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Agnieszka Podfigurna
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-701 Poznan, Poland

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Review
Published: 24 July 2021 in Endocrines
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The aim of the study is to present the problem of functional hypothalamic amenorrhea, taking into account any disease and treatment, diagnosis, and consequences of this disease. We searched PubMed (MEDLINE) and included 38 original and review articles concerning functional hypothalamic amenorrhea. Functional hypothalamic amenorrhea is the most common cause of secondary amenorrhea in women of childbearing age. It is a reversible disorder caused by stress related to weight loss, excessive exercise and/or traumatic mental experiences. The basis of functional hypothalamic amenorrhea is hormonal, based on impaired pulsatile GnRH secretion in the hypothalamus, then decreased secretion of gonadotropins, and, consequently, impaired hormonal function of the ovaries. This disorder leads to hypoestrogenism, manifested by a disturbance of the menstrual cycle in the form of amenorrhea, leading to anovulation. Prolonged state of hypoestrogenism can be very detrimental to general health, leading to many harmful short- and long-term consequences. Treatment of functional hypothalamic amenorrhea should be started as soon as possible, and it should primarily involve lifestyle modification. Only then should pharmacological treatment be applied. Importantly, treatment is most often long-term, but it results in recovery for the majority of patients. Effective therapy, based on multidirectional action, can protect patients from numerous negative impacts on fertility, cardiovascular system and bone health, as well as reducing mental morbidity.

ACS Style

Agnieszka Podfigurna; Blazej Meczekalski. Functional Hypothalamic Amenorrhea: A Stress-Based Disease. Endocrines 2021, 2, 203 -211.

AMA Style

Agnieszka Podfigurna, Blazej Meczekalski. Functional Hypothalamic Amenorrhea: A Stress-Based Disease. Endocrines. 2021; 2 (3):203-211.

Chicago/Turabian Style

Agnieszka Podfigurna; Blazej Meczekalski. 2021. "Functional Hypothalamic Amenorrhea: A Stress-Based Disease." Endocrines 2, no. 3: 203-211.

Journal article
Published: 07 December 2020 in Journal of Clinical Medicine
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Premature ovarian insufficiency (POI) is a type of hypergonadotropic hypogonadism caused by impaired ovarian function before the age of 40. Due to the hypoestrogenism, women with POI experience a variety of health complications, including an increased risk of bone mineral density loss and developing osteopenia and osteoporosis, which poses an important problem for public health. Purpose: The aim of this study was to evaluate and compare the values of bone mineral density (BMD), T-score and Z-score within the lumbar spine (L1-L4) using the dual energy X-ray absorptiometry method. The dual-energy X-ray absorptiometry (DXA) scans described in this original prospective article were performed at the time of POI diagnosis and after treatment with sequential hormone replacement therapy (HRT). Materials and methods: This study included 132 patients with a mean age of 31.86 ± 7.75 years who had been diagnosed with idiopathic POI. The control group consisted of 17 healthy women with regular menstrual cycles, with a mean age of 23.21 ± 5.86 years. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free thyroxine (fT4), insulin, and fasting serum glucose were measured. Lumbar spine (L1-L4) BMD was assessed by means of dual-energy X-ray absorptiometry. DXA scans were performed at the time of diagnosis and following treatment with sequential hormone replacement therapy (HRT) comprised of daily oral 2 mg 17-β-estradiol and 10 mg dydrogesterone. The mean time of observation was 3 ± 2 years. Results: Patients in the POI group presented with characteristic hypergonadotropic hypogonadism. They had a significantly decreased mean lumbar spine BMD when compared to healthy controls (1.088 ± 0.14 g/cm2) vs. 1.150 ± 0.30 g/cm2) (p = 0.04) as well as a decreased T-score (0.75 ± 1.167 vs. −0.144 ± 0.82) (p = 003). There was a significant increase in BMD (1.088 ± 0.14 vs. 1.109 ± 0.14; p < 0.001), T-score (−0.75 ± 1.17 vs. −0.59 ± 1.22; p < 0.001), and Z-score (−0.75 ± 1.12 vs. −0.49 ± 1.11; p < 0.001) after the implementation of HRT when compared to pre-treatment results. Conclusions: In conclusion, this study has demonstrated that patients with POI often have decreased bone mineral density and that the implementation of HRT has a significant and positive influence on bone mass. The implementation of full-dose HRT and monitoring of bone status is particularly important in these patients.

