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Сазонова ДВ, Перепелова МА, Шутова АС, Никанкина ЛВ, Колесникова ГС, Пигарова ЕА, Дзеранова ЛК. [Combination of macro-TSH and macroprolactinemia phenomena in a patient with autoimmune thyroiditis and vitiligo]. PROBLEMY ENDOKRINOLOGII 2024; 70:34-39. [PMID: 39509634 PMCID: PMC11610638 DOI: 10.14341/probl13390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 11/15/2024]
Abstract
Laboratory diagnostic methods are the main tools in the practice of a doctor of any specialty, including an endocrinologist. Factors were identified that could change the concentration of the biologically active fraction of the test substance, subsequently complicating the interpretation of laboratory results and making the right clinical decision. The literature describes a variety of circulating autoantibodies involved in binding to pituitary hormones (prolactin (PRL), thyroid-stimulating hormone (TSH), growth hormone, luteinizing, follicle-stimulating, and adrenocorticotropic hormones), hypothalamus (vasopressin and oxytocin), pancreas (insulin and glucagon) , parathyroid glands (parathyroid hormone), as well as with thyroid hormones. As a rule, the resulting macromolecules lead to an increase in laboratory parameters, in which the prevailing fraction of the hormone does not have biological activity, which determines the main problem of this phenomenon. The most common variants include immune complexes with PRL and TSH, causing the phenomena of macroprolactinemia and macrothyrotropinemia (macro-TSH-emia/macro-TSH), respectively. Most laboratory test systems used in clinical practice are capable of determining only the total amount of PRL and TSH. The presented clinical observation describes a combination of the phenomena of macro-TSH and macroprolactinemia in a patient with autoimmune thyroiditis (AIT) and vitiligo.
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Affiliation(s)
- Д. В. Сазонова
- Национальный медицинский исследовательский центр эндокринологии
| | | | - А. С. Шутова
- Национальный медицинский исследовательский центр эндокринологии
| | - Л. В. Никанкина
- Национальный медицинский исследовательский центр эндокринологии
| | | | - Е. А. Пигарова
- Национальный медицинский исследовательский центр эндокринологии
| | - Л. К. Дзеранова
- Национальный медицинский исследовательский центр эндокринологии
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Szabó F, Köves K, Gál L. History of the Development of Knowledge about the Neuroendocrine Control of Ovulation-Recent Knowledge on the Molecular Background. Int J Mol Sci 2024; 25:6531. [PMID: 38928237 PMCID: PMC11203711 DOI: 10.3390/ijms25126531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/30/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
The physiology of reproduction has been of interest to researchers for centuries. The purpose of this work is to review the development of our knowledge on the neuroendocrine background of the regulation of ovulation. We first describe the development of the pituitary gland, the structure of the median eminence (ME), the connection between the hypothalamus and the pituitary gland, the ovarian and pituitary hormones involved in ovulation, and the pituitary cell composition. We recall the pioneer physiological and morphological investigations that drove development forward. The description of the supraoptic-paraventricular magnocellular and tuberoinfundibular parvocellular systems and recognizing the role of the hypophysiotropic area were major milestones in understanding the anatomical and physiological basis of reproduction. The discovery of releasing and inhibiting hormones, the significance of pulse and surge generators, the pulsatile secretion of the gonadotropin-releasing hormone (GnRH), and the subsequent pulsatility of luteinizing (LH) and follicle-stimulating hormones (FSH) in the human reproductive physiology were truly transformative. The roles of three critical neuropeptides, kisspeptin (KP), neurokinin B (NKB), and dynorphin (Dy), were also identified. This review also touches on the endocrine background of human infertility and assisted fertilization.
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Affiliation(s)
- Flóra Szabó
- Division of Gastroenterology and Nutrition, Children’s Hospital of Richmond, Virginia Commonwealth University, Richmond, VA 23298, USA;
| | - Katalin Köves
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, Semmelweis University, 1094 Budapest, Hungary
| | - Levente Gál
- Department of Biological Sciences, Virginia Tech, Blacksburg, VA 24061, USA;
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Voznyak O, Zinkevych I, Lytvynenko A, Hryniv N, Ilyuk R, Kobyliak N. Gender Differences in Patients with Prolactinoma: Single-center Ukrainian Experience. Rev Recent Clin Trials 2024; 19:204-214. [PMID: 38561622 DOI: 10.2174/0115748871288948240325080936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Prolactinomas are the most common type of pituitary gland tumors that secrete overly prolactin. They account for approximately 60% of all hormone-secreting hypophysis tumors. AIM This study aims to analyze gender differences in patients with prolactinomas who were operated on transsphenoidal surgery and conduct a single-center retrospective analysis of patient data. MATERIAL AND METHODS This study evaluated the medical records of 109 patients (61 females and 48 males) from 2009 to 2019 at Feofaniya Clinical Hospital of the State Administration of Affairs in Kyiv, Ukraine. The primary criterion for including patients was a Serum Prolactin (PRL) level of over 100 ng/ml and the presence of a pituitary adenoma (PA) as observed on MRI. Additionally, the histological examination needed to confirm the presence of Prolactin-Secreting Pituitary Adenomas (PSPAs) without plurihormonal activity through both microscopy and immunohistochemical (IHC) staining. RESULTS Significant differences in preoperative PRL levels were not observed. However, males had significantly larger tumor sizes and prevalence of macroadenomas. In male patients, the preoperative PLR levels showed a weak negative correlation with age (r=-0.304, p < 0.036) and a positive correlation with tumor size (r=0.555, p < 0.001) and cavernous sinus invasion (r=0.339, p < 0.018). In females, preoperative PRL was significantly associated only with tumor size and Knosp grade. CONCLUSION Prolactin-Secreting Pituitary Adenomas (PSPAs) are more common in women than men and are characterized by larger and more invasive tumors with high PRL levels at diagnosis. The PRL level and tumor size before surgery can predict early biochemical remission in both males and females with an accuracy of 58.3% and 68.8%, respectively.
