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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Reports of complications due to estrogen-progestagen combinations are summarized. Common minor symptoms include nausea, abdominal distress, headache, depression, and weight gain. Some of these are directly due to the pill, but others are not; for instance, depression may result from pyrodoxine deficiency, but psychodynamic factors explain the problem in others. Effects on the reproductive organs include secondary amenorrhea in about 2 of every 1000 women; structural and functional changes of the ovaries, uterus, and cervix; increase in incidence of yeast vulvovaginitis; and inhibition of lactation. Most changes in laboratory values of various constituents of blood and other body fluids reflect changes in hepatic function. Thromboembolic diseases, hypertension, and hypertriglyceridemia are rare but more serious conditions for which the pill may be responsible in some cases. Contribution of the pill to carcinogenesis and fetal abnormalities has not been proven.
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PMID:Clinical complications of oral contraceptives. 109 Jan 18

Physicians examined 216 women who presented at Chittaranjan Seva Sadan College of Obstetrics, Gynaecology, and Child Health in Calcutta, India, and had undergone surgical sterilization at least 2 years earlier. Endometrial biopsies during the late secretory phase in the 32 cases with excessive bleeding during the late menstrual period found proliferative changes: dilated glands in 28 cases and poor secretory phase in 4 cases. The 12 ovarian biopsies revealed cortical stromal hyperplasia in 1 case. None of the control cases (i.e., those with no menorrhagia) had any ovarian changes. Observed pelvic pathologies included in the order of frequency: cystic ovaries, hydrosalpinx, uterine fibroids, pelvic endometriosis, uterine prolapse, chronic cervicitis, and scar endometriosis. Most of the 216 women were 25 to 35 years old and the youngest was 22 years old. Menorrhagia was the most common complaint (59.2%) and 30 to 35 year old women suffered from it the most. Among women who had no pelvic pathology, dysfunctional uterine bleeding was responsible for menorrhagia. Dysmenorrhea was the next most frequent complaint (29.6%). Intermenstrual bleeding, abnormally infrequent menstruation, and secondary amenorrhea were other menstrual disturbances (5.56%, 4.17%, and 1.39%, respectively). Other relatively common symptoms associated with surgical sterilization were abdominal pain (25%), abdominal discomfort and backache (14.8%), and whitish, viscid vaginal or uterine discharge (12.03%). Less frequent symptoms were obesity, painful scar, insomnia, irritability, depression, and regret. Proper preoperative and postoperative counseling would have prevented many of the complications.
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PMID:Aftermaths of surgical sterilisation with special reference to menstrual disturbances. 153 7

Hormonal and clinical evaluation was performed in eleven females with diagnosis of pseudocyesis. Plasma levels of pituitary gonadotropins (FSH-LH), progesterone, estradiol and thyroid hormones (T3, T4, TSH) under basal conditions were measured through radioimmunoassay. Diagnosis of pseudocyesis was made according to the following criteria: a) secondary amenorrhea (greater than 12 weeks); b) two or more symptoms of gestation; c) conviction of being pregnant; d) negative HCG or pelvic ultrasound study. The circulation levels of gonadotropins were within normal limits. Progesterone exhibited a ovulatory pattern and thyroid hormones were normal for every instance. Once case had slight hyperprolactinemia (26.0 ng/ml) with impaired gonadotropin production and ovulatory progesterone. All patients had galactorrhea. The psychological study disclosed a tendency toward depression. Our findings partially confirmed previous observations, differing basically on that we observed normal hormonal trend.
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PMID:[Pseudocyesis: clinical and hormonal evaluation]. 251 25

