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[Usefulness of determining serum levels of prolactin in women with menstruation disorders].

In 173 women with oligomenorrhea or amenorrhea, serum level of prolactin (PRL) was determined by radioimmunoassay method. In 22 cases (12.7%) the concentration of PRL was above 15 ng/ml. From the above women in 9 cases (5.2%) of all examined patients pituitary microadenoma was diagnosed. In 1 patient with pituitary microadenoma, coexisting partially empty sella was diagnosed. The mean basal PRL concentration in women with menstruation disturbances without hyperprolactinemia (group I) was found to be 7.1 +/- 3.1 ng/ml while the women with hyperprolactinemia without pituitary microadenoma (group II) was 32.9 +/- 5.8 ng/ml. In women with diagnosed pituitary microadenoma (group III) PRL concentration was 131.8 +/- 47.7 ng/ml. The group II and III demonstrated statistically significant increase of serum prolactin level in comparison to group I. Moreover in comparison with group I, statistically significant reduction of serum level of FSH, LH and estradiol 17 beta was confirmed in group with pituitary microadenoma. In group II significant decrease of serum concentration of LH and estradiol 17 beta was stated as well as lack of significant difference in serum level of FSH, in comparison to group I.

Adenoma↗

[Menstruation disorders in insulin-dependent diabetes mellitus--epidemiology and causes].

About 20% of all women with insulin-dependent diabetes mellitus (IDDM) have menstrual irregularities. Eight percent have amenorrhea. Fluctuations in blood glucose and insulin concentration are probably contributing factors, but the irregular menstrual cycles are mainly caused by disorders in the central ovulatory mechanisms. Hypothalamic GnRH release is regulated by several neuropeptides. Dopamine and opiates exert an inhibitory effect, and there is evidence for an abnormally high dopaminergic hypothalamic activity among women with IDDM. There might also be disorders of the opioid, serotonergic and GABA'ergic systems, but the consequences of there possibilities remain uncertain.

Diabetes Mellitus, Type 1↗

[Use of nomegestrol acetate in the treatment of menstruation disorders. Our experience in 56 cases].

OBJECTIVE: To investigate tolerability and efficacy of nomegestrol acetate, a new 19-nor-progesterone derivative, in the treatment of oligomenorrhea and amenorrhea; to compare this drug with didrogesteron, a widely-used spatial isomer of progesterone. METHODS: 56 women, aged 22 to 50, affected by menstrual disorders or premenstrual syndrome, entered the study. They were divided in two homogeneous groups by randomization. In the first group nomegestrol acetate was administered 5 mg daily per os; in the second group patients were treated by the usual didrogesteron dose, that is 10 mg twice a day per os; both treatments were administered for 10 days from day 16, during three consecutive menstrual cycles. Efficacy, compliance and biological tolerance were evaluated. RESULTS: 24 patients in the group treated by nomegestrol acetate and 22 in the group treated by didrogesteron completed the study. After the first cycle of therapy, nomegestrol acetate showed a higher efficacy in reducing menstrual loss; results are statistically homogeneous in the two groups at the end of the study. There were no reports of pain in both the groups. Evaluation of biological and clinical parameters at the end of the study did not show significant modifications in any subject. CONCLUSIONS: Nomegestrol acetate is an innovative and efficient molecule in the treatment of menstrual disorders. A good response to the drug is evident in a short time and with very low doses; its good compliance, if compared with other progesteron-derivatives, indicates nomegestrol acetate as a first-line therapy for polymenorrhea, olygomenorrhea and premenstrual syndrome.

Adult↗

[Action of dydrogesterone in postpubertal menstruation disorders].

Seventy-four post-pubertal young women with menstrual disturbances of a functional nature were treated with 20 mg of dydrogesterone per day from the 16th to the 25th day of the cycle for three cycles. Overall efficacy was considered satisfactory, results being significantly more positive with regard to disturbances in the duration of the cycle rather than excessively heavy periods. The authors draw attention to the possibility of the restoration of luteal function in a patient treated with dydrogesterone and the validity of temperature curve and plasma progesterone levels in this context.

Adolescent↗

[Bone metabolism in female runners. Menstruation disorders are frequent among long-distance runners, but the bone mass is not influenced, with the exception of runners with amenorrhea].

