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

Anorexia nervosa is an eating disorder observed with increasing frequency, especially among adolescent females. No consensus exists concerning the causes of the disorder. Social, psychosexual, family system, biological theories, and the regression hypothesis have been advanced to explain the phenomenon. The major characteristics are 25% loss of body weight, use of various means to lose weight, weight phobia, preoccupation with food, body image disturbances, as well as numerous associated medical conditions: bradycardia, hypotension, dehydration, hypothermia, electrolyte abnormalities, amenorrhea, metabolic changes, and abdominal distress. Anorexic adolescents resist treatment and may die if not cured. The following therapeutic modalities have been effective: hospitalization, and cognitive, behavioral, and family therapy. Some of the typical family patterns, early characteristics, social adjustment problems, and society's contribution to the disorder are presented.
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PMID:Adolescent eating disorder: anorexia nervosa. 408 15

A random sample of 41 women aged 18 to 35 years with secondary amenorrhea within Uppsala County, Sweden, were compared to 82 age-matched nonamenorrheic women with respect to a number of background variables of etiological interest, especially psychogenic factors and weight loss. Social-hygiene factors and gynecologic data were also considered. The study was retrospective and performed by a postal inquiry. In the amenorrheic group significant differences were obtained (p less than .05) for the following items: a higher proportion of unmarried women and women with intellectual occupations; a higher proportion with a greater incidence of stressful life events; more consumption of sedatives or hypnotic drugs; and more underweight. Previous menstrual irregularity was also more common. Amenorrhea following use of oral contraceptive agents was reported by 9 women, most of whom also showed pronounced underweight. Symptoms characteristic of anorexia were present in 2 amenorrheic women. There may have been others among those reporting marked underweight. The estimated prevalence of anorexia nervosa is 1 per 1000. The findings may be interpreted as either a true increase in incidence of the disorder or perhaps the method of investigation.
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PMID:Epidemiology of secondary amenorrhea. II. A retrospective evaluation of etiology with special regard to psychogenic factors and weight loss. 481 68

The effect of 3 commonly used progestogen only oral contraceptives (OCs)--norethisterone 350 mcg, ethynodiol diacetate 500 mcg, and dl-norgestrel 75 mcg or levonorgestrel 30 mcg--was analyzed in a study of 74 women ranging in age from 18-47 years. Numbers were to small to compare the effect of each preparation on weight and blood pressure. In terms of control of the menstrual cycle, ethynodiol diacetate and norethisterone were more often associated with amenorrhea than norgestrel, which produced more short cycles. Amenorrhea was more likely to occur when ethynodiol diacetate or norethisterone succeeded a combined OC or, in the case of norethisterone, when the woman was under 30 years of age. Weight did not appear to provide a prediction of irregular cycles, although all amenorrheic Women Weighed under 63 kg. Ethynodiol diacetate was associated with the highest number of irregular cycles, reflecting its variable metabolsim. These findings suggest that a history of missed periods or anorexia, body weight below 63 kg, and age under 30 years should be considered in the selection of a progestogen-only OC. Noregestrel may be a better choice than norethisterone for women in these categories.
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PMID:A study of women on the progestogen only pill. 672 16

The pituitary responsiveness to luteinising hormone releasing hormone (LRH) was studied in 68 women aged between 15 and 30 years. The patients suffered from primary and secondary amenorrhoea or anovulatory cycles in combination with hirsutism, primary sterility, oligo-amenorrhoea, adrenogenital syndrome, and nervous anorexia. Eleven women without any discernible endocrinological disorders were used as controls. Double stimulation was performed by two intravenous injections of 25 microgram LRH each, spaced by one two-hour interval. Blood samples were taken repeatedly prior to, between, and after the injections at intervals set beforehand. Luteinising hormone (LH) plasma concentrations were determined by radio-immuno-assay. The mean difference between the two basic values measured ten and five minutes before LRH application was as low as 20.1 per cent. In most cases, the maximum values occurred 30 minutes after both injections. A positive correlation (r = 0.91, p < 0.001) was found to exist between the level recordable 30 minutes after the first injection and the integral of all values included. Dependence of response to LRH application on the height of the basic values was more strongly pronounced than that on the underlying category of disease. The LRH test, perhaps, may be indicated in cases of low basic LH values (< 2 ng/ml) to verify suspicion of a hypogonadotrophic situation. Simplification of the test procedure to only one withdrawal of blood each immediately before and 30 minutes after LRH injection seems to be justified.
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PMID:[Restricted importance of LRH test in clinical routine diagnosis (author's transl)]. 700 54

