Management Of Amenorrhea Research Articles

Guideline of diagnosis and management of amenorrhea (2023)

Guideline of diagnosis and management of amenorrhea (2023)

Efficacy of Herbal Medicines in Management of Polycystic Ovarian Syndrome: A Scoping Review

Polycystic ovarian syndrome (PCOS) is most frequently stated gynaecological and metabolic disorder. Many pharmacological drugs have been used to treat PCOS with numerous side effects, which have resulted in the selection of alternative treatments from natural sources. Hence, this review aims to investigate the efficacy of medicinal herbs in regularising ovulation, hyperandrogenism, and other metabolic condition in PCOS. To conduct this review, extensive literature was searched between 2010 to 2021, from PubMed, Scopus, Google scholar, and ProQuest. Based on the keywords “polycystic ovarian syndrome” or “medicinal herbs” or “ovarian cysts” or “hyperandrogenism” or “insulin resistance”. Irrelevant studies were excluded from the database. Twelve clinical studies and nine animal studies were included in the review paper. Treatment included herbs such as “Cinnamomum zeylanicum Meism, 1864”,“Curcuma longa L. 1753”, “Tribulus terrestris L. (1753)”,“Cimicifuga racemosa (L.) Nutt., 1818” and “Vitex agnus-castus (1753)”. These bioactive compounds have shown to reduce luteinising hormone, progesterone, oestradiol and fasting insulin levels. The evidence supports Vitex agnus-castus and Cimicifuga racemosa have a synergistic impact in management of amenorrhea or oligomenorrhea, infertility, and ovulation. cinnamon spp. and Curcuma longa improve insulin resistance, dyslipidemia, and type 2 diabetes mellitus. Tribulus terresitris alone and in combination with “Withania somnifera Dunal, 1852” & “Nardostachys jatamansi (D.Don) DC, 1830” has shown promising effects but in the latent stage. Based on the evidence, it may be suggested herbal medicines are effective, alone or in alternative form, in amelioration of the symptoms of PCOS.

The Role of Hormonal Imbalances in Amenorrhea

Amenorrhea, the absence of menstrual periods in women of reproductive age, is a multifaceted and clinically significant gynecological condition that can have various underlying causes and far-reaching implications for a woman’s overall health and well-being. This abstract provides a concise overview of amenorrhea, encompassing its classification, etiology, clinical presentation, and management. Amenorrhea can be categorized into two primary types: Primary and secondary. Primary amenorrhea refers to the absence of menstruation by the age of 16 years in the presence of normal secondary sexual characteristics, or by the age of 14 years with no signs of puberty. Secondary amenorrhea, on the other hand, is characterized by the cessation of regular menstruation for at least three cycles or six months in women with a history of regular menstruation. The etiology of amenorrhea is diverse and may be attributed to various factors including hormonal imbalances, structural abnormalities in the reproductive tract, excessive exercise, stress, and eating disorders. Polycystic ovary syndrome (PCOS) and hypothalamic amenorrhea are common hormonal causes, while Asherman’s syndrome and structural abnormalities in the uterus are anatomical factors contributing to amenorrhea. The clinical presentation of amenorrhea varies depending on its underlying cause but often includes symptoms such as changes in weight, hair growth patterns, and breast development. An accurate diagnosis requires a comprehensive evaluation, which may involve hormonal assays, imaging studies, and sometimes a biopsy. The management strategies for amenorrhea depend on this cause. Hormone therapy, lifestyle modifications, and surgical interventions are recommended to address hormonal imbalances, structural abnormalities, or other contributing factors. Psychosocial support and counseling play crucial roles in the management of amenorrhea, especially when related to eating disorders or psychological stress.

Etiology and management of amenorrhea in adolescent and young adult women

In this article, we will review the etiology and management of amenorrhea in adolescent and young adult women, beginning with the diagnostic work-up and followed by etiologies organized by system. Most cases of amenorrhea are caused by dysfunction of the hypothalamic-pituitary-ovarian (HPO) axis, which is the major regulator of the female reproductive hormones: estrogen and progesterone. We begin by reviewing hypothalamic etiologies, including eating disorders and relative energy deficiency in sport. Then, pituitary causes of amenorrhea are reviewed, including hyperprolactinemia, empty sella syndrome, Sheehan's syndrome and Cushing's syndrome. Next, ovarian causes of amenorrhea are reviewed, including polycystic ovarian syndrome and primary ovarian insufficiency. Finally, other etiologies of amenorrhea are discussed, including thyroid disease, adrenal disease and reproductive tract anomalies. In conclusion, there is awide and diverse range of causes of amenorrhea in adolescents that originate from any level of the HPO axis, as well as anatomic and chromosomal etiologies. Treatment should be focused on the underlying cause. Preservation of bone density and risk of fractures should be discussed with amenorrheic patients since many causes of amenorrhea can result in decreased bone density and may be irreversible.