ACS Style

Agnieszka Podfigurna; Marzena Maciejewska-Jeske; Malgorzata Nadolna; Paula Mikolajska-Ptas; Anna Szeliga; Przemyslaw Bilinski; Paulina Napierala; Blazej Meczekalski. Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients. Journal of Clinical Medicine 2020, 9, 3961 .

AMA Style

Agnieszka Podfigurna, Marzena Maciejewska-Jeske, Malgorzata Nadolna, Paula Mikolajska-Ptas, Anna Szeliga, Przemyslaw Bilinski, Paulina Napierala, Blazej Meczekalski. Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients. Journal of Clinical Medicine. 2020; 9 (12):3961.

Chicago/Turabian Style

Agnieszka Podfigurna; Marzena Maciejewska-Jeske; Malgorzata Nadolna; Paula Mikolajska-Ptas; Anna Szeliga; Przemyslaw Bilinski; Paulina Napierala; Blazej Meczekalski. 2020. "Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients." Journal of Clinical Medicine 9, no. 12: 3961.

Review
Published: 28 July 2020 in International Journal of Molecular Sciences
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The hair cycle and hair follicle structure are highly affected by various hormones. Androgens—such as testosterone (T); dihydrotestosterone (DHT); and their prohormones, dehydroepiandrosterone sulfate (DHEAS) and androstendione (A)—are the key factors in terminal hair growth. They act on sex-specific areas of the body, converting small, straight, fair vellus hairs into larger darker terminal hairs. They bind to intracellular androgen receptors in the dermal papilla cells of the hair follicle. The majority of hair follicles also require the intracellular enzyme 5-alpha reductase to convert testosterone into DHT. Apart from androgens, the role of other hormones is also currently being researched—e.g., estradiol can significantly alter the hair follicle growth and cycle by binding to estrogen receptors and influencing aromatase activity, which is responsible for converting androgen into estrogen (E2). Progesterone, at the level of the hair follicle, decreases the conversion of testosterone into DHT. The influence of prolactin (PRL) on hair growth has also been intensively investigated, and PRL and PRL receptors were detected in human scalp skin. Our review includes results from many analyses and provides a comprehensive up-to-date understanding of the subject of the effects of hormonal changes on the hair follicle.

ACS Style

Monika Grymowicz; Ewa Rudnicka; Agnieszka Podfigurna; Paulina Napierala; Roman Smolarczyk; Katarzyna Smolarczyk; Blazej Meczekalski. Hormonal Effects on Hair Follicles. International Journal of Molecular Sciences 2020, 21, 5342 .

AMA Style

Monika Grymowicz, Ewa Rudnicka, Agnieszka Podfigurna, Paulina Napierala, Roman Smolarczyk, Katarzyna Smolarczyk, Blazej Meczekalski. Hormonal Effects on Hair Follicles. International Journal of Molecular Sciences. 2020; 21 (15):5342.

Chicago/Turabian Style

Monika Grymowicz; Ewa Rudnicka; Agnieszka Podfigurna; Paulina Napierala; Roman Smolarczyk; Katarzyna Smolarczyk; Blazej Meczekalski. 2020. "Hormonal Effects on Hair Follicles." International Journal of Molecular Sciences 21, no. 15: 5342.

