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Hormonal treatment of endometriosis

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Dysmenorrhea, or menstrual pain, is the most common menstrual symptom among adolescent girls and young women. Most adolescents experiencing dysmenorrhea have primary dysmenorrhea, defined as painful menstruation in the absence of pelvic pathology. When the patient's history suggests primary dysmenorrhea, empiric treatment should be initiated. When a patient does not experience clinical improvement for her dysmenorrhea within 3-6 months of therapy initiation, her obstetrician-gynecologist should investigate for possible secondary causes and for treatment adherence...
December 2018: Obstetrics and Gynecology
(no author information available yet)
Dysmenorrhea, or menstrual pain, is the most common menstrual symptom among adolescent girls and young women. Most adolescents experiencing dysmenorrhea have primary dysmenorrhea, defined as painful menstruation in the absence of pelvic pathology. When the patient's history suggests primary dysmenorrhea, empiric treatment should be initiated. When a patient does not experience clinical improvement for her dysmenorrhea within 3-6 months of therapy initiation, her obstetrician-gynecologist should investigate for possible secondary causes and for treatment adherence...
December 2018: Obstetrics and Gynecology
Ludovic Fournel, Antonio Bobbio, Edouard Robin, Emelyne Canny-Hamelin, Marco Alifano, Jean-François Regnard
Catamenial pneumothorax (CP) is defined as a recurrent spontaneous pneumothorax occurring in females of reproductive age. In the 'perimenstrual period,' it is still considered relatively rare although accounting for 20-35% of spontaneous pneumothoraces occurring in premenopausal women. It is the most frequent manifestation of thoracic endometriosis, which can also cause pneumothorax during the intermenstrual period (TER non-CP). Areas covered: In this article, we review and comment the clinical presentation, etiopathogenesis, diagnostic criteria, and therapeutic management of CP and TER non-CP...
November 20, 2018: Expert Review of Respiratory Medicine
Raphael Ouede, Blaise Demine Alexandre, Ayegnon Kouakou Gregoire, Landry Kohou-Kone, Edouard N'guessan, Maurice Gabin Kouacou, Jean-Marcel Ahui Brou, Flavien Kouassi Kendja, Yves Tanauh
This study aims to propose a therapeutic approach for catamenial pneumothorax based on outcomes reported in 18 cases. We conducted a retrospective study of 18 female elderly patients with an average age of 32.2 years who had undergone surgery for right (16 cases) and bilateral catamenial pneumothorax (2 cases) from January 1994 to December 2016. The patients were divided into 3 groups on the basis of the evolution of our surgical capability over time: group 1(G1) from January 1994 to June 2006, group 2 (G2) from July 2006 to February 2008, group 3(G3) from March 2008 to December 2016, these groups were composed of 5, 2 and 11 patients respectively...
2018: Pan African Medical Journal
Paul J Yong, Christina Williams, Sonja Bodmer-Roy, Chukwuemeka Ezeigwe, Sean Zhu, Kristina Arion, Kristin Ambacher, Ali Yosef, Fontayne Wong, Heather Noga, Susannah Britnell, Holly Yager, Mohamed A Bedaiwy, Lori A Brotto, Arianne Y Albert, Sarka Lisonkova, Catherine Allaire
INTRODUCTION: Deep dyspareunia is a common symptom in women, including in half of women with endometriosis, but little is known about its response to treatment and predictors of persistent deep dyspareunia over time. AIM: To follow up deep dyspareunia severity over a 1-year prospective cohort at an interdisciplinary center, and to identify baseline predictors of more persistent deep dyspareunia at 1 year. METHODS: Prospective 1-year cohort study at a tertiary referral center for pelvic pain and endometriosis, where a range of interdisciplinary treatments are provided at a single center (surgical, hormonal, physical, and psychological therapies)...
November 13, 2018: Journal of Sexual Medicine
Annelyn Torres-Reverón, Leslie L Rivera-Lopez, Idhaliz Flores, Caroline B Appleyard
Endometriosis is a disorder in which endometrial tissue is found outside the uterus causing pain, infertility and stress. Finding effective, non-hormonal and long-term treatments for endometriosis still remains one of the most significant challenges in the field. Corticotropin releasing hormone (CRH) is one of the main signaling peptides within the hypothalamic pituitary adrenal (HPA) axis released in response to stress. CRH can affect nervous and visceral tissues such as the uterus and gut via activation of two types of CRH receptors: CRHR1 and CRHR2...
