Menstrual activity

The answer is D. The patient s ambiguous secondary sex characteristics and lack of menstrual activity suggest the possibility of an androgen resistance syndrome. The male karyotype and blood testosterone levels confirm this. This clinical condition might have arisen as a result of steroid 5oc-reductase deficiency or inherited defects in the androgen receptor (testicular feminization). 

LynestrenoL Lynestrenol (73) has been used in oral contraceptives and to treat menstrual disorders. It is converted in vivo to its active metabohte norethindrone (102,103). It can be recrystallized from methanol, and is soluble in ethanol, ether, chloroform, and acetone, and insoluble in water (102). The crystal stmcture (104) and other spectral and analytical data have been reported for lynestrenol (62). 

RC, a 22-year-old woman, presents to your clinic requesting information on contraception. You begin to take a history and determine that the patient is currently sexually active and is not using any method of birth control. Her past medical history is significant only for acne, and she takes no medications except occasional ibuprofen for menstrual cramps. On further questioning, you discover that she has a positive family history for hypertension and coronary artery disease. As you begin to discuss various contraceptive options with the patient, it is clear that she has a preference for an oral contraceptive agent. 

A 50-year old woman with hypertension and diabetes comes into your clinic seeking advice about which incontinence pads work best. After questioning her, you determine that she has multiple issues of low volume urine loss daily, which is a significant change (increase) from 1 year ago. All episodes occur at times of physical activity. She s a single mother of three grown children, all delivered vaginally. Her last menstrual period was 11 months ago. 

The major adverse effect is irregular menstrual bleeding. Other side effects are headache, vaginitis, weight gain, acne, and breast and abdominal pain. It does not appear to decrease BMD. It is contraindicated in women who are pregnant, have active liver disease, a history of thromboembolic events, or a history of breast cancer. 

Kawaguchi K, Fujii S, Konishi I, Nanbu Y, Nonogaki H, Mori T (1989) Mitotic activity in uterine leiomyomas during the menstrual cycle. Am J Obstet Gynecol 160 637-641... 

Matteo, S. and Rissman, E.F. (1984).Increased sexual activity during the midcycle portion of the human menstrual cycle. Horm. Behav. 18, 249-255. 

Metabolic clearance of caffeine is altered according to menstrual phase and hormonal status in women (Lane et al. 1992). Clearance is slower during the late luteal phase compared to the follicular phase, prior to the onset of menstruation. However, the size of the effect and significance in everyday activity remains in question. 

Menstrual cycling is dependent upon the hormones secreted by the Graafian follicles. Once the primordial follicles are depleted, the secretion of oestrogen and progesterone progressively fails and menstrual cycle activity gradually decreases, a period which is characterised by irregular cycles. The differences in steroid hormone production or plasma levels between pre- and post-meno-pausal women are as follows ... 

A third study of 85 20-year-old women found an effect on menstrual synchrony of living together with one, two, or three other women, and of physical activity (Quadagno etal., 1981). 

These correlation studies stimulated experiments to identify the active chemical cues. Russell etal. (1980) rubbed underarm perspiration from a single woman onto the upper lip of five women aged 19-39 years. After 5 months, the odor-exposed women differed from one another in their onset of the menstrual cycle by 3.4 days, on average, compared with 9.2 days in the control group. Before the experiment, the mean differences had been 9.3 and 8.0 days, respectively. The volunteers were aware of the purpose of the experiment. 

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