DOCSLIB.ORG

Stress Induced Anovulation 615

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Stress Induced Anovulation 615 Stress Induced Anovulation 615 Stress Induced Anovulation S L Berga and T L Loucks Introduction Emory University School of Medicine, Atlanta, GA, USA A wealth of scientific and clinical evidence supports ã 2007 Elsevier Inc. All rights reserved. the notion that stress causes reproductive compro- mise and increases health burden. Neuroendocrine, Introduction metabolic, and behavioral responses to acute stress Neuroendocrine Mechanisms Linking Cognition, Mood, represent transient homeostatic adaptations that Behavior, and Gonadotropin-Releasing Hormone Drive promote survival in the face of perceived challenge; Pathogenesis of Stress-Induced Anovulation chronic stress elicits allostatic (sustained) adjustments Behavioral, Nutritional, and Metabolic Influences on the that also promote survival but at greater health cost Reproductive Axis (Figure 1). Reproductive compromise impedes popu- Synergism among Stressors lation replenishment and increases acute and chronic Treatment Considerations health burden in women, men, and children due to Summary metabolic dysfunction, obesity, diseases of aging, pre- term delivery, birth defects, costly and risky infertility therapies, and, through epigenetic mechanisms, it Glossary imprints the next generation. Stress is the most com- Allostasis A sustained adjustment that promotes mon and most commonly underappreciated cause survival in response to chronic challenge; of reproductive dysfunction (Table 1). Stress-induced may increase long-term health burden. anovulation (SIA), often termed functional hypotha- Anovulation The cessation of ovulation. lamic amenorrhea (FHA) or functional hypothalamic Cognitive- A form of psychoeducation or talk chronic anovulation, causes infertility and increases behavior therapy that addresses nonadaptive acute and chronic health burden. therapy thoughts, cognitions, attitudes, and Behaviors that chronically activate the limbic- conceptualizations. hypothalamic-pituitary-adrenal (LHPA) axis and/or Eumenorrhea A normal pattern of menstrual bleeding; chronically suppress the hypothalamic-pituitary- can occur in the absence of ovulation. thyroidal (HPT) axis compromise the hypothalamic- Gonadotropin- Decapeptide produced and released in a releasing hor- pulsatile mannner from hypothalamic pituitary-gonadal (HPG) axis in both women and mone (GnRH) neurons; stimulates the release of pitui- men by reducing hypothalamic gonadotropic-releasing tary lutenizing hormone (LH) and folli- hormone (GnRH) drive. Individuals with functional cle stimulating hormone (FSH). (not due to defined organic conditions) forms of Hypothalamic A condition characterized by suppres- hypothalamic hypogonadism typically engage in a hypogonadism sion of GnRH drive and, in turn, pitui- combination of behaviors in response to psychogenic tary LH and FSH, resulting in reduced stress that concomitantly induce intermittent or or absent gonadal steroidogenesis and chronic energy imbalance. Further, chronic adrenal gametogenesis. activation may increase the energetic cost of common Hypothalamic An allostatic adjustment in thyroidal activities such as running. In women, functional hypo- function that conserves energy expendi- hypothalamic hypogonadism exists on a spectrum thyroidism ture and is characterized by relatively nor- that includes polymenorrhea (menstrual interval mal levels of pituitary thyroid stimulating < hormone (TSH) in the presence of sup- 24 days), eumenorrhea with reduced luteal proges- pressed levels of thyroid hormones triio- terone secretion, and anovulatory eumenorrhea, dothyronine (T3) and thyroxine (T4). oligomenorrhea (menstrual interval 735 days), or