The purpose of the study was to investigate the prevalence of exercise-related menstrual and sex hormonal disturbances and the effect of exercise on bone mass and metabolism in female runners at various training levels. Two hundred and five premenopausal women (running 0-140 km a week) were recruited from a large population of female runners, who had responded to a questionnaire regarding exercise habits. Maximum oxygen uptake was determined by treadmill testing. Gynaecological status was assessed on entries in a menstrual calendar and by transvaginal ultrasonography; and sex hormonal status was measured three times with 10-day intervals. Bone mass was measured in the lumbar spine, proximal femurs and total body by dual energy x-ray absorptiometry, and in the forearm by single photon absorptiometry. Bone turnover was assessed by plasma osteocalcin, serum alkaline phosphatase, and urinary calcium and hydroxyproline. The results showed that sex hormonal disturbances were significantly related to training intensity. Compared with the normally active women, the baseline levels and fluctuations of oestradiol and progesterone in the elite runners were reduced by up to 25-44%, (0.01 < p < 0.05). The prevalence of amenorrhoea increased from 1% in the normally active to 11% in the elite runners. No statistically significant relation was found between running activity and bone mass or bone turnover. However, the group of amenorrhoeic runners had a 10% reduction in lumbar bone mass as compared to the normally menstruating runners (p < 0.05), but the bone turnover was similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Correlation between menstruation disorders and insulin resistance].

UNLABELLED: The association between menstrual cylce abnormalities and insulin resistance in parallel to further clinical and biochemical findings was evaluated. MATERIAL AND METHODS: An observational, retrospective and transversal study was performed through a review of clinical charts of female patients (18-35 years old) who had undergone pelvic ultrasound seen at our service of Reproductive Biology in the Hospital Juárez de México form January 1996 to May 2002 with the following: abnormal menses (n = 22), eumenorrhea as controls (n = 28); without uterine or ovarian tumors, endocrine dysfunction or contraceptives. We assessed body mass index (BMI), waist hip ratio (WHR), ferriman, acanthosis nigricans, lipid profile and hormonal quantification. We used the HOMA procedure (18) for diagnosis of insulin resistance (glucose nmol/L (18 x insulin mIU/mL (22.5 = > 5.2. RESULTS: The abnormal menstrual patterns found were opsomenorrhea (n = 34), opsoamenorrhea (n = 17), amenorrhea (n = 23), proiomenorrhea (n = 3) and eumenorrheic controls (n = 28). There were no differences in age and BMI. The frequency of insulin resistance found was: controls (35.7%), opsomenorrhea (41.17%), opsoamenorrhea (41.17%), amenorrhea (78.26%) and proiomenorrhea (0%); the group with amenorrhea was statistically significant (P < 0.002). Those patients with obesity found in our groups exhibited a highest percentage of insulin resistance (Pearson: 0.37). WHR bigger 0.85 prevailed among patients with insulin resistance (P = 0.039). The finding of polycystic ovary was prevalent among opsoamenorrhea and opsomenorrhea patients with insulin resistance. Hyperandrogenemia and polycystic ovaries showed a higher percentage in amenorrheic and opsomenorrheic females with insulin resistance (P = < 0.05). COMMENTS: The amenorrhea symptom had a significant correlation with insulin resistance and it was also associated to obesity, acanthosis and polycystic ovaries.

Acanthosis Nigricans↗

[Sex chromosome aberrations in patients with menstruation disorders].

We studied 150 women with primary/secondary amenorrhea and/or oligomenorrhea; in 61 cases we found an abnormal karyotype (i.e. 40.7%): 51 cases in the first group of 110 patients with amenorrhea (i.e. 46%) and 10 cases in the second group of 40 patients with oligomenorrhea and/or secondary amenorrhea (i.e. 25%). The chromosome aberrations we found consisted in X aneuploidy, male karyotype and the different structural changes as mono- and dicentric X isochromosomes, dicentric, ring, deleted or inverted X chromosomes. Our results suggest a cytogenetic examination in patients with primary amenorrhea as well as in patients with oligomenorrhea and/or amenorrhea secundaria.

Adolescent↗