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1.
J Sports Med Phys Fitness ; 59(9): 1564-1570, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31215202

RESUMO

BACKGROUND: Data documenting BMD in pre-professional adolescent ballet dancers is limited. This cross-sectional study assesses bone mineral density (BMD) in young adolescent elite ballet dancers and compares BMD values between males and females (with and without normal menarche) and body composition between dancers with and without low Z-score. METHODS: Cross-sectional study of third year ballet students (female=23; male=15; mean age 14.7 years; SD: 0.5) of The Royal Ballet School of Antwerp (Belgium) training 22 hours a week. They completed questionnaires and underwent dual energy X-ray absorptiometry (DXA) to measure BMD and body composition. Each female participant completed questionnaires assessing menstrual status. RESULTS: DXA revealed that 12 out of 38 (32%) of the dancers had Z-score <-1. On average, male dancers had a lower BMD compared to an age-matched reference population (mean Z-score -0.9; SD 0.5), with 7 out of 15 having Z-score <-1. Overall, absolute BMD values were highest in the legs, followed by spine and arms. Dancers with Z-score <-1 had a significantly lower total mass. 43% of female ballet dancers had not yet had their first period and 39% had oligomenorrhea, but no significant differences between groups was detected. CONCLUSIONS: A third of adolescent elite ballet dancers had low to very low Z-score. Nearly 2 out of 3 dancers with a Z-score <-1 were males, showing that low BMD is not limited to female dancers. Among female dancers menstrual dysfunction was frequent, without apparent impact on BMD or body composition in the studied age group.


Assuntos
Densidade Óssea/fisiologia , Dança/fisiologia , Absorciometria de Fóton , Adolescente , Bélgica , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Oligomenorreia/epidemiologia
2.
J Obstet Gynaecol ; 39(5): 652-658, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30856025

RESUMO

Oligomenorrhoea treatment with hormone therapy and Metformin is not usually well tolerated and is associated with a broad range of side effects. In Persian medicine, the management of oligomenorrhoea can be done with fennel and dry cupping. A clinical trial was conducted on 61 patients with oligomenorrhoea. The patients randomly received treatment for 6 months in two groups: fennel infusion plus dry cupping (Group A); versus treatment with Metformin (Group B). On the days between the two periods, the patients' BMI, pain levels and side effects were assessed. Thirty-one patients (mean age: 26.68) in Group A, and 30 patients (mean age: 28.90) in Group B were enrolled. The mean numbers of days between the two periods after 3 and 6 months in Group A was, respectively, 32.59 and 30.69, versus 40.66 and 431.22 in Group B. The mean pain severity dropped significantly in Group A. Fennel seed infusion plus a dry cupping uses a safe and effective therapeutic intervention in the management of oligomenorrhoea. IMPACT STATEMENT What is already known on this subject? Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women. Some common clinical manifestations of this syndrome include menstrual disorders such as oligomenorrhoea and amenorrhoea. The recommended therapeutic interventions include oral intervention, as well as metformin, which are associated with an increased risk of vascular thromboembolism, digestive complications such as nausea, and dizziness, and vitamin B12 deficiency. Therefore, the use of complementary medicine in controlling and treating PCOS is considered a valuable intervention in conventional medicine. In Persian traditional medicine, medicinal fennel (with the scientific name of Foeniculum Vulgare Mill) is commonly used in this regard. The practice of dry cupping during the monthly period that ends with ovulation is also recommended. What do the results of this study add? The present study concludes that fennel seed infusion plus a dry cupping therapy is effective and safe in reducing the days between two menstrual periods and manages oligomenorrhoea. What are the implications of these findings for clinical practice and/or further research? A clinical study is suggested for assessing the effect of fennel seed infusion plus dry cupping on oligomenorrhoea, with a large sample size and a longer follow up time.


Assuntos
Ventosaterapia , Foeniculum , Metformina/uso terapêutico , Oligomenorreia/terapia , Extratos Vegetais/administração & dosagem , Síndrome do Ovário Policístico/complicações , Terapia por Acupuntura , Adulto , Índice de Massa Corporal , Dismenorreia/terapia , Feminino , Foeniculum/química , Humanos , Irã (Geográfico) , Medicina Tradicional , Fitoterapia , Sementes/química
3.
Biomed Res Int ; 2019: 6126808, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30854398

RESUMO

Background: Acne is not only a skin condition but also a cardinal component of many systemic diseases or syndromes. This study was aimed to investigate the prevalence of acne in reproductive-age women in Sichuan province, China, and to evaluate acne as a skin problem alone or a symptom of gynecological/endocrinological disease. Methods: From October 2008 to September 2009, 1043 reproductive-age women from 19 to 45 years of age from seven communities of three districts in Sichuan province completed a standardized questionnaire and a physical examination. Acne was classified using the Pillsbury scale, and hirsutism was assessed using a modified Ferriman-Gallwey method. Diagnosis of polycystic ovary syndrome (PCOS) was based on the 2003 Rotterdam criteria. Some endocrine and metabolic markers were detected for the women diagnosed with PCOS related to acne and the control group. Results: The prevalence of acne was 32.5%, and the highest prevalence (9.6%) was seen in the 19-24-year-old age group. Prevalence among women eating dessert frequently, exercising seldom, or among sedentary workers was significantly higher in the acne group (14.1%, 55.6%, and 51.3%, respectively) than in the nonacne group (10.8%, 45.7%, and 35.5%; all P<0.05). The prevalence of oligomenorrhea and hirsutism in the acne group (17.6%, 24.7%) was significantly higher than in the nonacne group (8.6%, 15.1%; both P<0.05). Among the participants with acne, 64.3% had acne alone, 18.3% were diagnosed with hyperandrogenism, and 17.4% were diagnosed with PCOS. The level of serum androstendione in the group of PCOS (10.98±3.12 nmol/L) was significantly higher than that in the control group (8.85±3.09nmol/L) (P<0.05). Conclusion: When reproductive-age women with acne are encountered in gynecology-endocrinology or dermatology clinics, physicians should consider evaluating them from PCOS, hyperandrogenism, or acne alone.


