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L Moltz

Publications and source records attributed to L Moltz.

9 recordsLinked to original sources
PubMed1991

[Rational hormone diagnosis in normocyclic functional sterility].

Functional infertility in women with a normal menstrual cycle is the first symptom of a pathophysiological sequence of multiple different endocrinopathies. It usually progresses and leads to secondary amenorrhoea which is the most severe symptom of ovarian insufficiency. The percentage of abnormal hormonal parameters will increase with the duration and extent of the endocrinological aberration. The aim of this study is to examine the frequency of the different potential changes in hormone levels of an unselected group of female patients in a fertility clinic. 307 patients suffering from functional sterility (menstrual cycle 25-34 days) were investigated via basal hormone laboratory tests (including TRH test) under standardised conditions. 73 patients had pathological changes of the Fallopian tubes and in 116 patients their husbands had severe andrological problems. Excluded from this study were patients with bilateral occlusion of the Fallopian tubes and patients whose partners had a sperm count of less than 1 million/ml. The percentage of abnormal hormone levels (greater than mean + standard deviation + grey area) was 32.2% for prolactin (PRL), 7.8% for TSH, 20.9% for Delta-TSH, 18.4% for DHEA-sulfate (DS), 9.8% for testosterone (T), 18.9% for LH, and 11.5% for FSH (LH and FSH were specifically calculated only in 87 patients). In 65.5% of the patients the midluteal oestradiol (E2) and progesterone (P) levels were below normal, as sign of a corpus luteum insufficiency (CLI). A step- by-step diagnostic procedure would have yielded the following cumulative abnormal hormone levels retrospectively: (1) PRL (n = 99) = 32.2% (2) +TSH/delta TSH (n = 85) = 48.9% (3) +DS (n = 56) = 58.0% (4) +T (n = 30) = 59.3% (5) +LH/FSH (n = 28) = 62.2% [(6) +E2/P (n = 201) = 82.7%.] Only in 37.8% (116 patients) all hormone levels were within normal limits during the early follicular phase (FP); if the patients with signs of CLI are added, the percentage would be only 17.8% (n = 53). Case analysis demonstrated that functional sterility was accompanied by hyperprolactaemia in 32.4% of all patients, by abnormalities of the thyroid function (hypothyroidism 16.0%, hyperthyroidism 7.8%) in 23.8%, by hypothalamic and/or pituitary dysfunction in 28.7%, and by hyperandrogenaemia in 22.5%. Primary ovarian insufficiency was diagnosed in 4.6%. 31.3% of all patients (n = 307) had a combination of different hormonal abnormalities. The average duration of infertility among this group of patients was 6.3 years.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1990

[Endocrinological diagnosis of normocyclic functional sterility].

Normocyclic functional sterility can be regarded as a starting point to the common pathophysiology of different endocrinopathies. Those are finally leading to secondary amenorrhoea, as the most severe sign of ovarian insufficiency. The incidence of abnormal hormonal parameter increases parallel to the duration and the extent of the respective endocrinopathy. For a better causal classification of the endocrine disorder a complete hormonal assessment is mandatory, as characteristic historical data or significant clinical signs will often be missed in infertile patients. The completion of one single basic hormonal examination might lead to an exact differentiated diagnosis and then allows accordingly for the induction of a purposeful treatment. The pregnancy rates are considerably high proving the effectiveness of the thoughtful pretherapeutic diagnostic evaluation. The principle of cost-effectiveness is as well maintained by the follow-up of complete diagnosis and master-tailored therapy.

Androgens↗
PubMed1979

[Contraception in androgenised women with a low-dose cyproterone-acetate containing one-phase preparation (author's transl)].

101 hirsute women received Diane, a combination of 2 mg cyproterone acetate and 50 micrograms ethinyl oestradiol per capsule, from the fifth to twenty-fifth day during a total of 1105 cycles. The treatment was satisfactory in 96% of women with acne, 84% with androgenic alopecia, 79% with seborrhoea, and 50% of those with mild or moderate hirsutism. The effectiveness of treating hirsutism or alopecia depended on its severity and duration. There was no correlation between various measures of androgen levels before and during treatment and the clinical results. Side effects were similar to those after contraceptive one-phase preparations, both in kind and incidence. None of the women became pregnant. Diane is thus the drug of choice in hormonal contraception of patients with acne, seborrhoea, androgenic alopecia or mild hirsutism. It is also suitable in the follow-up or interval management of high-dose cyproterone acetate treatment of severe hirsutism, in order to maintain the effect obtained with lower hormone doses.

Acne Vulgaris↗
PubMed1977

Cribriform polypoid adenomatous (atypical) hyperplasia of the endocervical glands of the uterus under hormonal contraception.

The occurrence of cribriform adenomatous hyperplasia of the endocervical glands of the uterus was examined in 92 women, in whom punch biopsies of the ecto-endocervical line were taken during the second half of their cycle. Of these, 79 women had taken combined estrogen-progestogen preparations, 9 women had taken progestogens alone, while 14 patients formed a control group. There was a significant difference only between the control group without hormones and the groups treated with hormones. The groups of patients under the various regimens of hormonal treatment displayed a varying percentage of cribriform adenomatous hyperplasia. There was a clear tendency for such lesions to be observed more frequently under the combined type of contraception than under the sequential type. These differences were not, however, significant. A correlation with specific exogenous groups of steroids could not be established.

Adolescent↗
PubMed1976

[Treatment of infertile women with epimestrol (author's transl)].

155 patients have been treated with epimestrol during 593 menstrual cycles in a daily dosage of 5, 10 or 2.5 mg from the 1st to the 10th or from the 5th to the 14th day of the cycle. 143 patients with secondary amenorrhoea, anovulatory cycles, ovulatory oligomenorrhoea, corpus luteum insufficiency, and normal cycles received epimestrol after an average period of 2.4 years of involuntary infertility. The pregnancy rate was 21% (n = 30), the spontaneous abortion rate 13% (n = 4). Twelve further patients not seeking pregnancy were treated with epimestrol because of secondary amenorrhoea and (or) anovulatory bleeding. The results were as follows: 1) In eugonadotropic secondary amenorrhoea 8 out of 12 patients ovulated, 5 out of 10 patients wanting children became pregnant. No patient with hypogonadotropism ovulated. 2) Out of 25 patients with anovulatory cycles or bleeding 13 ovulated and 4 became pregnant. 3) 17 out of 68 oligomenorrhoeic patients became pregnant. 4) In 12 out of 24 patients with corpus luteum insufficiency the hyperthermic phase improved and four patients became pregnant. 5) In 12 patients without anomalous cycles these remained unchanged and there were no pregnancies. 6) No side effects could be observed.

Abortion, Spontaneous↗