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PubMedDate not supplied

Reproductive health in women with eating disorders.

Medical complications are often the precipitants that lead women with eating disorders to seek health care. Complications can be wide ranging but frequently include symptoms associated with reproductive health. Unfortunately, because of the denial, embarrassment, shame, and secrecy associated with these psychiatric illnesses, the underlying cause of these complications can often go unacknowledged, delaying assessment and intervention. This article provides an overview of anorexia nervosa and bulimia nervosa, identifies the reproductive health issues that may occur in women with these disorders, and discusses the associated clinical implications for nursing practice.

Feeding and Eating Disorders↗
PubMed1975

Radioligand assay in reproductive biology.

Radioligand assays have been developed for the principal reproductive steroids and peptide hormones. Specific binding reagents have included antibodies, plasma binders, and intracellular receptors. In each assay, problems of specificity, sensitivity, and nonspecific inhibitors were encountered. Many features of the endocrine physiology in childhood, during puberty, and in adulthood have been characterized. Hormonal evaluations of endocrine disorders of reproduction are characterized on the basis of their characteristic pathophysiologic alterations.

Adult↗
PubMed1998

[From industrial hygiene for women to the protection of the reproductive health of workers. Principles and outlook].

The issues and prospects of workers' reproductive health as a problem of occupational health in nowadays Russia are outlined with due account for WHO, ILO, EC, etc. concepts and recommendations. Main principles of reproductive health protection are gender approach, additional protection of vulnerable groups, e. g. pregnant women and obligatory account for combined effects of occupational, environmental and socio-economic risk factors. Two groups of criteria are essential: criteria of health and criteria of emancipation. Criteria for evaluation of reproductive health disorders are worked out based on official statistical indices and it is proposed to rate some of these as of extra category class for effective risk assessment and risk management. The strategy and priorities in workers' reproductive health are discussed and need for international cooperation is noted for resolving this problem.

Adolescent↗
PubMed2003

The 'oestrogen hypothesis'- where do we stand now?

The original 'oestrogen hypothesis' postulated that the apparent increase in human male reproductive developmental disorders (testis cancer, cryptorchidism, hypospadias, low sperm counts) might have occurred because of increased oestrogen exposure of the human foetus/neonate; five potential routes of exposure were considered. This review revisits this hypothesis in the light of the data to have emerged since 1993. It addresses whether there is a secular increasing trend in the listed disorders and highlights the limitations of available data and how these are being addressed. It considers whether new data has emerged to support the suggestion that increased oestrogen exposure could cause these abnormalities and reviews new data on potential routes via which such increased exposure could have occurred. Secular trends: The disorders listed above are now considered to represent a syndrome of disorders (testicular dysgenesis syndrome, TDS) with a common origin in foetal life. Testicular cancer has increased in incidence in Caucasian men worldwide and lifetime risk is 0.3-0.8%. Secular trends in cryptorchidism are unclear but it is by far the commonest (2-4% at birth) congenital abnormality in either sex. Secular trends for hypospadias are not robust, although most studies suggest a progressive increase; registry data probably under-estimates incidence, but based on this data hypospadias is the second most common (0.3-0.7% at birth) congenital malformation. Retrospective analyses of sperm count data show a global downward trend but this is inconclusive - prospective studies using standardized methodology show significant differences between countries and very low sperm counts in the youngest cohort of men. For all disorders, other then testis cancer, standardized prospective studies are the best way forward and are in progress across Europe. Oestrogen effects: Evidence that foetal exposure to oestrogens can induce the above disorders has strengthened. New pathways via which such changes could be induced have been identified, including suppression of testosterone production by the foetal testis, suppression of androgen receptor expression and suppression of insulin-like factor-3 (InsL3) production by foetal Leydig cells. Other evidence suggests that the balance between androgen and oestrogen action may be important in induction of reproductive tract abnormalities. Oestrogen exposure: Although many new environmental oestrogens have been identified, their uniformly weak oestrogenicity excludes the possibility that they could induce the above disorders. However, emerging data implicates various environmental chemicals in being able to alter endogenous levels of androgens (certain phthalates) and oestrogens (polychlorinated biphenyls, polyhalogenated hydrocarbons), and the former have been shown to induce a similar collection of disorders to TDS. Other mechanisms via which increased fetal exposure to pregnancy oestrogens might occur (increasing trend in obesity, dietary changes) are also discussed.

Estrogens↗
PubMed2006

Gender disadvantage and reproductive health risk factors for common mental disorders in women: a community survey in India.

