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heavy menstrual bleeding

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https://www.readbyqxmd.com/read/29420229/sociodemographic-differences-in-symptom-severity-and-duration-among-women-referred-to-secondary-care-for-menorrhagia-in-england-and-wales-a-cohort-study-from-the-national-heavy-menstrual-bleeding-audit
#1
Amit Kiran, Rebecca Sally Geary, Ipek Gurol-Urganci, David A Cromwell, Loveleen Bansi-Matharu, Judy Shakespeare, Tahir Mahmood, Jan van der Meulen
OBJECTIVE: To examine symptom severity and duration at time of referral to secondary care for heavy menstrual bleeding (HMB) by socioeconomic deprivation, age and ethnicity DESIGN: Cohort analysis of data from the National HMB Audit linked to Hospital Episode Statistics data. SETTING: English and Welsh National Health Services (secondary care): February 2011 to January 2012. PARTICIPANTS: 15 325 women aged 18-60 years in England and Wales who had a new referral for HMB to a gynaecology outpatient department METHODS: Multivariable linear regression to calculate adjusted differences in mean symptom severity and quality of life scores at first outpatient visit...
February 2, 2018: BMJ Open
https://www.readbyqxmd.com/read/29385977/abnormal-uterine-bleeding-managing-endometrial-dysfunction-and-leiomyomas
#2
Annabelle Brennan, Martha Hickey
Abnormal uterine bleeding refers to any change in the regularity, frequency, heaviness or length of menstruation. There are several potential causes for bleeding disturbance, the two most common being primary endometrial dysfunction and fibroids. Management of abnormal uterine bleeding involves both medical and surgical options and will largely depend on a patient's fertility plans. The use of levonorgestrel-releasing intrauterine devices for heavy menstrual bleeding is increasing in Australia, and they are considered first-line medical management for women accepting of hormonal therapies...
February 5, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29368658/health-laparoscopic-supracervical-hysterectomy-versus-second-generation-endometrial-ablation-for-the-treatment-of-heavy-menstrual-bleeding-study-protocol-for-a-randomised-controlled-trial
#3
Kevin Cooper, Kirsty McCormack, Suzanne Breeman, Jessica Wood, Neil W Scott, Justin Clark, Jed Hawe, Robert Hawthorn, Kevin Phillips, Angela Hyde, Alison McDonald, Mark Forrest, Samantha Wileman, Graham Scotland, John Norrie, Siladitya Bhattacharya
BACKGROUND: Heavy menstrual bleeding (HMB) is a common problem affecting approximately 1.5 million women in England and Wales with a major impact on their physical, emotional, social and material quality of life. It is the fourth most common reason why women attend gynaecology outpatient clinics and accounts for one-fifth of all gynaecology outpatient referrals. Initial treatment in primary care is medical - either by means of oral or injected medication or the levonorgestrel-intrauterine system (Mirena®)...
January 24, 2018: Trials
https://www.readbyqxmd.com/read/29362355/hypoxia-and-hypoxia-inducible-factor-1%C3%AE-are-required-for-normal-endometrial-repair-during-menstruation
#4
Jacqueline A Maybin, Alison A Murray, Philippa T K Saunders, Nikhil Hirani, Peter Carmeliet, Hilary O D Critchley
Heavy menstrual bleeding (HMB) is common and debilitating, and often requires surgery due to hormonal side effects from medical therapies. Here we show that transient, physiological hypoxia occurs in the menstrual endometrium to stabilise hypoxia inducible factor 1 (HIF-1) and drive repair of the denuded surface. We report that women with HMB have decreased endometrial HIF-1α during menstruation and prolonged menstrual bleeding. In a mouse model of simulated menses, physiological endometrial hypoxia occurs during bleeding...
