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Biomedical subjects

B A Gross

Publications and source records attributed to B A Gross.

13 recordsLinked to original sources
PubMed1999

Bone density effects of continuous estrone sulfate and varying doses of medroxyprogesterone acetate. Ogen/Provera Study Group.

OBJECTIVE: To establish the optimum oral daily dose of medroxyprogesterone acetate with estrone sulfate for 2 years to maintain bone density. METHODS: A multicenter, double-blind study involved 568 postmenopausal women given estrone sulfate, 1.25 mg, and randomized to receive 2.5, 5, or 10 mg of medroxyprogesterone acetate. Bone density analyses of the lumbar spine and femoral neck were done at baseline and 12 and 24 months. RESULTS: There was a significant increase from baseline to 24 months in mean lumbar spine (4.0% +/- 0.27%) and femoral neck (3.2% +/- 0.28%) bone density, with no significant differences between the treatment groups. Factors most influencing bone density changes were baseline bone density and treatment duration. Significant increases were seen in the spine over 2 years; in the hip, those occurred in the first 12 months only. In both sites, lower baseline bone density resulted in greater increases. In the spine only, no previous hormone replacement therapy, higher body mass index, more than 2 years postmenopause, and nonsmoking resulted in greater gains. Once those covariates and center-to-center variations were corrected for, in the spine, the 10-mg group had smaller increases than the other groups. Changes were unrelated to age, parity, calcium, and alcohol intakes in either site. CONCLUSION: Daily estrone sulfate, 1.25 mg, with 2.5, 5, or 10 mg medroxyprogesterone acetate was effective for preventing bone loss in postmenopausal women.

Adult↗
PubMed1997

Fertility of fully breast-feeding women in the early postpartum period.

OBJECTIVE: To examine bleeding between 6 and 8 weeks postpartum in fully breast-feeding women and its association with fertility as assessed by hormone analysis. METHODS: Seventy-two fully breast-feeding women were followed prospectively from 42 days postpartum. Vaginal bleeding was recorded daily. Women who experienced bleeding were compared with women who did not with respect to time of ovulation and time of first menses. RESULTS: Nearly half of the women experienced some vaginal bleeding or spotting between 6 and 8 weeks postpartum. These women eventually menstruated and ovulated earlier than the women who did not bleed, but the differences were not significant. The study had 34% and 45% power to detect a 20% difference in the proportion menstruating and ovulating, respectively, at 6 months postpartum, and 10% and 16% power to detect the same differences at 1 year. Seven women experienced ovarian follicular development before day 56, but neither bleeding nor follicular development was associated with ovulation in any woman in the first 8 weeks postpartum. CONCLUSIONS: It is unlikely that vaginal bleeding in fully breast-feeding women in the first 8 weeks postpartum represents a return to fertility.

Female↗
PubMed1991

Is the lactational amenorrhea method a part of natural family planning? Biology and policy.

The lactational amenorrhea method is a natural method of family planning for women who breastfeed their infants. The underlying physiology results in a natural suppression of ovulation, and the concomitant amenorrhea, induced by exclusive (or almost exclusive) breastfeeding. This in addition to the infant's age of 6 months or less and specific feeding pattern are the parameters used to identify the possible return of fertility. The lactational amenorrhea method provides at least 98% protection against pregnancy. Data from a recent multicenter study of breastfeeding support the use of the lactational amenorrhea method as a natural family planning method. The lactational amenorrhea method can be incorporated into natural family planning programs and teaching.

Amenorrhea↗
PubMed1988

Breast-feeding and natural family planning.

The records of 50 Australian postpartum women who intended to breast-feed for longer than 6 months were analyzed. Fifty percent of the women breast-fed longer than 12 months, and 50% resumed menses by 40 weeks after childbirth. Fifty-four women provided records of mucus and BBT for at least 4 weeks before resumption of menses. Ovulation before menses while fully breast-feeding was probable in only one woman. Fifty percent of the first postpartum cycles had a short luteal phase. Thirty-two women chose NEP to avoid pregnancy during the study period. Mucus and BBT proved to be a good marker of ovulation during postpartum cycles. The mean number of days available for intercourse according to the Ovulation Method was 22.6 days between 6 and 12 postpartum weeks, and 12 days during the 4 weeks before menses. Confidence in NFP during lactational amenorrhoea and first postpartum cycles is analyzed. Finally, research aimed at improving the teaching and use of NFP for postpartum breast-feeding women is described.

Adult↗
PubMed1987

Natural family planning indicators of ovulation.

