1,721,161 research outputs found

    Endocrinologia Ginecologica

    No full text
    Testo di clinica e diagnostica di endocrinologia ginecologic

    Neuroendocrine aspects of amenorrhea related to stress

    No full text
    Reproductive functions are controlled by a very sophisticated system that is composed by the perfect syncronization of neuronal end endocrinological functions. Hypothalamus is the neuroendocrine gland that discharges GnRH that stimulates LH and FSH secretion from pituitary thus promoting ovarian function. Whatever affects the hypothalamic activity might be able to interfere with the reproductive axis. In fact changes in such sophisticated stimulatory system is able to negatively affect the periodical function of the ovary and may induce amenorrhea. Stressant situations, due to physical, psychologic or metabolic stressors, are able to negatively modulate the hypothalamus-pituitary-ovarian axis (HPO) mainly acting through an impairment of the many neuromodulators and neuropeptides that are produced inside the brain and in the hypothalamic areas. Stress induced amenorrhea is usually called hypothalamic amenorrhea (HA) and affect a consistent percentage of women, independently from the age. Nevertheless, quite often HA is diagnosed in adolescents or in girls below 20 years of age. Undernutrition, excess of training, psychological stress, are able to induce HA and then hypo-estrogenism due to the reduced ovarian activity. When sports or exaggerated training is performed before or during the onset of menarche, a specific delay of menarche might occur, as direct consequence of the unbalance between feeding, energy consumption and psychological stress. Osteopenia and osteoporosis are possible consequence of such situation. Clinicians have to pay great attention to all kind of delay of occurrence of meanarche or of amenorrhea, especially if related to lost of weight, since these might mask adverse environmental situations that might induce HA through an exaggerated stress-induced neuroendocrine response

    Inositol as putative integrative treatment for PCOS

    No full text
    Studies over the last decade have demonstrated that some polycystic ovary syndrome (PCOS) patients have abnormal insulin sensitivity (insulin resistance), independently from being overweight or obese. This induces the risk of developing type 2 diabetes in such PCOS patients. The use of insulin sensitizers (i.e. metformin), reduces such metabolic, and most hormonal, impairments. As metformin often induces side effects, new integrative strategies have been proposed to treat insulin resistance, such as the use of inositols. Such compounds are mainly represented in humans by two inositol stereoisomers: myo-inositol (MYO) and d-chiro-inositol (DCI). MYO is the precursor of inositol triphosphate, a second messenger that regulates thyroid-stimulating hormone (TSH) and FSH as well as insulin. DCI derives from the conversion of myo-inositol via an insulin-dependent pathway. Several preliminary studies have indicated possible benefits of inositol therapy in PCOS patients, but to date no meta-analysis has been performed. This review aims to give clinical insights for the clinical use of inositol in PCOS
    corecore