Academic literature on the topic 'Secondary oligomenorrhea'

Polycystic Ovarian Syndrome (PCOS) is multi-organ syndrome that affects 6–25% of females during reproductive age. It disrupts normal hormone levels of females and affects adrenal hormone and sex hormones along with pituitary hormones including adrenocorticotropic, growth hormone and gonadotropins hormones. It results in several secondary characteristics in females such as infertility, hormonal imbalance, oligomenorrhea, amenorrhea, obesity and hirsutism. Polycystic ovarian syndrome is associated with mental and reproductive disorder and almost 4–18% mature female students are affected by polycystic ovarian syndrome. Female affected by polycystic ovarian syndrome have increased risk of infertility, ovarian cancer, skin problems and psychological problems such as anxiety, depression and changes in sleep along with mood swings. This chapter discusses the Prevalence, Symptomatology and Management of Polycystic Ovarian Syndrome. For the management of PCOS, the role of some medicinal plants including Asparagus racemosus, Tinospora cordifolia, Foeniculum vulgare, Ocimum tenuiflorum, Actaea racemosa, and Lepidium meyenii have also been discussed in addition to other treatment modalities. The literature data was searched out and compiled using relevant original research articles and reviews published and indexed in Google Scholar, Scientific Information Database, Elsevier, PubMed and Science Direct.

Abstract Oligomenorrhoea is conventionally defined as an intermenstrual interval of greater than 42 days and is usually indicative of anovulation. Although the focus of this chapter is on oligomenorrhoea, it should be noted that its causes and management are very similar to those of secondary amenorrhoea or irregular menses which are also manifestations of anovulation. Anovulatory menses carries the implication that the ovary is producing oestrogen concentrations which are in the mid-follicular phase range but that progesterone secretion will be deficient. A series of anovulatory menses may, however, be interspersed by the occasional ovulatory cycle, a phenomenon which is relevant when considering the management of patients with oligomenorrhoea, as will be discussed later.

Folliculogenesis and ovulation depend upon adequate gonadotropin stimulation, which in turn requires appropriate gonadotropinreleasing hormone (GnRH) input. There exists a group of related disorders in which GnRH drive to the pituitary is reduced, resulting in secondary diminution of follicle-stimulating hormone (FSH) and luteinizing hormone input to the ovary. Clinically, reduced GnRH drive results in a spectrum of ovarian compromise, ranging from luteal insufficiency to chronic anovulation. Variable menstrual patterns follow, including amenorrhoea, polymenorrhoea, with or without menorrhagia, and oligomenorrhoea, depending on the extent of follicular activity across time. Rarely, there is an organic or congenital cause for reduced GnRH drive, such as a brain tumour, coeliac disease, or migration of an insufficient number of GnRH neurons from the olfactory placode into the hypothalamus during fetal development. Typically, the cause is functional, that is, due to the endocrine consequences of certain psychological or behavioural variables. Anorexia nervosa provides the most dramatic example, but most women who develop functional hypothalamic anovulation do not meet criteria for an eating disorder and do not develop one subsequently. Because of the occult and heterogeneous nature of the behavioural variables that contribute to the genesis of this related group of disorders, a variety of names have been used to describe this syndrome, including exercise amenorrhoea, stress-related or stress-induced anovulation, functional hypothalamic amenorrhoea, functional hypothalamic chronic anovulation, and psychogenic amenorrhoea. Occasionally, psychiatric syndromes other than eating disorders such as depression coexist with functional hypothalamic anovulation, but unlike anorexia nervosa, in which amenorrhoea is almost universal, amenorrhoea is less common in women with bulimia and depression. Despite the multiplicity of names, the pathogenesis of anovulation in these diverse clinical settings is similar. In recognition of their common nature, I have chosen herein to refer to this group of disorders as ‘functional hypothalamic anovulation’ or FHA. As noted above, not all women have reduced gonadotropin secretion to the extent that they become amenorrhoeic or even persistently anovulatory, but most investigations have focused on subjects with the most complete expression of these related disorders, namely, those who are amenorrhoeic due to chronic anovulation. Generally, functional hypothalamic anovulation is considered to be a form of secondary amenorrhoea, but it can present as primary amenorrhoea. The diagnosis of functional hypothalamic anovulation is one of exclusion.

Introduction: The practice of regular physical exercises brings numerous benefits in addition to when combined with adequate nutrition, which has been increasingly stimulated as a way of preventing chronic diseases, improving bone mass, acquiring adequate body mass index, in addition to reducing the risk of cardiovascular disease. However, more rigorous training regimens adopted by athletes in the reproductive period can cause hormonal changes, even stopping menstruation. By combining ovulatory dysfunction, low bone mineral density and an energy deficit, we have the female athlete triad. Objective: objective of the present study is to verify the prevalence of these physiological alterations in elite athletes in response to exercise. Methodology: To obtain a current analysis, a bibliographic review of the published works was carried out and inserted in the PUBMED, LILACS and SCIELO databases, crossing the keywords “amenorrhea”, “athlete” and “menstrual disorders”. As a result, articles were obtained that provide an overview of the latest updates on the topic. Results and discussions: Hypothalamic amenorrhea is one of the most common causes of secondary amenorrhea, and its occurrence is due to a defect in the release of the GnRH hormone, which leads to a decrease in the release of gonadotropins (FSH and LH). The final consequences of this process are important hormonal changes, which are manifested through severe hypoestrogenism. Menstrual dysfunctions, when associated with low body mass, low fat percentage and premature osteoporosis, can be indicators of the Female Athlete Triad (TMA). It can have short- and long-term consequences. In the short term, oligomenorrheic athletes have been victims of high injury rates, particularly stress fractures, and in the long term, those that become osteoporotic are at increased risk of fractures with their resulting morbidity, albeit at a young age. Conclusion: With the increase in the discussion about the benefits of sport, new conditions related to it have been increasingly studied. It is important to emphasize that the athlete’s training load should not exceed the normal functioning condition of the organism. According to the studies analyzed, information on the occurrence of amenorrhea and other menstrual disorders, accompanied by adjuvant conditions should gain more attention among health professionals in the sport and its practitioners. health consequences, and developing educational actions for target groups, such as coaches, coaches, parents, athletes, sports administrators and institutional authorities