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)

Recently, a decrease in bone mineral content (BMC) in hyperprolactinaemic women with long-lasting amenorrhoea has been reported, and attributed either to a direct effect of PRL on bone or secondary to the oestrogen deficiency. To verify if PRL by itself has a direct effect on bone, we have studied BMC at the lumbar level by double-photon absorptiometry in 22 patients with hyperprolactinaemia, selected on the basis of normal or near-normal oestradiol levels. The results were compared with those obtained in 28 healthy closely-matched women, and seven hyperprolactinaemic patients with long-lasting amenorrhoea and oestrogen deficiency. No significant difference in BMC was observed between hyperprolactinaemic patients with normal oestrogen levels (mean +/- SEM = 3.87 +/- 0.10 gHA/cm) and normal subjects (mean +/- SEM = 3.76 +/- 0.10 gHA/cm). Moreover, no significant change was observed during a 6 month follow-up in 13 patients. On the other hand, a significant difference (P less than 0.05) was detected in BMC between the hyperprolactinaemic patients with normal oestradiol levels and those with long-lasting amenorrhoea and oestrogen deficiency (mean +/- SEM = 3.39 +/- 0.18). These results suggest that hyperprolactinaemia by itself is not a risk factor for the development of osteoporosis.
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PMID:Vertebral bone density in non-amenorrhoeic hyperprolactinaemic women. 316 98

The aim of the study was to test the effect of increasing the frequency of breastfeeding upon ovarian function following the end of postpartum amenorrhoea. Women exclusively breastfeeding (n = 14) who experienced their first postpartum menstruation between the third and fifth month after delivery were randomly allocated to an experimental (n = 7) and a control (n = 7) group and studied during the next two cycles. Women in the experimental group agreed to increase the number of breastfeeding episodes per day throughout the second cycle. Blood samples were drawn twice a week from the first to the third postpartum menstruation for prolactin, oestradiol and progesterone determinations. The number of breastfeeding episodes per day and night and the length of each episode were recorded daily. An average frequency of 11 nursing episodes per 24 h was reported during the first study cycle in both groups. The experimental group increased by 50% the breastfeeding frequency after the second menstruation while the control group kept its spontaneous feeding pattern. The increase of suckling frequency occurred mainly during day hours. The total breastfeeding time per 24 h was not increased. The length of the menstrual cycle was not altered by the increased suckling frequency. The endocrine pattern differed neither between the first and second cycle of the experimental group nor between the experimental and control group, with the exception of PRL levels which were higher in the experimental group throughout both cycles. Twenty cycles (71%) showed progesterone values compatible with ovulation (greater than 9.5 nmol/l). The highest progesterone values and the highest oestradiol values observed in the ovulatory cycles of lactating women were within the range found in non-nursing fertile women. Plasma levels of PRL were significantly elevated in all cycles but one, in comparison with PRL levels in non-nursing women. It is concluded that if cyclic ovarian function is reestablished early in fully nursing women, a mere increase in the number of breastfeeding episodes, without augmenting total suckling time and the frequency of nocturnal episodes, does not provide a sufficient stimulus to resuppress the pituitary-ovarian axis.
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PMID:A study on the feasibility of suppressing ovarian activity following the end of postpartum amenorrhoea by increasing the frequency of suckling. 321 44

