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Endometriosis hormonal treatment

Soo Youn Song, Mia Park, Geon Woo Lee, Ki Hwan Lee, Ha Kyun Chang, Sang Mi Kwak, Heon Jong Yoo
OBJECTIVE: To compare the efficacy of levonorgestrel releasing intrauterine system (LNG-IUS) with other treatments as a postoperative maintenance therapy for endometriosis in terms of pain reduction, recurrence prevention, side effects and patients' satisfaction. STUDY DESIGN: We searched MEDLINE, EMBASE, and the Cochrane Library from January 1986 until February 2018. Two evaluators independently extracted and reviewed prospective and retrospective articles based on pre-determined selection criteria...
October 9, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
S Khayat, B Elliott, M H Dahan
Endometriosis is common among those with infertility, although many cases go undiagnosed. This study was performed to determine whether empiric treatment with two months of depo-leuprolide 3.75 mg monthly (dep-GnRH-ag) and letrozole 5 mg daily improves pregnancy outcomes in patients with at least two unexplained failed embryo transfers (ETs) but without a previous diagnosis of endometriosis. A retrospective cohort study was performed with subjects who failed at least two good quality ET. The study excluded women with a known history of endometriosis or ovarian cysts (possible endometriomas)...
October 17, 2018: Gynecological Endocrinology
Sunwoo Park, Whasun Lim, Gwonhwa Song
Endometriosis is a benign gynecological disease of women of reproductive ages, wherein endometrial cells grow ectopically, decreasing their quality of life due to chronic pelvic pain and severe dysmenorrhea. Although surgery and hormone therapies are gold standards for treating endometriosis, side effects are common and the recurrence rate is nearly 50%. Recent studies are exploring phytochemicals as pharmacological adjuvants for treating endometriosis. Delphinidin is an anthocyanin with anti-inflammatory, antioxidative, and anticancerous properties...
October 15, 2018: Journal of Cellular Biochemistry
Endah Rahmawati, Wei-Chung Vivian Yang, Yen-Ping Lei, Pawan Kumar Maurya, Huei-Wen Chen, Chii-Ruey Tzeng
INTRODUCTION: Many cell-migration-related molecules are associated with endometriosis. Tensin 1 (TNS1), which has been implicated in cell migration, may play a role in endometriosis. The study goal was to evaluate the TNS1 expression in endometrial tissue and serum from women with endometriosis treated with gonadotropin-releasing hormone agonist (GnRHa). MATERIAL AND METHODS: Tissue and serum samples were collected from women with endometriosis who were treated (n = 29) with GnRHa or untreated (n = 30)...
October 12, 2018: Acta Obstetricia et Gynecologica Scandinavica
Ruchi Shah, Ravi P Jagani
Endometriosis is characterized as the ectopic presence of endometrium in various locations within the abdominal cavity, such as the fallopian tube, the pouch of Douglas, the ovaries, outside the ovaries, and more. The inner lining of the uterus, endometrium, is a dynamic tissue that undergoes morphological and functional changes cyclically. The proliferation of endometrial cells during menstruation is influenced by increasing circulating estrogen levels. Adult progenitor stem cells are likely responsible for this remarkable regenerative capacity and hence, enhanced capacity to generate endometriosis...
2018: Critical Reviews in Biomedical Engineering
Daniela Alberico, Edgardo Somigliana, Benedetta Bracco, Dridi Dhouha, Anna Roberto, Paola Mosconi, Federica Facchin, Paolo Vercellini
OBJECTIVE: To explore the potential benefits of pregnancy on endometriosis symptoms. This is a retrospective study that has been conducted at Academic department and referral center for endometriosis. STUDY DESIGN: We included all conservative women who had a live birth after at least one surgery for endometriosis and who reported pre-pregnancy moderate to severe pelvic pain symptoms (at least one among dysmenorrhea, deep dyspareunia, non menstrual pelvic pain and dyschezia)...
August 22, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
M Candiani, J Ottolina, E Posadzka, S Ferrari, L M Castellano, I Tandoi, L Pagliardini, A Nocun, R Jach
STUDY QUESTION: Does CO2 laser vaporization offer better results in treating endometrioma in terms of ovarian reserve preservation compared to traditional cystectomy? SUMMARY ANSWER: Assessing both antral follicle count (AFC) and serum anti-Müllerian hormone (AMH) levels as measures of ovarian reserve, the results suggest that CO2 technology may be an alternative treatment for endometrioma, causing minimal damage to adjacent healthy ovarian tissue. WHAT IS KNOWN ALREADY: Excisional surgery has been questioned as an ideal surgical approach for endometriomas because it is associated with potential reduction of ovarian reserve...
