Search

The aim of the study was to investigate are there associations between common female sex-specific health conditions (oligo/amenorrhea, hyperandrogenism, menopause and polycystic ovary syndrome [PCOS]) and high-sensitivity troponin-T (hs-TnT) levels. Cross-sectional and longitudinal analyses of a general population-based prospective cohort study were performed. The hs-TnT levels of 3146 women aged 46 were measured using an Elecsys® Troponin T high-sensitivity assay. Median hs-TnT levels and 25 and 75 percentiles of the cases and controls were compared. Also, a logistic regression analysis using a binary outcome – undetectable hs-TnT (< 3.0 ng/L) versus detectable hs-TnT (≥ 3.0 ng/L) – was performed. Women with oligo/amenorrhea at age 31 had significantly higher hs-TnT levels at age 46 than women without oligo/amenorrhea (4.06 [3.59; 4.86] vs 3.98 [3.44; 4.71] ng/L, p =.042). Menopausal women had significantly higher hs-TnT levels than premenopausal women (4.15 [3.54; 4.91] vs 3.95 [3.45; 4.68] ng/L, p =.012) at age 46. Women with PCOS or hyperandrogenism had comparable hs-TnT levels with their controls. In the adjusted logistic regression analysis, oligo/amenorrhea (odds ratio [OR] = 1.52 [0.90–2.57]), hyperandrogenism (OR = 1.20 [0.75–1.92]), PCOS (OR = 1.51 [0.81–2.84]) and menopause (OR = 1.05 [0.63–1.74]) were not significantly associated with detectable hs-TnT. This study was the first to investigate how oligo/amenorrhea, hyperandrogenism, PCOS and menopause are associated with hs-TnT. Although women with oligo/amenorrhea and menopause had higher hs-TnT levels than women without these conditions, the difference was small. Larger studies are required to better understand the effects of oligo/amenorrhea on cardiovascular health. No previous studies have investigated the association between common female sex-specific health conditions, such as oligo/amenorrhea, hyperandrogenism and PCOS, and hs-TnT levels. Only one prior study has investigated the association between menopause and hs-TnT levels. Hs-TnT levels were significantly higher in women with oligo/amenorrhea and relatively early menopause at age 46 than women without these conditions, whereas women with hyperandrogenism or PCOS and their controls have comparable hs-TnT levels. The effect of oligo/amenorrhea on cardiovascular health should be further investigated. A simple question about the presence of oligo/amenorrhea might identify women at increased risk of cardiovascular disease. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate risk factors for endometrial intraepithelial neoplasia/malignancy in premenopausal women with abnormal uterine bleeding or oligomenorrhea. Specifically, we aimed to elucidate whether body mass index (BMI) or age confers a higher risk. A retrospective cohort study was performed at a large academic center examining risk factors for endometrial hyperplasia/malignancy in premenopausal women undergoing endometrial sampling. Of the 4170 women ages 18–51 who underwent endometrial sampling from 1987 to 2019, 77 (1.85%) were found to have endometrial intraepithelial neoplasia or malignancy. Clinical predictors of EIN/malignancy in this population included obesity (OR: 3.84, 95%, p <.001), Body mass index [(OR30 vs. 25:2.11, p <.001) and OR35 vs. 30: 1.65, p <.001], Diabetes (OR: 3.6, p-value <.001), hormonal therapy use (OR: 2.93, p <.001), personal history of colon cancer (OR: 9.90, p =.003), family history of breast cancer (OR: 2.65, p <.001), family history of colon cancer (OR: 3.81, p <.001), and family history of endometrial cancer (OR: 4.92, p =.033). Age was not significantly associated with an increased risk of disease. Adjusting for other factors, a model using BMI to predict the risk of EIN/malignancy was more discriminative than a model based on age. Increased BMI, may be more predictive of endometrial hyperplasia/malignancy than age in premenopausal women with abnormal uterine bleeding. Modification of evaluation guidelines in a contemporary demographic setting could be considered. [ABSTRACT FROM AUTHOR]

Bone stress injury (BSI) is prevalent in female distance runners. Menstrual disturbances are associated with impaired bone health in endurance athletes. This study aimed to investigate the association between menstrual function and BSI and explore whether plyometric training may protect against BSI in individuals with menstrual disturbances. Competitive female distance runners (n = 183) aged 18–40 years were surveyed for training habits, menstrual function, and BSI, during the previous 12 months. Oligo/amenorrhoea during the previous 12 months (<9 menses) was deemed to indicate menstrual disturbance; hormonal contraceptive users and those previously diagnosed with a pathology that impacted menstrual function were excluded. BSI incidence rate was 2.25 (p = 0.02, 95% CI: 1.14–4.41) times greater in oligo/amenorrhoeic than eumenorrhoeic runners. BSI incidence rate was similar in oligo/amenorrhoeic and eumenorrhoeic runners that did plyometric training, but 3.78 (p = 0.001, 95% CI: 1.68–8.5) times greater in oligo/amenorrhoeic versus eumenorrhoeic runners that did not. However, the effect of plyometrics was non-significant (menstrual function × plyometric training interaction, p = 0.06; main effect, p = 0.89). Conventional plyometric training may not reduce BSI incidence in female distance runners, but menstrual disturbances and prolonged periods of low energy availability should be avoided. [ABSTRACT FROM AUTHOR]

