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PubMed1996

Does weight-bearing exercise protect against the effects of exercise-induced oligomenorrhea on bone density?

Does weight-bearing exercise offset bone loss associated with oligomenorrhea? If so, bone mineral density (BMD) will be stable at weight bearing sites but decrease at non-weight-bearing sites with increasing duration of oligomenorrhea. To test this hypothesis, BMD (g/cm2), was measured by dual-energy X-ray absorptiometry in 41 oligomenorrheic ballet dancers aged 17.7 +/- 0.2 years (mean +/- SEM) and 46 age-matched controls with normal menstrual function. BMD correlated negatively with the duration of oligomenorrhea at weight-bearing and non-weight-bearing sites (femoral neck, r = -0.33, p < 0.05; Ward's triangle, r = -0.29, p = 0.06; trochanter, r = -0.33, p < 0.05; lumber spine, r = -0.25, p = 0.1; skull, r = -0.29, p = 0.06; arms, r = -0.32, p < 0.05; ribs, r = -0.30, p = 0.06). The slopes of the regression of BMD on duration of oligomenorrhea were greater at the proximal femur (trochanter, -0.28 +/- 0.13, femoral neck, -0.24 +/- 0.11; Ward's triangle, -0.29 +/- 0.15) than the skull (-0.15 +/- 0.08, p < 0.05, p < 0.1, p < 0.1 respectively). The slopes at the trochanter and femoral neck were also greater than at the ribs (-0.10 +/- 0.05; both p < 0.1). In the dancers with oligomenorrhea of less than 40 months duration, BMD was higher than the age-predicted mean at weight-bearing sites (except the lumber spine), but not at non-weight-bearing sites (femoral neck, 9.1 +/- 3.4%; Ward's triangle, 10.0 +/- 1.7%; trochanter, 9.4 +/- 4.1%, all p < 0.05; lumbar spine, -2.1 +/- 2.7%, NS; skull, -2.5 +/- 2.1%, NS; ribs, -3.0 +/- 1.6% NS; arms, -3.9 +/- 1.6%; p < 0.05). In the dancers with greater than 40 months oligomenorrhea, BMD was no higher than the age predicted mean, at the weight bearing sites, and was lower at non-weight bearing sites (femoral neck, 4.3 +/- 2.3%, NS; Ward's triangle, 3.5 +/- 3.2%, NS; trochanter, 2.1 +/- 2.7%, NS; lumbar spine, -3.8 +/- 2.1%, NS; arms, -7.5 +/- 0.8%, p < 0.05; skull, -6.2 +/- 1.8%, p < 0.01; ribs, -5.4 +/- 1.1%, p < 0.0001). In conclusion, weight-bearing exercise is unlikely to offset the deleterious effects of oligomenorrhea. Bone loss appears to occur at all sites but may begin from a higher level at weight-bearing sites and may proceed more rapidly.

Absorptiometry, Photon↗
PubMed1981

Minor müllerian anomalies and oligomenorrhea in infertile women. A new syndrome.

Because a causal relationship was suspected between mild müllerian anomalies and oligomenorrhea-amenorrhea, the hysterosalpingograms of 134 consecutive infertility patients were reviewed. The review was blind with respect to menstrual pattern and other data. Mild müllerian anomalies of the uterus were exhibited in 21.6%; and among them, 58.6% had oligomenorrhea or amenorrhea. By comparison, oligomenorrhea or amenorrhea was found in only 19.6% of the remainder of infertility patients with normal uterine cavities (p less than 0.01). The association between mild müllerian anomalies and oligomenorrhea is further confirmed by the latter being idiopathic in 82.4% of these patients, in contrast to 30% of the group with normal uteri (p less than 0.01). Perusal of the literature shows that this relationship does not appear to have been substantiated previously, but occasionally it has been mentioned as a chance coincidence. On the basis of the patient's hormonal status and studies of the literature, the author advances the hypothesis of a defect in the steroid receptor proteins in the congenitally somewhat deformed uterus, in explanation of these patients' oligomenorrhea. The conclusion is that there must be a hitherto unheeded syndrome of fairly mild müllerian anomalies and eugonadotropic oligomenorrhea with demonstrable ovulation in infertile or low-fertility women. Perhaps, an increased tendency to abortion in the first or second trimester is another characteristic of this syndrome.

