hypomenorrhoea

BACKGROUND: Endometrial ablation has recently gained popularity as a treatment of menorrhagia in the general population. In the von Willebrand disease (VWD) patient, intuitively, it would appear that the failure rate would be higher because of the underlying hypocoaguability increasing the likelihood for re-bleeding. In a consecutive series of seven patients, we assessed the efficacy and safety of endometrial ablation in VWD-related menorrhagia. PATIENTS AND METHODS: We performed a retrospective analysis using chart review and a 21-item questionnaire administered to seven (six type 1, one type 2A) women who underwent endometrial ablation between the years 1997 and 2001...

This study aims to evaluate the long-term effectiveness and define one of the indicators of successful outcome of endometrial resections. The study was carried out in a district general hospital setting. This was a retrospective analysis of 54 consecutive women who underwent endometrial resection over a 5-year period. Three (5.5%) complications were noted. Two were primary haemorrhage and one was a postoperative vaginal discharge. Eighty per cent of the patients expressed satisfaction with the outcome of their treatment...

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OBJECTIVE: To compare the effectiveness of the Cavaterm thermal balloon endometrial ablation system with the Nd:YAG laser for the treatment of dysfunctional uterine bleeding. DESIGN: Randomised controlled trial. SETTING: Minimal access gynaecological surgery unit in a district general hospital. POPULATION: Seventy-two women with dysfunctional uterine bleeding requesting conservative surgical management of their condition...

OBJECTIVES: To assess the effect of danazol pretreatment in women undergoing endometrial resection for dysfunctional uterine bleeding. STUDY DESIGN: A total of 132 patients were randomly divided into danazol pretreated and untreated groups. Endometrial resection was carried out using a 24Fr cutting wire loop electrode and 1.5% glycine as the distension media. Patients were followed-up for 6 years. The t-test and Chi-square tests were used to test differences between the two groups...

Forty patients due to undergo endometrial ablation as a treatment for dysfunctional uterine bleeding were recruited to assess the efficacy and safety of endometrial laser intrauterine thermo-therapy using the gynelase. At 12 months the average menstrual score reduction was 88%, the amenorrhoea rate was 70%, and the hypomenorrhoea rate 16%. Four women (10%) have had a hysterectomy for persistent menorrhagia, and one (3%) for pelvic pain. One patient (3%) has had a further endometrial laser ablation. There were no major complications...

OBJECTIVE: In order to assess the efficacy and tolerability of leuprorelin acetate depot in pre-operative flattening of the endometrium prior to hysteroscopic endometrial ablation, 94 patients from eight centres were included in the per protocol analysis. MATERIAL AND PATIENTS: The patients included were pre- or peri-menopausal, had completed their family planning and had intractable uterine bleeding. The primary target criterion was the reduction in maximum endometrial thickness after two injections of leuprorelin acetate depot with an interval of four weeks between injections...

OBJECTIVE: To evaluate our first experience with thermal balloon therapy of abnormal uterine bleeding. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology, 1st Medical Faculty, Charles University, Prague. METHODS: Ten procedures of balloon thermal endometrial ablations were performed between November 1998 and February 1999. From ten patients with abnormal uterine bleeding, 4 patients with concomitant polymorbidity (sclerosis multiplex, hypertension, hepatopathia, pyelonephritis) where more invasive intervention was not recommended or was contraindicated...

OBJECTIVE: The evaluation of the effect of transcervical resection of submucous myoma/s in patients with abnormal uterine bleeding. DESIGN: Prospective clinical study. SETTING: Department of Obstetrics and Gynaecology, 1st Medical Faculty, Charles University and General Faculty Hospital in Prague, Czech Republic. METHODS: 45 patients with resected submucous myoma/s within the period 1995-1998 were selected. Patients in whom resection of myoma was combined with endometrial ablation were excluded...

A total of 94 pre- or peri-menopausal patients from eight centres with intractable uterine bleedings and completed family planning were assessed as part of a clinical trial on the use of leuprorelin acetate monthly depot prior to endometrial ablation. The primary target criterion was flattening of the endometrium after two injections of 3.75 mg leuprorelin acetate depot with an interval of one month between injections. Endometrial thickness before the first injection was compared with the thickness prior to surgery (two weeks after the second injection)...

This study evaluates the use of local anaesthesia in a subset of patients undergoing uterine thermal balloon endometrial ablation for the treatment of menorrhagia. Out of 51 patients with dysfunctional uterine bleeding, 18 were included for uterine balloon therapy under local anaesthesia. Inclusion criteria were dysfunctional bleeding with absence of organic lesions in the uterine cavity, adequate relaxation and pain control during physical examination and diagnostic hysteroscopy, and patient desire to avoid a general anaesthetic...

