Reproductive disorder

On completion of this case study, you will be able to  

Clinical Physiology and Pharmacology Farideh Javid and Janice McCurrie 2008 John Wiley Sons, Ltd 

Q1 Define the term menstruation and describe the phases of the menstrual cycle. 

Q2 Explain the profile of gonadotropic hormones activity, i.e. luteinizing hormone (LH) and follicle-stimulating hormone (FSH), in a typical 28-day female reproductive cycle 

Q3 What is amenorrhoeal Comment on its pathophysiology and pharmacological management. 

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Sharpe, R.M. and Skakkebaek, N.E. (2003). Male reproductive disorders and the role of endocrine disruption Advances in understanding and identification of areas for future research. Pure and Applied Chemistry 75, 2023-2038. 

Hyperprolactinemia commonly affects women of reproductive age more than men. Although this disorder occurs in less than 1% of the general population, the estimated prevalence in women with reproductive disorders (e.g., amenorrhea) is as high as 9% to 17%.43 Numerous etiologies of hyperprolactinemia are presented in Table 43-5.43,44 Any medications that block... 

Increased frequency of female reproductive disorders (USPHS 1994) Increased frequency of menstrual dysfunction (USPHS 1994)... 

Reproductive disorders Endometrial disorder Leukorrhea Uterine disorder Uterovaginal prolapse Vaginal discomfort Urinary system disorders Micturition frequency Urinary incontinence Gastrointestinal disorders Abdominal pain Constipation... 

Human exposure to migrating substances (e.g., di(2-ethylhexyl)phthalate) may result in reproductive disorders. There is a hazard that vinyl chloride monomers or bisphenol A migrating into food may induce carcinogenic, mutagenic, and teratogenic episodes. 

It implements the Precautionary Principle. Arguments against the Precautionary Principle commonly centre on what degree of evidence of harm is necessary before action is taken to restrict the use of a substance. When applying the Substitution Principle, it is not necessary to wait for cancers, reproductive disorders or genetic defects and elusive evidence of cause and effect. If alternatives with less hazardous intrinsic properties are available, use of the hazardous substance is not permitted. The potential for harm is then reduced or avoided altogether. 

IGFs thus play an essential role in many facets of reproductive function. Traditionally, therapeutic intervention in reproductive disorders at a molecular level has relied almost exclusively upon administration of gonadotrophins or LHRH (luteinizing hormone releasing hormone Chapter 8). Because of their widespread reproductive effects, IGFs may yet prove a valuable adjunct therapy in some instances. 

The purpose of this chapter is to review the methods that are currently in use to evaluate sexual function and fertility. Sexual function and fertility are complex reproductive functions that can be affected by environmental exposures. Reproductive disorders include spontaneous abortions, impaired spermatogenesis, menstrual disorders, impotence, early menopause and others. Any disturbance in the integrity of the reproductive system can affect these functions. 

Scialli AR, Swan SH, Amier RW, Baird DD, Eskenazi B, Gist G, Hatch MC, Kesner S. Lemasters GK, Marcus M, Paul ME, Schulte P, Taylor Z, Wilcox AJ, Zahniser C (1997) Assessment of reproductive disorders and birth defects in communities near hazardous chemical sites. II. Female reproductive disorders. Reprod Toxicol, 11 231-242. 

Harmful if inhaled, swallowed, or absorbed through skin. May cause irritation. Prolonged exposure can cause narcotic effect. Chronic effects include damage to liver, kidneys, and blood.2 May cause reproductive disorders.4 TLV-TWA 5 ppm, 18 mg/m3.5... 

The risk of different reproduction disorders must be evaluated if there is a considerable systemic exposure, as moisturizers are extensively used within the population. 

The isolated aldehyde citral can be a skin irritant or sensitizer and has been implicated in reproductive disorders. In Citrus Union (lemon oil) it makes up to 5% of the composition. It has been shown that the hazardous effects are markedly reduced by the presence of the terpenes d-limonene and a-pinene also present in the oil. 

Current concerns with estrogenic compounds and their influence on a broad range of reproductive disorders, along with possible carcinogenic effects, have renewed interest in chlorinated pesticides. The need for ongoing scientific research to assess the potential risk posed by these compounds seems inevitable. 

Measure of male feminization measuring the distance between the anus and the base of the penis. Measuring the anogenital distance in neonatal humans has been suggested as a noninvasive method to predict neonatal and adult reproductive disorders. 

Phthalates A family of chemicals that are produced from alcohols and from phthalic anhydride. They are often used to make PVC more flexible in applications such as packaging materials. There are environmental concerns about their use, since they may be a cause of reproductive disorders. 

Environmentalists and health advocates claim that PVC is dangerous because it releases dioxins, which potentially cause cancer. Elements in PVC called phthalates are also suspected of causing reproductive disorders. This is a blow to the vinyl producers in the world, which make 16 billion pounds of the plastic per year amounting to more than 6 billion in sales, according to the Vinyl Institute. 

The number of individuals affected by reproductive disorders is difficult to assess, and few population-based data are available for either men or women. Noticeably absent are data on fecundity and fertility impairments affecting men and only limited information on male-mediated developmental outcomes exists. Population-based data for impaired female fertility are available for select endpoints from the National Surveys of Family Growth (NSFG), which are conducted periodically and most recently in 1995. Data from the NSFG show that 6.2 million women (10.2%) between the ages of 15 and 44 in the United States had impaired fertility in 1995 (Stephen 1996). This number was estimated to increase to 6.3 million women in 2000 (Stephen and Chondra 1998). Other reproductive disorders in females that impact fecundity include endometriosis and polycystic ovarian syndrome (PCOS). The prevalence of endometriosis in women of reproductive age is reported to be 10% (Houston 1984 Olive and Schwartz 1993), and no population-based prevalence data exist for PCOS. 

Piperidinyl and pyrrolidinyl nitric oxide derivatives, (HI), prepared by Anggard(5) were capable of acting both as nitric oxide donors and as scavengers of superoxide ions and used in the treatment of conditions associated with oxidative stress such as neurological disorders, drug- and disease-induced nephropathies, and reproductive disorders. 

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