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Narges Sadeghi, Farnoush Paknezhad, Mohamadreza Rashidi Nooshabadi, Maria Kavianpour, Sima Jafari Rad, Hossein Khadem Haghighian
Primary dysmenorrhea is one of the most common complaints of women. The aim of this study was to investigate the adjuvant effect of vitamin E and omega-3 fatty acids, separately or in combination, supplements on pain in the treatment of primary dysmenorrhea. This clinical trial conducted on students of university. Qualified girls completed the VAS before randomization. Arrangement was determined according to the severity of the pain (mild 0-3; moderate 3.1-6; severe 6.1-10). One hundred patients were randomly assigned to four groups receiving omega-3 (n = 25), vitamin E (n = 25), vitamin E- omega-3 (n = 25), or placebo (n = 25)...
March 15, 2018: Gynecological Endocrinology
B Borghese, P Santulli, L Marcellin, C Chapron
Endometriosis and adenomyosis are histologically defined. The frequency of endometriosis cannot be precisely estimated in the general population. Endometriosis is considered a disease when it causes pain and/or infertility. Endometriosis is a heterogeneous disease with three well-recognized subtypes that are often associated with each other: superficial endometriosis (SUP), ovarian endometrioma (OMA), and deep infiltrating endometriosis (DIE). DIE is frequently multifocal and mainly affects the following structures: the uterosacral ligaments, the posterior vaginal cul-de-sac, the bladder, the ureters, and the digestive tract (rectum, recto-sigmoid junction, appendix)...
March 11, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Logan W Thomas, Ashley Elsensohn, Terese Bergheim, Jessica Shiu, Anand Ganesan
IMPORTANCE: Intramuscular (IM) steroids can be used to treat a wide variety of dermatologic diseases. Although seemingly effective and safe, this form of corticosteroid therapy may be underused amongst dermatologists. OBJECTIVE: The objective of this review is to determine the evidence regarding the efficacy and side effect profile of intramuscular triamcinolone in the treatment of dermatologic disease. EVIDENCE REVIEW: A PubMed search engine was used for this study...
March 1, 2018: Journal of Drugs in Dermatology: JDD
X T Han, H Y Guo, D L Kong, J S Han, L F Zhang
Objective: To access the influence factors of diagnostic delay of endometriosis. Methods: We designed a questionnaire of diagnostic delay of endometriosis. From February 2014 to February 2016, 400 patients who had dysmenorrhea and diagnosed with endometriosis by surgery in Peking University Third Hospital were surveyed retrospectively. Time and risk factors of diagnostic delay were analyzed. Results: The diagnostic delay of 400 patients was 13.0 years (0.2-43.0 years), 78.5%(314/400) patients thought pain was a normal phenomenon and didn't see the doctor...
February 25, 2018: Zhonghua Fu Chan Ke za Zhi
C Huchon, G Aubry, S Ploteau, A Fauconnier
In case of consultation for chronic pelvic pain or suspicion of endometriosis, it is recommended to evaluate the pain (intensity, resonance) and to search out the evocative and localizing symptoms of endometriosis (Grade B). The main symptoms suggestive of endometriosis are: severe dysmenorrhea (NP2), deep dyspareunia (NP2), painful defecation during menstruation (NP2), urinary tract symptoms during menstruation (NP2) and infertility (NP2). In patients with chronic pelvic pain, it is recommended to search deep infiltrating endometriosis in patients with painful defecation during menstruation or severe deep dyspareunia (Grade B)...
March 9, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
S Geoffron, J Cohen, M Sauvan, G Legendre, J M Wattier, E Daraï, H Fernandez, N Chabbert-Buffet
The available literature, from 2006 to 2017, on hormonal treatment has been analysed as a contribution to the HAS-CNGOF task force for the treatment of endometriosis. Available data are heterogeneous and the general level of evidence is moderate. Hormonal treatment is usually offered as the primary option to women suffering from endometriosis. It cannot be used in women willing to conceive. In women who have not been operated, the first line of hormonal treatment includes combined oral contraceptives (COC) and the levonorgestrel-releasing intra uterine system (52mg LNG-IUS)...
March 10, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
John Jarrell
Historically, the evolutionary origins of menstruation have been based on two theories: the ability to eliminate infectious agents carried to the uterus with spermatozoa and the comparative conservation of energy with menstruation compared to its absence. In the menstruating species, more recent theories have identified spontaneous decidualization as the key adaptive mechanism. Spontaneous decidualization is seen as a mechanism to provide the mother with protection from the invasive characteristics of the embryo...