In this study, we aimed to investigate the relationship between body mass index (BMI), waist circumference (WC) or waist-to-hip ratio (WHR) and oligomenorrhea or irregular menstruation in Chinese women of childbearing age. A total of 1,423 Han women aged 19–39 years who were routinely examined at the Physical Examination Center of Peking University People's Hospital were enrolled by convenience sampling method. All participants were asked to fill up menstrual questionnaires. Binary logistic regression models were used to assess the odds ratio (OR) of different BMI, WC and WHR groups for the prevalence of oligomenorrhea and irregular menstruation. Moreover, we used the ROC curves to compare the predictive effects of BMI, WC and WHR on oligomenorrhea and irregular menstruation. Among the 1,423 participants, 93 women (6.5%) had BMI ≥ 30 kg/m2, 6.5% of the participants had oligomenorrhea, and 22.6% had irregular menstrual menstruation. Overall, those with BMI ≥30 kg/m2 (OR = 2.543; 95%CI 1.332–4.856; p =.005) or WC ≥ 90 cm (OR = 2.023; 95%CI 1.198–3.416; p =.008) were more likely to have long menstrual cycle. The prevalence of irregular menstruation was higher in the BMI ≥30 kg/m2 (OR = 2.509; 95%CI 1.591–3.958; p <.001), WC ≥ 90 cm (OR = 2.299; 95%CI 1.619–3.265; p <.001) and WHR ≥ 0.86 (OR = 1.739; 95%CI 1.293–2.339; p <.001) groups. The ROC curve showed that all three anthropometric indices had predictive effect, while there was no significant difference in predicting oligomenorrhea. WC was a better predictor for irregular menstruation compared with BMI. Obesity, oligomenorrhea and irregular menstruation were common in Chinese women of childbearing age, and obesity was associated with oligomenorrhea and irregular menstruation. Abdominal obesity might have a stronger predictive effect on irregular menstruation. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to evaluate the effects of a long-term treatment with α-lipoic acid (ALA) combined with myo-inositol (MI) on clinical and metabolic features of women with polycystic ovary syndrome (PCOS). Fifty-seven women with PCOS and a history of oligoamenorrhea were treated with MI and ALA (800 mg + 2000 mg per day). Forty-four of them had complete clinical charts and were considered eligible for the study. Information about cycle length and body mass index (BMI) was checked after 6, 12, and 24 months. After 12 months ovarian volume, total testosterone plasma levels and changes in hirsutism were also evaluated. The metabolic parameters were evaluated in 16 women after 6 and 18 months of the treatment. Cycle length was significantly reduced at 6 (p <.001), 12, and 24 months of treatment (p <.01). BMI showed a reduction only at 6 months (p <.05), thereafter returning similar to the basal values. No changes of testosterone and ovarian volume were observed. HOMA-IR and fasting insulin were unchanged, but the insulin response to a 3 h OGTT was improved after 6 (p <.01) and 18 months (p <.05) of treatment. No individual suffered from any adverse event. In conclusion, the combination of ALA and MI showed to be useful as long-term therapy in PCOS women, providing a normalization of the menstrual cycle and an amelioration of insulin levels with a high tolerability. [ABSTRACT FROM AUTHOR]

Polycystic ovarian syndrome (PCOS) is a common and complex condition characterized by endocrine features and influenced by genetic and environmental factors. In Southeast Asia and Thailand, the prevalence of PCOS is unknown. The aim of this study was to estimate the prevalence of and determine factors associated with PCOS in Thai adolescents. We administered a validated questionnaire to 600 university female participants aged 17-19 years from Mahidol University in Bangkok. Of these, 548 (91.33%) responded and agreed to participate. Two-hundred and seventy-nine girls (50.91%) were identified as likely having PCOS and defined as ‘probable cases’. Of those 279 participants, 248 (88.88%) were evaluated further for PCOS using the Rotterdam criteria. A complete history was taken, and a physical examination including trans-abdominal ultrasound was performed. Blood chemistry tests were performed to exclude similar conditions and to investigate potential co-morbidities. The prevalence of PCOS in Thai adolescents was found to be 5.29%. After multivariate analyses, moderate acne was the strongest risk factor for PCOS. The odd ratios (95% confidence interval) for the presence of mild acne, moderate acne, and oligo- or amenorrhea in participants with PCOS were 2.83 (1.01-7.90; p = .47), 31.69 (10.07-99.67; p < .001), and 5.89 (2.42-14.37; p < .001), respectively. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the clinical, endocrine, metabolic features and prevalence of metabolic syndrome (MBS) in Turkish adolescents with polycystic ovary syndrome (PCOS) and the differences in metabolic parameters between adolescent PCOS with or without the presence of polycystic ovaries (PCO) on ultrasound. Subjects (n = 77) were classified into two groups: oligomenorrhea (O) and clinical and/or biochemical hyperandrogenism (HA) (n = 38), without PCO and O + HA with PCO (n = 39). The control group consisted of 33 age-matched adolescents. Adolescents with PCOS had a significantly higher body mass index (BMI), waist circumference and levels of LH, LH/FSH ratio, triglyceride, insulin, HOMA-IR, free androgen index and lower levels of SHBG and FSH. After adjustment for BMI, LH, LH: FSH ratio remained significantly higher. Adolescents with PCOS had a higher prevalence of MBS. No significant differences in lipid profiles, insulin levels and insulin sensitivity in both the PCOS groups were seen. HDL-C levels were lower in the O + HA + PCO group compared to the controls. BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS.Impact statementMany studies have investigated the effect of PCOS on metabolic and cardiovascular risks. It is thought that PCOS increases metabolic and cardiovascular risks. Increase in metabolic and cardiovascular risks associated with PCOS may be handled with early diagnosis and early intervention of PCOS in adolescents, although the diagnosis of PCOS in adolescents could be hard because of the features of PCOS overlapping normal pubertal physiological events. However, early identification of adolescent girls with PCOS may provide opportunities for prevention of well-known health risks associated with this syndrome and reduction of long-term health consequences of PCOS by reducing androgen levels and improving metabolic profile. Our results also support that BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS. [ABSTRACT FROM PUBLISHER]

