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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endometriosis is one of the most common benign gynecological diseases, affecting an estimated 10-15% of all premenopausal women. In this open multicentric prospective study, we investigated the effectiveness and tolerance of a gonadotropin releasing hormone agonist (goserelin) for the treatment of symptomatic endometriosis. One hundred and thirteen patients were included in the study. During the treatment, we documented a relevant reduction in the rAFS score and in the additive diameter of the implants. In addition, we noted a reduction in pelvic pain and an improvement of symptoms on pelvic examination. These effects were also reported during the follow up visits (24 weeks). Only 12 patients had intolerable side effects (hot flushes, sweating during the night, vaginal dryness, depression), which could be managed with transdermal 17 beta estradiol, without reducing therapeutic effectiveness. In conclusion, gonadotropin releasing hormone analogs proved to be an excellent treatment for symptomatic endometriosis and are generally well tolerated.
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PMID:[Effectiveness and tolerance of a gonadotropin releasing hormone (goserelin) in treatment of symptomatic endometriosis]. 1035 39

Objective: We performed a pilot study to determine if patients with chronic pelvic pain have a consistent or unique sleep disorder by a polysomnographic sleep study.Methods: Overnight polysomnography was performed prospectively in 11 women with chronic pelvic pain (ages 33-44 years, mean 35). None of the women were taking sedating or psychoactive medications in the month prior to testing. Sleep indices were derived using polysomnography scoring guidelines currently recommended by the American Sleep Disorder Association.Results: Statistical comparisons with age-matched normative data (Williams and Karacan, 1974) revealed increased stage 1 sleep (P < 10(-7)), reduced REM sleep (P < 10(-6)), increased slow wave sleep (P <.001), and REM sleep onset latencies (P <.01) in women with chronic pelvic pain. One woman had periodic leg movements, but none had obstructive sleep apnea.Conclusion: Previously, sleep disorders in patients with chronic pelvic pain (CPP) have been characterized by history alone. We have characterized sleep disturbances in individuals with CPP by polysomnographic sleep studies. Patients with CPP have different sleep patterns than patients with depression. Our preliminary findings and review of the literature conclude that patients with CPP have a unique sleep disorder. We are currently studying the effects of low doses of amitriptyline in altering sleep patterns to determine if there is a clinical response.
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PMID:Polysomnographic characteristics of sleep disorders in chronic pelvic pain. 1083 70

Following identification of the proportion of pelvic congestion among symptomatic patients complaining of chronic pelvic pain, and in a totally asymptomatic group of patients requesting tubal ligation, the efficiency of goserelin acetate versus medroxyprogesterone acetate was compared objectively using pelvic venogram scores, and subjectively by symptom resolution, improvement of psychological status and sexual functioning in a prospective randomized trial in 47 patients with pure pelvic congestion syndrome. Patients received either goserelin acetate (3.6 mg/month for 6 months) or medroxyprogesterone acetate (MPA; 30 mg/day for 6 months). Among patients with chronic pelvic pain, those with pure pelvic congestion were mostly parous, had the most severe pelvic signs and symptom scores, lowest rates of sexual functioning, and higher states of anxiety and depression as compared with others. At 1 year after treatment, goserelin remained superior to MPA in terms of pelvic venographic improvement as an objective measure. In alleviation of signs and symptomatology, improvement of sexual functioning and reduction of anxiety and depressive states as subjective measures, goserelin acetate achieved a statistically significant advantage (P = 0.0001) compared with MPA.
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PMID:A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion. 1192 19

Violence against women has recently drawn attention in the medical community as a leading cause of preventable morbidity and mortality. Specific algorithms designed to identify women at risk can be applied to create an opportunity for screening, diagnosis and treatment during medical care initiated for common conditions. This study investigated the incidence and history of battering among women seeking general medical care, and looked for potential risk factors and associations with presenting symptoms. We used a self-administered, anonymous survey to question 1780 adult female outpatients visiting a tertiary care internal medicine teaching hospital in Mexico City. We calculated current abuse (physical and/or sexual abuse by a partner within the past year), abuse during pregnancy, childhood abuse, and lifetime abuse. We found levels of violence against women in Mexico comparable to those reported from other countries. 152 women (9%) reported current physical and/or sexual abuse. An identical number also reported abuse during pregnancy. Lifetime prevalence was 41%. Women currently or previously abused reported more physical symptoms in the last six months than did non-abused participants. Pelvic pain, depression, headache and substance abuse were frequent among abused women. Currently abused women also scored higher (p<0.01) on indicators of depression. Current abuse correlated strongly with a childhood history of physical and/or sexual abuse, with low educational level of the victim, with substance abuse by the partner or by the woman herself, and with higher parity.
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PMID:Prevalence of battering among 1780 outpatients at an internal medicine institution in Mexico. 1229 45

Preliminary results of side effects are reported by 66 physicians of the M.F.P.F. (Mouvement Francais de Planning Familial) on 2026 women taking Stediril, 610 taking Aconcept, and 824 taking Ov 28 for at least 6 months (less for dropouts) since 1969. There were no pregnancies or severe complications except 1 case of jaundice and 2 of thrombosed hemorrhoids. Blood pressure was unchanged in 60-70% of cases, and the graph of these changes, except for a slight increase at "up to 10 mm Hg," was a symmetrical bell curve. Stediril and Ov 28 had identical effects on blood pressure, but the curve for Aconcept was flatter. Weight gain of 1 kg or more was reported in 37% of Stediril users and 42% of Ov 28 users (p less than .05). Other side effects showing significant differences between products were: nausea greater with Ov 28, depression greater with Aconcept, metrorragia greater with Stediril, pelvic pain less with Stediril, headaches less with Ov 28, amenorrhea less with Stediril. This absence of serious side effects was considered the most significant French statisitc published to date on oral contraceptives.
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PMID:[Statistical study of side effects in 3460 women taking combined estrogen-progestagens: preliminary results]. 1230 13

