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    Recombinant follicle-stimulating hormone (follitropin alfa) for ovulation induction in Japanese patients with anti-estrogen-ineffective oligo- or anovulatory infertility: results of a phase II dose-response study.
    Reprod Med Biol 2010 Jun 23;9(2):91-97. Epub 2009 Dec 23.
    Department of Obstetrics and GynecologyShowa University School of MedicineTokyoJapan.
    Purpose: To determine the optimal regimen of recombinant human follicle-stimulating hormone (r-hFSH) for ovulation induction (OI) in Japanese women with amenorrhea I or anovulatory infertility.

    Methods: In this randomized, double-blind, dose-finding study, women aged 20-39 years were enrolled. Patients underwent a chronic low-dose step-up regimen with starting doses of r-hFSH of 37. Read More

    Successful Management of Abdominal Pregnancy: Two Case Reports.
    Oman Med J 2018 Mar;33(2):171-175
    Department of Obstetrics and Gynecology, Dubai Hospital, Dubai, UAE.
    Abdominal pregnancy is a rare, life-threatening condition defined as pregnancy in the peritoneal cavity exclusive of tubal, ovarian, or intraligamentary locations. It can be primarily located in the peritoneal cavity or secondary to a ruptured ectopic pregnancy or tubal abortion. We present two cases of abdominal pregnancy, one primary and another secondary, both diagnosed and successfully managed in our institution. Read More

    Migration and its influence on the knowledge and usage of birth control methods among Afghan women who stay behind.
    Public Health 2018 Apr 10. Epub 2018 Apr 10.
    Maastricht University, Maastricht Graduate School of Governance/UNU-MERIT, The Netherlands.
    Objective: The objective of this article is to investigate the link between migration and knowledge and use of birth control methods among female household members (of migrants) who stay behind in Afghanistan. Migrants can remit birth control information received in the destination country to non-migrants staying in the origin country, who may as a consequence adjust their health behaviour accordingly. The consequences of this interaction for knowledge and use are what we aim to test. Read More

    Clinico-hysteroscopic analysis of severe intrauterine adhesions among Nigerian infertile women.
    Pan Afr Med J 2017 14;28:226. Epub 2017 Nov 14.
    Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria.
    Introduction: Severe intrauterine adhesions are difficult to manage and are associated with poor reproductive outcomes following treatment. The objective was to study the clinical presentation and hysteroscopic findings of severe intrauterine adhesions seen at hysteroscopy in two fertility/gynaecological endoscopy units in Nigeria.

    Methods: A prospective study of 19 out of 76 women managed for intrauterine adhesions in our units. Read More

    Efficacy and safety of pulsatile gonadotropin-releasing hormone therapy among patients with idiopathic and functional hypothalamic amenorrhea: a systematic review of the literature and a meta-analysis.
    Fertil Steril 2018 Apr 28;109(4):708-719.e8. Epub 2018 Mar 28.
    Department of Reproductive Endocrinology, Alexandra Hospital, University of Athens, Athens, Greece.
    Objective: To systematically review and appraise the existing evidence in relation to the efficacy and safety of pulsatile gonadotropin-releasing hormone (pGnRH) for the treatment of women with hypothalamic amenorrhea (HA).

    Design: Systematic review and meta-analysis.

    Setting: Not applicable. Read More

    Low Bone Mineral Density in Elite Female Athletes With a History of Secondary Amenorrhea in Their Teens.
    Clin J Sport Med 2018 Mar 27. Epub 2018 Mar 27.
    Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.
    Objective: To determine whether secondary amenorrhea during teenage years influences bone mineral density (BMD) in female athletes in their 20s.

    Design: Original research.