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Affiliation(s)
- Oleksandr Voznyak
- Centre of Neurosurgery, Clinical Hospital "Feofaniya", Zabolotny str, 21, Kyiv, 03143, Ukraine
| | - Iaroslav Zinkevych
- Centre of Neurosurgery, Clinical Hospital "Feofaniya", Zabolotny str, 21, Kyiv, 03143, Ukraine
| | - Andrii Lytvynenko
- Centre of Neurosurgery, Clinical Hospital "Feofaniya", Zabolotny str, 21, Kyiv, 03143, Ukraine
| | - Nazarii Hryniv
- Centre of Neurosurgery, Clinical Hospital "Feofaniya", Zabolotny str, 21, Kyiv, 03143, Ukraine
| | - Roman Ilyuk
- Centre of Neurosurgery, Clinical Hospital "Feofaniya", Zabolotny str, 21, Kyiv, 03143, Ukraine
| | - Nazarii Kobyliak
- Medical Laboratory CSD, Kyiv, 02000, Ukraine
- Department of Endocrinology, Bogomolets National Medical University, Kyiv, 01024, Ukraine
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Hajjo R, Momani E, Sabbah DA, Baker N, Tropsha A. Identifying a causal link between prolactin signaling pathways and COVID-19 vaccine-induced menstrual changes. NPJ Vaccines 2023; 8:129. [PMID: 37658087 PMCID: PMC10474200 DOI: 10.1038/s41541-023-00719-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 08/04/2023] [Indexed: 09/03/2023] Open
Abstract
COVID-19 vaccines have been instrumental tools in the fight against SARS-CoV-2 helping to reduce disease severity and mortality. At the same time, just like any other therapeutic, COVID-19 vaccines were associated with adverse events. Women have reported menstrual cycle irregularity after receiving COVID-19 vaccines, and this led to renewed fears concerning COVID-19 vaccines and their effects on fertility. Herein we devised an informatics workflow to explore the causal drivers of menstrual cycle irregularity in response to vaccination with mRNA COVID-19 vaccine BNT162b2. Our methods relied on gene expression analysis in response to vaccination, followed by network biology analysis to derive testable hypotheses regarding the causal links between BNT162b2 and menstrual cycle irregularity. Five high-confidence transcription factors were identified as causal drivers of BNT162b2-induced menstrual irregularity, namely: IRF1, STAT1, RelA (p65 NF-kB subunit), STAT2 and IRF3. Furthermore, some biomarkers of menstrual irregularity, including TNF, IL6R, IL6ST, LIF, BIRC3, FGF2, ARHGDIB, RPS3, RHOU, MIF, were identified as topological genes and predicted as causal drivers of menstrual irregularity. Our network-based mechanism reconstruction results indicated that BNT162b2 exerted biological effects similar to those resulting from prolactin signaling. However, these effects were short-lived and didn't raise concerns about long-term infertility issues. This approach can be applied to interrogate the functional links between drugs/vaccines and other side effects.
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Affiliation(s)
- Rima Hajjo
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan.
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Jordan CDC, Amman, Jordan.
| | - Ensaf Momani
- Department of Basic Medical sciences, Faculty of Medicine, Al Balqa' Applied University, Al-Salt, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Dima A Sabbah
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan
| | - Nancy Baker
- ParlezChem, 123 W Union St., Hillsborough, NC, 27278, USA
| | - Alexander Tropsha
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Mahboobifard F, Rahmati M, Amiri M, Azizi F, Ramezani Tehrani F. To what extent does polycystic ovary syndrome influence the cut-off value of prolactin? Findings of a community-based study. Adv Med Sci 2022; 67:79-86. [PMID: 34998115 DOI: 10.1016/j.advms.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/03/2021] [Accepted: 12/17/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) and hyperprolactinemia are the most frequent endocrine disorders in women which share several common features. There are inconsistent results regarding the existence of a possible pathophysiological interplay between these endocrinopathies and the elevation of prolactin (PRL) in PCOS. The purpose of this study was to explore the upper reference limit of PRL in PCOS women. PATIENTS AND METHODS This study is a cross-sectional analysis using data collected from two population-based PCOS prevalence studies. After considering the exclusion criteria, 216 women with PCOS diagnosed based on the Rotterdam criteria and 702 eumenorrheic non-hirsute controls, were enrolled. The age distribution of PRL and the effect of PCOS on the percentiles of serum PRL were compared between the PCOS group and controls. The possible contributing factors for the elevation of PRL were evaluated. RESULTS In the subgroup of women with PCOS, aged ≤35 years, the age-adjusted model of quantile regression revealed a significant elevation of PRL from the 60th percentile onwards, leading to an increase of nearly 10 ng/ml (p = 0.023, 95% CI 1.3-17.62) of the 95th percentile of PRL. Hyperprolactinemic PCOS women had higher levels of luteinizing hormone (LH). CONCLUSIONS In PCOS women, aged ≤35 years, the upper reference limit of serum PRL was approximately 1.5-fold higher than in controls. The pathway underlying PRL elevation in PCOS might be attributed to a decline in central dopaminergic tone associated with PCOS which leads to an increase in levels of both - PRL and LH.
