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The Menstrual Cycle: Physiology, Reproductive Disorders, and Infertility / Edition 1

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Overview


This volume clarifies in a logical and didactic manner the sequence of events that characterize the human menstrual cycle. Each major organ involved in the cycle, the brain, the pituitary gland, the ovary, and the uterus is discussed and its contribution specifically outlined. The chapters trace the physiologic events within each of these organs, describe the hormones by which they communicate, and outline how critical aspects of the cycle are synchronized so that an ovulatory cycle can occur. Thus neuroendocrine control of the menstrual cycle is examined in detail, and the processes of follicular development, maturation, ovulation, and maintenance of the corpus luteum are thoroughly covered. The book then turns to pathophysiology and examines the conditions under which the menstrual cycle may become abnormal. Pathophysiological mechanisms that cause cycle disturbance, anovulation, and infertility are reviewed, as are clinical presentations of common menstrual disorders and their treatment. Progress in reproductive biology has been rapid, and the research spans several disciplines. In this volume information dispersed in many publications has been synthesized and concisely presented, providing an in-depth understanding of the processes that control reproductive function in the female.

This book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: Catherine S. Stika, MD (Northwestern University Feinberg School of Medicine)
Description: This book is an in-depth review of the normal and abnormal menstrual cycle as well as the evaluation and treatment of menstrual dysfunction.
Purpose: The purpose is to discuss the events of the menstrual cycle and its associated cellular and physiological changes and the hormonal dynamics at each organ level. It includes reviews of menarche, menopause, and the fertile cycle as well as menstrual dysfunction. Also discussed are steroid contraception, assisted reproduction, and premenstrual syndrome.
Audience: No audience is specifically identified by the authors, although in my judgment, it appears to be targeted to advanced residents, general gynecologists interested in endocrinology, and fellows in reproductive-endocrinology.
Features: The illustrations are entirely in black-and-white and are of average quality. The majority of the illustrations are referenced and not original to the text. The legends are frequently confusing and contain descriptions that rather than provide a clear explantation of events in the illustration would be more appropriately placed within the body of the text. Deciphering the illustrations is often tedious. The references are organized by topic but are dated; there is only a rare reference from 1990 and 1991. This book is occasionally poorly organized. The discussion under the general heading of "The Initial Clinical Evaluation of the Abnormal Cycle" evolves into an overview of an entire infertility workupincluding laparoscopy and hysterosalpingography. In the chapter "Diagnosis of Menstrual Cycle Dysfunction" flow charts are presented but the specific tests are never discussed in the text. The authors recommend approaching the evaluation of amenorrhea as either primary orsecondary. The di scussion of end-organ failure follows that scheme but not that for hypothalamic-pituitary dysfunction.
Assessment: Although the discussions are usually in-depth and thorough, the organization of this book and its illustrations are confusing and significantly detract from its usefulness as an aid to either clinical practice or academic understanding.
Catherine S. Stika
This book is an in-depth review of the normal and abnormal menstrual cycle as well as the evaluation and treatment of menstrual dysfunction. "The purpose is to discuss the events of the menstrual cycle and its associated cellular and physiological changes and the hormonal dynamics at each organ level. It includes reviews of menarche, menopause, and the fertile cycle as well as menstrual dysfunction. Also discussed are steroid contraception, assisted reproduction, and premenstrual syndrome. "No audience is specifically identified by the authors, although in my judgment, it appears to be targeted to advanced residents, general gynecologists interested in endocrinology, and fellows in reproductive-endocrinology. "The illustrations are entirely in black-and-white and are of average quality. The majority of the illustrations are referenced and not original to the text. The legends are frequently confusing and contain descriptions that rather than provide a clear explantation of events in the illustration would be more appropriately placed within the body of the text. Deciphering the illustrations is often tedious. The references are organized by topic but are dated; there is only a rare reference from 1990 and 1991. This book is occasionally poorly organized. The discussion under the general heading of The Initial Clinical Evaluation of the Abnormal Cycle evolves into an overview of an entire infertility workupincluding laparoscopy and hysterosalpingography. In the chapter Diagnosis of Menstrual Cycle Dysfunction flow charts are presented but the specific tests are never discussed in the text. The authors recommend approaching the evaluation of amenorrhea as either primary orsecondary. The discussion of end-organ failure follows that scheme but not that for hypothalamic-pituitary dysfunction. "Although the discussions are usually in-depth and thorough, the organization of this book and its illustrations are confusing and significantly detract from its usefulness as an aid to either clinical practice or academic understanding.

