Abnormal Menstrual Patterns Research Articles

Effects of combined ethinylestradiol, and desogestrel on hormone profiles and sex hormone binding globulin in women with polycystic ovarian disease

A longitudinal study to determine the effects of combined ethinylestradiol (EE) and desogestrel (DG) on hormone profiles and levels of sex hormone binding globulin (SHBG) were carried out in 19 Thai women with polycystic ovarian disease (PCOD). Evaluations were performed before and after 3 and 6 cycles of treatment. Regularity of cycles was observed in all patients. Most of them had improvement of androgenic symptoms. Body weight decreased slightly after 6 cycles of treatment. During the treatment course, serum luteinizing hormone (LH), testosterone (T), free T and dehydroepiandrosterone sulfate decreased significantly. Serum follicle stimulating hormone (FSH) and prolactin levels did not change. LH-tc—FSH ratio markedly decreased. SHBG level increased to the control level. After discontinuation of the pill, menstrual disturbances recurred in all patients. It appears that low-dose combined OCs containing DGf is suitable for use in women with PCOD. However, long-term treatment may be needed since the abnormal menstrual pattern returned after stopping the pill.

Treatment of menstrual irregularities with dexamethasone in congenital adrenal hyperplasia

Abnormal menstrual patterns occur frequently in adolescent girls with congenital adrenal hyperplasia (CAH). In this report, two sisters with CAH secondary to the 21-hydroxylase defect are described in whom the administration of dexamethasone, a long-acting glucocorticoid, initiated or regulated their menstrual cycles. Plasma levels of 17-hydroxyprogesterone and androstenedione were elevated while on therapy with 80 mg/day of hydrocortisone, and became normal after treatment with daily dexamethasone, 1.5 mg. Urinary excretion of 17-ketosteroids and pregnanetriol showed a similar pattern. Plasma steroid levels remained suppressed after lowering ther dexamethasone dose to 0.75 mg daily, an amount equivalent to less than the original hydrocortisone dose. These data suggest that dexamethasone has a potential role in the management of patients with CAH who have menstrual irregularities, particularly if conventional therapy does not suppress adrenal steroid production.

Effects of uremia and chronic hemodialysis on the reproductive cycle

Abnormal menstrual patterns in 22 women with chronic renal failure are presented. In 4 of these women, ovulatory function was evaluated. Three of the 4 women subjected to the ovulatory study were receivingg maintenance hemodiailysis therapy and the fourth patient studied had severe urenal failure but was receiving medical management only. The nature of the menstrual abnormalily in all 23 women was correlated with the degree of renal failure as estimated by creatinine clearance, endogenous and/or effective. Ovulatury cycles were demonstrated in one woman receiving maintenance hemodialysis therapy. On the basis of three of the four parameters studied, another woman receiving maintenance hemodialysis therapy probably ovulated. Contraceptive therapy is recommended for women in the childbearing age group receiving maintenance hemodiaysis theapy.

MENSTRUAL PROBLEMS: DYSFUNCTIONAL UTERINE BLEEDING.

Many problems arise in association with menstruation. The flow may be abnormal in periodicity, duration, or amount. The flow may be decreased (oligomenorrhea or amenorrhea) or increased (polymenorrhea, hypermenorrhea, or intermenstrual bleeding). Pain of varying degrees, associated with either a normal or an abnormal menstrual pattern, may be present at various times. There may be premenstrual tension or even emotional disturbances at or near the time of menstruation. And it must not be forgotten that the fertility of the individual may be related to the menstrual pattern. Of these many problems of menstruation, one will be considered at present, that of dysfunctional uterine bleeding. As Brewer 1 has so aptly stated, the term dysfunctional uterine bleeding is as difficult to define as the bleeding is to cure. Yet a definition is in order. Dysfunctional uterine bleeding refers to abnormal bleeding, for which a cause cannot be found, which occurs during

Menstrual patterns in myxedema

The menstrual patterns of 50 premenopausal myxedematous women between 16 and 40 years of age were evaluated. Abnormal menstrual patterns occurred in 56 per per of these patients. More than one form of menstrual irregularity was noted in two cases. Menorrhagia and metrorrhagia, alone or combined, constituted the abnormal patterns in 75 per cent of the patients.Amenorrhea occurs infrequently with myxedema. “Occult” menorrhagia should be considered in the evaluation of the patient with thyroid disease.