    Setting: Japan Institute of Sports Sciences. Read More

    The traditional medicine aspects, biological activity and phytochemistry of Arnebia spp.
    Med Glas (Zenica) 2018 Feb;15(1):1-9
    Department of Pharmacognosy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
    Arnebia, a sub cosmopolitan and important genus of the Boraginaceae family, comprises 25 species distributed among the world. Based on the studies of Persian medicine texts, there are some promising bioactivities for this genus that is unknown in modern medicine and some of them are still the basis of new remedies. This article presents Arnebia according to the most important ancient information by the most famous Persian medicine books like Makhzan Al Advieh, Tohfat Al-Momenin, Al-Qanun, Al-Seidaneh and Ekhtiarate Badiei. Read More

    Ulipristal acetate for uterine fibroids: 2 years of real world experience in a UK hospital.
    J Obstet Gynaecol 2018 Mar 12:1-5. Epub 2018 Mar 12.
    a Department of Obstetrics and Gynaecology , Birmingham Heartlands Hospital NHS Trust, Birmingham Heartlands Hospital , Birmingham , UK.
    Ulipristal acetate (UPA), is a selective progesterone-receptor modulator, it decreases fibroid size and reduces menstrual bleeding. We reviewed its use at the Heart of England Foundation Trust (HEFT), one of the largest prescribing trusts in the UK. The electronic records of patients treated with UPA from January 2013 to August 2015 were reviewed. Read More

    A novel, homozygous mutation in () in a 46, XY patient with dysgenetic testes presenting with primary amenorrhoea: a case report.
    Int J Pediatr Endocrinol 2018 2;2018. Epub 2018 Mar 2.
    1Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, WA Australia.
    Background: () mutations have been described in only a limited number of individuals with 46, XY disorders of sex development (DSD) presenting as either partial or complete gonadal dysgenesis. Gonadal tumours and peripheral neuropathy have been associated with mutations. Herein we report a novel, homozygous mutation of identified through a targeted, massively parallel sequencing (MPS) DSD panel, in a patient presenting with partial gonadal dysgenesis. Read More

    Levonorgestrel emergency contraceptive pills use during breastfeeding; effect on infants' health and development.
    J Matern Fetal Neonatal Med 2018 Feb 20:1-5. Epub 2018 Feb 20.
    a Department of Obstetrics and Gynecology , Faculty of Medicine, Assiut University , Assiut , Egypt.
    Objective: The current study aims to evaluate the effect of the use of single packet of levonorgestrel emergency contraceptive pills (LNG-ECPs) during breastfeeding on the health and development of the nursing infant.

    Materials And Methods: The current study was an ancillary observational cohort study carried out in a university hospital. We counseled all women delivered and planning birth-space and breastfeed for at least 1 year for participation during postpartum hospital stay. Read More

    Adverse effects of doping with anabolic androgenic steroids (AAS) in competitive athletics, recreational sports and bodybuilding.
    Minerva Endocrinol 2018 Feb 19. Epub 2018 Feb 19.
    Centre of Reproductive Medicine and Andrology, University Hospital Münster, Muenster, Germany -
    Despite the fact that sports organizations and legislators have introduced various mechanisms to discourage athletes from using performance and appearance enhancing substances a high percentage of athletes admits to their unabated application. In competitive athletics, bodybuilding and in recreational sports anabolic androgenic steroids (AAS) continue to be the substances most abused. This review summarizes the side effects of AAS abuse on organs and system functions in both sexes. Read More

    Cause or Coincidence? Spontaneous Hematometra in Young Women on Depomedroxyprogesterone Acetate: A Small Case Series.
    J Pediatr Adolesc Gynecol 2018 Feb 14. Epub 2018 Feb 14.
    Department of Obstetrics & Gynecology, Queen's University, Kingston ON, Canada.
    Background: Abdominal pain, secondary amenorrhea and abnormal uterine bleeding (AUB) are common gynecologic presentations in adolescence. Rarely this can be associated with an acquired hematometra. Hematometra is a condition of retained blood or clot within the uterus. Read More

    Adrenal myelolipoma with hyperandrogenemia and schizophrenia.
    Cancer Manag Res 2018 1;10:177-180. Epub 2018 Feb 1.
    Department of Urology, Peking University Third Hospital, Beijing, China.
    Adrenal myelolipoma with hyperandrogenemia is extremely rare. We report a case of a 26-year-old Chinese female with schizophrenia, who presented with a hormonally active tumor causing hyperandrogenemia. The mass was found by computerized tomography when she had her gynecologic examination for secondary amenorrhea, and it was confirmed to be an adrenal myelolipoma after a histopathological study. Read More