Limbic- Neuroendocrine circuit that mediates amenorrhea (absence of menstruation for >3–6 hypothalamic- stress perception and stress responses. months). In men, oligoasthenospermia (very low pituitary- sperm count with low motility and abnormal mor- adrenal axis phology) may result, but this is typically not clinically Metabolism Biochemical processes that regulate evident unless fertility is being sought or severe energy expenditure and storage. testosterone deficiency results in muscle wasting or Secondary Cessation of menses in a woman of other phenotypic alterations. amenorrhea reproductive age who was previously eumenorrheic. This article focuses primarily on SIA/FHA in Stress Physical and psychological stimuli that women. SIA/FHA typically results from psychogenic challenge the status quo and elicit homeo- stress coupled with a mild energy imbalance and static or allostatic behavioral responses. represents an allostatic adaptation, that is, a stable 616 Stress Induced Anovulation Homeostasis Chronic stress Allostasis Cognitive-behavior therapy Metabolic challenge Psychogenic challenge –Excessive exercise –Performance pressure –Undernutrition –Unrealistic expectations –Nutrient deficiency –Poor coping strategies Central neuromodulation Hypothalamic adjustment Pituitary Glands Thyroid, parathyroid, gonads, adipocytes, pancreas, adrenal Figure 1 Conceptualization of synergism between metabolic and psychogenic stress in the pathogenesis of stress-induced anovulation. Table 1 Common causes of anovulation/amenorrheaa not promote recovery from allostatic endocrine adjustments in the adrenal and thyroidal axes. In- Percentage deed, the rationale for the use of sex steroid replace- Stress-induced anovulation/ functional 34 ment is based on the erroneous assumption that hypothalamic amenorrhea functional forms of hypothalamic hypogonadism rep- Hyperandrogenism/PCOS 29 resent only or primarily a loss of sex steroid exposure Hyperprolactinemia 13 due to reduced GnRH drive. Further, the replacement Premature menopause 12 Asherman’s syndrome 5 of sex hormones masks deficits that accrue from Other 7 chronically altered adrenal and thyroidal functions. a Long-term deleterious consequences of SIA/FHA Based on data presented in Reindollar, R. H., Novak, M., Tho, probably include an increased risk of cardiovascular S. P. T., et al. (1986), Adult-onset amenorrhea: a study of 262 patients, American Journal of Obstetrics and Gynecology 155, disease, osteoporosis, depression, other psychiatric 531–543. PCOS, polycystic ovarian syndrome. conditions, dementia, and neurodevelopmental com- promise in offspring. Although fertility can be restored with exogenous administration of gonado- change in behaviors and secretory patterns that pro- tropins or pulsatile GnRH, fertility management motes acute survival but at some health cost. SIA/FHA alone does not engender adrenal and thyroidal recov- affects roughly 5% of women of reproductive age; less ery. Pregnancy in the face of ongoing psychogenic severe forms of hypothalamic hypogonadism are more stress and metabolic imbalance may increase the like- common and are less clinically evident (Figure 2). lihood of poor obstetrical, fetal, or neonatal out- Stress-induced anovulation is theoretically revers- comes. In contrast, behavioral and psychological ible, but reproductive recovery appears to depend on interventions that address problematic behaviors the restoration of eucortisolemia and at least partial and attitudes have the potential to facilitate repro- recovery from functional hypothalamic hypothyroid- ductive recovery along with adrenal and thyroidal ism. Hormone replacement strategies have limited recovery. In short, full endocrine recovery offers bet- benefit for women with SIA/FHA because they do ter individual, maternal, and