Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 300 menopausal patients, 82 experienced climacteric symptoms, with vasomotor disturbances absent in 42 (Group 1) and present in 40(Group 2). Group 2 patients commonly complained of headaches, insomnia and dyspareunia, while Group 1 complained mostly of loss of libido and depression. Group 2 was managed rather successfully with treatment of conjugated equine estrogens (Premarin) daily for 3 weeks; Group 1 was given the same treatment but the response was disappointing. Women with vasomotor symptoms exhibited a lower, mean plasma estradiol concentration compared with that observed during days 1-10 of the menstrual cycle. Concenerations of FSH (Plasma follicle stimulating hormone) and LH (luteinizing hormone) in women with vasomotor symptoms were similar to those of younger, regularly menstruating women. Group 2 patients treated for 6 months with estrogen had a 2.1 fold increase in mean plasma estradiol concentration and 39% and 66% reduction of pretreatment plasma FSH and LH concentrations, respectively; Group 1 did not exhibit such changes. Patients with estrogen-responsive symptoms exhibited high concentrations of FSH (15 U/1 was the diagnostic cut-off point). Effective patient selection for estrogen replacement therapy can be achieved by using this measurement in the presence of characteristic symptoms.
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PMID:Relation between plasma hormone profiles, symptoms, and response to oestrogen treatment in women approaching the menopause. 21 37

The symptomatic and endocrine changes following hysterectomy and bilateral oophorectomy have been studied in 100 patients, 1 to 31 years after surgery. The most frequent symptoms at the time of interview were depression (62 patients), insomnia (48 patients), loss of libido (46 patients) and dyspareunia (38 patients). Vasomotor symptoms were recorded in 28 patients. Although 94 patients claimed that hot flushes were the first symptomatic changes noticed, 60 had complete relief from these symptoms within 6 months of surgery; 34 patients had no symptoms and only 4 patients were taking oestrogen therapy at the time of interview. Plasma oestradiol and testosterone levels were 78 per cent and 27 per cent respectively below the mean values of day 1 to 10 of the menstrual cycle, similar to those found at comparable years after a normal menopause. The plasma FSH level was about 14 times and the plasma LH level about twice the respective preoperative value. Unlike after the normal menopause, these gonadotrophin levels did not show any decline with increasing age. There was no correlation between plasma hormone levels and the presence of vasomotor symptoms or depression.
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PMID:Endocrine changes and symptomatology after oophorectomy in premenopausal women. 92 14

During the last decade the development of a great amount of knowledge about the menopause has allowed to establish almost standardized hormonal treatments in order to prevent its symptoms and its late sequelae. Nevertheless, up to now the relationship between typical climacteric symptoms and the actual risk of late sequelae has not been assessed. The climacteric symptoms have hence been related to the involutional aspects of the external genitalia and to the levels of the sex steroids and gonadotropin hormones. An inverse relation between neuropsychical manifestations (insomnia, anxiety, depression, reduced memory, reduced libido) and 17-beta-oestradiol and progesterone levels has been shown. On the contrary, FSH and LH levels showed a direct relationship with neurovegetative symptoms. The relationship between the involutional aspects of the external genitalia and the atrophy related and the neuropsychical symptoms shows the need to evaluate these classes of symptoms, which appear to be most related to oestrogen and progesterone deprivation, in decision making toward hormonal replacement therapy.
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PMID:[Climacteric symptomatology: relation with hormone levels and trophic features of the external genitalia]. 181 99