Assuntos
Acne Vulgar/diagnóstico , Hirsutismo/diagnóstico , Hiperandrogenismo/diagnóstico , Síndrome do Ovário Policístico/diagnóstico , Acne Vulgar/complicações , Acne Vulgar/epidemiologia , Adulto , Diagnóstico Diferencial , Feminino , Hirsutismo/complicações , Hirsutismo/epidemiologia , Humanos , Hiperandrogenismo/complicações , Hiperandrogenismo/epidemiologia , Pessoa de Meia-Idade , Oligomenorreia/complicações , Oligomenorreia/diagnóstico , Oligomenorreia/epidemiologia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/epidemiologia , Reprodução/fisiologia , Anormalidades da Pele/complicações , Anormalidades da Pele/diagnóstico , Anormalidades da Pele/epidemiologia , Adulto Jovem
4.
J Pediatr Endocrinol Metab ; 32(2): 203-206, 2019 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-30681972

RESUMO

Background Resistance to thyroid hormone (RTH) commonly presents with goiter, attention deficit hyperactivity disorder (ADHD), short stature and tachycardia. However, due to its variable presentation with subtle clinical features, a third of the cases are mistreated, typically as hyperthyroidism. Case presentation A 15-year-old female with ADHD and oligomenorrhea was initially diagnosed as Hashimoto's thyroiditis but found to have a rare heterozygous mutation in c803 C>G (p Ala 268 Gly) in the THRß gene, confirming resistance to thyroid hormone. Conclusions Fluctuating thyroid function tests in addition to thyroid peroxidase antibody (TPO Ab) positivity complicated the diagnosis of RTH, initially diagnosed as Hashimoto's thyroiditis. A high index of suspicion is needed to prevent misdiagnosis and mistreatment.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Doença de Hashimoto/diagnóstico , Oligomenorreia/diagnóstico , Síndrome da Resistência aos Hormônios Tireóideos/diagnóstico , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno do Deficit de Atenção com Hiperatividade/metabolismo , Diagnóstico Diferencial , Feminino , Genes erbA/genética , Doença de Hashimoto/genética , Doença de Hashimoto/metabolismo , Humanos , Mutação , Oligomenorreia/genética , Oligomenorreia/metabolismo , Prognóstico , Testes de Função Tireóidea , Síndrome da Resistência aos Hormônios Tireóideos/genética , Síndrome da Resistência aos Hormônios Tireóideos/metabolismo , Hormônios Tireóideos/metabolismo
5.
J Pediatr Endocrinol Metab ; 32(2): 135-142, 2019 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-30685743

RESUMO

Background To develop a diagnostic assessment tool, using clinical, biochemical and sonographic markers, to help clinicians in the differential diagnosis of functional oligomenorrhea (FO) and endocrine-metabolic oligomenorrhea (EMO). Methods Sixty-two adolescents with oligomenorrhea without evident hormonal imbalances or severe energy deficit were selected. They were divided into two groups (EMO and FO) and they all underwent the following assessment: physical examination (height, weight, presence of hirsutism or acne), blood exams and transabdominal ultrasonography. The biochemical markers included: hemoglobin, thyrotropin stimulating hormone (TSH), prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), free (FT) and total testosterone (TT), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding globulin (SHBG). Uterine and ovarian volume, ovarian morphology, endometrial thickness and pulsatility index (PI) of uterine arteries were evaluated with ultrasound. Results Body mass index (BMI), hemoglobin, LH levels and LH/FSH ratio were significantly higher in women with EMO than in those with FO. Increased androgens values were found in the EMO group, but only A and FT were significantly different (p=0.04). Ovarian volume and uterine artery PI were the only ultrasound features significantly different, with higher values in the EMO population (p<0.05). Considering these variables, with a receiving characteristic operating curve, new cut-offs were calculated, and a diagnostic assessment tool elaborated (area under curve [AUC] 0.88, specificity 99%, sensibility 59%, p<0.001]. Conclusions This diagnostic tool, specific for adolescents, could be useful in the management of oligomenorrhea. Recognizing and distinguishing EMO and FO is very important in order to establish an appropriate treatment and a correct follow-up.


Assuntos
Biomarcadores/sangue , Doenças do Sistema Endócrino/diagnóstico , Hormônios Esteroides Gonadais/sangue , Doenças Metabólicas/diagnóstico , Oligomenorreia/diagnóstico , Adolescente , Diagnóstico Diferencial , Doenças do Sistema Endócrino/sangue , Feminino , Seguimentos , Humanos , Masculino , Doenças Metabólicas/sangue , Oligomenorreia/sangue , Prognóstico
6.
Indian J Pediatr ; 86(Suppl 1): 34-41, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30628040

