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Journal of Pediatric and Adolescent... Dec 2018Primary ovarian insufficiency (POI) in adolescents not due to cytotoxic therapy has not been well studied. Causes of POI have been described in adults, but adolescents... (Review)
Review
STUDY OBJECTIVE
Primary ovarian insufficiency (POI) in adolescents not due to cytotoxic therapy has not been well studied. Causes of POI have been described in adults, but adolescents might represent a unique subset necessitating a targeted approach to diagnosis, workup, and treatment. We sought to better characterize adolescent POI through a descriptive multicenter study.
DESIGN
Case series of patients with POI.
SETTING
Six tertiary care institutions.
PARTICIPANTS
Patients presenting from 2007 to 2014 aged 13-21 years diagnosed with noncytotoxic POI, with exclusions for those who received gonadotoxic therapy, with 46XY gonadal dysgenesis, or lack of evidence of hypergonadotropic hypogonadism on chart review.
INTERVENTIONS
Review and data extraction of records identified according to International Classification of Diseases Ninth or Tenth Revision codes.
MAIN OUTCOME MEASURES
Data were analyzed for signs and symptoms, workup, and treatments. Complete workup was on the basis of American College of Obstetricians and Gynecologists guidelines. Characteristics of patients with POI who presented with delayed puberty/primary amenorrhea vs secondary amenorrhea were compared.
RESULTS
One hundred thirty-five records were identified. Those who had received cytotoxic therapy (n = 52), 46XY gonadal dysgenesis (n = 7), or on review did not have POI (n = 19) were excluded. Of 57 remaining cases, 16 were 45X, 2 had galactosemia, and 4 had X-chromosome abnormalities. Most did not undergo full etiologic evaluation. Girls diagnosed after primary amenorrhea/delayed puberty were less symptomatic and more likely to receive an estrogen patch than those diagnosed after secondary amenorrhea.
CONCLUSION
Noncytotoxic POI in adolescents is an uncommon condition with, to our knowledge, only 64 cases in 6 institutions over 7 years. These patients might not undergo complete etiological workup. Aside from 45X, the most common etiologies were X-chromosome abnormalities or galactosemia.
Topics: Adolescent; Amenorrhea; Female; Gonadal Dysgenesis; Humans; Primary Ovarian Insufficiency; Puberty, Delayed; Young Adult
PubMed: 29940314
DOI: 10.1016/j.jpag.2018.06.006 -
Fertility and Sterility Nov 2006Amenorrhea is the absence or abnormal cessation of the menses. Primary and secondary amenorrhea describe the occurrence of amenorrhea before and after menarche,... (Review)
Review
Amenorrhea is the absence or abnormal cessation of the menses. Primary and secondary amenorrhea describe the occurrence of amenorrhea before and after menarche, respectively.
Topics: Amenorrhea; Female; Follicle Stimulating Hormone; Humans; Hyperprolactinemia; Hypothalamic Diseases; Menarche; Polycystic Ovary Syndrome; Primary Ovarian Insufficiency; Prolactin; Thyrotropin
PubMed: 17055812
DOI: 10.1016/j.fertnstert.2006.08.013 -
Obstetrics and Gynecology Clinics of... Mar 2000Eating disorders are relatively common and frequently result in gynecologic abnormalities. The gynecologist must appreciate the various manifestations of these complex... (Review)
Review
Eating disorders are relatively common and frequently result in gynecologic abnormalities. The gynecologist must appreciate the various manifestations of these complex health problems as well as the biopsychosocial approach needed to help the adolescent or young adult woman recover from these chronic conditions. By recognizing both the medical and gynecologic aspects of eating disorders, the oversimplified viewpoint of considering these conditions as purely psychiatric disorders can be avoided. Open and consistent communication with patients, with a focus on health rather than dysfunction and mental illness, facilitates the acceptance of a comprehensive approach involving the gynecologist, dietitian, and mental health provider.