Indirect evidence of the occurrence of ovulation, which is generally accepted, is an increase in plasma or serum progesterone. Pelvic ultrasonography can estimate the probable time of ovulation within 12 h. There is a close association between the rise in progesterone, luteinizing hormone (LH) and oestrogen peaks and ovulation. A WHO study reported that ovulation occurred at a median time of 8 h after the rise in plasma progesterone, 15 h after the LH peak and 24 h after the oestrogen peak. The basal body temperature (BBT) method is the most effective in determining the premenstrual infertile period, but it is unreliable for an accurate determination of ovulation and the postmenstrual infertile period. Nor is BBT an effective method of predicting ovulation during postpartum lactational amenorrhoea. Therefore, BBT is usually used as a secondary indicator of ovulation and is combined with more reliable indicators. Observed changes in cervical mucus patterns can be used to define the probable fertile period, although this method produces a wide range of days. The peak mucus symptom is closely correlated with ovulation. Mucus symptoms can be used as a guide for the timing of blood or urine samples for estimation of LH, oestrogen and progesterone or their metabolites. Symptothermal methods incorporate other symptoms such as cervical changes, intermenstrual pain, breast tenderness and backaches, but these are secondary signs of ovulation and are recommended to be used in conjunction with mucus and BBT.

Body Temperature↗
PubMed1986

Radioimmunoassay of prolactin in blood spotted on filter paper.

In this method for estimating prolactin, 50 microL of whole blood obtained by finger puncture is spotted onto filter paper and blood-spot samples are "punched out" with a 3-mm (diameter) paper punch. The blood is extracted with aqueous buffers and the prolactin measured in large batches by radioimmunoassay. Results were identical with those for prolactin in serum. Prolactin in blood spots is stable at room temperature for up to one week and for several months at -20 degrees C. This simple technique for obtaining blood samples for prolactin estimation has particular potential for field studies of lactating women.

Female↗
PubMed1983

Effect of breast-feeding status on prolactin secretion and resumption of menstruation.

This study investigated prospectively the effect of supplementary breast feeding on the duration of lactational amenorrhoea and serum prolactin levels during prolonged breast feeding in a group of 34 Australian mothers. Although supplementary feeding correlated statistically with the decline in mean serum prolactin levels and the subsequent resumption of menstruation, critical analysis of the data revealed that serum prolactin levels were declining with time before the introduction of supplementary feeding. It was concluded that the resumption of menstruation during prolonged lactational amenorrhoea is associated with the introduction of supplementary infant feeding, but other factors may be more important in this process. The good correlation between the decline in serum prolactin levels and the return of cyclic ovarian activity in individual mothers suggests that measurement of serum prolactin level may be a useful predictive index for returning fertility during breast feeding.

Amenorrhea↗
PubMed1981

The hormonal and ecological correlates of lactation infertility.

Some factors that may influence the results of studies of breastfeeding behavior in different cultures are identified. Findings of some of the demographic studies of rural areas in the so-called less developed nations are contrasted with studies in urbanized areas of such nations, as well as with studies from developed nations. A review of the physiology of lactation, specifically the role of prolactin is given along with some preliminary findings from the author's ongoing research in Australia.

Amenorrhea↗
PubMed1979

Prolactin secretion during prolonged lactational amenorrhoea.

Basal serum prolactin levels were elevated up to 66 weeks postpartum in lactating amenorrhoeic women. The serum prolactin level in fully breast-feeding women was significantly higher than in women who were partially breast-feeding. The mean basal serum prolactin level in menstruating, lactating women was significantly higher than the mean level in women who had weaned and had normal menstrual cycles. The rise in prolactin due to suckling was seen up to 66 weeks postpartum. The marked variability and lack of reproducibility of individual suckling responses may obscure the importance of prolactin secretion in the postpartum period. Nevertheless, this study confirms that prolactin secretion is increased in women with prolonged lactational amenorrhoea.

Amenorrhea↗
PubMed1979

Integrated concentrations of prolactin in breast-feeding mothers.

Mean 24-hour integrated concentrations of serum prolactin (PRL) in 8 breast-feeding mothers (62 +/- 10.4 microgram/l) was significantly higher than in 4 control subjects (14.8 +/- 3.3 microgram/l). No correlation was found between the mean integrated concentrations and time after delivery or breast-feeding status. There was no relationship between the mean integrated concentration of PRL or the basal PRL and the frequency of feedings, the total suckling time, the mean interval between feedings or the longest interval between feedings in the 24-hour period. The study provides conclusive evidence for increased prolactin secretion in long-term puerperal lactation.

Amenorrhea↗
PubMedDate not supplied

Breastfeeding and the symptothermal method.

This prospective study was conducted among experienced users of periodic abstinence methods in Sydney, Montreal, and Birmingham (England) in order to describe the relationship between a laboratory measurement of ovulation and the natural symptoms of fertility during breastfeeding. Daily urinary estrogen and pregnanediol glucuronide assays were used to estimate the date of ovulation and to determine potentially fertile days. A standard set of Symptothermal Method (STM) rules was applied to daily STM records to assess the correspondence of the natural symptoms of fertility to the underlying hormonal profile. The STM symptoms and rules accurately identified 77-94 percent of the women's potentially fertile days, but abstinence was also recommended on about half of the days when the women were not fertile. An integrated set of common rules for STM use during breastfeeding is highly sensitive but not specific in its ability to screen for ovulation.

Adult↗