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)

Mifepristone, a new steroid and progesterone antagonist, was administered to 150 women with amenorrhea of less than 42 days who were seeking abortions. A single dose of 600 mg was given to each woman to take orally at home in the evening. The clinical events that should occur were explained to the women and they were given a permanent emergency telephone number. Follow-up visits were scheduled on the 8th day, when clinical tests, ultrasound examinations, and blood sampling were performed. Success was assumed if vaginal bleeding occurred between days 3-8, ultrasonic examination confirmed uterine vacuity, and a decrease in plasma HCG level was observed. A total of 131 of the 150 women were considered to have had complete abortion. The remaining 19 women included 14 developing pregnancies, 2 curettages for heavy bleeding, and 1 extrauterine pregnancy. Daily amount and duration of bleeding were compared to abundant menstruation. Only 2 women reported heavy bleeding leading to curettage. Only 16 women had hemoglobin levels low enough to justify iron therapy. None needed a transfusion. Several other side effects were reported--uterine contractions and pelvic pain, transient asthenia, and slight nausea. All biological tests remained in the normal range. Having shown a success rate of 87.3% and with mild side effects, Mifepristone appears to be a simple and safe agent for termination of early pregnancy, and a good alternative to surgical abortion.
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PMID:Termination of early pregnancy by a single dose of mifepristone (RU 486), a progesterone antagonist. 320 66

Five patients with primary hypogonadotrophic amenorrhea were treated for the induction of ovulation with I.V. pulsatile Gn-Rh doses ranging from 2.5 to 12.5 micrograms/90 min) for 15 cycles. Ovulation occurred during Gn-Rh treatment in 7 cycles (A) or after i.m. HGC administration (5,000-10,000 IU) (B = 6) (ovulation rate = 86%). Four pregnancies (A = 2; B = 2) were obtained (in one case there was a twin pregnancy). Echographic and endocrine patterns were evaluated. Ovulatory follicular diameter was 18.3 +/- 6.0 mm, no difference between A and B (21.8 +/- 5.6 and 16.0 +/- 5.1 mm, respectively) was observed. In addition E2 preovulatary plasma levels were similar in the two groups examined (334 +/- 131 and 300 +/- 89 pg/ml, respectively). Also endocrine and echographic profiles of conceptive (C) and non conceptive (NC) cycles were similar. Furthermore all doses resulted effective in determining the ovarian response and no difference was found at different dosage used. It is concluded that pulsatile GnRh is a "physiological" way of inducing ovulation in PHA patients. By analysis of the present data we consider it advisable to induce ovulation by the enhancement of the endogenous LH peak which occurs during Gn-Rh administration (A group) and then periodic injections of HCG can be used for maintaining the luteal function.
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PMID:Pulsatile Gn-Rh induced ovulatory cycles: echographic and endocrine aspects. 391 62

Induction of ovulation with subcutaneous pulsatile (every 90 min.) administration of HMG (Pergonal) 75 or 150 IU/day using a portable pump (Nipro SP-3I) was performed in 3 PCO patients (6 cycles), 4 first grade amenorrhea (Am-I) patients (7 cycles) and 4 Am-II patients (4 cycles). All patients ovulated except one cycle of Am-I patients and one PCO woman conceived. In regard to the duration of administration and the total dose of HMG until ovulation, the administration of 150 IU/day (M +/- SD=15.2 +/- 5.0 days, 2280 +/- 774 IU) is superior to 75 IU/day (39.5 +/- 11.4 days, 3900 +/- 1357 IU), and there was no significant difference between this method and the daily intramuscular injection of HMG. The group treated with HCG in the luteal phase revealed a longer luteal phase (14.0 +/- 2.3 days) than the nontreated group (12.6 +/- 1.5 days). Ovarian hyperstimulation was observed in one case and subsided spontaneously after admission. There were no other side effects. In conclusion, this method has the following advantages: A high ovulation rate, comparable with daily intramuscular administration. It is a less painful procedure than daily intramuscular injection. It is possible for the patient to lead normal life, insertion and removal being easily done by herself.
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PMID:[Induction of ovulation with subcutaneous pulsatile administration of human menopausal gonadotropin]. 392 77

