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PubMed · 12339786

Ovarian function during lactation.

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M H Badraoui, F Hefnawi. 1982. Ovarian function during lactation.. https://pubmed.ncbi.nlm.nih.gov/12339786/

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[Sex hormones profile in women on dialysis program in treatment with erythropoietin].

OBJECTIVE: The end stage renal disease has accompaniments in body systems, including hormonal changes. The present study was designed to evaluate the pattern of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and estradiol (E2) in 47 women with end stage renal disease (ESRD), on regular dialysis and receiving recombinant human erythropoietin (r-HuEPO). METHODS: One patient was on intermittent peritoneal dialysis, 4 on continuous ambulatory peritoneal dialysis and 42 on maintenance haemodialysis. They were divided into: Group I consisted of 10 women with regular menses, aged lesser than 48 years; Group II consisted of 15 women with amenorrhea, aged lesser than 48 years and; Group III, consisted of 22 women with amenorrhea, aged 48 years or more. Levels of FSH, LH, PRL and E2 were obtained by ELISA. RESULTS: All groups showed FSH, LH and E2 levels in the normal range for normal women without renal failure, and there was no statistical significance in the levels of these hormones between women with regular menses or women with amenorrhea aged lesser than 48 years. The serum concentrations of PRL were above the normal range in all groups. The patients aged 48 or more showed hormonal profile consistent with post-menopausal (i.e. high FSH, high LH and low estradiol). CONCLUSIONS: We conclude that ovarian function is intact on ESRD and we have to search for other causes for amenorrhea in women that do not have an abnormal hormonal sex profile.

Amenorrhea↗

Lactational amenorrhea for family planning.

BACKGROUND: 50 % of pregnancies are unwanted. For several reasons including difficulty in obtaining contraceptives, no or ineffective contraception is used to prevent these unwanted pregnancies. The Lactational Amenorrhoea Method(LAM) however is a contraceptive method available and accessible for many women. OBJECTIVES: To assess in fully breastfeeding women, staying amenorrheic, the efficacy of the Lactational Amenorrhoea Method as a contraceptive method. The efficacy of LAM, as defined in 1988 in Bellagio, was compared with alternative definitions of LAM; the outcomes were measured using pregnancy and menstruation life tables. SEARCH STRATEGY DATA SOURCES: MEDLINE searches from 1966 until 2002 and EMBASE from 1988 until 2002; reference lists of studies and review articles; books related to LAM; published abstracts from breastfeeding, reproductive health, contraceptive conferences; and e-mail communication with coordinators of such studies. SELECTION CRITERIA: From 454 potentially relevant studies 154 investigated the risk of pregnancy during LAM or lactational amenorrhea. Two reviewers applied the following inclusion criteria: prospective study, cases and -if available- controls had to be sexually active, pregnancy had to be confirmed by physical examination or a pregnancy test. Life table menstruation rates and life table pregnancy rates were taken as endpoints. Thirteen publications, reporting on 9 intervention groups and 2 control groups, met the inclusion criteria and were included in this systematic review. Their quality was assessed. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data, disagreements were resolved through discussion. Because of the heterogeneity of the included studies, the studies were analyzed using narrative methods. MAIN RESULTS: For the outcome two controlled studies of LAM users reported life table pregnancy rates at 6 months of 0.45 and 2.45 percent and 5 uncontrolled studies of LAM users reported 0-7.5 percent. Life table pregnancy rates of women fully breastfeeding and amenorrheic but not using any contraceptive method were 0.88 in one study and 0.9-1.2 percent (95% CI 0. 0-2.4 ) in a second study, depending on the definition of menstruation used. The life table menstruation rate at 6 months in all studies varied between 11.1-39.4 percent. REVIEWER'S CONCLUSIONS: No clear difference in life table pregnancy rates was found between women using LAM and supported in doing so, and fully breastfeeding, amenorroic women not using any method. Because the length of lactation amenorrhoea of women using LAM is too different between populations studied, and population specific, it is uncertain whether LAM extends lactational amenorrhoea.

Amenorrhea↗

Psychoneuroendocrine correlates of secondary amenorrhea.

Functional hypothalamic amenorrhea is a common, non-organic and theoretically reversible form of anovulation due to reduced hypothalamic GnRH drive. Numerous studies suggest that this altered hypothalamic homeostasis is caused by a synergism between psychogenic challenge, promoted in part by dysfunctional attitudes, and metabolic compromise induced by undernutrition and overexercise. The recent growing interest in psychiatric comorbidity underlines the importance of reconsidering the boundaries between psychological disorders and somatic conditions. That not withstanding, it is mandatory in gynecological endocrinology to explore the issue of secondary amenorrhea from a psychoneuroendocrine perspective in order to devise biopsychosocial interventions which address the individual distress. In this brief review we will try to critically discuss the issue providing evidences from personal studies as clues for better understanding the extent of the complex psychoneuroendocrine network controlling menstrual function.

Amenorrhea↗