Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Medicinal castration using GnRH-analogues is a new therapeutic possibility for treating metastasizing breast cancer in premenopausal women. A total of 22 premenopausal patients were included in the study reported here, all of them low-risk cases. Twenty of the 22 patients had hormone receptor-positive primary tumors. A slow-release depot form of Zoladex (ICI 118630) was used as a GnRH agonist and was administered subcutaneously (3.6 mg) at four-week intervals. The long-term administration of Zoladex brought about a significant reduction in blood FSH, estradiol, and progesterone levels within one to four weeks. In contrast, there were no detectable changes in ACTH, DHEAS, cortisol, testosterone, prolactin, or androstendion levels. Therapy-induced amenorrhea occurred in all cases. The objective remission rate achieved (complete and partial remission) was 45%. As opposed to other formulations, the use of Zoladex as a GnRH analog in depot form has significant advantages, which become particularly evident through improved compliance. With Zoladex therapy an effective drug-induced castration can be accomplished in premenopausal women. As regards its efficacy it is comparable to an ovarectomy, though with less pronounced side effects.
 ...
PMID:[Therapy with gonadotropin releasing hormone agonists (zoladex) in premenopausal females with metastastic breast cancer]. 297 41

Analogs of GnRH, given chronically in a continuous fashion, produce a paradoxic inhibition of pituitary gonadotropin secretion and, consequently, gonadal steroidogenesis. Thus, GnRH analogs are an attractive class of compounds for achieving a medical castration in the treatment of hormone-dependent neoplasms. In a group of 25 premenopausal patients with progressive advanced breast cancer, daily sc administration of 1-10 mg Leuprolide [D-Leu6-Pro9GnRH ethylamide (NEt)] induced objective tumor regression in 44% with a median duration of 9 months. All women treated for at least 10 weeks developed amenorrhea. Profound suppression of gonadotropins, estradiol, and progesterone secretion occurred in all patients on chronic therapy and persisted for the whole treatment period. These effects on tumor growth and ovarian hormone levels are similar to those observed after surgical ovariectomy. Other GnRH analogs such as Buserelin and Zoladex have been found to have similar antitumor and hormonal effects which are also comparable to those produced by surgical ovariectomy. The mode of drug administration is important. Consistent suppression of ovarian function has only been observed with sc injections of the analogs. Chronic intranasal therapy has been found to induce an incomplete suppression of ovarian function in most patients, probably as a result of the poor absorption of these compounds through this route (approximately 2%). Treatment of metastatic breast cancer with GnRH analogs has been associated with remarkable absence of significant toxicity. Despite some evidence in favor of a direct antitumor effect independent of suppression of ovarian function, the use of GnRH analogs in the therapy of advanced breast cancer should be restricted to premenopausal women.
 ...
PMID:Treatment of breast cancer with gonadotropin-releasing hormone. 308 18

The aim of the study is to establish the efficacy of preoperative use of GnRH agonists in women with uterine fibromyomas. The study is a randomized prospective one and includes 34 patients, divided in two groups: group I--with preoperative application of GnRH agonists--Zoladex and group II--without medication. In Zoladex group amenorrhea was achieved in 76% of patients after 7-8 weeks of treatment. After a 3-months treatment with Zoladex Hb levels increased from 8.9 +/- 0.9 gl/l to 11.7 +/- 1.2 g/l; levels of serum Fe--from 7.3 +/- 4 mumol/l to 18.5 +/- 5 mumol/l. Total uterine volume decreased by 30% before surgery (from 328 +/- 85 ml to 233 +/- 61 ml), while myoma volume decreased by 39% (from 178 +/- 62 ml to 109 +/- 44 ml). Mean blood loss during surgery (hysterectomy) is definitely less in patients, treated with Zoladex--194 +/- 75 ml., compared to 287 +/- 102 ml in control group. The significant reduction in myoma volume in 6 patients due to presurgical treatment with Zoladex made smaller operation--myomectomy, possible. Side effects, related to GnRH agonist Zoladex, are well tolerated and transitory and did not lead to retreatment from the trial.
 ...
PMID:[A comparative efficacy study of the preoperative use of GnRH agonists in women with uterine fibromyomas]. 1072 53

GnRH agonists, applied for a long period of time or as depot forms, lead to blocking of gonadotropin and ovarian steroid synthesis. We used their property to induce amenorrhea for treating menorrhagic and menometrorrhagic bleeding in adolescence caused by inborn aplastic and hypoplastic anaemia. In patients with uterine bleeding during the first regular menstrual period or recurring during menstrual periods Zoladex (depot GnRH agonist) has been applied, resulting in stop of bleeding in 2 to 4 days. The drug-induced amenorrhea provides the possibility for physiologic restoring of hemoglobin levels, improvement of therapeutic results from adjuvant antianaemic therapy. Thus a more favourable basis for treating of the main disorder is being created. When surgery is indicated, GnRH agonists provide the opportunity for planning of operating management or for laser ablation of endometrium.
 ...
PMID:[The use of GnRH agonists in severe uterine hemorrhages in adolescence caused by congenital aplastic and hypoplastic anemias]. 1073 Mar 89