child health. Stress Induced Anovulation 617 250 30 250 30 25 25 200 200 20 20 1 1 1 − 1 − − 150 − 150 15 15 100 LH IU l FSH IU l 100 LH IU l 10 10 FSH IU l 50 50 5 5 0 0 0 0 12 3 4 5 6 7 8 9 10 1112131415161718192021222324252627282930 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728293031 350 20 350 20 300 300 1 − 1 − 1 15 1 − 250 − 15 250 200 200 10 10 150 150 100 5 100 Estradiol pg ml 5 Progesterone ng ml Estradiol pg ml 50 50 Progesterone ng ml 0 0 0 0 12 3 4 5 6 7 8 9 10 1112131415161718192021222324252627282930 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728293031 (a) Cycle day (b) Cycle day 250 30 250 30 25 25 200 200 20 1 20 − 1 1 1 − − 150 − 150 15 15 LH IU l 100 100 FSH IU l LH IU l FSH IU l 10 10 50 50 5 5 0 0 0 0 12 3 4 5 6 7 8 9 10 1112131415161718192021222324252627282930 1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930313233343536 350 20 350 20 300 300 1 1 − − 1 15 − 250 1 15 − 250 200 200 10 10 150 150 100 Estradiol pg ml 5 100 Progesterone ng ml Estradiol pg ml 5 50 Progesterone ng ml 50 0 0 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930313233343536 (c)Cycle day (d) Cycle day LH FSH Estradiol Progesterone Figure 2 Continuum of ovarian function in women with preserved menstrual cyclicity. a, Ovulatory eumenorrhea; b, luteal insufficiency; c–d, eumenorrheic anovulation. Pituitary gonadotropin (LH and FSH) and ovarian sex steroid (estradiol and progesterone) levels were obtained daily for one cycle. FSH, follicle-stimulating hormone; LH, luteinizing hormone. Note that FSH > LH, but FSH < 20 IU/L, thus the cause of hypogonadism is hypothalamic rather than reduced ovarian reserve. Neuroendocrine Mechanisms Linking The proximate cause of hypothalamic forms of Cognition, Mood, Behavior, and hypogonadism, including SIA/FHA, is reduced hypo- Gonadotropin-Releasing Hormone Drive thalamic GnRH input. Gonadal function depends directly on secretion from the hypothalamus of Our conceptualization of the bidirectional interaction GnRH as pulses.
Load more

Recommended publications
  • Infertility Update
    Infertility Update George R Attia, M.D Director of IVF Program University of Texas Southwestern Medical Center at Dallas Infertility • Inability to conceive after one year of adequate unprotected intercourse (six months if the woman is over age 35) Time Required for Conception in Couples Who Will Attain Pregnancy 100 93 95 90 85 80 72 70 nt 57 60 na g 45 e 50 r P 40 % 30 25 20 10 0 1 month 2 months 3 months 6 months 1 Year 2 Year 3 ear 7% 3% 35% Male Factor 20% Tubal Factor Ov dysfunction Unexplained Others 35% 10% 10% 40% Anovulatory Tubal & Pelvic Unusual factors Unexplained 40% • Anovulation • Tubal Factor • Male • Pelvic Factor (Endometriosis, adhesion) • Unexplained • Uterine/cervical (fibroid) 10% PCOS Others 90% Ovulation • History •BBT • LH kits • Mid luteal phase Progesterone (cycle length –7) • Ultrasound • EMB (day 21-26) • Anovulation • Tubal / Pelvic Factor • Male • Unexplained • Uterine/cervical (fibroid) Tubal & Pelvic Factors • Tubal disease, PID • Tubal surgery • Pelvic adhesions • Endometriosis Tubal Factor • Tubal infertility after PID (12%, 24%, 50%) • One-half of patients who found to have tubal damage and/or pelvic adhesion have no history of antecedent disease Tubal Factor • Hysterosalpingography • Hysteroscopy / laparoscopy • Falloscopy • Anovulation • Tubal Factor • Male • Unexplained • Uterine/cervical (fibroid) Male Factor Infertility • Anatomic defects (hypospadias, Retrograde ejac.) • Genetics Causes • Trauma • Infection • Endocrine disorders •Varicocele Male Factor Infertility • Vol. > 2 ml, Conc. > 20x106,
    [Show full text]
  • Polycystic Ovary Syndrome, Oligomenorrhea, and Risk of Ovarian Cancer Histotypes: Evidence from the Ovarian Cancer Association Consortium