RU 38-486 (17 beta-hydroxy-11 beta-(4-dimethylaminophenyl)-17 alpha-(1-propynyl)estra-4,9-dien-3-one), an antiprogestational compound, was given to 33 women seeking termination of pregnancy. The patients were divided into two groups, 24 patients in group I with amenorrhoea up to 7 6/7 wk = 55 days, and 9 patients in group II with 8-10 wk amenorrhoea. The patients received 200 mg orally per day for 4 days. The start, duration and amount of bleeding were determined for 14 days. beta-HCG, plasma progesterone, estradiol and cortisol were determined at day 0 and day 7. All patients started to bleed during treatment. The frequency of complete abortion was 79% (19 out of 24 patients) in group I. In group II 33% (3 out of 9 patients) had a complete abortion. Most of the patients experienced only minor side-effects in terms of mild uterine pain and bleeding as in a spontaneous abortion. However, 2 patients in group II with 8 and 9 2/7 wk amenorrhoea suffered from heavy bleeding, requiring blood transfusion and curettage. In the patients with complete abortion, beta-HCG, estradiol and progesterone decreased significantly within 1 week. Cortisol concentrations remained within the normal range at day 0 and day 7. Treatment with RU 486 provides an acceptable method of early abortion, especially in women who refuse operative treatment and prefer a 'spontaneous abortion'. In 22 women RU 486 was administered from day 24 to day 27 of the menstrual cycle as a late 'morning-after pill' in the same dosage. All women except one started to bleed before day 28 and observed a normal menstrual period. One woman stayed amenorrhoeic for 2 months; she was not pregnant but apparently had an anovulatory cycle with a low progesterone level.
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PMID:Interruption of early pregnancy by an anti-progestational compound, RU 486. 405 13

The results of a comparative study of the efficacy and acceptability of sulprostone administered intramuscularly and vacuum aspiration for termination of very early pregnancy is reported. The period of amenorrhoea varied from 35 to 45 days with a positive pregnancy test. Group A (20 cases) received intramuscular sulprostone in doses of 500 micrograms and 1000 micrograms 4 hours apart without any pre-treatment. The success rate was 85%. Group B (20 cases) underwent vacuum aspiration with 100% success rate. Incidence of vomiting was comparable in both groups. Severe abdominal cramps/pain occurred in 11% following sulprostone administration. No immediate serious complication occurred. Estimation of serum HCG was done before sulprostone administration and 2 weeks later. A decline was noted 2 weeks post-treatment in successful cases, thus confirming the effectiveness of the therapy.
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PMID:Evaluation of intramuscular sulprostone and vacuum aspiration for termination of early pregnancy. 408 46

Using monoclonal antibodies (OKT3, OKT4, OKT8) peripheral blood lymphocyte subsets were determined in 40 normal primiparous pregnant women and compared with those of 31 nonpregnant controls. In pregnant women plasma concentrations of estradiol, progesterone, human placental lactogen (HPL), beta subunit of human chorionic gonadotropin (beta HCG), and alpha-fetoprotein were measured by means of radioimmunoassay. We studied if correlations between peripheral lymphocyte subsets and plasma hormone levels might exist. We observed in pregnant women from 10 to 40 wk of amenorrhea a decrease in the percentage of OKT3 and OKT8 cells, and during the course of pregnancy an increase in the percentage of OKT4 cells. This increase inversely correlated with plasma beta HCG levels and directly correlated with plasma HPL levels.
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PMID:Correlation of plasma hormone levels and peripheral circulating lymphocyte subpopulations during human pregnancy. 620 11

The workup of the adolescent with menstrual dysfunction is directed toward separating the "functional" irregular menstrual pattern of an immature hypothalamic/pituitary/ovarian (HPO) axis from the large number of endocrine and anatomic abnormalities that can become manifest in this age group. The HPO axis is not fully mature at menarch. Since the positive feedback response to estrogen, which allows ovulation, is frequently absent in the immediate postmenarchial peroid, menstrual irregularity is common. 55% of cycles are anovulatory in the 1st year. With futher maturation of the HPO axis a pattern of regular ovulatory cycles emerges, and in women 11 years after menarche by age 18 but a basic evaluation is indicated if menarche does not occur by age 16 or if secondary sexual development does not being by age 14. Secondary amenorrhea is the absence of menses for at least 3 months in a patient who previously had established cycles. With the exception of anatomic abnormalities of the lower reproductive tract that result in primary amenorrhea exclusively, there is considerable overlap between the differential diagnosis of primary and secondary amenorrhea. Causes of amenorrhea in adolescents are pregnancy, drugs and systemic diseases, hypothalamic and pituitary amenorrhea, "postpill" amenorrhea; hyperprolactinemia, androgen resistance, congenital anomalies of the genital tract, and androgen excess. Despite the large number of disorders that can cause menstrual abnormalities, the initial workup of the patient who presents with amenorrhea or delayed development can be simplified to a careful history, physical examination, and a few screening laboratory tests. The adolescent who has no development by age 14 or no menarche by age 16, whose menses cease for 4 months or more, or who has persistent oligomenorrhea or signs of androgen excess deserves an evaluation. Since the option of 1st trimester therapeutic abortion depends on early diagnosis of unwanted pregnancy, this diagnosis should be excluded without delay. The history should include: neonatal history -- maternal ingestion of virilizing hormones, previous maternal miscarriages, congenital lymphedema; family history -- heights of family members, age at menarche and fertility of female family members, and history of endocrine disorders; growth and pubertal developments; past medical history -- chronic disease, congenital anomalies, previous surgery, radiation exposure, chemotherapy, or drug use; and review of symptoms. The physical examination should include: height, weight, arm span, blood pressure; assessment of sexual maturity; and endocrine and gynecologic assessment. The screening tests for the patient with amenorrhea include urinary HCG, complete blood count, sedimentation rate, thyroid function, prolactin, FSH and LH, and assessment of estrogen status.
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PMID:Adolescent menstrual irregularity. 637 75