Case report
Published: 18 June 2020 in International Journal of Environmental Research and Public Health
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Background: Many studies show the occurrence of several multiple endocrine neoplasia syndromes caused by different mutations, for example, in MEN1 and RET genes. Nevertheless, there are less common mutations causing multiple endocrine glands tumors. Examples of such mutations are CHEK2 gene mutations, causing breast, kidney, gastric, colorectal, prostate, lung, ovarian, and thyroid cancers. Case description: In 2005, a 30-year-old woman was admitted to the hospital due to uncontrolled hypertension and obesity. Performed tests have shown ACTH (adrenocorticotropic hormone)—independent micronodular adrenal hyperplasia (AIMAH) as a cause. In 2010, the further diagnostic analysis revealed Cushing’s disease caused by ACTH-secreting pituitary microadenoma. Additionally, in 2011, the patient underwent the strumectomy of multinodular struma. Papillary thyroid carcinoma was found in the excised tissue. In 2018, transvaginal ultrasonography revealed a tumor of the right ovary. After a performed hysterectomy with bilateral salpingo-oophorectomy, the histopathology result has shown female adnexal tumors of probable Wolffian origin (FATWO) located in the broad ligament of the uterus. Due to the history of multiglandular diseases, the patient was referred to genetic testing. We found a positive pathogenic mutation in CHEK2-suppressor gene involved in DNA repair, cell cycle arrest, and apoptosis in response to DNA damage. Conclusion: CHEK2 variants may predispose to a range of endocrine glands tumors, including those identified in our patient. Multiple endocrine glands tumors, as in the presented patient, are a serious problem of public health, due to numerous hospitalizations and necessary repeated surgical treatments. Moreover, the association between CHEK2 and ovarian cancer can be a serious problem with reproductive health.

ACS Style

Anna Szeliga; Aleksandra Pralat; Wiktoria Witczak; Agnieszka Podfigurna; Cezary Wojtyla; Anna Kostrzak; Blazej Meczekalski. CHEK2 Mutation in Patient with Multiple Endocrine Glands Tumors. Case Report. International Journal of Environmental Research and Public Health 2020, 17, 1 .

AMA Style

Anna Szeliga, Aleksandra Pralat, Wiktoria Witczak, Agnieszka Podfigurna, Cezary Wojtyla, Anna Kostrzak, Blazej Meczekalski. CHEK2 Mutation in Patient with Multiple Endocrine Glands Tumors. Case Report. International Journal of Environmental Research and Public Health. 2020; 17 (12):1.

Chicago/Turabian Style

Anna Szeliga; Aleksandra Pralat; Wiktoria Witczak; Agnieszka Podfigurna; Cezary Wojtyla; Anna Kostrzak; Blazej Meczekalski. 2020. "CHEK2 Mutation in Patient with Multiple Endocrine Glands Tumors. Case Report." International Journal of Environmental Research and Public Health 17, no. 12: 1.

Journal article
Published: 21 October 2018 in Journal of Clinical Medicine
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Premature ovarian insufficiency (POI) is hypogonadism associated with amenorrhea, increased levels of gonadotropins, and hypoestrogenism. Deficiency of estrogens may contribute to higher risk of cardiovascular diseases and death. POI patients present several risk factors for the development of cardiovascular diseases (CVD): endothelial dysfunction, abnormal lipid profile, insulin resistance, and insulin action disturbances. Therefore, patients present a higher risk of developing metabolic syndrome. Materials and methods: Follicle stimulating hormone (FSH), luteinizing hormone (LH), 17β-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid stimulating hormone (TSH), thyroxine (fT4), fasting serum glucose and insulin concentrations, homeostatic model for insulin resistance (HOMA-IR), and lipid profiles were assessed in 56 women (mean age: 30.7 ± 6.9) suffering from POI diagnosed according to European Society of Human Reproduction and Embryology (ESHRE) criteria and 68 healthy age-and-weight matched women (mean age: 27.3 ± 4.5). Results: After regression analysis with BMI and age correction, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) serum concentrations were found to be significantly higher in the POI group, when compared to healthy subjects, whilst triglycerides, glucose, insulin serum concentrations, HOMA-IR, as well as systolic (SBP) and diastolic blood pressure (DBP) did not differ significantly between both groups. A significant positive correlation was identified between TC and LDL-C levels, regardless of BMI and age, whilst SBP correlated only with serum glucose concentration. Additionally, FSH correlated positively with fasting serum glucose concentration after BMI and age correction. Conclusions: Certain metabolic parameters appeared to correlate with POI and these correlations persisted after correction for BMI and age. More research is required to determine the influence of absent ovulatory function on metabolic profiles in POI women. This information may additionally help in early identification of CVD risk factors in those patients.

