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https://www.readbyqxmd.com/read/29133081/-medical-treatment-of-endometriosis-hormonal-treatment-of-pain-impact-on-evolution-and-future-perspectives
#1
Sophie Geoffron, Guillaume Legendre, Emile Daraï, Nathalie Chabbert-Buffet
CONTEXT: Endometriosis is a chronic painful disease, for which hormone therapy is usually offered as a first line option to women not willing to conceive. OBJECTIVES: To analyse and synthesize the literature, from 2006 onwards, on pain control, and disease evolution in oemn using combined hormonal contraceptives, progestins and GnRH analogs. Data on other current and future treatment perspectives is included as well. SOURCES: Medline (Pubmed), the Cochrane Library, and endometriosis treatment recommendations published by European Society of Human Reproduction and Embryology (ESHRE), National Institute for health and Care Excellence (NICE), American College of Obstetricians and Gynecologists (ACOG), Royal College of Obstetricians and Gynaecologists (RCOG) and Société des Obstétriciens et Gynécologues du Canada (SOGC)...
November 10, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29092828/how-we-treat-heavy-menstrual-bleeding-associated-with-anticoagulants
#2
Kochawan Boonyawat, Sarah H O'Brien, Shannon M Bates
Anticoagulant-associated heavy menstrual bleeding (HMB) is an underrecognized but not uncommon problem in clinical practice. Premenopausal women should be advised of the potential effect of anticoagulant therapy on menstrual bleeding at the time of treatment initiation. Consequences of HMB should be assessed and treated on an ongoing basis. In the acute setting, the decision to withhold anticoagulants is based on an individual patient's risk of thrombosis and the severity of the bleeding. For women who require long-term anticoagulation, the use of levonorgestrel intrauterine system, tranexamic acid (during menstrual flow), high dose progestin-only therapy, and combined hormonal contraceptives are effective for controlling HMB; the risk of thrombosis during anticoagulant therapy with these treatments is not well studied, but is likely to be low...
November 1, 2017: Blood
https://www.readbyqxmd.com/read/29066045/medical-therapy-for-fibroids-an-overview
#3
REVIEW
Vikram Sinai Talaulikar
Uterine fibroids are the most common benign tumours in women of reproductive age group and are a cause of significant healthcare burden. Although surgical treatments have been the traditional gold standard for symptomatic uterine fibroids, several medical therapeutic approaches have been used to achieve symptom suppression in women who wish to preserve their uterus or are at elevated risk of complications during surgery. Medical therapies used for uterine fibroids include tranexamic acid, NSAIDs, contraceptive steroids, progesterone coil, GnRH analogues, aromatase inhibitors, SERMs and progesterone receptor modulators...
September 28, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29055780/pregnancy-outcomes-associated-with-extended-use-of-the-52-mg-20%C3%AE-g-day-levonorgestrel-releasing-intrauterine-system-beyond-60months-a-chart-review-of-776-women-in-brazil
#4
Luis Bahamondes, Arlete Fernandes, M Valeria Bahamondes, Cassia T Juliato, Moazzam Ali, Ilza Monteiro
OBJECTIVE: To assess the contraceptive performance of the 52-mg 20 μg/day levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena, Bayer Oy, Turku, Finland) among women who maintain the same device without changes after 60months. STUDY DESIGN: This is a chart review study in which we assessed the charts of 766 women who continue the same LNG-IUS for contraception beyond 60months. The women were evaluated at the Family Planning clinic, University of Campinas Medical School, Campinas, SP, Brazil from November 1990 to March 2011...
October 18, 2017: Contraception
https://www.readbyqxmd.com/read/29038072/amenorrhea-rates-and-predictors-during-one-year-of-levonorgestrel-52mg-intrauterine-system-use
#5
Philip D Darney, Gretchen S Stuart, Michael A Thomas, Carrie Cwiak, Andrea Olariu, Mitchell D Creinin
OBJECTIVE: Evaluate amenorrhea patterns and predictors of amenorrhea during the first year after levonorgestrel 52mg intrauterine system (IUS) placement. STUDY DESIGN: This cohort analysis includes 1714 nulliparous and parous women who received a Liletta® levonorgestrel 52mg IUS in a multicenter trial to evaluate efficacy and safety for up to 8years. Participants maintained a daily diary with bleeding information. We assessed bleeding patterns in 90-day intervals; amenorrhea was defined as no bleeding or spotting in the preceding 90days...