Adult↗
PubMed1997

Testosterone concentrations and oligomenorrhea in women with acne.

BACKGROUND: Androgen excess is frequently associated with oligomenorrhea as well as acne. Oligomenorrhea in hirsute women has been demonstrated to be associated with higher active testosterone levels than found in eumenorrheic hirsute women. This study was designed to evaluate whether similar findings are present in women with acne. Forty-four consecutive women with acne were evaluated by measuring their levels of total testosterone, biologically active testosterone, and free testosterone. The women with oligomenorrhea and acne had significantly higher levels of biologically active testosterone than those with eumenorrhea and acne. This implies that biological active testosterone should be measured in oligomenorrheic women with acne and, if elevated, consideration should be given to antiandrogen therapy. METHODS: Data were collected from 44 consecutive Caucasian women aged 14 to 38 years. The patients were separated into two groups based on menstrual history. Group 1 had regular menses, and group 2 had oligomenorrhea, defined as menstrual intervals of greater than 36 days. All patients had blood samples drawn on their initial office visit, regardless of the phase of the menstrual cycle, and the levels of total testosterone (TT), biologically active testosterone (BT), and free testosterone (FT) were obtained. RESULTS: The serum TT level was 87 +/- 41.3 ng/dL (range, 31-150 ng/dL) in oligomenorrheic women and 56 +/- 27.5 ng/dL (range 8-107 ng/dL) in eumenorrheic women. There was no statistically significant difference. The serum BT level in oligomenorrheic women was 33 +/- 16.9 ng/dL (range, 11-51 ng/dL) and in eumenorrheic women 19 +/- 13.6 ng/dL (range, 11-51 ng/dL). This difference was statistically significant (p < 0.05). The serum FT level in oligomenorrheic women was 18 +/- 9.4 pg/mL (range, 1-29 pg/mL) and in eumenorrheic women 10 +/- 7.1 pg/mL (range, 1-32 pg/mL). This difference was not statistically significant (Table 1). CONCLUSIONS: Women with acne and oligomenorrhea, similar to women with hirsutism and oligomenorrhea, have higher levels of biologically active testosterone than those with normal menses.

Acne Vulgaris↗
PubMed1998

[Has oligomenorrhea a pathological meaning? The importance of this symptom in internal medicine].

BACKGROUND: Oligomenorrhea, defined as a menstrual cycle lasting 36 to 90 days, can be a normal condition in the first years after the menarche. When it persists or appears after a period of normal menstrual cycles, an underlying illness must be sought. AIM: To assess ovulation and causes of anovulatory cycles in women with oligomenorrhea, compared with causes of secondary amenorrhea. PATIENTS AND METHODS: One hundred one women of less the 35 years old, presenting with oligomenorrhea persisting 5 years after menarche or lasting more than two years after a period of normal menstrual cycles, were studied. Ovulation was studied measuring serial plasma progesterone during normal or induced (with intramuscular progesterone) menstrual cycles. RESULTS: Eighty nine percent of women had anovulatory oligomenorrhea. The main causes were polycystic ovarian disease in 51% and hypothalamic dysfunction in 31%. Thirty percent of women with secondary amenorrhea had polycystic ovarian disease and 14% had hyperprolactinemia. Women older than 20 years old or with more than 10 years of gynecological age had a higher frequency of polycystic ovarian disease and a lower prevalence of hypothalamic dysfunction. CONCLUSIONS: There is a high frequency of anovulatory oligomenorrheas. Therefore, this symptom deserves a thorough endocrinological assessment to uncover underlying diseases. Special attention must be paid to polycystic ovary syndrome, due to its importance in internal medicine as a risk factor for myocardial infarction, high blood pressure, and type 2 diabetes mellitus.

Adolescent↗
PubMed1983

Fundal contour of the uterine cavity in the new syndrome of minor müllerian anomalies and oligomenorrhea. A prospective controlled study.

