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

During the past decade, the development of various gonadotrophin-releasing hormone (Gn-RH) agonists, which induce reversible hypo-oestrogenism has opened a new area in the medical management of endometriosis. In an open, multicentre phase III study, the efficacy, tolerance and safety of the Gn-RH agonist leuprorelin acetate were tested. The preliminary results of 104 women treated in seven German centres are presented. Pelvic endometriosis was diagnosed by laparoscopy and classified according to the American Fertility Society scoring system: 33% of patients had minimal, 22% mild, 28% moderate and 8% severe endometriosis and in 9% no pathological results were obtained. The patients' mean age was 30 +/- 6 years and 66 had infertility problems. Treatment was started within the first 3 days of the menstrual cycle and consisted of a subcutaneous injection of leuprorelin acetate 3.75 mg, repeated once monthly over 24 weeks. A follow-up period of 12 months after the last injection has been completed in 70 patients, including a second laparoscopy. At all visits, symptoms were evaluated, physical examinations performed, and blood samples collected for haematological screening, serum chemistry determinations and measurement of the gonadotrophins oestradiol and progesterone and leuprorelin acetate. The median score at laparoscopy fell from 12 before operation to 8 after operation and 2 after treatment with leuprorelin acetate. Of the total number of patients, 89% had improvements in their endometriosis, 8% a deterioration and 3% no change. Patients reported improvement in the following: dysmenorrhoea 93%, dyspareunia 62% and pelvic pain 70%. However, all women complained of at least one of the following symptoms: hot flushes 86%, sleep disturbance 62%, sweating 61%, headache 41%, nausea 32% and depression 20%. Fifty-five percent of patients reported additional side effects such as vaginal dryness, fatigue and lower abdominal pain. After the third injection, amenorrhoea persisted in 94% of the women. Four weeks after the first leuprorelin acetate injection median concentrations of oestradiol fell from 45 pg/ml to 11 pg/ml, follicle-stimulating hormone from 7 U/L to 3 U/L and luteinising hormone from 5 U/L to 1 U/L and remained almost unchanged over the observation period. During the 6 months' treatment, laboratory parameters showed no significant deviations from normal; only total cholesterol, high-density lipoprotein cholesterol and alkaline phosphatase increased. Treatment results were judged as good and satisfactory in 82% and 11% of cases, respectively. On the basis of this study, it can be concluded that leuprorelin acetate treatment is safe, well tolerated and effective in the medical management of endometriosis and endometriosis-related complaints.
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PMID:Treatment of endometriosis with leuprorelin acetate depot: a German multicentre study. 153 21

Human fertility is part of biological anthropology embracing human population biology devoted to the analysis of the nature, caused, origin, and development of human variation at molecular, cellular, and whole body levels. The successful outcome of human fertility depends on the interactions of biochemical, physiological, and psychological processes whose disturbance results in slight variations in behavior and even total infertility. The Hutterites in the US have the highest average fertility with over 11 live births/women. Hunter-gatherer groups rarely have more than 4 children/woman. The case of a woman who gave birth to 67 children was recorded. Total infertility often occurs even in noncontracepting societies. The most important factor that determines the character of genetic variation within the human species seems to be comparative population growth, as this was the factor determining which populations spread and which became extinct. The study of the determinants of female fertility has attracted attention recently because pregnancy and motherhood affect daily life, and in turn, reproduction is also affected by daily life. Lactational amenorrhea plays a vital role in child spacing, but the mechanism of breast feeding is complex with factors of duration, frequency, milk production, and suckling frequency interwoven. Female reproduction comprises whole body function, nutrition, body composition (the recent debate on fat stores affecting the onset of fertility), physical work, and mental health all influencing the endocrinological state. Heavy physical labor and intensive training by sportswomen can result in amenorrhea. Beta-endorphins also play a role in lactational amenorrhea along with nutrition and body composition. Infectious and venereal diseases particularly affect fertility, yet genetics protect the placenta against falciparum malaria in sickle-cell trait women.
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PMID:Human fertility studies under field conditions. Introduction. 163 57

