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)

In women migraine attacks are often related to hormonal changes and it has been demonstrated that migraine attacks correlate with falling plasma estrogen levels. Sulpiride, a benzamide derivative with neuroleptic and thymoleptic properties, is known to act at the hypothalamic level and in particular, to inhibit releasing factors responsible for follicle-stimulating hormone and prolactin secretion. In this way, sulpiride keeps estrogen levels low and prevents major fluctuations. 34 women and 6 men with classical, recurrent attacks of migraine were treated with sulpiride 300 mg/day, for several month and up to a two-year period. Of these, 55 percent became completely free of migraine, 20 percent improved, and the remaining 25 percent did not benefit. When sulpiride was withdrawn, migraine frequently recurred. Side effects were related to the above-mentioned hormonal changes: amenorrhea or delayed menstruation in 60 percent, breast tension in 40 percent and transient galactorrhea in 14 percent. Some weight gain was reported from allmost all patients.
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PMID:[Sulpiride in the prevention of migraine. A mechanism of hormonal interaction?]. 85 8

36 original cases, 24 from the Hopital de Sainte-Anne in Paris and 12 from the surrounding region, of ischemic (30) or hemorrhagic (6) strokes in women taking oral contraceptives are reported. The patients were 20-55 years, half under 30; took various types of pills from 10 weeks to 10 years, mean 28 months; 30 of them for contraception but other for migraine, Reclus disease, amenorrhea, sterility, and endometri osis. 27 women had related history: ischemic vascular accident (5), hyp ertension (5), thromboembolism (4), Basedow disease (3), heavy smoking (3), essential comitiality (2), migraine (1), essential hyperlipidemia (1). The women with ischemic strokes were younger, 61% under 30. A 3rd had premonitory symptoms like headache, progressing rapidly to massive hemiplegia in 17, discrete hemiplegia in 11, loss of consciousness in 6, and convulsions in 3. The cerebrospinal fluid was clear in 11 cases tested. Angiography revealed lesions in the internal carotid in 4, sylvian arteries in 9, posterior cerebral in 1, but no anomaly in 8. Only 5 recovered completely: 3 died and 7 retained major neurologic dysfunction. 6 women had hemorrhagic strokes, 2 intracerebral hematomas, and 4 cerebromeningeal hemorrhages. 5 were operated on, 3 with good results and 2 were left with severe neurologic sequelae. The authors insisted that none of these women had been given any preliminary tests or followed with any attention to their related history while taki ng oral contraceptives.
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PMID:[Cerebrovascular accidents and oral contraceptives (reflections a propos of 36 observations)]. 121 91

This article serves as a summary of the principles of prescription, hormone content, minor side effects, prescriptions for atypical individuals and significant drug interactions for oral contraceptives. There are 5 principles for prescribing oral contraceptives: the lowest possible dose should be given that is effective and produces the least side effects: adequate instructions should be given about the mode of action, taking the medication and possible side effects; adequate instructions about managing missed pills should be given; adequate supervision and explanations should be given if side effects occur; remember that each woman is different and idiosyncratic reactions to different formulations can occur. Possible side effects include: breakthrough bleeding, amenorrhoea, dysmenorrhoea, breast fullness and tenderness, nausea, chloasma, depression, acne, migraines and weight gain. Certain individuals such as epileptics, diabetics, women over 35 and women who have recently given birth need special care. Rifampicin, the phenytoins and barbiturates can all decrease the effectiveness of oral contraceptives. Oral contraceptives may effect the action of anticoagulants, antidiabetic agents and imipramine.
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PMID:Choosing an oral contraceptive. 307 12