RESUMO

OBJECTIVE: To explore the independent role of age at menarche on menstrual abnormalities among adolescents. METHODS: The present study was a multicenter cross-sectional study on a large sample (n = 3782) of Italian girls aged 13-21 y attending secondary school who already had menarche. Girls were asked to fill in a questionnaire on menarcheal age and menstrual features during the latest three menses. The gynecological age was computed as the difference between age at the survey and the age at menarche. Main outcome measures were: prevalence of oligomenorrhea, polymenorrhea, menstrual cycle irregularity, abnormal bleeding length and dysmenorrhea. Irregularity in the recent past and since menarche was also studied. Multiple logistic models were used to identify any independent association between each abnormal feature and age at menarche or gynecological age. Adjusted ORs and 95%CI were performed. RESULTS: After adjusting for covariates, menarcheal age was not independently associated with polymenorrhea (OR = 0.81; 95%CI 0.63-1.04), oligomenorrhea (OR = 1.16; 95%CI 0.94-1.43), menstrual cycle irregularity (OR = 0.99; 95%CI 0.86-1.14), abnormal bleeding length (OR = 0.96; 95%CI 0.87-1.06) and dysmenorrhea (OR = 1.03; 95%CI 0.85-1.24). The multivariate analysis suggests that the higher prevalence of oligomenorrhea and menstrual cycle irregularity among the girls who were older at menarche might be purely explained by their younger gynecological age. CONCLUSIONS: No evidence of any independent influence of age at menarche on menstrual abnormalities among young girls was shown by the investigation. The findings suggest that, after menarche, adolescent girls' menstrual health should be checked to monitor the endocrine system maturation and to early intercept latent disorders becoming symptomatic.


Assuntos
Menarca/fisiologia , Distúrbios Menstruais/epidemiologia , Distúrbios Menstruais/psicologia , Instituições Acadêmicas , Adolescente , Adulto , Fatores Etários , Idade de Início , Estudos Transversais , Dismenorreia/epidemiologia , Dismenorreia/psicologia , Feminino , Humanos , Itália/epidemiologia , Modelos Logísticos , Ciclo Menstrual/psicologia , Menstruação , Análise Multivariada , Oligomenorreia/epidemiologia , Oligomenorreia/psicologia , Pais , Prevalência , Estudantes , Inquéritos e Questionários , Adulto Jovem
7.
J Clin Endocrinol Metab ; 104(5): 1449-1458, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30476179

RESUMO

OBJECTIVE: Transdermal, but not oral, estrogen replacement improves bone mineral density (BMD) in athletes with oligoamenorrhea (OA). Our objective was to determine mechanisms that may explain the impact of route of estrogen administration on bone outcomes. METHODS: Seventy-three participants with OA between 14 and 25 years old received (i) a 17ß-estradiol transdermal patch continuously with cyclic oral micronized progesterone (PATCH), (ii) a combined ethinyl estradiol and desogestrel pill (PILL), or (iii) no estrogen/progesterone (NONE) for 12 months. We evaluated morning fasting levels of a marker of bone formation [N-terminal propeptide of type 1 procollagen (P1NP)], a marker of bone resorption (N-telopeptide), IGF-1, insulinlike growth factor binding protein 3, total testosterone, estradiol, SHBG, sclerostin, preadipocyte factor-1 (Pref-1), brain-derived neurotrophic factor (BDNF), calcium, 25(OH) vitamin D, and PTH levels at baseline and 12 months. RESULTS: Groups did not differ for age, weight, exercise activity, or markers of bone formation at baseline. Over 12 months, P1NP decreased the most in the PILL group (P = 0.03) associated with a decrease in IGF-1 levels (r = 0.37; P = 0.003). Sclerostin, Pref-1, and BDNF decreased in the PATCH group over 12 months. PATCH had the greatest increases in estradiol (P ≤ 0.0001), and estradiol increases were associated with increases in bone density. CONCLUSION: Transdermal 17ß-estradiol given over 12 months does not cause the decrease in IGF-1 observed with oral ethinyl estradiol. It also leads to decreases in sclerostin, Pref-1, and BDNF, which may mediate the beneficial effects of estrogen.


Assuntos
Atletas/estatística & dados numéricos , Biomarcadores/análise , Densidade Óssea/efeitos dos fármacos , Remodelação Óssea/efeitos dos fármacos , Reabsorção Óssea/patologia , Estrogênios/administração & dosagem , Oligomenorreia/tratamento farmacológico , Adolescente , Adulto , Reabsorção Óssea/induzido quimicamente , Vias de Administração de Medicamentos , Estrogênios/efeitos adversos , Feminino , Seguimentos , Humanos , Adulto Jovem
8.
Gynecol Obstet Invest ; 84(1): 35-44, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30048979

RESUMO

OBJECTIVES: To investigate the effect of metformin on endometrial receptivity in women with polycystic ovary syndrome (PCOS). METHODS: Twenty volunteer women with polycystic ovaries and oligomenorrhea were prospectively investigated. All women were treated with exogenous estradiol and progesterone to simulate a normal menstrual cycle (28-day duration) after GnRH-induced pituitary desensitization. Ten of the women received no other medication (group A, control), while the remaining 10 received metformin (group B, metformin). Endometrial biopsy was performed in all women on day 21 of the 2 simulated cycles. RESULTS: The expression of corticotropin - releasing hormone and urocortin in the endometrium was investigated. There was no significant difference between the 2 groups. A 3-day delay in the secretory maturation of the glandular epithelium relatively to the stroma was observed in 7 out of 10 women of group B (70%) as compared to only 1 out of 10 women of group A (10%, p = 0.02). CONCLUSIONS: It is shown for the first time that metformin administration to women with PCOS did not affect the expression of endometrial receptivity markers but delayed histological glandular maturation. It is suggested that metformin may have an impact on the function of the endometrium in PCOS.