BACKGROUND: Gender disadvantage and reproductive health are major determinants of women's health in developing countries. OBJECTIVE: To determine the association of factors indicative of gender disadvantage and reproductive health with the risk of common mental disorders (CMDs) in women. DESIGN: Cross-sectional survey from November 1, 2001, to June 15, 2003. PARTICIPANTS: A total of 3000 women randomly selected from a sampling frame of women aged 18 to 45 years in Goa; 2494 women participated. MAIN OUTCOME MEASURES: The primary outcome was the presence of a CMD, as defined by the Revised Clinical Interview Schedule. An interview and blood and vaginal/urine specimens were collected to ascertain risk factors. RESULTS: The prevalence of CMD was 6.6% (95% confidence interval [CI], 5.7%-7.6%). Mixed anxiety-depressive disorder was the most common diagnosis (64.8%). Factors independently associated with the risk for CMD were factors indicative of gender disadvantage, particularly sexual violence by the husband (odds ratio [OR], 2.3; 95% CI, 1.1-4.6), being widowed or separated (OR, 5.4; 95% CI, 1.0-30.0), having low autonomy in decision making (OR, 1.98; 95% CI, 1.2-3.2), and having low levels of support from one's family (OR, 2.2; 95% CI, 1.4-3.3); reproductive health factors, particularly gynecological complaints such as vaginal discharge (OR, 3.2; 95% CI, 2.2-4.8) and dyspareunia (OR, 2.5; 95% CI, 1.4-4.6); and factors indicative of severe economic difficulties, such as hunger (OR, 2.7; 95% CI, 1.6-4.6). There was no association between biological indicators (anemia and reproductive tract infections) and CMD. CONCLUSIONS: The clinical assessment of CMD in women must include exploration of violence and gender disadvantage. Gynecological symptoms may be somatic equivalents of CMD in women in Asian cultures.

Adolescent↗
PubMedDate not supplied

Digestive and metabolic adaptations of ruminants to undernutrition, and consequences on reproduction.

In response to undernutrition, short- (days) and medium-term (weeks) adaptations are more pronounced for splanchnic organs than for other tissues. For the latter, the long-term response involves a sequential mobilization (fat > muscle > bone) with relative priorities differing among anatomical sites. Among chemical components, the body lipids are extensively used (up to 80%) in underfed animals, while the range of protein utilization is limited (up to 15-20%). The decrease in energy expenditure during undernutrition is mostly due to a short- and medium-term decrease in feeding activity, and in the mass and activity of splanchnic tissues. In the long-term, energy expenditure and tissue masses decrease concomitantly, but there does not appear to be a significant decrease in expenditure per unit tissue weight. Nitrogen losses decrease in response to decline in nitrogen fluxes and also due to sparing by renal activities and sometimes by urea recycling. However, ruminants do not seem to be able to compensate for a low level of intake (below maintenance) by an increase in digestive efficiency. Numerous hormones (insulin, growth hormone, insulin-like growth factor I, catecholamines, thyroid hormones, cortisol, leptin, etc.) are involved in the changes during undernutrition of nutrient fluxes between tissues, either through control of synthesis and/or degradation in peripheral tissues (adipose tissue and muscle), or through hepatic conversions of substrates (gluconeogenesis, ureagenesis and ketogenesis), in order to maintain the constancy of the internal environment (homeostasis) and/or to sustain productive functions (teleophoresis). However, reproductive process may be blocked in underfed animals.

Adaptation, Physiological↗
PubMed1997

Spastic disorders of the esophagus.

Spastic disorders of the esophagus are found in up to 50% of patients referred for manometry, therapy representing the most prevalent motility disorders in clinical practice. They share in common their manifestations of hypermotility, one of two principal types of esophageal motor dysfunction. Diffuse esophageal spasm is segregated from the nonspecific spastic disorders because of its demonstrated interference with bolus transit. However, the overlap among the spastic disorders in manifestation, course, and management is great; segregation of any disorder within this group is not of paramount importance. Spastic disorders, pain reproduction with provocative testing, and psychological abnormalities are coprevalent in patients with unexplained symptoms, but a cause-effect relationship of the motor abnormalities with the other findings is not established. The physician's charge in determining the relevance of a spastic disorder to the clinical presentation and for creating a treatment plan is to establish a direct relationship of motor dysfunction with symptoms-a task that may require correlation of transit abnormalities with symptoms using tests other than manometry. A variety of treatment options, invasive and noninvasive, are available today for patients who have spastic disorders, and each is effective in appropriately selected candidates.