This article deals with the use of oral contraceptives and IUDs by chronically ill adolescent females. Results of controlled studies of contraceptive choices and problems are reviewed for teenagers with cardiac disease, epilepsy, multiple sclerosis, migraine headaches, asthma, cystic fibrosis, inflammatory bowel disease, hepatitis, diabetes mellitus, thyroid disease, oligomenorrhea and amenorrhea. If oral contraceptives (OC) are prescribed for use in teens with cardiac disease, a contraceptive with 35ug or less of estrogen and the equivalent of 1 mg or less of norethindrone should be used. The low-dose progestin only pill can be prescribed, but should be used in conjunction with a back-up barrier method. Reports to date have failed to reveal increased seizure activity in epileptic pattients on OCs, and there is no significant evidence to date that OCs alter the course of multiple sclerosis. Although the evidence is inconclusive, the physician should use extreme caution in prescribing OCs for teens with prior migraines. Regarding asthmatic patients, no problems have been reported with IUD use except in regard to steroid therapy and its possible effect on reducing IUD effectiveness. No adverse effects 2ndary to the use of OCs in asthmatic patients have been reported. OCs should be avoided or used with extreme caution in the cystic fibrosis patient. Teens with active inflammatory bowel disease should be advised that OCs may be ineffective or dangerous; there are no reports available on the effects of the IUD on the disease. The pill is contraindicated during active liver disease or cirrhosis. The IUD is not highly recommended for contraception in diabetic teenagers, whereas a low-dose combined OC can be used with extreme caution. However, OCs should be avoided in the diabetic patient with nephropathy, vascular complications or retinopathy. There is at present no contraindication for contraceptive use by women with thyroid disease. Finally, patients with prolonged post pill amenorrhea and infertility are generally females with amenorrhea or oligomenorrhea before pill use.
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PMID:Contraceptive use in the chronically ill adolescent female: Part I. 351 58

Metoclopramide, a dopamine antagonist, is approved in the U.S. for the treatment of various gastrointestinal disorders. Its use has been investigated in a wide variety of diseases, including those not involving the intestinal tract. Although more study is required before routine clinical use of metoclopramide can be advocated, it may be effective in the treatment of tardive dyskinesia, in decreasing the risk factors associated with anesthetic-related aspiration, and as an adjunct in the treatment of gastric bezoars. It also may be used safely in patients with Parkinson's disease. The use of metoclopramide in the treatment of neurogenic bladder, orthostatic hypotension, tumor-associated gastroparesis, nonprolactinemic amenorrhea, failure to thrive, Tourette's syndrome, anorexia nervosa, and hiccups, as well as an adjunct to migraine therapy, has been investigated, but sufficient evidence has not been accumulated to advocate the use of metoclopramide in these disorders.
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PMID:Potential uses for metoclopramide. 390 32

490 women who used Stediril (.5 mg norgestrel and .05 mg ethinyl estradiol, combined) for a total of 5600 cycles or 466 woman-years over a 3 year period are presented. They all took the pills primairly for contraception; most were 20-30 years old, and took Stediril 3-6 months. Some other indications were 119 cases of menstrual irregularity, 15 of spaniomenorrhea, 14 of premenstrual syndrome and 3 of acne, all relieved. 46 of 50 cases of menorrhagia, 83 of 89 of dysmenorrhea and 32 of 34 with pelvic pain were relieved. Withdrawal bleeding was usually less than before and tended to diminish with time. There were 46 women with nausea, 3 of whom stopped Stediril. Migraines sometimes a ppeared, sometimes disappeared, but often occurred regularly on the first day between pill cycles. 52 women complained of breast congestion for the first time. Weight rose in 2301, fell in 98 and stayed constant in 134 after 3 months: weight was easily controlled with diet and appetite supressant drugs. No hypertension was observed. There were 19 single cycles of amenorrhea, several cases of persistant amenorrhea and 4 cases of amenorrhea after stopping. 2-3% of cycles were marked by metrorrhagia; 63 women had spotting, 8 had significant metrorrhagia; 7 had metrorrhagia followed by withdrawal bleeding in that cycle. 1 woman had a thromboembolism of the left leg after 2 pill cycles during which she gained 3 kg. There was 1 pregnancy due to irregular pill use.
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PMID:[Clinical study of an estro-progestative association in low doses. Experience of 3 years (490 patients-5600 cycles)]. 426 90