January 23, 2018: Nature Communications
https://www.readbyqxmd.com/read/29347935/real-world-experience-of-women-using-extended-cycle-vs-monthly-cycle-combined-oral-contraception-in-the-united-states-the-national-health-and-wellness-survey
#5
Rossella E Nappi, Iñaki Lete, Lulu K Lee, Natalia M Flores, Marie-Christine Micheletti, Boxiong Tang
BACKGROUND: The real-world experience of women receiving extended-cycle combined oral contraception (COC) versus monthly-cycle COC has not been reported. METHODS: Data were from the United States 2013 National Health and Wellness Survey. Eligible women (18-50 years old, premenopausal, without hysterectomy) currently using extended-cycle COC (3 months between periods) were compared with women using monthly-cycle COC. Treatment satisfaction (1 "extremely dissatisfied" to 7 "extremely satisfied"), adherence (8-item Morisky Medication Adherence Scale©), menstrual cycle-related symptoms, health-related quality of life (HRQOL) and health state utilities (Medical Outcomes Short Form Survey-36v2®), depression (9-item Patient Health Questionnaire), sleep difficulties, Work Productivity and Activity Impairment-General Health, and healthcare resource use were assessed using one-way analyses of variance, chi-square tests, and generalized linear models (adjusted for covariates)...
January 18, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29346128/management-of-heavy-menstrual-bleeding-during-direct-oral-anticoagulant-therapy-for-recurrent-venous-thromboembolism-a-case-report
#6
Michela Giustozzi, Maria C Vedovati, Giancarlo Agnelli
: A high risk of venous thromboembolism (VTE) recurrence requires extended anticoagulation but limits the options to control heavy menstrual bleeding (HMB) in women of reproductive age. We report the management of HMB in a 48-year-old woman with a history of menometrorrhagia, recurrent VTE and multiple VTE risk factors. Due to the occurrence of HMB during extended rivaroxaban treatment, the presence of a uterine fibroid and the contraindication to interrupt anticoagulation for high risk of VTE recurrence, she received hormonal treatment first with a gonadotropin-releasing hormone agonist and then with progestin...
January 15, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29344938/a-clinical-audit-on-the-efficacy-and-safety-of-uterine-artery-embolisation-for-symptomatic-adenomyosis-results-in-117-women
#7
Eisen Liang, Bevan Brown, Maxim Rachinsky
BACKGROUND: Uterine artery embolisation (UAE) is a possible uterine-sparing treatment option for women with unsuccessful conservative management for adenomyosis-related heavy menstrual bleeding (HMB) and dysmenorrhoea. AIM: To conduct a clinical audit on the efficacy and safety of UAE for symptomatic adenomyosis. MATERIALS AND METHODS: Retrospective review of 309 women who underwent UAE identified 117 women with magnetic resonance imaging features of adenomyosis (junctional zone thickness ≥ 12 mm)...
January 18, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29336529/high-prevalence-of-reduced-thrombin-generation-and-or-decreased-platelet-response-in-women-with-unexplained-heavy-menstrual-bleeding
#8
H P Eising, M Roest, P G de Groot, D Huskens, J Konings, R T Urbanus, B de Laat, J A Remijn
INTRODUCTION: Heavy menstrual bleeding (HMB) is a condition that affects 20%-30% of women of reproductive age. HMB has a multifactorial pathophysiology, which is incompletely understood. HMB symptoms are very common in patients with established haemostasis defects, likewise, women with heavy menstrual bleeding have a higher prevalence of impaired Von Willebrand factor (VWF) levels and function, thrombocytopenia, impaired platelet function and impaired coagulation. The aim of this study was to quantify the prevalence of impaired platelet function, impaired coagulation and reduced VWF activity in patients with HMB...
January 16, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29280410/iron-balance-and-iron-supplementation-for-the-female-athlete-a-practical-approach
#9
Charles R Pedlar, Carlo Brugnara, Georgie Bruinvels, Richard Burden
Maintaining a positive iron balance is essential for female athletes to avoid the effects of iron deficiency and anaemia and to maintain or improve performance. A major function of iron is in the production of the oxygen and carbon dioxide carrying molecule, haemoglobin, via erythropoiesis. Iron balance is under the control of a number of factors including the peptide hormone hepcidin, dietary iron intake and absorption, environmental stressors (e.g. altitude), exercise, menstrual blood loss and genetics. Menstruating females, particularly those with heavy menstrual bleeding are at an elevated risk of iron deficiency...
December 27, 2017: European Journal of Sport Science
https://www.readbyqxmd.com/read/29274443/gynecologic-bleeding-complications-in-post-menarchal-adolescent-females-on-anti-thrombotic-medications
#10
Heather Soni, Jennifer Kurkowski, Danielle Guffey, Jennifer E Dietrich, Lakshmi V Srivaths
INTRODUCTION: The prevalence, clinical features and management of gynecologic bleeding complications and health care provider awareness of these in post-menarchal adolescents on anti-thrombotic medications has rarely been addressed in the literature. We sought to review our experience in a pediatric tertiary care center addressing these issues. MATERIALS AND METHODS: A retrospective chart review was conducted with Institutional Review Board approval from 2004-2014, on eligible post-menarchal adolescents on antithrombotic medications...