Bone loss in subjects with anorexia nevrosa was first demonstrated in 1984 and later confirmed by computed tomography and absorptiometry. Both cortical and trabecular bone is involved. Bone mineral content decreases early and has been estimated at 6 to 8% in 90% of the subjects with anorexia nevrosa. It is correlated with age and the duration of the anorexia and the associated amenorrhoea. Other factors including low weight, early onset, primary amenorrhoea, low serum oestradiol and high serum cortisol are also observed. In severe cases, fractures, similar to those observed in post-menopause osteoporosis, include vertebral wedge fractures, fractures of the ribs, the femoral neck, the forearm and the pelvis. In subjects with long-standing anorexia nevrosa, fractures often occur without weight loss and the diagnosis may be missed. A careful work-up is needed in all cases of bone loss in young women. The osteoporotic process is reversible in most cases if the anorexia can be overcome. Bone mineral content in cured subjects has been shown to be the same as in age-matched controls, but in severe long-term cases, relapse and chronicity lead to continued bone loss. Normal menarche can generally be established with oestrogen therapy although significant gains in bone mineral content does not always follow. When progesterone-oestrogen therapy is combined with small dose fluorine (11.5 mg/day) bone mineral content has been shown to improve. Many subjects however refuse medication, especially oral contraceptives, hindering psychiatric care which should always have first priority. The mechanism of bone loss in anorexia nevrosa is similar to that in post-menopause osteoporosis but may be favoured by other factors including alcohol intake and drug abuse. Certain authors have also hypothesized a common mechanism relating the amenorhoea observed in women training for high performance sports and that in anorexia nevrosa. In clinical practice, first intention treatment should rely on hormone replacement but medication is often refused and can interfere with necessary psychiatric treatment. Sports appear to have a beneficial effect on femoral neck mineralization but in hyperactive subjects the effect is often inversed with increased bone loss. Patent osteoporosis can be treated with fluorine and biphosphonate.
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PMID:[Osteoporosis in anorexia nervosa]. 817 56

Ten top class female distance runners, ten female anorexics and twenty female gymnasts of a similar age were compared for height, mass, %fat, fat mass, lean body mass, age of menarche and incidence of amenorrhoea. The mean age of the distance runners, anorexics, and gymnasts was 13.6 years, 14.7 years, and 13.3 years respectively. In comparison to normal data on females of a similar age they were shorter, lighter, had lower fat masses, and %fat, and the gymnasts and anorexics had lower lean body masses. However, the gymnasts and runners had higher lean body masses compared with the anorexic group. There were no significant differences in body composition by hydrostatic weighing but of these three groups the anorexics tended to have the highest total skinfold, %fat and fat masses. Only 20% of the gymnasts, 40% of the runners and 70% of the anorexics had started menstruating compared with 95% of girls of a similar age. Of the girls in our study who had started menstruating one gymnast, (25% of sub-group) two runners (50% of sub-group) and seven anorexics (100% of sub-group) had developed secondary amenorrhoea. The low body masses, low fat masses, delayed menarche and secondary amenorrhoea in athletes are discussed in relation to low caloric intake, stress, hormone levels, high training loads and genetic factors. Our data demonstrating no significant differences in body composition variables between the three groups of young girls, support the main contention that this type of physique may arise through different mechanisms leading to a common outcome, but without a proven causal link between anorexia and athletic performance.
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PMID:Gymnasts, distance runners, anorexics body composition and menstrual status. 869 38

