Application of Piracetam Electrophoresis in Complex Sanatorium-Resort Treatment of Girls with Amenorrhea

Aim. The aim of this work was to study the effectiveness of the piracetam electrophoresis application in the complex sanatoriumresorttreatment of girls with amenorrhea. Material and methods. 56 girls aged 12 to 17 years were under observation, who were treated in the gynecological department ofthe children’s clinical sanatorium “Zdravnitsa”. Primary amenorrhea was recorded in 15 girls, secondary amenorrhea in 41. Long-termresults of sanatorium-resort treatment were studied in 8 girls with secondary amenorrhea. The control group consisted of 20 healthygirls, comparable in age, who underwent hormonal studies. Results. Upon admission to the sanatorium, the main complaint of all girls was the absence of menstruation, many had chronicinflammatory pathology of the ENT organs and pathology of the musculoskeletal system. There was a decrease in ovarian steroidogenesis,while hypoestrogenism was observed in the majority of patients. Girls with amenorrhea are characterized by a high levelof vertigo, an average level of anxiety, fatigue and a fairly low level of irritability. After the sanatorium-resort treatment, an improvementin the general condition of the girls was noted; during their stay in the sanatorium, menstruation was observed in 4 girls withsecondary amenorrhea. After the treatment, a significant positive dynamics of steroid and peptide hormones was revealed in girlswith primary and secondary amenorrhea. In girls with secondary amenorrhea, the ratio of LH/FSH approached the physiological one,but remained significantly higher than normal indicators. Under the influence of sanatorium-resort treatment, the level of adrenalinein the urine normalized in all girls with primary amenorrhea, and in the majority with secondary amenorrhea. There was a positivedynamics of the girls’ psycho-emotional state. According to the long-term results data of sanatorium-resort treatment, the restorationof menstrual function was observed within a year in half of the girls with secondary amenorrhea. Conclusion. The use of the 5% piracetam solution electrophoresis in a complex sanatorium-resort treatment of girls with amenorrheaimproved the general health of girls, normalized hormonal levels and restored menstrual function in half of the girls with secondaryamenorrhea within a year after a course of treatment in the sanatorium.

Focus on BMI and subclinical hypothyroidism in adolescent girls first examined for amenorrhea or oligomenorrhea. The emerging role of polycystic ovary syndrome

Primary amenorrhea, oligomenorrhea and secondary amenorrhea are diagnosed commonly during adolescence. Weight aberrations are associated with menstrual disorders. Autoimmune thyroiditis is frequent during adolescence. In this study, the commonest clinical and hormonal characteristics of amenorrhea or oligomenorrhea during adolescence were investigated.In this cross-sectional study, one hundred and thirty-eight consecutive young patients presenting with amenorrhea or oligomenorrhea referred to an adolescent endocrinology and gynecology university clinic were studied. Clinical examination and an abdominal ultrasound were performed. Testosterone, free-testosterone, estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), dehydroepiandrosterone sulfate (DHEA-S), 17-OH progesterone, sex hormone binding globulin (SHBG), ΔPatients with primary and secondary amenorrhea presented more often with body mass index (BMI) <18.5 and BMI >25 kg/mAmong adolescent patients presenting with amenorrhea or oligomenorrhea for the first time those with low and high BMI present more often with primary and secondary amenorrhea, respectively. Obesity is involved in the development of hyperandrogenemia and hyperinsulinemia, particularly in PCOS patients. In these patients, subclinical hypothyroidism may be concealed and it should be investigated. These patients should be treated for abnormally increased or decreased BMI and be investigated for autoimmune thyroiditis.