Differential effect of estrogen on pituitary responsiveness to GnRH in women with different forms of hypothalamic amenorrhea

1990 ◽  
Vol 122 (5) ◽  
pp. 651-655
Author(s):  
G. A. Schuiling ◽  
N. Valkhof ◽  
T. R. Koiter ◽  
R. M. Lappöhn
Keyword(s):  
Weight Loss ◽  
Pituitary Gland ◽  
Normal Weight ◽  
Estradiol Valerate ◽  
Primary Amenorrhea ◽  
Endocrine Disorders ◽  
Ovulatory Cycle ◽  
Hypothalamic Amenorrhea ◽  
Secondary Amenorrhea ◽  
High Concentrations

Abstract. The effect of treatment with estradiol valerate (6 days, 2-6 mg/day) on basal levels of LH and FSH and on response of LH and FSH levels to GnRH challenge (2 × 25 μg GnRH, iv) were investigated in women with "hypothalamic amenorrhea", but without other endocrine disorders. Three groups were studied: 11 women with primary amenorrhea, 10 women exhibiting secondary amenorrhea related with weight loss, and 7 women with normal weight and with amenorrhea persisting after a period of severe weight loss. Before treatment with estradiol valerate the estradiol concentrations in all women were at the lower limit of the follicular phase of a normal ovulatory cycle. In addition, there were no differences between the groups in basal LH and FSH levels and in responses to GnRH challenges. Treatment with estradiol valerate suppressed the basal levels of FSH but not of LH in all women. Estradiol did not affect the response to GnRH challenge in women with primary amenorrhea, weakly augmented the response in women with secondary amenorrhea associated with weight loss, and strongly increased the response in secondary amenorrheic women who had regained normal weight. The results are interpreted in the light of the well-established fact that estrogen augments the gonadotropin response only if the pituitary gland is not exposed to high concentrations of GnRH. It is hypothesized that the differential response to GnRH of the present patients after estrogen treatment reflects differences in GnRH exposure of the pituitary gland, with patients with primary amenorrhea having the highest level of GnRH exposure.

Primary Amenorrhoea with Pituitary Dwarfism: A rare case report

2016 ◽  
Vol 2 (2) ◽  
pp. 145-147
Author(s):  
Siva S ◽  
Divya Gopineni ◽  
Shafi P ◽  
Chandra Sekhar
Keyword(s):  
Pituitary Gland ◽  
General Medicine ◽  
Pituitary Hormones ◽  
Thyroid Stimulating Hormone ◽  
Primary Amenorrhea ◽  
Pituitary Dwarfism ◽  
Primary Amenorrhoea ◽  
Sexual Characteristics ◽  
Loss Of Appetite ◽  
Secondary Sexual

Females with pituitary dwarfism and a multiple deficiency of pituitary hormones show ovarian dysfunction due to hypogonadotropism. Primary amenorrhea can be diagnosed if a patient has normal secondary sexual characteristics but no menarche by 16 years of age. A 16 year-old female patient admitted in general medicine department with chief complaints of shortness of breath on exertion since 15 days, swelling of both legs since 10 days, loss of weight since 5 months, loss of appetite since 3 months, history of pain during swallowing. Pelvis scan examination reveals that uterus measures 3.2×0.5×0.5cm; uterus is hypo plastic, ovaries not visualized. Patient parents reveled that from patient birth to 11years of age her growth and other developments were normal, after that her growth is stopped and no changes were observed in development since 5 years. Patient has hypothyroidism so pituitary gland make an important role to maintain hormone levels, pituitary gland produces thyroid stimulating hormone (TSH) which stimulates thyroid gland to produce thyroid hormones. Primary Amenorrhea, short stature and poorly developed secondary sexual characters which could have been contributed and should be subjected for karyotyping. This type of Pituitary Dwarfism is very difficult to manage.

scholarly journals Sepsis as a Pan-Endocrine Illness—Endocrine Disorders in Septic Patients

2021 ◽  
Vol 10 (10) ◽  
pp. 2075
Author(s):  
Weronika Wasyluk ◽  
Martyna Wasyluk ◽  
Agnieszka Zwolak
Keyword(s):  
Host Response ◽  
Peripheral Resistance ◽  
Endocrine System ◽  
Endocrine Disorders ◽  
Hormonal Changes ◽  
Adrenergic Stimulation ◽  
Hypothalamic Amenorrhea ◽  
Somatotropic Axis ◽  
Almost All ◽  
Triiodothyronine Concentration