Topics: Adolescent; Adult; Amenorrhea; Feeding and Eating Disorders; Female; Humans; Sex Offenses
PubMed: 10693185
DOI: 10.1016/s0889-8545(00)80009-1 -
BMJ Sexual & Reproductive Health Jan 2021
Topics: Aftercare; Amenorrhea; Female; Humans; Polycystic Ovary Syndrome; Referral and Consultation; Ultrasonography; Young Adult
PubMed: 32546579
DOI: 10.1136/bmjsrh-2020-200600 -
Fertility and Sterility Mar 2016To identify factors associated with cancer treatment-induced amenorrhea and time to return of menses.
OBJECTIVE
To identify factors associated with cancer treatment-induced amenorrhea and time to return of menses.
DESIGN
Population-based cohort study.
SETTING
Not applicable.
PATIENT(S)
Female cancer survivors who were diagnosed with cancer between the ages of 20 and 35 and were at least 2 years postdiagnosis at the time of recruitment (median = 7 years; interquartile range, 5-11).
INTERVENTION(S)
None.
MAIN OUTCOME MEASURE(S)
Amenorrhea (≥6 months without menses) and resumption of menses.
RESULT(S)
After excluding women with hysterectomies before cancer diagnosis, 1,043 women were eligible for analysis. Amenorrhea occurred in 31.6% of women. Among women treated with chemotherapy (n = 596), older age at diagnosis (30-35 vs. 20-24 years: adjusted odds ratio [aOR] = 2.37; 95% confidence interval [CI], 1.30, 4.30) and nulligravidity (vs. gravid: aOR = 1.50; 95% CI, 1.02, 2.21) were risk factors for amenorrhea. Among amenorrheic women, menses resumed in most (70.0%), and resumption occurred within 2 years of treatment for 90.0% of women. Survivors of breast cancer were more likely to resume menses at times greater than 1 year compared with lymphoma and pelvic-area cancers. Women diagnosed at older ages, those exposed to chemotherapy, and those exposed to any radiation experienced longer times to return of menses. Women who were older at diagnosis were more likely to have irregular cycles when menses returned.
CONCLUSION(S)
Treatment-induced amenorrhea is common in cancer survivors, although most women resume menses within 2 years. However, once resumed, older women are more likely to have irregular cycles. Age at diagnosis and pregnancy history affect the risk of amenorrhea.
Topics: Adult; Age Factors; Amenorrhea; Antineoplastic Agents; Female; Georgia; Humans; Logistic Models; Menstrual Cycle; Neoplasms; Odds Ratio; Parity; Pregnancy; Proportional Hazards Models; Radiation Injuries; Radiotherapy; Registries; Risk Factors; Survivors; Time Factors; Treatment Outcome; Young Adult
PubMed: 26658130
DOI: 10.1016/j.fertnstert.2015.11.020 -
The Western Journal of Medicine Feb 1995The Council on Scientific Affairs of the California Medical Association presents the following epitomes of progress in physical medicine and rehabilitation. Each item,...
The Council on Scientific Affairs of the California Medical Association presents the following epitomes of progress in physical medicine and rehabilitation. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and clinical importance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, and scholars to stay abreast of progress in medicine, whether in their own field of special interest or another.The epitomes included here were selected by the Advisory Panel to the Section on Physical Medicine and Rehabilitation of the California Medical Association, and the summaries were prepared under the direction of Murray E. Brandstater, MD, and the panel.
Topics: Amenorrhea; Feeding and Eating Disorders; Female; Humans; Osteoporosis; Sports
PubMed: 7725687
DOI: No ID Found -
Fertility and Sterility Dec 1981Since women have become more involved in physical fitness and competitive endurance sports, the incidence of menstrual dysfunction has increased. Long-distance running... (Review)
Review
Since women have become more involved in physical fitness and competitive endurance sports, the incidence of menstrual dysfunction has increased. Long-distance running and other sports may lead to alterations in gonadotropins, androgens, estrogens, progesterone, or prolactin, which in some women may directly or indirectly result in amenorrhea or infertility. The effects of running and strenuous exercise on the menstrual cycle and reproductive hormones remain controversial. Reported incidences of menstrual dysfunction vary widely, and many factors have been implicated in the onset of this problem. Exercise associated menstrual dysfunction seems to occur more frequently in nulliparous athletes, in athletes with delayed menarche, and in athletes with low body fat. It is important to realize that disruption of the menstrual cycle, ranging from mild changes in flow to amenorrhea, is a relatively common problem for the female athlete engaged in strenuous endurance sports. Yet no evidence exists at present to indicate conclusively that this menstrual dysfunction is harmful to the female athlete's reproductive system.
