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)

Secondary hypergonadotropic, hypoestrogenic amenorrhea, or premature menopause, is usually considered an irreversible process. Four patients with this entity were observed to have evidence of ovulation. Three of these patients became pregnant while they were treated with estrogen replacement therapy (ERT) for their hypoestrogenic symptoms. Estrogen replacement may be effective in reversal of this process.
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PMID:Premature menopause: a reversible entity? 22 54

Drugs that are known to affect breast morphology or breast secretion may be classified into 2 major groups: 1) drugs having a central action on the pituitary or hypothalamus and 2) steroids and several other compounds that act peripherally. Drugs in the 1st group affect lactation through stimulation or suppression of the lactogenic pituitary hormone prolactin. Their action may be directly on the pituitary or indirectly on the hypothalamus where the secretion of hypothalamic prolactin-inhibiting factor is affected. Drugs in the 2nd group act peripherally by exerting their action mainly at the level of breast tubules and acini. The most frequently used are estrogens which stimulate growth of the breast and suppress lactation, and suppress breast cancer in some women. Centrally acting drugs which cause galactorrhea also cause an increase in prolactin secretion, but the presence of estrogen-primed breast tissue is needed. A list of such drugs (including rauwolfia and phenothiazine derivatives, and opiates) is given. The most common mechanism of action by which psychotropic drugs increase prolactin secretion is by interfering with formation or release of dopamine from hypothalamus neurons and its subsequent action via an alpha-adrenergic receptor on hypothalamic cells that secrete prolactin-inhibiting factor. Reserpine and other rauwolfia drugs deplete hypothalamic neurons of catecholamines and prevent their reuptake by nerve endings. Phenothiazines interfere with the action of catecholamines at the alpha-adrenergic receptor sites. Prolonged use of drugs that stimulate pituitary activity may lead to formation of microadenomas of the pituitary. Continuation of galactorrhea for more than 2 weeks after stopping therapy suggest this result. L-dopa suppresses abnormal lactation by reduction in serum prolactin levels. Br-ergocryptine, an ergot derivative, has galactorrhea-blocking and prolactin-suppressing activity but is devoid of alpha-adrenergic activity. Barbiturates and pyridoxine may cause decrease in milk flow of nursing mothers. Peripherally acting drugs consist of estrogen, progesterone, and androgen as well as hypoglycemic-producing agents, thyroid hormone, corticosteroids, and spironolactone. Estrogen is the only steroid effective in suppression of puerperal lactation. There are several steroids effective in causing remission of breast cancer. The presence of an intact pituitary is apparently necessary if estrogens are to be effective in breast cancer. Corticosteroids may be effective in patients insenstive to sex hormones. Cytotoxic agents may be more effective when used in combination with corticosteroids. Galactorrhea occurring in a nulliparous woman taking oral contraceptives is always abnormal and suggests the possibility of a pitutitary tumor. Women with postpill galactorrhea-amenorrhea may also have such tumors. All cases of galactorrhea when sex hormones have been used should be studied for pituitary tumor.
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PMID:Drugs that affect the breast and lactation. 109 75

A 37 year-old female with Kallmann syndrome and NIDDM who had two successful deliveries is reported. She had experienced no menstruation until she had treatment with gestagen in her early twenties. She had withdrawal bleeding only once. At the age of 25, she consulted her family doctor, complaining of amenorrhea. Estrogen progesterone cyclic therapy caused withdrawal bleeding, and clomiphene citrate failed to induce apparent ovulation. In January 1978, 150 IU of hMG was administered daily for 9 days, and then 3000 IU of hCG daily for the following 2 days. This therapy induced pregnancy, which failed spontaneously on June 4th. A year later, in January 1979, 150 IU of hMG was again administered daily for 7 days followed by 6000 IU of hCG for 3 days. This therapy again induced pregnancy. On September 27th, 1979, she delivered a girl vaginally, weighing 3830 g. After this delivery, she experienced no menstruation. In June 1985, she consulted her family doctor again, and she was diagnosed as being pregnant. Since her fasting blood glucose was 145 mg/dl, she was admitted to Kosei Hospital to control her blood glucose. On October 15th, she delivered a girl weighing 2600 g. On June 13th, 1989, she was referred to Kosei Hospital by her family doctor to achieve an accurate control of her blood glucose. During this admission, she was diagnosed as having Kallmann syndrome because of congenital anosmia and hypogonadotropic hypogonadism without any abnormal morphological changes. Vitamin B1 infusion test was negative.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of two successful deliveries by a woman with Kallmann syndrome and NIDDM]. 190 34

