Frank E. Chang

Acute effects of exercise on plasma catecholamines in sedentary and athletic women with normal and abnormal menses

Norepinephrine plays a role in the regulation of luteinizing hormone secretion and may therefore be involved in the etiology of exercise-induced menstrual dysfunction. This study evaluated both intraexercise and postexercise responses of epinephrine, norepinephrine, and dopamine in sedentary women and women runners with normal and abnormal menstruation. Five eumenorrheic nonrunners and five eumenorrheic, four oligomenorrheic, and five amenorrheic runners were evaluated on 2 consecutive days. On day 1, the women cycled on a bicycle ergometer against an increasing work load until exhaustion, and on day 2, the women underwent a submaximal exercise regimen. Serial blood draws were taken at specified time intervals during intraexercise and postexercise periods on both days. The data collected during exercise for all groups showed that epinephrine and norepinephrine had a sixfold to sevenfold rise on day 1 and had a threefold rise on day 2. Dopamine increased twofold during both exercise protocols. On day 1 norepinephrine displayed a significantly higher percentage change from baseline to peak levels for oligomenorrheic and amenorrheic runners than for eumenorrheic runners and sedentary women. This latter finding is consistent with the hypothesis that periodic marked elevations in norepinephrine levels during maximal exercise may interfere with pulsatile luteinizing hormone release and hence may play a role in the occurrence of menstrual dysfunction in women runners.

Serum carotene levels in female long-distance runners.

Hypercarotenemia has been associated with anorexia nervosa and hypothalamic amenorrhea. With the emergence of a spectrum of menstrual dysfunction, including anovulation in women runners, the hypothesis of hypothalamic amenorrhea in these patients has been formulated. Other authors have proposed exercise-associated amenorrhea to be distinct from hypothalamic amenorrhea based on endocrine profiles. Using carotene as an index test of hypothalamic amenorrhea, we have studied female long-distance runners (greater than 25 miles/week) and have found no difference in the carotene levels between ovulatory (midfollicular) and anovulatory runners. These data support other evidence that exercise-associated amenorrhea is distinct from hypothalamic amenorrhea.

Demographic variables related to successful anonymous oocyte donor recruitment

Only 4% of initial applicants to the oocyte donor program completed the screening process and actually donated a cohort of oocytes. Medical screen-outs were more likely for women who had children, were unmarried, and were less educated, whereas psychological screen-outs were more common among younger applicants, and both younger and African-American women were more likely to withdraw without donating.

Hormone-Producing Tumors of the Ovary and Placenta

As the ovary and placenta are endocrine organs, any neoplastic lesion arising from them may be active in hormone production. Although rare, they present interesting and challenging problems to clinicians. Hormone-producing ovarian tumors make up approximately 5% of all ovarian tumors. The histological diversity of these tumors is great and includes both primary and metastatic tumors of the ovary. Table 25–1 classifies these hormone-producing tumors into five major categories. Although androgens and estrogens are the most common hormones secreted by these tumors, human chorionic gonadotropin (hCG), thyroxine (T4), serotonin, and human placental lactogen (hPL) may be secreted as well. The clinical presentation is therefore extremely interesting in many of these cases. Although in vivo and in vitro studies of hormone production as well as ultrastructural studies have increased our understanding of these tumors, the histogenesis and pathophysiology of many of these tumors remains poorly understood.