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Stress Management and Meditation
Published in Mehwish Iqbal, Complementary and Alternative Medicinal Approaches for Enhancing Immunity, 2023
Graves' disease patients not only had a considerably significant amount of stressful events in life, but they also had a huge impact of stressful and negative life events contrasted with normal controls and patients with toxic nodules (Matos-Santos et al., 2001). One of the studies documented a substantial rise in Graves' disease incidence throughout the civil war in Eastern Serbia (Paunkovic et al., 1998). Stress may give rise to a weakness in immunological surveillance, ultimately causing the synthesis of thyroid-stimulating hormone receptor antibodies (Ranabir & Reetu, 2011). Moreover, stress can lead to menstrual abnormalities, anovulation and amenorrhea in females. Amid newly imprisoned females, along with stress, 33% had irregularities of menstruation and 9% had amenorrhea (Allsworth et al., 2007), and in males, there can be changed morphology and motility of sperm and diminished sperm count (McGrady, 1984). Oligospermia, impotency and ejaculatory problems may be related to psychological components in males' infertility (Palti, 1969). Psychological stress may give rise to persistent stimulation of the neuroendocrine systems. Stress hormone (cortisol) promotes central obesity, a rise in ghrelin and a leptin drop, and encourages enhanced appetite and food consumption. This condition gives rise to the recent obesity epidemic (Siervo et al., 2009).
Amenorrhea
Published in S Paige Hertweck, Maggie L Dwiggins, Clinical Protocols in Pediatric and Adolescent Gynecology, 2022
The most common cause of secondary amenorrhea is pregnancyOther common causes include stress, weight loss, low energy availability (disordered eating and/or overexercise), or changes in the environment
Pregnancy, Delivery and Postpartum
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Katy Kuhrt, Kopal Singhal Agarwal, Chawan Baran, Rebecca Best, Maria Garcia de Frutos, Miranda Geddes-Barton, Laura Bridle, Black Benjamin
Symptoms include:abdominal or pelvic painamenorrhoea or missed periodvaginal bleeding – usually light to moderatebreast tendernessgastrointestinal symptoms, such as diarrhoeadizziness, fainting or syncopeshoulder tip pain.
The risk of menopausal symptoms in premenopausal breast cancer patients and current pharmacological prevention strategies
Published in Expert Opinion on Drug Safety, 2021
Taxanes, anthracyclines and cyclophosphamide are the most commonly used cytotoxins for the treatment of BC. The two meta-analyses have evaluated the incidence of CRA in relation to different chemotherapeutic regimens [57,58]. In the meta-analysis by Zhao et al., a total of 15,916 premenopausal BC patients from 46 studies were included. In the pooled analysis, cyclophosphamide-based regimens, taxane-based regimens, and anthracycline-based regimens were all associated with increased incidence of CRA. The risk of amenorrhea also increased with the dose of chemotherapy administration. The three-drug combination regimen of cyclophosphamide, adriamycin/epirubicin, followed by taxanes was found to cause the highest rate of CRA compared with other three-drug combinations. Another meta-analysis conducted by Zavos et al. included 23,673 patients from 74 studies and reported an overall rate of CRA of 55%. This study highlighted that the rate of CRA was increased by age with an estimate of 26%, 39%, and 77% for women <35, 35–40, and >40 years old, respectively [58]. The risk of amenorrhea based on reported rates of CRA in commonly used combination regimens according to different age groups is summarized in Table 2.
Premature ovarian insufficiency: a toolkit for the primary care physician
Published in Climacteric, 2021
I. Lambrinoudaki, S. A. Paschou, M. A. Lumsden, S. Faubion, E. Makrakis, S. Kalantaridou, N. Panay
It is particularly important that careful consideration is given to assessing the age of menarche and the regularity of menses (Table 1). Early menarche has been associated with subsequent POI. Primary or secondary amenorrhea are the pathognomonic symptoms which characterize the diagnosis of POI. The initial presentation may be with oligomenorrhea (menstrual irregularity), but it is important that POI is not over-diagnosed in those with regular cycles and no history of menstrual disturbance1. Although amenorrhea is not officially diagnosed unless menstruation has been absent for 6 months, there is general agreement that it is justified to commence investigations if menstruation has been absent for 3–4 months. Changes in the length, heaviness or intervals of menstruation should also be investigated, whether or not there are co-existing symptoms. It must not be forgotten that there are other common causes of amenorrhea, e.g. pregnancy, polycystic ovary syndrome (PCOS), hyperprolactinemia or hypothalamic dysfunction due to stress/weight loss and that these need to be excluded in subsequent investigations.
Robotic Hysterectomy as a Step of Gender Affirmative Surgery in Female-to-Male Patients
Published in Journal of Investigative Surgery, 2021
Pierluigi Giampaolino, Luigi Della Corte, Francesco Paolo Improda, Luca Perna, Marcello Granata, Attilio Di Spiezio Sardo, Giuseppe Bifulco
From June 2016 to March 2018, 20 patients underwent total hysterectomy and bilateral salpingo-oophorectomy. The age range of the patient group was between 19.5 and 28.4 years of age (median: 23.5 years); none of them had pregnancies in the past while all had testosterone therapy for the maintenance of male secondary sexual characteristics, started 6 months before. None have shown notable comorbidities, and none were overweight or obese with a median BMI of 22.3 kg/m2 (range: 21–24.7). Before starting testosterone, baseline hemoglobin and lipid profile were obtained, as these indices change over time, and no alteration was found. The duration of testosterone therapy before surgery was of 24.4 weeks (range: 23–27). Eighteen patients (90%) were in amenorrhea for more than a year following medical therapy. All characteristics of these patients are summarized in Table 3.