    Published OnlineFirst November 15, 2017; DOI: 10.1158/1055-9965.EPI-17-0655 Research Article Cancer Epidemiology, Biomarkers Polycystic Ovary Syndrome, Oligomenorrhea, and & Prevention Risk of Ovarian Cancer Histotypes: Evidence from the Ovarian Cancer Association Consortium Holly R. Harris1, Ana Babic2, Penelope M. Webb3,4, Christina M. Nagle3, Susan J. Jordan3,5, on behalf of the Australian Ovarian Cancer Study Group4; Harvey A. Risch6, Mary Anne Rossing1,7, Jennifer A. Doherty8, Marc T.Goodman9,10, Francesmary Modugno11, Roberta B. Ness12, Kirsten B. Moysich13, Susanne K. Kjær14,15, Estrid Høgdall14,16, Allan Jensen14, Joellen M. Schildkraut17, Andrew Berchuck18, Daniel W. Cramer19,20, Elisa V. Bandera21, Nicolas Wentzensen22, Joanne Kotsopoulos23, Steven A. Narod23, † Catherine M. Phelan24, , John R. McLaughlin25, Hoda Anton-Culver26, Argyrios Ziogas26, Celeste L. Pearce27,28, Anna H. Wu28, and Kathryn L. Terry19,20, on behalf of the Ovarian Cancer Association Consortium Abstract Background: Polycystic ovary syndrome (PCOS), and one of its cancer was also observed among women who reported irregular distinguishing characteristics, oligomenorrhea, have both been menstrual cycles compared with women with regular cycles (OR ¼ associated with ovarian cancer risk in some but not all studies. 0.83; 95% CI ¼ 0.76–0.89). No significant association was However, these associations have been rarely examined by observed between self-reported PCOS and invasive ovarian cancer ovarian cancer histotypes, which may explain the lack of clear risk (OR ¼ 0.87; 95% CI ¼ 0.65–1.15). There was a decreased risk associations reported in previous studies. of all individual invasive histotypes for women with menstrual Methods: We analyzed data from 14 case–control studies cycle length >35 days, but no association with serous borderline including 16,594 women with invasive ovarian cancer (n ¼ tumors (Pheterogeneity ¼ 0.006).
    [Show full text]
  • Pulsatile Release of Bioactive Luteinizing Hormone in Prepubertal Girls: Discordance with Immunoreactive Luteinizing Hormone Pulses
    003 I-399818712 104-0409$02.00/0 PEDIATRIC RESEARCH Vol. 21, No. 4, 1987 Copyright O 1987 International Pediatric Research Foundation, Inc I'rfnied in U.S. A. Pulsatile Release of Bioactive Luteinizing Hormone in Prepubertal Girls: Discordance with Immunoreactive Luteinizing Hormone Pulses EDWARD 0. REITER, DARLENE E. BIGGS, JOHANNES D. VELDHUIS, AND INESE Z. BEITINS Department of Pediatrics, Baystate Medical Center, SpringJield, Massachusetts 01 199 [E.O.R., D.E.B.]; Department of Medicine, University of Virginia Medical School, Charlottesville, Virginia 22908 [J.D.V.]; and Department qf Pediatrics of the University of Michigan Medical Center, Ann Arbor, Michigan 48109 [I.Z.B.] ABSTRACT. An assessment of pulsatile secretion of lu- the onset of puberty is an increase in the frequency, as well as teinizing hormone (LH), measured by both immunoassay amplitude, of GnRH pulses from the hypothalamus which is (I-LH) and rat interstitial cell testosterone production translated into gonadotropin secretory pulses from the pituitary. bioassay (B-LH), as well as of folicle-stimulating hormone Increased LH pulse frequency and amplitude, as measured by I- and glycoprotein hormone a-subunit was carried out in LH have been demonstrated in early pubertal children (1-4). In seven normal prepubertal and six normal premenarcheal addition, the mean I-LH levels have been shown to rise with pubertal girls. Samples were obtained at 20-min intervals advancement of puberty in both cross-sectional and longitudinal for a 6-h period. The hormone secretion profiles were studies (5, 6). analyzed by several computerized methods yielding pulse Pituitary gonadotropins are known to be heterogeneous.