Sepsis is defined as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. One of the elements of dysregulated host response is an endocrine system disorder. Changes in its functioning in the course of sepsis affect almost all hormonal axes. In sepsis, a function disturbance of the hypothalamic–pituitary–adrenal axis has been described, in the range of which the most important seems to be hypercortisolemia in the acute phase. Imbalance in the hypothalamic–pituitary–thyroid axis is also described. The most typical manifestation is a triiodothyronine concentration decrease and reverse triiodothyronine concentration increase. In the somatotropic axis, a change in the secretion pattern of growth hormone and peripheral resistance to this hormone has been described. In the hypothalamic–pituitary–gonadal axis, the reduction in testosterone concentration in men and the stress-induced “hypothalamic amenorrhea” in women have been described. Catecholamine and β-adrenergic stimulation disorders have also been reported. Disorders in the endocrine system are part of the “dysregulated host response to infection”. They may also affect other components of this dysregulated response, such as metabolism. Hormonal changes occurring in the course of sepsis require further research, not only in order to explore their potential significance in therapy, but also due to their promising prognostic value.

scholarly journals Effect of a weight loss program on serum adiponectin and insulin resistance among overweight and obese premenopausal females

2020 ◽  
Vol 95 (1) ◽  
Author(s):  
Walaa H. Foula ◽  
Rana H. Emara ◽  
Mona K. Eldeeb ◽  
Samiha A. Mokhtar ◽  
Fikrat A. El-Sahn
Keyword(s):  
Public Health ◽  
Insulin Resistance ◽  
Weight Loss ◽  
Adiponectin Level ◽  
Normal Weight ◽  
Weight Loss Program ◽  
Serum Adiponectin ◽  
Health Clinic ◽  
Serum Adiponectin Level ◽  
Health Crisis

Abstract Background Obesity has emerged as a public health crisis in many populations including Egypt. Adipose tissue produces a number of adipokines, one of them is adiponectin which has attracted much attention because of its antidiabetic and antiatherogenic effects. Objective To determine the effect of a weight loss program on serum adiponectin level and insulin resistance among overweight and obese adult premenopausal females. Study design A pre-postintervention study was carried out among 95 premenopausal overweight and obese females (body mass index ≥ 25 kg/m2) aged 20 to 40 years at the integrated health clinic affiliated to the High Institute of Public Health, Alexandria, Egypt, from February 2016 to February 2017. All participants underwent a weight loss program based on a reduced calorie balanced diet and advised to increase their physical activity. Dietary instructions and follow-up were done weekly throughout 16 weeks. Blood samples were collected to investigate serum adiponectin level and insulin resistance at the beginning and the end of the intervention. Results After 16 weeks, a significant decrease in body weight by 9.7% was associated with a significant increase in serum adiponectin from 13.3 ± 4.9 μg/ml to 18.5 ± 5.6 μg/ml. Both fasting insulin and insulin resistance had decreased significantly by 13.6% and 13.7%, respectively. Conclusion A weight reduction program depending on a reduced calorie diet for 16 weeks was associated with a significant increase in total adiponectin level and reduction in insulin resistance. An emphasis on the importance of keeping normal weight through nutritional education and the promotion of healthy diets is recommended to reduce the risk of occurrence of insulin resistance, type 2 diabetes, and cardiovascular diseases.

Weight reduction in the management of hypertension: Epidemiologic and mechanistic evidence

1986 ◽  
Vol 64 (6) ◽  
pp. 818-824 ◽  
Author(s):  
Efrain Reisin
Keyword(s):  
Blood Pressure ◽  
Weight Loss ◽  
Weight Control ◽  
Sodium Intake ◽  
Close Association ◽  
Peripheral Resistance ◽  
Volume Ratio ◽  
Epidemiological Studies ◽  
Left Ventricular ◽  
Normal Weight

A number of studies have established a close association between increased body mass and elevated blood pressure. The presence of obesity in hypertensive subjects is associated with some hemodynamic, metabolic, and endocrinic characteristics: an increased intravascular volume with a high intracellular body water/interstitial fluid volume ratio, increased cardiac output, stroke volume, and left ventricular work while peripheral resistance was reduced or normal. Weight loss of at least 10 kg can reduce blood pressure independently of changes in sodium intake in obese persons of both sexes with mild, moderate, or severe high blood pressure. The fall in arterial pressure in obese hypertensives after weight loss may reverse many of the previously mentioned altered findings and underscore previous epidemiological studies that have shown that weight control could be an important measure in the treatment of hypertension.