Because the long-term effects of estrogen replacement in adolescents with ovarian failure and hypothalamic amenorrhea have not been previously studied, we conducted a 2-year study of 35 patients to determine factors contributing to baseline bone density measures (bone density, bone mineral content, and bone width) and the response to estrogen therapy. Estrogen-deficient patients were often profoundly osteopenic by single-photon absorptiometry of the radius and dual-photon absorptiometry of the spine, despite estrogen replacement. Variables that were significant predictors of better initial single-photon absorptiometry measurements included increased age, increased body mass index, spontaneous pubertal development, lack of radiation therapy, and lower serum osteocalcin. Patients treated with estrogen/progestin had stable cortical bone mineral content and bone density at the distal one-third of the radius, a slight improvement in bone density at the distal one-tenth of the radius, and on encouraging, but marginal, improvement in the z score (standard deviation from the mean) of bone mineral content at the distal one-tenth. The z scores for cortical bone width and bone density decreased, suggesting a possible relative worsening over time. In untreated estrogen-deficient girls, bone mineral content and bone density decreased (but not significantly); the z score of cortical bone width showed a significant decrease. Using dual-photon absorptiometry, a history of radiation therapy was found to be a predictor of lower bone density compared with age-matched controls. Estrogen progestin therapy did not result in changes in serum levels of lipids and antithrombin III, weight, or blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Estrogen deficiency in adolescents and young adults: impact on bone mineral content and effects of estrogen replacement therapy. 217 Aug 85

Premenopausal breast cancer patients frequently develop amenorrhea during adjuvant chemotherapy. Despite psychic distress and severe weight loss are possible causes for secondary amenorrhea in cancer patients, it is in this case due to the gonadotoxicity of the cytostatic drugs. Alkylating agents, such as cyclophosphamide, damage ovaries directly, resulting in ovarian fibrosis, atretic follicles and decline in estrogen production. Elevated plasma levels of LH and FSH show adequate reaction of the hypothalamohypophyseal unit. There is no change in the androgen production of stromal cells as well as in the plasma levels of prolactin and adrenal androgen precursors. Ovarian damage goes along with hot flushes, loss of libido and dyspareunia. The onset of amenorrhea is age- and dose-related. Commonly the changes are irreversible. Estrogen replacement therapy promptly removes menopausal symptoms but is contra-indicated regarding the possible hormone-dependence of the tumor. In this case low dose medroxy-progesterone acetate is indicated.
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PMID:[Effects of adjuvant chemotherapy of breast cancer on gonadal function]. 223 81

Bone mineral density (BMD) was measured in 17 patients with gonadal dysgenesis, 21 patients with premature ovarian failure, 14 patients with hyperprolactinemia, 23 patients postoophorectomy and 41 normal healthy women. Each group was divided into two subgroups, on the basis of whether or not they were receiving estrogen replacement therapy. Linear regression analysis showed a significant loss of BMD at a rate of 0.006 g/cm2 per year in the lumbar spine of normal healthy women. The distribution of individual values in each study group was near or within normal confidence limits, except for the group with gonadal dysgenesis. The mean BMD of each group without estrogen replacement therapy was significantly less than that of the control group. There was a significant correlation between the duration of amenorrhea and BMD values in the groups with premature ovarian failure and postoophorectomy. These results indicate that BMD, measured by dual photon absorptiometry, was reduced in amenorrheic patients, especially in patients with gonadal dysgenesis. Estrogen replacement therapy was able to decrease the severity of bone loss, but failed to increase the bone mass. Dual photon absorptiometry (DPA) is a simple, effective, and accurate tool for assessing the severity of osteoporosis and monitoring the effect of therapy.
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PMID:Measurement of bone mineral density in amenorrheic women with dual photon absorptiometry. 263 46

Menstrual dysfunction is common in adolescents who are involved in intensive athletic activity or who are limiting their nutritional intake excessively. The mechanism for hypothalamic amenorrhea in athletes and dieters is not yet fully understood. Other causes of menstrual dysfunction due to pregnancy, central lesions, hormone imbalance, or ovarian failure should be excluded in the athlete with amenorrhea. Amenorrheic patients who have sufficient estrogen effect on their endometrium to have withdrawal bleeding following exposure to progestins should be cycled with progestins on a regular basis to prevent endometrial hyperplasia. Estrogen replacement with cyclic progestin should be considered in the hypoestrogenic adolescent with prolonged amenorrhea. The long-term consequences of hypothalamic amenorrhea in adolescents remain to be determined.
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PMID:Anorexia nervosa, athletics, and amenorrhea. 266 86