Assuntos
Endométrio/efeitos dos fármacos , Endométrio/fisiopatologia , Hipoglicemiantes/farmacologia , Metformina/farmacologia , Síndrome do Ovário Policístico/tratamento farmacológico , Adulto , Hormônio Liberador da Corticotropina/metabolismo , Quimioterapia Combinada , Endométrio/patologia , Estradiol/uso terapêutico , Estrogênios/uso terapêutico , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Metformina/uso terapêutico , Oligomenorreia/etiologia , Síndrome do Ovário Policístico/complicações , Progesterona/uso terapêutico , Progestinas/uso terapêutico , Estudos Prospectivos , Urocortinas/metabolismo
9.
Fertil Steril ; 111(2): 389-396, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30527835

RESUMO

OBJECTIVE: To test the hypothesis that the polycystic ovary syndrome (PCOS) phenotype, or its component features, is less severe in adolescents than in young adult patients, in a referred (clinical) population. DESIGN: Cross-sectional study. SETTING: Tertiary-care academic medical center. PATIENT(S): Two hundred seventy-four adolescents and young adults aged 13.0-24.9 years with PCOS according to the National Institute of Health 1990 criteria. Patients were categorized as adolescents (AD: 13.0-18.9 years; n = 91) and young adults (YA: 19.0-24.9 years; n = 183). Adolescents were further categorized as early adolescents (Early-AD: 13.0-15.9 years; n = 31) and late adolescents (Late-AD: 16.0-18.9 years; n = 60). INTERVENTION(S): History, physical examination, hormonal assays with the use of standardized protocols. MAIN OUTCOME MEASURE(S): Unadjusted and adjusted odds ratios (ORs; adjusted for body mass index [BMI] when applicable) were calculated for biochemical hyperandrogenism (HA), hirsutism (HIR), acne, and degree of oligo/amenorrhea (OA). PCOS phenotypes were classified as HIR+HA+OA, HA+OA, and HIR+OA. RESULT(S): Our analysis demonstrated minimal significant difference in the prevalence of the three PCOS phenotypes, or component features, between AD and YA patients. The risks for obesity were higher for YA versus AD, and the risk of acne was lower for YA versus AD. There was no significant difference between Early-AD and Late-AD. BMI-adjusted models did not significantly modify the main findings. CONCLUSION(S): The present study suggests that the PCOS phenotype is established in early adolescence, remains constant into adulthood, and is not related to BMI.


Assuntos
Síndrome do Ovário Policístico/epidemiologia , Acne Vulgar/sangue , Acne Vulgar/diagnóstico , Acne Vulgar/epidemiologia , Adolescente , Fatores Etários , Alabama/epidemiologia , Amenorreia/sangue , Amenorreia/diagnóstico , Amenorreia/epidemiologia , Biomarcadores/sangue , Índice de Massa Corporal , Estudos Transversais , Sulfato de Desidroepiandrosterona/sangue , Feminino , Hirsutismo/sangue , Hirsutismo/diagnóstico , Hirsutismo/epidemiologia , Humanos , Hiperandrogenismo/sangue , Hiperandrogenismo/diagnóstico , Hiperandrogenismo/epidemiologia , Obesidade/diagnóstico , Obesidade/epidemiologia , Oligomenorreia/sangue , Oligomenorreia/diagnóstico , Oligomenorreia/epidemiologia , Fenótipo , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/diagnóstico , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Globulina de Ligação a Hormônio Sexual/análise , Testosterona/sangue , Adulto Jovem
10.
Neuro Endocrinol Lett ; 39(3): 219-225, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30431736

RESUMO

INTRODUCTION: Vitamin D (VD) plays a crucial role in calcium metabolism as well as immunological and endocrine homeostasis. Previous studies revealed strong inverse correlation between VD levels and insulin resistance, parathyroid dysfunctions and autoimmune thyroid disease. Insufficient evidence concerns its dependency of ovarian hormones. Malfunctioning of the ovaries results in menstrual disorders that are one of the most common endocrine impairments in young women of reproductive age. MATERIAL AND METHODS: The study was aimed to evaluate the correlation between 25(OH)D serum concentration and estradiol, testosterone as well as body mass index (BMI) in women with oligomenorrhea. 134 women of reproductive age with oligomenorrhea were eligible for the study. 25-hydroxyvitamin D [25(OH)D], estradiol, testosterone and sex hormone-binding globulin (SHBG) were measured using chemiluminescence immunoassay. Free androgen index (FAI) and body mass index (BMI) were calculated. RESULTS: Critical 25(OH)D deficiency (<10 ng/ml) was found in 13.4% of women, the risk of deficiency (<30 mg/dl) was diagnosed in 69.4%, while sufficient level of VD (>30 mg/ml) in 17.2% of them. Significant negative correlation was detected between 25(OH)D and estradiol serum concentrations (r=-0.2; p=0.049), as well as BMI levels (r=-0.22; p=0.01). However, no significant correlation was found between 25(OH)D and testosterone (r=-017; p=0.055), SHBG (r=0.08; p=0.4) and FAI (r=-0.1; p=0.24). CONCLUSIONS: Thorough assessment of vitamin D deficiency/insufficiency is required among patients with menstrual disorders, especially those overweighed and obese. Early screening and VD supplementation in women with estrogen-dependent disorders may become a part of routine management in order to optimize endocrine health.