    A Case of Primary Amenorrhea with Swyer Syndrome.
    J Hum Reprod Sci 2017 Oct-Dec;10(4):310-312
    Department of Obstetrics and Gynaecology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India.
    Swyer syndrome with complete gonadal dysgenesis is associated with an absence of testicular differentiation in a phenotypic female with a 46, XY karyotype. A 14-year-old unmarried girl was referred with complaints of primary amenorrhea and nondevelopment of breast. Her built was normal. Read More

    Ulipristal Acetate for Treatment of Symptomatic Uterine Leiomyomas: A Randomized Controlled Trial.
    Obstet Gynecol 2018 Mar;131(3):431-439
    George Washington University School of Medicine, Women's Health & Research Consultants, Washington, DC; Uniformed Services University of the Health Sciences, Bethesda, Maryland; Johns Hopkins University School of Medicine, Baltimore, Maryland; Allergan plc, Madison, New Jersey; and Augusta University, Augusta, Georgia.
    Objective: To assess efficacy and tolerability of ulipristal acetate, a selective progesterone receptor modulator, for treatment of symptomatic uterine leiomyomas.

    Methods: This phase 3, double-blind, placebo-controlled study enrolled premenopausal women (aged 18-50 years) with abnormal uterine bleeding, one or more discrete leiomyomas, and uterine size 20 weeks of gestation or less. Patients were randomized 1:1:1 to 5 mg ulipristal, 10 mg ulipristal, or placebo once daily for 12 weeks followed by 12-week drug-free follow-up. Read More

    Mayer-Rokitansky-Kuster-Hauser Syndrome: A Unique Case Presentation.
    Mil Med 2018 Feb 5. Epub 2018 Feb 5.
    Department of Obstetrics and Gynecology, San Antonio Military Medical Center 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX 78234.
    Background: Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a congenital condition characterized by aplasia of the vagina with or without concurrent uterine and/or cervical aplasia. Type II (MURCS) is a rare form involving MUllerian agenesis, Renal agenesis, and Cervicothoracic Somite anomalies.

    Case: A 17-yr-old virginal female presented for evaluation of primary amenorrhea and pelvic pain. Read More

    Case report: an identical twin with Sertoli-Leydig cell tumor.
    Gynecol Endocrinol 2018 Jan 24:1-4. Epub 2018 Jan 24.
    a Department of Obstetrics and Gynaecology, Division of Reproductive Endocrinology and Infertility , University of British Columbia , Vancouver , Canada.
    Our report details the workup and management of a 43-year-old woman with an identical twin who presented with 2 years of virilization and secondary amenorrhea. Serum total testosterone was elevated. An MRI did not identify adnexal or adrenal pathology. Read More

    Sequential versus simultaneous use of chemotherapy and gonadotropin-releasing hormone agonist (GnRHa) among estrogen receptor (ER)-positive premenopausal breast cancer patients: effects on ovarian function, disease-free survival, and overall survival.
    Breast Cancer Res Treat 2018 Apr 13;168(3):679-686. Epub 2018 Jan 13.
    Department of Breast Surgery, Fudan University Shanghai Cancer Center, 270 Dongan Road, Xuhui, 200032, Shanghai, People's Republic of China.
    Objective: To investigate ovarian function and therapeutic efficacy among estrogen receptor (ER)-positive, premenopausal breast cancer patients treated with gonadotropin-releasing hormone agonist (GnRHa) and chemotherapy simultaneously or sequentially.