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The utility of prolactin serial sampling and the best prolactin cut-offs associated with persistent hyperprolactinemia. Porto Biomed J 2021; 6:e133. [PMID: 33869885 PMCID: PMC8049160 DOI: 10.1097/j.pbj.0000000000000133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/25/2021] [Indexed: 12/31/2022] Open
Abstract
Background: A single prolactin sampling is recommended for the diagnosis of hyperprolactinemia. We aimed to study the utility of the prolactin serial sampling and to determine the best cut-offs associated with persistent hyperprolactinemia. Methods: Retrospective study of hyperprolactinemic patients [referral prolactin (rPRL)] that underwent prolactin serial samplings. Prolactin at 0 minutes (PRL0′), 20 to 30, and 40 to 60 minutes. The lowest of these last 2 was defined as nadir prolactin (nPRL). Persistent hyperprolactinemia was defined as nPRL above normal. We excluded patients under dopamine receptor agonists. Receiver-operating characteristic (ROC) curves were used to determine the best rPRL and PRL0′ cut-offs predicting persistent hyperprolactinemia. Results: We studied 53 patients (3 males). Median rPRL 48.0 ng/mL (39.5–72.5), PRL0′ 34.3 ng/mL (18.0–50.8) and nPRL 29.5 ng/mL (11.4–44.4). PRL0′ was elevated in 35 (66.0%) patients and in 7 of them a normal nPRL was reached; therefore 28 (52.8%) had persistent hyperprolactinemia. The area under curve (AUC) for the association between rPRL and persistent hyperprolactinemia was 0.70 (95%CI: 0.56–0.84); best cut-off: 53.4 ng/mL [sensitivity 53.6%, specificity 80.0%, positive predictive value (PPV) 75.0%, and negative predictive value (NPV) 60.6%]. In the 35 patients with elevated PRL0′, the AUC was 0.92 (95%CI: 0.81–1.00); best cut-off: 35.2 ng/mL (sensitivity 85.7%, specificity 85.7%, PPV 60.0%, and NPV 96.0%). Conclusions: Approximately 1/3 of the patients reached a normal PRL0′. In an additional 20%, prolactin normalized after serial samplings. Patients with rPRL >53.4 ng/mL had 75% probability of having persistent hyperprolactinemia and those with PRL0′ <35.2 ng/mL had a 96% probability of not having persistent hyperprolactinemia.
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Taşkömür AT, Erten Ö. The effect of tubal ligation surgery during cesarean operation on dysmenorrhoea, dyspareunia and menstrual cycle. J Gynecol Obstet Hum Reprod 2021; 50:102054. [PMID: 33422694 DOI: 10.1016/j.jogoh.2020.102054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/10/2020] [Accepted: 12/28/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES The use of tubal ligation as a contraceptive method has started to increase because it is a safe procedure with high protection. This increase also brings to mind what the procedure-related adverse effects may be. The aim of this study was to investigate the long-term effects whether tubal ligation performed during caesarean had an effect on dysmenorrhea, dyspareunia, menstrual pattern, and hormones. METHODS Our study was retrospectively conducted by archive scanning and phone calls of a total of 220 patients who were divided into two groups as the study group, which underwent tubal ligation during the caesarean section (n = 110), and the control group (n = 110), which had caesarean section but did not undergo tubal ligation. Patients who did not meet the inclusion criteria were not included in the study. The patients were invited to the hospital on the second or third days of their menstrual cycles. Serum TSH, FSH, LH, E2, PRL levels of these patients were studied. Their dysmenorrhoea, dyspareunia symptoms and menstrual cycle patterns were questioned. The results of the groups were compared. RESULTS There was no significant difference between the hormone levels and dysmenorrhoea-dyspareunia evaluations of both groups (p > 0.05). However, it was found that menstrual cycle irregularity was higher in the group that underwent tubal ligation and this difference was statistically significant (p < 0.05). CONCLUSION In women who underwent tubal ligation during caesarean section, it was found that there was no difference in menstrual cycle pattern, hormone levels, dysmenorrhea, and dyspareunia, except for menstrual cycle irregularity.
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Affiliation(s)
- Aysun Tekeli Taşkömür
- Amasya University Sabuncuoğlu Şerefeddin Education and Research Hospital, Gynocology and Obstetrics Clinic, Amasya, Turkey.
| | - Özlem Erten
- Kütahya University of Health Sciences Faculty of Medicine, Department of Gynocology and Obstetrics, Kütahya, Turkey.
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Chen M, Wang M, Chen Y, He J, Zou J, Meng J, Zhao L, Wu J. Comparative assessment of effect of malt with different bud length on prolactin in hyperprolactinemia rat. BRAZ J PHARM SCI 2021. [DOI: 10.1590/s2175-979020200004181104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Min Chen
- The Third Hospital of Wu-han, China
| | - Mingyan Wang
- College of pharmacy of Xin Jiang Medical University, China
| | | | - Jin He
- Wuhan JinYinTan Hospital, China
| | - Jili Zou
- The Third Hospital of Wu-han, China
| | | | - Lin Zhao
- The Third Hospital of Wu-han, China
| | - Jinhu Wu
- The Third Hospital of Wu-han, China
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Okawa ER, Gardner R, Feltmate C, Hirsch MS, Craig JW, Chan YM. An Unusual Cause of Secondary Amenorrhea in an Adolescent: Expanding the Differential. J Endocr Soc 2020; 4:bvaa159. [PMID: 33241170 PMCID: PMC7672807 DOI: 10.1210/jendso/bvaa159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Indexed: 11/24/2022] Open
Abstract
Secondary amenorrhea is not uncommon in the adolescent female population. There are multiple etiologies to consider, and a comprehensive evaluation is often pursued. Sometimes, however, despite a thorough workup, the diagnosis remains unclear. Here, we report an unusual cause of secondary amenorrhea in a 15-year-old girl. Our patient presented with secondary amenorrhea after a 4-year history of regular menstrual cycles. Her evaluation was notable for very low FSH and low estradiol but normal LH; pregnancy, adrenal, thyroid, prolactin studies, and brain magnetic resonance imaging scan did not reveal a cause of her amenorrhea. Her transabdominal ultrasound showed an enlarged right ovary, initially suggestive of a hemorrhagic cyst. Inhibin A and B were measured because of the persistently low FSH; these were found to be very elevated, concerning for an inhibin-producing tumor. The patient had surgical removal of her right ovary; pathology revealed a juvenile granulosa-cell tumor. Postoperatively, the patient had normalization of serum inhibin A and B and resumption of normal menstrual cycles. This report illustrates that careful consideration of laboratory findings and other studies is essential for correctly identifying the underlying cause of secondary amenorrhea, particularly when the results are not consistent with common causes of this condition.
