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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Guidelines for perimenopausal hormone therapy are listed in outline form. Various symptoms of metabolic changes, of changes in the balance of the neurovegetative system, and of nervous system influences related to social and cultural factors can be treated with substitutive hormone treatment during menopause. Special considerations apply to women who have undergone ovariectomy. Cyclical estrogen treatment should be used, and gestagens should be given in addition to estrogens. In prescribing hormone therapy, all absolute and relative contraindications should be considered. Obese women should be on a strict diet during therapy, and smoking should be stopped. In the case of irregular bleeding, curettage should be performed to exclude the possibility of malignant cancer. The patient should have regular checkups to determine if possible side effects are of a serious nature. Types of medications and treatment regimens for menopausal women, for treating women who have or have not undergone ovariectomy, and for treating menopausal disorders are listed.
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PMID:[The treatment of women with climacteric symptoms with emphasis on perimenopausal hormone therapy]. 22 71

Endometrial adenocarcinoma is commonly seen in the perimenopausal and postmenopausal age groups. Certain medical conditions (such as diabetes, hypertension, and obesity) are often associated with development of this disease. Consequently, when irregular bleeding develops, a decision to sample the endometrium is often predicated on the patient's age and the presence of these associated conditions. Often, healthy young women receive empirical hormonal therapy for irregular bleeding without prior endometrial sampling. An unusual case of endometrial adenocarcinoma arising during lactation in a young healthy woman is presented.
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PMID:Occurrence of endometrial adenocarcinoma during lactation. 687 19

Concerns about abnormal menstrual bleeding are a common reason for women to consult a primary care physician. The first step in the evaluation is to determine the patient's ovulatory status. Women with heavy bleeding but normal ovulatory cycles should be evaluated for coagulopathies, structural lesions, and hypothyroidism. In the absence of a systemic or structural cause, menorrhagia can be treated with OCPs or NSAIDs. Intermenstrual bleeding in OCP users may be due to noncompliance or the use of low-dose pills. Encouraging patient compliance and adjustment of the estrogen dose can often solve the problem. If the patient is not on OCPs, intermenstrual bleeding is usually due to a structural or inflammatory lesion. The differential diagnosis for anovulatory bleeding is extensive. Pregnancy, systemic illnesses, and structural lesions should be ruled out by history, physical examination, and laboratory evaluation. Endometrial biopsy is indicated in patients over age 35 and younger patients with risk factors for endometrial cancer, such as chronic anovulation and obesity. Dysfunctional uterine bleeding is a nonspecific term for abnormal uterine bleeding in the absence of systemic or structural disease. It is usually associated with anovulation. Adolescents frequently have dysfunctional uterine bleeding owing to immaturity of the hypothalamic-pituitary-ovarian axis. Perimenopausal women have an increased incidence of irregular bleeding secondary to decreased estrogen production by the ovary. Obesity, polycystic ovary syndrome, stress, crash diets, and vigorous exercise can all disrupt normal ovulatory function. Treatment options for dysfunctional uterine bleeding include oral contraceptives, cyclic progesterone, or hormone replacement with estrogen and progesterone. Patients with structural lesions or those who do not resume normal withdrawal bleeding patterns on hormone therapy should be referred to a gynecologist for further evaluation and treatment.
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PMID:Abnormal uterine bleeding. 787 94

This study included 125 women with specific complaints following tubal ligation. In most instances the ligations had been done 7 years previously, mostly for multiparity. 92% had been ligated by the abdominal route 88.8% had symptoms including menstrual irregularities, chronic pain, obesity, psychoses, intermittent acute retention of urine, ventral hernia, and 2 cases of sterilization failure. Average age at time of tubectomy had been 31 years; average parity, 3-4. There was a shift towards right in mean maturation index of cervical cells soon after sterilization. This shift then decreased for a year, then gradually rose, stabilizing at 12 years. Amenorrhea was present in 5 cases with high mean maturation levels. 17 cases of oligomenorrhea all showed ahigh estrogenic activtiy. Of 27 cases of menorrhagia endometrial biopsies were taken in 13. 12 showed the proliferative phase and 1 the secretory phase. These findings correlated with cytological findings, but cervical mucus in 3 cases did not coincide. Of the 27 cases 21 were anovular. In all the karyopyknotic index was high. 2 cases showed clinical evidence of inflammation. Of 10 cases of dysmenorrhea, 3 were ovulatory; inflammation was present in 3. In 12 cases of polymenorrhea 7 showed high estrogenic activities. In 1 a polyp had caused the irregular bleeding. The observed shifts of maturation index of cervical cells toward the right are considered indicative of hyperovarian activity. Results show that ovarian activity after sterilization by tubectomy was normal or increased. The increased activity was considered either psychological,neurovascular, or caused by inflammation. Of the 10 cases with inflammation, 9 were associated with menstrual disorders.
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PMID:Menstrual disorders after sterilization with special reference to ovarian activity. 1225 47

Women with polycystic ovarian syndrome have chronic anovulation and androgen excess not attributable to another cause. This condition occurs in approximately 4% of women. The fundamental pathophysiologic defect is unknown, but important characteristics include insulin resistance, hyperandrogenism, and altered gonadotropin dynamics. Inadequate follicle-stimulating hormone is hypothesized to be a proximate cause of anovulation. Obesity frequently complicates polycystic ovarian syndrome but is not a defining characteristic. The diagnostic approach should be based largely on history and physical examination, thus avoiding numerous laboratory tests that don't contribute to clinical management. Women with polycystic ovarian syndrome typically present because of irregular bleeding, hirsutism, and/or infertility. These conditions can be treated directly with oral contraceptives, oral contraceptives plus spironolactone, and ovulation induction, respectively. However, women with polycystic ovarian syndrome also have a substantially higher prevalence of diabetes and increased risk factors for cardiovascular disease. They should also be screened, therefore, for these conditions and followed closely if any risk factors are uncovered. For obese women with polycystic ovarian syndrome, behavioral weight management is a central component of the overall treatment strategy.
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PMID:Polycystic ovary syndrome. 1470 63

The polycystic ovary syndrome (PCOS), then called the Stein-Leventhal syndrome, was first described in 1935. Originally, diagnosis required pathognomonic ovarian findings and the clinical triad of hirsutism, amenorrhea, and obesity. During fertility years, women with PCOS are often seen for immediate concerns such as infertility, menstrual irregularity, and symptoms of androgen excess. During the past two decades, however, such patients have been observed to have increased risk of cardiovascular disease, dyslipidaemia, hypertension and diabetes and increased risk for endometrial cancer. The management of polycystic ovary syndrome is now complex and includes life style modifications, dietary-induced weight loss, oral contraceptives, clomiphene citrate, gonadotropins, antiandrogens and insulin-sensitising agents. These observations have led to a unique clinical perspective about PCOS--one that recognizes the need to address the immediate issues of irregular bleeding, hirsutism, and infertility, but also emphasizes the long-term goals of preventing diabetes, heart disease, and cancer.
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PMID:[Long-term health consequences of polycystic ovaries syndrome: metabolic, cardiovascular and oncological aspects]. 1808 38