scholarly journals Weight-Loss Behaviors of Avoiding Between Meal and Midnight Snack in Teenagers Associated with Gestational Diabetes: The Japan Environment and Children’s Study

2021 ◽  
Author(s):  
Marina Minami ◽  
Takafumi Watanabe ◽  
Masamitsu Eitoku ◽  
Nagamasa Maeda ◽  
Mikiya Fujieda ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gestational Diabetes ◽  
Odds Ratio ◽  
Weight Control ◽  
Dietary Habits ◽  
Normal Weight ◽  
Crude Odds Ratio ◽  
Live Births ◽  
Weight Loss Behavior ◽  
Previous Cesarean

Abstract Background: Dietary habits and weight control before pregnancy are important in preventing gestational diabetes. This study aims to examine whether the weight-loss behavior of avoiding between meal and midnight snacks in teenagers is associated with subsequent gestational diabetes mellitus (GDM).Methods: A total of 89,227 (85.7% of the total) mother-infant pairs of live births were included in our study of the Japan Environment and Children's Study (JECS). In the second or third trimesters, participants were asked to report their weight-loss behaviors during their teenage years. Response items included avoidance of meals and midnight snacking. The main outcome of our study was the prevalence of GDM.Results: Overall, 2,066 (2.3%) participants had GDM. Relative to those without GDM, women with GDM were older, were smokers, had a higher prevalence of hypertension, previous cesarean delivery, mental illness, and higher body mass index (BMI). Weight-loss behavior in their teenage years was associated with a decreased risk of GDM (unadjusted crude odds ratio, 0.83; 95% confidence interval [CI]: 0.76–0.91), model 1 (adjusted odds ratio [aOR], 0.86; 95% CI: 0.79–0.94), and model 2 (aOR, 0.80; 95% CI: 0.73–0.88). Weight-loss behavior in teens was associated with a decreased risk of GDM in the normal weight [aOR, 0.79; 95% CI: 0.70–0.89) and overweight (aOR, 0.82; 95% CI: 0.69–0.98) groups.Conclusions: The results suggest that weight-loss behaviors of avoiding in-between meals and midnight snacking as teenagers are associated with a decreased risk of developing GDM.

scholarly journals Interpretasi Ayat Iddah Bagi Wanita Menopause, Amenorea, Dan Hamil Dengan Pendekatan Medis

2018 ◽  
Vol 8 (1) ◽  
pp. 103-130
Author(s):  
Nur Lailatul Musyafa’ah
Keyword(s):  
Pregnant Women ◽  
Key Words ◽  
Medical Knowledge ◽  
Menstrual Period ◽  
Medical Examination ◽  
Primary Amenorrhea ◽  
Waiting Period ◽  
Secondary Amenorrhea ◽  
Medical Perspective

Abstract: This article discusses the verse of the Quran concerning iddah (waiting period after divorce or death of husband). The concerned verse is QS. 65:4. It stipulates iddah for menopause women, amenorrhea women, and pregnant women. Muslim jurists agree that waiting period for menopause and amenorrhea women is three lunar months, whereas pregnant women must wait until labor. Medical examination shows several advantages for waiting period. Firstly, the word “in irtabtum” (when you have doubt) in the verse for menopause women, that women before menopause tend to get their menstrual period irregularly which in medical perspective a menopause women are those who have not get their menstrual period in a full year. Secondly, the attribute to women who not yet get menstruation and not yet pregnant, because there are two types of amenorrhea; primary and secondary. Primary amenorrhea for those who never get menstruation whereas secondary amenorrhea is caused by pregnancy or other causes. Thirdly, the attribute in the verse of iddah for pregnant women with “an yadha’na hamlahunna” not with “an yalidna” means that pregnancy take place when ovum was fertilized by sperm. Thus, when there is no pregnancy, either because of miscarriage or labor, the iddah concludes. Key words: iddah, Quranic interpretation, medical knowledge

scholarly journals Spontaneous Neural Activity Changes after Bariatric Surgery: a resting-state fMRI study

2021 ◽  
Author(s):  
Yashar Zeighami ◽  
Sylvain Iceta ◽  
Mahsa Dadar ◽  
Mélissa Pelletier ◽  
Mélanie Nadeau ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Visual Cortex ◽  
Neural Activity ◽  
Dorsolateral Prefrontal Cortex ◽  
Severe Obesity ◽  
Normal Weight ◽  
Post Surgery ◽  
Spontaneous Neural Activity ◽  
Dorsolateral Prefrontal

