Gynecological challenges in the diagnosis and care of patients with DSD: The role of the obstetrician gynecologist in the multidisciplinary approach to the patient

Gómez-Lobo, Veronica; Oelschlager, Anne-Marie Amies; Gynecology, Adolescent

doi:10.1002/ajmg.c.31557

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…to help transition these complex patients from pediatric to adult care and can also provide counseling on fertility preservation, menstrual suppression/control, medication teratogenicity, and primary ovarian insufficiency. [27][28][29] Besides alleviating provider discomfort with contraception counseling, other common gynecologic issues encountered by this population of patients can be addressed. Female patients with CF have been shown to have menstrual irregularities often associated with hypothalamic amenorrhea, due to CF-associated factors like undernutrition and chronic stress.…”

Section: Discussionmentioning

confidence: 99%

“…Gynecologists participate in multidisciplinary teams caring for disorders of sexual differentiation, anorectal malformations, and cancer and bone marrow transplant patients. They have been shown to help transition these complex patients from pediatric to adult care and can also provide counseling on fertility preservation, menstrual suppression/control, medication teratogenicity, and primary ovarian insufficiency 27‐29 . Besides alleviating provider discomfort with contraception counseling, other common gynecologic issues encountered by this population of patients can be addressed.…”

Section: Discussionmentioning

confidence: 99%

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Reproductive health counseling and contraceptive use in adolescents with cystic fibrosis

Hernandez

Burdick

Adeyemi‐Fowode

2021

Pediatric Pulmonology

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Background: Cystic fibrosis (CF) is a progressive, genetic disease posing reproductive health concerns to affected women, such as high-risk pregnancies and medication interactions leading to contraceptive failure. Reproductive health counseling in this population is of the utmost importance, but barriers to providing it include lack of time, knowledge, and provider discomfort. We sought to evaluate reproductive health counseling and contraceptive use in female adolescent CF patients. Methods: An Institutional Review Board approved retrospective chart review was performed between March 2008 and March 2018. Females 10-21 years old with the diagnosis of CF were reviewed. Descriptive statistics were used. Results: Thirty-three patients met inclusion criteria: 16 non-sexually active and 17 sexually active. Thirteen patients were counseled about pregnancy risks. All sexually active patients used contraception, with the most common being condoms and combined oral contraceptive pills. Six pregnancies occurred, resulting in five live births and one termination.Conclusions: Less than half of patients were counseled about pregnancy and contraception, and most patients chose high failure methods. Female adolescents with CF should be routinely screened for sexual activity, offered long-acting reversible contraception, and counseled on the effects of CF on pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reproductive health counseling and contraceptive use in adolescents with cystic fibrosis

Hernandez

Burdick

Adeyemi‐Fowode

2021

Pediatric Pulmonology

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“…Testosterone and estrogen, produced in male and female gonads respectively, instruct many secondary sex characteristics throughout the organism 14 . Defects in steroid hormone synthesis and/or signaling are associated with common Differences of Sex Development such as congenital adrenal hyperplasia and androgen insensitivity syndrome 15 . Ecdysone is the dominant steroid hormone in insects like Drosophila and regulates larval molting, gut regeneration, and adult female reproduction [16][17][18][19] .…”

Section: Mainmentioning

confidence: 99%

Steroid signaling controls sex-specific development in an invertebrate

Grmai,

Jimenez,

Baxter

et al. 2023

Preprint

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SummaryIn vertebrate sexual development, two important steroid hormones – testosterone and estrogen – regulate the sex-specific development of many tissues. In contrast, invertebrates utilize a single steroid hormone, ecdysone, to regulate developmental timing in both sexes. Here, we show that in the fruit flyDrosophila melanogaster, sex-specific ecdysone activity controls important aspects of gonad sexual dimorphism. Rather than being regulated at the level of hormone production, hormone activity is regulated cell-autonomously through sex-specific hormone reception. We found thatEcdysone receptor (EcR)is regulated down-stream of the sex determination factor Doublesex (Dsx), the founding member of the Dsx/Mab3 Related Transcription Factor (DMRT) family that regulates gonad development in all animals. EcR is restricted to the developing ovary and repressed in the testis at a time when ecdysone initiates ovary morphogenesis. EcR activity drives ovary development and antagonizes development of the testis stem cell niche. Interestingly, de-repression of the ecdysone response in the testis led to rapid feminization, which is known to cause infertility. This work demonstrates that invertebrates can also use steroid hormone signaling to control sex-specific development. Further, it may help explain recent work showing that vertebrate sexual development is surprisingly cell-autonomous. For example, in birds that have a mixture of cells with male and female genotypes, the male cells develop as male and the female cells develop as female despite exposure to the same circulating hormones. Sex-specific regulation of steroid hormone response in vertebrates may well underly such cellular sexual fate choices.

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Transitional Care in Endocrinology

Dwyer

Hauschild

2019

Transition From Pediatric to Adult Healthcare Services for Adolescents and Young Adults With Long-Term Conditions

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Gynecological challenges in the diagnosis and care of patients with DSD: The role of the obstetrician gynecologist in the multidisciplinary approach to the patient

Cited by 4 publications

References 11 publications

Reproductive health counseling and contraceptive use in adolescents with cystic fibrosis

Reproductive health counseling and contraceptive use in adolescents with cystic fibrosis

Steroid signaling controls sex-specific development in an invertebrate

Transitional Care in Endocrinology

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