October 13, 2017: Contraception
https://www.readbyqxmd.com/read/28994639/migraine-menopause-and-hormone-replacement-therapy
#6
E Anne MacGregor
Perimenopause marks a period of increased migraine prevalence in women and many women also report troublesome vasomotor symptoms. Migraine is affected by fluctuating estrogen levels with evidence to support estrogen 'withdrawal' as a trigger of menstrual attacks of migraine without aura, while high estrogen levels can trigger migraine aura. Maintaining a stable estrogen environment with estrogen replacement can benefit estrogen-withdrawal migraine particularly in women who would also benefit from relief of vasomotor symptoms...
January 1, 2017: Post Reproductive Health
https://www.readbyqxmd.com/read/28924270/clinical-efficacy-of-levonorgestrel-and-norethisterone-for-the-treatment-of-chronic-abnormal-uterine-bleeding
#7
Muhammad Nadeem Ashraf, Agha Habib-Ur-Rehman, Zahid Shehzad, Shakir DakheelAllah AlSharari, Ghulam Murtaza
OBJECTIVE: To compare the clinical efficacy of levonorgestrel intrauterine system with oral norethisterone for the treatment of idiopathic chronic abnormal uterine bleeding. METHODS: This cross-sectional study was conducted at Bahawal Victoria Hospital, Jubilee Female Hospital, Civil Hospital and private clinics of consultant gynaecologists in Bahawalpur, Pakistan, from March to August 2014, and comprised patients presenting with abnormal uterine bleeding. The patients were equally and randomly divided into two groups, i...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28921518/high-birth-rates-despite-easy-access-to-contraception-and-abortion-a-cross-sectional-study
#8
Helena Hognert, Finn Egil Skjeldestad, Kristina Gemzell-Danielsson, Oskari Heikinheimo, Ian Milsom, Øjvind Lidegaard, Ingela Lindh
INTRODUCTION: The aim was to describe and compare contraceptive use, fertility, birth and abortion rates in the Nordic countries. MATERIAL AND METHODS: National data on births, abortions, fertility rate (1975-2013), redeemed prescriptions of hormonal contraceptives and sales figures of copper intrauterine devices (2008-2013) among women 15-49 years of age in the Nordic countries were collected and analysed. RESULTS: Use of hormonal contraceptives and copper intrauterine devices varied between 31-44%...
September 16, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28915701/comparison-among-fertility-sparing-therapies-for-well-differentiated-early-stage-endometrial-carcinoma-and-complex-atypical-hyperplasia
#9
REVIEW
Qing Zhang, Gonghua Qi, Margaux J Kanis, Ruifen Dong, Baoxia Cui, Xingsheng Yang, Beihua Kong
OBJECTIVE: To compare fertility-sparing therapies including oral progestogens, hysteroscopic resection (HR), and the levonorgestrel- releasing intrauterine system (LNG-IUS) in achieving disease regression, recurrence and live birth rate in well differentiate early-stage endometrial carcinoma (eEC) and complex atypical hyperplasia(CAH). STUDY DESIGN: This was a meta-analysis of previous studies focus on the fertility-sparing therapy for well differentiate early-stage endometrial carcinoma (eEC) and complex atypical hyperplasia (CAH)...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28913650/does-levonorgestrel-releasing-intrauterine-system-increase-breast-cancer-risk-in-peri-menopausal-women-an-hmo-perspective
#10
Nava Siegelmann-Danieli, Itzhak Katzir, Janet Vesterman Landes, Yaakov Segal, Rachel Bachar, Hadas Rotem Rabinovich, Martin Bialik, Joseph Azuri, Avi Porath, Yossef Lomnicky
PURPOSE: To evaluate the association between levonorgestrel-releasing intrauterine system (LNG-IUS) use and breast cancer (BC) risk. METHODS: A cohort of all Maccabi Healthcare Services (MHS) female members aged 40-50 years between 1/2003 and 12/2013 was used to identify LNG-IUS users as "cases," and 2 age-matched non-users as "controls." Exclusion criteria included: prior BC diagnosis, prior (5 years pre-study) and subsequent treatment with other female hormones or prophylactic tamoxifen...