December 20, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29260904/ulipristal-acetate-for-the-management-of-acute-heavy-menstrual-bleeding-without-fibroids
#11
Josep Estadella, Pia Español, Fiorella Ascencio, Josep Perelló, Joaquim Calaf
Heavy menstrual bleeding is a common condition among women of childbearing age. Although hysterectomy was the usual approach in acute cases in the past, other minimally invasive therapies or pharmacological alternatives, such as the levonorgestrel intrauterine device have shown to be highly effective. This case report presents the case of a pluripathological patient with acute heavy menstrual bleeding and severe anemia, who was successfully managed with ulipristal acetate, a selective progesterone receptor modulator...
December 20, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29234102/endometrial-apoptosis-and-neutrophil-infiltration-during-menstruation-exhibits-spatial-and-temporal-dynamics-that-are-recapitulated-in-a-mouse-model
#12
Gregory M Armstrong, Jacqueline A Maybin, Alison A Murray, Moira Nicol, Catherine Walker, Philippa T K Saunders, Adriano G Rossi, Hilary O D Critchley
Menstruation is characterised by synchronous shedding and restoration of tissue integrity. An in vivo model of menstruation is required to investigate mechanisms responsible for regulation of menstrual physiology and to investigate common pathologies such as heavy menstrual bleeding (HMB). We hypothesised that our mouse model of simulated menstruation would recapitulate the spatial and temporal changes in the inflammatory microenvironment of human menses. Three regulatory events were investigated: cell death (apoptosis), neutrophil influx and cytokine/chemokine expression...
December 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29223999/two-years-follow-up-of-patients-with-abnormal-uterine-bleeding-after-insertion-of-the-levonorgestrel-releasing-intrauterine-system
#13
Numan Cim, Sunullah Soysal, Sena Sayan, Begum Yildizhan, Erbil Karaman, Orkun Cetin, Harun Egemen Tolunay, Recep Yildizhan
AIM: To evaluate the efficacy and safety of levonorgestrel-releasing intrauterine system (LNG-IUS) in the long-term treatment of heavy menstrual blood loss in women unrelated to intrauterine pathology. METHODS: One hundred and six parous women aged 33-48 years with recurrent heavy menstrual bleeding (HMB) participated in this study. The women were followed up for 24 months and were assessed for intensity of bleeding both for pre- and post-insertion periods. An LNG-IUS was inserted in each patient within 7 days of the start of menstrual flow...
December 8, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/29201425/heavy-menstrual-bleeding-diagnosis-and-medical-management
#14
REVIEW
Intira Sriprasert, Tarita Pakrashi, Thomas Kimble, David F Archer
Heavy menstrual bleeding (HMB) is a common gynecological problem that has a significant impact on a woman's quality of life and the activities of daily living. Due to the difficulty in accurately describing menstrual bleeding abnormalities using older terminology, the PALM-COEIN classification system of the Federation Internationale de Gynecologie et d'Obstetrique was proposed to describe and identify the etiology of abnormal endometrial bleeding. As there is no single pathway that is associated with HMB, there are several therapeutic interventions involving different molecular pathways to reduce HMB...
2017: Contraception and Reproductive Medicine
https://www.readbyqxmd.com/read/29197944/experience-of-symptoms-and-disease-impact-in-patients-with-adenomyosis
#15
Linda M Nelsen, William R Lenderking, Robin Pokrzywinski, Zaneta Balantac, Libby Black, Shibani Pokras, Mary Beth Enslin, Melisa Cooper, Andrea S Lukes
BACKGROUND: Adenomyosis is a poorly understood, benign disease of the uterus. OBJECTIVE: In this study, patient interviews were conducted to characterize the symptoms and impact of adenomyosis. METHODS: This was a cross-sectional study in which women with adenomyosis were recruited from five US clinics and a health-related social network forum. Participants (aged 18-55 years) were pre-menopausal with a history of regular menstrual cycles...
