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PubMed1995

Performances of copper T 380A and multiload copper 375/250 intrauterine contraceptive devices in a comparative clinical trial.

An evaluation of the performances of copper T 380A (TCU 380A) and multiload copper 375/250 (MLCU 375/250) intrauterine contraceptive devices (IUCDS) was carried out at University College Hospital, Ibadan, Nigeria (UCH) in a clinical comparative trial. The IUCDS showed similar low vent rates at one year of continuous use. The difference in cumulative net probabilities for termination due to pelvic inflammatory disease was weakly significant at the sixth month of follow up with MLCU 250 having the highest rate. (TCU 380A-0%; MLCU 375-0%; MLCU 250-3.1%; X2 = 6.0; P < 0.05). This significant difference disappeared by the twelfth month of continuous use. Likewise, the difference in cumulative net probabilities for overall termination was significant at six months and insignificant at twelve months of follow up. The continuation rate after one year were 86%, 92% and 87% respectively for TCU 380A, MLCU 375 and MLCU 250. These rates were higher than 80% and 51% quoted for the previously available Lippes loop in the same environment [1,2]. It was therefore concluded that the three IUCDS are comparable in performances in the first year of use and could be used at our family planning clinic or any other clinic in a similar setting.

Adult↗
PubMed1993

[The multiple interactions between infertility and sexuality].

After investigating into literature and clinical experience, we shall line out in this study 4 types of interactions between sexuality and infertility: sexual causes to feminine (vaginism, with and without heavy dyspareunia) or masculine (impotency, ante-portas ejaculation, anejaculation, dysejaculation), infertility; influence of tests and of treatments for infertility on sexual life; influence of infertility on sexuality focusing on the various ambiguous feelings (of culpability, inferiority, aggressivity, passivity); and last, the psychological and sexual interactions with medical assisted procreation, reinforcing the sexual separation of man and woman if the body is considered a machine. Psychosomatic guidance of the couple during these steps (with reassurance as the being helped conception) will allow maintaining on removing sexual attraction.

Attitude to Health↗
PubMed1994

[The course of pregnancy in congenital thyroid gland aplasia. Case report with special reference to maternal hypothyroidism].

A report is given on a 28 years old women with congenital aplasia of the thyroid gland. She was substituted with thyroxine (300 micrograms per day). Her first pregnancy was complicated by gestational hypertension and pre-eclampsia. Delivery was by forceps. During the first trimester of her second pregnancy, bleedings occurred. The thyroid-stimulating hormone level (TSH-level) was increased (18.3 microU/ml). The patient did not show clinical signs of manifested hypothyroidism. The thyroxine dosis was increased. Bleedings disappeared. Labour was terminated and induced. Labour intra partum was hypoactive. The delivery was again by forceps. The newborn did not show any signals of hypothyroidism. Dysfunction of thyroid gland is associated with reduced fertility. Hypothyroidism in pregnancy is associated with an adverse outcome in fetal health as well as an increase in obstetric complications. Thyroid hormones play a vital role in fetal development and maturation of brain. Women with a hypothyroidism have a lower rate of pregnancy and a higher rate of spontaneous miscarriages compared to a normal population. Recognition and treatment of thyroid disorders in reproductive age occur before conception. Iodoprophylaxis is necessary for prevention of congenital hypothyroidism (cretinism). Iodoprophylaxis is necessary to prevent endemic goiter in pregnancy. Euthyroid goiter is an indication for a combined treatment with jodid and levothyroxine. Treatment should be individualized. Assessment of efficacy of treatment is based on measurement of TSH- and free thyroid hormone (fT4)-levels.

Abortion, Threatened↗
PubMed1994

Educating physicians about women's health. Survey of Canadian family medicine residency programs.

OBJECTIVE: To identify which women's health issues are taught in the 2-year core curriculum of Canadian family medicine residency programs and whether educators think their current teaching of women's health is adequate. DESIGN: Mailed survey using a questionnaire. PARTICIPANTS: All program and unit directors of the 16 Canadian family medicine residency training programs were surveyed. Replies were received from 63% (10 of 16) of program directors and 79% (55 of 70) of unit directors. MAIN OUTCOME MEASURES: Percentage of programs teaching specific women's health topics from a list of 21 possible topics; percentage offering educational opportunities with sexual assault teams and women's shelters; participants' assessment of the adequacy of current teaching in each training program; plans to increase women's health education. RESULTS: Topics such as violence against women and medical conditions more common among women were taught in more than 80% of programs, but poverty and the health care concerns of Native and immigrant women were included in fewer than 40% of programs. Half of the program directors indicated that residents were given educational opportunities with sexual assault teams or women's shelters. Unit directors gave a lower estimate. Most (90%) program directors thought their current teaching of women's health issues was inadequate and had plans to increase it, as did 64% of unit directors. CONCLUSION: Violence against women and the traditional medical topics of osteoporosis, weight disorders, and reproductive and breast cancer are frequently taught in family medicine training programs. However, the social and cultural aspects of health are addressed less often. It is encouraging that many family medicine programs plan to increase their teaching of women's health.

