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Related Concept Videos

Menopause01:28

Menopause

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Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
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Hormonal Regulation of the Menstrual Cycle01:22

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The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
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The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
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Hormonal Control of the Ovarian Cycle01:30

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The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
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Oogenesis02:07

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In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
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The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Prolactinomas: evolution after menopause.

Maria Susana Mallea-Gil1, Marcos Manavela1, Analia Alfieri1

  • 1Departamento de Neuroendocrinología (Neuroendocrinology Department), Sociedad Argentina de Endocrinología y Metabolismo, Ciudad Autónoma de Buenos Aires, Argentina.

Archives of Endocrinology and Metabolism
|February 25, 2016
PubMed
Summary
This summary is machine-generated.

Dopamine agonist treatment for prolactinomas can likely be stopped after menopause. Most patients experienced tumor reduction or disappearance and normalized prolactin levels, suggesting estrogen decline plays a role.

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Area of Science:

  • Endocrinology
  • Oncology
  • Reproductive Medicine

Background:

  • Prolactinomas are pituitary tumors that secrete prolactin (PRL).
  • Dopamine agonists are the primary treatment for prolactinomas.
  • The long-term effects of dopamine agonist therapy and its potential cessation after menopause are not fully understood.

Purpose of the Study:

  • To evaluate the changes in tumor size and prolactin levels in patients with micro and macroprolactinomas after stopping dopamine agonists post-menopause.
  • To assess the impact of estrogen decline on prolactinoma behavior after drug cessation.

Main Methods:

  • Retrospective study of 29 female patients with prolactinomas (22 microadenomas, 7 macroadenomas) treated with dopamine agonists during fertile years.
  • Treatment was suspended upon reaching menopause.
  • Tumor size and prolactin levels were monitored before treatment, during menopause, and during follow-up after suspension (4-192 months).

Main Results:

  • Pre-treatment prolactin levels were significantly higher in macroadenomas compared to microadenomas.
  • After treatment suspension in menopause, prolactin levels normalized in most patients.
  • Significant tumor reduction or complete disappearance was observed in both microadenomas (13/22 decreased, 9/22 disappeared) and macroadenomas (3/7 decreased, 3/7 disappeared).

Conclusions:

  • Dopamine agonist therapy for prolactinomas may be safely discontinued after menopause.
  • Reduced estrogen levels following menopause likely contribute to prolactinoma regression.
  • Sustained normal prolactin levels and tumor shrinkage/disappearance were achieved in the majority of patients after drug cessation.