Amenorrhea

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  • Amenorrhea means the absence of menstruation. Primary amenorrhea is the absence of menarche in a girl aged 16 years or older. Secondary amenorrhea 4 is the absence of menses for 6 months in women with previously irregular cycles or 3 months in women with regular cycles (21–35 days).

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  • Contraceptive use accounts for a substantial portion of the variation in observed fertility rates (others include age of marriage, abortion rates, post- partum amenorrhea and abstinence, and occurrence of marital separations). Although there have been dramatic increases in the use of family planning services, unmet need for family planning remains very high in low-prevalence regions.

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  • The Subcommittee on Body Composition, Nutrition, and Health of Military Women (BCNH subcommittee) was established in 1995 through a grant administered by the U.S. Army Medical Research and Materiel Command as part of the Defense Women's Health Research Program.

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  • Current radical surgery against localized prostate cancer (PCa), such as open (Memmelaar, 1949; Reiner & Walsh, 1979; Walsh & Donker, 1982), laparoscopic (Schuessler et al., 1997; Abbou et al., 2000; Guillonneau et al., 2003) or robot-assisted prostatectomy (Binder & Kramer, 2001; Menon et al., 2002; Menon et al., 2004), has a possible risk to injure supporting structures that surround and support the prostate as well as the external sphincter and the neurovascular bundle.

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  • Ovarian reserve shrinks throughout life and reaches a critical threshold level at the inception of the menopause. At this point, a woman notes her first skipped menstrual period. The menopausal transition begins with the onset of first menstrual irregularity, or skipped menses, and ends with the final menstrual period. Progressive loss of ovarian follicles results in decreased production of inhibin and a loss of restraint on FSH secretion.

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  • Role of the hypothalamic-pituitary-gonadal axis in the etiology of amenorrhea. Gonadotropin-releasing hormone (GnRH) secretion from the hypothalamus stimulates follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion from the pituitary to induce ovarian folliculogenesis and steroidogenesis. Ovarian secretion of estradiol and progesterone controls the shedding of the endometrium, resulting in menses and, in combination with the inhibins, provides feedback regulation of the hypothalamus and pituitary to control secretion of FSH and LH.

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  • Algorithm for evaluation of amenorrhea. β-hCG, human chorionic gonadotropin; PRL, prolactin; FSH, follicle-stimulating hormone; TSH, thyroidstimulating hormone. Hypogonadotropic Hypogonadism Low estrogen levels in combination with normal or low levels of LH and FSH are seen with anatomic, genetic, or functional abnormalities that interfere with hypothalamic GnRH secretion or normal pituitary responsiveness to GnRH. Although relatively uncommon, tumors and infiltrative diseases should be considered in the differential diagnosis of hypogonadotropic hypogonadism (Chap. 333).

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  • Refusal to maintain body weight at or above a minimally normal weight for age and height. (This includes a failure to achieve weight gain expected during a period of growth leading to an abnormally low body weight.) Intense fear of weight gain or becoming fat. Distortion of body image (e.g., feeling fat despite an objectively low weight or minimizing the seriousness of low weight). Amenorrhea. (This criterion is met if menstrual periods occur only following hormone—e.g., estrogen—administration.

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  • Although women account for more physician office visits than men, most women receive diagnoses and treatments based on what has worked for men. Until recently, medical research has largely ignored many health issues important to women, and women have long been under-represented in clinical trials. Many health education programs have realized this inequity and have begun to incorporate women’s health programs into their curriculum.

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  •  Abstract Background. Medical termination of pregnancy can be successfully performed with a combination of mifepristone (RU 486) and a prostaglandin analogue. We conducted a prospective, randomized trial to compare oral with vaginal administration of the prostaglandin E1 analogue misoprostol for first-trimester abortion in women treated initially with mifepristone. Methods. The study population consisted of 270 women seeking abortion within 63 days after the onset of amenorrhea. The dose of mifepristone was 600 mg, and the dose of misoprostol was 800 mg.

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  •  The combination of mifepristone (RU 486) and a prostaglandin analogue given either intramuscularly or intravaginally is effective in terminating early pregnancy, but the prostaglandin component of the regimen is cumbersome to administer and has side effects. We conducted two studies to determine the efficacy of 600 mg of mifepristone followed by a small dose of misoprostol, an orally active prostaglandin E1 analogue, for the same purpose.

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  • Family planning refers to a conscious effort by a couple to limit or space the number of children they want to have through the use of contraceptive methods. Information about use of contraceptive methods was collected from female respondents by asking if they (or their partner) were currently using a method. Contraceptive methods are classified as modern and traditional methods. Modern methods include female sterilization, male sterilization, pill, IUD, injectables, implants, male condom, diaphragm, lactational amenorrhea method (LAM), and standard days method.

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