Attitude of Health Personnel↗
PubMed1993

[Laparoscopic evaluation of reproductive organs in women treated for infertility].

The authors discuss 84 cases of laparoscopic examination of women with primary or secondary infertility. The patients qualified for this examination had undergone at least 26 weeks of conventional treatment with no effect. In 7 cases the reproductive organ was found to be in order, with fallopian tubes fully patent. In 43 cases tubular inpatency was found. The remaining patients suffered from other reproductive organ disorders. Therefore, the laparoscopic examination made detailed recognition of the causes of infertility possible and thus helped to establish the proper treatment. Additionally, in some cases it enabled the immediate removal of the source of infertility.

Adult↗
PubMed1994

Neuroendocrine aspects of epilepsy.

The relationships between the effects of seizures on hormones and the influences of hormones on seizures crosses anatomic boundaries and medical specialties. This article focuses on these interrelationships in men and women with epilepsy. Anatomic and physiologic connections between limbic structures and the hypothalamus are reviewed, as are the neuroendocrine aspects of single seizures and reproductive endocrine disorders.

Endocrine System Diseases↗
PubMedDate not supplied

Medicogenetic features and surgical treatment of patients with congenital malformations of the uterus and vagina.

OBJECTIVE: To analyze clinical examination, surgical treatment, main features of the surgical plan, and course of the early postoperative period and immediate results of surgery in 624 patients with various malformations of the uterus and vagina. METHODS: General clinical examination: endoscopic methods, including hysteroscopy and laparoscopy, cytogenetic and genealogic investigation, estimation of biochemical markers (serum levels) of patients with Müllerian anomalies (polymorphous and monomorphous loci). RESULTS: Karyotype examination revealed that 90.7% of 86 patients examined had normal 46XX karyotype, while sex chromosome mosaicism was present in 9.3% of cases. Genealogic analyses have shown that 39.8% of probands' relatives had reproductive system disorders. Genetic analysis of genealogical trees of patients with malformations of uterus and vagina revealed the recessive type of inheritance. Utilization of up-to-date procedures (hysteroscopy, resectoscopy, laparoscopy) facilitates performing the operations for genital malformations, provides reduction of operation time and postoperative hospital stay, and considerably increases the efficacy of surgical treatment. CONCLUSIONS: Factors of heredity play an important role in etiology of congenital malformation of the uterus and vagina. Modern endoscopic procedures can be successfully used in differential diagnosis of genital malformations, as well as during surgical treatment.

Adolescent↗
PubMedDate not supplied

[Social-hygienic and medico-biological risk factors in spontaneous abortion and infertility].

Statistically significant socio-hygienic and biomedical factors have a far greater impact on miscarriages than on primary and secondary infertility. A conclusion is made that during gestation the organism reacts to a variety of exposures, whereas infertility is a grave disorder of reproductive health which develops as a result of combined exposure to the most potent endogenous and exogenous risk factors. Miscarriages in the workers occupationally exposed to hazardous factors later often transform into stable infertility.

Abortion, Spontaneous↗
PubMed2004

Endometrial morphology and pituitary-gonadal axis dysfunction in women of reproductive age undergoing chronic haemodialysis--a multicentre study.

BACKGROUND: Although disorders of the reproductive system are very common in women undergoing chronic haemodialysis, this issue remains a neglected area. The aim of the study was to evaluate the endometrial morphology and its relationship with pituitary-gonadal axis dysfunction in uraemic women of reproductive age undergoing haemodialysis. METHODS: The baseline survey with determination of the sex hormones concentrations was performed in 75 haemodialysed women aged 18-45 years. The control group consisted of 33 healthy premenopausal women, aged 18-45 years, with normal menstruation. Then, 40 haemodialysis women, who met the inclusion criteria and gave their informed consent, underwent endometrium suction biopsy. RESULTS: The pathological endometrial morphology was observed in 80% of biopsied subjects. Atrophia or subatrophia was recognized in almost half of the cases, and proliferative changes in one-third of them. Full atrophia with no mitotic figures was found in all but one non-menstruating woman. In one case, adenocarcinoma in situ was diagnosed and successfully treated. The analysis of the relationship between hormonal status and endometrial morphology revealed the substantial influence of oestradiol on endometrium as a target organ. In women with atrophic changes, oestradiol concentrations were significantly decreased, whereas in the remaining subjects, the increase of serum oestradiol seemed to be accompanied by a shift in endometrium morphology from secretional pattern, through proliferative changes to glandular hyperplasia. Mean serum 17-beta oestradiol was decreased in women with amenorrhoea, and increased in those with eumenorrhoea (P<0.001). Except women with regular menses, mean serum progesterone concentrations were in the lower normal range. Seventy-five percent of the studied population had menstrual disorders, and amenorrhoea constituted almost a half of them. CONCLUSIONS: Pathological endometrium morphology is very common in uraemic women of reproductive age undergoing haemodialysis, with proliferative changes in one-third and atrophia in almost a quarter of them. The results of the study suggest a preserved normal reactivity of endometrium on circulating oestrogens.

Adolescent↗
PubMed2000

Reproduction in women reporting chronic musculoskeletal disorders.

UNLABELLED: The present population based study assessed aspects of female health as a part of a national cardiovascular screening program in 40-42 year old women in the Sor-Trondelag county. Fertility, events related to the menstrual cycle, reproduction, and the use of contraceptive methods in women reporting musculoskeletal diseases (MSD) were compared to women without these disorders (references). A higher proportion of women with MSD reported subfertility. No significant difference in mean age of menarche or menstrual cycling pattern was found, however women reporting MSD had significantly more often metrorrhagia than references. Mother's age at birth of the first and last child differed from references only in two of the patient groups, and interval between pregnancies was longer in women with MSD. Women with MSD more often chose sterilisation as a contraceptive method. CONCLUSION: Reproduction was altered in women with MSD. It remains to elucidate the interrelationship between rheumatic disorders and gynecological dysfunction.

Adult↗
PubMed1989

[The role of environmental and genetic factors in the development of pathology of the reproductive system in girls].

Genetic and environmental effects on reproductive development of girls are described. Possible genetic involvement is postulated in girls with opsomenorrhea, second-degree amenorrhea and juvenile bleedings. Abnormal development of the menstrual function is more commonly associated with chronic tonsillitis, stress or weight loss. Environmental effects are particularly frequent and pronounced one year before or during the menarche. Central menstrual disorders were associated with parental reproductive disorders in 47% of the cases.

Adolescent↗
PubMedDate not supplied

Course of psychiatric disorders across the menstrual cycle.

Women of reproductive age with psychiatric disorders may experience a fluctuating course of illness over the menstrual cycle. Some data suggest an exacerbation of symptoms during the premenstrual and menstrual phases. The usefulness of such reports is limited, however, by the lack of prospective assessments and the small number of patients involved. Additionally, many reports do not specify whether the exacerbations reflect an intensification of the underlying psychiatric disorder or a new onset of symptoms that occur only during certain phases of the menstrual cycle. Because symptomatic intensification has been reported for illnesses including schizophrenia, bipolar disorder, depression, anxiety disorders, bulimia nervosa, and substance abuse, the data bring attention to the importance of assessing the relationship between a female patient's symptomatic exacerbation and the menstrual-cycle phase in which it occurs. We present a review of the literature on the course of psychiatric symptoms across the menstrual cycle and discuss the potential effects of estrogen and progesterone on these symptoms.

Female↗
PubMed2003

Therapy for polycystic ovarian syndrome.

Polycystic ovarian syndrome is the most common endocrine disorder in women of reproductive age. Women with this disorder exhibit an array of disorders, including oligo-ovulation, hyperandrogenism, obesity, hyperlipidemia, infertility and insulin resistance. Of the sequelae that women experience, insulin resistance is associated with the most profound long-term morbidity. Initially, treatment regimens targeted specific symptomatology in these women, such as oligomenorrhea or hirsutism. With the discovery of the common association between insulin resistance and polycystic ovarian syndrome, however, we are able to utilize a new class of systemically targeted drugs that work on many of the symptoms found in these women.

Contraceptives, Oral↗