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 49 patients affected by PCO syndrome the serum levels of dehydroepiandrosterone-sulphate (DHEAs) were determined and correlated with the clinical presentation and the endocrine pattern. Twenty-three patients (47%) had high DHEAs levels (h-DHEAs patients). They presented a milder clinical presentation (low incidence of amenorrhea) than PCO patients with normal DHEAs levels (n-DHEAs patients). In h-DHEAs patients the finding of a normal DHEAs response to ACTH and of slightly increased 170HP serum levels suggested that the elevation of serum DHEAs was not due to an adrenal enzymatic deficiency but to a tonic hyperstimulation of the adrenals. Two subgroups of h-DHEAs patients were identified: in the first subgroup, PRL and estrone levels were increased and probably explained the DHEAs hypersecretion; in the second subgroup, the endocrine pattern was very similar to that observed in n-DHEAs patients and a clear explanation for DHEAs increase was not found, although the possibility of an exaggerated secretion of some pituitary hormones with adrenal androgen stimulating activity must be considered.
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PMID:Increased DHEAs levels in PCO syndrome: evidence for the existence of two subgroups of patients. 300 97

To gain insight into the PRL-releasing effect of GnRH, serum PRL and gonadotropin responses to a 10-microgram iv bolus dose of exogenous GnRH were studied in hypergonadotropic hypogonadal women (HHW) and patients with functional hypothalamic amenorrhea (FHA). The results were compared with those obtained in normal cycling women during the early follicular phase of the cycle. GnRH induced a significant increase in PRL levels (P less than 0.001) in HHW compared to early follicular phase women, in whom no significant response occurred. In HHW, the maximal PRL percent increment was positively correlated with the ratio of the maximal percent increments of FSH and LH (r = 0.93). GnRH induced a significant increase in PRL levels in every FHA patient, but in four of them (high PRL responders), the PRL response was at least 5-fold greater than in the other six (low PRL responders). The clinical profiles, basal hormone concentrations, and LH responses to GnRH were similar in these two groups of FHA patients, but the FSH response to GnRH was greater (P less than 0.05) in the high PRL responders. The maximal percent increment of PRL was also positively correlated with the maximal percent increment of FSH (r = 0.76; P = 0.01). These data demonstrate that in these two hypogonadal models, the PRL response to exogenous GnRH corresponds to the FSH response and suggests that GnRH-stimulated PRL release may be mediated by a paracrine effect between FSH-enriched gonadotrophs and lactotrophs.
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PMID:Prolactin-releasing action of gonadotropin-releasing hormone in hypogonadal women. 308 30

To examine the long term effectiveness of transsphenoidal microsurgery for patients with PRL-secreting pituitary tumors, we studied 54 women at yearly intervals after transsphenoidal surgery. Five years after surgery, 19 women (35%) had normal serum PRL concentrations, and 23 (43%) had persistent hyperprolactinemia. Hyperprolactinemia recurred in 12 of 31 patients (39%) who had normal PRL concentration 6 weeks after surgery. None of the patients with recurrent hyperprolactinemia had radiographic evidence of tumor regrowth, and only 3 of 12 had amenorrhea. A serum PRL level below 6 ng/ml 6 weeks after surgery occurred more frequently in cured patients than in those who had a recurrence. PRL responses to TRH were normal in cured patients 1 and 5 yr after surgery and abnormal in those who had recurrent hyperprolactinemia. The PRL responses to chlorpromazine- and insulin-induced hypoglycemia were blunted in patients with normal as well as elevated PRL levels. Patients with recurrent, as well as those with persistent, hyperprolactinemia had no nocturnal rise in serum PRL 5 yr after surgery. The 39% recurrence rate of hyperprolactinemia and persistent abnormalities in pituitary-hypothalamic regulation of PRL secretion after transsphenoidal surgery raise important questions about the choice of primary therapy for patients with PRL-secreting tumors.
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PMID:Long term follow-up of women with surgically treated prolactin-secreting pituitary tumors. 308 39