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Affiliation(s)
- Erin R Okawa
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - Roxanne Gardner
- Department of Gynecology, Boston Children's Hospital, Boston, Massachusetts.,Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Colleen Feltmate
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts.,Department of Gynecologic Oncology, The Dana Farber Cancer Institute, Boston, Massachusetts
| | - Michelle S Hirsch
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jeffrey W Craig
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Yee-Ming Chan
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
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Saei Ghare Naz M, Rostami Dovom M, Ramezani Tehrani F. The Menstrual Disturbances in Endocrine Disorders: A Narrative Review. Int J Endocrinol Metab 2020; 18:e106694. [PMID: 33613678 PMCID: PMC7887462 DOI: 10.5812/ijem.106694] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/02/2020] [Accepted: 09/12/2020] [Indexed: 12/20/2022] Open
Abstract
CONTEXT Menstrual cycle is considered the fifth vital sign among women. This study aimed to summarize the menstrual disturbances in different endocrine disorders. EVIDENCE ACQUISITION In this narrative review, relevant studies (up to December 2019) were searched based on the MeSH keywords diabetes, polycystic ovary syndrome, Cushing's syndrome, thyroid dysfunction, hyperprolactinemia, menstrual cycle, uterine bleeding, and menstruation. Databases used for searching articles included Google Scholar, Scopus, PubMed, and Web of science for observational, experimental, and review studies. RESULTS Endocrine disorders trigger the onset of menstrual disturbance across the reproductive lifespan of women. Endocrine glands (pituitary, thyroid, pancreas, adrenal, and ovaries) have a functional role in endocrine regulation of the menstrual cycle. According to available evidence, oligomenorrhea (cycles longer than 35 days) is the most common menstrual disturbance among endocrine disorders (thyrotoxicosis, hypothyroidism, polycystic ovary syndrome, Cushing's syndrome, and diabetes). Complex endocrine pathways play an essential role in a women's menstrual calendar. CONCLUSIONS The menstrual cycle length and amount of bleeding can be indicative of endocrine disorders. Further studies are needed to identify the unknowns about the association between endocrine disorders and the menstrual cycle.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Rostami Dovom
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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The Role of Hormones in Male Sexual Function. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Delcour C, Robin G, Young J, Dewailly D. PCOS and Hyperprolactinemia: what do we know in 2019? CLINICAL MEDICINE INSIGHTS. REPRODUCTIVE HEALTH 2019; 13:1179558119871921. [PMID: 31523136 PMCID: PMC6734626 DOI: 10.1177/1179558119871921] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 07/31/2019] [Indexed: 12/16/2022]
Abstract
Polycystic ovary syndrome (PCOS) and hyperprolactinemia (HPRL) are the two most common etiologies of anovulation in women. Since the 1950s, some authors think that there is a pathophysiological link between PCOS and HPRL. Since then, many authors have speculated about the link between these two endocrine entities, but no hypothesis proposed so far could ever be confirmed. Furthermore, PCOS and HPRL are frequent endocrine diseases and a fortuitous association cannot be excluded. The evolution of knowledge about PCOS and HPRL shows that studies conducted before the 2000s are obsolete given current knowledge. Indeed, most of the studies were conducted before consensual diagnosis criteria of PCOS and included small numbers of patients. In addition, the investigation of HPRL in these studies relied on obsolete methods and did not look for the presence of macroprolactinemia. It is therefore possible that HPRL that has been attributed to PCOS corresponded in fact to macroprolactinemia or to pituitary microadenomas of small sizes that could not be detected with the imaging methods of the time. Recent studies that have conducted a rigorous etiological investigation show that HPRL found in PCOS correspond either to non-permanent increase of prolactin levels, to macroprolactinemia or to other etiologies. None of this recent study found HPRL related to PCOS in these patients. Thus, the link between PCOS and HPRL seems to be more of a myth than a well-established medical reality and we believe that the discovery of an HPRL in a PCOS patient needs a standard etiological investigation of HPRL.
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Affiliation(s)
- Clémence Delcour
- Department of Obstetrics and Gynecology, Robert-Debré hospital, AP-HP, Paris, France
- INSERM, U1141, Paris Diderot university, Sorbonne Paris Cité, Paris, France
| | - Geoffroy Robin
- CHU Lille, Department of Reproductive Medicine & Lille University, Lille, France
- EA 4308, Lille University, Lille, France
| | - Jacques Young
- Department of Endocrinology and Reproductive Medicine, CHU Kremlin Bicetre, Paris, France
| | - Didier Dewailly
- INSERM U1172 Team 2, JPARC, Université de Lille, 59000 Lille, France
- Didier Dewailly, INSERM U1172 Team 2, JPARC, Université de LilleI, 52 rue Paul Duez, Lille, 59000, France.
