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Postmenopause
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
What most women really want is proof that they are no longer fertile and cannot get pregnant. A blood test that measures levels of estrogen, as well as a reproductive hormone called follicle-stimulating hormone (FSH), may be helpful. A high FSH with a low estrogen level is highly suggestive of a postmenopausal state. Unfortunately, it is not always confirmatory, because these hormone levels can fluctuate greatly during the menopause transition. This means that results of blood tests can be confusing and not provide a clear answer. Nevertheless, blood tests can be valuable indicators of menopause status and prompt discussion and shared decision-making about your treatment options.
Embryology, Anatomy, and Physiology of the Male Reproductive System
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
By ~12 years (puberty), the HPG axis is reactivated and the hypothalamus generates pulsatile GnRH.Increased levels of gonadotropins reach adult levels.Elevated testosterone levels stimulate androgen-dependent development of male sexual function, characteristics, and growth.FSH initiates and regulates spermatogenesis.Testosterone levels increase and reach a further peak in the 2nd−3rd decade of life, then plateau until a slow decline during the ageing process.
Regulation of the Pituitary Gland by Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
A rise of FSH during the early follicular phase of the menstrual cycle stimulates the growth and maturation of antral ovarian follicles and increases E2 synthesis by granulosa cells. At midcycle, concomitant with the surge of LH, there is also a small rise in FSH although its physiological significance is unclear. FSH is clinically used for controlled ovarian stimulation in women undergoing assisted reproduction, i.e., in vitro fertilization of retrieved oocytes. FSH is also used to treat anovulatory infertility in women. The necessity for FSH in female reproduction is clearly demonstrated clinically and in animal models. Women with loss-of function mutations in the FSHB or FSHR genes have primary or secondary amenorrhea (an abnormal absence of menstruation), and the development of their follicles is arrested at the preantral stage. Similar phenotypes are observed in Fshb- and Fshr-deficient mice.
Efficacy and Safety of Nutraceutical on Menopausal Symptoms in Post-Menopausal Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Published in Journal of Dietary Supplements, 2022
Teerapong Rattanatantikul, Mart Maiprasert, Pansak Sugkraroek, Akkarach Bumrungpert
Blood samples were collected by a registered nurse after an overnight fast at baseline, half-way through the intervention (6 weeks) and at the end of treatment (12 weeks) for biochemical assessments. Parameters for evaluating the safety of the treatment included markers for kidney and liver function, as well as levels of serum hormones (FSH, LH, Estradiol, and SHBG). FSH was measured by an immunoradiometric assay (Arslan et al. 2003). LH was measured by radioimmunoassay (Wheeler 2013). Estradiol was measured by standard immunoassay (Rosner et al. 2013). SHBG was measured by chemiluminescent assay (Dittadi et al. 2013). Kidney function was assessed by determination of blood urea nitrogen (BUN) and creatinine (Cr). Liver function was assessed by determination of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Fasting blood glucose was determined by the glucose oxidase method (Duxbury 2004). Lipid profiles were determined by an enzymatically colorimetric assay (Thongoun et al. 2013). An anti-inflammatory marker, human serum C-reactive protein (hs-CRP) was determined by the latex immunoturbidimetry assay (Horiuchi et al. 2010). All biochemical analyses were carried out at N Health Asia Lab, Bangkok, Thailand, a medical laboratory with ISO15189:2007 certification.
Risk of dosing errors in ART treatment: user experience of single- vs multi-use follitropin alfa pens
Published in Expert Opinion on Drug Delivery, 2021
Helen Saunders, Linda Bjärgestad Lamp, Hasan Donat, Monja Messner, Maren Reder, Helen Kendrew
Follicle-stimulating hormone (FSH) is a pituitary glycoprotein hormone that plays a key role in regulating reproductive function in both males and females. During controlled ovarian stimulation for assisted reproductive technologies (ART), several different medications and dosing regimens are often used [1]. The medications involved include gonadotropin treatment in the form of FSH, which is self-injected daily, usually over a period of 9 to 11 days [2,3]. FSH is available in many different forms and administered through different systems, such as vials and syringes; disposable, single-use, pre-filled pens; multi-use pre-filled pens; and re-useable pens requiring insertion of cartridges [4–7]. Self-administration of FSH with these different delivery systems can be confusing and stressful for patients, potentially leading to the possibility of dosing errors during the treatment cycle [8]. One of the most common reasons for treatment discontinuation during ART is the high overall burden of care, and this can be attributed to factors related to the patient, clinic, or the actual treatment [9].
Efficacy and safety of follitropin alpha biosimilars compared to their reference product: a Meta-analysis
Published in Gynecological Endocrinology, 2021
Maria Cristina Budani, Stefania Fensore, Marco Di Marzio, Gian Mario Tiboni
Concerning the ovarian follicle development, follicle-stimulating hormone (FSH) is a gonadotrophic hormone produced by the anterior lobe of the pituitary gland [3]. FSH is a heterodimeric glycoprotein that consists of two distinct subunits, α and β. The α-subunit is common to all pituitary and placental glycoprotein hormones whereas the β-subunit is hormone-specific and the heterodimer confers biological activity [4]. Controlled ovarian stimulation (COS) for assisted reproductive technology (ART) is initiated and maintained through the exogenous administration of gonadotropins. Available exogenous FSH formulations include: highly purified human menopausal gonadotropin (hMG) obtained by extraction and purification from urine of menopausal women, highly purified human urinary FSH (u-hFSH) obtained by extraction and purification from human urine and recombinant FSH (r-FSH) obtained with recombinant technology [5].