Insulin-dependent diabetes mellitus and menstrual dysfunction

Marie L. Griffin, Stephen A. South, Vladimir I. Yankov, Robert A. Booth, Christopher M. Asplin, Johannes D Veldhuis, William S. Evans

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Disordered reproductive function has long been recognized as a prevalent problem among women of reproductive age who suffer from insulin-dependent diabetes mellitus (IDDM). Delay in menarchial age is frequently seen if IDDM develops in the peripubertal years and some form of menstrual dysfunction is found in nearly one-third of all women of reproductive age with IDDM. This review summarizes some of the prevailing views regarding the mechanisms through which uncontrolled IDDM is thought to disrupt normal Hypothalamic-pituitary-gonadal function. Although animal studies have suggested that poorly controlled IDDM may adversely affect the uterovaginal outflow tract and/or ovarian function, no clinical studies have suggested that abnormal uterine or ovarian function underlies the menstrual dysfunction observed in young diabetic women. Similarly, pituitary function as assessed by basal gonadotropins and gonadotrophin-releasing hormone (GnRH)-stimulated gonadotropin release appears to be normal in young women with IDDM. Moreover, although there has been some suggestion that pituitary function may decline with increasing duration of diabetes, this issue has not been thoroughly investigated. It appears that the oligo/amenorrhea noted in IDDM is principally hypothalamic in origin and may represent intermittent (and perhaps reversible) failure of the GnRH pulse generator, similar to the situation observed in women who engage in endurance training or who suffer from anorexia nervosa. Although the exact pathophysiological mechanisms that subserve dysfunction of the GnRH neuronal system are not well understood, attention has focused on increased central opioidergic activity, increased central dopaminergic activity, and central glucose deprivation. In this era of emphasis on tight glycaemic control and its impact in preventing diabetes complications, the consequences of IDDM on reproductive potential appear to be important and must be included in future investigative efforts.

Original languageEnglish (US)
Pages (from-to)331-340
Number of pages10
JournalAnnals of Medicine
Volume26
Issue number5
DOIs
StatePublished - 1994
Externally publishedYes

Fingerprint

Type 1 Diabetes Mellitus
Gonadotropin-Releasing Hormone
Gonadotropins
Anorexia Nervosa
Amenorrhea
Diabetes Complications
Glucose

Keywords

  • Diabetes mellitus
  • Infertility
  • Menstrual dysfunction
  • Reproductive disorders

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Griffin, M. L., South, S. A., Yankov, V. I., Booth, R. A., Asplin, C. M., Veldhuis, J. D., & Evans, W. S. (1994). Insulin-dependent diabetes mellitus and menstrual dysfunction. Annals of Medicine, 26(5), 331-340. https://doi.org/10.3109/07853899409148347

Insulin-dependent diabetes mellitus and menstrual dysfunction. / Griffin, Marie L.; South, Stephen A.; Yankov, Vladimir I.; Booth, Robert A.; Asplin, Christopher M.; Veldhuis, Johannes D; Evans, William S.

In: Annals of Medicine, Vol. 26, No. 5, 1994, p. 331-340.

Research output: Contribution to journalArticle

Griffin, ML, South, SA, Yankov, VI, Booth, RA, Asplin, CM, Veldhuis, JD & Evans, WS 1994, 'Insulin-dependent diabetes mellitus and menstrual dysfunction', Annals of Medicine, vol. 26, no. 5, pp. 331-340. https://doi.org/10.3109/07853899409148347
Griffin ML, South SA, Yankov VI, Booth RA, Asplin CM, Veldhuis JD et al. Insulin-dependent diabetes mellitus and menstrual dysfunction. Annals of Medicine. 1994;26(5):331-340. https://doi.org/10.3109/07853899409148347
Griffin, Marie L. ; South, Stephen A. ; Yankov, Vladimir I. ; Booth, Robert A. ; Asplin, Christopher M. ; Veldhuis, Johannes D ; Evans, William S. / Insulin-dependent diabetes mellitus and menstrual dysfunction. In: Annals of Medicine. 1994 ; Vol. 26, No. 5. pp. 331-340.
@article{ddfd1c697cbc4c5aaab43cedca94a3c7,
title = "Insulin-dependent diabetes mellitus and menstrual dysfunction",
abstract = "Disordered reproductive function has long been recognized as a prevalent problem among women of reproductive age who suffer from insulin-dependent diabetes mellitus (IDDM). Delay in menarchial age is frequently seen if IDDM develops in the peripubertal years and some form of menstrual dysfunction is found in nearly one-third of all women of reproductive age with IDDM. This review summarizes some of the prevailing views regarding the mechanisms through which uncontrolled IDDM is thought to disrupt normal Hypothalamic-pituitary-gonadal function. Although animal studies have suggested that poorly controlled IDDM may adversely affect the uterovaginal outflow tract and/or ovarian function, no clinical studies have suggested that abnormal uterine or ovarian function underlies the menstrual dysfunction observed in young diabetic women. Similarly, pituitary function as assessed by basal gonadotropins and gonadotrophin-releasing hormone (GnRH)-stimulated gonadotropin release appears to be normal in young women with IDDM. Moreover, although there has been some suggestion that pituitary function may decline with increasing duration of diabetes, this issue has not been thoroughly investigated. It appears that the oligo/amenorrhea noted in IDDM is principally hypothalamic in origin and may represent intermittent (and perhaps reversible) failure of the GnRH pulse generator, similar to the situation observed in women who engage in endurance training or who suffer from anorexia nervosa. Although the exact pathophysiological mechanisms that subserve dysfunction of the GnRH neuronal system are not well understood, attention has focused on increased central opioidergic activity, increased central dopaminergic activity, and central glucose deprivation. In this era of emphasis on tight glycaemic control and its impact in preventing diabetes complications, the consequences of IDDM on reproductive potential appear to be important and must be included in future investigative efforts.",
keywords = "Diabetes mellitus, Infertility, Menstrual dysfunction, Reproductive disorders",
author = "Griffin, {Marie L.} and South, {Stephen A.} and Yankov, {Vladimir I.} and Booth, {Robert A.} and Asplin, {Christopher M.} and Veldhuis, {Johannes D} and Evans, {William S.}",
year = "1994",
doi = "10.3109/07853899409148347",
language = "English (US)",
volume = "26",
pages = "331--340",
journal = "Annals of Medicine",
issn = "0785-3890",
publisher = "Informa Healthcare",
number = "5",

