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Query: UMLS:C0003128 (anovulation)
 1,718 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A group of 46 patients with secondary amenorrhea without galactorrhea or hyperprolactinemia were studied retrospectively after being clinically categorized into four groups with the use of progesterone-induced uterine bleeding and measurement of serum gonadotropins and prolactin levels. The ability to have regular spontaneous menstrual cycles and to conceive was assessed after a follow-up period of 10 years. Patients who had been classified as having hypothalamic pituitary "failure" (hypoestrogenic amenorrhea) with low levels of circulating estradiol had a greater rate of recovery of spontaneous ovulation and menses when compared with patients who had been classified as having only hypothalamic pituitary dysfunction (euestrogenic amenorrhea). The patients with diagnosis of hyperandrogenic chronic anovulation or polycystic ovary syndrome generally required clomiphene citrate for induction of ovulation and almost all the patients with premature ovarian failure (hypergonadotropic amenorrhea) remained estrogen-deficient and unable to ovulate. Hyperprolactinemia or an identifiable pituitary adenoma has not developed in any of the patients to date.
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PMID:Ten-year follow-up of patients with secondary amenorrhea and normal prolactin. 204 15

Estrogens are involved in the regulation of the secretion and release of prolactin, and so are a large number of neurotransmitters and neuropeptides. This explains why the circulating level of prolactin is very labile. Most of these elements work by bringing about small changes in the tone of the dopaminergic inhibitor system, which is the principal controlling factor for this hormone. Most hyperprolactinaemias of a pathological nature seem to be the result of a failure of this dopaminergic inhibiting system. Prolactin has a rudimentary luteotrophic function, but it does act as an inhibitor of female gonadic function as soon as the circulating level reaches about 30 ng/ml, and it exerts its effects at two levels--the ovarian and the hypothalamic. Estimating levels of prolactin should be carried out according to a strict protocol so that many causes of non-pathological rise can be excluded. Hyperprolactinaemia should be sought whenever anovulation is found whether it is accompanied by galactorrhoea or not. Certain cases of hyperprolactinaemia are secondary to different types of aetiology which have to be searched for. When confronted with a case of primary hyperprolactinaemia the search should be towards diagnosis of a pituitary adenoma, which is often present although very small. Two examinations that are of most value to diagnose this condition are standard X-rays of the pituitary fossa and scanning tomography.
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PMID:[Prolactin, bromocriptine and gonadic function in women: recent discoveries. I. The physiology of prolactin and the physiopathology and diagnosis of hyperprolactinaemias]. 612 96

The clinical use of bromocriptine was investigated in 50 hyper- and 30 normoprolactinaemic women attending an infertility clinic and presenting with anovulatory cycles, oligomenorrhoea or amenorrhoea and the complaint that they had failed to become pregnant. The results confirmed that bromocriptine is effective in the treatment of hyperprolactinaemic states. Bromocriptine supresses prolactin secretion irrespective of the underlying pathologic process. Hyperprolactinaemia in humans is frequently associated with anovulation. Serum prolactin values showed no close correlation with the degree of menstrual abnormalities or galactorrhoea. Basal FSH and LH levels and the gonadotropin response to LH-RH were essentially normal in hyperprolactinaemia. Circulating E2 levels were largely subnormal suggesting an inhibitory effect of prolactin on ovarian E2 production. Prolactin levels over 100 ng/ml are suggestive of pituitary adenoma.
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PMID:Hyperprolactinaemia and female infertility. 644 Jan 15

84 patients with elevated serum PRL levels, ranging from 25 to 253 ng/ml, were treated with an antiserotonin agent, metergoline, at the dose of 12 mg/day for 90 days. The clinical complaint was of amenorrhea in 70 cases (plus galactorrhea in 44 cases) and of anovulation in 14 cases (plus galactorrhea in 6 cases). Hyperprolactinemia was due to a pituitary adenoma in 18 cases; in 53 cases it was of unknown origin, while in 7 cases it followed treatment with neuroleptics or with oral contraceptives and in 6 cases it followed a puerperium. In patients with amenorrhea, metergoline induced the appearance of menses in 61 cases (94%), and of ovulation in 46 cases (82%). In 13 of the 14 patients with anovulation, ovulation was restored. Galactorrhea disappeared in 40 out of 50 patients. Metergoline normalized serum PRL levels (less than 20 ng/ml) in 46 cases and significantly reduced serum PRL levels in all but 3 of the remaining patients. In spite of suggested nonhormonal contraceptive measures, 14 patients became pregnant; 2 had abortions and the remaining 12 patients completed by vaginal delivery, uneventful pregnancies. These results indicate metergoline as a safe and effective drug in the management of hyperprolactinemic amenorrhea and anovulation. 49 patients were followed for 2 additional months, receiving no treatment (24 cases) or metergoline at a reduced daily dosage (8 mg/day, 25 cases). Within 60 days, 60% of the first group had relapse of the clinical condition and a rebound elevation of serum PRL levels while only 20% of the second group experienced relapse of amenorrhea and rebound elevation of serum PRL levels (p less than 0.01).
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PMID:Metergoline in the management of hyperprolactinemic amenorrhea and anovulation. 703 5

To determine the prevalence of hyperprolactinemia in an ovulatory patients presenting to a general gynecology clinic, a 1-year prospective study (1978) was instituted. A total of 119 patients with at least 3 months of anovulation were screened with serum prolactin determinations. Those patients demonstrating hyperprolactinemia were further evaluated with a serum TSH level and hypocycloidal polytomography of the pituitary sella. In patients with anovulation with or without galactorrhea, a hyperprolactinemia prevalence rate of 15% was established. Anovulatory patients with galactorrhea had a hyperprolactinemia prevalence rate of 43%. This was compared to the 9% prevalence of hyperprolactinemia in patients with nongalactorrheic anovulation (P less than .001). Twenty-two percent of the patients with nongalactorrheic anovulation (2 of 9) were found to have a prolactin-secreting pituitary adenoma. In patients with hyperprolactinemia, galactorrhea, and anovulation, 67% (6 of 9) of patients had a prolactin-secreting pituitary adenoma. The authors therefore conclude that the 15% prevalence rate of hyperprolactinemia in all anovulatory women is sufficiently high to warrant continued screening of serum prolactin determinations in all anovulatory women.
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PMID:Prevalence of hyperprolactinemia in anovulatory women. 718 48

A cohort of 487 patients with chronic anovulation syndrome diagnosed between January 1, 1970, and January 1, 1980, were followed up to determine the frequency of pituitary adenomas among them. Of the 487 patients, four (0.8%) had pituitary adenoma. This compares with an expected number of 0.42, yielding a relative risk of 9.5 (95% confidence interval, 2.6 to 24.3). Within this cohort, the prevalence rate was 2.7% for galactorrhea and 3.3% for hyperprolactinemia. The prevalence rate of abnormal radiologic findings was 6.4% for roentgenography of the sella, 25.4% for sellar tomography, and 14.7% for computed tomography. In addition, 15 patients with pituitary adenomas and 60 control subjects were compared for prior anovulation syndrome. The relative risk of pituitary adenomas for patients with chronic anovulation syndrome in this case-control study was 24.3 (95% confidence interval, 4.9 to 120.6).
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PMID:The association between pituitary adenomas and chronic anovulation syndrome. 720 Jul 27