A prospective, controlled, and blinded study was instituted (1) to demonstrate the relationship found previously between mild müllerian anomalies and oligomenorrhea or amenorrhea in another population of infertile or low-fertility women, (2) to substantiate and define the degree of uterine anomaly in patients with this new syndrome, and (3) to demonstrate that fundal anomalies in the patients are not secondary to mechanical trauma. Twenty consecutive patients with oligomenorrhea or amenorrhea, 44 consecutive infertility patients, and 19 patients who underwent hysterosalpingography (HSG) for other reasons made up the study group. A mild uterine developmental anomaly was demonstrated on revision of the HSG films in 50% of the patients with oligomenorrhea or amenorrhea as compared with (1) 25% of the infertility patients with normal menstrual intervals (p less than 0.05) and (2) none of the patients who underwent HSG for other reasons (p less than 0.025). The height (H) of the fundal excavation was less than 10% of the line (L) connecting the peaks of the uterine horns (H/L ratio) on all hysterosalpingograms, which gave rise to doubt whether the uterine contour was normal or abnormal. This applied to five patients with normal whether the uterine contour was normal or abnormal. This applied to five patients with mild müllerian anomalies, the H/L ratio was greater than 0.100 and the mean values for patients with oligomenorrhea and normal intervals were 0.187 and 0.165, respectively (p greater than 0.05). On this basis, it is suggested that the limit between abnormal and normal contour at HSG should perhaps be fixed at an H/L ratio of 0.100. There was no finding in the present study to indicate that the uterine anomalies were secondary to previous curettage, therapeutic abortion, operations on the uterus, or pelvic inflammatory disease.

Adult↗
PubMed1994

Endocrine profile of women with amenorrhea and oligomenorrhea.

OBJECTIVES: To find out the common causes of amenorrhea and oligomenorrhea in south Indian women and to draw up a protocol for evaluation of women with these problems. METHODS: A retrospective study of 426 women with amenorrhea and oligomenorrhea was carried out. RESULTS: Forty-one patients had primary amenorrhea, 132 had secondary amenorrhea and 289 women presented with oligomenorrhea. Hypergonadotropic amenorrhea and congenital absence of the uterus and vagina accounted for 60% of primary amenorrhea. Chronic anovulatory disorders and premature ovarian failure were found in 72% of women with secondary amenorrhea but weight loss related amenorrhea was uncommon. CONCLUSIONS: On the basis of the observations made, a protocol for evaluation and management of women with amenorrhea and oligomenorrhea was evolved.

Adult↗
PubMed2003

Hormonal profile of women with self-reported symptoms of oligomenorrhea and/or hirsutism: Northern Finland birth cohort 1966 study.

The hormonal profiles of nested female patients (n = 500) with self-reported symptoms typical of polycystic ovary syndrome (PCOS), oligomenorrhea, and/or hirsutism and their randomly selected controls (n = 1026) at the age of 31 yr were analyzed in a general population-based Northern Finland birth cohort 1966 to find out whether the symptomatic women also have the endocrine characteristics of PCOS and could be detected in a general population using simple questions. Higher medians of serum testosterone (T) (2.10 vs. 1.90 nmol/liter, P < 0.001), LH (5.40 vs. 4.85 U/liter, P = 0.005), insulin (53.8 vs. 51.66 pmol/liter, P = 0.040), and free androgen index (FAI) (4.01 vs. 3.03, P < 0.001) and lower glucose/insulin ratio (91.1 x 10(8) vs. 94.9 x 10(8), P = 0.048) and SHBG (52.4 vs. 60.7 nmol/liter, P < 0.001) were observed among the cases, but no difference was observed in cortisol and glucose levels between the cases and controls. Of all the women in the cohort, 10.2% reported only oligomenorrhea and had biochemical findings similar to the whole case group. Those who reported only hirsutism (10.4%) were in between the case and control groups according to biochemical findings. The subjects who reported both oligomenorrhea and hirsutism (3.4%) had the highest T, LH, FAI, insulin, and glucose and the lowest SHBG and glucose/insulin ratio, compared with the case group and the groups with either symptom only indicating a dose-response manner in typical endocrine profile of PCOS by adding up symptoms. The levels of T and FAI were higher and SHBG lower in groups with overweight or obesity both at 14 and 31 yr, compared with groups with normal weight at 14 yr and overweight or obesity at 31 yr. In the group with normal weight at 14 and 31 yr and the group with overweight or obesity at 14 yr but normal weight at 31 yr, the levels of T and FAI were lowest and SHBG highest. T and FAI were higher and SHBG lower among the cases than the controls in groups stratified by weight development from adolescence to adulthood. In conclusion, this longitudinal study of a large, stable population indicates that women with self-reported symptoms of hirsutism and/or oligomenorrhea show endocrine characteristics of PCOS and can be detected in a general population using simple questions. These symptoms are markers of the underlying metabolic alterations possibly associated with increased health risks in later life.