Chemotherapy for malignant disease can cause gonadal dysfunction. However, little is known about the reversibility and severity of these effects in girls treated during childhood or puberty. For this reason we investigated clinical data and endocrine parameters (FSH, LH, PRL, E2, progesterone) of 51 adolescent females. Our clinical data showed that intermittent pulse chemotherapy as administered to most patients with solid tumours leads to a more pronounced growth retardation than continuous low dose chemotherapy as given to patients with leukemia and lymphomas. Girls treated prior to menarche failed to start menstruation while on chemotherapy, but all had their menarche shortly after cessation of the treatment. Most of the girls treated post menarche developed amenorrhoea, whereas some had irregular cycles unless they were on a very mild drug regimen. From the endocrinous data we concluded that primary ovarian failure was rare and occurred in adolescent girls only after a combination of chemotherapy and radiotherapy. In girls with regular menstrual cycles after treatment a high incidence of anovulation or an inadequate luteal phase could be observed. The latter symptoms may be signs of hypothalamic ovarian failure as caused by stress, anxiety and emotions associated with a malignant disease.
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PMID:[Puberty and ovarian function following cytostatic therapy in childhood]. 308 79

Two young women with clinically established pseudocyesis were studied by endometrial biopsy, basal hormonal serum levels and dynamic pituitary testing. Basal serum levels of PRL and TSH were in the normal range; estradiol - 17 beta, progesterone and FSH were in the follicular phase range, but LH was in the follicular phase range in one patient and in the climateric range in the other one. The histologic assessment of the endometrial biopsies disclosed a proliferative endometrium in both patients. A group of six patients with hypothalamic amenorrhea were subjected to dynamic pituitary testing to compare results with those obtained in the two patients with pseudocyesis. The dynamic pituitary response to GnRH, TRH and metoclopramide was normal in the two patients with pseudocyesis and in the group with hypothalamic amenorrhea; moreover, challenge with estradiol benzoate (EB) in the two patients with pseudocyesis disclosed a normal positive feedback of LH. These observations and the analysis of data already published suggest that the amenorrhea of pseudocyesis is associated neither with a persistent corpus luteum nor chronic hyperprolactinemia. We suggest that an abnormality in neurotransmitter pathways results in alterations of pituitary hormone secretion. However, additional patients must be studied to prove or disprove this hypothesis.
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PMID:Pituitary function in human pseudocyesis. 311 Feb 52

The exact cause of amenorrhea during the puerperium is still a matter of debate. PRL might inhibit primarily the release of FSH and LH or their stimulating effects on the ovary. In the study presented here, 28 healthy women were investigated, 13 of them lactating puerperae. In the other 15, lactation was prevented by drugs (metergoline in 9, bromocriptine in 6). The women's serum PRL, FSH, LH, beta-HCG and 17 beta-estradiol as well as their FSH and LH response to LHRH (100 micrograms i.v.) were tested 1, 3, 7 and 14 days after vaginal delivery. Serum PRL levels remained elevated in the lactating puerperae and dropped in the puerperae treated with metergoline or bromocriptine. The pattern of FSH, LH and beta-HCG levels as well as the FSH and LH response to LHRH were superimposable in lactating and in nonlactating women. 17 beta-estradiol levels dropped in all puerperae from day 1 to 7, but rose from day 7 to 14 only in the puerperae treated with metergoline or bromocriptine and not in the lactating women. These data indicate that PRL directly affects the ovarian response to FSH and LH, whereas the release of FSH and LH remains unaffected. A stimulatory effect of metergoline and bromocriptine on the ovarian steroidogenesis cannot be excluded.
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PMID:Puerperal lactation, gonadotropin release and estradiol release: effects of metergoline and bromocriptine. 312 58

