Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042755 (masculinization)
 2,562 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Persistent amenorrhea, an uncommon sequela of oral contraceptive (OC) use, would not be a major problem except for the fact that an estimated 50 million women worldwide use OCs. Following OC use, women often experience some delay in resuming normal menses, but according to most studies, fewer than 1% fail to begin menstruating regularly within 6 months. In about 1/2 of this small percentage of women, failure to resume normal menses within 6 months is caused by an identifiable underlying disorder. The remaining 1/2 are considered to have "postpill amenorrhea," the result of a disruption of the normal hypothalamic-pituitary-ovarian feeding mechanism, which may be reversible with appropriate treatment. In evaluating patients with postpill amenorrhea, it is important to rule out premature ovarian failure, polycystic ovary syndrome, weight loss, and hyperprolactinemia before arriving at a diagnosis of idiopathic postpill amenorrhea. Prior to 6 months, detailed laboratory evaluation is not indicated, but after 6 months of amenorrhea, the history and physical status should again be carefully evaluated. Any history of weight change, galactorrhea, hirsutism, headaches, or "hot flashes" should be noted. On examination, evidence of hirsutism, virilization, expressible galactorrhea, or ovarian enlargement should be sought. The presence of any of these findings warrants laboratory testing. Pregnancy should always be excluded before further testing. If the patient shows no clinical evidence of premature ovarian failure, polycystic ovaries, anorexia nervosa, or hyperprolactinemia, or if laboratory evaluation fails to confirm clinical suspicions, it is appropriate to wait another 6 months before further evaluation. These disorders may be differentiated from idiopathic postpill amenorrhea by measuring serum levels of gonadotropins, estradiol, testosterone, and prolactin and by sella polytomography. It is important to define whether the treatment objective is resumption of a normal menstrual pattern or restoration of fertility, or both, for therapy will differ depending upon the objective. Ovulation can be induced with clomiphene or bromocriptine in 50-75% of women. Rarely, human menopausal gonadotropin and human chorionic gonadotropin may be needed. If fertility is not an issue, cyclic estrogen and progesterone may be useful to maintain adequate estrogen effects but will obviously continue to suppress the hypothalamic-pituitary-ovarian axis.
 ...
PMID:Management of post-pill amenorrhea. 1227 95

Females and males typically play different roles in survival of the species and would be expected to respond differently to food scarcity or excess. To elucidate the physiological basis of sex differences in responses to energy intake, we maintained groups of male and female rats for 6 months on diets with usual, reduced [20% and 40% caloric restriction (CR), and intermittent fasting (IF)], or elevated (high-fat/high-glucose) energy levels and measured multiple physiological variables related to reproduction, energy metabolism, and behavior. In response to 40% CR, females became emaciated, ceased cycling, underwent endocrine masculinization, exhibited a heightened stress response, increased their spontaneous activity, improved their learning and memory, and maintained elevated levels of circulating brain-derived neurotrophic factor. In contrast, males on 40% CR maintained a higher body weight than the 40% CR females and did not change their activity levels as significantly as the 40% CR females. Additionally, there was no significant change in the cognitive ability of the males on the 40% CR diet. Males and females exhibited similar responses of circulating lipids (cholesterols/triglycerides) and energy-regulating hormones (insulin, leptin, adiponectin, ghrelin) to energy restriction, with the changes being quantitatively greater in males. The high-fat/high-glucose diet had no significant effects on most variables measured but adversely affected the reproductive cycle in females. Heightened cognition and motor activity, combined with reproductive shutdown, in females may maximize the probability of their survival during periods of energy scarcity and may be an evolutionary basis for the vulnerability of women to anorexia nervosa.
 ...
PMID:Sex-dependent metabolic, neuroendocrine, and cognitive responses to dietary energy restriction and excess. 1756 58