ACS Style

Agnieszka Podfigurna; Angelika Stellmach; Anna Szeliga; Adam Czyzyk; Blazej Meczekalski. Metabolic Profile of Patients with Premature Ovarian Insufficiency. Journal of Clinical Medicine 2018, 7, 374 .

AMA Style

Agnieszka Podfigurna, Angelika Stellmach, Anna Szeliga, Adam Czyzyk, Blazej Meczekalski. Metabolic Profile of Patients with Premature Ovarian Insufficiency. Journal of Clinical Medicine. 2018; 7 (10):374.

Chicago/Turabian Style

Agnieszka Podfigurna; Angelika Stellmach; Anna Szeliga; Adam Czyzyk; Blazej Meczekalski. 2018. "Metabolic Profile of Patients with Premature Ovarian Insufficiency." Journal of Clinical Medicine 7, no. 10: 374.

Review
Published: 14 June 2018 in Gynecological Endocrinology
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Women during perimenopausal period experience a range of symptoms, which interfere with physical, sexual, and social life. About 65-75% of symptoms connected with postmenopausal period are vasomotor symptoms (VMS), such as hot flushes and night sweats. Hot flushes are subjective sensation of heat associated with cutaneous vasodilatation and drop in core temperature. It is suspected that VMS are strongly correlated with pulsatile oversecretion of gonadotropin-releasing hormone (GnRH) and subsequently luteinizing hormone (LH). Evidence has accumulated in parallel showing that lack of negative feedback of steroid hormones synthesized in ovary causes overactivation of hypertrophied kisspeptin/neurokinin B/dynorphin (KNDy) neurons, located in infundibular nucleus. Oversecretion of both kisspeptin (KISS1) and neurokinin B (NKB), as well as downregulation of dynorphin, plays dominant role in creation of GnRH pulses. This in turn causes VMS. Administration of senktide, highly potent and selective NK3R agonist, resulted in increase of serum LH concentration, induction of VMS, increase in heart rate, and skin temperature in postmenopausal women. These finding suggest that modulation of KNDy neurons may become new therapeutic approach in the treatment of VMS.

ACS Style

Anna Szeliga; Adam Czyzyk; Agnieszka Podfigurna; Andrea R. Genazzani; Alessandro D. Genazzani; Blazej Meczekalski. The role of kisspeptin/neurokinin B/dynorphin neurons in pathomechanism of vasomotor symptoms in postmenopausal women: from physiology to potential therapeutic applications. Gynecological Endocrinology 2018, 34, 913 -919.

AMA Style

Anna Szeliga, Adam Czyzyk, Agnieszka Podfigurna, Andrea R. Genazzani, Alessandro D. Genazzani, Blazej Meczekalski. The role of kisspeptin/neurokinin B/dynorphin neurons in pathomechanism of vasomotor symptoms in postmenopausal women: from physiology to potential therapeutic applications. Gynecological Endocrinology. 2018; 34 (11):913-919.

Chicago/Turabian Style

Anna Szeliga; Adam Czyzyk; Agnieszka Podfigurna; Andrea R. Genazzani; Alessandro D. Genazzani; Blazej Meczekalski. 2018. "The role of kisspeptin/neurokinin B/dynorphin neurons in pathomechanism of vasomotor symptoms in postmenopausal women: from physiology to potential therapeutic applications." Gynecological Endocrinology 34, no. 11: 913-919.