To investigate the neuroendocrine changes that regulate initiation of normal menstrual function after parturition, serum LH, FSH, and PRL concentrations were determined at 20-min intervals for 12-24 h in eight nonlactating postpartum women on a weekly basis between postpartum days 10-26. Sleep was monitored by EEG. On postpartum day 10, serum LH concentrations were similar to early follicular phase levels in normal cycling women, while FSH concentrations were lower than early follicular phase levels. Mean LH pulse frequency during each postpartum interval was 3.6 +/- 0.6 (+/- SE), 4.4 +/- 0.6, and 4.1 +/- 0.8 pulses/12 h on postpartum days 10-11, 17-21, and 24-26, respectively. Because mean serum LH levels and LH pulse frequency did not change significantly between postpartum days 10 and 26, the results from the two or three studies in each woman were combined for the purpose of comparing LH pulse characteristics during the waking and sleeping periods. During the waking hours, mean LH pulse frequency (6.1 +/- 0.5 pulses/12 h) was significantly greater than during sleep (4.1 +/- 0.4 pulses/12 h; P less than 0.02). The amplitude of the serum immunoreactive LH pulses (P less than 0.05) and bioactive LH levels (P less than 0.05) were significantly higher during sleep than during the waking period, with five of the eight women having higher sleep-associated immunoreactive LH and bioactive LH levels between postpartum days 17-26. These changes were associated with an increase in the bioactive to immunoactive LH ratio from 3.3 +/- 0.4 (awake) to 4.5 +/- 0.5 (sleep; P less than 0.05). Although serum PRL levels remained elevated during the puerperium, the diurnal pattern of PRL secretion was conserved. With each successive week postpartum, serum PRL concentrations declined. These results suggest that the increment in LH secretion (and, by inference, increased GnRH secretion) during sleep is a feature of postpartum pituitary-ovarian reactivation. Although the mechanism(s) responsible for the increase in GnRH secretion is not known, this hormonal pattern is analogous to that during early puberty and during recovery from anorexia nervosa and hypothalamic amenorrhea. Taken together, these findings provide evidence to support the concept of a centralized preprogrammed scheme for pituitary-gonadal reactivation.
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PMID:Gonadotropin and prolactin secretion increases during sleep during the puerperium in nonlactating women. 312 16

Plasma melatonin, PRL, and LH levels were measured in samples collected every 2 h for 24 h from 14 normally cycling women during the early follicular, periovulatory, and luteal phases of their menstrual cycles. Plasma melatonin levels also were measured in samples collected at the same interval from 7 patients with hypothalamic amenorrhea. A distinct daily rhythm in plasma melatonin was evident in all subjects, with peaks occurring around 0300 h. Each woman's rhythm was remarkably consistent throughout the menstrual cycle (in terms of the phase, amplitude, and total melatonin secreted). Plasma PRL levels also exhibited daily rhythms which did not change during the menstrual cycle; the nocturnal peak plasma PRL level tended to occur 1-2 h after that for melatonin. Among the amenorrheic women, both daytime and nighttime melatonin levels were significantly higher (P less than 0.005) than in the normal women. Their plasma PRL levels were similar to those in the normal women. We conclude that, as for PRL, the circadian rhythm of melatonin secretion does not change significantly during the normal menstrual cycle. The elevated plasma melatonin levels in women with hypothalamic amenorrhea suggest that the hormone may be involved in the neuroendocrine pathology underlying this disorder.
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PMID:The circadian rhythm of plasma melatonin during the normal menstrual cycle and in amenorrheic women. 312 48