September 14, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28892980/evaluating-the-efficacy-of-levonorgestrel-intrauterine-system-and-danazol-for-relief-of-postoperative-pain-in-endometriosis
#11
Ashima Taneja, Satinder Kaur, R K Soni, Bhanupriya, Jaspreet Kaur, Laveen Singla
INTRODUCTION: Endometriosis is an oestrogen-dependent disorder, manifests during reproductive years and is associated with pain and infertility. There is considerable debate about the effectiveness of various interventions for pain relief. AIM: To evaluate the efficacy of Levonorgestrel Intrauterine System (LNG-IUS) and Danazol in postoperative pain relief for patients with endometriosis. MATERIALS AND METHODS: Hundred patients with diagnosis of endometriosis, who were treated laparoscopically, entered the study to receive either danazol (600 mg once daily) or LNG-IUS (inserted during immediate post operative period) postsurgery, for pain relief...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28867443/association-of-hormonal-contraception-with-depression-in-the-postpartum-period
#12
Timothy A Roberts, Shana Hansen
OBJECTIVES: Studies have demonstrated an association between hormonal contraception use with subsequent depression and antidepressant use. This association has not been assessed among postpartum women. STUDY DESIGN: This study is a secondary analysis of insurance records from 75,528 postpartum women enrolled in the US military medical system, who delivered between October 2012 and September 2014. Our analyses excluded women who used antidepressants or had a diagnosis of depression in the 24months prior to delivery...
September 1, 2017: Contraception
https://www.readbyqxmd.com/read/28844878/overcoming-barriers-to-levonorgestrel-releasing-intrauterine-system-placement-an-evaluation-of-placement-of-lng-ius-8-using-the-modified-evoinserter%C3%A2-in-a-majority-nulliparous-population
#13
Kristina Gemzell-Danielsson, Dan Apter, Eeva Lukkari-Lax, Katrin Roth, Marco Serrani
OBJECTIVES: To report placement success rate, and ease and pain associated with placement, of the levonorgestrel-releasing intrauterine system (LNG-IUS) 8 using the modified EvoInserter® placement device. STUDY DESIGN: This was a pooled analysis using data from three previously reported Phase III studies in nulliparous (83.3%) or parous (16.7%) women aged 12-35 years (N=965). LNG-IUS 8 was placed using the modified Evolnserter®. The main outcomes assessed were placement success, ease of placement as reported by healthcare professionals (HCPs), pain at placement as reported by participants, and assessment of the EvoInserter® placement device by HCPs...
August 24, 2017: Contraception
https://www.readbyqxmd.com/read/28833891/relationship-between-user-satisfaction-with-the-levonorgestrel-releasing-intrauterine-system-and-bleeding-patterns
#14
Nelsilene M Carvalho, Victoria Chou, Waleska Modesto, Deborah Margatho, Elaine A L Garcia, Luis Bahamondes
AIM: Satisfaction with a contraceptive method constitutes an important factor in its acceptance and long-term use. The objective of this study was to assess the relationship between user satisfaction with the 20-μg/day levonorgestrel-releasing intrauterine system (LNG-IUS) and the bleeding patterns reported at two different time-points during follow-up. METHODS: A total of 251 LNG-IUS users aged 18-45 years were invited to answer a questionnaire on their return to the clinic for a routine follow-up visit and again 1 year later...
August 17, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28826801/postplacental-intrauterine-device-expulsion-by-12-weeks-a%C3%A2-prospective-cohort-study
#15
Lisa M Goldthwaite, Jeanelle Sheeder, Jennifer Hyer, Kristina Tocce, Stephanie B Teal
BACKGROUND: An intrauterine device placed immediately following a delivery can serve as an effective and safe contraceptive strategy in the postpartum period. There is limited evidence that the levonorgestrel intrauterine system may have a higher rate of expulsion compared to the copper intrauterine device; however, rates of expulsion for these 2 intrauterine device types have not been compared directly. OBJECTIVE: We sought to compare expulsion rates by 12 weeks' postpartum for the levonorgestrel intrauterine system and copper intrauterine device...