Hysteroscopic endometrial ablation (HEA) is a new alternative for patients with dysfunctional uterine bleeding (DUB), resistant to medical treatment. The relatively thin endometrium is a big advantage at the time of operation. In this article the results of an initial series of hysteroscopic operations (HEA) are given--as a whole and depending on preoperative treatment with GnRH-agonist. Seventeen patients with DUB underwent HEA. Six of them were pretreated with Goserelin acetate (Zoladex 3.6 mg, Astra Zeneca) two subcutaneous application at 28 days interval. The other 11 women were operated in the early postmenstrual period without medical pretreatment. Comparison was made between the two groups regarding preoperative endometrial thickness, operative time, operative complications, duration of hospital stay, change of the menstrual pattern after 6 and 12 months. Results showed 41.2% achievement of persistent amenorrhoea in patients as a whole (62.7% in the Zoladex group and 27.2% in the untreated group). Better results in the patients with Zoladex pretreatment (shorter operative time, higher incidence of amenorrhoea, patient's higher evaluation of the operation) can be explained with the reduced endometrial thickness at the time procedure. The authors consider the hysteroscopic roller-ball endometrial ablation as an upto-date cost-effective method for treatment of DUB. The method is quick, with very low incidence of complications, easy toleration, immediately recovery of the patient and the only possibility for women with high anaesthesiologic and operative risk. Two depot-doses of Zoladex before hysteroscopy lead to better intra- and postoperative results.
 ...
PMID:[Hysteroscopic ablation of the endometrium in cases of dysfunctional uterine bleeding--advantage of preparations including zoladex]. 1206 49

Goserelin ('Zoladex'), a luteinizing hormone-releasing hormone (LHRH) agonist induces reversible ovarian ablation in premenopausal women. It is the most extensively studied LHRH agonist for the treatment of breast cancer and data from a large clinical trial program show that, alone or in combination with tamoxifen, goserelin is at least as effective as cyclophosphamide-methotrexate-5-fluorouracil (CMF) chemotherapy in patients with hormone-sensitive, early disease. Furthermore, goserelin has been shown to add benefit when used in addition to standard adjuvant therapy (surgery +/- radiotherapy +/- chemotherapy +/- tamoxifen) and may be beneficial when used after chemotherapy. In patients with hormone-sensitive, early breast cancer, treatment-induced amenorrhea has been associated with an improved prognosis and goserelin provides a highly effective and reliable method of achieving amenorrhea. The reversibility of amenorrhea upon cessation of goserelin treatment may confer long-term advantages compared with permanent methods of ovarian ablation. Ultimately, patients should be provided with sufficient information on the risks and benefits of the treatment options available to them so that they can be involved in treatment decisions.
 ...
PMID:Overview of luteinizing hormone-releasing hormone agonists in early breast cancer-benefits of reversible ovarian ablation. 1235 20

The purpose of this study was to compare changes in bone mineral density (BMD) in premenopausal patients with node-positive early breast cancer treated with goserelin (Zoladex) or cyclophosphamide, methotrexate and 5-fluorouracil (CMF). Patients ( n=1640) were randomized to goserelin (3.6 mg every 28 days for 2 years) or CMF (sixx28-day cycles) treatment. In a protocoled sub-study involving 96 patients from eight centers (goserelin: n=53; CMF: n=43), lumbar spine (L2-L4) and femoral neck BMD were assessed by dual X-ray absorptiometry at baseline and then annually for 3 years. At the end of the 2-year goserelin-treatment period, mean BMD losses for goserelin-treated and CMF-treated patients were -10.5% and -6.5% ( P=0.0005) for lumbar spine and -6.4% and -4.5% ( P=0.04) for femoral neck, respectively. At 3 years, partial recovery of BMD was observed in goserelin recipients. In contrast, mean BMD losses for the CMF group indicated persistent BMD loss. No significant differences in BMD were observed between groups at the 3-year assessment of the spine or femoral neck. In the CMF group, based on amenorrhea status at 48 weeks, BMD losses at the lumbar spine were greater for amenorrheic than non-amenorrheic patients. Ovarian suppression resulting in amenorrhea was closely related to BMD loss in both treatment groups. Overall, patients who received CMF did not show recovery of BMD throughout follow-up, whereas partial recovery was observed 1 year after cessation of goserelin therapy, associated with the return of ovarian function in the majority of patients.
 ...
PMID:Bone mineral density in premenopausal women treated for node-positive early breast cancer with 2 years of goserelin or 6 months of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). 1453 Sep 12

We have a patient with essential /idiopathic/ thrombocitopeny and primary sterility, who becomes pregnant after medical and operative treatment. With the beginning of the menarche her menstrual cycle goes irregular with menstrual bleeding duration from 8 to 20 days, cystic ovaries, non-ovulation cycles, trombocytopeny and anemia. A laparotomy was performed twice, because of the existence of hemoperitoneum, caused by a rupture of the corpus luteum. After achieving a amenorrhoea with Zoladex treatment, a splenectomia was performed. As a result we observe a physiological recovery of the menstrual cycle, the ovulation cycle and the pregnancy. The patient's hematology and hemostaseology statuses went back to normal.
 ...
PMID:[Pregnancy after treatment of primary sterility with zoladex in patient with essential thrombocytopenia]. 1663 21