Esophageal Motility Disorders↗
PubMed1989

Neuroendocrine consequences of alcohol abuse in women.

Alcohol abuse and alcoholism are associated with a broad spectrum of reproductive system disorders. Amenorrhea, anovulation, luteal phase dysfunction, and ovarian pathology may occur in alcohol-dependent women and alcohol abusers. Luteal phase dysfunction, anovulation and persistent hyperprolactinemia have also been observed in social drinkers studied under clinical research ward conditions. The mechanisms underlying alcohol-related disruptions of the hypothalamic-pituitary-ovarian-adrenal axis are unknown. The reproductive consequences of alcohol abuse and alcoholism range from infertility and increased risk for spontaneous abortion to impaired fetal growth and development. Recent studies of alcohol's effects on pituitary gonadotropins and on gonadal, steroid and adrenal hormones in women are reviewed. Research on the acute effects of alcohol on opioid antagonist and synthetic LHRH-stimulated pituitary gonadotropins is summarized. The implications of alcohol's effects on reproductive hormones for impairment of fetal growth and development are discussed.

Alcohol Drinking↗
PubMedDate not supplied

[Sexual behaviour of adolescents].

INTRODUCTION: Numerous studies have shown that sexual behaviour increases among adolescents. Disharmony between biological and psychosocial maturity among young people may cause risky behavior, and endanger psychophysical and reproductive health of young persons. MATERIAL AND METHODS: A questionnaire on sexual behaviour was completed by 169 adolescents, 1st and 4th year high school students. RESULTS: Every 6th first grade and every 2nd fourth grade adolescent is sexually active. Male adolescents begin sexual activities significantly earlier (at the age of 15.6) than female adolescents (16.5). Also, young men have significantly more partners (3.6) than girls (1.3), and more parallel sexual relations than girls. Only 1/3 of sexually active adolescents always use some kind of contraception, more frequently boys (41.9%) than girls (26.7%). DISCUSSION: Early commencement of sexual activity results with longer active period before realization of the reproductive function, which increases risk for reproductive health disorders. Unprotected sexual intercourse and large number of partners also present significant risk factors. CONCLUSION: Sexual life of adolescents begins at the age of 16, on average, and only every third always uses contraceptive protection, which points to a need for better education on reproductive health by using contemporary methods. It is also necessary to increase availability of contraceptives (condoms) at all places where adolescents spend time (in schools, bars, cinemas, disco clubs etc.) in order to achieve responsible sexual behavior and protection of reproductive health among youth.

Adolescent↗
PubMed1991

Reproductive endocrine considerations and hormonal therapy for men with epilepsy.

Androgen deficiency is unusually common among men with epilepsy. It may contribute to reproductive and sexual dysfunction and possibly exacerbate seizure frequency. The most important androgen is testosterone. it exists in the serum in a free form or bound to albumin or sex hormone-binding globulin (SHBG). Free testosterone levels have correlated significantly with measures of potency and sexual interest. The possibility that measures of non-SHBG-bound testosterone may provide a more sensitive assessment of biologically and perhaps clinically significant androgen levels is raised for consideration. Androgen deficiency may result from increased catabolism and binding induced by antiepileptic drugs (AEDs). It is a feature of the reproductive endocrine disorders that are often associated with epilepsy: hypogonadotropic hypogonadism, hypergonadotropic hypogonadism, and functional hyperprolactinemia. It may be a consequence of medication-induced elevations in serum estradiol. Estradiol exerts a potent inhibitory influence on luteinizing hormone secretion and may contribute to premature aging of the reproductive system, both at the level of the testes and the hypothalamus. Testosterone therapy may moderately benefit reproductive and sexual function. Despite its antiseizure effects in animal experiments, however, it has not been reported to improve seizures clinically. One possible explanation is that AEDs that induce enzyme synthesis may enhance the conversion of testosterone to estradiol by aromatase. This possibility is supported by the improved seizure control achieved with the adjunctive use of the aromatase inhibitor testolactone or the antiestrogen clomiphene.

Anticonvulsants↗
PubMed1983

Effects of selenium, vitamins, and ration fiber on placental retention and performance of dairy cattle.