Topics: Adipose Tissue; Adolescent; Adult; Amenorrhea; Child; Female; Hormones; Humans; Infertility, Female; Menarche; Menstruation Disturbances; Pregnancy; Running; Sports Medicine
PubMed: 7030795
DOI: 10.1016/s0015-0282(16)45908-x -
Annals of Medicine Apr 1993The contraceptive effect of breast-feeding is the single most important determinant of human population growth rates in traditional societies without access to modern... (Review)
Review
The contraceptive effect of breast-feeding is the single most important determinant of human population growth rates in traditional societies without access to modern forms of contraception; lactational amenorrhoea is Nature's contraceptive. Even today, breast-feeding still prevents more pregnancies than all modern forms of contraception in many developing countries. Afferent neural inputs from the nipple pass via the spinal cord to the hypothalamus, where they cause a local release of beta endorphin. This acts to depress GnRH secretion, thereby inhibiting pituitary gonadotrophin secretion, ovarian follicular development, ovulation and menstruation. The hypothalamic beta endorphin release also inhibits dopamine production, resulting in increased pituitary prolactin secretion. The higher the suckling frequency, the more beta endorphin that is released and hence the longer the duration of lactational amenorrhoea. Lactational amenorrhoea can be relied up to give over 98% contraceptive protection to breast-feeding women in the first 6 months postpartum, regardless of their nutritional status or the time of first supplement introduction to the baby. This is because the first postpartum menstruation usually precedes the first ovulation during these early months. Once menstruation has resumed, lactation's contraceptive effect can no longer be relied upon, even though the woman continues to breast-feed. In breast-feeding women whose amenorrhoea extends beyond 6 months, there is an increasing tendency for the first ovulation to precede the first menstruation, thereby decreasing the reliability of lactational amenorrhoea as a contraceptive. Nevertheless, many women who continue to breast-feed may still have up to 1-2 years of good contraceptive protection from prolonged lactational amenorrhoea.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Amenorrhea; Australia; Breast Feeding; Contraception; Developing Countries; Europe; Family Planning Services; Female; Humans; Postpartum Period; Pregnancy; United States
PubMed: 8489757
DOI: 10.3109/07853899309164164 -
Journal of Obstetric, Gynecologic, and... 1990Abnormal genital bleeding and secondary amenorrhea (cessation of menses) are common gynecologic complaints that can indicate serious physical problems. Abnormal genital... (Review)
Review
Abnormal genital bleeding and secondary amenorrhea (cessation of menses) are common gynecologic complaints that can indicate serious physical problems. Abnormal genital bleeding is the most common reason for a gynecological office visit and a leading indication for dilatation of the cervix and curettage of the uterus. One of four women with abnormal genital bleeding may have serious physical problems. Although pregnancy is the most common cause of secondary amenorrhea, other conditions related to abnormal pregnancy, functional disorders, physiological changes, or pathology also must be considered. Procedures for evaluating abnormal genital bleeding and secondary amenorrhea are discussed. Information is provided to assist nurses in collecting and assessing data and planning interventions to promote the health of women with these common problems.
Topics: Adolescent; Adult; Amenorrhea; Female; Humans; Menstrual Cycle; Middle Aged; Nursing Assessment; Uterine Hemorrhage
PubMed: 2405118
DOI: 10.1111/j.1552-6909.1990.tb02523.x -
BMJ (Clinical Research Ed.) Oct 1996
Topics: Amenorrhea; Family Planning Services; Female; Humans; Lactation; Postpartum Period
PubMed: 8876083
DOI: 10.1136/bmj.313.7062.893