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder of women of reproductive age characterized by polycystic ovarian morphology, anovulation or oligomenorrhea, and hyperandrogenism. It is shown that disruption in the steroidogenesis pathway caused by excess androgen in PCOS is a critical element of abnormal folliculogenesis and failure in dominant follicle selection. Vitamin D plays an important role in the regulation of ovulatory dysfunction and can influence genes involved in steroidogenesis in granulosa cells. In the present study, we investigated the effects of vitamin D3 on steroidogenic enzyme expression and activities in granulosa cell using a PCOS mouse model. In our study, the PCOS mouse model was developed by the injection of dehydroepiandrosterone (DHEA) for 20 days. The mRNA and protein expression levels of genes involved in steroidogenesis in granulosa cells were compared between polycystic and normal ovaries using real-time PCR and Western blotting assays. Granulosa cells of DHEA-induced PCOS mice were then cultured with and without vitamin D3 and mRNA and protein expression levels of steroidogenic enzymes and serum 17beta-estradiol and progesterone levels were investigated using qRT-PCR, western blot, and radioimmunoassay, respectively. Steroidogenic enzymes includingCyp11a1, StAR, Cyp19a1, and3β-HSDwere upregulated in granulosa cells of PCOS mice when compared to normal mice. Treatment with vitamin D3 decreased mRNA and protein expression levels of steroidogenic enzymes in cultured granulosa cells. Vitamin D3 also decreased aromatase and 3β-HSD activity that leads to decreased 17beta-estradiol and progesterone release. This study suggests that vitamin D3 could modulate the steroidogenesis pathway in granulosa cells of PCOS mice that may lead to improving follicular development and maturation. This is a step towards a possible conceivable treatment for PCOS. Abbreviations:AMHR-II: anti-müllerian hormone receptor-II; 3β-HSD: 3β-hydroxysteroid dehydrogenase; Cyp11a1: Cytochrome P450 Family 11 Subfamily A Member 1; Cyp19a1: cytochrome P450 aromatase; DHEA: dehydroepiandrosterone; FSH: follicle stimulating hormone; FSHR: follicle stimulating hormone receptor; IVF:in vitrofertilization; 25OHD: 25-hydroxy vitamin D; OHSS: ovarian hyperstimulation syndrome; PCOS: polycystic ovarian syndrome; P450scc: P450 side-chain cleavage enzyme; StAR: steroidogenic acute regulatory protein; VDRs: vitamin D receptors [ABSTRACT FROM PUBLISHER]

We evaluated the association of hirsutism and oligomenorrhea (persistent menstrual cycles > 45 days) as screening criteria for the detection of biochemical hyperandrogenism (BH) and polycystic ovaries (PCOM) during adolescence and determined which androgens, granulosa cell hormone, ultrasonographic parameters have the best association with polycystic ovary syndrome (PCOS). Hirsute girls with oligomenorrhea (N = 26 Hirs/Oligo group) and non-hirsute girls with regular cycles (N = 63, C group) were studied. Prevalence of BH and PCOM, diagnostic performance of androgens and ultrasound parameters for PCOS diagnosis were analyzed. BH and PCOM prevalence were higher in the Hirs/Oligo girls than in the C girls (76.9% versus 25.5%; 92.3% versus 33.3%, respectively;p < 0.0001). A complete PCOS phenotype (Hirs/Oligo with BH and PCOM) was observed in 73.1% of the Hirs/Oligo group. The presence of both BH and PCOM was observed in 7.9% of the C group. The parameters with the best diagnostic performance were free androgen index ≥6.1, testosterone ≥2.4 nmol/L, follicle number ≥12 and ovarian volume ≥10 ml anti-Müllerian hormone (AMH) exhibited a low diagnostic accuracy. Hirsutism and persistent menstrual cycle over 45 days are highly associated with BH and PCOM suggesting that the presences of both criteria are necessary for the diagnosis of PCOS during adolescence. 我们评估多毛合并月经稀发（持续的月经周期超过45天）作为生化高雄激素（BH）和青春期多囊卵巢（PCOM）筛选标准的情况，并确定雄激素，颗粒细胞激素，超声参数中哪个与多囊卵巢综合征（PCOS）联系最为密切。本文研究了多毛合并月经稀发的女孩（N=26 多毛/月经稀发组）和非多毛并且月经规律女孩（N=63 C组）BH和PCOM的患病率，并分析了雄性激素和超声参数对PCOS的诊断性作用。BH和PCOM在多毛/月经稀发女孩组的患病率高于C 组女孩（分别是76.9%和25.5%；92.3%和33.3%；P＜0.0001）。73.1%的多毛/月经稀发组患者呈现了一个完整的PCOS表型（多毛/月经稀发合并BH和PCOM）。仅有7.9%的C组患者出现了BH和PCOM。最好的诊断性参数是游离雄激素指数≥6.1，睾酮≥2.4 nmol/L，卵泡数≥12和卵巢体积≥10ml,而抗苗勒管激素（AMH）诊断准确性低。多毛和持续性月经周期超过45天与BH和PCOM高度相关表明了这两个标准在诊断青春期PCOS中是必要的。 [ABSTRACT FROM AUTHOR]

