Effects of nutrition on human reproduction.
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Birth Weight↗
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Results for “Reproductive disorders”
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Status of current research on endometriosis.
Endometriosis, a benign gynecologic disorder, occurs in about 10% of women of reproductive age and in up to 50% of women with infertility. Endometriosis is defined as the presence of endometrial glandular and stromal cells outside their normal location in the uterus. Commonly affected areas in the abdominopelvic cavity include the ovaries, the cul-desac and other kinds of pelvic peritoneum, bowel and diaphragm. Rarely is it found in extraabdominal sites, including the pleura and pericardium. While it is not a malignant disorder, endometriosis exhibits cellular proliferation, cellular invasion and neoangiogenesis. The steroid hormone dependence of endometriosis is underscored by its appearance during the reproductive years. Furthermore, the progress of this enigmatic disease can be tempered by administration of antiestrogens, inhibitors of endogenous estradiol production, and hormonal and surgical castration. It is a disorder that markedly affects well-being and physical and emotional health in women. Research on the pathogenesis of endometriosis currently interfaces with four areas of basic research, including the fields of genetics, environmental science, cancer biology and immunology. Here we focus on current research in the latter two disciplines and their relevance to endometriosis research.
Cytokines↗
Differential menstrual cycle regulation of hypothalamic-pituitary-adrenal axis in women with premenstrual syndrome and controls.
Previous studies in animals indicate that reproductive steroids are potent modulators of the hypothalamic-pituitary-adrenal (HPA) axis, a physiologic system that is typically dysregulated in affective disorders, such as major depression. Determination of the role of reproductive steroids in HPA axis regulation in humans is of importance when attempting to understand the pathophysiology of premenstrual syndrome (PMS), a disorder characterized by affective symptoms during the luteal phase of the menstrual cycle. We performed two studies using treadmill exercise stress testing to determine the effect of menstrual cycle phase and diagnosis on the HPA axis in women with PMS and controls and the role of gonadal steroids in HPA axis modulation in control women. The results of these studies indicate that women with PMS fail to show the normal increased HPA axis response to exercise during the luteal phase and that progesterone, not estradiol, produces increased HPA axis response to treadmill stress testing in control women. These data demonstrate that women with PMS, when symptomatic, appear to have an abnormal response to progesterone and, furthermore, do not display the HPA axis abnormalities characteristic of major depression.
Adrenocorticotropic Hormone↗
Coevolution of male and female reproductive traits in a simultaneously hermaphroditic land snail.
Inter- and intraspecific studies in gonochoristic animals reveal a covariation between sperm characteristics and the size of the female reproductive tract, indicating a rapid evolutionary divergence, which is consistent with the theory of post-copulatory sexual selection. Simultaneous hermaphrodites differ from species with separate sexes (gonochorists) in that they possess both functional male and female reproductive organs at the same time. We investigated whether in hermaphroditic animals intraspecific variation in reproductive traits results from divergent coevolution, by quantifying the variation in male and female traits among six natural populations of the snail Arianta arbustorum and examining the covariation in interacting traits. There was a significant among-population variation in spermatophore volume, number of sperm transferred and sperm length, as well as in volume of the sperm storage organ (spermatheca) and number of tubules, but not in spermatheca length. We found a positive association between sperm number transferred and spermatheca volume. This result suggests that the same post-copulatory mechanisms as in gonochorists drive the correlated evolution of reproductive characters in hermaphrodites.
Animals↗
[Autosomal translocation in gynaecology and obstetrics. 1. Reproduction behaviour and chance of chromosomal translocation carriers (author's transl)].
Nineteen chromosal translocations (1.8 per cent) were recorded from 1,055 chromosomal analyses, between 1972 and 1980. Three translocations were unbalanced. Their carriers were no longer suitable for reproduction for the severity of their chromosomally caused disorders. Another three translocation carriers declined to have children of their own by voluntary decision or due to functional disorders, although they had been carriers of balanced translocations. Thirteen translocation carriers insisted on having children. With 41 pregnancies reviewed, abortion was the result of 58.5 per cent, birth of still malformations of 12.2 per cent, birth of living malformations in 7.3 per cent, and birth of clinically intact children in 22 per cent (three cases of balanced translocation). There were five D/G translocations and three D/D translocations. All the other translocations were singular. Only one in seven pregnancies of D/G translocation carriers (4 +/- 0.8) resulted in the birth of a clinically intact child. One in three pregnancies of other translocation carriers (2.6 +/- 0.3) yielded the same result. Female translocation carriers were 1.6 times as frequent as males. Their rates of abortion and malformation were twice as high as those of other women. -Clinically intact children were born only to nine of 13 couples, notwithstanding prenatal diagnosis. Handicapped children were recorded from 23 per cent of the couples reviewed. The need is emphasised for psychological guidance of such couples which should be offered by the attending gynaecologist.
