Longitudinal sex and stress hormone profiles among reproductive age and post-menopausal women after severe TBI: A case series analysis

被引:33
作者
Ranganathan, Prerna [1 ]
Kumar, Raj G. [1 ]
Davis, Kendra [1 ]
McCullough, Emily H. [1 ]
Berga, Sarah L. [2 ]
Wagner, Amy K. [1 ,3 ,4 ]
机构
[1] Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA
[2] Wake Forest Univ, Dept Obstet Gynecol, Winston Salem, NC 27109 USA
[3] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA
[4] Univ Pittsburgh, Safar Ctr Resuscitat Res, Pittsburgh, PA USA
关键词
Hypogonadism; sex hormone physiology; traumatic brain injury; cortisol; amenorrhea; luteal hormone; functional hypothalamic amenorrhea; CORTICOTROPIN-RELEASING HORMONE; TRAUMATIC BRAIN-INJURY; NEUROENDOCRINE DYSFUNCTION; HYPOTHALAMIC AMENORRHEA; CORTISOL SECRETION; HEAD TRAUMA; RESPONSES; COMA; HYPOGONADISM; DISABILITY;
D O I
10.3109/02699052.2016.1144081
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Primary objectives: To describe hormone profiles for pre-/post-menopausal women, to monitor time to resumption of menstruation among pre-menopausal women and to describe cortisol associated LH suppression and phasic variation in other sex hormones over time Methods and procedures: This study determined amenorrhea duration and characterized acute (days 0-7) and chronic (months 1-6) gonadotropins [luteinizing hormone and follicle stimulating hormone (LH, FSH)], sex hormones (progesterone, estradiol) and stress hormone (cortisol) profiles. Women were pre-menopausal (n = 3) or post-menopausal (n = 3). Among premenopausal women, menstrual cycle resolution and phase association (luteal/follicular) was monitored using self-report monthly reproductive history questionnaires. This study compared post-TBI hormone profiles, stratified by menopausal status, to hormone levels from seven controls and described 6- and 12-month outcomes for these women. Main outcomes and results: Consistent with functional hypothalamic amenorrhea (FHA), menstruation resumption among pre-menopausal women occurred when serum cortisol normalized to luteal phase control levels. For post-menopausal women, serum cortisol reductions corresponded with resolution of suppressed LH levels. Conclusions: The stress of TBI results in anovulation and central hypothalamic-pituitary-ovarian (HPG) axis suppression. Future work will examine acute/chronic consequences of post-TBI hypercortisolemia and associated HPG suppression, the temporal association of HPG suppression with other neuroendocrine adaptations and how HPG suppression impacts multidimensional recovery for women with TBI.
引用
收藏
页码:452 / 461
页数:10
相关论文
共 52 条
  • [1] [Anonymous], 2013, TRAUMATIC BRAIN INJU
  • [2] ARIMURA A, 1971, P SOC EXP BIOL MED, V136, P290
  • [3] Comparison of Cognitive Behavioral Therapy and Supportive Psychotherapy for the Treatment of Depression Following Traumatic Brain Injury: A Randomized Controlled Trial
    Ashman, Teresa
    Cantor, Joshua B.
    Tsaousides, Theodore
    Spielman, Lisa
    Gordon, Wayne
    [J]. JOURNAL OF HEAD TRAUMA REHABILITATION, 2014, 29 (06) : 467 - 478
  • [4] Barbieri RL, 2014, METHODS MOL BIOL, V1154, P145, DOI 10.1007/978-1-4939-0659-8_7
  • [5] Barton D.J., 2015, J. Head Trauma Rehabil
  • [6] NEURO-ENDOCRINE ABERRATIONS IN WOMEN WITH FUNCTIONAL HYPOTHALAMIC AMENORRHEA
    BERGA, SL
    MORTOLA, JF
    GIRTON, L
    SUH, B
    LAUGHLIN, G
    PHAM, P
    YEN, SSC
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1989, 68 (02) : 301 - 308
  • [7] Women with functional hypothalamic amenorrhea but not other forms of anovulation display amplified cortisol concentrations
    Berga, SL
    Daniels, TL
    Giles, DE
    [J]. FERTILITY AND STERILITY, 1997, 67 (06) : 1024 - 1030
  • [8] ABNORMAL CORTISOL SECRETION AND RESPONSES TO CORTICOTROPIN-RELEASING HORMONE IN WOMEN WITH HYPOTHALAMIC AMENORRHEA
    BILLER, BMK
    FEDEROFF, HJ
    KOENIG, JI
    KLIBANSKI, A
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1990, 70 (02) : 311 - 317
  • [9] Rates of Major Depressive Disorder and Clinical Outcomes Following Traumatic Brain Injury
    Bombardier, Charles H.
    Fann, Jesse R.
    Temkin, Nancy R.
    Esselman, Peter C.
    Barber, Jason
    Dikmen, Sureyya S.
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2010, 303 (19): : 1938 - 1945
  • [10] CORTISOL SECRETION AND METABOLISM IN ANOREXIA-NERVOSA
    BOYAR, RM
    HELLMAN, LD
    ROFFWARG, H
    KATZ, J
    ZUMOFF, B
    OCONNOR, J
    BRADLOW, HL
    FUKUSHIMA, DK
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1977, 296 (04) : 190 - 193