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Geburtshilfe Und Frauenheilkunde Jun 2024Breast cancer (BC) stands as a global concern, given its high incidence and impact on women's mortality. This complex disease has roots in various risk factors, some...
Breast cancer (BC) stands as a global concern, given its high incidence and impact on women's mortality. This complex disease has roots in various risk factors, some modifiable and others not. Understanding and identifying these factors can be instrumental in both preventing BC and improving survival rates. Remarkably, women's reproductive behaviors have emerged as critical determinants of BC susceptibility. Numerous studies have shed light on how aspects including age of menarche, first pregnancy and menopause along with number of pregnancies, hormone replacement therapies, can influence one's risk of developing BC. Furthermore, the act of breastfeeding and its duration have shown an inverse relationship with BC risk. This review delves into the biological and molecular mechanisms associated with breastfeeding that contribute to BC protection. It highlights the role of endocrine processes triggered by suckling stimulation, the gradual onset of lactational amenorrhea, delayed weaning, reduced lifetime menstrual cycles, chromosomal repair mechanisms, and immunological events throughout the lactation cycle. These insights provide a potential explanation for the protective effects conferred by breastfeeding against breast carcinomas.
PubMed: 38884025
DOI: 10.1055/a-2313-0637 -
International Journal of Surgery Case... Jun 2024Ectopic pituitary neuroendocrine tumor (EPNET) is a very rare entity, seldom with apoplexy evolution. Only three cases of intracranial ectropic pituitary neuroendocrine...
INTRODUCTION AND IMPORTANCE
Ectopic pituitary neuroendocrine tumor (EPNET) is a very rare entity, seldom with apoplexy evolution. Only three cases of intracranial ectropic pituitary neuroendocrine tumor apoplexy were reported in the literature.
CASE PRESENTATION
We report the case of a 45-year-old woman with a history of amenorrhea, and headaches. Neuroimaging showed a very aggressive giant mass within the clivus with the invasion of the sphenoidal sinus and encasement of internal carotid arteries with an empty sella. Endocrinology work-up revealed an exceedingly high level of prolactin surprisingly without galactorrhea. Immunohistochemical analysis after an endonasal biopsy confirmed the diagnosis of prolactinoma. One month after Cabergoline initiation, an apoplexy of the ectopic pituitary neuroendocrine tumor occurred. Conservational management with a decrease in cabergoline dose was performed.
DISCUSSION
This article highlights data from various cases reported in the literature in addition to our case to confirm the extreme rarity of apoplexy as a complication of EPNET.
CONCLUSION
Pituitary apoplexy in ectopic pituitary neuroendocrine tumor is extremely rare. Therefore, in case of unusual localization of pituitary neuroendocrine tumor, a thorough follow-up is necessary to detect complications and ensure early management.
PubMed: 38878728
DOI: 10.1016/j.ijscr.2024.109874 -
Frontiers in Public Health 2024Low energy availability (LEA) is a state of inadequate energy reserves that results from a negative energy balance. This condition can lead to severe health risks such...
INTRODUCTION
Low energy availability (LEA) is a state of inadequate energy reserves that results from a negative energy balance. This condition can lead to severe health risks such as amenorrhea and osteoporosis. Various causes for LEA, such as eating disorders and exercise addiction, have been reported in the literature. However, data in Saudi Arabia are lacking. This cross-sectional study measures the prevalence of LEA, eating disorders, and exercise addiction among adult females in Saudi Arabia and identifies possible associated risk factors.
METHODS
The sample comprised 119 female athletes who filled out an online survey adapted from the LEA in Females Questionnaire, the Eating Disorder Examination Questionnaire, and the Exercise Addiction Inventory.
RESULTS
Participants showed a high prevalence of LEA (66.4%), eating disorder (33.6%), and exercise addiction (10.1%), confirming the association between normal weight and LEA in females living in Saudi Arabia ( < 0.00).
DISCUSSION AND CONCLUSION
With an increasing number of females in the country interested in following a healthy lifestyle, there is a need to raise the awareness of the population on the issues of LEA, eating disorders, and exercise addiction and their effects on the body by developing educational programs about energy intake and healthy physical activity routines.
Topics: Humans; Female; Saudi Arabia; Cross-Sectional Studies; Athletes; Adult; Feeding and Eating Disorders; Surveys and Questionnaires; Exercise; Prevalence; Risk Factors; Young Adult; Energy Intake; Adolescent; Behavior, Addictive
PubMed: 38873295
DOI: 10.3389/fpubh.2024.1411724 -
Endocrine Journal Jun 2024In the early 2000s, metastin, an endogenous ligand for G protein-coupled receptor 54 (GPR54), was discovered in human placental extracts. In 2003, GPR54 receptor...
In the early 2000s, metastin, an endogenous ligand for G protein-coupled receptor 54 (GPR54), was discovered in human placental extracts. In 2003, GPR54 receptor mutations were found in a family with congenital hypogonadotropic hypogonadism. Metastin was subsequently renamed kisspeptin after its coding gene, Kiss1. Since then, studies in mice and other animals have revealed that kisspeptin is located at the apex of the hypothalamic-pituitary-gonadal axis and regulates reproductive functions by modulating gonadotropin-releasing hormone (GnRH). In rodents, kisspeptin (Kiss1) neurons localize to two regions, the hypothalamic arcuate nucleus (ARC) and the anteroventral periventricular nucleus (AVPV). ARC Kiss1 neurons co-express neurokinin B (NKB) and dynorphin and are thus termed KNDy neurons. Kiss1 neurons in humans are concentrated in the infundibular nucleus (equivalent to the ARC), with few Kiss1 neurons localized to the preoptic area (equivalent to the AVPV), and the mechanisms underlying GnRH surge secretion in humans are poorly understood. However, peripheral administration of kisspeptin to humans promotes gonadotropin secretion, and administration of kisspeptin to patients with hypothalamic amenorrhea or congenital hypogonadotropic hypogonadism restores the pulsatile secretion of GnRH/luteinizing hormone. Thus, kisspeptin undoubtedly plays an important role in reproductive function in humans. Studies are currently underway to develop kisspeptin receptor agonists or antagonists for clinical application. Modification of KNDy neurons by NKB agonists/antagonists is also being attempted to develop therapeutic agents for various menstrual abnormalities, including polycystic ovary syndrome and menopausal hot flashes. Here, we review the role of kisspeptin in humans and its clinical applications.
PubMed: 38866494
DOI: 10.1507/endocrj.EJ24-0006 -
Congenital cervico-vaginal aplasia with a functional uterus: A case report and review of literature.SAGE Open Medical Case Reports 2024Maldevelopment of the vagina and cervix is frequently accompanied by uterine aplasia or hypoplasia. Complete cervico-vaginal aplasia with a normally developing uterus is...
Maldevelopment of the vagina and cervix is frequently accompanied by uterine aplasia or hypoplasia. Complete cervico-vaginal aplasia with a normally developing uterus is a very uncommon type of developmental failure. Failure to treat the condition can result in complications such as hematometra and hematosalpinx caused by the retrograde flow of blood into the fallopian tubes. In this case report, we describe the case of a 32-year-old woman experiencing cyclic abdominal pain and primary amenorrhea. The patient exhibited cervico-vaginal agenesis, with a functional uterus that was complicated by hematometra and bilateral hematosalpinx.
PubMed: 38864032
DOI: 10.1177/2050313X241260217 -
Journal of Medical Case Reports Jun 2024Currently, there is a scarcity of cases and diagnostic data regarding ectopic adrenocortical adenomas, particularly in relation to their impact on gonadal function and... (Review)
Review
BACKGROUND
Currently, there is a scarcity of cases and diagnostic data regarding ectopic adrenocortical adenomas, particularly in relation to their impact on gonadal function and localization diagnostic techniques. We report a typical case of ectopic adrenocortical adenomas and the data of treatment follow-up, and review the literature of 31 available cases of ectopic adrenocortical adenomas.
CASE PRESENTATION
A 27-year-old Chinese female patient was admitted to our hospital for hypertension, hyperglycaemia and primary amenorrhea. The patient was functionally diagnosed with ACTH-independent CS and hypogonadotropic hypogonadism. Radiological evaluations, including Computed Tomography (CT) and functional imaging, identified a mass at the left renal hilum. Histological assessments post-surgical excision confirmed the mass to be an ectopic adrenocortical adenoma. A subsequent 3-month follow-up showed no signs of disease recurrence, a swift recovery of the cortisol axis was observed, with a partial recuperation of the gonadal axis.
REVIEW
Our literature review shows that the most common ectopic areas of cortisol adenomas are renal hilum and hepatic region. The most positive biomarker is Melan A, and only a few cases have been diagnosed with functional localization.
CONCLUSION
Ectopic adrenocortical adenomas may be asymptomatic in the early stage and can impact gonadal function. Physicians who treat hypogonadism must be aware of the need to test cortisol levels and perform functional localization in patients with lumps present.
Topics: Humans; Female; Adult; Hypogonadism; Adrenocortical Adenoma; Adrenal Cortex Neoplasms; Tomography, X-Ray Computed; Hydrocortisone
PubMed: 38863038
DOI: 10.1186/s13256-024-04595-z -
Sports Medicine - Open Jun 2024Endurance exercise has the potential to affect reproductive function, with amenorrhea in female athletes. However, most studies focus on women. Evidence on the...
BACKGROUND
Endurance exercise has the potential to affect reproductive function, with amenorrhea in female athletes. However, most studies focus on women. Evidence on the association between endurance exercise and male fertility is limited.