2018: PloS One
N K Akhkubekova, A S Kaysinova, A A Fedorov, N B Efimenko, I I Gaidamaka, E N Chalaja, L A Cherevashchenko, L V Tsallagova, E E Urvacheva, A B Ovsienko
BACKGROUND: The use of agonists of gonadotropin-releasing hormone (GnRH) for the rehabilitation treatment of the patients presenting with endometriosis genitalis externa is known to significantly enhance the risk of development of hypoestrogenism. The so-called 'add-back-therapy' is carried out as a preventive measure to eliminate hypoestrogenism caused by the intake of GnRH agonists without detriment to the effectiveness of anti-hormonal therapy. AIM: The objective of the present study was to estimate the effectiveness of the new method ('add-back hormone replacement therapy') in comparison with anti-hormonal therapy with the use of GRH agonists at the stage of the early postoperative medical rehabilitation based on the drinking of mineral waters (MW) and radon therapy (RT) in the patients who had undergone the laparoscopic interventions for the treatment of endometrioid heterotopies of the ovaries (1-3 months post-operatively)...
2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
Weilin Zheng, Lixing Cao, Zheng Xu, Yuanyuan Ma, Xuefang Liang
Endometriosis is caused by the growth or infiltration of endometrial tissues outside of the endometrium and myometrium. Symptoms include pain and infertility. Surgery and hormonal therapy are widely used in Western medicine for the treatment of endometriosis; however, the side effects associated with this practice include disease recurrence and menopause, which can severely influence quality of life. Angiogenesis is the main biological mechanism underlying the development of endometriosis. Numerous natural products and Chinese medicines with potent anti-angiogenic effects have been investigated, and the molecular basis underlying their therapeutic effects in endometriosis has been explored...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Achmad Kemal Harzif, Melisa Silvia, Ana Mariana, Lydia Olivia, Bara Tracy Lovita, Budi Wiweko
INTRODUCTION: Endometriosis is a frequent gynecological disorder. Its findings on the abdominal wall are rare cases, usually reported with a history of former surgery. The activation of PPARy expression could be one of alternative non-hormonal treatment for endometriosis. PRESENTATION OF CASE: A patient, 34 years old, suspected of endometriosis since 5 years ago because of pain during menstruation. Since the last 4 months, she had worsening of dysmenorrhea and palpable lumps during menses...
October 24, 2018: International Journal of Surgery Case Reports
Ying Li, Yu-Dong Liu, Shi-Ling Chen, Xin Chen, De-Sheng Ye, Xing-Yu Zhou, Jing Zhe, Jun Zhang
STUDY QUESTION: Is there a specific mechanism underlying the association between lung adenocarcinoma transcript 1 (MALAT1) and endometriosis-related infertility? SUMMARY ANSWER: The down-regulation of MALAT1 in endometriosis granulosa cells (GCs) may have an adverse effect on the growth and development of oocytes by inhibiting GC proliferation, due to cell cycle-dependent mechanisms that enhance P21 expression through activation of the extracellular signal-regulated kinase (ERK)/mitogen-activated protein kinase (MAPK) pathway...
October 27, 2018: Molecular Human Reproduction
X Chen, H Y Liu, J H Lang, Q B Fan, H H Shi, D W Sun, J H Leng, L Zhu, Z F Liu
Objective: To evaluate the impact of gonadotropin-releasing hormone agonist (GnRH-a) used before surgery on natural pregnancy rates in patients with ovarian endometriomas. Methods: In this retrospective study, 57 patients with ovarian endometriomas who had a consecutive laparoscopic surgery between June, 2010 to September, 2015 in Peking Union Medical College Hospital were included. Those patients were divided into preoperative GnRH-a treatment group ( n= 31) and non-GnRH-a treatment group ( n= 26) . There were no differences in patients' characteristics between the two groups...
October 25, 2018: Zhonghua Fu Chan Ke za Zhi
Valerie A Flores, Arne Vanhie, Tran Dang, Hugh S Taylor
Context: Progestin-based therapy is the first-line treatment for managing endometriosis-associated pain. However, response to progestins is currently variable and unpredictable. Predictive markers for response to progestin-based therapy would allow for a personalized approach to endometriosis treatment. Objective: We hypothesize that progesterone receptor (PR) levels in endometriotic lesions determine response to progestin-based therapy. Design: Retrospective cohort study...
December 1, 2018: Journal of Clinical Endocrinology and Metabolism
Huiling Xue, Meiyun Liu, Wanjiao Hao, Ye Li
Objective: To investigate the effects of laparoscopic surgery combined with triptorelin acetate, gestrinone and mifepristone on pregnancy rate, pregnancy outcome, long-term recurrence and adverse reactions in patients with endometriosis (EMT) complicated with infertility. Methods: In this study, 150 patients with EMT and infertility were selected and randomly divided into triptorelin group (group A), gestrinone group (group B) and mifepristone group (group C), with 50 people in each group...
September 2018: Pakistan Journal of Medical Sciences Quarterly
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)...
November 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...
December 1, 2018: Human Reproduction
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