To further evaluate the potency and time course of the PRL-lowering effect of single oral doses of cabergoline, two doses of the drug were given to 51 hyperprolactinemic patients who also received 2.5 mg bromocriptine according to a randomized cross-over design. One group (n = 26) received 0.3 mg, and the other (n = 25) received 0.6 mg. Both cabergoline doses induced a significant fall in serum PRL levels, which lasted, on the average, from 3 h to 5 days after 0.3 mg and from 3 h to 14 days after 0.6 mg; the mean maximum decrease after 0.3 mg was -65 +/-4% (+/- SEM), significantly (P less than 0.05) less than that after bromocriptine (group mean, -73 +/- 4%), and it was -76 +/- 3% after 0.6 mg, not significantly different from that induced by bromocriptine (group mean, -71 +/- 4%). The effect of 0.6 mg cabergoline was significantly greater than that of 0.3 mg (P less than 0.01). In a second study designed to evaluate the possible therapeutic use of the new drug, 0.3 or 0.6 mg cabergoline was administered orally once weekly for 9 weeks to 2 groups of 15 and 16 hyperprolactinemic patients, respectively. Serum PRL levels fell significantly by the first week and reached a plateau after 2 doses in the 0.6 mg cabergoline-treated group and after 5 doses in the 0.3 mg-treated group; the absolute PRL decrease was greater in the former. Ten patients in each group achieved normal serum PRL levels, and a marked decrease (greater than 50% of pretreatment values) occurred in all patients treated with 0.6 mg and in 13 treated with 0.3 mg weekly. Resumption of menses occurred during the treatment period in 15 of the 17 premenopausal women with amenorrhea. Six patients who had poor responses had better responses when given higher drug doses for 4 weeks, and serum PRL levels became normal in the 3 receiving 0.6 mg twice weekly. These data confirm that cabergoline is a long-acting oral dopaminergic drug and suggest that it may be a useful agent for the treatment of patients with hyperprolactinemia.
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PMID:Prolactin-lowering effect of acute and once weekly repetitive oral administration of cabergoline at two dose levels in hyperprolactinemic patients. 327 84

In order to elucidate the endocrinological background of patients in whom ovulation induction by pulsatile LH-RH administration resulted in failure, 16 women with hypothalamic amenorrhea were treated with 10 to 20 micrograms of LH-RH injected subcutaneously every 2 hrs. Six women did not ovulate, and 5 of them showed pituitary desensitization since the basal gonadotropin concentration gradually decreased and the response to LH-RH test (100 micrograms i.v.) became blunted by the treatment. No significant differences between the ovulated and desensitized groups were seen in basal LH, FSH, E2, PRL levels, LH/FSH ratio and response to LH-RH test performed prior to the treatment. In addition, the plasma LH-RH profile after subcutaneous injection of 10 micrograms of LH-RH was highly pulsatile in both groups. However, in the desensitized group, all were obese, showed impaired GH response to both insulin tolerance and GH-RH tests, and had episodic LH secretion with higher frequency compared to the ovulated group. These results suggest that the desensitized women had occult pituitary dysfunction and hypersecretion of endogenous LH-RH which stimulated the pituitary close to the level of desensitization. The mechanism of hypersecretion of endogenous LH-RH is discussed.
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PMID:[Endocrinological background of pituitary desensitization during pulsatile LH-RH therapy for ovulation induction in amenorrheic women]. 332 57

To determine whether hyperprolactinemic women with menses are at risk for the development of osteopenia and to define the effects of PRL excess and estrogen deficiency on bone mass in amenorrheic women, spinal and radial bone densities were measured in 25 hyperprolactinemic women (13 with amenorrhea and 12 with regular menstrual periods) and 11 women with hypothalamic amenorrhea. The degree of hyperprolactinemia was comparable in the hyperprolactinemic women with and without menstrual periods [mean, 55 +/- 18 (+/- SD) and 57 +/- 16 micrograms/L, respectively]. The mean spinal bone density in the hyperprolactinemic amenorrheic women (148 +/- 26 mg/K2HPO4.cm3) was significantly lower (P less than 0.01) than that in 19 normal women (178 +/- 21 mg/K2HPO4.cm3), and 6 of the former group had values greater than 2 SD below normal. However, the mean spinal bone density in the eumenorrheic hyperprolactinemic women (171 +/- 22 mg/K2HPO4.cm3) was similar to that in the normal women and was significantly greater (P less than 0.05) than that in the hyperprolactinemic amenorrheic women. The mean spinal bone density in the women with hypothalamic amenorrhea (128 +/- 24 mg/K2HPO4.cm3) and normal PRL levels was also significantly (P less than 0.001) lower than that in normal women or hyperprolactinemic euenorrheic women. Six of the women with hypothalamic amenorrhea had bone density measurements greater than 2 SD below normal. The spinal bone density values were similar in the amenorrheic women with or without hyperprolactinemia. The mean radial bone density in the hyperprolactinemic women with amenorrhea (0.69 +/- 0.03 g/cm2) was comparable to that in the women with hypothalamic amenorrhea (0.69 +/- 0.05 g/cm2), and both groups had significantly (P less than 0.05) lower values than normal women (0.72 +/- 0.03 g/cm2). Radial bone density was normal in the hyperprolactinemic eumenorrheic women. The mean serum estradiol level in the hyperprolactinemic amenorrheic women (120 +/- 90 pmol/L) was significantly (P less than 0.05) lower than that in the hyperprolactinemic eumenorrheic women measured during the follicular phase of their cycles (240 +/- 180 pmol/L) and was comparable to that in the women with hypothalamic amenorrhea (80 +/- 40 pmol/L). Multiple comparisons of clinical variables, serum hormone concentrations, and bone mass demonstrated a significant correlation (P = 0.0125) between bone density and serum dehydroepiandrosterone sulfate levels, which suggests a role for endogenous androgens in the maintenance of premenopausal bone mass.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Effects of prolactin and estrogen deficiency in amenorrheic bone loss. 337 29