In 21 patients with amenorrhea after taking oral contraceptives, the urinary excretion of estrogens and the plasma concentrations of LH, FSH and prolactin were determined. In five of these women the amenorrhea was accompanied by galactorrhea. Ten of the 21 patients had had origomenorrhea before contraceptive therapy. The progesterone test was negative in 9 patients and clomiphene test was negative in 10 patients. The urinary excretion of estrogens and plasma LH and FSH values were low normal while the prolactin concentration in group A (amenorrhea without galactorrhea) amounted to 12.8 +/- 2.4 micrograms/l of plasma and in group B (amenorrhea with galactorrhea) to 85.4 +/- 15.8 micrograms/l (p < 0.01). The pituitary response to 100 micrograms synthetic LH-RH i.m. was similar to that found in the early follicular phase of the ovulatory cycle and showed that the pituitary was capable of synthesizing and secreting LH and FSH. Two of the three women from group A who wanted to become pregnant conceived under the therapy with Clomid and HCG. In all women from group B, in response to Parlodel (bromocriptine) therapy administered in 5-mg dose daily, the plasma concentration of prolactin decreased to a normal level, galactorrhea ceased within 15-62 days, and menstruation resumed within 38-75 days. In three women it is very probable that the cycle became biphasic, and a previously clomiphene negative patient became a clomiphene responder.
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PMID:Amenorrhea following oral contraception. 677 90

Virilism in females is often associated with menstrual disorders. There is an evident correlation between the severity of virilism, the level of androgens and the degree of menstrual disorder. A study was carried out between January 1978 and December 1980 on 75 women with various degrees of virilism. The majority of women with severe hirsutism and male-type alopecia were found in the group with amenorrhoea. Furthermore, the four cases with the full-blown picture of severe virilism were found exclusively in this group. Clarification of the virilizing manifestations on the basis of a determination of the basic hormonal status (including the steroid fractions), the dexamethasone suppression test (including the HCG stimulation test) and the oestrogen-gestagen suppression test, diagnostic laparoscopy and phlebography of the adrenal gland is discussed and the methods evaluated.
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PMID:[Androgenetic amenorrhea]. 682 May 86

Intravenous pump administration (Zyklomat, Ferring) of GnRH (Lutrelef, Ferring) has been used to induce ovulation in 16 patients suffering from hypothalamic amenorrhea between January 1989 and December 1991. One to 6 cycles were performed for a total of 47 cycles. GnRH pulses were set at 20 micrograms/pulse every 90 min up during the follicular phase and decreased to 1 pulse/120 min during the 3-5 days following ovulation. Thereafter, the luteal phase was supported by 1000 IU HCG/48 h up to the end of the 5th week. Response to the treatment was monitored with seriC E2, P and LH and vaginal echography. Cycles (N = 3) were cancelled when E2 did not reach at least 0.25 nmol/l after 30 days. An E2 level > 0.8 nmol/l, associated with a mature follicle (> 20 mm), and the presence of a LH peak or an increased progesterone level were used to determine the day of ovulation. In case of normozoospermy (N = 9), sexual intercourse was recommended to the patients (27 cycles), whereas an intrauterine insemination was performed in case of a male factor (N = 7, 20 cycles). Results can be summarized as follows: 39 (83%) cycles were ovulatory and led to 9 (19%) clinical and 6 (13%) biochemical pregnancies. Five (8.5%) pregnancies aborted and 5 (11%) came to full term. After exclusion of the male factors, the pregnancy rate reaches 26%/initiated cycle, 28%/ovulatory cycle and 56%/patient. No patient developed a hyperstimulation syndrome or a multiple pregnancy. Three cycles (6.3%) were interrupted due to 2 superficial phlebitis and 1 pump failure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ovulation induction by pulsatile intravenous administration of Gn-RH to patients with hypothalamic amenorrhea]. 833 81


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