October 9, 2018: Human Reproduction
Hae-Won Kim, Jeong-Eun Yoo
Endometriosis is a common benign gynecologic tumor, and it can destroy a patient's life. Surgery and hormone therapy are established therapies for endometriosis. However, there are many cases of recurrent endometriosis after conventional therapies. This report presents a case of a patient who has repetitive recurrence of endometriosis after laparoscopic excision and hormone therapy. A 32-years-old female patient first had laparoscopic surgery to remove endometriosis in 2011. The disease recurred two more times after the first excision...
September 2018: Integrative Medicine Research
Claire L Newton, Carmen Riekert, Robert P Millar
Dysregulation at any level of the hypothalamic-pituitary-gonadal (HPG) axis results in, or aggravates, a number of hormone-dependent diseases such as delayed or precocious puberty, infertility, prostatic and ovarian cancer, benign prostatic hyperplasia, polycystic ovarian syndrome, endometriosis, uterine fibroids, lean body mass, as well as metabolism and cognitive impairment. As gonadotropin-releasing-hormone (GnRH) is an essential regulator of the HPG axis, agonist and antagonist analogs are efficacious in the treatment of these conditions...
October 2018: Minerva Ginecologica
Indrajit Chowdhury, Saswati Banerjee, Adel Driss, Wei Xu, Sherifeh Mehrabi, Ceana Nezhat, Neil Sidell, Robert N Taylor, Winston E Thompson
Endometriosis is a chronic gynecological inflammatory disorder in which immune system dysregulation is thought to play a role in its initiation and progression. Due to altered sex steroid receptor concentrations and other signaling defects, eutopic endometriotic tissues have an attenuated response to progesterone. This progesterone-resistance contributes to lesion survival, proliferation, pain, and infertility. The current agency-approved hormonal therapies, including synthetic progestins, GnRH agonists, and danazol are often of limited efficacy and counterproductive to fertility and cause systemic side effects due to suppression of endogenous steroid hormone levels...
September 27, 2018: Journal of Cellular Physiology
Abolfazl Mehdizadeh Kashi, Yousef Moradi, Shahla Chaichian, Zahra Najmi, Kamyar Mansori, Forugh Salehin, Azade Rastgar, Sorour Khateri
Objective: Endometriosis, a common hormone-dependent chronic inflammatory disease causes various symptoms including pelvic pain, which affect the physical and psychological quality of life in women of reproductive age. The present study aimed to assess the quality of life of Iranian women with endometriosis using the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) questionnaire. Methods: This cross-sectional study performed in Tehran between October 2014 and July 2016 included 70 Iranian women with endometriosis...
September 2018: Obstetrics & Gynecology Science
Kuniaki Ota, Kenji Sato, Mamoru Tanaka
Ureteral involvement is rare, with an estimated frequency of 10-14% in cases of deep infiltrating endometriosis. An important complication of ureteral involvement is asymptomatic loss of renal function. We reported that a 49-year-oId woman presented with chronic pelvic pain due to severe dysmenorrhea and without any urological symptoms. Magnetic resonance imaging (MRI) identified a 7 cm endometrioma compressing and infiltrating the rectal wall, and chronic left hydronephrosis. Isotope renogram decreased 14% function in the left kidney...
October 2017: Gynecology and minimally invasive therapy
Hiroaki Takagi, Emi Takata, Jinichi Sakamoto, Satoko Fujita, Masahiro Takakura, Toshiyuki Sasagawa
Dienogest (DNG) is considered to be effective against ovarian endometrioma (OMA). We report a rare case of OMA transformation to ovarian cancer during long-term endometriosis treatment with a periodic administration of a gonadotropin-releasing hormone agonist (Gn-RH agonist) and DNG. The patient was a 41-year-old Japanese woman. OMA and adenomyosis of the uterus were revealed via computed tomography. Consequently, she underwent conservative treatment without undergoing surgery because her overall status was poor...