1.AbstractBackgroundMetabolic disorders associated with obesity could lead to alterations in brain structure and function. Whether these changes can be reversed after weight loss is unclear. Bariatric surgery provides a unique opportunity to address these questions because it induces marked weight loss and metabolic improvements which in turn may impact the brain in a longitudinal fashion. Previous studies found widespread changes in grey matter (GM) and white matter (WM) after bariatric surgery. However, findings regarding changes in spontaneous neural activity following surgery, as assessed with the fractional amplitude of low frequency fluctuations (fALFF) and regional homogeneity of neural activity (ReHo), are scarce and heterogenous. In this study, we used a longitudinal design to examine the changes in spontaneous neural activity after bariatric surgery (comparing pre- to post-surgery), and to determine whether these changes are related to cardiometabolic variables.MethodsThe study included 57 participants with severe obesity (mean BMI=43.1±4.3kg/m2) who underwent sleeve gastrectomy (SG), biliopancreatic diversion with duodenal switch (BPD), or Roux-en-Y gastric bypass (RYGB), scanned prior to bariatric surgery and at follow-up visits of 4 months (N=36), 12 months (N=29), and 24 months (N=14) after surgery. We examined fALFF and ReHo measures across 1022 cortical and subcortical regions (based on combined Schaeffer-Xiao parcellations) using a linear mixed effect model. Voxel-based morphometry (VBM) based on T1-weighted images was also used to measure GM density in the same regions. We also used an independent sample from the Human Connectome Project (HCP) to assess regional differences between individuals who had normal-weight (N=46) or severe obesity (N=46).ResultsWe found a global increase in the fALFF signal with greater increase within dorsolateral prefrontal cortex, precuneus, inferior temporal gyrus, and visual cortex. This effect was more significant 4 months after surgery. The increase within dorsolateral prefrontal cortex, temporal gyrus, and visual cortex was more limited after 12 months and only present in the visual cortex after 24 months. These increases in neural activity measured by fALFF were also significantly associated with the increase in GM density following surgery. Furthermore, the increase in neural activity was significantly related to post-surgery weight loss and improvement in cardiometabolic variables, such as insulin resistance index and blood pressure. In the independent HCP sample, normal-weight participants had higher global and regional fALFF signals, mainly in dorsolateral/medial frontal cortex, precuneus and middle/inferior temporal gyrus compared to the obese participants. These BMI-related differences in fALFF were associated with the increase in fALFF 4 months post-surgery especially in regions involved in control, default mode and dorsal attention networks.ConclusionsBariatric surgery-induced weight loss and improvement in metabolic factors are associated with widespread global and regional increases in neural activity, as measured by fALFF signal. These findings alongside the higher fALFF signal in normal-weight participants compared to participants with severe obesity in an independent dataset suggest an early recovery in the neural activity signal level after the surgery.

scholarly journals The value of blood serotonin for effective weight loss in obese women

2015 ◽  
Vol 12 (3) ◽  
pp. 31-35
Author(s):  
Natal'ya Vadimovna Anikina ◽  
Elena Nikolaevna Smirnova
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Clinical Laboratory ◽  
Normal Weight ◽  
Obese Patients ◽  
Obese Women ◽  
Endothelin 1 ◽  
Excessive Accumulation ◽  
Made In

Introduction. Obesity is a disorder of energy balance, which leads to excessive accumulation of fat. In recent years, many important discoveries were made in this field, including the discovery of hormones produced by adipose tissue and the identification of many of the central and peripheral pathways of energy balance.Objective. To study the levels of hormones that affect appetite and metabolism in women with obesity baseline and after weight loss while taking sibutramine.Materials and methods. The study included 56 women aged 42,9±9,5 years, with a BMI of 34,6±6,1 kg/m2. All patients underwent clinical, laboratory and instrumental examination. Hormonal study included determination of serotonin, leptin, ghrelin, endothelin-1, adiponectin.Results: In women with obesity we identified hyperleptinemia and increased serotonin levels. The decrease in body weight in patients receiving sibutramine was accompanied by lower levels of serotonin, leptin, ghrelin, endothelin-1, and increase of adiponectin.Conclusions: Obese patients have significantly elevated levels of leptin, serotonin, ghrelin compared to women of normal weight. Sibutramine treatment leads to a decrease in serotonin, leptin, ghrelin and is more effective in women with a BMI less than 36,5 kg/m2.