This essay on the effects of modern effective contraception on psychological and sexual behavior concentrates on the characteristis of French society. Contraception is obviously a weapon against multiple illegal abortons, and a means for professional, social and sexual liberation of women. For physicians it provides a medium of interacting for the first time with the sexual life of patients, sometimes resulting in spectacular cures of psychosomatic disorders such as pelvic pain, menometrorrhagia, depression and anxiety. The opportunity for more frequent sexual relations, free of fear of pregnancy, may permit the release of orgasm and an experience of new sensation, authenticity and confidence for the woman. But contraception may also reveal or aggravate sexual dysfunction and participate in the deterioration of sexual adjustment. The physician must be aware of patients' prior psychosexual situation in order not to make contraception a scapegoat for so-called pill or IUD side effects. This requires sound medical training and a good doctor-patient relationship. For many young women maternity is the sign of womanhood, and for mature women and their partners, fertility is the essence of feminine attraction. This unconscious belief is often the basis for forgetting pills, frigidity, impotence and masochistic pregnancy. Children are unconsciously the bridge toward immortality.
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PMID:[Influence of contraception on psychology and sexual life]. 1230 76

Chronic pelvic pain is difficult to diagnose and to treat [81] because of the multiple and often overlapping causes [82]. A systematic approach aids in the thorough evaluation and appropriate therapy. At the initial visit(s), a thorough history should be taken and complete physical examination performed. Screening for co-existing conditions, such as depression, narcotic dependency, and physical, sexual, or emotional abuse is crucial so these issues may be addressed immediately while additional causes for pelvic pain are evaluated. The relative likelihood of gastrointestinal, urologic, musculoskeletal, or gynecologic etiology must be considered to guide a more thorough initial evaluation. With gynecologic chronic pelvic pain, differentiation between hormonally responsive and nonresponsive conditions is helpful for diagnosis and treatment. Therapy can then be instituted or an appropriate referral made.
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PMID:Diagnosis and management of chronic pelvic pain. 1247 27

Epidemiologic data have demonstrated the significance of chronic prostatitis/chronic pelvic pain syndrome (CP/CPSS) for the urological practice. Apart from the rare cases of bacterial prostatitis numerous somatic models have failed to completely explain pathogenetic interrelations; therapeutic attempts frequently have produced unsatisfactory results. Additionally, psychosomatic factors have often been neglected. A number of personality variables have turned out to play an important role in questionnaire-based studies, namely somatization and depression, as well as anxiety, hypochondriasis, and weak masculine identity. However, these preliminary results need further evaluation. In the future, diagnostic and therapeutic strategies should pay attention to the complex interweavement of somatic and psychogenic factors in the pathogenesis of CP/CPSS.
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PMID:[Psychosomatic aspects of the chronic pelvic pain syndrome]. 1504 82

Criminal statistics say that 300,000 children are sexually abused in the Federal Republic of Germany every year: 70-75% are abused by their own fathers or another psychological parent. Most victims are girls aged 7-12 years. Sexual abuse during childhood can lead to severe psychosomatic dysfunctions both in children and adults. Possible long-term results are depression, anxiety, emotional and cognitive problems, personal dysfunction, eating and sleeping disorders, alcohol or drug abuse, relationship problems, social maladaptation, and somatizations. Many urological dysfunctions without organic findings can be caused by sexual abuse. Among others, chronic pelvic pain (CPPS), enuresis, incontinence, and sexual dysfunction can occur. When children or adults see the urologist because of their symptoms there is always the danger of reproducing the abusive event by invasive diagnostic methods.Sometimes harming themselves the patients bring this situation about unconsciously. With the following article we want to heighten the awareness among urologists.
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PMID:[Urological dysfunction after sexual abuse and violence]. 1504 85

A young woman presented with multiple central hypersensitivity disorders, including fibromyalgia, headache, pelvic pain and several smooth muscle spasm disorders, including irritable bowel syndrome, irritable bladder and Raynaud's phenomenon. She also had significant fatigue and sleep problems. Her case illustrates the importance and surprising frequency of atypical bipolar mood disorders in people with multiple central hypersensitivity pain disorders, especially with depression and anxiety resistant to antidepressant treatment. Considering neurological mechanisms common to her overlapping disorders was very helpful in guiding treatment choices. This experience illustrates the value of serotonin receptor type 2 (5HT2) inhibition with atypical neuroleptics, of neural cation channel and glutamate inhibition with anticonvulsants, and the potential usefulness of antidepressants after establishing 5HT2 control to enhance downward inhibitory tracts. Medications with combined usefulness for both bipolar mood and pain disorders were highly effective for her multiple hypersensitivity problems.
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PMID:Serotonin mechanisms in pain and functional syndromes: management implications in comorbid fibromyalgia, headache, and irritable bowl syndrome - case study and discussion. 1576 Aug 6


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