Subfecundity is caused by disease and nutrition as well as by genetic, environmental, and psychological components. Sexually transmitted diseases (STDs) are caused by 21 different pathogens of which syphilis, gonorrhea, and chlamydia are the most important. Syphilis is caused by the bacterium Treponema pallidum with incidence of 10% in Thailand. 20% in Papua New Guinea, and 40% in Ethiopia. Stillbirths in infected mothers range from 66% to 80%. Gonorrhea is caused by the bacterium Neisseria gonorrhoea and its incidence was 18% in female patients in Ugandan clinic. 20% of women in Africa with cervical gonorrhea develop salpingitis. The risk of pelvic inflammatory disease is several times higher in IUD users. The bacterium Chlamydia trachomatis caused infertility in 15.4% of men in a 1991 study. Herpes simplex virus 2 infects 15-30% of sexually active adults, and the chance of fetal transmission is 40% when maternal lesions are present. Diseases other than STDs include tuberculosis (TB) whose development is aided by conditions such as malnutrition, malaria, leprosy, syphilis, and African sleeping sickness. Genital TB causes a 5-50% rate of menstrual disorders including amenorrhea and a 55-85% rate of sterility in women. Malaria is caused by Plasmodium protozoa, and the feverish state included by it can lead to oligospermia. Severe malarial anemia can lead to fetal and maternal mortality. The protozoa Trypanosoma causes African sleeping sickness that produces azoospermia and impairs the pituitary gland and ovaries. Schistosomiasis (bilharzia) and filariasis have less direct effect on fecundity but they negatively impact nutritional status. Maternal nutrition substantially impacts fetal and infant survival. During the Dutch famine of 1944-45 there was a 50% decrease in births 9 months subsequently. A 10-15% weight loss results in amenorrhea.
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PMID:Endemic disease, nutrition and fertility in developing countries. 163 64

Infertility and amenorrhea are reported in most cases of Wilson's disease. In this report, we describe a case of Wilson's disease with pancytopenia and liver cirrhosis for over 4 years, without any specific treatment. After 2 years of D-penicillamine therapy, the patient became pregnant and delivered a liver mature female baby with a body weight of 2,800 g. Both before the pregnancy and after delivery, brainstem auditory evoked potential studies showed similar bilaterally abnormal prolongation in the III-V and I-V intervals. In visual evoked potentials, the P 100 latency was delayed bilaterally. Although serial evoked potential studies failed to show any improvement, a successful pregnancy was proven to be possible in a patient with Wilson's disease who had received regular D-penicillamine treatment.
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PMID:Successful pregnancy after D-penicillamine therapy in a patient with Wilson's disease. 168 Oct 22

An introduction of the lactational amenorrhea method (LAM) if natural family planning for fully breastfeeding postpartum women is presented based on the Bellagio Consensus Statement and a study at centers in Australia, England and Canada. Natural family planning programs have until recently advised women to accept a 7-12 week period of natural infertility after childbirth, and to improve results of natural family planning by weaning the baby early to obtain regular menstrual cycles so they can use their prior natural method. Now that more women are breastfeeding, and lactational amenorrhea is being studied worldwide, it is recognized that LAM is about 98% effective for the 1st 6 months postpartum in fully breastfeeding women. The collaborative study found that the 1st ovulation occurred on Day 264 in Canada and 237 in Australia on average. An algorithm for questioning a mother to learn if she is a candidate for LAM from the Bellagio Consensus is included. MOre research needs to be done on the significance of spotting, how intense breastfeeding must be, whether any supplementation of use of a pacifier is possible, whether the pregnancy rate can be reduced, and what program changes are needed to put LAM into effect.
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PMID:Is the lactational amenorrhea method a part of natural family planning? Biology and policy. 175 61

This literature review compares the merits and disadvantages of the levonorgestrel-releasing IUD made by Leiras Pharmaceuticals, Turkey, Finland (LNG-IUD-20), with the Nova-T, Copper-T (TCu) and 220C, and Copper-T-38-Ag (TCu-380Ag). This IUD releases 20 mcg levonorgestrel daily from a Silastic sleeve on the vertical shaft containing 52 mg. The plasma level stabilized after a month at about 0.2 ng/ml, about half as high as that seen with Norplant implants. It is identical in size to the Nova-T. The Cu-T IUDs differ with respect to copper wire or sleeves, or silver-cored wire. The chief studies reviewed here were 2 multi-center trails primarily in European countries, and a 2 large multi-center trials in India. Cumulative pregnancy rates were 0.0 to 0.6 per 100 users for the LNG IUD, compared to slightly higher failures for inert or copper IUDs. While removal rates for bleeding, pain and pelvic inflammatory disease were lower for the LNG-IUD-20, removals for oligomenorrhea, amenorrhea and hormonal side effects were higher than for the other IUDS. In the Indian trials, removals for amenorrhea and irregular bleeding were much higher than rates reported in the European studies, resulting in significantly lower continuation rates overall. The results pointed to district benefits for the LNG-IUD-20, such as lower blood loss and anemia, relief of dysmenorrhea and menorrhagia, as well as possible lower risks of ectopic pregnancy in case of failure, less PID (pelvic inflammatory disease), and the claim by the maker that strictly correct placement is not necessary. Disadvantages of the LNG-IUD-20 are more difficult insertion due to the wider diameter; oligomenorrhea, amenorrhea and irregular bleeding; hormonal side effects such as acne, weight gain, nausea, headache and breast tension; and potential risk of functional ovarian cysts. The LNG-IUD-20 is considered comparable to copper IUDs in effectiveness, safety, longevity, and return to fertility after removal. Users should be counseled that the oligomenorrhea or amenorrhea is neither a medical problem or indicative of infertility, is common for the 1st 2 months, is reversible on removal, may signal an improved hemoglobin profile, relief of dysmenorrhea, and may be preferred to heavy bleeding from other IUDS. The program implications of this IUD are potential lower incidence of ectopic pregnancy and PID. The effect of its use on breast feeding, cost-effectiveness compared to Norplant, in-country manufacture, and cultural acceptance need to be determined in specific locales.
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PMID:An evaluation of the levonorgestrel-releasing IUD: its advantages and disadvantages when compared to the copper-releasing IUDs. 177 15