One hundred and twenty Holstein cows were assigned to a randomized complete block design to determine effects of selenium, vitamins, and ration fiber on incidence of placental retention and other health and reproductive problems. The selenium treatment (50 mg selenium, 680 IU vitamin E) was administered as a single injection approximately 3 to 4 wk prepartum. The vitamin treatment (3 million IU vitamin A, 450,000 IU vitamin D3, 300 IU vitamin E) consisted of two injections, one administered at 3 to 4 wk prepartum and another at 2 to 3 wk postpartum. Fiber treatments were: control, 15.7% crude fiber; beet pulp, 19.3% crude fiber; and soyhull, 19.0% crude fiber. Feeding of experimental rations was begun 1 day postpartum, and the ration effect on placental retention was examined only at subsequent parturition. The overall placental retention rate of 28% was not affected by either selenium, vitamin, or combined treatments. Ration treatments did not affect the placental retention rate of 42% at subsequent parturition. Cows receiving the soyhull ration required fewer services per conception. Incidence of foot problems tended to be higher in the cows that received the combined selenium and vitamin A, D, E treatments. Supplemental selenium, vitamins A, D, and E, and ration fiber treatments did not reduce incidence of placental retention or improve most other health and reproductive measures.

Animals↗
PubMed1998

Follicle stimulating hormone international standards and reference preparations for the calibration of immunoassays and bioassays.

Follicle stimulating hormone is a dimeric glycoprotein hormone which is used widely in reproductive and developmental medicine both as a diagnostic analyte and as a therapeutic product. It is therefore a good example of a clinically important heterogeneous material for which a number of different assay methodologies have been developed. Immunoassays for follicle stimulating hormone (FSH) are used in the diagnosis of disorders of reproduction and development, whereas in vivo bioassays are used for calibration of therapeutic preparations. Different immunoassay systems, based on different formats, exhibit variability in their estimates of activity of FSH which arises from different specificities of antibodies for different forms of FSH which are encountered. In order to minimise between assay variation and to enable better between laboratory comparisons the World Health Organisation (WHO) has issued a series of ampouled preparations of FSH. The availability of these materials has been reviewed previously but on the completion of a recent collaborative study to evaluate candidate standards for rDNA-derived FSH and highly purified urinary FSH (urofollitropin) it is now appropriate to review the current status of these standards and to discuss the future of standardisation for FSH in particular and where appropriate to make reference to other materials.

Animals↗
PubMed2000

Epilepsy in adolescents: hormonal considerations.

A correlation between seizure disorders and reproductive hormones has been recognized for centuries. Through basic scientific and clinical studies, an understanding of the interrelationships has become clearer. Puberty does not increase the incidence of seizures. Catamenial seizures, when diagnosed, may be improved with hormonal manipulation. Therapeutic regimens for those treated unsuccessfully with antiepileptic therapy need continued validation. Patients with seizure disorders have an increased incidence of menstrual disorders. Hormonal contraception is not contraindicated in this population, yet requires a more cautious approach to avoid failure.

Adolescent↗
PubMed2006

Deconstructing mammalian reproduction: using knockouts to define fertility pathways.

Reproduction is the sine qua non for the propagation of species and continuation of life. It is a complex biological process that is regulated by multiple factors during the reproductive life of an organism. Over the past decade, the molecular mechanisms regulating reproduction in mammals have been rapidly unraveled by the study of a vast number of mouse gene knockouts with impaired fertility. The use of reverse genetics to generate null mutants in mice through targeted disruption of specific genes has enabled researchers to identify essential regulators of spermatogenesis and oogenesis in vivo and model human disorders affecting reproduction. This review focuses on the merits, utility, and the variations of the knockout technology in studies of reproduction in mammals.

Animals↗
PubMed1992

Postpartum performance of dairy heifers freshening at young ages.

Records from Florida Agricultural Experiment Station dairy herd for 1144 heifers freshening from 1959 to 1979 were studied to evaluate effects of age and problems at parturition on subsequent yield and reproduction. Statistical analysis was by method of ordinary least squares analysis of variance; five measures of reproduction, survival to second lactation, and 15 measures of yield were studied. Mean first parturition age was 25.8 mo with 40% of individuals less than or equal to 23 mo; survival to second parturition was 67%. No effects of age at first parturition were detected on survival, postpartum reproductive performance, or milk composition other than lactose-mineral, chloride, and acidity percentages; effects on yield were similar to previous reports. Stillbirth did not affect subsequent reproductive performance but was associated with decreased milk yield: 181 kg or 5.2% of overall mean. Milk yield was depressed by 239 kg for retained fetal membrane, 173 kg for dystocia, and 98 kg for metritis; milk composition essentially was unaltered. Heritability of postpartum days to first estrus was .14; estimates were 0 for days to first service, days open, and calving interval. Additional research is needed on interrelationships of gestation length with subsequent yield and reproduction and in alleviating detrimental effects of problems at parturition.

Age Factors↗