Amenorrhea

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Pouneh K. Fazeli - One of the best experts on this subject based on the ideXlab platform.

  • Neuroendocrine Causes of Amenorrhea—An Update
    The Journal of Clinical Endocrinology and Metabolism, 2015
    Co-Authors: Lindsay T Fourman, Pouneh K. Fazeli
    Abstract:

    Context: Secondary Amenorrhea—the absence of menses for three consecutive cycles—affects approximately 3–4% of reproductive age women, and infertility—the failure to conceive after 12 months of regular intercourse—affects approximately 6–10%. Neuroendocrine causes of Amenorrhea and infertility, including functional hypothalamic Amenorrhea and hyperprolactinemia, constitute a majority of these cases. Objective: In this review, we discuss the physiologic, pathologic, and iatrogenic causes of Amenorrhea and infertility arising from perturbations in the hypothalamic-pituitary-adrenal axis, including potential genetic causes. We focus extensively on the hormonal mechanisms involved in disrupting the hypothalamic-pituitary-ovarian axis. Conclusions: A thorough understanding of the neuroendocrine causes of Amenorrhea and infertility is critical for properly assessing patients presenting with these complaints. Prompt evaluation and treatment are essential to prevent loss of bone mass due to hypoestrogenemia and/o...

  • neuroendocrine causes of Amenorrhea an update
    The Journal of Clinical Endocrinology and Metabolism, 2015
    Co-Authors: Lindsay T Fourman, Pouneh K. Fazeli
    Abstract:

    Context: Secondary Amenorrhea—the absence of menses for three consecutive cycles—affects approximately 3–4% of reproductive age women, and infertility—the failure to conceive after 12 months of regular intercourse—affects approximately 6–10%. Neuroendocrine causes of Amenorrhea and infertility, including functional hypothalamic Amenorrhea and hyperprolactinemia, constitute a majority of these cases. Objective: In this review, we discuss the physiologic, pathologic, and iatrogenic causes of Amenorrhea and infertility arising from perturbations in the hypothalamic-pituitary-adrenal axis, including potential genetic causes. We focus extensively on the hormonal mechanisms involved in disrupting the hypothalamic-pituitary-ovarian axis. Conclusions: A thorough understanding of the neuroendocrine causes of Amenorrhea and infertility is critical for properly assessing patients presenting with these complaints. Prompt evaluation and treatment are essential to prevent loss of bone mass due to hypoestrogenemia and/o...

  • Hyperprolactinemia and Pituitary Causes of Amenorrhea
    Amenorrhea, 2010
    Co-Authors: Pouneh K. Fazeli, Lisa B. Nachtigall
    Abstract:

    Pituitary causes of Amenorrhea constitute approximately 18% of cases of secondary Amenorrhea but only approximately 7% of cases of primary Amenorrhea [1]. The most common pituitary cause of Amenorrhea is hyperprolactinemia constituting 80% of all pituitary causes of secondary Amenorrhea and approximately 15% of cases of secondary Amenorrhea due to any cause [2]. In this chapter, we review the causes, clinical presentation, diagnostic evaluation, and current treatment strategies for Amenorrhea due to hyperprolactinemia and other pituitary disorders. We present an illustrative case of secondary Amenorrhea due to a pituitary cause.

Sandra M Swain - One of the best experts on this subject based on the ideXlab platform.

  • Amenorrhea from breast cancer therapy not a matter of dose
    The New England Journal of Medicine, 2010
    Co-Authors: Sandra M Swain, Jonghyeon Jeong, Norman Wolmark
    Abstract:

    To the Editor: In our article on concurrent versus sequential administration of chemotherapy drugs for women with operable, node-positive, early-stage breast cancer (June 3 issue),1 we report that premenopausal women in whom Amenorrhea developed as a consequence of receiving adjuvant chemotherapy had a superior outcome to those without Amenorrhea. In response to questions regarding our data analyses, we have performed two additional analyses. One is a 12-month landmark Kaplan–Meier analysis to address the concern that our previous results may have been biased by the misclassification of women without Amenorrhea who had a relapse or died before reaching 24 months of . . .

  • Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer
    Journal of Clinical Oncology, 2006
    Co-Authors: J Walshe, Neelima Denduluri, Sandra M Swain
    Abstract:

    Chemotherapy and ovarian ablation both independently improve survival in premenopausal women with hormone-sensitive breast cancer. Amenorrhea is a well-recognized occurrence after chemotherapy. The rate of chemotherapy-induced Amenorrhea varies with patient age and chemotherapy regimens administered. However, the impact of chemotherapy-induced Amenorrhea on prognosis is still being defined. Older studies in premenopausal women argue that the benefit with chemotherapy is a result of direct cytotoxicity alone. However, studies that restrict outcome analysis to hormone receptor–positive tumors suggest that chemotherapy has a dual mechanism in women with hormone-responsive tumors; indirect endocrine manipulation secondary to chemotherapy-induced ovarian suppression and direct cytotoxicity. The significant health ramifications involved with the induction of premature menopause as well as potential benefits necessitate a comprehensive evaluation of chemotherapy-induced Amenorrhea. This review will discuss the i...

Alessandro D Genazzani - One of the best experts on this subject based on the ideXlab platform.