The present status of oral contraceptive steroids and the IUD, the 2 most effective and increasingly popular contraceptive methods (used by 41.6% of all U.S. married couples practicing contraception in 1970), is presented. Oral steroid contraceptives with varying quantity and activity of estrogen (ethinyl estradiol or mestranol) and progestogen (norethindrone, norethynodrel, ethynodiol diacetate, or norgestrel), are of 3 types: combination, sequential, and minidose progestogen alone. The most effective contraceptive available is the combined oral pill with a pregnancy rate of less than .2 % per 100 women after 1 year. Contraceptive action is exerted primarily through inhibition of ovulation and secondarily by alterations in cervical mucus, endometrial glands, the ovary, and in the oviduct and uterine muscle. In comparison, sequential oral contraceptives are less effective with greater side effects, and should only be used in women with amenorrhea. Effects of oral contraceptives other than contraception include those on the (1) the primary targets of the female reproductive system, (2) on other endocrine oragans and (3) on the remainder of the body. In the first group, changes may include transitory stromal fibrosis in the ovary, enlarged fibromyomata, intermenstrual bleeding or amenorrhea, increased amount of cervical mucus, polypoid hyperplasia of the endocervical glands, breast tenderness, and changes in lactation. Changes in the second category which may occur affect the adrenal glands, hypothalamus, the thyroid (increased thyroid-binding globulin), and pancreas (alterations in glucose metabolism). Effects on the rest of the body may include increase in serum lipids and changed atherogenic index, abnormalities in liver function, thromboembolism (incidence in oral contraceptive users 4.4 times that in non-users), melasma, alterations in the central nervous system with increased incidence of cerebral vascular accidents, hypertension, and increased body weight. Absolute contraindications to oral contraceptive therapy include cancer of the breast and uterus, pregnancy, active liver disease, hyperlipidemia, and history of gestational diabetes, thromboembolic phenomena or coronary artery disease. Relative contraindications include depression, migraine, myomata of the uterus, hypertension, epilipsy, oligomenorrhea and amenorrhea. Reliable epidemiologic data on IUDs from the Cooperative Statistical Program indicated first year pregnancy rate of 2.5%. Problems with the IUD include: 1) pregnancy with device in situ, which is associated with a higher incidence of spontaneous abortion; 2) ectopic pregnancy, which is prevented at a rate of only 90% compared with intrauterine pregnancies prevented in 97-98%; and 3) expulsions (20% of which are unnoticed), the expulsion rate being higher with decreasing age and parity, higher in the first than second year of use, and higher with smaller than larger devices. A major problem is discontinuation for medical reasons (15% rate in the first year), mainly bleeding and pain. Perforation, another serious complication, occurs initially at time of insertion with an incidence of 1 per 2500 insertions for the loop. IUDs were found to produce a sterile inflammatory tissue reaction, which is postulated as the primary causative factor for their contraceptive effect in humans.
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PMID:Current status of contraceptive steroids and the intrauterine device. 459 80