Review
Published: 01 March 2018 in Maturitas
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Numerous social and environmental factors (environmental hazards, social factors such as education and career, higher economic status desired before the decision is made to have children) influence a women's decision to postpone pregnancy until late reproductive age. In turn, age is related to a fall in ovarian reserve. The main goal of testing ovarian reserve is the identification of women with so-called diminished ovarian reserve (DOR). Additionally, it provides assistance in the counselling of women who are planning to use assisted reproductive techniques (ART). This review examines current methods of testing ovarian reserve and their application. The most useful methods of assessing ovarian reserve are ultrasonographic count of ovarian antral follicles (AFC) and serum tests of both the anti-Müllerian hormone (AMH) level and the third-day level of follicle stimulating hormone (FSH). However, there are limitations to the currently used methods of testing ovarian reserve, especially in relation to their specificity and sensitivity. It is also difficult to predict egg quality based on these tests. The value of screening programmes of ovarian reserve is yet to be determined.

ACS Style

Agnieszka Podfigurna; Krzysztof Lukaszuk; Adam Czyzyk; Michal Kunicki; Marzena Maciejewska-Jeske; Grzegorz Jakiel; Blazej Meczekalski. Testing ovarian reserve in pre-menopausal women: why, whom and how? Maturitas 2018, 109, 112 -117.

AMA Style

Agnieszka Podfigurna, Krzysztof Lukaszuk, Adam Czyzyk, Michal Kunicki, Marzena Maciejewska-Jeske, Grzegorz Jakiel, Blazej Meczekalski. Testing ovarian reserve in pre-menopausal women: why, whom and how? Maturitas. 2018; 109 ():112-117.

Chicago/Turabian Style

Agnieszka Podfigurna; Krzysztof Lukaszuk; Adam Czyzyk; Michal Kunicki; Marzena Maciejewska-Jeske; Grzegorz Jakiel; Blazej Meczekalski. 2018. "Testing ovarian reserve in pre-menopausal women: why, whom and how?" Maturitas 109, no. : 112-117.

Review
Published: 01 January 2018 in Menopausal Review
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Cardiovascular diseases (CVDs) represent the world’s leading cause of death among women. Women with premature ovarian insufficiency (POI) may be at higher risk of cardiovascular disease, such as myocardial infarction or stroke, than women with normal menopause. The increased burden may be mediated by a worsening of cardiovascular risk factors, such as lipid profiles, with accompanying loss of ovarian function. In contrast, the increased burden may be caused by factors that precede and potentially contribute to both CVD events and ovarian decline, such as smoking. Women with X chromosome-related POI like Turner syndrome (TS) are a distinct group with unique medical needs. Regardless of the cause, women with POI may serve as an important population to target for CVD screening and prevention strategies. These strategies should include the use of CVD risk stratification tools to identify women who may benefit from lifestyle modification and pharmacological therapy to prevent CVD.

ACS Style

Agnieszka Podfigurna; Błażej Męczekalski. Cardiovascular health in patients with premature ovarian insufficiency. Management of long-term consequences. Menopausal Review 2018, 17, 109 -111.

AMA Style

Agnieszka Podfigurna, Błażej Męczekalski. Cardiovascular health in patients with premature ovarian insufficiency. Management of long-term consequences. Menopausal Review. 2018; 17 (3):109-111.

Chicago/Turabian Style

Agnieszka Podfigurna; Błażej Męczekalski. 2018. "Cardiovascular health in patients with premature ovarian insufficiency. Management of long-term consequences." Menopausal Review 17, no. 3: 109-111.

Chapter
Published: 04 November 2017 in Menopause
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Premature ovarian insufficiency (POI) can be defined as a cessation of ovarian function in women younger than 40 years old and is linked to the development of hypergonadotropic hypogonadism. The hypogonadism clinically presents as amenorrhea, which sometimes is preceded by oligomenorrhea and decreased circulating estradiol levels. Different clinical definitions of POI have been proposed (see below).

ACS Style

Agnieszka Podfigurna; Adam Czyzyk; Monika Grymowicz; Roman Smolarczyk; Blazej Meczekalski. Primary Ovarian Insufficiency. Menopause 2017, 23 -66.

