Endocrine Abstracts

Background: Due to practical limitations, the diagnosis of hypogonadism is predominantly based on a single measure of reproductive hormones, often with confirmation on a second occasion. Factors associated with reproductive hormone variation include: pulsatile secretion, diurnal rhythm, and food intake, which can affect the accuracy of diagnosis of reproductive disorders. There is limited data quantitatively estimating the variability of reproductive hormone levels over the da...

Ovarian ageing is a naturally occurring physiological process, marked by dynamic changes in ovarian function and hormone secretion. A key of ovarian regulator is follicle stimulating hormone (FSH). FSH is secreted as two glycosylation variants: partially glycosylated FSH (FSH21) and fully glycosylated FSH (FSH24). Analysis has shown that the ratio of FSH21:FSH24 changes with age, with FSH21 predominant during reproductive prime, and FSH24 predominant around menopause. How FSH ...

The Class A G protein-coupled receptor (GPCR), follicle-stimulating hormone receptor (FSHR), and its associated heterodimeric glycoprotein hormone (FSH) are essential for reproduction. As such, they’re key targets of assisted conception. Post-translational modification of FSH gives rise to two predominant glycosylation variants, which are modulated with ageing: partially glycosylated FSH (FSH21/18), predominates in women’s reproductive prime (20’s), displays fas...

Background: The COVID-19 pandemic has adversely affected population mental health. In April 2021 we conducted an observational study which demonstrated disruption in women’s reproductive and mental health during the first year of the pandemic. Our objective therefore was to perform follow up studies in this cohort of women at 6-monthly intervals, to assess the longer term enduring impact of the pandemic on reproductive and mental health.Materials/Me...

G protein-coupled receptors are the largest family of mammalian receptors, with key roles in controlling most physiological processes. Ovarian function is no exception, with a key ovarian GPCR, follicle stimulation hormone receptor (FSHR), and its endogenous ligand, FSH, critical for pre-antral-antral follicle growth and survival. An increasingly important way that GPCRs have been shown to regulate ligand specificity and signal amplitude is via association and formation of dim...

Introduction: Long-term increased morbidity and mortality in Turner Syndrome (TS) due to vascular disease is recognized, and suggested risk factors include metabolic parameters and possible change in haemostasis, however elevated red cell parameters in women with TS have not previously been noted.Methods: Following an observation of unexplained occurrence of elevated hemoglobin, a quality improvement-project was conducted to retrospectively review full b...

Defects in any of the four functional domains of the androgen receptor (AR) (resulting from loss-of-function or gain-of-function mutations), may affect androgen action. Specific AR splice variants have been reported in women with PCOS (Wang et al, PNAS 2015 112 4743). In this study we sought to identify AR splice variants in granulosa-lutein (GL) cells of women with and without PCOS and to assess their functional significance. GL cells were ...

Membrane trafficking of G-protein coupled receptors (GPCRs) is a critical mechanism by which cells mediate complex signaling pathways. Endosomes are increasingly recognized as platforms for GPCR signaling. The VEE was first identified using the LHR, a GPCR that is key in reproduction. We have shown that recycling of the LHR is driven by receptor mediated Gαs cAMP signaling from the VEE and PKA-dependent phosphorylation of the adaptor protein, APPL1, while APPL1 negatively...

Introduction: Educational interventions for healthcare professionals (HCPs) in diabetes and endocrinology often limits patient and public involvement (PPI). We studied the effectiveness of Simulation via Instant Messaging-Birmingham Advance (SIMBA) as a tool to improve knowledge about polycystic ovary syndrome (PCOS) in HCP and women with PCOS. Additionally, we aimed to identify and reduce gaps in knowledge and expectations between HCP and women living with PCOS.<p class="...

Introduction: It has been suggested that sexual dysfunction affects as many as 43% of women in the population. In relation to this, symptoms of hypoactive sexual desire disorder (HSDD) can be alleviated with testosterone replacement.Aim: To determine what is the pre- and 24-hour post dose circulating level of testosterone in women applying Testogel 16.2 mg/g.Methods: In a group of 10 menopausal women applying Testogel 16.2 mg/g at ...

The onset of lactation occurs during postpartum days 1-4 and is associated with altered mammary metabolism leading to increased milk component synthesis. We hypothesised that increases in metabolic hormones or cytokines after childbirth may support these processes. To investigate this, we recruited n=12 pregnant women following informed consent and measured: prolactin; thyroid-stimulating hormone; insulin; cortisol; insulin-like growth factor-1; and interleukin-6 (IL-...

Background: Monosodium glutamate (MSG) use for food addictive have become quite alarming taken together with the huge reports of its toxic effects in the different organ of the body. Thus, this study demonstrates the therapeutic potentials of Mc on MSG-induced ovarian toxicity in female Wistar rats.Methods: A total of 28 female rats (weight=165&pm;3g) were randomly assigned into 4 groups (A – D, n=7) and treated orally as follows: A – ...