Abortion, Spontaneous↗
Risk factors for retained placenta and the effect of retained placenta on the occurrence of postpartum diseases and subsequent reproductive performance in dairy cows.
The objectives of this study were to determine the risk factors for retained placenta by evaluating several reproductive factors in individual cows, and to determine the effects of retained placenta on the occurrence of postpartum diseases and subsequent reproductive performance in dairy herds. The health status, cow parity, calving, and breeding dates were recorded from 805 calvings in nine dairy herds from October 2000 to March 2004. We used logistic regression to evaluate the effects of these factors on the incidence of retained placenta. A stepwise procedure, used to obtain the appropriate model with alpha = 0.05, revealed that abnormal partus and gestation length were important risk factors for retained placenta. The occurrence of endometritis and metabolic disorders was greater (p<0.01) in the group with retained placentas than in the control group. The mean intervals from calving to first service and conception were prolonged (p<0.05) by 7 and 18 days, respectively, in the group with retained placentas compared to the control group. These results suggest that abnormal partus and gestation length are strongly correlated with the development of retained placenta, which increases the occurrence of postpartum diseases and subsequently decreases reproductive performance in dairy herds.
Animals↗
Special issues related to the treatment of depression in women.
Depressive disorders in women are commonly associated with reproductive events. This association may be due in part to the changing balance between estrogen, progesterone, and other hormones that affect neurotransmitter function throughout a woman's lifecycle. Alternatively, they may be related to psychosocial events surrounding these pivotal times or to both sets of conditions. Some data suggest that depression in women tends to respond differently to antidepressant treatment than depression in men, underscoring the need to examine the risk and treatment of depressive disorders in males and females separately. Women have benefited considerably from serotonin reuptake inhibitor anti-depressants that are currently available. These agents appear to be more effective than the older tricyclic antidepressants in treating various depressive disorders that occur commonly or exclusively in women. Additionally, serotonin reuptake inhibitors have increased tolerability in women, who generally experience more adverse effects from tricyclics and monoamine oxidase inhibitors than do men. Estrogen appears to enhance antidepressant response in postmenopausal women receiving estrogen replacement therapy. More research is needed, however, that examines how the balance between estrogen, progesterone, and other hormones affects neurotransmitter function.
Adult↗
Recognizing women's common mental health problems: the earthquake assessment model.
Women's reproductive events may coincide with the onset of a mood or anxiety disorder or the exacerbation of a previously existing one due to the interconnection of neurotransmitters, stress, and reproductive hormones. The women's health nurse plays a critical role in the identification of mood and anxiety disorders during a woman's life span. This article provides nurses with a mental health assessment model, describes the common mood and anxiety disorders, and discusses simple management and referral strategies.
Adolescent↗
Testing the Paleolithic-human-warfare hypothesis of blood-injection phobia in the Baltimore ECA Follow-up Study--towards a more etiologically-based conceptualization for DSM-V.
OBJECTIVE: The research agenda for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has emphasized the need for a more etiologically-based classification system, especially for stress-induced and fear-circuitry disorders. Testable hypotheses based on threats to survival during particular segments of the human era of evolutionary adaptedness (EEA) may be useful in developing a brain-evolution-based classification for the wide spectrum of disorders ranging from disorders which are mostly overconsolidationally such as PTSD, to fear-circuitry disorders which are mostly innate such as specific phobias. The recently presented Paleolithic-human-warfare hypothesis posits that blood-injection phobia can be traced to a "survival (fitness) enhancing" trait, which evolved in some females of reproductive-age during the millennia of intergroup warfare in the Paleolithic EEA. The study presented here tests the key a priori prediction of this hypothesis-that current blood-injection phobia will have higher prevalence in reproductive-age women than in post-menopausal women. METHOD: The Diagnostic Interview Schedule (version III-R), which included a section on blood and injection phobia, was administered to 1920 subjects in the Baltimore ECA Follow-up Study. RESULTS: Data on BII phobia was available on 1724 subjects (1078 women and 646 males). The prevalence of current blood-injection phobia was 3.3% in women aged 27-49 and 1.1% in women over age 50 (OR 3.05, 95% CI 1.20-7.73). [The corresponding figures for males were 0.8% and 0.7% (OR 1.19, 95% CI 0.20-7.14)]. CONCLUSIONS: This epidemiological study provides one source of support for the Paleolithic-human-warfare (Paleolithic-threat) hypothesis regarding the evolutionary (distal) etiology of bloodletting-related phobia, and may contribute to a more brain-evolution-based re-conceptualization and classification of this fear circuitry-related trait for the DSM-V. In addition, the finding reported here may also stimulate new research directions on more proximal mechanisms which can lead to the development of evidence-based psychopharmacological preventive interventions for this common and sometimes disabling fear-circuitry disorder.