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Chanson P, Maiter D. The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new. Best Pract Res Clin Endocrinol Metab 2019; 33:101290. [PMID: 31326373 DOI: 10.1016/j.beem.2019.101290] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Prevalence and incidence of prolactinomas are approximately 50 per 100,000 and 3-5 new cases/100,000/year. The pathophysiological mechanism of hyperprolactinemia-induced gonadotropic failure involves kisspeptin neurons. Prolactinomas in males are larger, more invasive and less sensitive to dopamine agonists (DAs). Macroprolactin, responsible for pseudohyperprolactinemia is a frequent pitfall of prolactin assay. DAs still represent the primary therapy for most prolactinomas, but neurosurgery has regained interest, due to progress in surgical techniques and a high success rate in microprolactinoma, as well as to some underestimated side effects of long-term DA treatment, such as impulse control disorders or impaired quality of life. Recent data show that the suspected effects of DAs on cardiac valves in patients with prolactinomas are reassuring. Finally, temozolomide has emerged as a valuable treatment for rare cases of aggressive and malignant prolactinomas that do not respond to all other conventional treatments.
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Affiliation(s)
- Philippe Chanson
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, Hôpital de Bicêtre, F-94275, Le Kremlin-Bicêtre, France; UMR-S1185 Université Paris-Sud, Univ Paris-Saclay, F-94276, Le Kremlin-Bicêtre, France; Institut National de la Santé et de la Recherche Médicale (Inserm) U1185, F-94276, Le Kremlin Bicêtre, France.
| | - Dominique Maiter
- Service d'Endocrinologie et Nutrition, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Matalliotakis M, Koliarakis I, Matalliotaki C, Trivli A, Hatzidaki E. Clinical manifestations, evaluation and management of hyperprolactinemia in adolescent and young girls: a brief review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:149-157. [PMID: 30889169 PMCID: PMC6502148 DOI: 10.23750/abm.v90i1.8142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Indexed: 12/20/2022]
Abstract
Hyperprolactinemia (HPrl) is considered as a rare endocrinopathy in childhood. In children and adolescent girls, there are three major categories of HPrl causes; physiological, pathological and iatrogenic. Through hypogonadotropic hypogonadism, prolactin hypersecretion and production leads to the typical functional syndrome which is observed in female children and adolescents; delayed puberty, primary or secondary amenorrhea and/or galactorrhea. Regarding prolactinomas, clinical signs manifest with mass compression of the optic chiasm and anterior pituitary gland or prolactin hypersecretion. Targeted identification of HPrl is of significant importance for proper management and follow-up. The aim of this review is to focus on the evaluation of HPrl in adolescent and young girls. In addition, we aimed to summarize the current knowledge regarding the proper management of such cases. (www.actabiomedica.it)
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Affiliation(s)
- Michail Matalliotakis
- Obstetrics and Gynecology Department of Venizeleio General Hospital, Heraklion, Crete, Greece.
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Pituitary magnetic resonance imaging abnormalities in young female patients with hypogonadotropic hypogonadism. Obstet Gynecol Sci 2019; 62:249-257. [PMID: 31338342 PMCID: PMC6629987 DOI: 10.5468/ogs.2019.62.4.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/05/2018] [Accepted: 01/29/2019] [Indexed: 11/21/2022] Open
Abstract
Objective To elucidate the association between clinical and laboratory characteristics and pituitary magnetic resonance imaging (MRI) abnormalities in young female patients with hypogonadotropic hypogonadism (HH). Methods We retrospectively investigated a series of 74 female patients (age range, 14–42 years) with normoprolactinemic HH who underwent pituitary MRI. Pubertal milestones and hormonal features of patients with small pituitary glands (PGs) and space-occupying lesions were compared with those of patients with normal PGs. Results The overall frequency of abnormal PGs was 35.1%, with space-occupying lesions observed in 8 patients (10.8%), and small PG observed in 18 patients (24.3%). The mean serum gonadotropin level was not different between patients with and without pituitary MRI abnormalities (P>0.05). Space-occupying lesions were not associated with low gonadotropin levels, type of amenorrhea, or presence of secondary sex characteristics. The frequency of space-occupying lesions was higher in patients with interrupted puberty (25.0%) than in patients who did not go through puberty (4.8%) or had a normal puberty (9.8%), but were not statistically significant (P>0.05). Small PG was associated with low gonadotropin levels and type of amenorrhea (P<0.05). Conclusion Clinically significant space-occupying lesions were not associated with low gonadotropin levels, type of amenorrhea, or presence of secondary sex characteristics. However, the frequency of space-occupying lesions was higher in patients with interrupted puberty than in patients who did not go through puberty or who with normal puberty.
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Petkus DL, Murray-Kolb LE, De Souza MJ. The Unexplored Crossroads of the Female Athlete Triad and Iron Deficiency: A Narrative Review. Sports Med 2018; 47:1721-1737. [PMID: 28290159 DOI: 10.1007/s40279-017-0706-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Despite the severity and prevalence of iron deficiency in exercising women, few published reports have explored how iron deficiency interacts with another prevalent and severe condition in exercising women: the 'female athlete triad.' This review aims to describe how iron deficiency may interact with each component of the female athlete triad, that is, energy status, reproductive function, and bone health. The effects of iron deficiency on energy status are discussed in regards to thyroid function, metabolic fuel availability, eating behaviors, and energy expenditure. The interactions between iron deficiency and reproductive function are explored by discussing the potentially impaired fertility and hyperprolactinemia due to iron deficiency and the alterations in iron metabolism due to menstrual blood loss and estrogen exposure. The interaction of iron deficiency with bone health may occur via dysregulation of the growth hormone/insulin-like growth factor-1 axis, hypoxia, and hypothyroidism. Based on these discussions, several future directions for research are presented.