February 8, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Paolo Vercellini, Laura Buggio, Maria Pina Frattaruolo, Alessandra Borghi, Dhouha Dridi, Edgardo Somigliana
Available medical treatments for symptomatic endometriosis act by inhibiting ovulation, reducing serum oestradiol levels, and suppressing uterine blood flows. For this, several drugs can be used with a similar magnitude of effect, in terms of pain relief, independently of the mechanism of action. Conversely, safety, tolerability, and cost differ. Medications for endometriosis can be categorized into low-cost drugs including oral contraceptives (OCs) and most progestogens, and high-cost drugs including dienogest and GnRH agonists...
February 15, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Mustafa Serinken, Cenker Eken, Özgür Karcıoğlu
BACKGROUND: Dysmenorrhea is one of the most common acute pain disorders among women of reproductive age. AIMS: The present study aimed to compare the effects of IV paracetamol to dexketoprofen in patients presented with primary dysmenorrhea to the emergency department. STUDY DESIGN: Randomized Controlled Trial. METHODS: Patients over 18 years old presented with pelvic pain related to menstruation were accepted as eligible for the study...
February 2, 2018: Balkan Medical Journal
Rebecca M Zuckerman, Rebecca L Silton, Frank F Tu, Joshua S Eng, Kevin M Hellman
Somatic symptoms are a robust, transdiagnostic risk factor for pain conditions. However, the extent to which somatic symptoms contribute to the manifestation of the women's pain syndromes, such as dysmenorrhea and noncyclic pelvic pain (NCPP), is unclear due to high rates of co-occurrence. Therefore, the present study investigated the primary hypothesis that somatic symptoms would be elevated in NCPP and distinctly influence the relationship between dysmenorrhea and co-occurring NCPP. A secondary analysis was performed on cross-sectional questionnaire data from 1012 nonpregnant reproductive-aged women...
March 10, 2018: Archives of Women's Mental Health
M Sauvan, N Chabbert-Buffet, S Geoffron, G Legendre, J-M Wattier, H Fernandez
OBJECTIVE: To analyse the literature on the treatment of adolescent painful endometriosis. METHOD: This work is based on a Review of the literature between January 2006 and December 2017. The Medline (Pubmed) and Cochrane database were searched for meta-analyzes, randomized trials, literature reviews, controlled, not controlled and retrospective studies published on the subject. Studies concerning adolescent's dysmenorrhea without endometriosis were excluded. RESULTS: Study quality is heterogeneous...
March 5, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Tamara N Kruse, Michelle R Bowman, Jan C Ramer, Melissa A Fayette, Leah L Greer, Cynthia K Stadler, Michael M Garner, Jeffry S Proudfoot
Uterine lesions in two orangutans were effectively managed with surgical intervention. A 26-year-old hybrid orangutan ( Pongo spp.) was diagnosed with uterine adenomyosis based on advanced imaging. Histologic evaluation identified multifocal myometrial endometriosis, a variant of adenomyosis. A 27-year-old Bornean orangutan ( Pongo pygmaeus) was diagnosed with a focal uterine fibroid based on histologic examination. The animals were housed at separate institutions and initially presented with dysmenorrhea and menorrhagia...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
N Bourdel, P Chauvet, M Canis
In this chapter we have examined the possibilities of screening endometriosis, both in the general population as well as in the target population. We then proposed decision trees, for primary and secondary care. Currently, there is not enough data in the literature to develop or organize a screening test for endometriosis. Screening for endometriosis is not recommended in the general population (level A). There is also no evidence to support systematic screening in a population with genetic risk factors (endometriosis in a relative), or with other clinical risk factors (increased menstrual volume, short cycles, early menarche) (level A)...
March 4, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Elisabetta Garavaglia, Annalisa Inversetti, Stefano Ferrari, Paola De Nardi, Massimo Candiani
INTRODUCTION: Bowel endometriosis can cause debilitating symptoms. Surgical colorectal resection is often required for symptomatic relief. Aim of our study was to evaluate quality of life over a one-year follow-up period in patients submitted to a colorectal resection for the treatment of deep endometriosis. Change in intestinal and extra-intestinal symptoms, and reproductive outcome were also evaluated. METHODS: A prospective observational study was conducted on a cohort of 20 women affected by intestinal endometriosis and submitted to a laparoscopic colorectal resection...