Adult↗
The Norplant condition: protecting the unborn or violating fundamental rights?
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California↗
Maintaining the violinist: a mother's obligations to the fetus she decides to keep.
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Abortion, Induced↗
Dysgerminoma in a mentally ill patient, with infantile reproductive organs and infantile secondary sex characters.
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Dysgerminoma↗
[Disorders of penile erection and their treatment].
With a prevalence of 1 to 2% among males of reproductive age, erectile dysfunction is relatively common. For the patient and his partner, erectile disorders may represent a highly stressful situation. Frequently, a number of overlapping causes may be found to be responsible, with a psychological component--which may also arise secondarily--being involved in nearly every form of erectile dysfunction. Possible causes, the diagnostic approach and therapeutic options are discussed.
Erectile Dysfunction↗
Age and the prevalence of bleeding disorders in women with menorrhagia.
OBJECTIVE: A study was conducted to evaluate the frequency and types of hemostatic defects occurring in adolescent and perimenopausal-age women diagnosed with menorrhagia. METHODS: A total of 115 women with a physician diagnosis of menorrhagia, including 25 adolescent women, 25 perimenopausal-age women, and 65 women between the ages of 20 and 44, underwent comprehensive hemostatic testing for possible bleeding disorders. Frequencies of bleeding disorders were calculated and compared. RESULTS: Forty-seven percent of women were found to have hemostatic abnormalities, including platelet dysfunction, von Willebrand's disease, and coagulation factor deficiencies. Adolescents and perimenopausal-age women with menorrhagia were just as likely to have hemostatic abnormalities as were women aged 20 to 44. CONCLUSION: These results demonstrate that underlying bleeding disorders are frequently found in adolescent, postadolescent reproductive age, and perimenopausal-age women presenting with menorrhagia and suggest that women with menorrhagia should be considered for further hemostatic evaluation.
Adolescent↗
Sporadic sexual reproduction: sex to some degree.
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Animals↗
Overview of orofacial pain: epidemiology and gender differences in orofacial pain.
Chronic orofacial pain is a prevalent problem that encompasses numerous disorders with diverse causes and presenting symptoms. Compared with men, women of reproductive age seek treatment for orofacial pain conditions, as well as other chronic pain disorders more frequently. Important issues have been raised regarding gender and sex differences in genetic, neurophysiologic, and psychosocial aspects of pain sensitivity and analgesia. Efforts to improve our understanding of qualitative sex differences in pain modulation signify a promising step toward developing more tailored approaches to pain management.
Analgesia↗
Anxiety disorders in women.
Women have higher overall prevalence rates for anxiety disorders than men. Women are also much more likely than men to meet lifetime criteria for each of the specific anxiety disorders: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), simple phobia, panic disorder, and agoraphobia. Considerable evidence suggests that anxiety disorders remain underrecognized and undertreated despite their association with increased morbidity and severe functional impairment. Increasing evidence suggests that the onset, presentation, clinical course, and treatment response of anxiety disorders in women are often distinct from that associated with men. In addition, female reproductive hormone cycle events appear to have a significant influence on anxiety disorder onset, course, and risk of comorbid conditions throughout a woman's life. Further investigations concerning the unique features present in women with anxiety disorders are needed and may represent the best strategy to increase identification and optimize treatment interventions for women afflicted with these long-neglected psychiatric disorders.
Agoraphobia↗
Women and reproductive-related trauma.
Women are at higher risk for developing posttraumatic stress disorder (PTSD) than men, leading to significant psychosocial burden and healthcare-related costs. Research has shown an association between the negative impact of traumatic experiences and the reproductive life cycle in women. Pregnant women with a history of abuse/trauma frequently report intrusive reemergence of symptoms. Women who experience miscarriage may present with even higher prevalence rates of PTSD symptoms. Both psychologic and physiologic factors are believed to be relevant to the development of peripartum posttraumatic stress symptoms. Much less is known, however, about treatment. A case series of patients who presented with PTSD symptoms in the context of reproductive-related traumatic events (e.g., miscarriage, stillbirth) or who experienced reemergence of symptoms during pregnancy is presented, including treatment strategies.
Abortion, Spontaneous↗