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Affiliation(s)
- Dylan L Petkus
- Department of Kinesiology, The Pennsylvania State University, 104 Noll Laboratory, University Park, PA, 16802, USA
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Mary Jane De Souza
- Department of Kinesiology, The Pennsylvania State University, 104 Noll Laboratory, University Park, PA, 16802, USA.
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Luan S, Mu M, Sun L. The mechanism of selfheal extract in treating hyperprolactinemia. Cancer Biomark 2017; 20:575-580. [PMID: 28946556 DOI: 10.3233/cbm-170454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Selfheal has been used for many years in hyperprolactinemia induced galactorrhea, menstrual disorders, and dysgenesis with satisfactory curative effect. However, its mechanism is still unclear. This study intended to investigate the effect of selfheal extract on hyperprolactinemia in vivo and in vitro, in order to elucidate its mechanism of anti-hyperprolactinemia. PATIENTS AND METHODS Hyperprolactinemia rat model was established. High dose (28.8 g/(kg⋅d)), middle dose (14.4 g/ (kg⋅d)), and low dose (7.2 g/(kg⋅d)) of selfheal extract were used to treat the model to observe impact on serum estradiol (E2), progesterone (P), prolactin (PRL), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels. Three cell lines MMQ, GH3, and PC12 were applied to investigate selfheal extract effect on PRL secretion, dopamine D2 receptor, and dopamine transporter (DAT). RESULTS High and middle dose of selfheal extract significantly reduced PRL level in hyperprolactinemia rat compared with model group (P< 0.01). Compared with normal control, 5 mg/ml and 10 mg/ml selfheal extract obviously inhibited PRL secretion in MMQ cells that high expressed D2 receptor after 24 hours (P< 0.01), but did not affect PRL secretion in GH3 cells lack of D2 receptor. 8 mg/ml selfheal extract markedly suppressed D2 receptor and DAT expression in PC12 cells that strongly expressed D2 receptor and DAT (P< 0.01). CONCLUSIONS Selfheal extract treated hyperprolactinemia through dopamine D2 receptor with significant effect.
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Affiliation(s)
- Suxian Luan
- Department of Reproductive Medicine, Weifang People's Hospital, Weifang, Shandong 261041, China
| | - Meiling Mu
- Department of Reproductive Medicine, Weifang People's Hospital, Weifang, Shandong 261041, China
| | - Liangzhi Sun
- Department of Orthopaedics, Weifang People' s Hospital, Weifang, Shandong 261041, China
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Millar RP, Sonigo C, Anderson RA, George J, Maione L, Brailly-Tabard S, Chanson P, Binart N, Young J. Hypothalamic-Pituitary-Ovarian Axis Reactivation by Kisspeptin-10 in Hyperprolactinemic Women With Chronic Amenorrhea. J Endocr Soc 2017; 1:1362-1371. [PMID: 29264460 PMCID: PMC5686678 DOI: 10.1210/js.2017-00328] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 10/11/2017] [Indexed: 11/23/2022] Open
Abstract
Context: Hyperprolactinemia-induced hypogonadotropic amenorrhea (hPRL-HA) is a major cause of hypothalamic gonadotrophin-releasing hormone (GnRH) deficiency in women. In hyperprolactinemic mice, we previously demonstrated that hypothalamic kisspeptin (Kp) expression was diminished and that Kp administration restored hypothalamic GnRH release, gonadotropin secretion, and ovarian cyclicity, suggesting that Kp neurons could also play a role in hPRL-HA. Objective: To study the effect of Kp-10 on the gonadotropic-ovarian axis in women with hPRL-HA. Patients: Two women (32 and 36 years old) with chronic hPRL-HA (prolactin: between 94 and 102 and 98 and 112 ng/mL, respectively) caused by cabergoline-resistant microprolactinomas. Interventions: Cabergoline was discontinued 6 months before inclusion. Blood samples were taken every 10 minutes for 12 hours during 2 consecutive days to evaluate luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion. Serum estradiol (E2), testosterone (T), and inhibin B (IB) levels were also measured. Vehicle or Kp-10 (1.5 μg/kg/h) was infused intravenously for 12 hours. Results: Kp-10 induced a significant increase in LH and FSH levels and increased LH pulses. E2, T, and IB serum levels were also significantly increased. Conclusions: In this exploratory study, we demonstrated that administration of Kp-10 reactivated gonadotropin secretion in women with hPRL-HA and increased ovarian activity. Our data suggest that, as in rodents, GnRH deficiency in hPRL-HA is also mediated by an impairment of hypothalamic Kp secretion. Kp-10 or its analogues could have therapeutic application as an alternative approach to restore ovarian function and fertility in women with hPRL-HA resistant to dopamine agonists and in whom pituitary surgery is not possible.
