{"title":"A clinician's guide to the use of gonadotropin-releasing hormone analogues in women.","authors":"K S Moghissi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Gonadotropin-releasing hormone (GnRH) and its analogues have been extensively used in clinical medicine since they were identified and synthesized in 1971. Native GnRH stimulates gonadotrophs of the anterior pituitary and has been used for induction of ovulation. The GnRH agonists, which have greater potency and a longer half-life than native GnRH, produce an initial stimulation of pituitary gonadotrophs that results in secretion of follicle-stimulating hormone and luteinizing hormone and the expected gonadal response. This response is followed by downregulation and inhibition of the pituitary-gonadal axis. The GnRH antagonists promptly suppress pituitary gonadotropin by GnRH-receptor competition, thereby avoiding the initial stimulatory phase of the agonists. Discontinuation of GnRH antagonist treatment leads to a rapid and predictable recovery of the pituitary-gonadal axis. The GnRH analogues are potent therapeutic agents that are considerably useful in a variety of clinical indications. These indications include management of endometriosis, uterine leiomyomas, hirsutism, dysfunctional uterine bleeding, premenstrual syndrome, assisted reproduction, and some hormone-dependent tumors.</p>","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"5 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21640640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New diagnostic methods for chlamydial infection in women.","authors":"M R Hammerschlag","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"4 5","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21485131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Vedantham, S C Goodwin, B McLucas, M Lee, R Perrella, A E Forno, M DeLeon
{"title":"Uterine artery embolization for fibroids: considerations in patient selection and clinical follow-up.","authors":"S Vedantham, S C Goodwin, B McLucas, M Lee, R Perrella, A E Forno, M DeLeon","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"4 5","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21485132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ob-Gyn interactive case challenge--a case of sadness and anxiety 9 months postpartum.","authors":"D M Gangi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>If you were the primary care provider, how would you diagnose and treat postpartum anxiety and depression in this young, first-time mother? After a normal, uncomplicated pregnancy, this 27-year-old woman developed anxiety and depressed mood, which she was still struggling to control 9 months after the birth of her child. Among the diagnostic possibilities to consider are occult malignancy, diabetes mellitus, and thyroid disorder, as well as major depression/anxiety disorder and postpartum depression.</p>","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"4 2","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"1999-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21203003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Virtual consult--pregnant woman with sickle-cell disease.","authors":"S Borhan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A young woman in her 20s with a lifelong history of sickle-cell disease presents with sickle-cell crisis while in active labor. After delivery of the neonate via cesarean section, her fever spikes to nearly 106 F (41.1 C) and stays there. Clinicians are invited to comment on this case in a discussion moderated by Joseph Pastorek, MD, FACOG.</p>","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"4 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20962915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exercise at menopause: a critical difference.","authors":"M Burghardt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Even at menopause, fitness can reduce the risk of heart disease, osteoporosis, and diabetes, yet only 38% of women over age 19 exercise regularly. A sports medicine expert recommends that exercise be encouraged and prescribed, even for women with a variety of comorbidities.</p>","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"4 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20962909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hormone alterations in breast cancer: examining the hypotheses.","authors":"W H Hindle","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many of the epidemiologic risk factors for breast cancer offer clinicians little help in anticipating who is likely to be struck with the disease or how to prevent it. There are only a handful of clinically significant risk factors for breast cancer. These include being a woman, growing older, already having breast cancer in 1 breast, and having a first-degree relative (mother, sister, or daughter) who has been diagnosed with breast cancer. Most risk factors have a weak association with breast cancer, occur too infrequently, or are physiologic events not amenable to intervention. In recent years, the search for breast cancer causes has led to the identification of genetic markers that seem to predispose some women to breast cancer. For decades, however, researchers have been assessing and analyzing hormonal changes in the hope of finding a predictable breast cancer marker or cause that can easily be manipulated to prevent or more effectively treat the disease. Nearly a dozen hormonal hypotheses of breast cancer causes have been proposed -- among them estrogen excess, low luteal-phase progestational activity, adrenal androgen deficiency, ovarian androgen excess, melatonin deficiency, prolactin excess, and thyroid insufficiency. For most, the data are equivocal and inconclusive. The androgen deficiency hypotheses, however, may have some bearing on premenopausal breast cancer, and the ovarian dysfunction hypothesis may have some bearing on postmenopausal breast cancer.</p>","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"4 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20962912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"OB/GYN virtual consult--menorrhagia for 6 months in a 31-year-old.","authors":"M Griffiths","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>What treatment options would you advise for a young woman with vaginal bleeding of 6 months' duration? Malcolm Griffiths, MD, in the Department of Obstetrics and Gynaecology, Luton & Dunstable Hospital, Luton, UK, moderates this case.</p>","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"4 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20962910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}