    Method: This study was a phase 3, open-label, parallel, randomized controlled trial (NCT01712893). Two hundred sixteen premenopausal patients (under 45 years) diagnosed with invasive ER-positive breast cancer were enrolled from July 2009 to May 2013 and randomized at a 1:1 ratio to receive (neo)adjuvant chemotherapy combined with sequential or simultaneous GnRHa treatment. Read More

    Successful detection of SRY gene via fine needle biopsy: A case of extragenital gestational choriocarcinoma in the kidney.
    Mol Clin Oncol 2017 Dec 18;7(6):1057-1060. Epub 2017 Oct 18.
    Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8641, Japan.
    The current report describes a case of extragenital gestational choriocarcinoma in the kidney. A 36-year-old woman with a history of two deliveries of male babies visited the present hospital due to secondary amenorrhea following a positive urinary pregnancy test. Despite a high serum level of human chorionic gonadotropin, at 51,800 mIU/ml, diagnostic imaging methods and pathological examination did not detect any conceptus in the genital tract. Read More

    Etiology and management of primary amenorrhoea: A study of 102 cases at tertiary centre.
    Taiwan J Obstet Gynecol 2017 Dec;56(6):761-764
    Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
    Objective: To determine the prevalence of etiologic causes of primary amenorrhea in Indian population.

    Materials And Methods: A retrospective study was performed using 102 complete medical records of women with primary amenorrhea who attended the Gynaecologic Endocrinology Clinic, Department of Obstetrics and Gynaecology, AIIMS, New Delhi from September 2012 to September 2015. Cases were analysed according to clinical profile, development of secondary sexual characteristics, physical examination, pelvic and rectal examination, X-ray of chest and lumbo-sacral spine, hormone profile, pelvic USG, MRI, and cytogenetic study including karyotype. Read More

    Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility.
    Cochrane Database Syst Rev 2017 11 29;11:CD003053. Epub 2017 Nov 29.
    Department of Obstetrics and Gynaecology, The General Infirmary of Leeds, United Leeds Teaching Hospitals NHS Trust, Belmont Grove, Leeds, UK, LS2 9NS.
    Background: Polycystic ovary syndrome (PCOS) is characterised by infrequent or absent ovulation, and high levels of androgens and insulin (hyperinsulinaemia). Hyperinsulinaemia occurs secondary to insulin resistance and is associated with increased risk of cardiovascular disease and diabetes mellitus. Insulin-sensitising agents such as metformin may be effective in treating PCOS-related anovulation. Read More

    GnRH receptor gene mutations in adolescents and young adults presenting with signs of partial gonadotropin deficiency.
    PLoS One 2017 28;12(11):e0188750. Epub 2017 Nov 28.
    Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
    Biallelic, partial loss-of-function mutations in GNRHR cause a wide spectrum of reproductive phenotypes from constitutional delay of growth and puberty to complete congenital hypogonadotropic hypogonadism. We studied the frequency of GNRHR, FGFR1, TAC3, and TACR3 mutations in nine adolescent and young adult females with clinical cues consistent with partial gonadotropin deficiency (stalled puberty, unexplained secondary amenorrhea), and describe phenotypic features and molecular genetic findings of monozygotic twin brothers with stalled puberty. Two girls out of nine (22%, 95%CI 6-55%) carried biallelic mutations in GNRHR. Read More

    Induction and Maintenance of Amenorrhea in Transmasculine and Nonbinary Adolescents.
    Transgend Health 2017 1;2(1):195-201. Epub 2017 Nov 1.
    Department of Medicine, Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts.
    The treatment of persistent uterine bleeding in those patients who identify as transmasculine or nonbinary is often straightforward, but can be difficult in a subset of patients. This article reviews the physiology of the normal menstrual cycle and the hormonal influences on the endometrium, and then explores options for the treatment of persistent bleeding for people both already on testosterone and for those who are either not ready for or who do not desire testosterone. Read More

    A Case of Haematometra Secondary to Cervical Stenosis after Vesicle Vaginal Fistula Surgical Repair.
    Case Rep Obstet Gynecol 2017 8;2017:2303840. Epub 2017 Oct 8.
    Department of Obstetrics & Gynaecology, Catholic University of Health and Allied Sciences, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania.
    . Haematometra is a rare postobstetrics fistula surgical repair outcome complication; however the condition can be misinterpreted especially in limited resource areas that lack routine ultrasound guidance and with a slowly progressed increase in size of abdomen accompanied with a history of amenorrhoea together with a history of having unprotective sexual intercourse which may increase the possibility of being controversial to full-term gravid uterus. The causes of haematometra might be either due to congenital abnormality of the vaginal canal or acquired iatrogenically. Read More