2018: Case Reports in Obstetrics and Gynecology
Xianping Wang, Xufeng Ding, Xiao Xiao, Fang Xiong, Rui Fang
The aim of the present study was to explore the influence of positive simple thyroid peroxidase antibody (TPO-Ab) on female infertility. Venous blood was collected on an empty stomach from infertile female patients (all of whom were in line with the World Health Organization's diagnostic criteria for infertility) receiving treatments at The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from 2014 to 2017 to detect thyroid function and thyroid antibodies [thyroglobulin antibody (TG-Ab), TPO-Ab and thyroid microsome antibody (TM-Ab)]...
October 2018: Experimental and Therapeutic Medicine
Yvette N Lamb
Elagolix (ORILISSA™), an orally bioavailable, second-generation, non-peptide gonadotropin-releasing hormone (GnRH) receptor antagonist, is being developed AbbVie and Neurocrine Biosciences for the treatment of reproductive hormone-dependent disorders in women. In July 2018, the US FDA approved elagolix tablets for the management of moderate to severe pain associated with endometriosis. This approval was based on positive results in two replicate phase III trials; additional phase III trials in the USA, Canada and Puerto Rico are currently evaluating elagolix as both monotherapy and in combination with low-dose hormone add-back therapy in the same indication...
September 2018: Drugs
Nancy T Nguyen, Maqdooda Merchant, Miranda L Ritterman Weintraub, Chelsea Salyer, Joanna Poceta, Lucero Diaz, Eve F Zaritsky
STUDY OBJECTIVE: To investigate rates of utilization of alternative treatments before hysterectomy for benign gynecologic indications within a large integrated health care system. DESIGN: Retrospective cohort study of patients who underwent hysterectomies for benign gynecologic conditions between 2012 and 2014 (Canadian Task Force classification II-2). SETTING: Kaiser Permanente Northern California, a community-based integrated health system...
August 28, 2018: Journal of Minimally Invasive Gynecology
Di Xie, Fan Chen, Shou-Zhen Xie, Zhi-Lan Chen, Ping Tuo, Rong Zhou, Juan Zhang
The clinical outcomes of five groups of infertility patients receiving frozen-thawed, cleavage-stage embryo transfers with exogenous hormone protocols with or without a depot gonadotropin-releasing hormone (GnRH) agonist were assessed. A retrospective cohort analysis was performed on 1003 cycles undergoing frozen-thawed, cleavage-stage embryo transfers from January 1, 2012 to June 31, 2015 in the Reproductive Medicine Center of Wuhan General Hospital of Guangzhou Military Region. Based on the infertility etiologies of the patients, the 1003 cycles were divided into five groups: tubal infertility, polycystic ovary syndrome (PCOS), endometriosis, male infertility, and unexplained infertility...
August 2018: Current medical science
Wentao Yu, Guanyuan Liu, Chongdong Liu, Zhenyu Zhang
The present study aimed to identify which patients with adenomyoma would benefit from sparing the uterus and which patients should undergo a hysterectomy to avoid secondary surgery. Patients with pathology-proven adenomyoma admitted to Beijing Chao-Yang Hospital between November 2005 and November 2015 were retrospectively reviewed. Relief and reappearance of dysmenorrhea following laparoscopic adenomyomectomy were evaluated. All 49 patients (mean age, 40.6±5.2 years; age range, 26-51 years) presented with severe dysmenorrhea prior to surgery...
September 2018: Oncology Letters
Mathilde Bourdon, Jade Raad, Yaniv Dahan, Louis Marcellin, Chloé Maignien, Marc Even, Khaled Pocate-Cheriet, Marie Charlotte Lamau, Pietro Santulli, Charles Chapron
BACKGROUND: Many women whose fertility may have been impaired by endometriosis require assisted reproductive technology (ART) in order to become pregnant. However, the influence of ovarian endometriosis (OMA) on ovarian responsiveness to hyperstimulation has not been clearly established. OBJECTIVE: To evaluate the risk of a poor ovarian response (POR) to stimulation and ART outcomes in women with OMA. MATERIALS AND METHODS: We conducted a large observational controlled matched cohort study in a tertiary care university hospital between 01/10/2012 and 31/12/2015...
2018: PloS One
Thomas Römer
PURPOSE: Endometriosis is a debilitating disease with high recurrence rates requiring long-term management. Progestins such as dienogest are used empirically when first symptoms occur and post-surgery to reduce recurrence. This retrospective, practice-based study assessed the efficacy and safety of dienogest in women with endometriosis treated for at least 60 months. METHODS: 37 women (age 39 ± 8 years) with laparoscopically diagnosed endometriosis received dienogest 2 mg orally once daily...
October 2018: Archives of Gynecology and Obstetrics
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