Adult↗
PubMed2004

Metabolic cardiovascular disease risk factors in women with self-reported symptoms of oligomenorrhea and/or hirsutism: Northern Finland Birth Cohort 1966 Study.

The metabolic cardiovascular disease (CVD) risk factors of women with self-reported oligomenorrhea and/or hirsutism, which are symptoms of polycystic ovary syndrome (PCOS), were investigated in a general population-based Northern Finland Birth Cohort 1966 Study to determine whether women with PCOS symptoms at 31 yr would be distinguishable from asymptomatic controls in terms of CVD risk factors. A total of 518 cases with oligomenorrhea and/or hirsutism and 1036 randomly selected controls were analyzed. C-Reactive protein (CRP; median, 0.70 vs. 0.60 mg/liter; P = 0.026), triglycerides (mean, 0.97 vs. 0.91 mmol/liter; P = 0.039), body mass index (BMI; mean, 25.1 vs. 24.2 kg/m(2); P < 0.001), and waist/hip ratio (mean, 0.82 vs. 0.81; P = 0.001) were significantly higher, and high-density lipoprotein cholesterol levels were lower (mean, 1.60 vs. 1.66 mmol/liter; P = 0.002) in the cases compared with the controls. Total cholesterol, low-density lipoprotein cholesterol, and blood pressure showed no statistically significant differences between the cases and the controls. In terms of metabolic CVD risk factors, women reporting hirsutism alone were indistinguishable from the control group, and those who reported both oligomenorrhea and hirsutism had the most severe changes in risk factor profiles. Because obesity is strongly related to PCOS symptoms, the analyses were stratified by BMI. After stratification into normal weight (BMI, <25 kg/m(2)), overweight (25 kg/m(2) or=30 kg/m(2)) groups, the waist/hip ratio was significantly higher among the overweight cases (mean, 0.84 vs. 0.83; P = 0.04). Among the obese women, high-density lipoprotein cholesterol was significantly lower (mean, 1.32 vs. 1.48 mmol/liter; P = 0.002) among the cases, and triglycerides tended to be higher (mean, 1.43 vs. 1.27 mmol/liter; P = 0.068) than in controls. In conclusion, these results indicate that self-reported symptoms of oligomenorrhea and/or hirsutism, particularly in the presence of both symptoms, may be helpful to identify women with metabolic cardiovascular risk factor accumulation associated with PCOS.

Adult↗
PubMed1991

[Characteristics of the functional state of different sections of the autonomic nervous system and their role in the pathogenesis of oligomenorrhea].

Analysis of the clinical picture of oligomenorrhea and of the results of studies of the function of various sections of the autonomic nervous system (ANS) in 58 patients of a reproductive age has revealed differences in these functions, related to the time of menstrual disorders onset. Oligomenorrhea patients with menarche complained of cardiovascular, respiratory, and emotional-motivational disorders, examinations have revealed in them dysfunctional disorders and reduced reserve potentials of both ANS sections. In oligomenorrhea patients in whom the condition developed at the age of 18-25 after a period of regular menstruations the effects of various stress factors resulted in reduction of the functional activity of the ergotropic (sympathoadrenal) section of the ANS. Differences in the pathogenetic mechanisms of oligomenorrhea development in the two groups of patients are discussed.

Adolescent↗
PubMedDate not supplied

Hysteroscopic evaluation and endocrinological aspects of women with müllerian anomalies and oligomenorrhea.