    Genetic Etiology of Primary Premature Ovarian Insufficiency
    Acta Clin Croat 2016 12;55(4):629-635
    University Department of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia
    Primary premature ovarian insufficiency (PPOI) is characterized by hypergonadotropic amenorrhea and hypoestrogenism in women under 40 years of age. PPOI incidence is 1:10,000 in women aged 18-25, 1:1000 in women aged 25-30 and 1:100 in women aged 35-40. In 10%-28% of cases, PPOI causes primary and in 4%-18% secondary amenorrhea. Read More

    Assessment of ovarian function after chemotherapy in women with early and locally advanced breast cancer from Serbia.
    Arch Gynecol Obstet 2018 Feb 3;297(2):495-503. Epub 2017 Nov 3.
    Department of Obstetrics and Gynecology, Faculty of Medicine, Clinical Center of Serbia, University of Belgrade, Višegradska 26, 11 000, Belgrade, Serbia.
    Purpose: Among harmful effects of chemotherapy is the reduction of ovarian function. The aim was to determine the serum levels of FSH, LH, estradiol and AMH after chemotherapy followed by endocrine therapy in breast cancer patients.

    Methods: The study included 40 premenopausal hormone receptor-positive breast cancer patients aged 33-50 years. Read More

    How polymorphic markers contribute to genetic diseases in different populations? The study of inhibin A for premature ovarian insufficiency.
    Einstein (Sao Paulo) 2017 Jul-Sep;15(3):269-272
    Faculdade de Medicina do ABC, Santo André, SP, Brazil.
    Objective: To verify the incidence of the G679A mutation in exon 2 of the gene inhibin alpha (INHA), in women with secondary amenorrhea and diagnosis of premature ovarian insufficiency, and in controls.

    Methods: A 5mL sample of peripheral blood was collected from all study participants in an EDTA tube and was used for DNA extraction. For the patient group, 5mL of blood were also collected in a tube containing heparin for karyotype, and 5mL were collected in a dry tube for follicle stimulant hormone dosage. Read More

    Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2.
    Endocrinol Diabetes Metab Case Rep 2017 13;2017. Epub 2017 Oct 13.
    1st Department of Cardiology, Hellenic Red Cross Hospital, Athens, Greece.
    We describe a case of a 40-year-old woman who was admitted to the intensive care unit with a rapid onset of dyspnea and orthopnea. She presented progressive weakness, weight loss and secondary amenorrhea during last year, while intermittent fever was present for the last two months. Initial biochemical evaluation showed anemia, hyponatremia and increased C-reactive protein levels. Read More

    Mifepristone-misoprostol for menstrual regulation in public sector facilities in Bangladesh.
    Int J Gynaecol Obstet 2018 Feb 9;140(2):205-210. Epub 2017 Nov 9.
    Gynuity Health Projects, New York, NY, USA.
    Objective: To examine the use of mifepristone and misoprostol for menstrual regulation among Bangladeshi women attending public sector facilities.

    Methods: In a prospective study, women (aged ≥18 years) with up to 9 weeks of amenorrhea were enrolled at 24 government health facilities in Bangladesh from November 2012 to June 2015. Paramedics or female welfare visitors provided most menstrual regulation care. Read More

    Pooled analysis of menstrual irregularities from three major clinical studies evaluating everolimus for the treatment of tuberous sclerosis complex.
    PLoS One 2017 12;12(10):e0186235. Epub 2017 Oct 12.
    Royal Sussex County Hospital, Brighton, United Kingdom.
    Objectives: To determine the impact of everolimus on female fertility, including menstrual irregularities, secondary amenorrhea, and luteinizing and follicle stimulating hormone levels in female patients.

    Design: A pooled analysis from 3 prospective studies consisting of a core phase (≥6 months) and a long-term follow-up open-label extension.