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Affiliation(s)
- Robert P Millar
- Centre for Neuroendocrinology, Departments of Immunology and Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa.,Institute for Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa
| | - Charlotte Sonigo
- INSERM U1185, Paris Sud Medical School, Le Kremlin-Bicêtre, F-94276, France.,Reproductive Endocrinology Department, Le Kremlin-Bicêtre, F-94275, France
| | - Richard A Anderson
- MRC Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
| | - Jyothis George
- MRC Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
| | - Luigi Maione
- Reproductive Endocrinology Department, Le Kremlin-Bicêtre, F-94275, France.,Assistance Publique Hôpitaux de Paris (AP-HP), Bicêtre Hospital, Hormonology and Genetic Department, Le Kremlin-Bicêtre, F-94275, France
| | - Sylvie Brailly-Tabard
- Reproductive Endocrinology Department, Le Kremlin-Bicêtre, F-94275, France.,Assistance Publique Hôpitaux de Paris (AP-HP), Bicêtre Hospital, Hormonology and Genetic Department, Le Kremlin-Bicêtre, F-94275, France
| | - Philippe Chanson
- Reproductive Endocrinology Department, Le Kremlin-Bicêtre, F-94275, France.,Université Paris Sud, Paris-Sud Medical School, Le Kremlin-Bicêtre, F-94276, France
| | - Nadine Binart
- Reproductive Endocrinology Department, Le Kremlin-Bicêtre, F-94275, France
| | - Jacques Young
- Reproductive Endocrinology Department, Le Kremlin-Bicêtre, F-94275, France.,Université Paris Sud, Paris-Sud Medical School, Le Kremlin-Bicêtre, F-94276, France
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Endocrine Abnormalities in Adolescents with Menstrual Disorders. J Obstet Gynaecol India 2017; 68:58-64. [PMID: 29391677 DOI: 10.1007/s13224-017-1035-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022] Open
Abstract
Purpose To look for endocrine abnormalities like thyroid disorders, hyperprolactinemia, hyperandrogenism and PCOS among adolescents with menstrual disorders and to compare the above endocrine status with those without menstrual disorders. Methods This was a case-control study carried out in adolescent girls aged 10-19 years in gynecology outpatient department of a tertiary care hospital. Sample of venous blood (5 ml) was taken for hormonal studies as clinically indicated-thyroid function test, serum prolactin, total testosterone, which were analyzed by chemiluminescence system. Results Oligomenorrhea was the most common menstrual abnormality in our study, the prevalence being 61.0% in cases followed by primary amenorrhea (16.4%). Thyroid dysfunction was found in 13.6% girls with menstrual disorders compared to 3.5% in those without menstrual disorders, and this was statistically significant (p = 0.006). Biochemical hyperandrogenism was seen in 9.04% cases compared to 0.7% controls (p = 0.001). The overall prevalence of hyperprolactinemia was 0.94%, and there was no statistically significant difference in girls with and without menstrual disorders. The prevalence of PCOS was 12.4% in the study population and 22.6% cases. Oligomenorrhea and PCOS were the most prevalent phenotypes in 52.5% of PCOS girls. No endocrine abnormality was detected in cases of polymenorrhea, hypomenorrhea and intermenstrual bleeding. Conclusions Although immaturity of hypothalamic pituitary ovarian axis is considered to be the most common cause of menstrual irregularities in adolescent girls, endocrine abnormalities, namely thyroid dysfunction and hyperandrogenism, may be responsible in some cases, thus warranting further evaluation.
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Elsersy MAM. Efficacy of Combined Cabergoline and Metformin Compared to Metformin Alone on Cycle Regularity in Patients with Polycystic Ovarian Disease with Hyperprolactinemia: A Randomized Clinical Trial. J Obstet Gynaecol India 2017; 67:363-369. [PMID: 28867888 DOI: 10.1007/s13224-017-1022-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 06/01/2017] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Polycystic ovarian syndrome (PCOS) is a common reproductive disorder. Increasing serum prolactin in these patients could be detected in both follicular and luteal phase of the normal and stimulated cycles. Hyperprolactinemia affects the hypothalamic-pituitary-ovarian axis causing anovulation and abnormal uterine bleeding. In this study, the efficacy of combined cabergoline and metformin therapy was compared to metformin therapy alone in patients with PCOS on the body mass index, androgen profile and menstrual cycle regulation. METHODS Two hundred and fifty patients with polycystic ovarian syndrome (PCOS) with increased serum prolactin were randomly allocated into two groups: group (1) received oral metformin tablet 1000 mg per day and cabergoline 0.5 g tablet weekly for 3 months as a case group, and group (2) received oral metformin tablet 1000 mg per day and a placebo tablet weekly for 3 months as the control group (n = 123). Body mass index (BMI), menstrual cycle regularity, serum testosterone, serum prolactin and dehydroepiandrosterone sulfate (DHEAS) level were compared before and after treatment in both groups. RESULTS There was significant decrease in body mass index and improvement of androgenic profile in both groups after treatment. In group (1), there was significant improvement in cycle regularity and significant decrease in serum prolactin level post-treatment. CONCLUSIONS The use of cabergoline in addition to metformin had more favorable effect on cycle regularity and prolactin level in patients with polycystic ovarian syndrome with hyperprolactinemia than the use of metformin alone.
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Affiliation(s)
- Mervat Ali Mohamed Elsersy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Hai Jamma Hospital, Sera Altera Street, University Road, P.O.10153, Jeddah, 21433 Kingdom of Saudi Arabia
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Adra A, El Zibdeh MY, Abdul Malek AMM, Hamrahian AH, Abdelhamid AMS, Colao A, Anastasiades E, Ahmed EMAF, Ezzeddine JI, El Sattar MIA, Dabit ST, Ghanameh W, Nedjatian N, El-Kak F. Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2016. [DOI: 10.1016/j.mefs.2016.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Prevalence of hyperprolactinemia and thyroid disorders among patients with abnormal uterine bleeding. Int J Gynaecol Obstet 2015; 131:273-6. [PMID: 26372350 DOI: 10.1016/j.ijgo.2015.05.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/18/2015] [Accepted: 08/12/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the prevalence of hyperprolactinemia and thyroid disorders among patients with abnormal uterine bleeding (AUB) compared with matched controls. METHODS In 2013-2014, an observational study of women with AUB (group A) and women with regular menstruation (group B) was undertaken at one center in Egypt and one in the United Arab Emirates. Eligible women were aged 20-35 years and were not obese. Participants underwent clinical examinations, vaginal ultrasonography, office hysteroscopy (in selected cases), and measurement of hormone levels. RESULTS Hyperprolactinemia was present in 17 (16.2%) of 105 patients in group A and 4 (3.2%) of 125 patients in group B (P=0.009). In group A, a high thyroid-stimulating hormone (TSH) level was observed in 8 (7.6%) patients and low levels of free triiodothyronine/thyroxine were found in 5 (4.8%) patients, compared with 2 (1.6%) patients and 1 (0.8%) patient in group B (P=0.012 and P=0.008, respectively). Polymenorrhea was the most frequent presentation of AUB (n=60 [57.1%]). Five (29.4%) patients with hyperprolactinemia had galactorrhea. In group A, 8 (47.1%) patients with a high TSH had hyperprolactinemia, whereas 1 (1.1%) patient with a high TSH had a normal prolactin value (P=0.008). CONCLUSION Screening by evaluating prolactin and thyroid hormone levels is recommended for all patients with AUB, even in the absence of galactorrhea.