In a prospective study of 28 consecutive patients with oligomenorrhea, two had uterus didelphys, and the incidence of mild müllerian anomalies was 50.0%, assessed by hysterosalpingography (HSG). The objects of the study were (1) to confirm these müllerian anomalies hysteroscopically, (2) to assess the predictive value of an abnormal and a normal fundal contour on the HSG, and (3) to find anamnestic, chromosomal, or hormonal characteristics, if any, for women with oligomenorrhea and müllerian anomalies. Twelve patients underwent HSG followed by hysteroscopy, at which a septum or fundal convexity was confirmed in six out of seven patients in whom HSG had shown a mild to moderate indentation of the fundus, but showed no such sign in any of the five patients in the control group in whom the uterine contours had been normal on the HSG (P less than .01). There were no evident anamnestic, chromosomal, or hormonal characteristics for women having uterine developmental anomalies and oligomenorrhea, but there was a major or minor shift in certain androgenic metabolites in some of the patients in this group. It is concluded that HSG seems of great value in diagnosing uterine septa, but hysteroscopy afforded more precise information concerning the degree of fundal anomaly. Longitudinal, more standardized studies are needed for further elucidation of the etiology of the oligomenorrhea in these patients.

Adult↗
PubMed1995

Gymnasts exhibit higher bone mass than runners despite similar prevalence of amenorrhea and oligomenorrhea.

Female athletes exhibit a higher prevalence of exercise-associated amenorrhea and oligomenorrhea compared with nonathletic women, and both conditions are related to reduced bone mineral density (BMD), particularly at the spine. This study investigated bone mass and oligomenorrhea and amenorrhea in two groups of competitive female athletes with different skeletal loading patterns: gymnasts and runners. Bone mineral density (g/cm2) of the femoral neck, lumbar spine (L2-4), and whole body was assessed by dual energy X-ray absorptiometry (QDR-1000/W, Hologic Inc., Waltham, MA) in collegiate gymnasts (n = 21) and runners (n = 20), and nonathletic college women (n = 19). The runners and gymnasts had similar values for percent body fat (14.7 +/- 2.2% and 15.6 +/- 2.9%, respectively), which were lower (p < 0.001) than controls (22.3 +/- 3.0%). Lean body mass (LBM) did not differ among the groups, but when adjusted for body surface area, gymnasts had a higher LBM/height2 (p = 0.0001) compared with runners and controls. Muscle strength was significantly greater (p < 0.05) in gymnasts for quadriceps, biceps, and hip adductor force, compared with runners and controls. Gymnasts had a significantly later menarche age (16.2 +/- 1.7 years) compared with runners (14.4 +/- 1.7 years) and controls (13.0 +/- 1.2 years). The prevalence of oligo- and amenorrhea was 47% for gymnasts (6 amenorrheic, 4 oligomenorrheic), 30% for runners (3 amenorrheic, 3 oligomenorrheic), and 0% for controls. Furthermore, athletic groups had similar menstrual histories given the higher proportion of gymnasts who had experienced primary amenorrhea. When evaluated since menarche, however, runners had somewhat longer histories due to an earlier age at menarche and slightly older ages. Dietary calcium intake did not differ among groups, although mean values were below the RDA of 1200 mg/day. By athletic group, BMD at any site did not differ among women with amenorrhea versus oligomenorrhea versus eumenorrhea, although there was a trend for the regularly menstruating athletes in both groups to have slightly higher values. Lumbar spine BMD was lower (p = 0.0001) in runners (0.98 +/- 0.11 g/cm2) compared with both gymnasts and controls (1.17 +/- 0.13 and 1.11 +/- 0.11 g/cm2, respectively). Femoral neck BMD differed among all groups (p = 0.0001): gymnasts = 1.09 +/- 0.12 g/cm2 > controls = 0.97 +/- 0.10 g/cm2 > runners = 0.88 +/- 0.11 g/cm2. Whole body BMD was lower (p < 0.01) in runners (1.04 +/- 0.06 g/cm2) compared with gymnasts and controls (1.11 +/- 0.08 and 1.09 +/- 0.06 g/cm2, respectively).(ABSTRACT TRUNCATED AT 400 WORDS)

Absorptiometry, Photon↗
PubMed1982

Prevalence of oligomenorrhea and amenorrhea in a college population.

Menstrual disorders in college students have been reported as higher than in the general population. Several reasons, among them calorie-restricted diets, strenuous exercise, and college-related stress, have been attributed to this increased prevalence. During the period November, 1979, to January, 1980, 991 of 1,420 college students completed questionnaires which inquired about their menstrual history. The prevalence of oligomenorrhea in this group was 11.3% and that of amenorrhea was 2.6%. Significant factors associated with oligomenorrhea or amenorrhea in this group were weight loss (greater than 20 pounds) and jogging. In most women with oligomenorrhea or amenorrhea, menstrual irregularity was present prior to college entry. With the use of self-administered questionnaires, we could not identify any specific college stress to account for the presence of menstrual abnormalities in a college population.