Menorrhagia affects 20-30% of healthy women, many of whom undergo hysterectomy. In recent years, transcervical resection of the endometrium (TCRE) has become an alternative surgical option. This observational study assesses patient satisfaction following TCRE. The case notes of 55 patients who had a TCRE in the Coombe Womens' Hospital, Dublin, in 1992 were reviewed. Patients were sent a postal questionnaire at an interval ranging from 3 to 15 months post TCRE. 49 patients responded, of whom 76% were satisfied with TCRE...

OBJECTIVES: In thyroid textbooks it is stated that hyperthyroidism in women may be associated in almost 50% of the cases with hypomenorrhoea, oligomenorrhoea or amenorrhoea and perhaps with reduced fertility. Our experience at a busy thyroid clinic has given a picture which differs from that described in the literature. Most of our female thyrotoxic patients had normal menstruation. This study was performed to define the menstrual abnormalities in hyperthyroidism. DESIGN AND PATIENTS: We investigated the menstrual history, starting 6 months before the discovery of the disease, the smoking habits and the body mass index (BMI), in 214 female, premenopausal thyrotoxic patients and a similar number of normal controls matched for age and weight...

Hysteroscopic endometrial ablation under maximal anaesthesiological surveillance was performed in 34 high-risk patients to avoid hysterectomy. It was a collective of patients with heavy thrombo-embolic or thrombotic disease, either under permanent anticoagulation due to residual disease or multiple endoprosthetic treatment, or with endogenous coagulopathy. In all these women, hysterectomy was either a relative or an absolute contraindication. In 22 patients, treatment resulted in complete amenorrhoea or at least hypomenorrhoea (without menometrorrhagia) respectively cyclic spotting...

The Biograviplan (IUD) is a therapeutic system which, from a reservoir of 52 mg progesterone, permits the programmed release of the hormone within the uterus. It provides effective contraception over a period of 24 months. Spotting, intensified and prolonged menstrual bleeding can, in common with other IUDs, occur initially. Later, hypomenorrhoea and, occasionally, also silent menstruation extending over up to 3 cycles, can be seen. Dysmenorrhoea and menstrual pain are markedly reduced as compared with other IUDs...

As an alternative to hysterectomy 16 women with menorrhagia were treated with hysteroscopic transcervical resection of the endometrium with an unmodified urological resectoscope. Twelve patients requested total resection of the endometrial lining with the intention of producing amenorrhoea, and four chose partial resection and hypomenorrhoea. Surgery was completed successfully in 15; the remaining woman, who had an acutely retroflexed uterus, sustained a uterine perforation during insertion of the rigid hysteroscope...

OBJECTIVE: To assess the efficacy of destruction of the endometrium by ablation with a neodymium:YAG laser or resection with electrocautery in the management of menorrhagia. DESIGN: The efficacy of the treatment was assessed subjectively by each patient comparing the duration and amount of her menstrual bleeding before and after the operative procedure. Randomisation of treatments or patients was not undertaken. SETTING: The study was carried out in tertiary centres...

In transsexual men with homosexual behaviour and intact testicular function, as well as in homosexual men with normal gender identity, following a negative oestrogen feedback effect a delayed positive oestrogen feedback action on LH secretion was evoked. By contrast, in transsexual men with hypo- or asexuality and intact testes or hypergonadotrophic hypo- or agonadism, as well as in heterosexual men with normal gender identity, a negative oestrogen feedback effect was not followed by a positive feedback action on LH release...

Plasma levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), oestrogen and progesterone were measured daily in 15 thyrotoxic women in the reproductive age for 28 to 30 consecutive days before commencement of therapy and for a similar period following restoration of the euthyroid state. Five of these patients had secondary amenorrhoea whilst the other 10 had hypomenorrhoea. Twelve healthy volunteer eythyroid women of similar age and parity, with no history of menstrual abnormality, served as controls...

In 20 females the whole-body retention test using 59Fe was carried out for quantitative determination of menstrual blood loss. In hypomenorrhoea blood loss ranged from 10 to 40 ml and in normal menstruation from 70 to 150 ml. Blood losses in excess of 150 ml should be considered as hypermenorrhoea. This method constitutes an extension of diagnostic facilities with respect to confirmation of data given in the history of the patients concerning blood loss at menstruation and with particular problems (e.g. undisclosed cases of anaemia, bleedings with uterus myomatosus or with an indwelling endouterine pessary)...