The 2nd part of a review on medical therapy of endometriosis discusses pseudopregnancy brought on by oral contraceptives, and pseudomenopause induced by Danazol and GnRh agonist therapy. Oral contraceptives are not FDA approved for endometriosis, but many physicians prescribe 1 tablet daily for 2 weeks, then 2 tablets daily for 6-12 months, or higher doses in case of breakthrough bleeding. Pills cause endometrial decidual changes initially then atrophy. Danazol selectively inhibits release of FSH and LH by the pituitary, resulting in anovulation and atrophy of the endometrium. It is currently the preferred and most effective medical therapy for endometriosis, and is approved for this indication. It is used in doses of 200-800 mg in 2 divided doses, or 400-800 mg/day preoperatively. Side effects are androgenic, some of which are not reversible, antiestrogenic, metabolic and nonspecific, i.e., muscle spasms. Drug interactions such as increased insulin requirements have been reported. The GnRH antagonists, nafarelin, buserelin, histrelin and leuprolide must be given subcutaneously or nasally. The anti-ovarian side effects, hot flashes, calcium loss, vaginal dryness and insomnia are more prevalent than the androgenic side effects, weight gain, edema, myalgia, and decreased libido reported with Danazol. Clinical and laparoscopic evidence of improvement is temporary with drug treatment, in contrast to surgery. Infertility is common even with mild endometriosis, and the condition may recur, even after pregnancy.
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PMID:Clinical therapeutics of endometriosis, Part 2. 268 3

A group of 78 women with sudden flushes and associated disorders (pruritus vulvae, headache, anxiety, instability, depression, libido disturbances) related to the menopause were treated with one or two capsules of veralipride daily for 20 days. Excellent or good results were obtained in 54 of the 69 patients (78 p. cent) with sudden flushes, and 29 of the 57 cases (51 p. cent) with associated disorders. The difference in scores before and after treatment is very highly significant (p < 0.001). Clinical tolerance was good as only 2 cases of minimal galactorrhea. 2 cases of mastodynia, 3 cases with mild drowsiness, 2 patients with nervous tension or insomnia, 3 with digestive disorders, 1 with vertigo, and 1 with mild visual disturbances were observed. No modifications in the biological parameters studied were noted. Blood prolactin levels increased during treatment but returned to normal levels 4 days after discontinuation of therapy. No significant modifications in FSH, LH, E2, or E3 plasma levels were noted at the end of the study. Veralipride appears, therefore, to be the prototype for non-hormonal therapy of menopausal disorders.
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PMID:[A new therapeutic approach to menopausal sudden flushes and psychofunctional disorders (author's transl)]. 625 60

To study the types of patients with climacteric syndrome who respond to conjugated estrogen therapy, we investigated the results of 1- to 2-month therapy in 52 patients by comparing their pre- and post-drug level of blood estradiol (E2), FSH and LH as well as comparing information through a questionnaire on menopausal complaints listed according to Kupperman. Predrug E2 in the patients studied was lower than normal, but the lowering was not significantly specific to any particular climacteric symptom. Blood FSH was higher in the patients complaining of hot flushing, sweating, depression, feeling of something sticking in the throat, and decreased sexual desire, whereas blood LH was higher in the patients with hot flushing and sweating. Changes in various symptom were investigated in relation to hormonal changes found after conjugated estrogen therapy. In the patients whose E2 was increased and FSH and LH were decreased after the therapy, hot flushing, cold sensation, excitability and insomnia were ameliorated at a high rate. Numbness was favorably treated in the patients responding with increased E2, whereas shoulder stiffness, fatigability and headache was reduced in those responding with decreased LH.
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PMID:[Blood levels of estradiol, FSH and LH in women with climacteric syndrome--conjugated estrogen therapy]. 642 67

A double-blind cross-over study with Org OD 14 and placebo was performed in 82 menopausal patients presenting with hot flushes and associated symptoms. Patients were randomly allocated to Org OD 14 or placebo as first treatment, and switched to placebo or Org OD 14 as second treatment. Each treatment period lasted for 16 weeks; no wash-out period was introduced. Tablets containing 2.5 mg of Org OD 14 or matched placebo tablets were supplied. Data on the following variables were obtained and analysed by the non-parametric randomization test for paired observations: hot flushes, sweating, dizziness, palpitations, fatiguability, headache, sleeplessness, irritability, breathlessness, backache and loss of libido and, in 16 patients, on circulating levels of FSH, LH, PRL, T3, T4, cortisol (F), SHBG, TBG and CBG. Twenty patients (13 placebo, 7 Org OD 14) withdrew, because their symptoms did not improve and one patient withdrew for reasons unrelated to treatment, so that 61 patients completed the study. The data demonstrated a good clinical effect and statistically significant differences in favour of Org OD 14 for hot flushes and a number of associated symptoms. Many patients reported on a general feeling of well being and a mood-elevating effect following Org OD 14. Org OD 14 significantly suppressed FSH and LH levels, while those of PRL remained unchanged. Although there was slight suppression of TBG and T4 which attained statistical significance, there was no influence on the most important parameter, T3. SHBG levels were slightly suppressed, whereas F and CBG levels were unaffected.
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PMID:Placebo-controlled cross-over study of effects of Org OD 14 in menopausal women. 675 12