    Setting: One phase 2 single-center and two phase 3 multicenter studies. Read More

    Clinical characteristics of 138 Chinese female patients with idiopathic hypogonadotropic hypogonadism.
    Endocr Connect 2017 Nov 10;6(8):800-810. Epub 2017 Oct 10.
    Department of Obstetrics and GynecologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China.
    Objective: To evaluate the clinical features of Chinese women with idiopathic hypogonadotropic hypogonadism (IHH).

    Methods: We retrospectively reviewed the clinical characteristics, laboratory and imaging findings, therapeutic management and fertility outcomes of 138 women with IHH. All patients had been treated and followed up at an academic medical centre during 1990-2016. Read More

    Mayer-Rokitansky-Küster-Hauser Syndrome With Bilateral Ovarian Sertoli Cell Tumors: Review of the Literature and Report of a Rare Case.
    Female Pelvic Med Reconstr Surg 2017 Sep 15. Epub 2017 Sep 15.
    From the *Obstetrics and Gynecology Department, Newark Beth Israel Medical Center, Newark, NJ.
    Background: Patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome are infertile secondary to hypoplasia or complete agenesis of the uterus, yet they remain at risk of primary neoplasms of the ovaries because embryologically the uterus and ovaries develop via separate mechanisms.

    Case: A 72-year-old nulliparous woman with a history of primary amenorrhea underwent an exploratory laparotomy for a suspected uterine fibroid. In addition to the pelvic mass, the patient was found to have findings consistent with MRKH syndrome. Read More

    Accessory ovarian steroid cell tumor producing testosterone and cortisol: A case report.
    Medicine (Baltimore) 2017 Sep;96(37):e7998
    aDepartment of Endocrinology bDepartment of Gynecology cDepartment of Pathology, Chinese PLA General Hospital, Beijing, China.
    Rationale: An accessory ovary is a rare structure containing normal ovarian tissue, which has a direct or ligamentous connection with a normal and eutopic ovary.

    Patient Concerns: In the study, we reported a 46-year-old woman presented with secondary amenorrhea and virilization symptoms for 1 year.

    Diagnoses: Endocrine evaluation revealed slightly elevated serum cortisol, extremely elevated 24-hour urinary-free cortisol and serum testosterone. Read More

    [Prolactin-secreting microadenoma in menopausal women].
    Pan Afr Med J 2017 5;27:177. Epub 2017 Jul 5.
    Service d'Endocrinologie, CHU Farhat Hached de Sousse, Tunisie.
    Prolactin-secreting adenoma is rare in elderly women. Patient's clinical picture may be confused with that of menopause, making diagnosis sometimes difficult. We report the case of a 57-year old woman with a 2-year history of secondary amenorrhea without hot flushes associated with galactorrhea in order to highlight the peculiarities of prolactin-secreting microadenomas. Read More

    A Novel Mutation Identified in a Patient with Isolated Primary Pigmented Nodular Adrenocortical Disease.
    Case Rep Oncol 2017 May-Aug;10(2):769-776. Epub 2017 Aug 16.
    Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
    Primary pigmented nodular adrenocortical disease (PPNAD) is a rare cause of Cushing syndrome, especially the isolated form without Carney complex, associated with germline mutations in , the protein kinase A regulatory subunit type 1 alpha gene. We report a 31-year-old female who presented with secondary amenorrhea, cushingoid appearance, and hypertension without Carney complex. Biochemical laboratory examinations confirmed the ACTH-independent adrenal Cushing syndrome with negative Liddle test. Read More

    Secondary amenorrhea: Diagnostic approach and treatment considerations.
    Nurse Pract 2017 Sep;42(9):34-41
    Katherine Pereira is an associate professor at Duke University School of Nursing, Durham, N.C., and a family NP at Duke University Medical Center, Division of Endocrinology, Metabolism and Nutrition, Durham, N.C. Ann J. Brown is an associate professor of medicine and vice dean for faculty at Duke University School of Medicine, Durham, N.C.
    Disruptions in the menstrual cycle are a common complaint in primary care and women's health. Irregular or absent menstrual periods should trigger an evaluation to identify the root cause. This article discusses secondary amenorrhea and provides a systematic approach to its diagnostic evaluation, with referral considerations. Read More

