China
Africa
Explore chapters and articles related to this topic
Functional abnormal uterine bleeding
Published in T. Yee Khong, Annie N. Y. Cheung, Wenxin Zheng, Richard Wing-Cheuk Wong, Hao Chen, Diagnostic Endometrial Pathology, 2019
T. Yee Khong, Annie N. Y. Cheung, Wenxin Zheng
During an anovulatory cycle, there is follicular development without ovulation and subsequent corpus luteum formation. The follicle may persist for some time before eventually undergoing atresia. The endometrium in an anovulatory cycle is subjected to the stimulus of a relative estrogen excess that is unopposed by progesterone. Thus, the endometrium shows persistent proliferative activity at a time of the cycle when a secretory a pattern would be expected, even at the time of menstruation. Caution must be exercised as the proliferative phase can be as long as 22 days in some women. The endometrial glands are similar to those seen in the proliferative phase, and there may be a mild degree of simple hyperplasia that may be difficult to diagnose (Figure 5.2). This has led some to use the term disordered proliferative endometrium or, preferably, proliferative endometrium with features of anovulation (see Chapter 8).
Menstrual Disorders and Menopause
Published in James M. Rippe, Lifestyle Medicine, 2019
As circulating estrogen concentrations decline during perimenopause, variations in the regularity, timing, and nature of menstrual bleeding may occur. As menstrual cycles become increasingly irregular, bleeding may occur after a short luteal phase or anovulatory cycle. This is common in women over the age of 40. Such cycles may be associated with a lack of a corpus luteum, resulting in estrogen secretion unopposed by progesterone that can cause profuse bleeding.35
Reproductive System and Mammary Gland
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Justin D. Vidal, Charles E. Wood, Karyn Colman, Katharine M. Whitney, Dianne M. Creasy
Following menstruation, the endometrium will undergo repair as the next cycle begins. The endometrium will be small and compact with straight glands. While the endometrium is not always distinct from a prepubertal animal or anovulatory cycle, the presence of a recently regressing corpus luteum distinguishes this normal phase of the cycle.
Quantitative versus qualitative estrogen and luteinizing hormone testing for personal fertility monitoring
Published in Expert Review of Molecular Diagnostics, 2021
Thomas P. Bouchard, Richard J. Fehring, Qiyan Mu
The value of quantitative fertility monitoring carries the weight of increasing confusion with the data overload that a quantitative monitor provides. For example, there is variability in E3G levels, with an overlap in E3G values in the pre-fertile window and fertile window despite averages showing appropriate changes. Sometimes E3G values decrease from one day to the next, so there needs to be adequate parameters to delineate when the fertile window is entered, and like the CBFM that does not go back to ‘low’ after reaching a ‘high’ level, one must also remember that with quantitative levels, once a threshold is reached, the fertile window has begun until an LH peak is detected. Based a pos hoc evaluation of the Mira monitor results in this study, a threshold of 150 ng/ml was determined to be the ideal threshold or cutoff value for entry into the fertile window. If this were applied to all the cycles in this study, in 90% of cycles there was an E3G value of 150 ng/ml by day −5. Since there were frequent fluctuations up or down in the E3G levels, one would have to consider any day with E3G ≥ 150 ng/ml as an indication that the fertile window had begun, even if subsequent days had a lower E3G level. By day −4, 97% of cycles had at least one measurement of E3G ≥ 150 ng/ml. One cycle had E3G ≥ 150 ng/ml by day −3 and one cycle had overall low E3G levels that may have been part of an anovulatory cycle. This threshold will require follow-up studies for further validation.
Does Interest in Sex Peak at Mid-Cycle in Ovulatory Menstrual Cycles of Healthy, Community Dwelling Women? An 11-Month Prospective Observational Study
Published in Women's Reproductive Health, 2021
Allison B. Macbeth, Azita Goshtasebi, G. William Mercer, Jerilynn C. Prior
A major strength of the present study is that we analyzed data from an average of 11 consecutive cycles per woman in 61 initially ovulatory, healthy community dwelling women. It is also a strength that we identified and excluded all anovulatory cycles. Given that anovulatory cycles are clinically indistinguishable from ovulatory cycles (Prior et al., 2015), and at least one anovulatory cycle may occur yearly for a large proportion of women (Li et al., 2014), cycle-by-cycle ovulation documentation is necessary. Another strength is that our study included more women (n = 61) who were healthy, nonsmoking, and initially ovulatory in contrast with fewer healthy women in other studies (e.g., n = 18 [Dennerstein et al., 1994)]; n = 44 [Bancroft et al., 1983]). A further positive is that the Menstrual Cycle Diary© included a wide variety of positive and negative experiences as well as the usual, more closely menstrual cycle-related “symptoms” (e.g., flow, cramps, breast tenderness).
Pharmacodynamics of combined estrogen–progestin oral contraceptives: 4. Effects on uterine and cervical epithelia
Published in Expert Review of Clinical Pharmacology, 2020
Carlo Bastianelli, Manuela Farris, V. Bruni, Ivo Brosens, Giuseppe Benagiano
In 1966 Roland et al. [16] tried to determine which morphological alterations produced by a COC were due to the estrogen component. To this end, they administered daily 0.1 mg mestranol (MSN) to normally ovulating women and after 5 and 10 days observed straight, tubular glands with minimal tortuosity. After 15 and 20 days the glands remained tubular, but the tall columnar epithelium displayed accentuated stratification, but no secretion. Overall, the picture is indistinguishable from that observed in an anovulatory cycle. They then administered 50 μg of EE to normally ovulating women over three cycles. Biopsies taken after 5 and 10 days of medication showed a picture similar to that observed with MSN. However, a biopsy taken after 15 days showed in some glands the presence of subnuclear secretory vacuoles and the presence of products of secretion. After 20 days glands appeared tubular, with no mitoses, no secretion, and a cellular stroma without vascular development. Again, a picture identical to that seen in an anovulatory cycle.