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Endometriosis hormonal treatment

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...
August 3, 2018: Archives of Gynecology and Obstetrics
Cagdas Sahin, Ramanaiah Mamillapalli, Kyong W Yi, Hugh S Taylor
Endometriosis is an oestrogen-dependent, chronic inflammatory disease that affects 10% of reproductive-aged women. Current treatment options depend on female sex steroid hormone modulation; however, all have side effects and are not useful in women who want to conceive. microRNAs treatments have provided promising results for some chronic diseases and cancers. We have previously shown the microRNA Let-7b is repressed in endometriosis and that loss of Let-7 contributes to the pathophysiology of the disease. Here, we propose using microRNA Let-7b for the treatment of endometriosis in a murine model...
July 31, 2018: Journal of Cellular and Molecular Medicine
Horace Roman, Isabella Chanavaz-Lacheray, Marcos Ballester, Sofiane Bendifallah, Salma Touleimat, Jean-Jacques Tuech, Marilena Farella, Benjamin Merlot
STUDY QUESTION: What are fertility outcomes in patients surgically managed for large deep endometriosis infiltrating the rectum who intend to get pregnant postoperatively? SUMMARY ANSWER: Surgical management for rectal endometriosis is followed by high pregnancy rates, with a majority of natural conceptions. WHAT IS KNOWN ALREADY: Optimal management such as surgery versus first-line ART for patients with severe deep endometriosis who desire pregnancy is not defined...
July 25, 2018: Human Reproduction
Abdul Kadir Abdul Karim, Mohamad Nasir Shafiee, Nor Haslinda Abd Aziz, Mohd Hashim Omar, Nur Azurah Abdul Ghani, Pei Shan Lim, Reena Rahayu Md Zin, Norfilza Mokhtar
Endometriosis is a benign, chronic inflammatory condition characterized by the presence and growth of endometrial implants outside the uterine cavity. The cause of endometriosis is multifactorial. It is due to the diversity of hypothesis and plausibility of hormonal alterations which could play a major role. Evidence has shown that progesterone resistance is a key factor for endometriosis sufferers. Medical therapy can avoid surgical intervention, which may lead to a reduced in ovarian reserve, and its effects of earlier menopause and reduced fecundity...
July 25, 2018: Gynecological Endocrinology
Yuko Nishiyama, Shuichi Mori, Makoto Makishima, Shinya Fujii, Hiroyuki Kagechika, Yuichi Hashimoto, Minoru Ishikawa
The progesterone receptor (PR) plays an important role in various physiological systems, including female reproduction and the central nervous system, and PR antagonists are thought to be effective not only as contraceptive agents and abortifacients but also in the treatment of various diseases, including hormone-dependent cancers and endometriosis. Here, we identified phenanthridin-6(5 H )-one derivatives as a new class of PR antagonists and investigated their structure-activity relationships. Among the synthesized compounds, 37 , 40 , and 46 exhibited very potent PR antagonistic activity with high selectivity for PR over other nuclear receptors...
July 12, 2018: ACS Medicinal Chemistry Letters
Stephanie Seidler, Stas Shabanov, Axel Andres, Wolfram Karenovics, Jean-Marie Wenger, Nicola Pluchino
STUDY OBJECTIVE: To demonstrate a safe laparoscopic procedure for diaphragmatic infiltrative endometriosis. DESIGN: a video case SETTING: a teaching hospital PATIENTS: one patient presenting deep and severe diaphragmatic endometriosis. MATERIAL AND METHODS: Throughout this video, which was approved by the institutional board review, we demonstrate safe and complete surgical treatment of a patient suffering severe pelvic and diaphragmatic endometriosis...
July 18, 2018: Journal of Minimally Invasive Gynecology
Krina T Zondervan, Christian M Becker, Kaori Koga, Stacey A Missmer, Robert N Taylor, Paola Viganò
Endometriosis is a common inflammatory disease characterized by the presence of tissue outside the uterus that resembles endometrium, mainly on pelvic organs and tissues. It affects ~5-10% of women in their reproductive years - translating to 176 million women worldwide - and is associated with pelvic pain and infertility. Diagnosis is reliably established only through surgical visualization with histological verification, although ovarian endometrioma and deep nodular forms of disease can be detected through ultrasonography and MRI...