    An unusual cause of isolated secondary ovarian failure due to cerebral toxoplasmosis in an African woman with AIDS.
    BMJ Case Rep 2017 Aug 7;2017. Epub 2017 Aug 7.
    ABM University Health Board, Singleton Hospital, GUM/HIV, Swansea, UK.
    Primary ovarian failure is common. However, isolated secondary ovarian failure due to gonadotrophin deficiency is rare. A few cases of isolated gonadotrophin deficiency, due to congenital cerebral toxoplasmosis, have been described in children. Read More

    Enhanced Expression of FRA16B using AT-Rich DNA Binding Chemicals in a Woman with Secondary Amenorrhoea.
    J Clin Diagn Res 2017 Jun 1;11(6):QD01-QD03. Epub 2017 Jun 1.
    Professor and Head (Retd.), Department of of Genetics, Dr. ALM Postgraduate Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai, Tamil Nadu, India.
    Fragile sites represent regions of chromatin that fail to compact during mitosis. Based on the prevalence and pattern of inheritance they are classified as rare fragile sites or common fragile sites. Rare fragile sites either occur spontaneously or can be induced by certain AT-specific binding chemicals namely distamycin, Hoechst 33258, Berenil and others. Read More

    Diminished ovarian reserve in women with transfusion-dependent beta-thalassemia major: Is iron gonadotoxic?
    Eur J Obstet Gynecol Reprod Biol 2017 Sep 5;216:69-73. Epub 2017 Jul 5.
    Health Science University, Antalya Training and Research Hospital, Department of Hematology, Turkey.
    Objective: Iron accumulation in the endocrine glands has been implicated in the aetiopathogenesis of decreased reproductive capacity in patients with beta-thalassemia major (β-TM). The aim of the current study was to investigate the serum concentration of anti-Müllerian hormone (AMH), a marker of ovarian reserve, in women with transfusion-dependent β-TM.

    Study Design: In this case-control study, we recruited 43 women with transfusion-dependent TM and 44 age-matched healthy controls. Read More

    Reduced Neuromuscular Performance in Amenorrheic Elite Endurance Athletes.
    Med Sci Sports Exerc 2017 Dec;49(12):2478-2485
    1Department of Health Sciences, Lund University, Lund, SWEDEN; 2Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, DENMARK; 3Endocrinological and Reproductive Unit, Department of Obstetrics and Gynecology, Herlev Hospital, Herlev, DENMARK; 4Faculty of Health and Medical Sciences, University of Copenhagen, Herlev, DENMARK; and 5Department Endocrinology, Herlev Hospital, Herlev, DENMARK.
    Introduction: Secondary functional hypothalamic amenorrhea (SFHA) is common among female athletes, especially in weight-sensitive sports. The aim of this study was to investigate the link between SFHA and neuromuscular performance in elite endurance athletes.

    Methods: Sixteen eumenorrheic (EUM) and 14 SFHA athletes from national teams and competitive clubs participated. Read More

    Menopause and Chronic Kidney Disease.
    Semin Nephrol 2017 Jul;37(4):404-411
    Department of Medicine, University of Calgary, Calgary, Canada; Alberta Kidney Disease Network, Alberta, Canada; Libin Cardiovascular Institute of Alberta, Calgary, Canada. Electronic address:
    Premature menopause defined as secondary amenorrhea is common in women with kidney disease. Moreover, the aging population has resulted in increasing numbers of postmenopausal women with kidney disease. Though the pathophysiology is poorly understood, kidney transplantation and more frequent hemodialysis can restore menses and fertility, highlighting the challenges of diagnosing and managing the menopausal transition in the female population with kidney disease. Read More

