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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
Calcium and Magnesium
Published in Luke R. Bucci, Nutrition Applied to Injury Rehabilitation and Sports Medicine, 2020
Perhaps the most prevalent aspect of calcium and healing in sports medicine is bone loss associated with amenorrhea. Athletic amenorrhea is the absence of menstrual cycles or periods (no more than one period in the last 6 months).731 Incidence of athletic amenorrhea ranges from 7 to 71%, depending upon the group studied.731,732 Athletic amenorrhea is classified as secondary amenorrhea, meaning menstrual cycles were existent, but a secondary situation (exercise?) precipitated loss of cycles. Primary amenorrhea means no menstrual periods have occurred.
Implantation and In Utero Growth
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
Kugajeevan Vigneswaran, Ippokratis Sarris
The true incidence of Asherman syndrome is unclear. Estimates range from 6% to 40% after dilatation and curettage [35]. The American Society for Reproductive Medicine estimates IUA to be the cause of approximately 7% of all cases of secondary amenorrhea [36]. Uterine adhesions are almost exclusively caused by injury to the basal layer of the endometrium. This most commonly occurs during uterine curettage for miscarriages, terminations, or removal of retained products of conception. Evidence of association with cesarean section, myomectomy, removal of septae, and other intrauterine operations is also increasing [37].
The influence of estro-progestin therapy on neurohormonal activity in functional hypothalamic amenorrhea
Published in Gynecological Endocrinology, 2022
Anna Szeliga, Agnieszka Podfigurna, Gregory Bala, Blazej Meczekalski
Functional hypothalamic amenorrhea (FHA) is a chronic endocrine disorder caused by a disturbance of the pulsatile secretion of hormones in the hypothalamus, which in turn results in suppression of the hypothalamic-pituitary-ovarian axis. Inhibition of pulsatile gonadotropin-releasing hormone (GnRH) secretion in the hypothalamus results in suppression of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion from the pituitary gland. This sequence leads to the suppression of the hormonal and reproductive functions of the ovary [1, 2]. Secondary amenorrhea, which is the most common symptom, is characterized as amenorrhea occurring in a previously menstruating woman. It affects approximately 3-5% of the female population in reproductive age. FHA accounts for 25% to 35% of secondary amenorrhea, making it the most common cause of secondary amenorrhea in our population. At the same time, FHA is known to be the causative agent in only about 3% of primary amenorrhea, ceding to gonadal dysgenesis and polycystic ovary syndrome as leading causes. It is estimated that up to about 17 million women worldwide suffer from FHA [3, 4].
Recommendations for pregnancy in Fanconi anemia
Published in Expert Opinion on Biological Therapy, 2021
Charbel F. Matar, Rayan Bou-Fakhredin, Roberta Russo, Immacolata Andolfo, Achille Iolascon, Ali T. Taher
An early 2004 report described the case of a 17-year-old FA patient who was transplanted from her HLA-matched sibling. Secondary amenorrhea was apparent at 18 months post-transplant, and the patient had two natural pregnancies and delivered two healthy children [56]. Another successful pregnancy of a 19-year-old FA patient who underwent an HLA-matched sibling HSCT was described in 2006. Regular menstruation was observed at 6 months post-transplant and the patient went on to conceive naturally 48 months post-transplant and delivered a healthy child [17]. Another successful pregnancy in a FA patient who underwent HLA-matched sibling bone marrow transplant was reported in 2007. The patient was conditioned with Cyclophosphamide 20 mg/kg, with a total body irradiation (TBI) over 4 days (4 Gy total dose) and antithymocyte globulin (60 mg/kg total dose) [18]. The procedure was successful, with no development of any graft-versus-host disease. She entered puberty spontaneously aged 12 years and became pregnant naturally at 13 years and 16 years post-transplant and delivered two healthy children.
Ovarian steroid cell tumor as an example of severe hyperandrogenism in 45-year-old woman
Published in Gynecological Endocrinology, 2020
Anna Szeliga, Aleksandra Zysnarska, Agnieszka Podfigurna, Marzena Maciejewska-Jeske, Rafał Moszyński, Stefan Sajdak, Piotr Jasiński, Andrzej Frankowski, Andrea R. Genazzani, Błażej Męczekalski
There are three types of SCTs: stromal luteoma, Leydig cell tumor, and steroid cell tumor not otherwise specified (SCT NOS) – most not classifiable. Majority of SCT NOS present hormonal activity and only 25% are hormonally inactive [3]. Approximately, 56–77% of patients with hormonally active SCT NOS are characterized by features of hyperandrogenism [3]. Estrogen secretion is observed in 6–23% of SCT NOS and cortisol secretion in 6–10% of SCT NOS [3]. In patients with excessive estrogen secretion, menorrhagia and the irregular bleeding after menopause are commonly observed [7]. In the presented case, patient suffers from secondary amenorrhea, although serum levels of LH, FSH, and estradiol before the surgery were typical for follicular phase of cycle, probably due to conversion of the high levels of testosterone. Three weeks after surgery significant increase of FSH was observed, probably due to concomitant decrease of inhibin and testosterone and subsequent release of the negative feedback (Table 2).