  • low levels of serum inhibin a and inhibin b in women with hypergonadotropic Amenorrhea and evidence of high levels of activin a in women with hypothalamic Amenorrhea
    Fertility and Sterility, 1998
    Co-Authors: Felice Petraglia, Beda Hartmann, Stefano Luisi, Pasquale Florio, Silvia Kirchengast, M Santuz, Alessandro D Genazzani
    Abstract:

    Abstract Objective: To examine serum levels of inhibin A, inhibin B, and activin A in women with secondary hypergonadotropic or hypothalamic Amenorrhea. Design: Retrospective study. Setting: Universities of Udine, Pisa, and Modena in Italy, and of Wien in Austria. Patient(s): Forty women with idiopathic premature ovarian failure (POF), 23 women with hypogonadotropic hypothalamic Amenorrhea, 40 healthy postmenopausal women, and 40 age-matched women with normal ovarian function (controls). Intervention(s): Blood samples were collected between 8 and 9 am. Main Outcome Measure(s): Serum levels of inhibin A, inhibin B, and activin A. Result(s): Women with POF had lower concentrations of serum inhibin A and inhibin B than women with hypothalamic Amenorrhea and fertile controls, and the difference between these concentrations was statistically significant. Levels of inhibin A and inhibin B were low in postmenopausal women and were no different than in women with POF. Serum levels of activin A were not significantly different among women with POF, fertile controls, and postmenopausal women. Women with hypogonadotropic hypothalamic Amenorrhea had higher activin A values than did controls. No significant correlation was found between the level of inhibin A or inhibin B and the length of Amenorrhea or the level of FSH. Conclusion(s): Low levels of circulating inhibins A and B, but not activin A, reflect ovarian failure in women with POF, whereas women with hypogonadotropic hypothalamic Amenorrhea have normal levels of inhibins A and B and high levels of activin A.

Lindsay T Fourman - One of the best experts on this subject based on the ideXlab platform.

  • neuroendocrine causes of Amenorrhea an update
    The Journal of Clinical Endocrinology and Metabolism, 2015
    Co-Authors: Lindsay T Fourman, Pouneh K. Fazeli
    Abstract:

    Context: Secondary Amenorrhea—the absence of menses for three consecutive cycles—affects approximately 3–4% of reproductive age women, and infertility—the failure to conceive after 12 months of regular intercourse—affects approximately 6–10%. Neuroendocrine causes of Amenorrhea and infertility, including functional hypothalamic Amenorrhea and hyperprolactinemia, constitute a majority of these cases. Objective: In this review, we discuss the physiologic, pathologic, and iatrogenic causes of Amenorrhea and infertility arising from perturbations in the hypothalamic-pituitary-adrenal axis, including potential genetic causes. We focus extensively on the hormonal mechanisms involved in disrupting the hypothalamic-pituitary-ovarian axis. Conclusions: A thorough understanding of the neuroendocrine causes of Amenorrhea and infertility is critical for properly assessing patients presenting with these complaints. Prompt evaluation and treatment are essential to prevent loss of bone mass due to hypoestrogenemia and/o...

  • Neuroendocrine Causes of Amenorrhea—An Update
    The Journal of Clinical Endocrinology and Metabolism, 2015
    Co-Authors: Lindsay T Fourman, Pouneh K. Fazeli
    Abstract:

    Context: Secondary Amenorrhea—the absence of menses for three consecutive cycles—affects approximately 3–4% of reproductive age women, and infertility—the failure to conceive after 12 months of regular intercourse—affects approximately 6–10%. Neuroendocrine causes of Amenorrhea and infertility, including functional hypothalamic Amenorrhea and hyperprolactinemia, constitute a majority of these cases. Objective: In this review, we discuss the physiologic, pathologic, and iatrogenic causes of Amenorrhea and infertility arising from perturbations in the hypothalamic-pituitary-adrenal axis, including potential genetic causes. We focus extensively on the hormonal mechanisms involved in disrupting the hypothalamic-pituitary-ovarian axis. Conclusions: A thorough understanding of the neuroendocrine causes of Amenorrhea and infertility is critical for properly assessing patients presenting with these complaints. Prompt evaluation and treatment are essential to prevent loss of bone mass due to hypoestrogenemia and/o...

Haralampos M Moutsopoulos - One of the best experts on this subject based on the ideXlab platform.

  • predictors of sustained Amenorrhea from pulsed intravenous cyclophosphamide in premenopausal women with systemic lupus erythematosus
    The Journal of Rheumatology, 2002
    Co-Authors: John P A Ioannidis, Gikas E Katsifis, Athanasios G Tzioufas, Haralampos M Moutsopoulos
    Abstract:

    OBJECTIVE: To identify predictors of intravenous cyclophosphamide (IC) induced sustained Amenorrhea, especially in young premenopausal women with systemic lupus erythematosus (SLE). METHODS: The cumulative dose resulting in sustained Amenorrhea in 50 and 90% of the treated women (D50 and D90) and predictors of sustained Amenorrhea at various ages were determined with Kaplan-Meier plots and Cox regressions in a consecutively enrolled cohort of 67 premenopausal women with SLE who received a pulsed IC regimen (monthly doses of 0.75-1.00 g/m2) for nephritis (n = 59) or other indications (n = 8). RESULTS: Twenty-one of 67 women developed sustained Amenorrhea of > 12 months' duration. Age was the strongest determinant of this adverse event. For women in the upper age tertile (>or= 32 years old), D50 was 8 g/m2 and D90 was 12 g/m2, and no strong protective or predisposing factors were identified. Conversely, only 5 of 44 women Amenorrhea. In these young women the risk was modulated by the prior SLE disease duration (risk increased 1.28-fold per year; p = 0.002), the presence of anti-U1RNP antibodies (relative risk 9.5; p = 0.016), and the presence of anti-Ro antibodies (relative risk 13.5; p = 0.021). In multivariate modeling, anti-U1RNP and disease duration were still significant (p < 0.05). CONCLUSION: Sustained Amenorrhea is difficult to avoid in women 32 years or older, even with very short IC courses, and alternative regimens should be considered. In younger women treated with a monthly IC regimen, sustained Amenorrhea may occur predominantly in those with the recognized adverse predictors of this complication.