    [Show full text]
  • Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009†
    Human Reproduction, Vol.24, No.11 pp. 2683–2687, 2009 Advanced Access publication on October 4, 2009 doi:10.1093/humrep/dep343 SIMULTANEOUS PUBLICATION Infertility The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009† F. Zegers-Hochschild1,9, G.D. Adamson2, J. de Mouzon3, O. Ishihara4, R. Mansour5, K. Nygren6, E. Sullivan7, and S. van der Poel8 on behalf of ICMART and WHO 1Unit of Reproductive Medicine, Clinicas las Condes, Santiago, Chile 2Fertility Physicians of Northern California, Palo Alto and San Jose, California, USA 3INSERM U822, Hoˆpital de Biceˆtre, Le Kremlin Biceˆtre Cedex, Paris, France 4Saitama Medical University Hospital, Moroyama, Saitana 350-0495, JAPAN 53 Rd 161 Maadi, Cairo 11431, Egypt 6IVF Unit, Sophiahemmet Hospital, Stockholm, Sweden 7Perinatal and Reproductive Epidemiology and Research Unit, School Women’s and Children’s Health, University of New South Wales, Sydney, Australia 8Department of Reproductive Health and Research, and the Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland 9Correspondence address: Unit of Reproductive Medicine, Clinica las Condes, Lo Fontecilla, 441, Santiago, Chile. Fax: 56-2-6108167, E-mail: [email protected] background: Many definitions used in medically assisted reproduction (MAR) vary in different settings, making it difficult to standardize and compare procedures in different countries and regions. With the expansion of infertility interventions worldwide, including lower resource settings, the importance and value of a common nomenclature is critical. The objective is to develop an internationally accepted and continually updated set of definitions, which would be utilized to standardize and harmonize international data collection, and to assist in monitoring the availability, efficacy, and safety of assisted reproductive technology (ART) being practiced worldwide.
    [Show full text]
  • Diagnostic Evaluation of the Infertile Female: a Committee Opinion
    Diagnostic evaluation of the infertile female: a committee opinion Practice Committee of the American Society for Reproductive Medicine American Society for Reproductive Medicine, Birmingham, Alabama Diagnostic evaluation for infertility in women should be conducted in a systematic, expeditious, and cost-effective manner to identify all relevant factors with initial emphasis on the least invasive methods for detection of the most common causes of infertility. The purpose of this committee opinion is to provide a critical review of the current methods and procedures for the evaluation of the infertile female, and it replaces the document of the same name, last published in 2012 (Fertil Steril 2012;98:302–7). (Fertil SterilÒ 2015;103:e44–50. Ó2015 by American Society for Reproductive Medicine.) Key Words: Infertility, oocyte, ovarian reserve, unexplained, conception Use your smartphone to scan this QR code Earn online CME credit related to this document at www.asrm.org/elearn and connect to the discussion forum for Discuss: You can discuss this article with its authors and with other ASRM members at http:// this article now.* fertstertforum.com/asrmpraccom-diagnostic-evaluation-infertile-female/ * Download a free QR code scanner by searching for “QR scanner” in your smartphone’s app store or app marketplace. diagnostic evaluation for infer- of the male partner are described in a Pregnancy history (gravidity, parity, tility is indicated for women separate document (5). Women who pregnancy outcome, and associated A who fail to achieve a successful are planning to attempt pregnancy via complications) pregnancy after 12 months or more of insemination with sperm from a known Previous methods of contraception regular unprotected intercourse (1).
