rose somewhat more quickly and was greater in Ena than Kisa (35-50% vs. 12-20%). Similarly more women had ever used a method in Ena than Kisa (76% vs. 35.5%). Women in Ena were more likely to use natural methods than those in Kisa (77 episodes vs. 11 episodes). Adoption of injectables was the contraceptive which showed the strongest net growth in both areas. In Ena, adoption of the IUD also grew considerably. The contraceptive mix in Ena was more balanced than it was in Kisa. In Ena, natural method users had fallen. The 3 main methods were oral contraceptives (OCs), injectables, and IUDs. Injectables and OCs predominated in Kisa. Few women used natural methods. Tubal ligation increased among high parity women. Few women in either area used condoms. OCs, barrier methods, and natural methods were used for short-term birth spacing. The major reasons for discontinuation were wanting another child (34.3%) and method failure/poor compliance (30.2%). Considerable male out-migration from Kisa (58% vs. 21% for Ena) and high infertility levels (untreated sexually transmitted diseases transferred to wives from husbands who had out-migrated) may have kept fertility levels relatively low. Most husbands had returned to Kisa during the Christmas holiday (80% of couples together) resulting in birth seasonality with peaks in September-October. Postpartum amenorrhea played a greater role in protecting women against pregnancy in Kisa than it did in Ena (51% vs. 35%). Women of Kisa had higher number of live births and age at 1st birth than women in Ena (4.4 vs. 3.6 and 18.6 vs. 19.8, respectively, p.001), especially simultaneous postpartum amenorrhea and separation (15% vs. 2%).
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PMID:Fertility and contraceptive adoption and discontinuation in rural Kenya. 141 98

In this paper current issues on four psychosomatic disorders related to gynecology will be reviewed. The history, nosological problems and psychoneuroendocrine correlates of psychogenic amenorrhea have been summarized taking into account the important role of psychological factors in inducing loss of menses. Definition and diagnostic problems in assessing menstrually related disorders (formerly premenstrual syndrome) have been reviewed, looking at this syndrome as a disorder of adaptation to the cyclical changes of neuroendocrine functions. The impact of stress on fertility and, on the other hand, the effects of infertility on psychological well-being have been pointed out trying to ascertain the pathways involved in these mutual relationships. Finally, the issue of mood changes at menopause and the effects of steroid replacement on affective state have been discussed. As a whole, these evidences indicate the importance of a close cooperation between gynecologist and psychiatrist in the management of gynecological disorders.
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PMID:Psychosomatic disorders related to gynecology. 148 98

In order to determine whether serum-immunoreactive inhibin could constitute a biochemical marker for the presence and progression of ovarian granulosa cell tumors and their metastases, we measured immunoreactive inhibin concentrations in series of serum samples obtained from 8 patients with granulosa cell tumor. Six series were tested in retrospect. From these, three came from patients who had been treated with an abdominal hysterectomy and bilateral salpingo-oophorectomy. In the 2 patients with residual or recurrent disease, inhibin was elevated, 4 and 20 months respectively before clinical manifestations of recurrence became evident; it reflected the effects of secondary therapy. Inhibin remained undetectable in one patient who was free of disease during 11 years of follow-up. Inhibin concentrations were also inappropriately increased in 2 of 3 women with amenorrhea and infertility resulting from small granulosa cell tumors. After removal, inhibin concentrations became normal and fertility resumed. Fertility also returned in the third patient. There was a significant negative correlation between the serum inhibin and FSH concentrations, consistent with autonomous production of inhibin by granulosa cell tumors. It is concluded that granulosa cell tumors have the capacity to produce inhibin. In retrospect, inhibin proved to be a marker for both primary and also recurrent and residual disease.
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PMID:Inhibin as a marker for granulosa cell tumor. 150 91


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