Data is reviewed on premenstrual symptoms which have been related to high suicide and accident rates, employment absentee rates, poor academic performance and acute psychiatric problems. A recent study of healthy young women indicated that 39% had troublesome premenstrual symptoms, 54% passed clots in their menses, 70% had cyclical localized acneiform eruptions and only 17% failed to experience menstrual pain. Common menstrual disorders are classified as either dysmenorrhea or the premenstrual syndrome. Symptoms for the latter usually begin 2-12 days prior to menstruation and include nervous tension, irritability, anxiety, depression, bloated breasts and abdomen, swollen fingers and legs, headaches, dizziness, occasional hypersomia, excessive thirst and appetite. Some women may display an increased susceptibility to migraine, vasomotor rhinitis, asthma, urticaria and epilepsy. Symptoms are usually relieved with the onset of menses. While a definitive etiological theory remains to be substantiated, symptomatic relief has been reported with salt and water restriction and simple diuretics used 7 to 10 days premenstrually. Diazapam or chlordiazepoxide treatment is recommended before oral contraceptive therapy. The premenstrual syndrome may persist after menopause, is unaffected by parity, and sufferers score highly on neuroticism tests. Primary or spasmodic dysmenorrhea occurs in young women, tends to decline with age and parity and has no correlation with premenstrual symptoms or neuroticism. Spasmodic or colicky pain begins and is most severe on the first day of menstruation and may continue for 2-3 days. Treatment of dysmenorrhea with psychotropic drugs or narcotics is discouraged due to the risk of dependence and abuse. Temporary relief for disabling pain may be obtained with oral contraceptives containing synthetic estrogen and progestogen but the inherent risks should be acknowledged. Both disorders have been correlated to menstrual irregularity. Amenorrhea in many women may be precipitated by simple psychological events such as leaving home, while severely stressful events produce a higher incidence. Unless a physiological factor such as malnutrition is operating, menses usually recur spontaneously within a few months. Amenorrhea is a constant feature of anorexia nervosa and may precede related attitudes toward eating and body weight. This syndrome is best regarded as a chronic and often severe neurotic disorder requiring combined physiological and psychological treatment, although some evidence exists to indicate an endocrine disorder. Extensive basic research is needed on the complex relationship between the neuroendocrine system and emotion.
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PMID:Premenstrual symptoms. 473 36

20 patients treated with massive doses of progestagens (1250-4000 mg medroxyprogesterone im) for threatened abortion developed amenorrhea lasting 10-14 months, but 100 patients given a variety of more conservative treatments only suffered bleeding for up to 15 days. Of the 20 patients, 3 had 250 mg medroxyprogesterone per week, and 9 had 250-500 mg daily for 3-5 days, and 12 had unknown injections. After the spontaneous abortions, these women complained of nervousness, asthenia, migraines, loss of libido, and persistent weight gain of 3-17 kg. The cause of the amenorrhea was the depot effect of the progestagen inhibiting the release of gonadotropins and acting like a contraceptive. The menometrorrhagia was treated by up to 3 curettages in some cases or by estrogens (250 mcg ethinyl estradiol or 1-2 mg distilbene for 8-10 days). It was considered unwise to treat amenorrhea with combined estrogens and progestagens because metrorrhagia ensued. Recently, the author has administered Proluton Depot (microcrystalline progesterone), Primosiston (10 mg estradiol benzoate and 250 mg hydroxyprogesterone caproate), or Gravibinan (10 mg estradiol valerianate and 250 or 500 mg hydroxyprogesterone caproate). If the pregnancy miscarries, the first 2 treatments result in 3-5 days of bleeding, and the latter, 10-15 days. An even better treatment for threatened abortion is Gestanon (allylestrenol, orally), which gave no complications in 27 patients who miscarried.
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PMID:[Prolonged amenorrhea after abortion during intensive treatment with progestagens]. 556 18

Oral contraceptive agents (OCs) containing levonorgestrel, 150 micrograms, and ethinyl estradiol, 30 micrograms, account for almost half the sales of such agents in the United Kingdom. The remarkable success of this formulation has occurred primarily because it provides extremely low doses of both hormonal constituents yet still gives most users a very acceptable bleeding pattern: the incidence of breakthrough bleeding is about 6% and of amenorrhea, less than 3%. Approximately 90% of users have cycle lengths of 28 +/- 3 days. The risk of serious side effects is significantly lower than with formulas containing higher doses of progestogen and/or estrogen. Minor side effects occur in only a small percentage of cycles. Headache is reported in approximately 10% of all cycles and should be regarded as a potential indicator of increased risk. If it presents as focal migraine, use of the combined OC should be discontinued. The contraceptive effectiveness of the 150/30 formulation is similar to that of the 50 micrograms formulations among compliant women; in less compliant women the margin of error is reduced, and the possibility of an increased risk of accidental pregnancy must be considered.
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PMID:The 150/30 formulation. Experience in the United Kingdom. 640 2


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