Prolactin (PRL) is a hormone, mainly secreted by lactotroph cells of the anterior pituitary gland. Recent studies have shown it may also be produced by many extrapituitary cells. Its well-recognized PRL plays an important role in lactation during pregnancy, but it is involved in other biological functions such as angiogenesis, immunoregulation and osmoregulation. Hyperprolactinemia is a typical condition producing reproductive dysfunction in both sexes, resulting in hypogonadism, infertility and galactorrhea. It may be also asymptomatic. Lactotroph adenomas (prolactinoma) is one of the most common cause of PRL excess, representing approximately 40% of all pituitary tumors. Several other conditions should be excluded before a clear diagnosis of hyperprolactinemia is made. Hyperprolactinemia may be secondary to pharmacological or pathological interruption of hypothalamic–pituitary dopaminergic pathways or idiopathic. Stress, renal failure or hypothyroidism are other frequent conditions to exclude in patients with hyperprolactinemia. We will review biochemical characteristics and physiological functions of that hormone. Clinical and pharmacological approach to hyperprolactinemia will also be discussed. [ABSTRACT FROM AUTHOR]

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in the reproductive age group; it is characterized by oligo-ovulation or anovulation, hyperandrogenism and the presence of polycystic ovaries. It affects 8-10% of women in the reproductive age group and its main presentations are irregular periods, hirsutism and infertility in this group. Women with PCOS have impaired glucose tolerance, dyslipidemia, and increased risk of type 2 diabetes and metabolic syndrome. The phenotype of PCOS in menopausal women is difficult to define. Studies have included previous history of oligomenorrhea, infertility and hyperandrogenism (clinical or biochemical) to describe the phenotype for postmenopausal women. Hyperandrogenism seen in PCOS women persists after the menopausal transition. Similarly, PCOS women continue to manifest the metabolic alterations such as insulin resistance after menopause, which makes them more susceptible to type 2 diabetes mellitus. The metabolic syndrome occurs more often in women with PCOS and has been shown to be associated with increased risk of cardiovascular disease. Whether PCOS itself causes an increased cardiovascular disease risk later in life is still uncertain. This dilemma needs to be solved since young women with PCOS may be required to undergo expensive investigations and screening for cardiovascular disease, whilst their true disease risk is still unknown. [ABSTRACT FROM AUTHOR]

Multiple studies have indicated that selective cyclooxygenase-2 (COX-2) inhibitors possess clinically chemopreventive and preclinically anticancer activities. Their long-term use, however, may be limited by the cardiovascular toxicity. This study tried to investigate whether an apple oligogalactan (AOG) could enhance the growth inhibitory effect of celecoxib on colorectal cancer. Caco-2 and HT-29 cell lines were exposed to different concentrations of AOG (0–1 g/L), celecoxib (0–25 μmol/L), and their combination. COX-2 levels were assessed by reverse transcription PCR and Western blot. COX-2 activity was evaluated by measuring prostaglandin E2 concentration. A colitis-associated colorectal cancer (CACC) mouse model was used to determine the effect of the combination in vivo. AOG (0.1–0.5 g/L) could potentiate the inhibitory effect of physiologic doses of celecoxib (5 μmol/L) on cell growth and decrease COX-2 expressions both at RNA and protein levels. In vivo, the combination (2.5% AOG plus 0.04% celecoxib, w/w) prevented against CACC in mice effectively. Our data indicate that AOG could potentiate the growth inhibitory effect of celecoxib on colorectal cancer both in vitro and in vivo through influencing the expression and function of COX-2 and phosphorylation of MAPKs, which suggests a new possible combinatorial strategy in colorectal cancer therapy. [ABSTRACT FROM AUTHOR]

Background: Granulosa-cell tumors (GCT), rare malignancies that arise from sex-cord stromal cells, account for less than 5% of ovarian tumors. These tumors present with an endocrine syndrome and mass signs. Surgery is the primary treatment approach. The risk of recurrence is more frequent in the juvenile-onset form. Case report: We report the case of an obese 18-year-old Caucasian women with hirsutism and oligomenorrhea. Abdominal palpation revealed a voluminous firm mass. Hormonal evaluation documented severe hyperandrogenism. The ovary-specific tumor marker CA125 was elevated, whereas human-chorionic-gonadotropin was in the normal range. Abdominal imaging examination revealed a 19 cm mass in the left ovary. Twenty-four hours after removal of the mass, menstrual flow reappeared and androgens progressively normalized. Microscopically, the predominant pattern was one of uniform, bland, epithelioid to spindle-shaped cells. After three months, a significant weight loss was recorded, hirsutism had decreased slightly and oligomenorrhea reappeared. Δ4-Androstenedione levels remained elevated (4200 ng/L), whereas CA125 had normalized. In light of the pre-existing polycystic-ovary-syndrome (PCOS), the patient started estrogen-progestin treatment. Conclusion: We report an interesting case of a woman with severe hirsutism due to GCT, and a history of oligomenorrhea caused by PCOS. After surgery, a dramatic clinical improvement was observed, whereas PCOS signs persisted. [ABSTRACT FROM AUTHOR]