August 19, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796898/comparison-of-the-levonorgestrel-releasing-intrauterine-system-hysterectomy-and-endometrial-ablation-for-heavy-menstrual-bleeding-in-a-decision-analysis-model
#16
REVIEW
Michelle Louie, Jennifer Spencer, Stephanie Wheeler, Victoria Ellis, Tarek Toubia, Lauren D Schiff, Matthew T Siedhoff, Janelle K Moulder
BACKGROUND: A better understanding of the relative risks and benefits of common treatment options for abnormal uterine bleeding (AUB) can help providers and patients to make balanced, evidence-based decisions. OBJECTIVES: To provide comparative estimates of clinical outcomes after placement of levonorgestrel-releasing intrauterine system (LNG-IUS), ablation, or hysterectomy for AUB. SEARCH STRATEGY: A PubMED search was done using combinations of search terms related to abnormal uterine bleeding, LNG-IUS, hysterectomy, endometrial ablation, cost-benefit analysis, cost-effectiveness, and quality-adjusted life years...
November 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28780893/abnormal-uterine-bleeding-in-perimenopause
#17
S R Goldstein, M A Lumsden
Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office or primary-care setting. The wider availability of diagnostic tools has allowed prompt diagnosis and treatment of an increasing number of menstrual disorders in an office setting. This White Paper reviews the advantages and disadvantages of transvaginal ultrasound, blind endometrial sampling and diagnostic hysteroscopy. Once a proper diagnosis has been established, appropriate therapy may be embarked upon...
August 7, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28774663/fast-track-vs-delayed-insertion-of-the-levonorgestrel-releasing-intrauterine-system-after-early-medical-abortion-a-randomized-trial
#18
Riina Korjamo, Maarit Mentula, Oskari Heikinheimo
OBJECTIVE: To compare levonorgestrel (LNG) 52-mg intrauterine system (IUS) expulsion rates with fast-track (≤3 days) or delayed (2-4 weeks) insertion following mifepristone and misoprostol medical abortion. STUDY DESIGN: In this pilot trial, we randomized 108 women at ≤63 days' gestation to fast-track (n=55) or delayed (n=53) insertion. Follow-up visits occurred at 2-4 weeks, 3 months and 1 year. We assessed total and partial expulsion at 3 months and 1 year, adverse effects and bleeding profiles...
August 5, 2017: Contraception
https://www.readbyqxmd.com/read/28761925/recurrent-atypical-polypoid-adenomyoma-and-pregnancy-a-new-conservative-approach-with-levonorgestrel-releasing-intrauterine-system
#19
Eugenio Solima, Valeria Liprandi, Gaia M Belloni, Michele Vignali, Mauro Busacca
•Levonorgestrel IUD was effective in treatment of recurrent APA.•No side effects were reported.•No impairments on a subsequent pregnancy were reported.
August 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28754438/cost-effectiveness-of-treatments-for-heavy-menstrual%C3%A2-bleeding
#20
Jennifer C Spencer, Michelle Louie, Janelle K Moulder, Victoria Ellis, Lauren D Schiff, Tarek Toubia, Matthew T Siedhoff, Stephanie B Wheeler
BACKGROUND: Heavy menstrual bleeding affects up to one third of women in the United States, resulting in a reduced quality of life and significant cost to the health care system. Multiple treatment options exist, offering different potential for symptom control at highly variable initial costs, but the relative value of these treatment options is unknown. OBJECTIVE: The objective of the study was to evaluate the relative cost-effectiveness of 4 treatment options for heavy menstrual bleeding: hysterectomy, resectoscopic endometrial ablation, nonresectoscopic endometrial ablation, and the levonorgestrel-releasing intrauterine system...
July 25, 2017: American Journal of Obstetrics and Gynecology
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