    [Show full text]
  • Changes Before the Change1.06 MB
    Changes before the Change Perimenopausal bleeding Although some women may abruptly stop having periods leading up to the menopause, many will notice changes in patterns and irregular bleeding. Whilst this can be a natural phase in your life, it may be important to see your healthcare professional to rule out other health conditions if other worrying symptoms occur. For further information visit www.imsociety.org International Menopause Society, PO Box 751, Cornwall TR2 4WD Tel: +44 01726 884 221 Email: [email protected] Changes before the Change Perimenopausal bleeding What is menopause? Strictly defined, menopause is the last menstrual period. It defines the end of a woman’s reproductive years as her ovaries run out of eggs. Now the cells in the ovary are producing less and less hormones and menstruation eventually stops. What is perimenopause? On average, the perimenopause can last one to four years. It is the period of time preceding and just after the menopause itself. In industrialized countries, the median age of onset of the perimenopause is 47.5 years. However, this is highly variable. It is important to note that menopause itself occurs on average at age 51 and can occur between ages 45 to 55. Actually the time to one’s last menstrual period is defined as the perimenopausal transition. Often the transition can even last longer, five to seven years. What hormonal changes occur during the perimenopause? When a woman cycles, she produces two major hormones, Estrogen and Progesterone. Both of these hormones come from the cells surrounding the eggs. Estrogen is needed for the uterine lining to grow and Progesterone is produced when the egg is released at ovulation.
    [Show full text]
  • Signature Redacted May 14,2014 Certified By
    System Identification of Cortisol Secretion: Characterizing Pulsatile Dynamics OF TECHNOLOGy by Rose Taj Faghih JUN 1 0 2014 B.S., Electrical Engineering (2008) University of Maryland, College Park LIBRARIES S.M., Electrical Engineering and Computer Science (2010), Massachusetts Institute of Technology Submitted to the Department of Electrical Engineering and Computer Science in partial fulfillment of the requirements for the degree of Doctor of Philosophy at the MASSACHUSETTS INSTITUTE OF TECHNOLOGY June 2014 @ Massachusetts Institute of Technology 2014. All rights reserved. Signature redacted Author ........... ............................. Department of Electrical Engineering and Computer Science Signature redacted May 14,2014 Certified by........ .................................... Emery N. Brown Edward Hood Taplin Professor of Medical Engineering Professor of Computational Neuroscience Thesis Supervisor Certified by Si onRtIIm mdRctE~d Munther A. Dahleh Professor of Electrical Engineering and Computer Science Professor of Engineering Systems Division Thesis Supervisor b Signature redacted,; A cce;pte d Uy .... ....... 4, ..... ...... .. .... S/Prdsar Leslie A. Kolodziejski Chair, Department Committee on Graduate Students System Identification of Cortisol Secretion: Characterizing Pulsatile Dynamics by Rose Taj Faghih Submitted to the Department of Electrical Engineering and Computer Science on May 14, 2014, in partial fulfillment of the requirements for the degree of Doctor of Philosophy Abstract Cortisol controls the body's metabolism and response to inflammation and stress. Cortisol is released in pulses from the adrenal glands in response to pulses of adreno- corticotropic hormone (ACTH) released from the anterior pituitary; in return, cortisol has a negative feedback effect on ACTH release. Modeling cortisol secretion and the interactions between ACTH and cortisol allows for quantifying normal and abnormal physiology and can potentially be used for diagnosis and optimal treatment of some cortisol disorders.
    [Show full text]
  • Too Much, Too Little, Too Late: Abnormal Uterine Bleeding
    Too much, too little, too late: Abnormal uterine bleeding Jody Steinauer, MD, MAS July, 2015 The Questions • Too much (& too early or too late) – Differential and approach to work‐up – Does she need an endometrial biopsy (EMB)? – Does she need an ultrasound? – How do I stop peri‐menopausal bleeding? – Isn’t it due to the fibroids? • Too fast: She’s hemorrhaging—what do I do? • Too little: A quick review of amenorrhea Case 1 A 46 yo G3P2T1 reports her periods have become 1. What term describes increasingly irregular and heavy her symptoms? over the last 6‐8 months. 2. Physiologically, what Sometimes they come 2 times causes this type of per month and sometimes there bleeding pattern? are 2 months between. LMP 2 3. What is the months ago. She bleeds 10 days differential? with clots and frequently bleeds through pads to her clothes. She occasionally has hot flashes. She also has diabetes and is obese. Q1: In addition to a urine pregnancy test and TSH, which of the following is the most appropriate test to obtain at this time? 1. FSH 2. Testosterone & DHEAS 3. Serum beta‐HCG 4. Transvaginal Ultrasound (TVUS) 5. Endometrial Biopsy (EMB) Terminology: What is abnormal? • Normal: Cycle= 28 days +‐ 7 d (21‐35); Length=2‐7 days; Heaviness=self‐defined • Too little bleeding: amenorrhea or oligomenorrhea • Too much bleeding: Menorrhagia (regular timing but heavy (according to patient) OR long flow (>7 days) • Irregular bleeding: Metrorrhagia, intermenstrual or post‐ coital bleeding • Irregular and Excessive: Menometrorrhagia • Preferred term for non‐pregnant bleeding issues= Abnormal Uterine Bleeding (AUB) – Avoid “DUB” ‐ dysfunctional uterine bleeding.
