The recovery of ovarian function during breast-feeding

Shaaban, Mamdouh M.; Sayed, Gamal; Ghaneimah, Sharaf A.

doi:10.1016/0022-4731(87)90188-9

Cited by 36 publications

(16 citation statements)

References 9 publications

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“…The presence of ER has been demonstrated in human osteoblasts [36,37] and osteoclasts [38], suggesting that estrogen can exert direct effects on bone cells. As the duration and severity of hypoestrogenemia are reported to vary greatly among postpartum women [39], we anticipated that ER polymorphism might result in interindividual variation in bone homeostasis but we did not find such difference. Previously, ER polymorphism has been suggested to modulate bone metabolism [9], but no significant intergenotype differences concerning the changes in BMD were observed in that study either.…”

Section: Discussioncontrasting

confidence: 46%

Vitamin D and Estrogen Receptor Polymorphisms and Bone Mineral Changes in Postpartum Women

Holmberg-Marttila

Sievänen

Järvinen³

2000

Calcif Tissue Int

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BsmI restriction fragment length polymorphism (RFLP) of the vitamin D receptor (VDR) gene and PvuII RFLPs of the estrogen receptor (ER) gene and their relation to changes in areal bone mineral density (BMD) were examined in 43 healthy postpartum Finnish women aged 31.3 (SD 4.7) years. BMD was measured by dual energy X-ray absorptiometry at lumbar spine, right femoral neck, and dominant distal radius immediately after delivery, 1 month after resumption of menses, and 1 year thereafter. The RFLPs were represented as Bb (BsmI) and Pp (PvuII), the capital letters denoting the absence of and the small letters the presence of the restriction sites. The frequency of VDR alleles was as follows: bb (20.9%), Bb (60.5%), and BB (18.6%), and that of ER alleles was pp (39.5%), Pp (51.2%), and PP (9.3%). Altogether, BMD decreased significantly during postpartum amenorrhea at all sites [the mean bone loss ranging from -1.2 (SD 3.6)% at the distal radius to -3.7 (2.9)% at the femoral neck], and increased after resumption of menses [the 1-year follow-up BMD values ranging from -1.0 (2.4)% at the femoral neck to +3.3 (4.0)% at the lumbar spine as compared with baseline]. No obvious genotype-related differences were found between these changes. These results suggest that the BsmI and PvuII polymorphisms may not have substantial influence on BMD changes postpartum.

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Section: Discussioncontrasting

confidence: 46%

Vitamin D and Estrogen Receptor Polymorphisms and Bone Mineral Changes in Postpartum Women

Holmberg-Marttila

Sievänen

Järvinen³

2000

Calcif Tissue Int

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“…It is, on the one hand, possible that some mothers may develop a severe estrogen de®ciency [6] or other hormonal disturbance (e.g., in stress hormones) that would lead to a pronounced bone loss during the ®rst months of PPA. In those mothers whose physiology, for any reason, could not meet the demands of enhanced calcium metabolism, a short PPA might well evolve as a countermeasure against excessive bone loss and consequent deterioration of bone structure.…”

Section: Discussionmentioning

confidence: 99%

“…Pregnancy and consequent periods of amenorrhea and lactation concern the majority of women and expose their skeletons to subsequent periods of apparent bone loss and recovery [4]. It is well documented that lactation suppresses the resumption of ovarian activity and may delay the resumption of menses in postpartum women [5,6]. Besides apparent modulation of hypoestrogenemia and consequent amenorrhea, lactation is also associated with increased maternal demand for calcium.…”

Section: Introductionmentioning

confidence: 97%

Factors Underlying Changes in Bone Mineral During Postpartum Amenorrhea and Lactation

Holmberg-Marttila

Sievänen

Laippala

et al. 2000

Osteoporosis International

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To determine the physiologic and habitual factors that may modulate changes in bone mineral density (BMD) postpartum, dual-energy X-ray absorptiometry was performed at the lumbar spine, right femoral neck and dominant distal radius immediately after delivery, after resumption of menses, and 1 year thereafter in a cohort of 41 healthy postpartum Finnish women aged 31.5 (SD 4.6) years. Mean durations of lactation and postpartum amenorrhea (PPA) were 7.7 (3.7) and 5.9 (2.9) months, respectively. After PPA, significant bone losses of 2%-4% were observed at the lumbar spine and femoral neck. Duration of PPA and different lactational variables explained (adjusted R2) from 21% to 27% of the variability in changes in BMD during PPA. A recovery to postpregnancy BMD levels was observed at the lumbar spine; in contrast BMD at the femoral neck showed only a partial recovery. The duration of unsupplemented lactation was weakly (adjusted R2 = 0.13) associated with recovery at the lumbar spine, while a long duration of total lactation also showed a weak association (adjusted R2 = 0.02) with delayed recovery at the femoral neck. In conclusion, a systematic bone loss occurs during PPA, and after resumption of menstruation BMD recovers despite continued lactation. However, the time of bony recovery back to postpregnancy level seems to be modulated slightly by lactation habits. It is obvious that the control of postpartum BMD changes is a multifactorial process that may be specific to the skeletal site of interest.

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“…Long intervals of lactational amenorrhea lasting many months are seen in great apes such as the gorilla [20] and the chimpanzee [20,39], and in Old World monkeys, such as the baboon [1], Japanese monkeys [36], rhesus monkeys [2,42] and cynomolgus monkeys [18]. Residual lactational infertility occurs in women, as indicated by a higher ovulation to pregnancy ratio in nursing compared to non-nursing women [7,35]. Field studies indicate that this component of lactational infertility is also present in chimpanzees [39] and baboons [1].…”

Section: Introductionmentioning

confidence: 99%

Impact of lactation upon fertility in the New World primate capuchin monkey (Cebus apella)

Recabarren

Vergara

Martınez

et al. 2000

J of Medical Primatology

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In the present paper, we have studied the impact of lactation upon fertility in the capuchin monkey, Cebus apella, under laboratory conditions. Nursing females (ten females, 12 postpartum periods) presented lactational amenorrhea (first menses at 159.2 +/- 9.0 vs 42.6 +/- 5.8 days postpartum in five non-nursing females, seven postpartum periods). Plasma estradiol and progesterone concentrations during lactational amenorrhea were lower than those during the follicular phase of the menstrual cycle. Prolactin was higher than in non-nursing females at 31-60 days postpartum. Interbirth interval, studied in three non-nursing (four intervals) and six nursing females (eight intervals) lasted for 349.5 +/- 11.8 and 613.4 +/- 30.8 days, respectively. In non-nursing females, early recovery of the menstrual cycle was followed by a residual infertility (mating but no pregnancy) lasting 152.8 +/- 7.9 days. In nursing females, recovery of the menstrual cycle was followed by an extended residual infertility of 301.5 +/- 22.7 days. Thus, in the capuchin monkey, nursing prolongs the interbirth interval by inducing lactational amenorrhea and extending the residual infertility period.

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The recovery of ovarian function during breast-feeding

Cited by 36 publications

References 9 publications

Vitamin D and Estrogen Receptor Polymorphisms and Bone Mineral Changes in Postpartum Women

Vitamin D and Estrogen Receptor Polymorphisms and Bone Mineral Changes in Postpartum Women

Factors Underlying Changes in Bone Mineral During Postpartum Amenorrhea and Lactation

Impact of lactation upon fertility in the New World primate capuchin monkey (Cebus apella)

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