Three adolescent patients were diagnosed as having pseudocyesis based on an assessment including pelvic examination, pregnancy tests, and pelvic ultrasound scanning. Their psychosocial evaluation demonstrate a conversion reaction in already deprived and depressed adolescents. They responded to psychotherapeutic counseling. Pseudocyesis merits consideration in the differential diagnosis of secondary amenorrhea. It occurs psychologically in vulnerable adolescents who exhibit rather primitive defense mechanisms. Once a patient acknowledges that she is not pregnant, severe depression is a possible complication. A review is presented of the current medical literature on this subject.
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PMID:Pseudocyesis in adolescent females. 686 6

In order to evaluate the relationship of psychological distress to hyperprolactinemia, 20 patients with secondary amenorrhea were evaluated by a semi-structured research interview and administered the Kellner Symptom Questionnaire. Group A (10 patients with amenorrhea and hyperprolactinemia) reported significantly more symptoms of depression, hostility and anxiety than group B (10 patients with amenorrhea and normal basal levels of plasma prolactin). Both groups were significantly more anxious, depressed and reported more somatic symptoms than a normal control group (n = 10). 6 of the 10 patients in group A reported decrease in libido, while this was found only in 1 of the 10 patients of group B. The findings suggest that the syndrome of depression, hostility and anxiety in a woman complaining of amenorrhea, especially if associated with decreased libido and galactorrhea, can be a manifestation of hyperprolactinemia.
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PMID:Depression hostility and anxiety in hyperprolactinemic amenorrhea. 720 Jun 25

The authors stressed the reliability of lateral thin-section hypocycloidal tomography not only for the detection of pituitary microadenomas but also as an aid in surgical removal of them. Fourteen women with secondary amenorrhea were studied of which 13 cases showed high serum prolactin levels. Transsphenoidal surgery confirmed the presence of microadenomas less than 10 mm in all cases. The sellar volume measurement from plain radiographs of the skull was normal in all cases. The contour of the sella on plain lateral radiographs was abnormal in 4 cases (28.6%); double floor in 2 cases and localized ballooning in 2 cases. Hypocycloidal tomography was carried out at 2 mm intervals in both anteroposterior projection and lateral projection. Anteroposterior tomograms were abnormal in only 4 cases; each case with destruction of the sellar floor with small tumor shadow in the sphenoid sinus, central depression, lateral depression and sloping of the sellar floor. Lateral tomograms were, on the other hand, abnormal in all cases. Localized expansion with thinning in the anterior or anteroinferior portion of the sellar wall was found in 11 cases and the same finding in the inferior or inferoposterior portion of the sellar wall associated with thinning of the dorsum sellae was present in 3 cases. Lateral tomograms were considered more sensitive than anteroposterior tomograms from these results. We also studied the reliability of hypocycloidal tomography in the accurate localization of the tumor in comparing with the actual location of the tumor from the operative findings. In 12 cases the location of the tumor defined by hypocycloidal tomography was coincident with that by surgery. Moreover, when the sellar destruction was shown to be larger by hypocycloidal tomography, size of the tumor tended to be larger. These results suggested hypocycloidal tomography would be an accurate aid in surgical procedures.
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PMID:[Diagnosis of pituitary microadenoma by thin-section hypocycloidal tomography (author's transl)]. 745 35

Celiac disease (gluten-sensitive enteropathy) may manifest clinically with an array of nongastrointestinal symptoms among which are: dermatitis herpetiformis; dementia; depression; various neurological symptoms; osteoporosis; osteomalacia; dental enamel defects, and anemia of various types. Important data have accumulated in recent years regarding the association between celiac disease, fertility and pregnancy. Many primary care obstetricians and gynecologists and perinatologists are not aware of these important relationships. The aim of this review, utilizing a MEDLINE search from 1966 through March 2000 of the English language, is to describe the possible effects of celiac disease and its treatment upon the reproductive cycle, fertility, pregnancy, and menopause. Review of the literature reveals that patients with untreated celiac disease sustain a significantly delayed menarche, earlier menopause, and an increased prevalence of secondary amenorrhea. Patients with untreated celiac disease incur higher miscarriage rates, increased fetal growth restriction, and lower birth weights. It appears that improvement of celiac disease, as reflected by restoration of small bowel mucosa associated with implementation of a gluten-free diet, may decrease miscarriage rates, improve fetal nutritional support and overall perinatal outcome.
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PMID:Celiac disease: fertility and pregnancy. 1115 Aug 66

Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea). It is a heterogeneous disorder affecting approximately 1% of women <40 years, 1:10,000 women by age 20 and 1:1,000 women by age 30. The most severe forms present with absent pubertal development and primary amenorrhea (50% of these cases due to ovarian dysgenesis), whereas forms with post-pubertal onset are characterized by disappearance of menstrual cycles (secondary amenorrhea) associated with premature follicular depletion. As in the case of physiological menopause, POF presents by typical manifestations of climacterium: infertility associated with palpitations, heat intolerance, flushes, anxiety, depression, fatigue. POF is biochemically characterized by low levels of gonadal hormones (estrogens and inhibins) and high levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea). Beyond infertility, hormone defects may cause severe neurological, metabolic or cardiovascular consequences and lead to the early onset of osteoporosis. Heterogeneity of POF is also reflected by the variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects. POF has a strong genetic component. X chromosome abnormalities (e.g. Turner syndrome) represent the major cause of primary amenorrhea associated with ovarian dysgenesis. Despite the description of several candidate genes, the cause of POF remains undetermined in the vast majority of the cases. Management includes substitution of the hormone defect by estrogen/progestin preparations. The only solution presently available for the fertility defect in women with absent follicular reserve is ovum donation.
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PMID:Premature ovarian failure. 1672 28

Eating disorders (EDs) are conditions which are becoming more and more widespread among adolescents and they often lead them to seek the opinion of a professional health caregiver, including gynecologists and pediatricians. EDs, and particularly anorexia nervosa (AN), are usually classified as psychological or psychiatric disorders, but they may have major somatic implications and complications as osteoporosis, nutritional deficiencies, cerebral atrophy, cardiac and metabolic disorders. A key issue in the management is prevention or reduction of both the serious somatic consequences and the important mental health consequences (e.g. depression, psychosocial withdrawal, phobia and suicide), integrating different perspectives (psychological or psychiatric - individual and familial -, genetic, nutritional, pediatric, gynecological). Adolescence is a critical period for the onset of EDs though they may also involve younger children. In this case, the consequences on the development (height, weight, puberty) can also be significant. In this review, we will focus on eating disorders in adolescent girls with an emphasis on AN. We describe variations in ED characteristics and their management depending on age at occurrence. A possible ED should be considered by pediatricians consulted about delayed female growth and puberty as well as gynecologists in patients with primary or secondary amenorrhea or infertility.
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PMID:Eating disorders throughout female adolescence. 2284 35

Hypothalamic-pituitary-adrenal axis impairment in anorexia nervosa is marked by hypercortisolemia, and psychiatric disorders occur in the majority of patients with Cushing's syndrome. Here we report a patient diagnosed with anorexia nervosa who also developed Cushing's syndrome. A 26-year-old female had been treated for anorexia nervosa since she was 17 years old, and also developed depression and paranoid schizophrenia. She was admitted to the Department of Endocrinology, Metabolism, and Internal Medicine with a preliminary diagnosis of Cushing's syndrome. Computed tomography revealed a 27 mm left adrenal tumor, and she underwent laparoscopic adrenalectomy. She was admitted to hospital 6 months after this procedure, at which time she did not report any eating or mood disorder. This is a rare case report of a patient with anorexia nervosa in whom Cushing's syndrome was subsequently diagnosed. Diagnostic difficulties were caused by the signs and symptoms presenting in the course of both disorders, ie, hypercortisolemia, osteoporosis, secondary amenorrhea, striae, hypokalemia, muscle weakness, and depression.
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PMID:Two diagnoses become one? Rare case report of anorexia nervosa and Cushing's syndrome. 2357 93


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