July 19, 2018: Nature Reviews. Disease Primers
Annika W M Goorsenberg, Marit Pruis, Rogier C Boshuizen, Vikash Hindori, Annelie Slaar, Paul Bresser
BACKGROUND: Thoracic endometriosis (TE) is one of the causes of secondary pneumothorax in women. According to the literature, 1 in 3 premenopausal women with pneumothorax can be diagnosed with 'catamenial pneumothorax'. The diagnosis is often not or only belatedly made in practice, even though treatment is significantly different than that of primary pneumothorax. CASE DESCRIPTION: A 40-year-old woman came to the emergency department because of dyspnoea and right-sided chest pain...
May 2, 2018: Nederlands Tijdschrift Voor Geneeskunde
Anom Suardika, Tjokorda Gede Astawa Pemayun
Endometriosis is a disease of theories, but none has succeeded to explain the whole picture. Most widely available drugs for endometriosis aim to relieve symptoms and improve fertility. Unfortunately, many short and long-term side-effects are associated with the treatments. To overcome this problem, researchers have developed many novel therapeutic agents, including non-invasive technique. We aim to provide new insights on pathogenesis model and novel non-surgical treatments for endometriosis, including drugs already available in the market and also drugs which are still under research...
July 16, 2018: Journal of the Turkish German Gynecological Association
Piyush Bansal, Kavita Khoiwal, Neena Malhotra, Vatsla Dadhwal, Aparna Sharma, Dipika Deka
Objective: Treatment with laparoscopic surgery, gonadotropin-releasing hormone analog (GnRHa) therapy, superovulation (SO), and intrauterine insemination (IUI) have individual benefits in improving fertility outcomes in women with endometriosis. The aim of the study was to evaluate the role of GnRHa in improving outcome in women undergoing SO and IUI after surgical correction of mild endometriosis. Materials and Methods: This was a randomized controlled trial conducted in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India, over a period of 2 years and 6 months...
June 2018: Eurasian Journal of Medicine
Osamu Yoshino, Takashi Minamisaka, Yosuke Ono, Sayaka Tsuda, Azusa Samejima, Tomoko Shima, Akitoshi Nakashima, Kaori Koga, Yutaka Osuga, Shigeru Saito
Endometrioma is known to be an occurrence site of ovarian cancer, but there is no evidence on how to reduce the risk of canceration. Here, we report three cases of ovarian cancer arising from endometrioma during hormone therapies of GnRH analogue and tamoxifen, low-dose estrogen-progestin (LEP) and dienogest. In all cases, each hormonal treatment was effective in shrinking the size of the endometrioma. During hormonal treatments, solid parts inside endometrioma were observed, which was followed by surgery. The histology of the solid parts was clear-cell adenocarcinoma in all cases...
July 12, 2018: Journal of Obstetrics and Gynaecology Research
Valerie A Flores, Nina S Stachenfeld, Hugh S Taylor
BACKGROUND: Endometriosis is a gynecologic disorder affecting 6-10% of reproductive-aged women. First-line therapies are progestin-based regimens; however, failure rates are high, often requiring alternative hormonal agents, each with unfavorable side effects. Bazedoxifene with conjugated estrogens is approved for treatment of menopausal symptoms, and use in animal studies has demonstrated regression of endometriotic lesions. As such, it represents a potential treatment option for endometriosis...
August 2018: Obstetrics and Gynecology
Akemi Koshiba, Taisuke Mori, Hiroyuki Okimura, Kanoko Akiyama, Hisashi Kataoka, Osamu Takaoka, Fumitake Ito, Hiroshi Matsushima, Izumi Kusuki, Jo Kitawaki
AIM: We aimed to evaluate whether hormonal therapy immediately after postsurgical recurrence of ovarian endometrioma controls disease progression and can be an alternative therapeutic option to avoid multiple repeat surgeries. METHODS: We enrolled 146 patients treated for endometrioma at the University Hospital of Kyoto Prefectural University of Medicine between 2009 and 2015. After laparoscopic cystectomy using the stripping technique, opening of cul-de-sac obliterations and complete resection of the deep infiltrating endometriosis lesions, the patients either received no treatment (n = 83), oral contraceptives (OC; n = 32) or dienogest (DNG; n = 27), depending on their medical history...
