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Encyclopedia of Health and Medicine

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amniocentesis A diagnostic procedure to withdraw<br />

a sample <strong>of</strong> AMNIOTIC FLUID from the UTERUS <strong>of</strong><br />

a pregnant woman to obtain information about<br />

the health status <strong>of</strong> the FETUS. Obstetricians use<br />

amniocentesis, typically performed during the second<br />

trimester <strong>of</strong> PREGNANCY, to help diagnose<br />

GENETIC DISORDERS <strong>and</strong> health conditions <strong>of</strong> the<br />

developing fetus such as DOWN SYNDROME or SPINA<br />

BIFIDA <strong>and</strong> other NEURAL TUBE DEFECTS. Amniotic<br />

fluid contains cells from the fetus that can provide<br />

a KARYOTYPE (representation <strong>of</strong> CHROMOSOME pairamniocentesis<br />

243<br />

Age-related hormonal changes are most prominent<br />

in women, who experience significant transformation<br />

in their bodies with menopause. The<br />

cessation <strong>of</strong> OVULATION means a pronounced drop<br />

in estrogen within the body, affecting not only<br />

reproductive capability but also the functions <strong>of</strong><br />

nearly every system in the body. <strong>Health</strong> concerns<br />

that arise from these changes include increased<br />

risk for OSTEOPOROSIS, CARDIOVASCULAR DISEASE (CVD),<br />

<strong>and</strong> certain types <strong>of</strong> cancer. Men also experience<br />

age-related changes in sexuality <strong>and</strong> reproductive<br />

function. A man’s testosterone level peaks when<br />

he is in his early 20s <strong>and</strong> gradually declines with<br />

each decade <strong>of</strong> life. By age 60 most men have<br />

about half the testosterone they had at age 25.<br />

This decline results in changes such as diminished<br />

muscle mass <strong>and</strong> strength <strong>and</strong> male pattern baldness<br />

(ALOPECIA). A man’s risk for PROSTATE CANCER<br />

significantly increases after age 60. Though a man<br />

can still father children even into his 80s, declining<br />

testosterone affects LIBIDO (sex drive) <strong>and</strong> erectile<br />

function.<br />

See also ANDROPAUSE; BENIGN PROSTATIC HYPERPLA-<br />

SIA (BPH); ERECTILE DYSFUNCTION; LIFESTYLE AND<br />

HEALTH; MENSTRUATION; PROGESTERONE.<br />

alpha fetoprotein (AFP) A protein the LIVER produces.<br />

In PREGNANCY the amount <strong>of</strong> AFP in the<br />

woman’s BLOOD circulation increases, reflecting the<br />

activity <strong>of</strong> the FETUS’s liver as it develops <strong>and</strong><br />

becomes functional. A blood test measures AFP in<br />

the woman’s blood circulation early in the second<br />

trimester, between 15 <strong>and</strong> 22 weeks <strong>of</strong> pregnancy.<br />

Elevated AFP levels in pregnancy may indicate<br />

a multiple pregnancy, NEURAL TUBE DEFECTS or<br />

defects in the structure <strong>of</strong> the abdominal wall that<br />

allow the organs <strong>of</strong> the gastrointestinal system to<br />

form outside the body. Chronic liver disease, such<br />

as HEPATITIS or CIRRHOSIS, also elevates AFP. Excessive<br />

ALCOHOL consumption <strong>and</strong> cigarette smoking<br />

are common causes <strong>of</strong> falsely high measures. Low<br />

AFP levels may indicate a pregnancy that is not as<br />

advanced as the woman believes or suggest the<br />

chromosomal disorder DOWN SYNDROME.<br />

Other health circumstances elevate AFP blood<br />

levels in nonpregnant women <strong>and</strong> in men. Among<br />

them are liver disease, including LIVER CANCER, TES-<br />

TICULAR CANCER in men, <strong>and</strong> OVARIAN CANCER in<br />

women. Deviations from normal AFP levels in<br />

pregnancy suggest circumstances that may warrant<br />

further medical evaluation such as ULTRA-<br />

SOUND, AMNIOCENTESIS, <strong>and</strong> CHORIONIC VILLI SAMPLING<br />

(CVS).<br />

See also ALCOHOLISM; CHROMOSOMAL<br />

GENETIC DISORDERS; PRENATAL CARE.<br />

DISORDERS;<br />

amenorrhea The absence <strong>of</strong> menstrual periods.<br />

Primary amenorrhea occurs when a young<br />

woman does not begin menstruating by age 16;<br />

secondary amenorrhea occurs in women who<br />

have been menstruating <strong>and</strong> then stop (miss six or<br />

more consecutive periods).<br />

Primary amenorrhea may result from GENETIC<br />

DISORDERS such as TURNER’S SYNDROME or from hormonal<br />

disorders such as pituitary ADENOMA (a<br />

tumor <strong>of</strong> the PITUITARY GLAND) or HYPOTHYROIDISM<br />

(underactive THYROID GLAND). PREGNANCY is the<br />

most common cause <strong>of</strong> secondary amenorrhea.<br />

Other factors that may cause either primary or<br />

secondary amenorrhea include intense physical<br />

exercise, excessive body weight (OBESITY), <strong>and</strong><br />

extreme underweight such as may result from<br />

EATING DISORDERS.<br />

Amenorrhea is a symptom <strong>of</strong> underlying conditions<br />

that affect the function <strong>of</strong> the OVARIES rather<br />

than itself a health condition. Because the hormones<br />

the ovaries produce affect many other<br />

functions within the body, it is important to identify<br />

its cause. Unresolved primary amenorrhea<br />

may have consequences such as permanent INFER-<br />

TILITY <strong>and</strong> failure to develop SECONDARY SEXUAL<br />

CHARACTERISTICS.<br />

See also BODY MASS INDEX (BMI); DYSMENORRHEA;<br />

EXERCISE AND HEALTH; FERTILITY; HORMONE; OBESITY<br />

AND HEALTH; OVULATION; PRIMARY OVARIAN FAILURE;<br />

WEIGHT LOSS AND WEIGHT MANAGEMENT.

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