Background: Adipocyte cells could produce numerous extracellular vesicles and orchestrate the balance of endocrinological system. Polycystic ovary syndrome (PCOS) is a refractory reproductive disease and also a kind of endocrine and metabolic disease. The aim of the study was to explore the effects of adipocyte-derived extracellular vesicles-miR-26b on cumulus cells (CCs) and development of PCOS.Methods: The crosstalk mediated by extracellular vesicle-mi...

A 41-year-old woman with primary ovarian failure secondary to Turner syndrome presented in December 2020 with heavy vaginal bleeding. She had not attended appointments during the Covid-19 epidemic because of concerns around contracting the virus. She was anaemic with haemoglobin 47g/dl. Ultrasound showed grossly thickened and heterogenous endometrium (60 mm). Cross sectional imaging and hysteroscopy confirmed locally advanced endometrial carcinoma (Stage 3). She proceeded to h...

Coupling the release of pituitary hormones to the developmental stage of the oocyte is essential for female fertility. It is thought to require estrogen to have simultaneous positive and negative feedback effects on two spatially-distinct regions of the hypothalamus, the arcuate nucleus and ‘AVPV’ nucleus. However, the mechanistic basis for this differential effect is not known. Therefore, we mapped the genomic binding of the estrogen receptor alpha (ERα) in bot...

Prostaglandin E2 acts via 4 GPCRs, EP1-4. EP2 regulates inflammation and has important roles in cardiovascular function, reproduction, and malignancy. GPCR signalling and trafficking are highly integrated as signals from the endomembrane can exhibit distinct profiles from the plasma membrane. Whether EP2 activity is spatially regulated and if this is modified by ligand bias is currently unknown. In HEK 293 cells, three selective EP2 ligands, butaprost, AH13205, and PGN9856i, e...

Introduction: Women with PCOS have a higher risk of metabolic syndrome and cardiovascular complications. We aimed to understand if routinely measured hormonal parameters can identify women with PCOS with a higher risk of metabolic syndrome (MetS).Methods: The data for the study consisted of a discovery cohort (PCOS clinic database) and a replication cohort (Hull PCOS Biobank.) We used eight routinely measured hormonal parameters in our clinics (free andr...

Metformin is a first-line therapy for type-2 diabetes mellitus and gestational diabetes mellitus (GDM) which shows significant benefits for maternal health. However, offspring exposed to metformin in-utero have an increased risk of being born small for gestational age and developing cardiometabolic complications in adulthood. The mechanisms responsible are unknown. As fetal growth is dependent on optimal placental function, we assessed whether metformin exposure alter...

Background: A growing number of people in the United Kingdom are seeking medical treatment to align their sexual characteristics with their gender identity. With waiting lists for specialist clinics currently lasting over four years, endocrinologists are increasingly called upon to manage transgender care as part of their general duties. While surveys and qualitative studies from North America have investigated doctors’ ideas and experiences of transgender care, little is...

Introduction: Adipocyte fatty acid binding protein (A-FABP) is mainly expressed in adipocytes, and circulating A-FABP has been associated with markers of obesity. Women with PCOS are at increased risk of developing abdominal obesity what could be related to serum concentration of A-FABP.Aim: The aim of the present study was to investigate the relationships between serum concentration of A-FABP and parameters of obesity e.g. waist to hip ratio (WHR) and t...

Polycystic ovarian syndrome (PCOS) is a common endocrine and gynaecological disorder, occurring in 5% to 20% women of reproductive age. It is characterized by hyperandogenism, ovulatory dysfunction and polycystic ovaries. Impaired hypothalamic-pituitary-ovarian axis, insulin resistance and oxidative stress are identified causal mechanisms of PCOS. Vernonia amydalina(VA) leaf is a medicinal plant containing bioactive phytochemicals known to improve insulin sensitivity....

Lactation promotes infant development and confers long-term health benefits to mothers and infants. However, the endocrine and paracrine mechanisms mediating milk synthesis remain to be fully elucidated. Hormones such as prolactin and progesterone trigger the onset of lactation, whereas local mammary factors are considered to play a greater role in the maintenance of milk synthesis. We hypothesised that mammary epithelial cytokines are required for established lactation, and u...

The onset of human lactation is characterised by increased breast fullness and the start of copious milk secretion. The process, which typically occurs 1-4 days postpartum, is triggered by a decrease in serum progesterone and high prolactin concentrations, although the exact levels are ill-defined. We aim to establish reference intervals for hormones triggering the onset of sustained lactation and understand how breastfeeding influences hormone secretion, so as to improve the ...

Background: Infertility affects 1 in 6 couples causing devastating psychological impact. In vitro fertilisation (IVF) treatment can aid couples to conceive, but personalisation of treatment is needed to optimise patient outcomes. Machine learning can aid in the analysis of large complex datasets such as those encountered during IVF treatment. One example is in determining the optimal follicle size on the day of trigger to maximise the number of oocytes collected. Both follicle...