    [Show full text]
  • An Optimization Formulation for Characterization of Pulsatile Cortisol Secretion
    An optimization formulation for characterization of pulsatile cortisol secretion The MIT Faculty has made this article openly available. Please share how this access benefits you. Your story matters. Citation Faghih, Rose T. et al. "An optimization formulation for characterization of pulsatile cortisol secretion." Frontiers in Neuroscience 9 (August 2015): 228 © 2015 Faghih, Dahleh and Brown As Published http://dx.doi.org/10.3389/fnins.2015.00228 Publisher Frontiers Research Foundation Version Final published version Citable link http://hdl.handle.net/1721.1/112222 Terms of Use Creative Commons Attribution 4.0 International License Detailed Terms http://creativecommons.org/licenses/by/4.0/ ORIGINAL RESEARCH published: 11 August 2015 doi: 10.3389/fnins.2015.00228 An optimization formulation for characterization of pulsatile cortisol secretion Rose T. Faghih 1, 2, 3, 4*, Munther A. Dahleh 1, 4, 5, 6 and Emery N. Brown 2, 3, 7, 8 1 Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA, 2 Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA, 3 Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA, 4 Laboratory for Information and Decision Systems, Massachusetts Institute of Technology, Cambridge, MA, USA, 5 Engineering Systems Division, Massachusetts Institute of Technology, Cambridge, MA, USA, 6 Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, MA, USA, 7 Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA, 8 Department of Anesthesia, Harvard Medical School, Boston, MA, USA Edited by: Jason Ritt, Cortisol is released to relay information to cells to regulate metabolism and reaction Boston University, USA to stress and inflammation.
    [Show full text]
  • Gonadotropin-Releasing Hormone Secretion Into Third
    BIOLOGY OF REPRODUCTION 59, 676±683 (1998) Gonadotropin-Releasing Hormone Secretion into Third-Ventricle Cerebrospinal Fluid of Cattle: Correspondence with the Tonic and Surge Release of Luteinizing Hormone and Its Tonic Inhibition by Suckling and Neuropeptide Y1 O.S. Gazal,3 L.S. Leshin,4 R.L. Stanko,3 M.G. Thomas,5 D.H. Keisler,6 L.L. Anderson,7 and G.L. Williams2,3 Animal Reproduction Laboratory,3 Texas A&M University Agricultural Research Station, Beeville, Texas 78102 USDA/ARS Russell Agricultural Research Center,4 Athens, Georgia 30613 Department of Animal and Range Sciences,5 New Mexico State University, Las Cruces, New Mexico 88003 Department of Animal Science,6 University of Missouri, Columbia, Missouri 65211 Department of Animal Science,7 Iowa State University, Ames, Iowa 50011 ABSTRACT [1]. Although a transnasal, transsphenoidal approach has been described for collecting mixed hypophyseal portal and Objectives of the current studies were to characterize the cavernous sinus blood in ewes and young calves to monitor pattern of GnRH secretion in the cerebrospinal ¯uid of the bo- vine third ventricle, determine its correspondence with the tonic GnRH release [2, 3], the complex anatomical architecture and surge release of LH in ovariectomized cows, and examine of the cranium presents a signi®cant barrier to the practical the dynamics of GnRH pulse generator activity in response to application of this method in adult cattle. Additionally, known modulators of LH release (suckling; neuropeptide Y push-pull perfusion techniques have been used to obtain [NPY]). In ovariectomized cows, both tonic release patterns and median eminence perfusates in the rat [4], rabbit [5], and estradiol-induced surges of GnRH and LH were highly correlat- sheep [6]; but these methods, to our knowledge, have not ed (0.95; p , 0.01).