    Late Diagnosis of 5-α-Reductase Type 2 Deficiency in an Adolescent Girl with Primary Amenorrhoea.
    Sultan Qaboos Univ Med J 2017 May 20;17(2):e218-e220. Epub 2017 Jun 20.
    Department of Family & Community Medicine, College of Medicine, Najran University, Najran, Saudi Arabia.
    Deficiency of the 5-α-reductase enzyme has been found to affect male sexual development. We report an 18-year-old patient who was referred to an endocrinology clinic in Jizan, Saudi Arabia, in April 2014 with primary amenorrhoea, virilisation and a lack of secondary sex characteristics. As female external genitalia were present at birth, she had been raised as a female. Read More

    Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial.
    Phytother Res 2017 Sep 7;31(9):1330-1340. Epub 2017 Jul 7.
    National Institute of Complementary Medicine, Western Sydney University, Building 5, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
    Polycystic ovary syndrome (PCOS) is a common, complex reproductive endocrinopathy characterized by menstrual irregularities, hyperandrogenism and polycystic ovaries. Lifestyle modification is a first-line intervention; however, there are barriers to success for this form of self-care, and women often seek adjunct therapies including herbal medicines. This pragmatic, randomized controlled trial, delivered in communities of Australia in overweight women with PCOS, compared the effectiveness and safety of a lifestyle intervention plus herbal medicine against lifestyle alone. Read More

    Successful pregnancy with donor eggs in-vitro fertilization after premature ovarian insufficiency in a tertiary hospital in a low-income setting: a case report.
    Fertil Res Pract 2016 21;2:12. Epub 2016 Nov 21.
    Clinique de l'Aeroport, Douala, Cameroon.
    Background: Premature Ovarian Insufficiency (POI) is classically defined as 4-6 months of cessation of menses (amenorrhea) in women under 40, associated with menopausal level of serum gonadotropins FSH > 40 IU/L and hypo-estrogenism and is also referred to as hypergonadotropic hypogonadism. This disorder can manifest as primary amenorrhea without the onset of menses (menarche), or as secondary amenorrhea after menarche and pubertal development. The diagnosis of this condition in Cameroon is sometimes difficult because of the high cost of hormonal assays and the few laboratories offering these services. Read More

    Premature ovarian insufficiency in general practice: Meeting the needs of women.
    Aust Fam Physician 2017 Jun;46(6):360-366
    Background: Premature ovarian insufficiency (POI), defined as amenorrhoea due to the loss of ovarian function before 40 years of age, can occur spontaneously or be secondary to medical therapies. POI is associated with cardiovascular morbidity, osteoporosis and premature mortality. Women with POI present in primary care with menstrual disturbance, menopausal symptoms, infertility and, often, significant psychosocial issues. Read More

    Emmenagogue properties of Milicia excelsa (Welw.) C.C. Berg (Moraceae) based, at least in part, on its ability to correlate the activity of the hypothalamic-pituitary axis to that of the ovaries.
    J Ethnopharmacol 2017 Jul 6;206:283-289. Epub 2017 Jun 6.
    Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaounde I, P.O. Box 812, Yaounde, Cameroon.
    Ethnopharmacological Relevance: Milicia excelsa (Welw.) C.C. Read More

    Vitamin D levels strongly influence bone mineral density and bone turnover markers during weight gain in female patients with anorexia nervosa.
    Int J Eat Disord 2017 09 7;50(9):1041-1049. Epub 2017 Jun 7.
    Department of Medicine, Rheumatology Unit, University of Verona, Piazzale L.A. Scuro 10, Verona, 37026, Italy.
    Objective: The aim of the study was to investigate a potential role for vitamin D status on bone mineral density (BMD) during weight gain in patients with anorexia nervosa (AN).

    Method: Spine and hip BMD assessed by dual-energy X-ray absorptiometry (DXA), serum vitamin D (25-OH-D), N-propeptide of type I collagen (P1NP), C-terminal telopeptide of type I collagen (CTX), and intact parathyroid hormone (PTH) were measured before and after a 20-week intensive weight-restoration program in ninety-one female patients with AN and secondary amenorrhoea.

    Results: Ninety-one consecutive female patients (age 13-45 years; weight 39. Read More

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