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The Menstrual Cycle: Physiology, Reproductive Disorders, and Infertility, by Michel Ferin, Raphael Jewelewicz, Michelle Warren

The Menstrual Cycle: Physiology, Reproductive Disorders, and Infertility

by Michel Ferin, Raphael Jewelewicz, Michelle Warren

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Format: Hardcover, 1st ed., 250pp. 
ISBN: 0195061934
Publisher: Oxford University Press, Incorporated 
Pub. Date: March 1993

Description from

From the Publisher

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 explores 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.

From Doody Review Services

Reviewer: Catherine S. Stika, MD (Northwestern University Medical School)

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 CycleDysfunction" 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.

Table of Contents

The Reproductive Cycle: An Overview  3
The Environment and Cyclicity  4
Menstrual Cycle Length   4
Principal Hormonal Markers of the Menstrual Cycle   4
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
The Ovarian Component   25
The Ovarian Steroids   25
Folliculogenesis   29
Oogenesis   36
The Ovulatory Process   37
The Corpus Luteum   40
Hypothalamic-Pituitary-Ovarian Communication   42
Hypothalamic-Pituitary Control of the Ovaries   42
The Feedback Loops   50
The Genital Tract   62
The Steroid Receptor   62
Cyclic Changes in the Genital Tract   65
The Fertile Menstrual Cycle   70
Events at Fertilization   70
The First Weeks of Pregnancy   73
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
The Last Menstrual Cycles: The Climacteric and Menopause   92
Physiology and Etiology of Menopause   92
Clinical Symptoms of Menopause   97
Management of Menopause   103
The Abnormal Menstrual Cycle: introduction   105
The Ovulatory Menstrual Cycle: An Integrative Description   105
The Initial Clinical Evaluation of the Abnormal Cycle   107
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
Diagnosis of Menstrual Cycle Dysfunction   129
End Organ Dysfunction   129
Ovarian Disorders   133
Hypothalamic-Pituitary Dysfunction   136
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
Therapeutic Approaches to Acyclicity   165
Management of Menstrual Irregularity   165
Induction of Ovulation   166
Assisted Reproduction   182
Hormonal Contraceptives   186
Chemistry and Mode of Action of Steroid Contraceptives   186
General Effects of Steroid Contraceptives   190
Other Hormonal Contraceptives   196
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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