Patients with a history of recurrent candidiasis and who were using Depo-Provera (medroxyprogesterone acetate, DMPA) for contraception were reviewed in order to determine the time relationship between episodes of proven candidiasis, episodes of pruritus vulvae suggestive of this infection (but unproven), and injection of DMPA. Recently, patients were included in the study who had been given DMPA specifically to prevent recurrences of candidiasis even when the drug's contraceptive action was unnecessary, such as after sterilization. In all cases, the infection was initially treated with a vaginal candidacide, most commonly 1 week of an imidazole. The patients ranged in age from 19-37 years at the time of the 1st injection. Diabetes had been eliminated in all the cases. DMPA was given intramuscularly at a dose of 150 mg every 12 weeks. Prior to 1983, an estrogen supplement was prescribed in most cases in an effort to produce monthly menstrual periods. Estrogen supplementation is no longer used routinely, with amenorrhea the aim, although it is occasionally given to women who experience breakthrough bleeding. Candidal infection was considered proven when the branching filaments of the species were seen on a stained vaginal smear or when the species were cultured in a laboratory from a vaginal swab taken a symptomatic patient. With the exception of 2 patients, clinical candidiasis did not occur within the time in which 150 mg of intramuscular DMPA is known to suppress ovulation in all women, i.e., 12 weeks -- except in the presence of exogenous estrogen (cases 1, 2, and 14) and in one case (15) in which the patient had an unplanned conception prior to the injection. Both patients who experienced clinical despite the use of DMPA alone (cases 8 and 13) asked remain on the drug because believe it was responsible for their longest remissions in the past few years. The study seemed to provide evidence that DMPA will prevent a recurrence of clinical candidiasis in many women who are prone to this condition. The study further indicated that estrogens may predispose women to this infection.
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PMID:Depo-Provera in the treatment of recurrent vulvovaginal candidiasis. 294 26

Idiopathic hemochromatosis in young adults has been increasingly recognized over the last three decades. Younger patients with hemochromatosis frequently have presenting problems other than diabetes, cirrhosis, and hyperpigmentation. A young woman with idiopathic hemochromatosis is described. Arthritis and secondary amenorrhea developed at age 20, and liver biopsy showed hemochromatosis at age 29. Further work-up revealed that the amenorrhea was due to underproduction of pituitary gonadotropins. The patient was treated with phlebotomy. Estrogen and progesterone replacement was begun because of severe osteoporosis. Serum iron studies may be useful in young patients with unexplained amenorrhea and/or arthropathy.
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PMID:Idiopathic hemochromatosis presenting as amenorrhea and arthritis. 357 42

Serial assays of urinary estrogens, pregnanediol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), WERE PERFORMED IN 2 NORMAL women who developed amenorrhea as a result of oral contraceptive use. Case 1, a woman aged 28 with 2 children took Ovulen (mestranol .1 mg and ethynodiol diacetate 1.0 mg) for 25 months followed by a substitution of chlormadinone acetate (.5 mg per day) when she developed increased menstrual irregularity. Following withdrawal of the medication, vaginal bleeding began and lasted 4 days, and she experienced regular cycles for the subsequent 2 years. The second woman aged 21 developed amenorrhea after 17 months' use of Gynovlar (ethinyl estradiol .05 mg and norethistrone acetate 3.0 mg). Amenorrheic for 21 months at the time of investigation, she was given clomiphene citrate for 5 days (50 mg/day). Further treatment with clomiphene and Pergonal (Serono-Rome) was necessary to resume normal cycles and permit conception which led to full term delivery. Estrogen levels were similar to those of the follicular phase of the normal menstrual cycle; however, they rose spontaneously to midcycle levels in case 1 and as a result of clomiphene treatment in case 2. FSH levels were normal but failed to show consistent patterns; LH patterns were highly irregular in both cases. The findings are consistent with the hypothesis that longterm therapy by oral contraceptives may cause irregular cyclic release of gonadotrophins at the hypothalamic level resulting in amenorrhea and anovulation.
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PMID:Endocrinological studies in two patients with post contraceptive cyclic dysfunction. 464 85


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