AMA Style

Agnieszka Podfigurna, Adam Czyzyk, Monika Grymowicz, Roman Smolarczyk, Blazej Meczekalski. Primary Ovarian Insufficiency. Menopause. 2017; ():23-66.

Chicago/Turabian Style

Agnieszka Podfigurna; Adam Czyzyk; Monika Grymowicz; Roman Smolarczyk; Blazej Meczekalski. 2017. "Primary Ovarian Insufficiency." Menopause , no. : 23-66.

Review
Published: 01 July 2017 in Minerva Ginecol
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Endometriosis is a chronic, inflammatory, condition of high incidence and serious reproductive and general health consequences. Understanding the pathogenesis of endometriosis is crucial for proper diagnostic and ordering the most effective treatment. Even though there is a large body of data regarding this pathology our understanding of the pathogenesis of this disease remains incomplete. The aim of this review is to summarize contemporary data regarding pathogenesis of endometriosis. Current data regarding endometrial origin, metaplastic and Mullerian embryonic rests theory will be reviewed here. Also genetic, epigenetic, environmental factors and immunological dysfunction role in endometriosis will be summarized. To conclude, a lot of effort must be put to integrate the abundant data from genetic, epigenetic and immunological studies to propose one coherent theory for the pathogenesis of endometriosis.

ACS Style

Adam Czyzyk; Agnieszka Podfigurna; Anna Szeliga; Blazej Meczekalski. Update on endometriosis pathogenesis. Minerva Ginecol 2017, 69, 447 -461.

AMA Style

Adam Czyzyk, Agnieszka Podfigurna, Anna Szeliga, Blazej Meczekalski. Update on endometriosis pathogenesis. Minerva Ginecol. 2017; 69 (5):447-461.

Chicago/Turabian Style

Adam Czyzyk; Agnieszka Podfigurna; Anna Szeliga; Blazej Meczekalski. 2017. "Update on endometriosis pathogenesis." Minerva Ginecol 69, no. 5: 447-461.

Review
Published: 11 June 2017 in Gynecological Endocrinology
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Ovarian hyperthecosis (OH) is characterized by the presence of abundant luteinized theca cells in ovaries that secret androgen. It typically presents as severe hyperandrogenism and/or virilization in postmenopausal woman. Here we describe a 66-year old woman with presentation of severe hirsutism, alopecia, clitoromegaly and laboratory finding of significantly elevated serum total testosterone concentration and hyperinsulinemia. Performed imaging studies revealed normal sized, homogeneous ovaries, signs of endometrial hypertrophy and normal adrenal glands. Due to severe hyperandrogenemia and signs of endometrial hypertrophy, the total abdominal hysterectomy with bilateral salpingo-oophorectomy has been performed. Pathological examination revealed OH and endometrial hyperplasia. Androgenic activity of ovarian stromal cells has been confirmed using alpha-inhibin histochemical staining. Postmenopausal hyperandrogenemia is a diagnostic and therapeutic challenge and the imaging studies often may be misleading and require careful and critical consideration.

ACS Style

Adam Czyzyk; Justyna Latacz; Dorota Filipowicz; Agnieszka Podfigurna; Rafal Moszynski; Piotr Jasinski; Stefan Sajdak; Michał Gaca; Andrea R Genazzani; Blazej Meczekalski. Severe hyperandrogenemia in postmenopausal woman as a presentation of ovarian hyperthecosis. Case report and mini review of the literature. Gynecological Endocrinology 2017, 33, 836 -839.

AMA Style

Adam Czyzyk, Justyna Latacz, Dorota Filipowicz, Agnieszka Podfigurna, Rafal Moszynski, Piotr Jasinski, Stefan Sajdak, Michał Gaca, Andrea R Genazzani, Blazej Meczekalski. Severe hyperandrogenemia in postmenopausal woman as a presentation of ovarian hyperthecosis. Case report and mini review of the literature. Gynecological Endocrinology. 2017; 33 (11):836-839.

