RESUMO
PIP: The various types of menstrual dysfunctions are classified, their symptoms are described, and appropriate treatment is suggested. The types considered are: subfollicular, persistent follicular (subdivided into simple, macrofollicular and microfollicular or androgenic), subluteal and persistent luteal. The subfollicular type is characterized by the early onset of menopause (before age 40); the follicular type by amenorrhea and sterility (simple type), alternating amenorrhea and bleeding (macrofollicular), and amenorrhea with occasional bleeding and hirsutism (microfollicular); the subluteal type by sterility; and the luteal type by either amenorrhea or hypermenorrhea. The type of dysfunction can be detected by laboratory tests (such as urinary estrogens, pregnanediol, and gonadotropins, functional cytology, 17-ketosteroids, plasma testosterone, appearance of the endometrium, and basal temperature). The subfollicular type is treated with estrogen, with or without progesterone, the follicular type with cyclical administration of progesterone (clomiphene can also be used), the subluteal type with progesterone, 17alpha-hydroxyprogesterone, and chorionic gonadotropin, and the luteal type with high doses of progesterone.^ieng
Assuntos
Amenorreia , Gonadotropina Coriônica , Clomifeno , Diagnóstico , Estrogênios , Hemorragia , Hirsutismo , Infertilidade , Menopausa , Distúrbios Menstruais , Progesterona , Biologia , Doença , Sistema Endócrino , Serviços de Planejamento Familiar , Fármacos para a Fertilidade , Gonadotropinas , Hormônios , Fisiologia , Progestinas , Reprodução , Substâncias para o Controle da Reprodução , Sinais e SintomasRESUMO
PIP: In a survey of 993 patients complaining of sterility and infertility, 365 were found to suffer from ovulatory disorders, and 133 of the latter were taking oral contraceptives. The patients were subjected to the following tests: basal temperature (monophasic curve in 33.08% of the cases), cervical mucus (negative crystallization in 40.60%), endometrium biopsy (Proliferative in 45.11%), and vaginal cytology (anovulatory pattern in 16.53% of the cases). Laparoscopy was used in 35 cases and biopsy of the ovaries in 18. After treatment with various drugs (such as cyclophenyl, clomiphene, human menopausal gonadotropin, human chorionic gonadotropin, estrogen, progestogen, corticoids, oral contraceptives), improvements were obtained in 82.93% of the cases with respect to basal temperature (from monophasic to biphasic), in 90.90% for cervical mucus (positive crystallization), in 35.28% for endometrium biopsy (from proliferative to sectretory), and in 42.86% for vaginal cytology (from anovulatory to ovulatory pattern). 45 pregnancies were obtianed. It is conluded that oral contraceptives can inhibit ovulation after suspending treatment, irrespective of its duration, especially in women previously suffering from menstrual disorders. The overall incidence of this syndrome is low, and it is generally reversible. It is desirable, however, to identify the women exposed to high risk of its occurrence, should the patient desire to stop the contraceptive treatment and have more children.^ieng