Assuntos
Obesidade/sangue , Oligomenorreia/sangue , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Adolescente , Adulto , Índice de Massa Corporal , Estradiol/sangue , Feminino , Humanos , Distúrbios Menstruais/sangue , Distúrbios Menstruais/epidemiologia , Obesidade/epidemiologia , Oligomenorreia/epidemiologia , Sobrepeso/sangue , Sobrepeso/epidemiologia , Fatores de Risco , Globulina de Ligação a Hormônio Sexual/metabolismo , Testosterona/sangue , Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Adulto Jovem
11.
Med Sci Sports Exerc ; 50(12): 2536-2543, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29975299

RESUMO

PURPOSE: Athletes in weight-bearing sports may benefit from higher bone mineral density (BMD). However, some athletes are at risk for impaired BMD with female athlete triad (Triad). The purpose of this study is to understand the influence of sports participation and Triad on BMD. We hypothesize that athletes in high-impact and multidirectional loading sports will have highest BMD, whereas nonimpact and low-impact sports will have lowest BMD. Triad risk factors are expected to reduce BMD values independent of sports participation. METHODS: Two hundred thirty-nine female athletes participating in 16 collegiate sports completed dual-energy x-ray absorptiometry (DXA) scans to measure BMD z-scores of the lumbar spine (LS) and total body (TB). Height and weight were measured to calculate body mass index (BMI). Triad risk assessment variables were obtained from preparticipation examination. Mean BMD z-scores were compared between sports and by sport category (high-impact, multidirectional, low-impact, and nonimpact). Multivariable regression analyses were performed to identify differences of BMD z-scores accounting for Triad and body size/composition. RESULTS: Athlete populations with lowest average BMD z-scores included synchronized swimming (LS, -0.34; TB, 0.21) swimming/diving (LS, 0.34; TB, -0.06), crew/rowing (LS, 0.27; TB, 0.62), and cross-country (LS, 0.29; TB, 0.91). Highest values were in gymnastics (LS, 1.96; TB, 1.37), volleyball (LS, 1.90; TB, 1.74), basketball (LS, 1.73; TB, 1.99), and softball (LS, 1.68; TB, 1.78). All Triad risk factors were associated with lower BMD z-scores in univariable analyses; only low BMI and oligomenorrhea/amenorrhea were associated in multivariable analyses (all P < 0.05). Accounting for Triad risk factors and body size/composition, high-impact sports were associated with higher LS and TB BMD z-scores and nonimpact sports with lower LS and TB BMD z-scores compared to low-impact sport (all P < 0.05). CONCLUSIONS: Both sport type and Triad risk factors influence BMD. Athletes in low-impact and nonimpact sports and athletes with low BMI and oligomenorrhea/amenorrhea are at highest risk for reduced BMD.


Assuntos
Amenorreia/complicações , Densidade Óssea , Síndrome da Tríade da Mulher Atleta/diagnóstico , Oligomenorreia/complicações , Esportes/classificação , Absorciometria de Fóton , Adolescente , Atletas , Composição Corporal , Índice de Massa Corporal , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Fatores de Risco , Universidades , Adulto Jovem
12.
J Clin Psychopharmacol ; 38(4): 317-326, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29912799

RESUMO

PURPOSE/BACKGROUND: Prolactin-related adverse effects contribute to nonadherence and adverse health consequences, particularly in women with severe mental illness. Treating these adverse effects may improve treatment acceptability, adherence, and long-term outcomes. METHODS/PROCEDURES: Premenopausal women with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder were recruited for a randomized, double-blind, placebo-controlled 16-week trial of adjunct aripiprazole (5-15 mg/d). Participants had elevated prolactin (>24 ng/mL) and were experiencing galactorrhea, amenorrhea, oligomenorrhea, or sexual dysfunction on a prolactin-elevating antipsychotic. Participants were evaluated biweekly for prolactin elevation and galactorrhea and completed a menstrual diary review. Psychiatric symptoms and adverse effects were closely monitored. FINDINGS/RESULTS: Forty-six women were randomized (n = 25 aripiprazole, n = 21 placebo). Thirty-seven completed at least 8 weeks of the study (n = 20 [80%] aripiprazole and n = 17 [81%] placebo). Aripiprazole (mean dose, 11.7 ± 2.4 mg/d) was effective for lowering prolactin relative to placebo (P = 0.04). In addition, 45% (9/20) of the aripiprazole group had a normalized prolactin (<24 mg/mL) compared with 12% (2/17) of the placebo group (P = 0.028). Galactorrhea resolved in 77% (10/13) of the aripiprazole-treated participants compared with 33% (4/12) in the placebo group (P = 0.028). Normalization of sexual function (<16 on the Arizona Sexual Experience Scale) occurred in 50% on aripiprazole (7/14) versus 9% (1/11) on placebo (P = 0.030). No differences between groups in symptoms or adverse effects were noted. Overall, women rated a mean score of 4.6 ± 0.6 on a 5-point Likert scale for sexual function improvement, suggesting their particular satisfaction with improvement in this domain. IMPLICATIONS/CONCLUSIONS: Building upon prior studies, this rigorous evaluation confirms the utility of adjunctive aripiprazole as a strategy for improving prolactin and managing prolactin-related adverse effects in premenopausal women with psychosis.


Assuntos
Antipsicóticos/uso terapêutico , Aripiprazol/uso terapêutico , Quimioterapia Combinada/métodos , Pré-Menopausa/efeitos dos fármacos , Prolactina/sangue , Transtornos Psicóticos/tratamento farmacológico , Adulto , Amenorreia/induzido quimicamente , Amenorreia/prevenção & controle , Antipsicóticos/efeitos adversos , Aripiprazol/administração & dosagem , Método Duplo-Cego , Feminino , Galactorreia/induzido quimicamente , Galactorreia/prevenção & controle , Humanos , Adesão à Medicação , Oligomenorreia/induzido quimicamente , Oligomenorreia/prevenção & controle , Qualidade de Vida
13.
Biomed Res Int ; 2018: 3052768, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29744355