2 Stars from Doody
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Product Details

  • ISBN-13: 9780195061932
  • Publisher: Oxford University Press, USA
  • Publication date: 1/28/1993
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 264
  • Product dimensions: 6.38 (w) x 9.56 (h) x 0.86 (d)

Meet the Author

Dr. Michel Ferin is Professor of Physiology in the Center for Reproductive Sciences at Columbia University. He is an expert in basic and applied research in the physiology and neuroendocrinology of the female reproductive system.
Dr. Raphael Jewelewicz is Associate Professor of Obstetrics and Gynecology and Director of the Division of Reproductive Endocrinology at Columbia University. He is one of the most experienced in reproductive endocrinology and infertility in the US.
Dr. Michelle Warren is an expert on hypothalmic amenorrhea and women's hormonal problems and a pioneer in research on the effects of exercise and diet on the reproductive system and osteoporosis. She is Associate Professor of Clinical Obstetrics and Gynecology and Clinical Medicine, and Head of Reproductive Endocrinology at Columbia University.

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Table of Contents

1 The Reproductive Cycle: An Overview 3
The Environment and Cyclicity 4
Menstrual Cycle Length 4
Principal Hormonal Markers of the Menstrual Cycle 4
2 The Neuroendocrine Component: The Hypothalamic-Pituitary Unit 8
The Hypothalamic GnRH System 8
The Anterior Pituitary Gland 14
The Endogenous Opioid Peptides and Other Neuropeptides 20
3 The Ovarian Component 25
The Ovarian Steroids 25
Folliculogenesis 29
Oogenesis 36
The Ovulatory Process 37
The Corpus Luteum 40
4 Hypothalamic-Pituitary-Ovarian Communication 42
Hypothalamic-Pituitary Control of the Ovaries 42
The Feedback Loops 50
5 The Genital Tract 62
The Steroid Receptor 62
Cyclic Changes in the Genital Tract 65
6 The Fertile Menstrual Cycle 70
Events at Fertilization 70
The First Weeks of Pregnancy 73
7 The First Menstrual Cycle: Adolescence and Puberty 78
Mechanisms Controlling the Timing of Puberty 78
The Physiology of Puberty 82
The Pathology of Puberty 87
8 The Last Menstrual Cycles: The Climacteric and Menopause 92
Physiology and Etiology of Menopause 92
Clinical Symptoms of Menopause 97
Management of Menopause 103
9 The Abnormal Menstrual Cycle: introduction 105
The Ovulatory Menstrual Cycle: An Integrative Description 105
The Initial Clinical Evaluation of the Abnormal Cycle 107
10 Introduction to the Pathophysiology of the Menstrual Cycle 114
Abnormalities of the GnRH Pulse Generator 114
Abnormalities in Hypothalamic-Pituitary-Ovarian Communication: Asynchrony 120
Hyperprolactinemia 124
11 Diagnosis of Menstrual Cycle Dysfunction 129
End Organ Dysfunction 129
Ovarian Disorders 133
Hypothalamic-Pituitary Dysfunction 136
12 Menstrual Cycle Dysfunction: Enhanced Androgen Secretion 154
The Pathogenesis of PCO 154
Clinical Aspects of PCO 159
Specific Aspects in the Treatment of PCO 162
13 Therapeutic Approaches to Acyclicity 165
Management of Menstrual Irregularity 165
Induction of Ovulation 166
Assisted Reproduction 182
14 Hormonal Contraceptives 186
Chemistry and Mode of Action of Steroid Contraceptives 186
General Effects of Steroid Contraceptives 190
Other Hormonal Contraceptives 196
15 The Premenstrual Syndrome 198
Pathophysiology of PMS 198
Clinical Aspects of PMS 199
Treatment of PMS 202
References 205
Index 247
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