Oxytocin - A Luteinising Hormone Regulating Peptide

John J. Evans (Senior Research Fellow)

University Department of Obstetrics and Gynaecology, Christchurch School of Medicine, Christchurch, New Zealand.

Summary

• Oxytocin directly stimulates luteinising hormone (LH) synthesis and release from anterior pituitary tissue.
  
  
• Oxytocin interacts with gonadotrophin-releasing hormone (GnRH) to stimulate enhanced LH release.
  
  
• Antagonists to oxytocin inhibit production of the preovulatory LH 'surge', indicating that endogenous oxytocin is crucial for the full development of the LH peak.
  
  
• Administration of oxytocin in an oestrogenised environment advances the LH surge.
  
  
• In the future, oxytocin may be the basis of certain fertility modulation procedures.

Editor's Comment

It appears that there is a complex network of factors that must be co-ordinated in order to regulate LH levels. This review summarises emerging evidence for the involvement of oxytocin in this process at the level of the anterior pituitary gland.

Rational Management of Dysfunctional Uterine Bleeding (DUB)

B. Shakuntala Baliga (Professor)
Shabnam Raza (Registrar)

Department of Obstetrics & Gynaecology, Lady Hardinge Medical College, New Delhi, India

Summary

• Diagnosing the exact cause of DUB is central to treating this problem and selecting the 'right' patients for the appropriate procedure remains the key to successful management.
  
  
• Medical therapy is the first-line choice of treatment, but DUB tends to recur after discontinuing drugs.
  
  
• Hysterectomy although the definitive treatment option is radical for young women.
  
  
• Various very effective endoscopic procedures are available; these are intermediate between pharmacotherapy and hysterectomy.
  
  
• Time will prove whether or not endoscopic procedures will be as cost-effective as hysterectomy and whether or not they can be used as first-line treatment in a select group of women.

Editor's Comment

The management of DUB has advanced greatly in recent years, primarily as a result of better understanding of the physiology of (normal) menstruation, the availability of sensitive tests to diagnose specific disorders presenting as DUB, and a widening range of therapeutic options. These developments are outlined here, together with a strategy to combat this common complaint.

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