OBJECTIVE
To synthesise existing literature on exercise-induced alterations in semen parameters and to assess the clinical impact on male fertility.
METHODS
Studies reporting on the association between semen parameters and endurance exercise in healthy men were eligible. Men attending fertility clinics were excluded. We searched MEDLINE (PubMed), Embase, SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and International Clinical Trials Registry Platform (ICTRP) from their inception to May 28th 2022. JBI Critical Appraisal Tool was used to assess the potential risk of bias.
RESULTS
Thirteen studies met inclusion criteria, reporting on 280 subjects. Eight articles reported on endurance runners, three on cyclists and four on triathletes. Four studies did not find any statistically significant sperm alterations. Five reported significant changes in semen parameters, but these were not clinically relevant, as semen parameters remained well above World Health Organisation (WHO) thresholds. Four articles reported a decrease in semen quality with potential clinical consequences as they found a reduced number of sperm cells exhibiting normal morphology in cyclists and triathletes and a greater amount of DNA fragmentation in triathletes.
CONCLUSION
Endurance exercise can have a negative effect on semen quality, although rarely with a clinically relevant impact on male fertility. Evidence is however limited, with poor quality of the included studies.
REGISTRATION
PROSPERO International prospective register of systematic reviews (CRD42022336753).
PubMed: 38861008
DOI: 10.1186/s40798-024-00739-z -
PloS One 2024Physique competitions are weight-sensitive sports in which stage presentation, aesthetic appearance and posing ability of the athletes are judged rather than physical...
Menstrual cycle disorders as an early symptom of energy deficiency among female physique athletes assessed using the Low Energy Availability in Females Questionnaire (LEAF-Q).
Physique competitions are weight-sensitive sports in which stage presentation, aesthetic appearance and posing ability of the athletes are judged rather than physical performance. The aim of this study was to assess low energy availability among female physique athletes by using the LEAF-Q. The study involved 104 females who were physique athletes. Monthly cycle disorders were reported in 58.65% of the women, that is periods stopped for three consecutive months or longer (amenorrhea). This situation occurred before the research was conducted in 43.27% of athletes and during the research in 15.38%. The physique athletes claimed that menstruation changes occurred when there was an increased exercise intensity, frequency or duration. Absence from training due to injury was reported by 27.88% of the women. The LEAF-Q identified 46.15% of the physique athletes as at risk (score ≥ 8) of low energy availability and the physiological consequences related to RED-S. Women who had menstrual cycle disorders were younger and did more training per week. Among women with menstrual disorders, cramps or stomach ache which cannot be related to menstruation occurred more frequently (p = 0.004). Absence from training or lack of participation in competition due to injuries occurred more frequently in the score ≥ 8 group (p = 0.024) thank the ≤ score 8 group. In the score ≥ 8 group menstruation changes, that is less bleeding or cessation of menstruation (p = 0.035), occurred more frequently when there was an increase in exercise intensity, frequency or duration (p = 0.002).
Topics: Humans; Female; Athletes; Menstruation Disturbances; Adult; Young Adult; Surveys and Questionnaires; Adolescent; Menstrual Cycle; Relative Energy Deficiency in Sport; Exercise; Energy Metabolism
PubMed: 38848428
DOI: 10.1371/journal.pone.0303703 -
Annals of Medicine and Surgery (2012) Jun 2024Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital anomaly characterized by the absence of the uterus and the upper two-thirds of the vagina. It is a rare...
INTRODUCTION
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital anomaly characterized by the absence of the uterus and the upper two-thirds of the vagina. It is a rare congenital anomaly with an incidence of 1 in 5000 female live births.
CASE SERIES
The authors describe three cases of females presenting with primary amenorrhoea who were diagnosed with MRKH syndrome. The patients were managed with McIndoe's vaginoplasty with neovagina creation with an amnion graft.
DISCUSSION
Management of MRKH syndrome involves vaginoplasty with neovagina creation. The approach to neovagina creation can be done surgically or non-surgically. Non-surgical creation of the vaginal cavity involves serial use of vaginal dilators, while there are several ways for surgical creation of neovagina. The modified Abbe-McIndoe procedure using amnion to create neovagina is a minimally invasive, rapid, and simple procedure with no risk of immune rejection because the amnion membrane lacks histocompatibility antigens. In addition, the graft is also readily available, storable, and inexpensive.
CONCLUSION
Diagnosis of MRKH syndrome can be made when a young female with primary amenorrhoea and normal secondary sexual characteristics has agenesis of the uterus, and upper two-thirds of the vagina revealed on ultrasonography or magnetic resonance imaging. The patient can be offered treatment with vaginoplasty with neovagina creation.
PubMed: 38846829
DOI: 10.1097/MS9.0000000000001877