Chicago/Turabian Style

Adam Czyzyk; Justyna Latacz; Dorota Filipowicz; Agnieszka Podfigurna; Rafal Moszynski; Piotr Jasinski; Stefan Sajdak; Michał Gaca; Andrea R Genazzani; Blazej Meczekalski. 2017. "Severe hyperandrogenemia in postmenopausal woman as a presentation of ovarian hyperthecosis. Case report and mini review of the literature." Gynecological Endocrinology 33, no. 11: 836-839.

Clinical trial
Published: 02 June 2017 in Gynecological Endocrinology
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Functional hypothalamic amenorrhea (FHA) is a relatively frequent disease due to the combination of metabolic, physical, or psychological stressors. It is characterized by the low endogenous GnRH-induced gonadotropin secretion, thus triggering the ovarian blockade and a hypoestrogenic condition. Up to now various therapeutical strategies have been proposed, both using hormonal treatment as well as neuroactive compounds. Since carnitine, namely l-acetyl-carnitine (LAC), has been demonstrated to be effective in the modulation of the central hypothalamic control of GnRH secretion, we aimed to evaluate whether a combined integrative treatment for 12 weeks of LAC (250 mg/die) and l-carnitine (500 mg/die) was effective in improving the endocrine and metabolic pathways in a group of patients (n = 27) with FHA. After the treatment, interval mean LH plasma levels increased while those of cortisol and amylase decreased significantly. When patients were subdivided according to baseline LH levels, only hypo-LH patients showed the significant increase of LH plasma levels and the significant decrease of both cortisol and amylase plasma levels. The increased 17OHP/cortisol ratio, as index of the adrenal activity, demonstrated the reduced stress-induced adrenal activity. In conclusion, our data sustain the hypothesis that the integrative administration of LAC plus l-carnitine reduced both the metabolic and the neuroendocrine impairment of patients with FHA.

ACS Style

Alessandro Genazzani; Giulia Despini; Adam Czyzyk; Agnieszka Podfigurna; Tommaso Simoncini; Blazej Meczekalski. Modulatory effects of l-carnitine plus l-acetyl-carnitine on neuroendocrine control of hypothalamic functions in functional hypothalamic amenorrhea (FHA). Gynecological Endocrinology 2017, 33, 963 -967.

AMA Style

Alessandro Genazzani, Giulia Despini, Adam Czyzyk, Agnieszka Podfigurna, Tommaso Simoncini, Blazej Meczekalski. Modulatory effects of l-carnitine plus l-acetyl-carnitine on neuroendocrine control of hypothalamic functions in functional hypothalamic amenorrhea (FHA). Gynecological Endocrinology. 2017; 33 (12):963-967.

Chicago/Turabian Style

Alessandro Genazzani; Giulia Despini; Adam Czyzyk; Agnieszka Podfigurna; Tommaso Simoncini; Blazej Meczekalski. 2017. "Modulatory effects of l-carnitine plus l-acetyl-carnitine on neuroendocrine control of hypothalamic functions in functional hypothalamic amenorrhea (FHA)." Gynecological Endocrinology 33, no. 12: 963-967.

Journal article
Published: 01 August 2016 in Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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ACS Style

Maciej Stagraczyński; Tomasz Kulczyk; Agnieszka Podfigurna; Błażej Męczekalski. [Estimation of mandibular bone status and lumbar bone mineral density in postmenopausal women]. Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego 2016, 41, 1 .

AMA Style

Maciej Stagraczyński, Tomasz Kulczyk, Agnieszka Podfigurna, Błażej Męczekalski. [Estimation of mandibular bone status and lumbar bone mineral density in postmenopausal women]. Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2016; 41 (242):1.

Chicago/Turabian Style

Maciej Stagraczyński; Tomasz Kulczyk; Agnieszka Podfigurna; Błażej Męczekalski. 2016. "[Estimation of mandibular bone status and lumbar bone mineral density in postmenopausal women]." Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego 41, no. 242: 1.