Adolescent↗
PubMed1976

Obesity and oligomenorrhea are associated with hyperandrogenism independent of hirsutism.

Obesity, oligomenorrhea, and hirsutism are frequently associated with high plasma androgen levels and/or low testosterone-binding globulin (TEBG) levels. Studied have been undertaken to determine the extent to which each of these clinical features may be related to this hormonal profile. Indexes of plasma free (unbound) androgen levels were focused upon because this fraction appears to be the biologically active portion of the plasma androgens. The hormonal profile was normal in women with either obesity or oligomenorrhea alone and abnormal in those with severe hirsutism alone. On striking new finding was that subjects with the combination of obesity and oligomenorrhea had elevated plasma total and free androgens and depressed TEBG even in the absence of hirsutism. Furthermore, the androgen levels were higher in obese oligomenorrheic women with mild hirsutism than in severely hirsute women who were not obese. Plasma estradiol concentrations were normal in these obese women. A simple explanation for elevated free plasma androgen levels in obese women who were oligomenorrheic yet had little if any hirsutism is not possible. The data are compatible with the concept that obesity is a variably expressed manifestation of slightly elevated plasma free androgen levels or that obesity is an incidental finding which somehow blunts the effect of high androgen levels on hair follicles. Regardless of the explanation, oligomenorrheic obese women must be suspected of having high androgen production even in the absence of hirsutism.

Adult↗
PubMedDate not supplied

Multiple ovarian cysts and oligomenorrhea as the initial manifestations of a gonadotropin-secreting pituitary macroadenoma.

OBJECTIVE: To report a case of a follicle-stimulating hormone (FSH)-secreting pituitary adenoma, which manifested with oligomenorrhea, dysmenorrhea, and multiple bilateral ovarian cysts. METHODS: We present a case report of a 29-year-old woman, including detailed laboratory, radiologic, and pathologic findings, who was diagnosed as having an FSH-secreting pituitary tumor. The pertinent literature is also reviewed. RESULTS: A 29-year-old woman, after experiencing oligomenorrhea and increasing abdominal girth for >1 year, presented with an acute abdomen. Ultrasonography revealed multicystic ovaries >15 cm in maximal diameter, causing bilateral adnexal torsion. After bilateral ovarian cystectomies, ultrasound study showed recurrence of the cysts. Relevant laboratory data were as follows: serum FSH 6.8 mIU/mL, luteinizing hormone 0.1 mIU/mL, prolactin 67 ng/mL, human chorionic gonadotropin <2 mIU/mL, progesterone 3.5 ng/dL, estradiol 237 pg/mL, thyrotropin 1.8 microIU/mL, testosterone <4 ng/dL, insulin 8.0 microIU/mL, and fasting plasma glucose 87 mg/dL. Magnetic resonance imaging (MRI) of the brain revealed a 2.5-cm pituitary mass, although the patient had no symptoms of pituitary dysfunction. Transsphenoidal removal of the mass was performed, and pathology studies were positive for FSH-secreting adenoma. Repeated MRI at 3 months showed an 0.8-cm residual tumor. The patient refused adjuvant radiotherapy. Regular menses resumed within 2 months postoperatively, and she later successfully became pregnant. Almost 3 years after treatment, the patient remained asymptomatic, results of pituitary function tests were normal, and follow-up MRI showed no signs of tumor regrowth. CONCLUSION: Although very uncommon, gonadotropin-secreting pituitary adenomas should be considered in the differential diagnosis of new-onset oligomenorrhea and dysmenorrhea, especially if associated with multicystic ovaries on ultrasound study, even in the absence of elevated levels of serum gonadotropins. Furthermore, we propose that it may be acceptable to withhold adjuvant radiotherapy in patients who are asymptomatic after transsphenoidal surgical excision of these tumors.

Adenoma↗
PubMed1975

Study of a kindred with thyroxine-binding globulin deficiency and oligomenorrhea.