scholarly journals MON-161 Body Weight Reduction Not Always Reduced Adrenal Gland Volume in Obese Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Tao Chen
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Adrenal Gland ◽  
Morphological Changes ◽  
Normal Weight ◽  
Obese Patients ◽  
Gland Volume ◽  
Significant Difference ◽  
Adrenal Gland Volume

Abstract Recent studies have shown that obesity is a major risk factor for idiopathic hyperaldosteronism (IHA). IHA patients have greater AGV than normal controls. However, it is unclear whether such changes are caused by obesity and whether losing weight could reverse the morphological and functional abnormalities of the adrenal gland. This study was to investigate the association of obesity with adrenal gland volume (AGV) and the effects of weight loss on AGV. This study recruited obese patients (N=25) who underwent sleeve gastrectomy and age- and sex-matched normal-weight (N=25) and overweight healthy volunteers (HV) (N=21). Thin-slice computed tomography was used to evaluate adrenal morphological changes. AGV was measured semiautomatically based on the digital imaging and communications in medicine (DICOM) image. The effects of weight loss on AGV were evaluated in patients for one year or more after sleeve gastrectomy. The results showed that left, right and total AGV were larger in obese patients than those in overweight and normal- weight HVs (6.77±0.36, 5.76±0.31, and 12.53±0.64 cm3 vs. 3.88±0.14, 3.09± 0.13 and 6.97± 0.24 cm3 vs. 3.38±0.23, 2.67±0.15 and 6.04±0.36 cm3). No statistically significant difference was identified between overweight and normal-weight HVs. Sleeve gastrectomy significantly reduced body weight (-27.1±2.5 kg), left AGV (-0.80±0.26 cm3), and right AGV (-0.88±0.20 cm2). However, the adrenal volume in five patients was not reduced, despite significant weight loss postsurgery. In brief, obesity leads to increased AGV, and in some cases, this effect seems to be irreversible. We speculate that obesity causes permanently adrenal morphological changes (increased volume or hyperplasia), and under certain circumstances, it results in excessive aldosterone secretion via altered adipokines (leptin, CTRP1, etc.).

scholarly journals Simultaneous alterations in ovaries and bone as a result of Polycystic Ovary Syndrome

2021 ◽  
Vol 3 (2) ◽  
pp. 2-14
Author(s):  
Ana Lúcia de Oliveira Bonfá ◽  
Eduardo Donato Alves ◽  
Víctor Fabrício ◽  
Keico Okino Nonaka ◽  
Janete Aparecida Anselmo-Franci ◽  
...  
Keyword(s):  
Cell Culture ◽  
Animal Model ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Estradiol Valerate ◽  
Endocrine Disorders ◽  
Ovary Syndrome ◽  
Bone Properties ◽  
In Vivo Animal Model

Polycystic ovary syndrome (PCOS) is one of the most widely recognized endocrine disorders affecting reproductive-age women. The etiopathogenesis and mechanisms of this syndrome remain unclear. Diagnosis requires two of the following: polycystic ovaries, oligo- or anovulation, and hyperandrogenism. Most women with PCOS display conditions such as metabolic abnormalities, diabetes, obesity, cardiovascular disease, and/or bone dysfunction. Considering the ethical limitations of human studies, animal and cell culture models that reflect some features of PCOS are important for investigation of this syndrome. The aim of the present work was to study some of the endocrine relationships between ovaries and bone tissue in a polycystic ovary syndrome animal model. The study was performed using an estradiol valerate PCOS-induced rat model (n = 30) and bone mesenchymal stem cell cultured from bone marrow of those animals. It was hypothesized that changes of the endocrine relationship between ovaries and bones could be observed in from in vivo animal model and in vitro cell culture assays. The ovarian morphological and endocrine changes seem to be correlated with endocrine, biophysical, and biomechanical changes in bone properties. Mesenchymal stem cells obtained from PCOS-induced rats, cultured for up to 21 days and differentiated into osteoblasts, presented lower viability and reduced mineralization of the extracellular matrix. Taken together, these results indicate important endocrine and structural effects of PCOS in ovaries and bones, contributing to part of the understanding of the pathophysiological mechanisms of PCOS.

Sign in / Sign up

Export Citation Format

Share Document