Anorexia nervosa is a psychologic illness characterized by marked weight loss, an intense fear of gaining weight even though the patient is underweight, a distorted body image and amenorrhea. Anorexia primarily affects adolescent girls and occurs in approximately 0.2 to 1.3 percent of the general population. Complications of anorexia nervosa are numerous, involving almost every organ system, although most complications may be reversed when a healthy nutritional state is restored. Treatment may be administered on an inpatient or outpatient basis and involves nutritional and psychologic rehabilitation.
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PMID:Anorexia nervosa: an overview. 922 65

Anorexia nervosa is associated with multiple endocrine abnormalities. Hypothalamic neuropeptides and monoamines are involved in the regulation of human appetite, and they are changed in several ways in anorexia nervosa. But it remains to be clarified whether these alterations are secondary or etiologic. Feeding behaviour in anorexia nervosa is characterised by a strong ambivalence and not by loss of appetite. Hypothalamic amenorrhea is a diagnostic criterion, and is not only secondary as it often precedes the weight loss and persists for a long time after weight and motor activity have returned to normal. Hypersecretion of corticotropin releasing hormone seems to be secondary to starvation, but at the same time it may keep up and intensify the anorexia, physical hyperactivity and amenorrhea. Low production of insulinlike growth factor-I and high growth hormone secretion reflects the nutritional deprivation. In conclusion most of the neuroendocrine abnormalities are secondary to weight loss, but some of them seem to participate in a circulus vitiosus and maintain the emaciated state.
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PMID:[Neuroendocrine disorders in anorexia nervosa--primary or secondary?]. 899 10

Although Thailand's National Family Planning Program introduced Norplant contraceptive implants in 1986, few women infected with human immunodeficiency virus (HIV) select this method, and its efficacy, clinical effects, and side effects in this population have not been investigated. To address these issues, a prospective cohort study was conducted during 1993-96 of 41 asymptomatic HIV-infected women who presented to the Family Planning Clinic at Ramathibodi Hospital in Bangkok, Thailand, and voluntarily accepted Norplant implants. All implants were inserted within 4 weeks after delivery or abortion. 63.4% of acceptors had not used any contraceptive method prior to pregnancy. At 6 and 12 months after insertion, 26% and 23%, respectively, reported irregular menstrual periods and 24.4% and 36.6%, respectively, reported amenorrhea. Side effects, reported by 3-10% of women, included headache, acne/chloasma, anorexia, and nausea. There were no significant changes in body weight, blood pressure, and hemoglobin between insertion and the 12-month follow-up. No pregnancies occurred during the study period. These findings suggest that Norplant implants are an effective, appropriate contraceptive method for HIV-infected women who want to avoid pregnancy but are not interested in sterilization.
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PMID:Use of Norplant implants in asymptomatic HIV-1 infected women. 917 51

Bulimia nervosa is a common eating disorder, affecting between 1% to 10% of adolescent girls and college aged women. Because excessive weight loss and amenorrhea are not significant features, as they are in anorexia, bulimia is much harder to diagnose. Orthopaedic surgeons have a unique opportunity to detect one of the few physical signs of the disease, which is skin lesions, consisting of abrasions, small lacerations, and callosities on the dorsum of the hand overlying the metacarpophalangeal and interphalangeal joints. These nondescript dorsal lesions are caused by repeated contact of the incisors to the skin of the hand that occur during self induced vomiting. This finding, known as Russell's sign, may be seen by orthopaedic surgeons during examinations for other reasons. Because eating disorders are recognized as a component of the female athlete triad of osteoporosis, amenorrhea, and eating disorders and because orthopaedic surgeons routinely care for female athletes susceptible to these disorders, recognizing this sign and its implications may have profound influence on the patient's musculoskeletal system and general health.
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PMID:Russell's sign. Subtle hand changes in patients with bulimia nervosa. 934 15


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