Irregular menses

EF is a 45-year-old woman who presents to the dermatologist for evaluation of facial acne. She has a history of a 25 lb (11.36 kg) weight gain, irregular menses, and frequent vaginal yeast infections over the past 2 years. She complains of increased facial hair growth and lower extremity muscle weakness. Physical examination reveals facial acne, facial hirsutism, truncal obesity, thin skin, and purple abdominal striae. Her past medical history is significant for hypertension, type 2 diabetes mellitus, hyperlipidemia, and rheumatoid arthritis. 

Depo-med roxyprogesterone acetate 150 mg intramuscularly every 12 weeks Irregular menses, amenorrhea... 

In Burma, a decoction of the aerial parts is drunk to treat irregular menses. In China, the plant is eaten as a salad and is a believed to improve general health. In several Southeast Asian countries the plant is used to break fevers and prompt urination. In... 

Symptoms of thyrotoxicosis include nervousness, anxiety, palpitations, emotional lability, easy fatigability, heat intolerance, loss of weight concurrent with an increased appetite, increased frequency of bowel movements, proximal muscle weakness (noted on climbing stairs or arising from a sitting position), and scanty or irregular menses in women. 

Possible adverse reactions include cramping diarrhea gastric bleeding ulceration gastritis vomiting drowsiness lethargy headache mental confusion ataxia irregular menses carcinoma of the breast. 

At high doses, ketoconazole causes a clinically significant reduction in testosterone synthesis and blocks the adrenal response to corticotropin. Gynecomastia, impotence, reduced sperm counts, and dimiiushed libido can occur in men, and prolonged drug use can result in irregular menses in women. These hormonal effects have led to the use of ketoconazole as a potential adjunctive treatment for prostatic carcinoma. 

Dong quai (dang gui, tang kuei) is the extract from the dried root of Radix Angelicae sinensis (Fig. 1), which belongs to the family Umbelliferae. It has been used for many years as a Chinese botanical remedy for management of menstrual cramps, irregular menses, and menopausal symptoms, and the... 

Sesbinia sesbin (L.) Merrill. Indian Tian Qing (root, leaf, bark, seed)57 Saponins, triterpene glycosides, steroid glycosides, glycoalkaloids, kaempferol trisaccharide.342 343 344 Diuretic, irregular menses, externally for bug bites, antitumor. 

Ng YY, Yu S, Chen TW, Wu SC, Yang AH, Yang WC. Interstitial renal fibrosis in a young woman association with a Chinese preparation given for irregular menses. Nephrol Dial Transplant 1998 13(8) 2115-17. 

While most cases of AN are seen in obese and prepubertal children, it can occur as a marker for various endocrinopathies as well as in female patients with elevated testosterone levels, irregular menses, and hirsutism. 

The initial evaluation of female infertility should include a detailed history and physical examination, including a Papanicolaou cervical and vaginal smear with appropriate cervical and endocervical cultures, a search for tubal patency and endometriosis or adhesions, and assessment of ovulation and adequate luteal function.After obvious treatable abnormalities have been excluded, a menstrual history indicates further endocrine evaluation and a postcoital test helps to determine coital snfticiency (Figure 53-16 see also earlier section on irregular menses). 

Adverse effects are dose dependent and can be lessened by initiating therapy with doses as low as 25 mg/day. They include potential hyperkalemia, irregular menses, breast tenderness, headache, and fatigue. ... 

Summary A 32-year-old female with irregular menses, hirsutism, mood swings, weight gain, truncal obesity, hypertension, abdominal striae, ecchy-moses, and elevated cortisol levels. 

Clinical presentation PrepubeAl —> precocious puberty Reproductive age -> irregular menses Postmenopausal —> vaginal bleeding Gross yellow-white mass Micro... 

Gastrointestinal system—nausea, vomiting, increased appetite, weight gain, and peptic ulcer Genitourinary system—amenorrhea and irregular menses ... 

The causes of the irregular menses and the gynecomastia in female patients and the lack of libido in male hyperthyroids are not known. Patients with thyrotoxicosis sometimes develops localized myxedema, usually in the lower third of the leg. This injury appears as an area of nonpitting and painless edema, with purplish discoloration of the skin. 

In polycystic ovarian disease, both of the generally enlarged ovaries contain many small follicular cysts (2-6 mm), but larger cysts may also be present. Polycystic ovarian syndrome (Stein-Leventhal syndrome) is characterized by the association of polycystic ovaries with irregular menses, prolonged uterine bleeding, amenorrhea, anovulation, and often hirsutism and obesity. The clinical manifestation of this syndrome begins at or shortly after puberty. 

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