Background: Optimization of sex hormone replacement therapy (SHRT) is essential in long-term management of patients with hypogonadism. However, approaches to formulations of therapy, dose change (if any), monitoring of adequacy of therapy and safety are not standardised.Objectives: The survey aimed to establish the approach to management of SHRT for male and female hypogonadism.Methods: Online survey, live for 4 weeks (1/11/2021) d...

Infertility has become a real public health problem because of its increasing prevalence, widespread distribution, and the difficulties inherent in its management. Male factor infertility is thought to be the cause of up to 50% of all infertilities across the world. In some parts of Africa and from time immemorial, a wide variety of plants are of great medicinal importance. Many plant extracts have been used as fertility agents in folklore and traditional medicines to enhance ...

Approximately 10% of the female present with features of hyperandrogenism in their life. It is common in adolescent and childbearing age and less common in menopausal age. A 56-year-old female with a history of type 2 diabetes mellitus, hypertension presented with progressively worsening features of virilization for 1 year. Patient had severe hirsutism, androgenic alopecia and clitoromegaly. She had no loss of weight, loss of appetite suggestive of underlying malignancy. Howev...

Introduction: Turner Syndrome (TS) is the most common chromosomal abnormality affecting phenotypic females. Short stature (SS) is one of the most consistent clinical features of TS, with consequent poor psychosocial outcomes. Management involves early diagnosis and administration of recombinant human growth hormone (rhGH). The cost of therapy however hampers treatment in resource-challenged regions. The objective of this presentation is to report the outcome and challenges of ...

The impact of BMI, exercise, smoking, drug and alcohol use on reproductive and thyroid hormones has little or conflicting evidence. We therefore aimed to investigate the association between these factors and serum hormone concentrations. Capillary blood samples were taken from 932 eumenorrheic Hertility Health users on menstrual cycle day 3 between Sept 2020 and June 2022. Serum concentrations of Anti-Müllerian hormone, Estradiol (E2), Luteinising Hormone (LH), Follicle-S...

Polycystic ovary syndrome (PCOS) is an endocrine disorder that is common among women in their reproductive ages. This condition is associated with insulin resistance, oxidative stress, hormonal imbalance, and inflammation. Various drugs are used in treating this disorder but with side effects, hence the need for an alternative treatment with minimal side effects. This study was aimed at investigating the effect of methanol extract of Vernonia amygdalina on the reprodu...

Reproductive morbidity is increased in women with diabetes, including a higher prevalence of polycystic ovary syndrome, hypothalamic amenorrhoea and premature ovarian failure. Routine discussion of reproductive and menstrual dysfunction for women with diabetes remains a peripheral feature of clinical consultations. Here we aimed to determine women’s own reproductive care experience. We surveyed women of all ages attending routine diabetes care using a detailed clinical qu...

Introduction: The XX male syndrome occurs in 1 in 20,000 births. This syndrome results from crossover between the X and Y chromosomes, which transfers the sex-determining region of the Y chromosome to the X chromosome. They lack the azoospermia factor region of the Y chromosome, which is essential for spermatogenesis; thus causing infertility.Case Description: 34-year-old gentleman was referred to endocrinology clinic for infertility and semen analysis s...

While evidence of concordance between reproductive hormone measurements in venipuncture and capillary serum exists, variation between blood collection tubes has not been investigated. We compared the performance of two capillary and venipuncture blood collection tubes (red and gold top) and assessed variation between two leading tube manufacturers. To compare tube types, venipuncture and finger prick capillary samples were concurrently collected from 11 premenopausal women in ...

In late pregnancy the mother must mobilise considerable energy stores to support fetal growth. Failure to appropriately nourish the fetus has significant obstetric consequences – gestational diabetes and fetal growth restriction (FGR). Despite this, relatively little is known about how metabolic responses are stimulated in the mother, and how they may go wrong. We previously found that high levels of the product of an imprinted gene, Delta-like homologue-1 (D...

Rare causes of severe androgen excess (AE) can present a diagnostic challenge to endocrinologists. Imaging may not identify occult ovarian pathology, and the detection of adrenal nodular disease may be indicative of incidental pathology. GnRH analogues can be used both as a medical treatment and as a diagnostic utility to confirm ovarian source, particularly in women with a preferential elevation of serum testosterone (T). In this case series, we present three cases highlighti...

Turner syndrome (TS) is the most common chromosomal anomaly in females and its occurrence is about 1:4000 live births. This is the only monomer disease that humans can survive (1). It is characterized by the presence of one X chromosome and a partial or complete loss of the second X chromosome. Clinical features of TS can vary, mainly classified into Growth failure, gonadal insufficiency, cardiovascular diseases, or learning disabilities. Short stature is the only phenotypic a...