Premature ovarian insufficiency (POI) is a life-changing diagnosis, with profound physical and psychological consequences. Despite the description of different genetic, immune and iatrogenic factors of POI, the etiology of most cases of this disease are unexplained, and optimal management strategies are still unclear. Recent data showed that POI may have a long period of oligomenorrhea before the fully developed form (complete ovarian failure stage), with the occurrence of amenorrhea and climacteric symptoms. The main problem in the recognition of early stages of POI is the lack of proper diagnostic criteria. Patients with an undiagnosed occult form of POI may present with menstrual irregularities, unexplained infertility or repeated IVF failures. We evaluated 23 patients with unexplained oligomenorrhea and/or infertility. After a proper evaluation of these patients, a low ovarian reserve was identified, and an occult form of POI was diagnosed. [ABSTRACT FROM PUBLISHER]

Aim. To detect whether oligomenorrhoea with minimal or nil 'unwanted hair growth' is a hyperandrogenic problem. Materials and methods. Fifty-nine women with oligomenorrhoea with modified Ferriman Gallway score (m FG) = <5 (Group A), 40 women with oligomenorrhoea with m FG score = > 6 (Group B) and 22 eumenorrhoeic non-hirsute 'control' women (Group C) were studied. Body mass index, Waist-hip ratio were noted during clinical examination. Serum testosterone, Sex hormone binding globulin, fasting insulin levels were measured in each woman. Free androgen index (FAI) was calculated. Results. No significant differences were noted in the clinical parameters. Though serum testosterone levels were within the normal ranges in Group A and Group B, they were significantly higher than that of Group C. Groups A and B had significantly higher FAI values and fasting insulin levels than Group C. Between Groups A and B there were no significant differences in any of the androgenic parameters studied. Conclusion. Oligomenorrhoea without definite hirsutism is an androgen excess disorder. Definition of biochemical hyperandrogenism needs more clarity. Hirsutism is not a sensitive indicator of hyperandrogenism. The role of insulin in this type of hyperandrogenism needs further studies. [ABSTRACT FROM AUTHOR]

Aim. Exercise is commonly cited as a remedy for menstrual symptoms. The purpose of the present study was to evaluate the effect of a period of exercise on physical and psychological symptoms of menstruation, dysmenorrhea, oligomenorrhea and amenorrhea. Methods. Participants of the study were 250 students of Shiraz University who enrolled in a fitness course. The study design was semi-experimental with one group. Prior and after 12 weeks of a physical fitness program, our subjects completed questionnaires on menstrual distress. The physical fitness training program included physical fitness exercises (cardiovascular endurance, muscular endurance, agility, speed, strength; duration: 90 min, frequency: twice weekly, intensity: 50 to 70% of maximum heart rate). The t test was used for analysis of the data. Results. Physical premenstrual symptoms (p = 0.005), psychological premenstrual symptoms (p = 0.019), dysmenorrhea (p = 0.0001) and oligomenorrhea (p = 0.034) were significantly reduced after the training program. There was no difference in the incidence of amenorrhea before and after the training program (p = 0.162). Conclusion. Our findings indicate that selected physical fitness exercises positively influenced menstrual symptoms. [ABSTRACT FROM AUTHOR]

Objective. The clinical symptoms of nonclassic adrenal hyperplasia (NCAH) are identical with polycystic ovary syndrome (PCOS). The aim of our study was to determine the prevalence of nonclassic adrenal hyperplasia (21-hydroxylase-deficiency) in hyperandrogenic women, its biochemical, endocrine and clinical characteristics and to compare them with parameters of patients with ovarian hyperandrogenism. Methods. Since 1999, 298 patients with elevation of at least one androgen and manifestation of one of the clinical androgenic symptoms (oligo/amenorrhea, hirsutism or acne) have been identified in our database. A diagnosis of NCAH was considered when the basal or stimulated 17-hydroxyprogesterone was elevated. Results. Only eight patients were identified as having 21- hydroxylase deficient NCAH in the whole group of 298 hyperandrogenic women. Hirsutism and acne were found only in three, two patients, five of them had oligo/amenorrhea. Seven patients had both elevated basal and stimulated 17-hydroxyprogesterone, while in one case only elevation of stimulated level was found. All of the NCAH patients had elevated concentrations of testosterone, six DHEA, lower SHBG was found in four patients. Surprisingly, none of the NCAH patients had increased DHEAS. Conclusion. In our study, the prevalence of NCAH in hyperandrogenic women was 2.68%. Their leading symptom was oligomenorrhea, skin androgenic disorders were a minor clinical problem. None of the NCAH patients had an elevated DHEAS, the androgen dominantly produced by the adrenal glands. [ABSTRACT FROM AUTHOR]

Secondary amenorrhea in women with normal estrogen levels increases the risk of endometrial carcinoma. Cyclical dydrogesterone induces regular withdrawal bleeding and effectively protects the endometrium of postmenopausal women receiving estrogens. In order to assess the efficacy of dydrogesterone in inducing regular withdrawal bleeds in premenopausal women with secondary amenorrhea or oligomenorrhea and normal estrogen levels, a double-blind, randomized, placebo-controlled, multicenter study was conducted in 104 women using cyclical dydrogesterone as is used for estrogen replacement therapy. Treatment consisted of dydrogesterone (10 mg/day on days 1-14 followed by placebo on days 15-28 of each cycle) given for six cycles of 28 days. The control group received placebo throughout the six cycles. Bleeding was documented by the patient on diary cards. The number of women with withdrawal bleeding during the first cycle was twice as high in the dydrogesterone group as in the placebo group (65.4% vs. 30.8%; p = 0.0004). Superiority of dydrogesterone was also observed for regularity of bleeding over the six cycles (p < 0.0001), although endometrial thickness after six cycles did not differ between the groups. In conclusion, dydrogesterone is significantly superior to placebo in inducing withdrawal bleeding, and maintaining regular bleeding, in women with secondary amenorrhea and normal estrogen levels. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing age and is characterized by chronic anovulation with either oligomenorrhea or amenorrhea and hyperandrogenism. The etiology of this entity remains unknown. It has been suggested that genomic variants in genes related to the regulation of androgen biosynthesis and function could be involved in genetic predisposition to PCOS. WNT-4 is a member of the WNT family of secreted molecules. Studies on female Wnt-4 knockout mice have suggested that this gene suppresses gonadal androgen synthesis in normal females. We investigated if 25 women with PCOS presented mutations in WNT-4 as the cause of their disorder. Direct sequencing of all five exons demonstrated no mutant alleles in any patient. This study demonstrates that, at least in the population studied, mutations of the open reading frame of WNT-4 gene or its intron/exon junctions are not the cause of PCOS. However, the present data do not rule out the possible existence of causative mutations in the WNT-4 gene promoter region. [ABSTRACT FROM AUTHOR]

Recently, an important role of insulin resistance has been demonstrated in polycystic ovary syndrome. New treatment strategies have emerged from this association, as well as a will to prevent long-term metabolic complications of the syndrome, namely metabolic syndrome, Type 2 diabetes mellitus and cardiovascular disease. Rosiglitazone, a member of the thiazolidinedione family, appears to efficiently treat oligoanovulation, menstrual irregularity and hirsutism but it might not be the best treatment for acne. By comparison, ethinylestradiol/cyproterone acetate is not only better than rosiglitazone in controlling menstrual irregularity and acne but also appears to be equally effective in alleviating hirsutism, although it is inferior in restoring fertility. As for long-term complications, rosiglitazone appears to treat the metabolic syndrome and prevent insulin resistance, Type 2 diabetes and cardiovascular disease, while no similar benefit is expected with ethinlyestradiol/cyproterone acetate. Both treatments are equally effective in preventing endometrial neoplasia. In summary, both rosiglitazone and ethinlyestradiol/cyproterone acetate are efficient in treating polycystic ovary syndrome, but there might be a significant advantage of rosiglitazone in preventing long-term metabolic complications of the syndrome. [ABSTRACT FROM AUTHOR]

Neuroendocrine adaptive responses to psychological stress include activation of the hypothalamic–pituitary–adrenal (HPA) axis and sometimes suppression of the hypothalamic–pituitary–gonadal (HPG) axis. In women who experience chronic stress, these responses are probably responsible for disturbances in the menstrual cycle. In the present experiment, we investigated the effect of an acutely stressful situation on the physiological and neuroendocrine responses in college age women. We hypothesized that females who are experiencing some degree of abnormal menstrual function or women who have less-robust cycles (oligomenorrheic females) would exhibit differences in gonadotropin secretion from eumenorrheic females when exposed to psychological stressors. Fifteen women completed this study: eumenorrheic ( n = 5) and oligomenorrheic women ( n = 5) who experienced a series of psychological stressors, and eumenorrheic controls ( n = 5). Blood samples were taken at 10 min intervals for 8 h (09:00–17:00) in each woman during the mid-follicular phase of the menstrual cycle. The psychological stressors were administered for 1 h beginning at 13:00 h. Luteinizing hormone (LH), growth hormone (GH) and cortisol were measured in each sample to assess the effect of stress on secretion of these hormones. Deconvolution analysis was used to analyze pulsatile hormone secretion and the approximate entropy (ApEn) statistic analyzed the regularity of release of each hormone. Although, there were significant changes in heart rate (HR), skin resistance (SR) and cortisol levels in the stressed women during the psychological stressor compared to resting baseline values but not in the controls, there was no difference in either LH or GH secretion between women who experienced stress and those who did not. Furthermore, there were no differences in the LH or GH secretion patterns in the oligomenorrheic and eumenorrheic women exposed to the psychological stressor. [ABSTRACT FROM AUTHOR]

