alexa Gynecologic and reproductive issues in women on dialysis.
Medicine

Medicine

Family Medicine & Medical Science Research

Author(s): Holley JL, Schmidt RJ, Bender FH, Dumler F, Schiff M

Abstract Share this page

Abstract Most women on dialysis are amenorrheic and do not ovulate, but little information about menstrual patterns in women on dialysis exists, especially since the introduction and use of recombinant human erythropoietin, a therapy that may improve sexual interest and function. In this study, women who were < or = 55 years of age at the start of dialysis (n = 76) completed questionnaires and form the study group. Women older than 55 years at the start of dialysis did not complete the entire questionnaire (n = 115), but their medication records were reviewed for estrogen replacement therapy. The questionnaire asked about pregnancies, menstrual periods (regularity, frequency, duration, character of flow, menopause), and menopause before beginning dialysis and currently. Women also responded to questions about sexual activity, use of birth control, contraception counseling by physicians, yearly Papanicolaou smears, and mammograms. Demographic data (age, race, age at the time dialysis started, mode of dialysis, use of recombinant human erythropoietin, and history of renal transplant) were also obtained through the questionnaires. Fifty-nine percent of the 76 women who completed the study were white and had been on dialysis a median of 3 years (range, 0.1 to 18 years). The median age was 43 years, 68\% were on hemodialysis, 90\% were receiving recombinant human erythropoietin, and 70\% had been pregnant (a total of 179 pregnancies; four pregnancies in four women occurred after the start of dialysis). Significantly more women were menstruating before dialysis started than currently (63\% v 42\%; P < 0.025), but the difference could be explained by patient age: currently menstruating women were younger (37 +/- 9 v 46 +/- 11 years; P = 0.0002). More women reported menstrual regularity before beginning dialysis (75\% v 42\% currently; P < 0.005), but there were no differences in number of days between or number of days of menstruation before beginning dialysis and currently. Menstrual flow was reported as heavier currently by more women (64\% heavy flow with clots v 38\% before dialysis started; P < 0.05). The median age at menopause was 47 years; 28\% of the women were postmenopausal. Fifty percent of the women were sexually active, but only 36\% used birth control. Discussions between the women and their nephrologist about possible pregnancy and contraception were reported by only 13\% of women. Sixty-three percent of the women reported having yearly Papanicolaou smears and 73\% had had a mammogram. Only 5\% of the 113 women who were older than 55 years when they began dialysis were receiving estrogen replacement therapy. Amenorrhea was reported in this study by a smaller proportion of women than in studies conducted before the introduction of recombinant human erythropoietin. The possibility that erythropoietin may restore normal hormonal cyclic function in women with end-stage renal disease requires further study. Nephrologists as well as primary care physicians and gynecologists need to focus more on the gynecologic concerns of women on dialysis, including the potential for pregnancy. The effects of estrogen replacement on atherosclerosis and osteoporosis, and consideration of such therapy in women on dialysis warrants attention.
This article was published in Am J Kidney Dis and referenced in Family Medicine & Medical Science Research

Relevant Expert PPTs

Relevant Speaker PPTs

  • Manal Ali Ghandour
    DIDPRIMARYHEALTHCAREDOCTORSLOSETHEBATTLEWITHTHESPECIALISTANDCONSULTANTS
    PPT Version | PDF Version
  • Abulkhair Beatti
    A new understanding of interferential current energy transfer in tissue
    PPT Version | PDF Version
  • Brian Littlechild
    The management of violence and aggression against staff in mental health work: responding effectively through a co-production approach to issues for service users, carers, staff and agencies
    PPT Version | PDF Version
  • John M. Clerici
    Development and Procurement of Biotechnology for Emerging Disease and Engineered Threats in the Public Health Preparedness Sector
    PPT Version | PDF Version
  • Randa Hamadeh
    Polio returns to Middle East, situation analysis, strategies and way forward
    PPT Version | PDF Version
  • Xiao-Song He
    Distinct priming effect of live attenuated versus inactivated influenza vaccines in repeated influenza vaccination
    PPT Version | PDF Version
  • Joyceline Ntoh Yuh
    Stigma and childbearing: Experiences of HIV- positive women in Cameroon
    PPT Version | PDF Version
  • Tsai-Ching Liu
    Women’s Health: Diabetes and Dust Storms
    PPT Version | PDF Version
  • Nisreen K Aref
    To compare serum leptin levels in obese women with polycystic ovary syndrome (PCOS) and normal ovulatory obese subjects in Saudi Arabia, and to evaluate the interrelationship between leptin concentration, sex hormones, and insulin resistance.
    PPT Version | PDF Version
  • Shondell Hickson
    Women and the Healthcare Law
    PPT Version | PDF Version
  • Nasser Nadim
    Nasser-Nadim- Clalit-Health-Organization-Services-Israel- A-different-perspective-to-white-matte
    PPT Version | PDF Version
  • Farah Islam
    Mental Health Consultation in Ontario’s Immigrant Populations
    PPT Version | PDF Version
  • Ghulam Rasool Mashori
    Effect of Calcium Antagonists on Insulin Release
    PPT Version | PDF Version
  • Monica C Chuong
    Bioprocess Development Upstream and Downstream Technologies
    PPT Version | PDF Version
  • Yosef Yarden
    Classically, the 3’untranslated region (3’UTR) is that region in eukaryotic protein-coding genes from the translation termination codon to the polyA signal. It is transcribed as an integral part of the mRNA encoded by the gene. However, there exists another kind of RNA, which consists of the 3’UTR alone, without all other elements in mRNA such as 5’UTR and coding region. The importance of independent 3’UTR RNA (referred as I3’UTR) was prompted by results of artificially introducing such RNA species into malignant mammalian cells. Since 1991, we found that the middle part of the 3’UTR of the human nuclear factor for interleukin-6 (NF-IL6) or C/EBP gene exerted tumor suppression effect in vivo. Our subsequent studies showed that transfection of C/EBP 3’UTR led to down-regulation of several genes favorable for malignancy and to up-regulation of some genes favorable for phenotypic reversion. Also, it was shown that the sequences near the termini of the C/EBP 3’UTR were important for its tumor suppression activity. Then, the C/EBP 3’UTR was found to directly inhibit the phosphorylation activity of protein kinase CPKC in SMMC-7721, a hepatocarcinoma cell line. Recently, an AU-rich region in the C/EBP 3’UTR was found also to be responsible for its tumor suppression. Recently we have also found evidence that the independent C/EBP 3’UTR RNA is actually exists in human tissues, such as fetal liver and heart, pregnant uterus, senescent fibroblasts etc. Through 1990’s to 2000’s, world scientists found several 3’UTR RNAs that functioned as artificial independent RNAs in cancer cells and resulted in tumor suppression. Interestingly, majority of genes for these RNAs have promoter-like structures in their 3’UTR regions, although the existence of their transcribed products as independent 3’UTR RNAs is still to be confirmed. Our studies indicate that the independent 3’UTR RNA is a novel non-coding RNA species whose function should be the regulation not of the expression of their original mRNA, but of some essential life activities of the cell as a whole.
    PPT Version | PDF Version

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords