Gynecologic Endocrinology

I. Basic Anatomy and Physiology.- 1. Historical Introduction to Gonadal Regulation of the Uterus and the Menses.- 2. The Neuroendocrine System.- Historical Background.- Posterior Pituitary or Neurohypophysis.- Normal Physiology of the Anterior Pituitary and Median Eminence.- Pathophysiology.- Releasing Hormones and Their Use in Therapy.- Summary.- Questions.- References.- Answers.- 3. Placental Endocrinology.- Placental Steroid Hormones.- Placental Protein Hormones.- Other Placental Proteins.- Periplacental Hormones.- Summary.- Questions.- References.- Answers.- II. Hormonal Physiology.- 4. Hormonal Physiology of the Ovary and Adrenal Cortex.- Steroidogenesis in Ovary and Adrenal.- Germ Cell and Oocyte.- Folliculogenesis.- Estrogen and Hormone Receptors in Folliculogenesis.- Selection of the Preovulatory (Dominant) Follicle.- Ovulation.- Formation, Maintenance, and Lysis of the Corpus Luteum.- Luteinization Inhibitor and Stimulator.- Follicle Regulatory Protein.- Oocyte Maturation Inhibitor.- Inhibin (Inhibin F, Folliculostatin, Gonadostatin).- Prolactin.- Gonadotropin-Releasing Hormone.- Relaxin.- Questions.- References.- Answers.- 5. Physiology of Relaxin.- Structure.- Species Specificity.- Measurement of Relaxin.- Sources of Relaxin in the Human Female.- Relaxin in the Nonpregnant State.- Relaxin and Pregnancy.- Role of Relaxin in Women.- Relaxin in the Male.- Future Trends.- Summary.- Questions.- References.- Answers.- 6. Normal Growth and Development of the Female.- Development of the Sexually Undifferentiated Embryo.- Development of the Female Fetus.- Neuroendocrine Function in the Fetus.- Intrauterine Fetal Growth.- The Newborn Period.- Infancy and Childhood.- Peripubertal Hormonal Changes.- Neuroendocrine Development during Puberty.- Growth and Sexual Maturation during Puberty.- Summary.- Questions.- References.- Answers.- 7. Thyroid Function and Disease in the Female.- and Historical Background.- Thyroid Physiology.- Thyroid Function Tests.- Thyroid Pathophysiology.- Management of Thyroid Diseases.- The Thyroid in Pregnancy and the Postpartum.- Summary.- Questions.- References.- Answers.- III. Diagnostic Procedures.- 8. Hormone Assays in Endocrine Systems.- Procedures for Testing.- Hormone Assay Procedures.- Testing Protocols.- Future of Hormone Assay in Endocrinology.- Summary.- Questions.- References.- Answers.- 9. Hormonal Cytopathology of the Vagina.- Cytologic Techniques.- Cytology under Physiologic Conditions.- Assessment of Hormonal Effects.- Cytology of Pregnancy and Abortion.- The Menopause.- Cytology of Amenorrhea.- Effect of Hormonal Administration and Contraception.- Hormonal Patterns of Miscellaneous Conditions.- Summary.- Questions.- References.- Answers.- 10. Cervical Mucus.- Production and Physiochemical Properties.- Sperm Penetration of Cervical Mucus.- Antibacterial Activity of Cervical Mucus.- Use of Cervical Mucus in Clinical Tests of Infertility.- Cervicovaginal Peroxidases and Prediction of the Time of Ovulation.- Summary.- Questions.- References.- Answers.- 11. Endometrium.- Historical Considerations.- Normal Endometrium.- Endometrial Responses.- Other Dysfunctional Bleeding Syndromes.- Organic Pathology.- Summary.- Questions.- References.- Answers.- 12. Diagnostic Imaging.- Skeletal Age.- Hysterosalpingography.- Genitography.- Neuroendocrinology Imaging.- Adrenals.- Gynecologic Ultrasound.- Gonadal Dysgenesis.- Skeletal Abnormalities.- Visceral Anomalies.- Summary.- Questions.- References.- Answers.- 13. Endoscopic Procedures.- History and Background.- Laparoscopy.- Hysteroscopy.- Contact Hysteroscopy.- Summary.- Questions.- References.- Answers.- IV. Endocrine Disorders in the Female.- 14. Ovarian Dysgenesis and Related Genetic Disorders.- Genetic Control of Testicular and Ovarian Development.- General Considerations.- Pathologic Features of Monosomy X (45,X).- Specific Sex Chromosomal Abnormalities.- Gonadal Dysgenesis in 46,XX Individuals.- Gonadal Dysgenesis in 46,XY Individuals.- Miscellaneous Conditions.- Management.- Summary and Conclusions.- Questions.- References.- Answers.- 15. Female Pseudohermaphroditism in 21-Hydroxylase Deficiency.- Steroidogenesis and Enzymatic Conversions of Adrenal Steroid Hormones.- FetalSexual Development.- 21-Hydroxylase Deficiency.- Sex Assignment in Congenital Adrenal Hyperplasia.- Summary.- Questions.- References.- Answers.- 16. Hypothalamic-Pituitary Disease.- Hypothalamic-Pituitary Disorders.- Diagnosis of Hypothalamic-Pituitary Disease.- Questions for the Future.- Conclusion.- Questions.- References.- Answers.- 17. Secondary Amenorrhea and the Menopause.- Secondary Amenorrhea.- The Climacteric and Menopause.- Summary.- Questions.- References.- Answers.- 18. Endometriosis.- Historical Background.- Definition.- Incidence.- Pathogenesis.- Clinical Features.- Diagnosis.