AN OVERVIEW OF AMENORRHEA

Amenorrhea is defined as the nonappearance of menstruation in women. Amenorrhea may be divided in to primary and secondary amenorrhea. Primary amenorrhea is caused due to anatomical, genetic, nutritional and other endocrine defects. Anatomical causes includes distal obstruction, MRKH and AIS. Primary Ovarian Insufficiency is the foremost causes of primary amenorrhea. The frequent causes of secondary amenorrhea are pregnancy. Other causes of secondary amenorrhea include PCOD, functional hypothalamic amenorrhea, POI. Depending upon the causes, the amenorrhea affected women should experiences the symptoms like hair loss, acne, excess facial hair, milky nipple discharge, etc along with the absence of menstruation. Amenorrhea is diagnosed using the patient laboratory data, pelvic ultrasonography, hysteroscopy. Management of amenorrhea is based upon its causes. PCOS patients is usually treated with regular exercise and healthy food diet. Amenorrhea is initially treated with hormonal therapy followed by hysterectomy. Regular intake of vitamin D and calcium is also recommended.

Amenorrhea: A Systematic Approach to Diagnosis and Management

Amenorrhea, the absence of menses, occurs in approximately 3 to 4% of women.4,7 It may be present as primary amenorrhea (the absence of menarche) or secondary amenorrhea (the absence of menses after menarche). The evaluation of the patient with amenorrhea requires an understanding of female anatomy and embryology as well as the hypothalamic-pituitary-ovarian axis. A logical systematic approach to adolescents and women with amenorrhea leads to the appropriate diagnosis and management. When considering the appropriate evaluation and management of amenorrhea, several classification schemes may be considered. The following review outlines the necessary background to understand the various clinical conditions. In addition, the step-wise approach to diagnosis and management is presented. This review contains 4 figures, 3 tables, and 45 references. Key Words: amenorrhea, anomalies, embryologic development, hyperandrogenism, hyperprolactinemia, hypothalamic dysfunction, ovarian insufficiency, puberty, thyroid dysfunction

Psiloxylon mauritianum (Bouton ex Hook.f.) Baillon (Myrtaceae): A promising traditional medicinal plant from the Mascarene Islands.

Psiloxylon mauritianum (PM) (Bouton ex Hook.f.) Baillon (Myrtaceae) is an evergreen endemic medicinal plant which has shown promising uses in traditional medicine from the Mascarene Islands (Mauritius and Réunion Islands). Folk use of this endemic plant in Mauritius and Réunion Islands has been geared toward the treatment and management of amenorrhea, dysentery and Type II diabetes mellitus. Recent findings from in vitro studies have led to the discovery of two potent acids namely corosolic acid and asiatic acid which have been shown to bear most inhibitory activities against Staphylococcus aureus. Such findings tend to appraise the therapeutic potential of this medicinal plant against infectious diseases. The present monograph has tried to establish the botanical description, traditional uses and the main constituents identified from PM (Bouton ex Hook.f.) Baillon. The limited documentation of in vitro assays of this plant demonstrates an urgent need for extensive research in order to validate other traditional uses and hence open new avenues for drug development.

Amenorrhea and bone health in adolescents and young women.

We present an update on amenorrhea in adolescent girls and young women. Amenorrhea may herald the onset of estrogen deficiency, which can adversely affect peak bone mass and ultimate risk of osteoporosis. Adolescence is a critical period for bone accretion. Important modifiable factors that optimize bone accretion during this time are calcium intake, vitamin D, nutrition, and exercise. Another modifiable factor in the hands of the clinician is the prompt recognition and therapy of amenorrhea associated with estrogen deficient states, caused by conditions such as hyperprolactinemia and ovarian failure. An important recent observation is that adolescents with amenorrhea who diet, but who do not meet diagnostic criteria for anorexia nervosa, are nonetheless at significant risk for low bone density. Also, multiple factors contribute to the bone loss experienced by patients with anorexia nervosa, and the associated estrogen deficiency may not be the major contributor. Recent evidence also suggests that the contraceptive depot medroxyprogesterone acetate may contribute to impaired bone accretion. While estrogen/progestin replacement therapy has a clear role in the management of girls and young women with primary ovarian insufficiency, the exact role of this therapy in the amenorrhea associated with anorexia nervosa or exercise remains controversial. Increasingly, osteoporosis prevention is recognized as an important role for health care providers of adolescent girls and young women. Viewed from this perspective, there is a need for more aggressive evaluation and management of amenorrhea, and research is needed to define sound and cost effective strategies.

Infertility in Women: Diagnosis and Treatment

ABSTRACT Management of Amenorrhea, by Charles J. Collins, 308 pp, with illus, $11.75, Springfield, Ill: Charles C. Thomas, Publisher, 1966.In Kleegman's and Kaufman's text, students of infertility will find the current clinical information available to help solve a problem as old as the history of mankind. There are nine sections to the book, including specific diagnostic tests, treatment, abortion, surgery, male infertility, and the final section devoted to topics such as the normal infertile couple, psychogenic aspects of infertility, prevention of infertility, and teaching of infertility in a medical curriculum.The text is well organized, amply illustrated, has good references, and is easy to read. One reason for the latter is the generous spacing of the material over the 340 pages.Many clinicians question the use of antibiotic combinations or broadspectrum antibiotics as a routine prophylactic before culdoscopy. A more detailed description of culdoscopy could have been given because of