The finding of a low total thyroxine level in an oligomenorrheic woman uncovered a new family with thyroxine-binding globulin deficiency and oligomenorrhea. Thirteen of 17 family members had the deficiency of thyroxine-binding globulin, with heterozygous female subjects showing overlap of levels with normal subjects. Oligomenorrhea was frequently found but segregated separately from the thyroxine-binding globulin deficiency; of seven women with low levels, three had normal monthly menstrual cycles. Fertility was not impaired.

Adolescent↗
PubMed1991

Androgens and oligomenorrhea in hirsute women.

A recent study demonstrated that hirsute women with irregular menses had higher levels of serum androgens that hirsute women with regular menses. To investigate this finding, we measured total testosterone, biologically active testosterone, free testosterone, androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone sulfate in 51 hirsute women with regular menses and compared the levels found to those found in 28 hirsute women with oligomenorrhea. There was no significant difference in the degree of facial hirsutism between the two groups. Oligomenorrheic women had significantly higher levels of free testosterone (p less than 0.02) and biologically active testosterone (p less than 0.05). The other androgens did not differ significantly between the two groups. The free fractions of testosterone are the metabolically active forms of the hormone and their levels are a function of the rates of production and clearance of testosterone that are elevated in states of hyperandrogenism. This study confirms that hirsute women with oligomenorrhea have higher levels of free and biologically active testosterone than those with regular menses.

Androgens↗
PubMed2003

Hyperandrogenicity is an alternative mechanism underlying oligomenorrhea or amenorrhea in female athletes and may improve physical performance.

OBJECTIVE: To evaluate endocrine mechanisms underlying oligomenorrhea or amenorrhea in female athletes. DESIGN: Cross-sectional study. SETTING: Women's health clinical research unit at a university hospital. PATIENT(S): Age- and BMI-matched groups of athletes active in endurance sports with and without menstrual disturbances and regularly cycling sedentary controls. INTERVENTION(S): Groups were compared with respect to endocrine status, body composition, and physical performance. MAIN OUTCOME MEASURE(S): Identification of a subgroup of oligomenorrheic or amenorrheic athletes with increased androgen levels and anabolic body composition. RESULT(S): A subgroup of 8 of 25 athletes with menstrual disturbances had significantly higher serum levels of free and total testosterone, androstenedione, LH-FSH ratio, and lower SHBG levels than did all other groups. Other oligomenorrheic or amenorrheic athletes had normal values comparable to those in regularly menstruating athletes and controls. The hyperandrogenic subgroup showed a more anabolic body composition, with higher total bone mineral density and upper-lower fat mass ratio than did oligomenorrheic or amenorrheic athletes with normal androgen levels. The hyperandrogenic subgroup had the highest VO2 max and the highest performance values in general. CONCLUSION(S): Menstrual disturbances in female athletes are often explained as a consequence of hypothalamic inhibition and caloric deficiency. We suggest that essential hyperandrogenism is an alternative mechanism underlying oligomenorrhea or amenorrhea in some female athletes and may imply an advantage for physical performance.

Adult↗
PubMed1980

Oligomenorrhea in adolescent girls.

Forty-two patients ages 15 to 20 years (average 17.3 years) were evaluated for oligomenorrhea. Group I consisted of 19 patients with evidence of androgen excess (hirsutism, clitoromegaly, acne); and Group II included 23 patients without evidence of androgen excess. Sixteen of the 19 patients in Group I had elevated serum LH and normal FSH values. Serum total testosterone concentration was elevated in 12 patients and free T was elevated in one additional patient. In nine patients urinary 17KS excretion was elevated and dexamethasone suppressible. For the purpose of treatment, patients in Group I were divided into three subgroups: IA, polycystic ovary syndrome--12 patients; IB, adrenal block--two patients; IC, combined adrenal and ovarian hyperandrogenism--five patients. Among the 23 Group II patients, four had persistently elevated serum LH and normal FSH values, suggesting PCO; three had menopausal levels of LA and FSH; one had hyperprolactinemia and a depressed floor of the pituitary sella; and the remaining 15 patients had low to normal serum levels of LH and FSH, consistent with hypothalamic suppression. Guidelines for the diagnosis and treatment of adolescents with oligomenorrhea are discussed on the basis of these findings.

17-Ketosteroids↗