The study covered 600 completed pregnancies over a 12-month period employing the simplified methodology developed by the WHO/MCH Working Group on Breastfeeding and Fertility. Postpartum lactation amenorrhea among breastfeeding respondents was similar in duration compared with that of all women: 43% were amenorrheic until 5 months postpartum, which declined to 9%-10% by 12 months postpartum. Only 9.6% of those breastfeeding were breastfeeding exclusively, while 90.4% were breastfeeding partially. 93.5% of the respondents breastfed on demand and 74.8% did more than 6 times a day. The Chi-square test indicated a link between amenorrhea and breastfeeding until 7 months postpartum. Breastfeeding alone did not increase the duration of postpartum amenorrhea, but research has indicated that the intensity, duration, and frequency of the suckling are factors that determine the length of postpartum infertility. These data could be used in guidelines for breastfeeding education as part of family planning programs to increase the duration and frequency of exclusive breastfeeding during the first 7 months for infant health protection and the reduction of the risk of pregnancy.
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PMID:Breast-feeding and fertility: risk of conception based on breast-feeding status in a selected Metro Manila urban poor community. 181 45

The purpose of the study was to describe hypothalamopituitary functional status of females with infertility in combination with hyperprolactinemia. To this end, changes in prolactin, LH, FSH and TSH in response to the administration of releasing hormones (Gn--RH and TRH) and the dopamine antagonist metoclopramide were assessed in 28 patients with hyperprolactinemic amenorrhea and 5 normal cycling women. Lactotrophs were found to be resistant to functional tests, the resistance increasing as the prolactin level went up. Gonadotrophic and thyrotrophic response to functional tests, on the contrary, increased with the progress of hyperprolactinemia. A conclusion is drawn that stable hyperprolactinemia is a result of disturbance in lactotrophic receptor apparatus, for which reason lactotrophs are no longer sensitive to dophamine inhibiting effect on prolactin secretion.
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PMID:[Disorders of the hypothalamo-hypophyseal system as a cause of infertility in hyperprolactinemia]. 183 59

Advantages and disadvantages of various methods of contraception in nulliparous women are reviewed with special emphasis in hormonal and intrauterine contraception. The use of hormonal contraceptives in young women can induce changes in the still immature hypothalamo-hypophyseal-ovarian system. One of the most frequent side-effects of hormonal contraceptives in young nulliparous women is amenorrhea. Short-term use of 2 or triphasic contraceptives with low content of estrogens and gestagens can stimulate secretion of hormones by ovaries and lead to development of polycystic ovary or endometrial hyperplasia. Intrauterine devices (IUD) do not have a negative systemic effect on the hypothalamo-hypophyseal-ovarian system. Among the IUD models recommended for the use in nulliparous women are Copper-T, Nova-T, Multiload. Effectiveness of IUD ranges from 91.3% for inert Lippes loop, to 98.3% for copper-containing IUD, and 99.8% for progesterone-containing IUD. Dilatation of narrow cervical canal in nulliparous women prior to insertion of IUD can cause traumatic injury of the cervical canal and subsequent cervix insufficiency. Anatomical characteristics of the uterus in young nulliparous women (greater length of the cervical canal in comparison with the length of the cervix cavity) require careful selection of the IUD size to fit the size of the cervix cavity. Complications associated with the use of an IUD include pelvic inflammation with subsequent tubal infertility. The frequency of ectopic pregnancy ranges from 4.1% after the use of inert IUD, to 3% after the use of copper-containing IUD, and 16% after the use of progesterone-containing IUD. Complications are the most frequent within the first 3-8 months of the use of IUD.
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PMID:[Intrauterine contraception in nulliparous women]. 186 76

In a prospective study, 140 patients with infertility because of ovulatory factors (group A) were followed up for 6 months after failure to achieve pregnancy using human menopausal gonadotropin (hMG) therapy. They included cases of oligomenorrhea, polycystic ovarian disease (PCOD), and hypogonadotropic amenorrhea. They were treated with hMG alone or in combination with clomiphene citrate or gonadotropin-releasing hormone agonist analog. The control group (B) included 83 infertile patients because of similar ovulatory factors. They were followed up for 6 months not preceded by ovulation induction. The overall pregnancy rate (PR) in group A (20.7%) was significantly higher than group B (7.2%). The PR was significantly higher in oligomenorrhea and PCOD patients when compared with the control group. There was no significant difference in the hypogonadotropic group.
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PMID:Improvement of spontaneous pregnancy rate after stopping gonadotropin therapy for anovulatory infertility. 190 Dec 80


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