RESUMO

Introduction: Menstrual bleeding cessation is one of the most frequent gynecologic disorders among women in reproductive age. The treatment is based on hormone therapy. Due to the increasing request for alternative medicine remedies in the field of women's diseases, in present study, it was tried to overview medicinal plants used to treat oligomenorrhea and amenorrhea according to the pharmaceutical textbooks of traditional Persian medicine (TPM) and review the evidence in the conventional medicine. Methods: This systematic review was designed and performed in 2017 in order to gather information regarding herbal medications of oligomenorrhea and amenorrhea in TPM and conventional medicine. This study had several steps as searching Iranian traditional medicine literature and extracting the emmenagogue plants, classifying the plants, searching the electronic databases, and finding evidences. To search traditional Persian medicine references, Noor digital library was used, which includes several ancient traditional medical references. The classification of plants was done based on the repetition and potency of the plants in the ancient literatures. The required data was gathered using databases such as PubMed, Scopus, Google Scholar, Cochrane Library, Science Direct, and web of knowledge. Results: In present study of all 198 emmenagogue medicinal plants found in TPM, 87 cases were specified to be more effective in treating oligomenorrhea and amenorrhea. In second part of present study, where a search of conventional medicine was performed, 12 studies were found, which had 8 plants investigated: Vitex agnus-castus, Trigonella foenum-graecum, Foeniculum vulgare, Cinnamomum verum, Paeonia lactiflora, Sesamum indicum, Mentha longifolia, and Urtica dioica. Conclusion. Traditional Persian medicine has proposed many different medicinal plants for treatment of oligomenorrhea and amenorrhea. Although just few plants have been proven to be effective for treatment of menstrual irregularities, the results and the classification in present study can be used as an outline for future studies and treatment.


Assuntos
Amenorreia/tratamento farmacológico , Medicina Herbária , Medicina Tradicional/tendências , Oligomenorreia/tratamento farmacológico , Amenorreia/epidemiologia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Medicina Tradicional/métodos , Oligomenorreia/epidemiologia , Fitoterapia/tendências , Plantas Medicinais/química , Sesamum/química
14.
Med. leg. Costa Rica ; 35(1): 94-101, ene.-mar. 2018. tab
Artigo em Espanhol | LILACS | ID: biblio-894342

RESUMO

Resumen El síndrome de ovarios poliquísticos (SOPQ) es la disfunción endocrino- metabólica más frecuente en mujeres de edad reproductiva. El diagnostico de esta patología se basa en la presencia de anovulación, hiperandrogenismo y ovarios poliquísticos. La etiología del SOPQ es compleja y multifactorial; por lo cual el tratamiento se basa en tratar las manifestaciones clínicas y la inducción de la ovulación en el momento que se desee la concepción.


Abstract Polycystic ovary syndrome is the most common endocrinologic and metabolic disfunction in reproductive- aged women. The diagnosis of this pathology is based on the presence of ovulatory dysfunction, hyperandrogenism and polycystic ovaries. Its ethiology is complex and with multiple factors, therefore its treatment is based on fixing the clinical manifestations of the syndrome and in the case of women who would like to conceive, in inducing ovulation.


Assuntos
Humanos , Feminino , Oligomenorreia , Síndrome do Ovário Policístico/diagnóstico , Hiperandrogenismo , Amenorreia , Hiperinsulinismo , Anovulação
15.
J Pediatr Adolesc Gynecol ; 31(4): 362-366, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29462707

RESUMO

STUDY OBJECTIVE: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenism and chronic anovulation, which affects 5%-10% of reproductive-age women. Diagnosis of adult patients with PCOS is made easily with clinical and laboratory methods and the anti-Müllerian hormone (AMH) level are accepted as a good indicator. However, there is still no complete consensus on the diagnosis of PCOS in adolescents. DESIGN AND SETTING: Prospective cohort study, December 2013 to November 2014. PARTICIPANTS: The study was conducted on adolescent girls with oligomenorrhea, with at least 2 years since menarche. The study group consisted of adolescent girls with complete PCOS and incomplete PCOS. A control group was formed of healthy adolescent girls. Complete PCOS was diagnosed according to the Rotterdam criteria, as the presence of all the following characteristics: oligomenorrhea, hyperandrogenism, and polycystic ovarian morphology on ultrasound image. Incomplete PCOS was accepted as "oligomenorrhea and polycystic ovarian morphology," or "oligomenorrhea and hyperandrogenism." INTERVENTIONS AND MAIN OUTCOME MEASURES: All patients underwent a physical examination and the anthropometric assessments, insulin resistance, and acanthosis nigricans were recorded. It was also noted whether or not the patient had an acne score. The Ferriman-Gallwey score was applied to evaluate hirsutism. RESULTS: The results of this study showed that no statistically significant difference was found between the PCOS and incomplete PCOS groups and the control group with respect to AMH levels. CONCLUSION: The use of adult-specific diagnostic methods in adolescence might result in an incomplete diagnosis and inadequate treatment plan. Although the serum AMH level clearly facilitates the diagnosis of PCOS, the use of the AMH level in adolescence in PCOS diagnosis is still controversial and further studies are needed.


Assuntos
Hormônio Antimülleriano/sangue , Síndrome do Ovário Policístico/sangue , Adolescente , Estudos de Coortes , Feminino , Humanos , Menarca , Oligomenorreia/sangue , Oligomenorreia/etiologia , Estudos Prospectivos
16.
Gynecol Endocrinol ; 34(6): 495-501, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29265900