In an open, non-randomized prospective phase-III-study the clinical and endocrine efficacy as well as the safety of leuprorelin acetate depot (Enantone-Gyn Monats-Depot) were investigated. The therapeutic results of 198 patients, gathered from 5 university institutions and two city hospitals, are reported. Endometriosis was classified by the revised American Fertility Society score (r-AFS) before and at the end of treatment. Serum levels of LH, FSH, prolactin, estradiol, progesterone, androstenedione, testosterone and leuprorelin acetate were determined by radioimmunoassay. The mean total r-AFS score changed as follows: before surgical intervention during first-look laparoscopy 21 +/- 24 at the end of first-look laparoscopy 15 +/- 19 at the end of the GnRH-treatment 8 +/- 14 During leuprorelin acetate treatment the r-AFS stages changed as follows: [table; see text] Using the scoring system 85.2% of the patients improved. Relief of dysmenorrhoea could be achieved in 95.4%, relief of dyspareunia in 64% and of pelvic pain in 69.4% of patients. Baseline hormone levels dropped sharply during treatment. [table; see text] Androstenedione, testosterone, blood pressure, body weight, haematological parameters, liver enzymes, creatinine, electrolytes and HDL-/LDL-cholesterin remained more or less unchanged. Side effects being hot flushes, sweating, sleeplessness, headache, nausea, depression and vaginal dryness were due to estradiol deprivation. In 135 patients resumption of menstruation occurred in 95.6% within the first three months post-treatment. 23 patients of whom 21 were judged as infertile, became pregnant immediately after treatment was finished. The study results confirm the efficacy of leuprorelin acetate depot in the treatment of even advanced stages of endometriosis.
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PMID:[Treatment of endometriosis with the GnRH agonist leuprorelin acetate depot (Enatone-Gyn monthly depot): a multicenter study]. 784 80

The effects of the estradiol control delivery patch made in China on the main manifestation in the 176 cases of ovarian failure patient were evaluated with the improvement of their symptoms, the changes of serum levels of LH, FSH, E2, the vaginal exfoliated cytologic maturation index (MI) and the histological alteration of endometrium. The results indicated that the six main symptoms including hectic fever, sweating, vaginal dry and hard-going, dizziness, emotioned lability and insomnia were improved significantly and progressively with prolongation of the treatment. The effective rates were 97.9%, 97.5%, 93.7%, 77.0%, 76.2%, 75.0% respectively form hectic fever to insomnia. The inhibitory effects on serum LH, FSH levels occurred on the 10th day of the treatment. The MI increased within whole course and the serum estradiol level elevated slightly and stably. There were no significant endometrial proliferation caused by the patch.
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PMID:[The effects of the estradiol control delivery patch in the treatment of 176 cases of ovarian failure]. 800 9

Despite the fact that irritability is frequently the main presenting complaint of perimenopausal and postmenopausal women, studies specifically researching irritability in this population are scant. One hundred sixty three (163) peri- and postmenopausal women non-HT users, attending a menopause clinic, were included in this cross-sectional study. The investigation focused on whether the occurrence of inward and outward irritability in menopause is associated with various menopausal parameters, such as vasomotor symptoms, insomnia, menopausal status, hormone levels, and with the presence of chronic disease. Furthermore, we examined the possible association of inward and outward irritability with measures of anxiety and depression. Outward and inward irritability of peri- and postmenopausal women seem to be related to chronic disease, a factor that may be partially influenced by the older age of menopausal women. Outwardly directed irritability is found to be related to FSH and LH levels, independently of specific menopausal symptoms, such as vasomotor symptoms or insomnia. Outward irritability was found to be positively correlated with depressive symptomatology, whereas inward irritability correlated with both anxiety and higher depressive symptomatology.
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PMID:[A study of irritability in menopausal women]. 2221 28


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