- Management.- Summary.- Questions.- References.- Answers.- 19. Dysmenorrhea and Prostaglandins.- Historical Aspects.- Definition and Classification.- Incidence.- Clinical Features.- Etiology of Dysmenorrhea.- Management.- Summary.- Questions.- References.- Answers.- 20. Fertility following Steroidal Oral Contraception and Diethylstilbestrol Exposure.- Postpill Amenorrhea Syndrome.- Reproductive Performance in Diethylstilbestrol-Exposed Women.- Summary.- Questions.- References.- Answers.- 21. Anorexia Nervosa and Other Weight-Loss-Associated Amenorrheas.- Pathophysiology.- Anorexia Nervosa.- Bulimia.- Simple Weight Loss.- Exercise-Induced Amenorrhea.- Summary.- Questions.- References.- Answers.- 22. Premenstrual Tension and Idiopathic Edema.- Premenstrual Tension: The Problem.- Pathophysiology.- Evaluation of the Patient with PMS.- Therapy.- Idiopathic Edema.- Summary.- Questions.- References.- Answers.- 23. Hirsutism and Virilism in Women.- Hirsutism.- Origin of Testosterone in Normal Women.- Androgen Excess in Hirsutism.- Androgen Metabolism in the Skin.- Testosterone Clearance versus Hirsutism.- Causes of Virilization in Women.- Clinical Clues in Evaluating Hirsutism.- Laboratory Tests for Virilization.- Treatment.- Summary.- Questions.- References.- Answers.- 24. Lactation and Galactorrhea.- Galactorrhea.- Definition and Diagnosis of Galactorrhea.- Causes of Galactorrhea.- Microadenomas.- Large Tumors.- Pregnancy and Pituitary Tumors.- Idiopathic Galactorrhea with Menses.- Idiopathic Galactorrhea with Amenorrhea.- Chiari-Frommel Syndrome.- Surgery and Trauma.- Drugs.- Hypothyroidism.- Empty Sella Syndrome.- Miscellaneous.- Treatment of Galactorrhea with Prolactin-Lowering Ergot Drugs.- Summary.- Questions.- References.- Answers.- 25. Hormone-Producing Tumors of the Ovary and Placenta.- Ovarian Tumors.- Placental Tumors (Gestational Trophoblastic Disease).- Summary.- Questions.- References.- Answers.- 26. Steroid Receptors in Breast, Uterine, and Ovarian Malignancy: Diagnostic and Therapeutic Applications.- Hormonal Control of Growth of Reproductive Tissues.- Breast Cancer.- Normal and Neoplastic Uterus.- Steroid Receptors and Ovarian Tumors.- Summary.- Questions.- References.- Answers.- 27. Understanding and Managing of Pregnancy in Women with Diabetes Mellitus.- Metabolic Changes in Pregnancy.- Detection of Diabetes.- Insulin-Dependent Diabetes Mellitus.- Gestational Diabetes.- Family Planning.- Summary.- Questions.- References.- Answers.- V. Infertility and its Future.- 28. Investigation of the Infertile Couple.- Investigation of Infertility.- Investigation of the Female.- Investigation of the Male.- Further Studies for Unexplained Infertility.- Summary.- Questions.- Answers.- 29. Male Infertility.- Male Physiology.- Androgen Production by the Testis.- Disorders of Testicular Function Associated with Infertility.- Diagnostic Evaluation of the Infertile Male.- Laboratory Evaluation of Testicular Function.- Summary of Therapeutic Intervention.- Summary.- Questions.- References.- Answers.- 30. Surgical Treatment of Infertility.- Pathophysiology.- Classification of Tubal Disease.- Classification of Operative Procedures.- Reparative Tubal Surgery.- Assessment of Tubal Surgical Success.- Pelvic Endometriosis.- Leiomyomata Uteri.- Metroplasty.- Summary.- References.- 31. Medical Treatment of Infertility.- Clomiphene Citrate.- Human Menopausal Gonadotropin.- Combined Clomiphene and hMG.- Gonadotropin-Releasing Hormone.- Bromocriptine.- Summary.- Questions.- References.- Answers.- 32. In Vitro Fertilization.- and Overview.- Historical Background.- Psychologic Principles Employed.- Clinical Methods and Procedures.- The Natural Cycle.- Stimulation of Ovulation.- Oocyte Retrieval and Aspiration Device.- Follicular Fluid and Oocyte Characteristics at Aspiration.- Transfer.- Results.- Summary.- References.- VI. New Frontiers in Gynecologic Endrocrinology.- 33. Endocrine Control of the Secretory Immune System in the Reproductive Tract of the Female: Response of IgA, IgG, and Secretory Component in the Uterus to Sex Hormones.- The Immune System in the Female Reproductive Tract.- Hormonal Influence on the Secretory Immune System of the Female Reproductive Tract.- Effect of Estradiol on IgA and IgG Levels in the Uterus of the Rat.- Cellular Aspects of the Immunoglobulin Response to Estradiol.- Effect of Estradiol and Progesterone on Secretory Component.- Levels of Secretory Component in Human Uterine Fluid during the Menstrual Cycle.- Effects of Steroid Hormones on Systemic Cellular and Humoral Immune Responses.- Conclusions.- Questions.- References.- Answers.- 34. Epidermal Growth Factor and Its Receptor and Their Possible Relationships to Gynecologic Endocrinology.- Epidermal Growth Factor.- The EGF Receptor.- Summary.- Questions.- References.- Answers.- Glossary of Abbreviations.