RESUMO

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine and metabolic disorder, characterized by chronic anovulation/oligomenorrhea, hyperandrogenism, and insulin-resistance. Moreover, some studies propose a possible association between insulin resistance and hyperhomocysteinemia, which is a significant long-term risk for factor for atherogenesis and chronic vascular damage, especially in situations where insulin levels are increased. Insulin-sensitizing agents are used in the treatment of PCOS: in fact, inositols were shown to have insulin-mimetic properties. Synergic action to myo-inositol is that of gymnemic acids that have antidiabetic, anti-sweetener, and anti-inflammatory activities. Gymnemic acid formulations have also been found useful against obesity due to their ability to delay the glucose absorption in the blood. L-methyl-folate increases peripheral sensitivity to insulin, maintaining folatemia stable, and thus restoring normal homocysteine levels. Unlike folic acid, L-methyl folate has a higher bioavailability, no drug/food interferences, high absorption, and it is stable to UV-A exposure. The aim of our study is to compare the clinical, endocrine, and metabolic parameters in 100 PCOS women treated with myo-inositol, gymnemic acid, and l-methylfolate (Group A) or myo inositol and folic acid only (Group B), continuously for 6 months. From a clinical point of view, it was noticed a more significant improvement of the menstrual cycle regularity and a more significant reduction of BMI in Group A. Moreover, a more significant decrease of total testosterone and increase of SHBG serum levels were noticed in Group A. The metabolic assessment found a more significant decrease of total cholesterol and homocysteine levels; OGTT glycemia and insulinemia values were significantly more improved after treatment with myo-inositol + gymnemic acid. In conclusion, we can state that a good option for the treatment of PCOS is the combined administration of myo-inositol + gymnemic acid + l-methyl-folate, especially for overweight/obese patients with marked insulin resistance and with associated hyperhomocysteinemia.


Assuntos
Hiperandrogenismo/tratamento farmacológico , Inositol/uso terapêutico , Oligomenorreia/tratamento farmacológico , Síndrome do Ovário Policístico/tratamento farmacológico , Saponinas/uso terapêutico , Tetra-Hidrofolatos/uso terapêutico , Triterpenos/uso terapêutico , Adulto , Glicemia , Índice de Massa Corporal , Peso Corporal/efeitos dos fármacos , Quimioterapia Combinada , Feminino , Humanos , Hiperandrogenismo/sangue , Inositol/administração & dosagem , Insulina/sangue , Resistência à Insulina , Ciclo Menstrual/efeitos dos fármacos , Oligomenorreia/sangue , Síndrome do Ovário Policístico/sangue , Saponinas/administração & dosagem , Tetra-Hidrofolatos/administração & dosagem , Resultado do Tratamento , Triterpenos/administração & dosagem , Adulto Jovem
17.
J Clin Lab Anal ; 32(5): e22372, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29243847

RESUMO

BACKGROUND: There are very few biomarkers available to diagnose cases with premature ovarian failure. Some complete blood count parameters have been introduced to be diagnostic biomarkers for several disorders associated with inflammatory process. Due to the evidence that indicated chronic inflammatory process to be underlying pathophysiology in premature ovarian insufficiency (POI), we aimed to assess the predictive value of complete blood count parameters for POI diagnosis. METHOD: A total of 96 women diagnosed to have premature ovarian failure were compared with 110 otherwise healthy women in terms of some basal hormone levels and complete blood count parameters. RESULTS: Mean age was similar between groups. Neutrophil/lymphocyte and mean platelet volume/lymphocyte ratios were significantly higher in group with POI (P < .001, P < .003, respectively). In group with POI, there were significant correlations between anti-Mullerian hormone and follicle stimulating hormone (r = -.30, P <.05), anti-Mullerian hormone and white blood cell count (r = .23, P < .05). Mean platelet volume/lymphocyte ratio significantly predicted cases with POI (AUC = 0.607, %95 CI: 0.529-0.684; P < .001). CONCLUSIONS: Neutrophil/lymphocyte and mean platelet volume/lymphocyte ratios are elevated in POI. There have been some controversies about the value of neutrophil/lymphocyte in POI diagnosis. We suggest mean platelet volume/lymphocyte ratio as a new biomarker in early POI because it is cheap and easily accessible compared to anti-Mullerian hormone.


Assuntos
Amenorreia/complicações , Contagem de Células Sanguíneas/métodos , Oligomenorreia/complicações , Insuficiência Ovariana Primária/etiologia , Insuficiência Ovariana Primária/patologia , Adulto , Hormônio Antimülleriano/metabolismo , Feminino , Hormônio Foliculoestimulante/metabolismo , Humanos , Linfócitos/patologia , Masculino , Neutrófilos/patologia , Curva ROC , Estudos Retrospectivos , Adulto Jovem
18.
J Pediatr Adolesc Gynecol ; 31(3): 258-262, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29233731

RESUMO

STUDY OBJECTIVE: Although early diagnosis of polycystic ovary syndrome (PCOS) in adolescents might allow for earlier treatment and prevention of chronic disorders, incorrect or premature diagnosis carries risks of unnecessary treatment and psychological distress. There is no consensus concerning which diagnostic criteria to use for adolescents and current criteria vary. The objective of this study was to determine whether using different diagnostic criteria will affect PCOS diagnosis in adolescents. DESIGN, SETTING, AND PARTICIPANTS: Fifty-two patients aged 13-18 years with at least 2 of the following criteria were included in the study: (1) oligomenorrhea or amenorrhea; (2) Clinical or biochemical hyperandrogenism; and (3) polycystic ovaries on ultrasonography. Patients were then categorized according to the 6 different criteria for PCOS. National Institutes of Health, Rotterdam criteria, Androgen Excess Society, Amsterdam criteria, Endocrine Society criteria, and the Pediatric Endocrine Society criteria. The characteristics of adolescents who were diagnosed with PCOS were also evaluated. INTERVENTIONS AND MAIN OUTCOME MEASURES: Forty-one patients out of 52 (78.8%) received diagnosis with National Institutes of Health and Endocrine Society criteria, all with Rotterdam criteria, 45/52 (86.5%) with Androgen Excess Society criteria, 36/52 (69.2%) with Amsterdam criteria and 34/52 (65.4%) with the Pediatric Endocrine Society criteria. RESULTS AND CONCLUSION: This study shows that the choice of guideline used does have a great effect on whether an adolescent received the PCOS diagnosis or not. For physicians using the broader criteria, care should be taken to ensure the patient does not receive diagnosis because of the physiological changes seen during puberty, which might mimic PCOS. For those using stricter criteria, close monitoring of patients who do not receive diagnosis is necessary to prevent chronic complications.


