Feature Paper in Reproductive Impairments and Pituitary Disorders

A special issue of Endocrines (ISSN 2673-396X). This special issue belongs to the section "Neuroendocrinology and Pituitary Disorders".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 6551

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Department of Obstetrics and Gynecology, Gynecological Endocrinology Center, University of Modena and Reggio Emilia, Modena, Italy
Interests: neuroendocrine/endocrine control of reproduction; hypothalamic dysfunctions; PCOS; obesity; hyperinsulinism; peri and postmenopausal disturbances
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Dear Colleagues,

Reproductive function is mostly regulated by the interaction of hormones produced by the hypothalamus, anterior pituitary, and gonads. They form the reproductive axis (also known as the hypothalamic–pituitary–gonadal (HPG) axis). Stress, impaired metabolism, PCOS, ovarian failure, endocrine diseases, excess physical activity, and psychodynamic aspects can negatively modulate the reproductive axis, resulting in defective reproductive impairments (endometriosis, adenomyosis, polycystic ovary syndrome, and uterine fibroids).

The pituitary gland is a critical mediator of endocrine homeostasis. Hormones of the anterior and posterior pituitary play critical roles in metabolism, osmoregulation, reproduction, stress, and other fundamental processes.

This Special Issue of Endocrines, entitled “Feature Paper in Reproductive Impairments and Pituitary Disorders”, aims to shed light on any aspect of endocrinology in reproductive impairments and pituitary disorders and welcomes submissions of reviews, opinions, research studies, and articles concerning relevant topics.

Prof. Dr. Alessandro Genazzani
Guest Editor

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Keywords

  • reproductive endocrinology
  • pituitary
  • reproductive impairments
  • Endocrine diseases
  • stress
  • PCOS
  • insulin resistance
  • menopause

Published Papers (2 papers)

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Research

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10 pages, 820 KiB  
Article
Modulatory Effects of Ethinyl Estradiol Plus Drospirenone Contraceptive Pill on Spontaneous and GnRH-Induced LH Secretion
by Alessandro D. Genazzani, Alessandra Sponzilli, Marcello Mantovani, Emma Fusilli, Francesco Ricciardiello, Elisa Semprini, Tommaso Simoncini and Christian Battipaglia
Endocrines 2024, 5(1), 36-45; https://doi.org/10.3390/endocrines5010003 - 23 Jan 2024
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Abstract
Background: Combined oral contraceptives (COCs) work mostly by preventing the pre-ovulatory gonadotropin surge, but the action of COCs on spontaneous episodic and GnRH (gonadotropin-releasing hormone)-induced LH (luteinizing hormone) release has been poorly evaluated. Oral contraceptives are known to act on the spontaneous hypothalamic–pituitary [...] Read more.
Background: Combined oral contraceptives (COCs) work mostly by preventing the pre-ovulatory gonadotropin surge, but the action of COCs on spontaneous episodic and GnRH (gonadotropin-releasing hormone)-induced LH (luteinizing hormone) release has been poorly evaluated. Oral contraceptives are known to act on the spontaneous hypothalamic–pituitary functions reducing both GnRH and gonadotropin release and blocking ovulation. Aim: To evaluate spontaneous and GnRH-induced LH release during both phases of the menstrual cycle or under the use of the contraceptive pill. Methods: A group of 12 women, subdivided into two groups, volunteered for the study. Group A (n = 6, controls) received no treatments, while Group B (n = 6) received a 21 + 7 combination of ethinyl-estradiol (EE) 30 µg + drospirenone (DRSP) 3 mg. Both groups were evaluated twice: Group A during follicular and luteal phases, Group B during pill assumption and during the suspension interval, performing a pulsatility test, GnRH stimulation test, and hormonal parameters evaluation. Spontaneous and GnRH-induced secretory pulses were evaluated, as well as the instantaneous secretory rate (ISR). Results: COC treatment lowered LH and FSH (follicle stimulating hormone) levels significantly if compared to the follicular phase of spontaneous cycles. During the suspension interval, hormone levels rapidly rose and became comparable to those of the follicular phase of the control group. The LH pulse frequency under COC administration during the suspension interval was similar to that observed during the follicular phase (2.6 ± 0.3 pulses/180 min and 2.3 ± 0.2 pulses/180 min, respectively). The GnRH-induced LH peaks were greater in amplitude and duration than those observed after ISR computation in both groups. The GnRH-induced LH release during the luteal phase of the control subjects was higher than in the follicular phase (51.2 ± 12.3 mIU/mL and 14.9 ± 1.8 mIU/mL, respectively). Conversely, subjects under COC showed a GnRH-induced LH response similar during COC and during the suspension interval. Conclusions: Our data support that the EE + DRSP preparation acts on both spontaneous pulsatile release and GnRH-induced LH release during the withdrawal period of the treatment, and that after 5–7 days from the treatment suspension, steroidal secretion from the ovary is resumed, such as that of androgens. This suggests that in hyperandrogenic patients, a suspension interval as short as 4 days might be clinically better. Full article
(This article belongs to the Special Issue Feature Paper in Reproductive Impairments and Pituitary Disorders)
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Review

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12 pages, 819 KiB  
Review
Primary Amenorrhea in Adolescents: Approach to Diagnosis and Management
by Laura Gaspari, Françoise Paris, Nicolas Kalfa and Charles Sultan
Endocrines 2023, 4(3), 536-547; https://doi.org/10.3390/endocrines4030038 - 23 Jul 2023
Cited by 1 | Viewed by 4839
Abstract
Primary amenorrhea (PA) describes the complete absence of menses by the age of 15 years. It is a devastating diagnosis that can affect the adolescent’s view of her femininity, sexuality, fertility and self-image. A normal menstrual cycle can occur only in the presence [...] Read more.
Primary amenorrhea (PA) describes the complete absence of menses by the age of 15 years. It is a devastating diagnosis that can affect the adolescent’s view of her femininity, sexuality, fertility and self-image. A normal menstrual cycle can occur only in the presence of: a properly functioning hypothalamus–pituitary axis, well-developed and active ovaries, outflow tract without abnormalities. Any dysfunction in any of these players can result in amenorrhea. PA evaluation includes the patient’s medical history, physical examination, pelvic ultrasonography and initial hormone evaluation, limited to the serum-follicle-stimulating hormone (FSH) and luteinizing hormone, testosterone and prolactin. A karyotype should be obtained in all adolescents with high FSH serum levels. The main causes of PA, whether or not accompanied by secondary sexual characteristics, include endocrine defects of the hypothalamus–pituitary–ovarian axis, genetic defects of the ovary, metabolic diseases, autoimmune diseases, infections, iatrogenic causes (radiotherapy, chemotherapy), environmental factors and Müllerian tract defects. PA management depends on the underlying causes. Estrogen replacement therapy at puberty has mainly been based on personal experience. PA can be due to endocrine, genetic, metabolic, anatomical and environmental disorders that may have severe implications on reproductive health later in life. In some complex cases, a multidisciplinary team best manages the adolescent, including a pediatrician endocrinologist, gynecologist, geneticist, surgeon, radiologist, and psychologist. Full article
(This article belongs to the Special Issue Feature Paper in Reproductive Impairments and Pituitary Disorders)
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