To determine whether women with PRL-secreting pituitary tumors have similar decreases in cortical and trabecular bone and to determine whether bone loss associated with hyperprolactinemia is reversible, we measured forearm and vertebral bone mineral in normal women and in amenorrheic women with treated and untreated hyperprolactinemia. The mean spinal bone mineral content in hyperprolactinemic women [130 +/- 23 (+/- SD) mg/mL] was 25% lower than that in normal women (167 +/- 28 mg/mL), while the mean forearm bone mineral content (0.71 +/- 0.04 g/cm2) was similar to that in normal women (0.73 +/- 0.05 g/cm2). Women with normal serum PRL levels and regular menses after transsphenoidal surgery had slightly higher mean spinal bone mineral content (149 +/- 28 mg/mL) than women who remained amenorrheic after surgery (129 +/- 19 mg/mL), but the mean value in the cured women remained significantly lower than that in normal women. In contrast, women who had undergone successful transsphenoidal pituitary surgery had mean forearm bone mineral comparable to that in normal women. There was no correlation between vertebral and radial bone mineral in hyperprolactinemic women and no correlation between bone mineral and serum PRL, serum estradiol, or duration of amenorrhea when age was taken into account. These findings suggest that hyperprolactinemia and/or decreased gonadal function in women with PRL-secreting pituitary tumors are associated with more prominent effects on trabecular bone in the spine than on cortical bone in the wrist. In addition, the abnormal spinal bone mineral content after successful treatment suggest that normalization of estradiol and PRL secretion is not sufficient to restore bone mineral content to normal, although it may be stabilized.
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PMID:Forearm and vertebral bone mineral in treated and untreated hyperprolactinemic amenorrhea. 355 23

The reaction of PRL, TSH, GH, LH and FSH has been studied after the administration of TRH and LHRH to 15 acromegalic women of fertile age. According to the presence or absence of menstruation the patients were divided into 2 groups: 8 patients menstruated regularly, 7 had secondary amenorrhoea. The results of the two groups were compare with each other and to findings in a group of healthy controls (9 women). It was found that in secondary amenorrhoea basal PRL values significantly exceeded those registered in the menstruating group and in the controls. PRL reaction was similar in the controls and the secondary amenorrhoea group, but the menstruating patients showed lower values than those of the control group. TSH release did not differ in the three groups. In secondary amenorrhoea paradoxical GH-reaction after TRH-LHRH in the 15th minute significantly exceeded the value of the menstruating group and its whole course pointed to a more intensive reaction. In secondary amenorrhoea both basal LH and FSH secretion as well as LH and FSH release fell far below the values of the menstruating group. The onset of amenorrhoea was not related to the duration of acromegaly. Disturbances of gonadotrophin secretion may be induced by disorders of regulatory mechanisms as well as by the damaging effect of the adenoma on normal pituitary tissue.
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PMID:Differences in pituitary trophormone release between menstruating and non-menstruating acromegalic women. 358 67