March 8, 2018: Journal of Psychosomatic Obstetrics and Gynaecology
Anna Maria Ierardi, Valeria Savasi, Salvatore Alessio Angileri, Mario Petrillo, Sara Sbaraini, Antonio Pinto, Francesco Hanozet, Anna Maria Marconi, Gianpaolo Carrafiello
Uterine fibroids are the most common benign pelvic tumor of the female genital tract and tend to increase with age; they cause menorrhagia, dysmenorrhea, pelvic pressure symptoms, back pain, and subfertility. Currently, the management is based mainly on medical or surgical approaches. The nonsurgical and minimally invasive therapies are emerging approaches that to the state of the art include uterine artery embolization (UAE), image-guided thermal ablation techniques like magnetic resonance-guided focused ultrasound surgery (MRgFUS) or radiofrequency ablation (RF), and percutaneous microwave ablation (PMWA)...
2018: BioMed Research International
M Sauvan, N Chabbert-Buffet, M Canis, P Collinet, X Fritel, S Geoffron, G Legendre, J-M Wattier, H Fernandez
OBJECTIVE: To provide clinical practice guidelines for the management of painful endometriosis in women without infertility. METHODS: Systematic review of the literature literature since 2006, level of evidence rating, external proofreading and grading of the recommendation grade by an expert group according to HAS methodology. RESULTS: Combined hormonal contraceptives (COP) and the levonorgestrel-releasing intra-uterin system (LNG-IUS) are recommended as first-line hormonal therapies for the treatment of painful endometriosis (grade B)...
March 3, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
S Ploteau, B Merlot, H Roman, M Canis, P Collinet, X Fritel
Minimal and mild endometriosis (stage 1 and 2 AFSR) can lead to chronic pelvic pain and infertility but can also exist in asymptomatic patients. The prevalence of asymptomatic patients with minimal and mild endometriosis is not clear but typical endometriosis lesions are found in about 5 to 10% of asymptomatic women and more than 50% of painful and/or infertile women. Laparoscopic treatment of minimal and mild endometriotic lesions is justified in case of pelvic pain because their destruction decrease significatively the pain compared with diagnostic laparoscopy alone...
March 3, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
J-M Wattier
A major symptom of endometriosis is pelvic pain with a wide range of intensity, rhythm, type, and expression, without clearly established relationship between pain and the disease. Endometriosis-associated pain has physical, psychological/behavioral and social consequences with a significant impact on patient quality-of-life in relation with the biopsychosocial model of chronic pain. Pain assessment in all of its dimensions, as well as assessing the consequences of pain is therefore a crucial part of therapeutic management...
March 3, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Qiao-Yu Jiang, Jue Li, Liang Zheng, Guang-Hua Wang, Jing Wang
BACKGROUND: This study investigates the constitution of traditional Chinese medicine (TCM) among women who want to be pregnant in one year and explores factors related to TCM constitution. METHODS: This study was conducted on women who participated in free preconception check-ups provided by the Zhabei District Maternity and Child Care Center in Shanghai, China. The information regarding the female demographic characteristics, physical condition, history of pregnancy and childbearing, diet and behavior, and social psychological factors was collected, and TCM constitution assessment was performed...
March 1, 2018: Journal of the Chinese Medical Association: JCMA
Vito Chiantera, Marco Petrillo, Elene Abesadze, Giulio Sozzi, Margherita Dessole, Mariano Catello Di Donna, Giovanni Scambia, Jalid Sehouli, Sylvia Mechsner
OBJECTIVE: Evaluation of clinical presentation and surgical outcome in patients with deep lateral pelvic endometriosis (dLPE). DESIGN: Retrospective multicentric study (Canadian Task Force Classification II-2). SETTING: University tertiary referral centres. PATIENTS: 148 women with deep infiltrating endometriosis (DIE). INTERVENTION: Laparoscopic excision of DIE. Disease Distribution was classified as: Central Pelvic Endometriosis (CPE) when DIE involved one of these anatomic sites: cervix, vagina, uterosacral ligaments, rectum, bladder and pelvic peritoneum; superficial Lateral Pelvic Endometriosis (sLPE) when parametria, ureters or hypogastric plexus were involved; deep Lateral Pelvic Endometriosis (dLPE) in presence of sacral plexus and/or sciatic nerve infiltration...
March 1, 2018: Journal of Minimally Invasive Gynecology
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