Assuntos
Síndrome do Ovário Policístico/diagnóstico , Adolescente , Amenorreia/etiologia , Feminino , Humanos , Hiperandrogenismo/etiologia , Oligomenorreia/etiologia , Ovário/diagnóstico por imagem , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Ultrassonografia/métodos
19.
Cancer Epidemiol Biomarkers Prev ; 27(2): 174-182, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29141849

RESUMO

Background: Polycystic ovary syndrome (PCOS), and one of its distinguishing characteristics, oligomenorrhea, have both been associated with ovarian cancer risk in some but not all studies. However, these associations have been rarely examined by ovarian cancer histotypes, which may explain the lack of clear associations reported in previous studies.Methods: We analyzed data from 14 case-control studies including 16,594 women with invasive ovarian cancer (n = 13,719) or borderline ovarian disease (n = 2,875) and 17,718 controls. Adjusted study-specific ORs were calculated using logistic regression and combined using random-effects meta-analysis. Pooled histotype-specific ORs were calculated using polytomous logistic regression.Results: Women reporting menstrual cycle length >35 days had decreased risk of invasive ovarian cancer compared with women reporting cycle length ≤35 days [OR = 0.70; 95% confidence interval (CI) = 0.58-0.84]. Decreased risk of invasive ovarian cancer was also observed among women who reported irregular menstrual cycles compared with women with regular cycles (OR = 0.83; 95% CI = 0.76-0.89). No significant association was observed between self-reported PCOS and invasive ovarian cancer risk (OR = 0.87; 95% CI = 0.65-1.15). There was a decreased risk of all individual invasive histotypes for women with menstrual cycle length >35 days, but no association with serous borderline tumors (Pheterogeneity = 0.006). Similarly, we observed decreased risks of most invasive histotypes among women with irregular cycles, but an increased risk of borderline serous and mucinous tumors (Pheterogeneity < 0.0001).Conclusions: Our results suggest that menstrual cycle characteristics influence ovarian cancer risk differentially based on histotype.Impact: These results highlight the importance of examining ovarian cancer risk factors associations by histologic subtype. Cancer Epidemiol Biomarkers Prev; 27(2); 174-82. ©2017 AACR.


Assuntos
Ciclo Menstrual/fisiologia , Oligomenorreia/complicações , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/patologia , Síndrome do Ovário Policístico/complicações , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Oligomenorreia/fisiopatologia , Neoplasias Ovarianas/fisiopatologia , Síndrome do Ovário Policístico/fisiopatologia , Fatores de Risco , Autorrelato , Fatores de Tempo
20.
J Obstet Gynaecol ; 38(2): 236-240, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28920502

RESUMO

The aim of this study was to investigate the clinical, endocrine, metabolic features and prevalence of metabolic syndrome (MBS) in Turkish adolescents with polycystic ovary syndrome (PCOS) and the differences in metabolic parameters between adolescent PCOS with or without the presence of polycystic ovaries (PCO) on ultrasound. Subjects (n = 77) were classified into two groups: oligomenorrhea (O) and clinical and/or biochemical hyperandrogenism (HA) (n = 38), without PCO and O + HA with PCO (n = 39). The control group consisted of 33 age-matched adolescents. Adolescents with PCOS had a significantly higher body mass index (BMI), waist circumference and levels of LH, LH/FSH ratio, triglyceride, insulin, HOMA-IR, free androgen index and lower levels of SHBG and FSH. After adjustment for BMI, LH, LH: FSH ratio remained significantly higher. Adolescents with PCOS had a higher prevalence of MBS. No significant differences in lipid profiles, insulin levels and insulin sensitivity in both the PCOS groups were seen. HDL-C levels were lower in the O + HA + PCO group compared to the controls. BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS. Impact statement Many studies have investigated the effect of PCOS on metabolic and cardiovascular risks. It is thought that PCOS increases metabolic and cardiovascular risks. Increase in metabolic and cardiovascular risks associated with PCOS may be handled with early diagnosis and early intervention of PCOS in adolescents, although the diagnosis of PCOS in adolescents could be hard because of the features of PCOS overlapping normal pubertal physiological events. However, early identification of adolescent girls with PCOS may provide opportunities for prevention of well-known health risks associated with this syndrome and reduction of long-term health consequences of PCOS by reducing androgen levels and improving metabolic profile. Our results also support that BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS.


Assuntos
Hiperandrogenismo/sangue , Oligomenorreia/sangue , Síndrome do Ovário Policístico/sangue , Adolescente , Análise de Variância , Índice de Massa Corporal , Estudos de Casos e Controles , Sulfato de Desidroepiandrosterona/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hiperandrogenismo/epidemiologia , Hiperandrogenismo/etiologia , Hiperandrogenismo/fisiopatologia , Hormônio Luteinizante/sangue , Síndrome Metabólica , Oligomenorreia/etiologia , Oligomenorreia/fisiopatologia , Síndrome do Ovário Policístico/diagnóstico por imagem , Síndrome do Ovário Policístico/epidemiologia , Síndrome do Ovário Policístico/fisiopatologia , Prolactina/sangue , Estudos Prospectivos , Fatores de Risco , Turquia/epidemiologia , Ultrassonografia
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