To examine the relations between age at menarche and menstrual cycle characteristics and preeclampsia risk, we analyzed data from a case-control study conducted from 1998 to 2002. Usual menstrual cycle characteristics among 286 preeclampsia cases and 471 normotensive controls were assessed using a structured interview during postpartum hospitalization. We used multivariable logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusting for confounders. We also examined the influence of pre-pregnancy body mass index (BMI) on selected hypothesized relations. Among lean women (pre-pregnancy BMI 2 ), preeclampsia risk was lower in those reporting cycles &geqslant;36 days in length (adjusted OR 0.78, CI 0.35–1.83) and menarche at &geqslant;14 years (adjusted OR 0.48, 95% CI 0.28–0.82). In contrast, among overweight or obese women, preeclampsia risk was higher in those with long cycles (OR 3.11, 95% CI 0.62–1.56, p interaction = 0.16) and late menarche (OR 1.53, 95% CI 0.59–3.97, p interaction = 0.03). These data suggest that adiposity influences the relations between usual menstrual cycle length, age at menarche, and preeclampsia. Overweight women with long cycles are at particularly high preeclampsia risk. [ABSTRACT FROM AUTHOR]

We evaluated whether the presence of polycystic ovaries in adolescent girls as a cause of oligomenorrhoea and amenorrhoea would pose any protective effect against osteoporosis or low bone mineral density (BMD) compared with girls having similar menstrual dysfunction but normal ovaries. A cross-sectional observational study was done in consecutive girls, aged between 16 and 19 years, presenting to the adolescent gynaecology clinic with oligomenorrhoea or amenorrhoea. All patients underwent full hormonal profile assessment, pelvic ultrasound for ovarian morphology, bio-impedance estimation of body fat, and dual-energy X-ray absorptiometry and quantitative peripheral computed tomography scans to determine BMD in axial and appendicular skeletal sites. Polycystic ovaries were diagnosed according to ultrasound morphology. These were then compared with an age-matched eumenorrhoeic control group that had undergone the same evaluation. Of 45 patients with oligomenorrhoea or amenorrhoea, 14 (31%) were diagnosed to have polycystic ovaries, while the other 31 had normal ovaries. The control group consisted of 45 age-matched eumenorrhoeic girls. The group with normal ovaries had lower BMD at the lumbar spine and hip, as well as lower total tibial volumetric BMD, than the eumenorrhoeic controls, but there were no significant differences between the group with polycystic ovaries and eumenorrhoeic controls. We conclude that adolescents with oligomenorrhoea and amenorrhoea with normal ovaries had lower BMD than eumenorrhoeic ones, but those with polycystic ovaries had BMD values comparable to those of eumenorrhoeic controls despite their menstrual dysfunction. [ABSTRACT FROM AUTHOR]

Introduction Insulin resistance is implicated in the pathogenesis of polycystic ovarian syndrome (PCOS). Insulin-sensitizing agents are increasingly used in the treatment of infertility and hirsutism in PCOS. However, not all women with PCOS are insulin-resistant.Objective To assess the degree of insulin resistance within a clinic population of women referred for treatment of oligomenorrhoea or infertility.Design We evaluated 25 consecutive PCOS outpatients referred for treatment of menstrual dysfunction/infertility and a matched control group. All underwent a standard oral glucose tolerance test (OGTT) with serial insulin measurements. Insulin sensitivity was calculated using homeostasis model assessment (HOMA).Results Five of the 25 clinic patients had abnormal glucose handling (two had previously unknown type 2 diabetes and three had impaired glucose tolerance). Fasting and 2-h insulin levels were significantly higher in the PCOS women. Mean HOMA-S (insulin sensitivity) was even lower for PCOS women with normal GTT status (mean (95% confidence interval): 0.53 (0.34–0.72)) than for controls (0.94 (0.84–1.04)) (F?=?4.2, p < 0.001). HOMA-B (pancreatic ß-cell function) was nearly tripled for normal GTT status PCOS women at 273 (205–342) versus 105 (70–139) for controls (F?=?6.8, p < 0.001).Conclusions The results suggest a role for routine measurement of HOMA-S in identifying women with PCOS with insulin resistance with a view to targeting them with insulin-sensitizing agents. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess and compare the incidence of delayed menarche and menstrual dysfunction among elite ice hockey players and figure skaters. Forty-three ice hockey players (23.5 ± 4.8 years, 68.2 ± 1.2kg, 1.68 ± 0.01 m) and 39 figure skaters (17.5 ± 3.4 years, 53.7 ± 5.8kg. 1.64 ± 0.05m) completed a self- administered questionnaire on their menstrual status and history, training regimens and lifestyle. Age at menarche did not differ significantly between ice hockey players (13.3 ± 1.3 years; and figure skaters (13.7 ± 1.4 years). Menarche was unrelated to nationality, vigorous training premenarche or age at which the athlete began her sport, but was correlated with the age at menarche of the athletes' mothers (r = 0.39, p < 0.05). Hormonal contraceptives were used by 35% of ice hockey players and 15% of the figure skaters. Amenorrhea and oligomenorrhea were experienced by 7.1% and 38.7% of postmenarcheal, ice hockey players and figure skaters respectively not using hormonal contraceptives. Menstrual dysfunction was associated with both age and age at menarche in the ice hockey players only. Training factors, and psychological pressure were perceived by the athletes to contribute to menstrual dysfunction. A greater training volume, younger age at commencing sport, lower body mass, greater subjective body image pressure and younger biological and gynaecological age were reported among the figure skaters, and were proposed to explain the higher incidence of menstrual dysfunction among the figure skaters compared with the ice hockey players. Figure skaters appear at increased risk of amenorrhea and oligomenorrhea compared with ice hockey players which may be linked to training and physical characteristics of the sports. [ABSTRACT FROM AUTHOR]