}

TY - JOUR

T1 - Insulin-dependent diabetes mellitus and menstrual dysfunction

AU - Griffin, Marie L.

AU - South, Stephen A.

AU - Yankov, Vladimir I.

AU - Booth, Robert A.

AU - Asplin, Christopher M.

AU - Veldhuis, Johannes D

AU - Evans, William S.

PY - 1994

Y1 - 1994

N2 - Disordered reproductive function has long been recognized as a prevalent problem among women of reproductive age who suffer from insulin-dependent diabetes mellitus (IDDM). Delay in menarchial age is frequently seen if IDDM develops in the peripubertal years and some form of menstrual dysfunction is found in nearly one-third of all women of reproductive age with IDDM. This review summarizes some of the prevailing views regarding the mechanisms through which uncontrolled IDDM is thought to disrupt normal Hypothalamic-pituitary-gonadal function. Although animal studies have suggested that poorly controlled IDDM may adversely affect the uterovaginal outflow tract and/or ovarian function, no clinical studies have suggested that abnormal uterine or ovarian function underlies the menstrual dysfunction observed in young diabetic women. Similarly, pituitary function as assessed by basal gonadotropins and gonadotrophin-releasing hormone (GnRH)-stimulated gonadotropin release appears to be normal in young women with IDDM. Moreover, although there has been some suggestion that pituitary function may decline with increasing duration of diabetes, this issue has not been thoroughly investigated. It appears that the oligo/amenorrhea noted in IDDM is principally hypothalamic in origin and may represent intermittent (and perhaps reversible) failure of the GnRH pulse generator, similar to the situation observed in women who engage in endurance training or who suffer from anorexia nervosa. Although the exact pathophysiological mechanisms that subserve dysfunction of the GnRH neuronal system are not well understood, attention has focused on increased central opioidergic activity, increased central dopaminergic activity, and central glucose deprivation. In this era of emphasis on tight glycaemic control and its impact in preventing diabetes complications, the consequences of IDDM on reproductive potential appear to be important and must be included in future investigative efforts.

AB - Disordered reproductive function has long been recognized as a prevalent problem among women of reproductive age who suffer from insulin-dependent diabetes mellitus (IDDM). Delay in menarchial age is frequently seen if IDDM develops in the peripubertal years and some form of menstrual dysfunction is found in nearly one-third of all women of reproductive age with IDDM. This review summarizes some of the prevailing views regarding the mechanisms through which uncontrolled IDDM is thought to disrupt normal Hypothalamic-pituitary-gonadal function. Although animal studies have suggested that poorly controlled IDDM may adversely affect the uterovaginal outflow tract and/or ovarian function, no clinical studies have suggested that abnormal uterine or ovarian function underlies the menstrual dysfunction observed in young diabetic women. Similarly, pituitary function as assessed by basal gonadotropins and gonadotrophin-releasing hormone (GnRH)-stimulated gonadotropin release appears to be normal in young women with IDDM. Moreover, although there has been some suggestion that pituitary function may decline with increasing duration of diabetes, this issue has not been thoroughly investigated. It appears that the oligo/amenorrhea noted in IDDM is principally hypothalamic in origin and may represent intermittent (and perhaps reversible) failure of the GnRH pulse generator, similar to the situation observed in women who engage in endurance training or who suffer from anorexia nervosa. Although the exact pathophysiological mechanisms that subserve dysfunction of the GnRH neuronal system are not well understood, attention has focused on increased central opioidergic activity, increased central dopaminergic activity, and central glucose deprivation. In this era of emphasis on tight glycaemic control and its impact in preventing diabetes complications, the consequences of IDDM on reproductive potential appear to be important and must be included in future investigative efforts.

KW - Diabetes mellitus

KW - Infertility

KW - Menstrual dysfunction

KW - Reproductive disorders

UR - http://www.scopus.com/inward/record.url?scp=0027942160&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027942160&partnerID=8YFLogxK

U2 - 10.3109/07853899409148347

DO - 10.3109/07853899409148347

M3 - Article

C2 - 7826593

AN - SCOPUS:0027942160

VL - 26

SP - 331

EP - 340

JO - Annals of Medicine

JF - Annals of Medicine

SN - 0785-3890

IS - 5

ER -