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The Opioid Epidemic
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Testosterone is the most commonly considered affected hormone. In both humans and animals, chronic opioid administration decreases gonadotropin-releasing hormone (GnRH) from the hypothalamus—perhaps by inhibiting biosynthesis.38 Luteinizing hormone (LH) secretion from the pituitary decreases. Opioids directly inhibit LH release from the pituitary as well. FSH impact is limited. Testosterone, estradiol, and progesterone secretion are inhibited. This can lead to menstrual irregularities in women.39 Hypogonadism was noted in 86% of men receiving intrathecal opiates while the rate for sustained release oral opioids was 89%.40,41 Interestingly, this was not seen in those treated with buprenorphine.42
Progestogen-only methods
Published in Sarah Bekaert, Alison White, Integrated Contraceptive and Sexual Healthcare, 2018
Sarah Bekaert, Alison White, Kathy French, Kevin Miles
Side effects are usually self-limiting and of relatively short duration. Nausea.Vomiting.Headache.Dizziness.Breast discomfort/breast changes.Depression.Skin disorders.Disturbance of appetite.Weight changes.Changes in libido.Chloasma.Rash.Depression.Menstrual irregularities.
Antifungals
Published in Sarah H. Wakelin, Howard I. Maibach, Clive B. Archer, Handbook of Systemic Drug Treatment in Dermatology, 2015
Marie-Louise Daly, Victoria J. Hogarth, Hui Min Liew, Mary Sommerlad, Rachael Morris-Jones
Itraconazole is embryotoxic and teratogenic in animals and is contraindicated in pregnancy except for life-threatening infections. Effective contraception must be in place during treatment and until the next menstrual period following treatment cessation. It may cause menstrual irregularities.
The effect of COVID-19 infection on the menstrual cycle: a cross-sectional investigation in the MENA region
Published in Human Fertility, 2023
Mohammad A. Alshrouf, Abdulrahman M. Karam, Muayad I. Azzam, Majed W. Al-Nazer, Minolia A. Al-Kubaisy, Abdallah Al-Ani, Nadia Muhaidat
Menstrual bleeding patterns are of paramount importance in determining premenopausal women’s reproductive health (Dasharathy et al., 2012). In addition, having a regular menstrual cycle indicates that hormones, the hypothalamic axis, and the uterus are functioning properly (Nagma et al., 2015). However, irregular menstruation is considered a common gynaecological problem, of which the prevalence varies in the literature from 5% to 35.6% (Kwak et al., 2019; Nohara et al., 2011; Sakai & Ohashi, 2013; Toffol et al., 2014; Zhou et al., 2010). Several modifiable factors, such as smoking, obesity, and stress, play a role (Bae et al., 2018). Moreover, menstrual irregularities are linked to a higher risk of cardiovascular disease (Solomon et al., 2002). Furthermore, abnormal menstrual symptoms significantly impact women’s daily lives, limiting their academic and professional achievements (Kadir et al., 2010). Therefore, these issues represent a substantial challenge to the medical system.
Treatment of pemphigus vulgaris: part 1 – current therapies
Published in Expert Review of Clinical Immunology, 2019
Rebecca L. Yanovsky, Michael McLeod, A. Razzaque Ahmed
Abnormal uterine bleeding (AUB) is a rarely reported side effect of CS therapy. Pathophysiology likely involves suppression of pituitary hormones stimulating menstruation or could be a side effect of corticosteroid-induced adrenal insufficiency leading to a decrease in gonadotropin releasing hormone. A case series identified 3 out of 3000 pemphigus patients (incidence 0.1%) who developed AUB after treatment with CS. Regardless, AUB can be a significant side effect in PV since it affects females and may be underreported due to limited history taking and lack of self-reporting among female patients [30]. Amongst these cases, one PV patient developed AUB after a single dose of 25mg of prednisone and subsequently a second dose of 40mg of prednisone. Another developed AUB after a single dose of 40 mg of prednisone. In two of three women, AUB disappeared after discontinuation of corticosteroid therapy. In the third woman, the AUB resolved on its own while she was still on CS therapy, but the mode of administration was altered. Menstrual irregularities have primarily involved menorrhagia [30]. Epidural steroid injection has been shown to cause abnormal uterine bleeding in up to 2.5% of pre- and post-menopausal women [31]. This observation is significant. Without the knowledge that corticosteroid therapy may be related to AUB, women who seek medical attention for AUB may undergo invasive testing and surgical procedures that are not required. Clinical AUB should be discussed with female patients with PV before initiating high-dose, long-term CS therapy.
Single nucleotide polymorphisms in treatment of polycystic ovary syndrome: a systematic review
Published in Drug Metabolism Reviews, 2019
Ritu Deswal, Smiti Nanda, Amita Suneja Dang
PCOS appear to underlie menstrual dysfunction in approximately 80% of patients. Abnormal menses manifests as oligomenorrhoea and primary/secondary amenorrhea resulting from oligo or anovulation. About 80–90% of women with PCOS have oligomenorrhoea and 10–20% have amenorrhea (Teede et al. 2010). Classes of drugs used to treat menstrual irregularities are (i) oral contraceptive pills (OCPs), (ii) insulin-sensitizing drugs, (iii) aromatase inhibitors, (iv) glucocorticoids, (v) gonadotropins, and (vi) sSelective estrogen receptor modulators (SERMs) (Williams and Creighton 2012). Most of the differences in treatment regimens among individuals were just because of genetic polymorphisms (Khrunin et al. 2010). The important genetic predictors related to MI have been discussed in Table 1. The drug of choice for treating MI in PCOS is clomiphene citrate, metformin, and oral contraceptives.