July 10, 2018: Journal of Obstetrics and Gynaecology Research
Simone Ferrero, Giulio Evangelisti, Fabio Barra
Pharmacotherapy has a pivotal role in the management of endometriosis with long-term treatments balancing clinical efficacy (control of pain symptoms and prevention of recurrence of the disease after surgery) with an acceptable safety profile. Treatment choice is based on several factors including age and patient preference, reproductive plans, intensity of pain, severity of disease and incidence of adverse effects. Areas covered: The aim of this review is to provide the reader with a complete overview of drugs that are currently available or are under investigation for the treatment of endometriosis highlighting on-going clinical trials...
July 2018: Expert Opinion on Pharmacotherapy
Matheus Roque, Beatrice Nuto Nóbrega, Marcello Valle, Marcos Sampaio, Selmo Geber, Thor Haahr, Peter Humaidan, Sandro C Esteves
Over the years concerns have arisen about possible adverse effects associated with controlled ovarian stimulation (COS) as regards not only the endometrium, but also on obstetrical and perinatal outcomes in pregnancies after fresh embryo transfer (ET) during in vitro fertilization (IVF) treatment. The improvements in cryopreservation techniques associated with the possible impairment in endometrial receptivity due to the supra-physiologic hormonal levels observed during conventional COS have increased the implementation of the so-called 'freeze-all' policy...
June 28, 2018: Panminerva Medica
Simone Ferrero, Fabio Barra, Umberto Leone Roberti Maggiore
Endometriosis is a chronic benign disease that affects women of reproductive age. Medical therapy is often the first line of management for women with endometriosis in order to ameliorate symptoms or to prevent post-surgical disease recurrence. Currently, there are several medical options for the management of patients with endometriosis. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in the treatment of chronic inflammatory conditions, being efficacious in relieving primary dysmenorrhea. Combined oral contraceptives (COCs) and progestins, available for multiple routes of administration, are effective first-line hormonal options...
July 2018: Drugs
Jeffrey T Jensen, William Schlaff, Keith Gordon
OBJECTIVE: To review the available clinical evidence on the use of combined hormonal contraceptive (CHC) agents (estrogen [E]-progestin combinations) for the treatment of endometriosis-related pain. DESIGN: A systematic review of the MEDLINE, Embase, and Derwent Drug File databases for prospective clinical studies. SETTING: Not applicable. PATIENT(S): Women with endometriosis diagnosed by validated means. INTERVENTION(S): Combined hormonal contraceptive agents, active comparators, placebo, or no treatment...
July 1, 2018: Fertility and Sterility
Isil Kasapoglu, Baris Ata, Ozlem Uyaniklar, Ayse Seyhan, Adnan Orhan, Sule Yildiz Oguz, Gurkan Uncu
OBJECTIVE: To evaluate whether endometrioma is associated with a progressive decline in ovarian reserve, and to compare the rate of decline with natural decline in ovarian reserve. DESIGN: Prospective, observational study. SETTING: Tertiary university hospital, endometriosis clinic. PATIENT(S): Forty women with endometrioma and 40 age-matched healthy controls. INTERVENTION(S): Women with endometriomas who did not need hormonal/surgical treatment at the time of recruitment and were expectantly managed...
July 1, 2018: Fertility and Sterility
P Collinet, X Fritel, C Revel-Delhom, M Ballester, P A Bolze, B Borghese, N Bornsztein, J Boujenah, T Brillac, N Chabbert-Buffet, C Chauffour, N Clary, J Cohen, C Decanter, A Denouël, G Dubernard, A Fauconnier, H Fernandez, T Gauthier, F Golfier, C Huchon, G Legendre, J Loriau, E Mathieu-d'Argent, B Merlot, J Niro, P Panel, P Paparel, C A Philip, S Ploteau, C Poncelet, B Rabischong, H Roman, C Rubod, P Santulli, M Sauvan, I Thomassin-Naggara, A Torre, J M Wattier, C Yazbeck, N Bourdel, M Canis
First-line diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The second-line investigations are: targeted pelvic examination performed by an expert clinician, transvaginal ultrasound performed by an expert physician sonographer (radiologist or gynaecologist), and pelvic MRI. Management of endometriosis is recommended when the disease has a functional impact. Recommended first-line hormonal therapies for the management of endometriosis-related pain are combined hormonal contraceptives (CHCs) or the 52mg levonorgestrel-releasing intrauterine system (IUS)...
June 18, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Paolo Vercellini
No abstract text is available yet for this article.
July 1, 2018: Fertility and Sterility
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