December 2, 2017: Patient
https://www.readbyqxmd.com/read/29197842/angiomatosis-of-the-uterus-cervix-and-fallopian-tubes-a-rare-and-benign-cause-of-intractable-heavy-menstrual-bleeding
#16
Jennifer C Pontré, Victor Ojedo, Bernadette McElhinney
Angiomatosis of the uterus, cervix and fallopian tubes is a rare and benign entity that has not been reported in the literature previously. We present a case of a 27-year-old patient with severe and intractable heavy menstrual bleeding unresponsive to all conservative and conventional forms of treatment. Following a laparoscopic hysterectomy, the histopathological finding of angiomatosis, a vascular abnormality in the uterus, cervix and fallopian tubes, provided a plausible explanation in this situation.
December 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29179757/lockjaw-from-a-metastatic-uterine-leiomyosarcoma-case-report-and-review-of-the-literature
#17
Isabel Hope, Karen Morton, Carrie Newlands, Simon Butler-Manuel, Thumuluru Kavitha Madhuri
BACKGROUND: Leiomyosarcoma (LMS) is a malignant tumour formed of cells with distinct smooth muscle features. Leiomyosarcomas rarely metastasise to the oral cavity and this literature review details all reported cases of metastasis to the mandible found in the literature. This offers a unique perspective by specifying mandible as the site of metastasis of leiomyosarcoma. CASE PRESENTATION: A 53-year-old female presented to her General Practitioner (GP) with heavy menstrual bleeding and was diagnosed with multiple fibroids...
November 28, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/29170088/simplified-medical-abortion-screening-a-demonstration-project
#18
Elizabeth G Raymond, Yi-Ling Tan, Rodica Comendant, Irina Sagaidac, Stelian Hodorogea, Melissa Grant, Patricio Sanhueza, Emigdio Van Pratt, Ginger Gillespie, Christy Boraas, Mark A Weaver, Ingrida Platais, Manuel Bousieguez, Beverly Winikoff
OBJECTIVES: To evaluate the safety and acceptability of outpatient medical abortion in selected women without a pretreatment ultrasound or pelvic examination. STUDY DESIGN: We conducted a prospective case-series study to estimate the incidence of serious adverse events (death, life-threatening event, hospitalization, transfusion, or any other medical problem that we judged to be significant), surgical completion of the abortion, and satisfaction in women provided with medical abortion without a pretreatment ultrasound or pelvic examination...
November 20, 2017: Contraception
https://www.readbyqxmd.com/read/29166373/pilot-study-of-novel-lab-methodology-and-testing-of-platelet-function-in-adolescent-women-with-heavy-menstrual-bleeding
#19
Anne D Rocheleau, Ayesha Khader, Anh T P Ngo, Colin Boehnlein, Cara McDavitt, Susan Lattimore, Michael Recht, Owen J T McCarty, Kristina M Haley
INTRODUCTION: Approximately 40% of adolescent women experience heavy menstrual bleeding (HMB), and 10-62% of them have an underlying bleeding disorder (BD). Diagnosing BD remains challenging due to limitations of available clinical platelet function assays. AIM: To characterize platelet function in a population of adolescent women with HMB using small-volume whole blood assays. METHODS: Anticoagulated whole blood was used to assess platelet GPIIbIIIa activation, α-granule secretion, and aggregation in response to multiple agonists...
November 22, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29141040/medical-therapy-versus-radiofrequency-endometrial-ablation-in-the-initial-treatment-of-heavy-menstrual-bleeding-itom-trial-a-clinical-and-economic-analysis
#20
Abimbola O Famuyide, Shannon K Laughlin-Tommaso, Sherif A Shazly, Kirsten Hall Long, Daniel M Breitkopf, Amy L Weaver, Michaela E McGree, Sherif A El-Nashar, Maureen A Lemens, Matthew R Hopkins
BACKGROUND: Radiofrequency endometrial ablation (REA) is currently a second line treatment in women with heavy menstrual bleeding (MHB) if medical therapy (MTP) is contraindicated or unsatisfactory. Our objective is to compare the effectiveness and cost burden of MTP and REA in the initial treatment of HMB. METHODS: We performed a randomized trial at Mayo Clinic Rochester, Minnesota. The planned sample size was 60 patients per arm. A total of 67 women with HMB were randomly allocated to receive oral contraceptive pills (Nordette ®) or Naproxen (Naprosyn®) (n = 33) or REA (n = 34)...
2017: PloS One
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