To investigate whether an enhanced dopamine (DA) inhibition on pituitary thyrotrophs and gonadotrophs may account for the abnormal TSH and LH dynamics in pathological hyperprolactinemia, we examined the effect of an acute lysis of the putative DA overinhibition, as obtained with continuous domperidone (DOM) infusion, on both basal and TRH-GnRH stimulated PRL, TSH and LH release in both normal cycling women and patients with pathological hyperprolactinemia. The effect of TRH-GnRH administration was also examined in women with DA-antagonist induced hyperprolactinemia, in order to evaluate the effect of a chronic lack of the physiological DA inhibition on pituitary hormone dynamics. Patients with both pathological and DA-antagonist induced hyperprolactinemia displayed an evident TSH and LH hyper-responsiveness to TRH-GnRH. The PRL response was reduced in the former but enhanced in the latter group. Domperidone infusion resulted in a marked increase in serum PRL levels in normal cycling women, but not in patients with pathological hyperprolactinemia. The abolition of the putative DA-overinhibition at the pituitary level with DOM infusion in patients with pathological hyperprolactinemia was followed by a slight increase in basal TSH output but did not modify the TSH and LH hyperresponsiveness to TRH-GnRH. The similarities in TSH and LH dynamics between patients with pathological and DA-antagonist induced hyperprolactinemia and the ineffectiveness of DOM infusion in modifying the TSH and LH hyper-responses to TRH-GnRH in the former group, seem to exclude the widely accepted idea that endogenous DA overactivity is responsible for the abnormal thyrotroph and lactotroph dynamics in women with hyperprolactinemic amenorrhea.
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PMID:Catecholamines and pituitary function. VII: Effects of acute and chronic dopamine-receptor blockade on pituitary response to TRH-GNRH in normal women and in patients with hyperprolactinemic amenorrhea. 313 Dec 22

To study the prognosis of adolescent ovulatory disturbance in patients with persistently elevated LH levels (greater than or equal to 25 mIU/ml), normal FSH levels and high LH/FSH (greater than 2.0), 17 patients aged 12-19 years were studied longitudinally for 4-9 years. These 17 patients consisted of 7 patients suffering from amenorrhea with estrogenic effect, 5 patients with functional bleeding, 3 patients with delayed menarche and 2 patients with oligomenorrhea. All of the patients showed exaggerated LH responses to 100 micrograms of LHRH administration while the FSH responses were not different from those obtained from normal women. Out of the 17 patients, 10 (58.8%) patients showed the values of testosterone and 7 (41.2%) androstenedione which were above the mean + 2SD of normal women. Consequently, the mean serum testosterone and androstenedione levels were significantly higher than those in normal women. The mean LH (36.6 +/- 8.3 mIU/ml), FSH (11.2 +/- 1.5 mIU/ml) and LH/FSH (3.3 +/- 0.8) at the age of 21.4 +/- 2.5 years were not different from the mean LH (39.9 +/- 13.3 mIU/ml), FSH (10.8 +/- 1.8 mIU/ml) and LH/FSH (3.8 +/- 1.5) at the age of 16.1 +/- 1.8 years, respectively. None of the 17 patients showed amelioration or deterioration of ovulatory disturbance during long-term observation. To further investigate the central dopamine activity, 10 mg of metoclopramide (MCP) was administered intravenously in these 17 patients. The LH and PRL responses to MCP were evaluated, and the results were compared to those obtained from 17 patients aged over 20 with PCO and from 17 normal women. The LH responses to MCP were positive in this juvenile patient group and the patients aged over 20 PCO group. However, the LH responses to MCP were negative in normal women in both the follicular and luteal phases. In contrast, the PRL responses to MCP were significantly attenuated in juvenile patients and in patients aged over 20 with PCO compared to those in normal women. Since the hormonal profiles in these 17 patients with anovulation or oligo-ovulation were very similar to those in the group aged over 20 with established PCO, it may be suggested that 1) at least part of the adult patients with PCO may have had PCO from late adolescence; 2) the majority of the patients with high LH and normal FSH levels in adolescence will suffer from ovulatory disturbance continuously; 3) in these patients, an aberration of central dopamine in control of LH and PRL may exist.
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PMID:[A longitudinal study on the prognosis of ovulatory disturbance in teenage patients with high LH and normal FSH serum levels]. 314 20


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