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Water Extract of Fructus Hordei Germinatus Shows Antihyperprolactinemia Activity via Dopamine D2 Receptor. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:579054. [PMID: 25254056 PMCID: PMC4164367 DOI: 10.1155/2014/579054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/29/2014] [Accepted: 08/14/2014] [Indexed: 11/25/2022]
Abstract
Objective. Fructus Hordei Germinatus is widely used in treating hyperprolactinemia (hyperPRL) as a kind of Chinese traditional herb in China. In this study, we investigated the anti-hyperPRL activity of water extract of Fructus Hordei Germinatus (WEFHG) and mechanism of action. Methods. Effect of WEFHG on serum prolactin (PRL), estradiol (E2), progesterone (P), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and hypothalamus protein kinase A (PKA) and cyclic adenosine monophosphate (cAMP) levels of hyperPRL rats were investigated. And effect of WEFHG on PRL secretion, D2 receptors, and dopamine transporters (DAT) was studied in MMQ, GH3, and PC12 cells, respectively. Results. WEFHG reduced the secretion of PRL in hyperPRL rats effectively. In MMQ cell, treatment with WEFHG at 1–5 mg/mL significantly suppressed PRL secretion and synthesis. Consistent with a D2-action, WEFHG did not affect PRL in rat pituitary lactotropic tumor-derived GH3 cells that lack the D2 receptor expression but significantly increased the expression of D2 receptors and DAT in PC12 cells. In addition, WEFHG reduced the cAMP and PKA levels of hypothalamus in hyperPRL rats significantly. Conclusions. WEFHG showed anti-hyperPRL activity via dopamine D2 receptor, which was related to the second messenger cAMP and PKA.
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The utility of transrectal ultrasound in adolescents when transabdominal or transvaginal ultrasound is not feasible. J Pediatr Adolesc Gynecol 2013; 26:265-8. [PMID: 23849089 DOI: 10.1016/j.jpag.2013.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 03/29/2013] [Accepted: 04/04/2013] [Indexed: 11/23/2022]
Abstract
STUDY OBJECTIVE To present the indications and diagnosis in adolescents undergoing transrectal ultrasound (RU). DESIGN Retrospective chart review. PARTICIPANTS Adolescents presenting to gynecology clinic between January 1, 2005 and December 31, 2012. MAIN OUTCOME MEASURES Detection of RU, transvaginal, and transabdominal (AU) ultrasound indications, and final diagnosis. RESULTS The main indications for RU were menstrual abnormalities, pelvic pain-dysmenorrhea, and vulvovaginitis. When compared according to final diagnosis adolescents with vulvovaginitis (13.9%) and amenorrhea (8.3%) were evaluated more with RU. CONCLUSION RU is highly acceptable and it provides images superior to AU. It can be used in adolescents to visualize the pelvic organs and to exclude genital abnormalities and mass lesions.
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Wang X, Chen YG, Ma L, Li ZH, Li JY, Liu XG, Zou JL, Wu JH. Effect of Chinese medical herbs-Huiru Yizeng Yihao on hyperprolactinemia and hyperplasia of mammary gland in mice. AFRICAN JOURNAL OF TRADITIONAL, COMPLEMENTARY, AND ALTERNATIVE MEDICINES 2013; 10:24-35. [PMID: 24146497 DOI: 10.4314/ajtcam.v10i4.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The study investigated the pharmacodynamism and mechanism of Chinese medicinal formula-Huiru Yizeng Yihao (NO.1 HRYZ) on the model rats of hyperpro-lactinemia and the model rats of hyperplasia of mammary gland (HMG), and studied the internal connection between hyperprolactinemia and HMG.. The hyperprolactinemia rat models were established by injecting metoclopramide dihydrochloride in the back of rats. The model rat of HMG was prepared by injecting estradiol in the thigh muscle of the rats and progesterone consecutively, while the tails of rats were clipped with tongs. Rats were treated with either NO.1 HRYZ or positive control drugs for four weeks. The concentrations of sex hormone in rat serum were examined using ELISA kits, and the morphology of mammary gland tissue in all group rats was observed with microscope. NO.1 HRYZ significantly decreased prolactin (PRL) and increased estradiol (E2), progesterone (P), follicle stimulating hormone (FSH), luteinizing hormone (LH) concentrations of hyperprolactinemia rats. It decreased E2, PRL, FSH, gonadotropin-releasing hormone (GnRH), 5-hydroxytryptamine (5-HT) and increased P concentrations of HMG rat. It also eliminated hyperplasia of lobules and gland alveolus compared with the model group. Treatment with NO.1 HRYZ could significantly regulate the sex hormone disorder of hyperprolactinemia and HMG rat models, and could eliminate the formation of HMG. Hyperprolactinemia was closely correlated with HMG, and hyperprolactinemia promoted the formation of HMG.
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Affiliation(s)
- Xiong Wang
- The Department of Pharmacy, The Third Hospitai of Wuhan, Wuhan,China
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