By Cary Dicken, Marie Menke, Genevieve Neal-Perry (auth.), Nanette F. Santoro, Genevieve Neal-Perry (eds.)
Amenorrhea: A Case-Based scientific consultant is a entire assessment of the present wisdom concerning basic girl reproductive body structure. Replete with attention-grabbing case vignettes and delivering diagnostic algorithms and healing suggestions for amenorrhea, Amenorrhea: A Case-Based scientific consultant is split into 3 sections. the 1st part consists of 2 chapters that offer a radical evaluate of simple technological know-how and scientific wisdom in regards to the organ platforms accountable for general body structure of the menstrual cycle. the second one part comprises dialogue approximately menstrual cycle disruption because it pertains to hypothalamic-pituitary disorder, surgical and average menopause, genetic defects, untimely ovarian failure/insufficiency and the consequences of caloric extra and restrict. The 3rd part deals an replace at the physiological results of lengthy amenorrhea brought on surgically or by way of hypothalamic disorder and in addition comprises an unique bankruptcy that focuses exclusively at the effect of race and ethnicity at the occurrence and prognosis of amenorrhea. Amenorrhea: A Case-Based scientific advisor brings jointly chapters from popular specialists who provide state of the art, clinically beneficial details in a case-based, reader-friendly style. This name can be a great addition to the bookshelves of all clinicians who perform in women’s healthiness settings.
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Additional resources for Amenorrhea: A Case-Based, Clinical Guide
Santoro and G. R. S. Taylor is a superficial thin layer with gland necks and dense stroma, while the stratum spongiosum is the deeper part of functionalis composed of glands and loosely arranged stroma. Only the functionalis layer of endometrium is shed with each cycle. The basalis layer contains the progenitor cells that regenerate the functionalis layer in each cycle. Endometrial tissue responds to sex steroid hormones produced in the follicular and luteal phases of the ovarian cycle. The menstrual cycle is divided into proliferative and secretory phases, and cytoarchitectural and molecular differences between the phases reflect endometrial responses to cyclic changes in ovarian hormone exposure.
The proliferative phase of the cycle is mainly mediated by the effects of estrogens. Estrogen receptor alpha (ERa, also known as ESR1) and estrogen receptor beta (ERb, also known as ESR2) are transcribed from different genes and have distinct expression patterns. ESR2 is expressed in the endometrium throughout the menstrual cycle . ERS1 varies throughout the menstrual cycle and is expressed by both epithelial and stromal cells during the proliferative phase . Estrogen receptors are largely lost in the epithelium after progesterone exposure.
However, cryptic adrenal failure is very serious and could indicate pituitary insufficiency with reduced ACTH, therefore, it is reasonable to obtain an 8:00 am cortisol. If the patient has a height below the 5th percentile, particularly with a family history of pituitary failure, then combined pituitary hormone deficiency (CPHD) should be considered. Genetic counseling and testing for mutations in genes such as PROP1, HESX1, SOX2, SOX3, LHX3, or LHX4 could be considered in these patients (Fig. 1) .
Amenorrhea: A Case-Based, Clinical Guide by Cary Dicken, Marie Menke, Genevieve Neal-Perry (auth.), Nanette F. Santoro, Genevieve Neal-Perry (eds.)