    [Show full text]
  • Oligo-Anovulation Is Not a Rarer Feature in Women with Documented Endometriosis
    Oligo-anovulation is not a rarer feature in women with documented endometriosis Pietro Santulli, M.D., Ph.D.,a,b Chloe Tran, M.D.,a Vanessa Gayet, M.D.,a Mathilde Bourdon, M.D.,a,b Chloe Maignien, M.D.,a Louis Marcellin, M.D.,a,b Khaled Pocate-Cheriet, M.D.,b Charles Chapron, M.D.,a,b and Dominique de Ziegler, M.D.a a Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique-Hopitaux^ de Paris (AP-HP), Hopital^ Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Universite Paris Descartes, Sorbonne Paris Cite; and b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Universite Paris Descartes, Sorbonne Paris Cite, Paris, France Objective: To study the prevalence of oligo-anovulation in women suffering from endometriosis compared to that of women without endometriosis. Design: A single-center, cross-sectional study. Setting: University hospital-based research center. Patient (s): We included 354 women with histologically proven endometriosis and 474 women in whom endometriosis was surgically ruled out between 2004 and 2016. Intervention: None. Main Outcome Measure(s): Frequency of oligo-anovulation in women with endometriosis as compared to that prevailing in the disease-free reference group. Results: There was no difference in the rate of oligo-anovulation between women with endometriosis (15.0%) and the reference group (11.2%). Regarding the endometriosis phenotype, oligo-anovulation was reported in 12 (18.2%) superficial peritoneal endometriosis, 12 (10.6%) ovarian endometrioma, and 29 (16.6%) deep infiltrating endometriosis. Conclusion(s): Endometriosis should not be discounted in women presenting with oligo-anovulation.
    [Show full text]
  • 2. Endocrine Control of the Oestrous Cycle
    2. ENDOCRINE CONTROL OF THE OESTROUS CYCLE Introduction 2.1 The cyclic changes that occur in the female reproductive tract are initiated and regulated by the hypothalamic-pituitary-ovarian (HPO) axis. Although folliculogenesis occurs independently of hormonal stimulation up until the formation of early tertiary follicles, the gonadotrophins luteinising hormone (LH) and follicle stimulating hormone (FSH) are essential for the completion of follicular maturation and development of mature preovulatory (Graafian) follicles. The sites of production and key functions of the major reproductive hormones in the female rat are summarised in Table 2.1. Pituitary gonadotrophin secretion drives follicular maturation and oestrogen secretion 2.2 Levels of LH and FSH begin to increase just after dioestrus. Both hormones are secreted by the same secretory cells (gonadotrophs) in the pars distalis of the anterior pituitary (adenohypophysis). FSH stimulates development of the zona granulosa and triggers expression of LH receptors by granulosa cells. LH initiates the synthesis and secretion of androstenedione and, to a lesser extent, testosterone by the theca interna; these androgens are utilised by granulosa cells as substrates in the synthesis of oestrogen. Pituitary release of gonadotrophins thus drives follicular maturation and secretion of oestrogen during prooestrus. 2.3 Gonadotrophin secretion by the anterior pituitary is regulated by luteinising hormone-releasing hormone (LHRH), produced by the hypothalamus. LHRH is transported along the axons of hypothalamic neurones to the median eminence where it is secreted into the hypothalamic-hypophyseal portal system and transported to the anterior pituitary. The hypothalamus secretes LHRH in rhythmic pulses; this pulsatility is essential for the normal activation of gonadotrophs and subsequent release of LH and FSH.
    [Show full text]