In order to determine the effects of protracted nursing in American women, blood was collected hourly for 24 h and nursing periods recorded in 20 mothers, 10 amenorrhoeic, 3 3/4 to 17 1/4 months postpartum (PP), and 10 menstruating, 5 1/4 to 46 months PP. These data were compared to the daytime nursing behaviour and 1000-1100 h PRL of women among !Kung hunter-gatherers of Botswana, a non-contraceptive using population with a birth space interval of greater than 3 years. Intense nursing behaviour maintained amenorrhoea and hyperprolactinaemia for 1 to nearly 2 years PP in both American and !Kung mothers. Among Americans, 80 min of nursing per day, in conjunction with a minimum of six nursing episodes, was highly predictive of remaining amenorrhoeic up to 18 months PP. Amenorrhoea was always accompanied by hyperprolactinaemia, but delay in the onset of menses was related more to nursing behaviour than to a particular 24 h PRL level. The 1000-1100 h sample is equivalent to and about half of the 24 h mean in high and low intensity nursers, respectively. The !Kung women were similar to the high intensity nursing American women in 1000-1100 h PRL, percent amenorrhoeic, and the number of minutes of daytime nursing.
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PMID:Nursing behaviour, prolactin and postpartum amenorrhoea during prolonged lactation in American and !Kung mothers. 379 66

A thirty-seven-year-old housewife whose chief complaints were recurrence of galactorrhea and amenorrhea three years after having a selective adenomectomy. Hormonal examination done as a result of the continuation of the endocrinism revealed a hyperprolactinemia and high level of TRH due to hypothyroidism. Serum prolactin responded to neither TSH stimulation nor L-Dopa suppression tests. In addition, serum TSH did not react to TRH test. Contrast enhancement CT showed an intrasellar enhancing mass the size of which was less than 1 cm in diameter. A unilateral septal transsphenoidal operation was performed; and a soft white-yellowish mass 7 X 5 X 5 mm in size was found in the left inferolateral aspect of the pituitary gland. Histological studies of frozen sections of this revealed it to be a pituitary adenoma, with the border between tumor and normal tissue being quite distinct. Immunocytochemical diagnosis further confirmed it to be both PRL and TSH producing adenoma. Electron microscopy showed more than three different hormone-producing cells. The PRL cells contained large, and the TSH cells had small hormone granules; but some tumor cells contained secretory granules of both sizes suggesting production of both PRL and TSH in the cytoplasm. It is necessary in the management of patients like this, during the post-operative period, to adequately institute a thyroid hormone replacement therapy so as to prevent recurrence.
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PMID:[A recurrent case of TSH-PRL secreting microadenoma following hypothyroidism]. 382 56

The effects of the H2 blockers most commonly used for treating ulcers (CMT + RNT) on the hypothalamic-hypophyseal-gonadal axis are analysed. The following conclusions may be drawn form the literature and from personal studies: a) Basal levels of PRL increase significantly after an i.v. bolus of CMT and, very probably, in the first few days of oral treatment. b) RNT orally or i.v., in standard therapeutic doses, has no effect on the secretion of prolactin which is only influenced by higher i.v. doses. c) From points a) and b) it would seem that H2 blockers determine PRL increases by interference at a central level in the histaminergic neurotransmission system. d) The mechanisms for determining alterations in LH secretion, secretory spikes and their frequency have not yet been clarified and are not even unanimously recognised. e) The gynaecomastia, galactorrhoea, amenorrhoea and impotence--reported only after long-term cimetidine treatment--can probably be attributed to the specific antiandrogen receptor property of CMT. f) The onset of menstrual problems or of modifications in sexual behaviour in fertile patients, should however be checked and their basal PRL monitored if necessary.
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PMID:[Dysfunction of the hypothalamo-hypophyseal-gonadal axis induced by histamine H2 antagonists. Review of the literature and personal observations]. 392 76


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