The aims of the study were to test whether nocturnal white light can normalizemenstrual cycles in oligomenorrheic women, and whether the phase of the menstrualcycle in which light is given is important for the shortening effect. Twenty-fivewomen with long menstrual cycles (35.9–53.4 days on average) were treatedfor 1–3 cycles, each of which was preceded and followed by at leasttwo untreated cycles. Treatments were 100 watt bedside lights administeredfor 5 consecutive nights. They centered at three different phases of the menstrualcycle: 6–7th, 14–17th or 23–25th days of the treated cycle(early, middle or late treatment, respectively). On average, the treatmentcycle lengths were modestly, but significantly reduced compared to the durationof baseline cycles (more than 11 %). The difference in the effects of theearly, middle and late treatment was not significant. However, if middle orlate treatments were administered in the latter half of the interval betweenthe menstrual cycle onset and probable time of ovulation, reductions of thetreated cycle length were substantial (more than 20 %, resulting in cyclesless than 33 days on average; p < 0.001). Other treatments produced onlyweak (up to 7 %), if any, cycle reductions. Moreover, we found a strong correlation(p < 0.001) between the duration of baseline cycle and differential effectof middle treatment (compared to early or late treatment). Middle treatmentsreduced treated cycle duration to the normal range in the subjects with shortermean baseline cycles (<42 days), while in the subjects with longer durationof baseline cycle the shortening effect was produced by late treatments (p= 0.005 and p = 0.001, respectively). The results support the suggestion thata bedside lamp used on nights prior to ovulation can cause reduction of longmenstrual cycles. [ABSTRACT FROM AUTHOR]

Macroprolactin may cause elevation of prolactin (PRL) concentrations measured by standard assays. In our study, we assessed the prevalence of pituitary lesions in women with macroprolactinaemia and either oligomenorrhoea or secondary amenorrhoea. Pituitary MRI scans were performed in 61 women aged 31.0 ± 6.7 years (mean ± SD), with raised PRL concentrations due to macroprolactinaemia, detected by 25% polyethylene glycol (PEG) precipitation method (PRL recovery <40%). After PEG precipitation of macroprolactin, free PRL concentrations were still raised in 36 (59%) women. Microadenomas were detected in 10 patients out of 61 (16.4%), with raised free PRL in 9 of these cases, while macroadenomas were detected in 4 out of 61 (6.6%) women, all of whom also had raised free PRL. In case of coexistence of macroprolactinaemia and raised free PRL after PEG precipitation of macroprolactin, the chance of finding of either a micro- or a macroadenoma was 36% (13 cases out of 36). We conclude that hyperprolactinaemia and macroprolactinaemia may coexist in the same patient. Furthermore, if free PRL is raised after PEG precipitation of macroprolactin, then the chance of finding either a pituitary micro- or macroadenoma in women with oligo-/amenorrhoea is over 30%. Therefore pituitary magnetic resonance imaging is mandatory in all such cases. [ABSTRACT FROM AUTHOR]

Steroid cell tumors, not otherwise specified, are rare ovarian sex cord-stromal tumors with malignant potential. The majority of these tumors produce steroids, with testosterone being the most common. A 44-year-old woman with hypothyroidism and hyperlipidemia presented with abrupt onset of oligomenorrhea, progressive virilization as acne, hirsutism and clitoromegaly, and a non-palpable pelvic mass. The preoperatively elevated serum testosterone level returned to normal after salpingo-oophorectomy, and then menstrual flow became regular. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 29-year-old woman with undiagnosed pregnancy during hysterosalpingography (HSG). It says that the woman has two-year history of infertility and oligomenorrhea. It states that HSG is a common procedure performed among patients with infertility. It adds that the woman was confirmed to have an intrauterine pregnancy through ultrasound scan, in which is likely six weeks pregnant at the time of the HSG.

The author discusses the involvement of celiac disease in women with infertility. The authors asserts the association of celiac disease with a relative risk of 9 for intrauterine growth restriction and suggests infertility specialists to know and care about the disease, which is common in infertile patients due to oligomenorrhea. In addition, the author advises all women with autoimmune conditions such as juvenile diabetes to be screened for the disease.

The article reports on the case of a 16-year-old girl presented with history of hirsutism and weight gain for five years and oligomenorrhea for two years. Treatment with drugs like leuprolide acetate and oral contraceptives have been shown to result in the normalization of circulating androgens in a few patients. The patient responded dramatically to oral contraceptives and spironolactone treatment.

Focuses on the complexity in detecting Cushing's syndrome in pregnant women due to its association with amenorrhea and oligomenorrhea and infertility. Assessment of pregnancy complications; Evaluation of treatments used in non-pregnant patients; Percentage of fetal loss; Suppression of the fetal hypothalamic pituitary adrenal axis.

Features the case study of a 29-year-old woman with oligomenorrhea and variation in menstrual cycle. Endocrine profile showing normal plasma levels of oestradiol and testosterone; Spontaneous pregnancy following pretreatment with gonadotrophins; Ovulation induction with menotrophin; Association of hypergonadotrophic hypogonadism in the presence of ovarian follicles.

Documents the case of a 35-year-old woman with oligomenorrhea and primary infertility. Serum assays showing level of oestradiol and luteinizing hormone; Enlargement of left ovary containing several follicles; Treatment with clomiphene citrate; Histological examination revealing a granulosa cell tumour.