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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

17 beta-Hydroxysteroid oxidoreductase (17-OHSD) activity in the endometrium of women with pelvic pain syndrome (PPS) and/or polycystic ovaries (PCO) was compared with that of a control group. In both groups there was a 10-fold increase in 17-OHSD activity in secretory phase tissue compared with that of the proliferative phase, measured by both oxidative and reduction pathways, and a highly significant correlation between the two directions (P less than 0.001). In normal subjects, the ratio of activity measured under oxidative conditions: reducing conditions, at all stages of the cycle except late proliferative phase, was 2.1-2.9. In the late proliferative phase the ratio was 5.5 which was significantly different from other stages of the cycle. Similar ratios were found for the PPS/PCO group (proliferative phase 2.5, secretory phase 5.6); these were also significantly different (P less than 0.01). On the basis of this study oestrogen metabolism in the endometrium of women with PPS and/or PCO appears to be no different from that of normal subjects. Measurement of enzyme activity in high speed soluble and particulate fractions of endometrial homogenate indicated the presence of two activities with different cofactor requirements. Gel filtration chromatography of the soluble fraction revealed a single peak of activity coincident with a molecular weight of 30 kDa with a strong preference for NAD + as cofactor. These preliminary findings suggest the presence of both soluble and particulate forms of 17-OHSD activity in the endometrium.
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PMID:17 beta-Hydroxysteroid oxidoreductase activity in the endometrium of normal women and patients with pelvic pain and polycystic ovaries. 262 48

Chronic pelvic pain in association with dilated pelvic veins and polycystic ovaries is a common complaint in women in the reproductive years, regardless of whether or not they have been pregnant. These women have a higher incidence of deaths and illnesses amongst family members and close relatives which makes them pay more attention to physical complaints such as pain which may make them more susceptible to environmental "stress" of daily life. A hypothesis is put forward which would link the effects of stress to the somatic changes observed in women with what is here described as the pelvic pain syndrome.
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PMID:Psychological and somatic factors in women with pain due to pelvic congestion. 306 64

From the 1st demonstration in 1937 that progesterone is an effective inhibitor of copulation-induced ovulation to the 1st combination oral contraceptive (OC), Enovid, the risks and hazards of OCs gradually presented and formulations have been changed, mostly reducing the estrogen content, in hopes of minimizing adverse effects. OCs remain the most effective contraceptive although there are many women who do not tolerate them, do not want IUDs, and prefer some method other than mechanical barriers. The author reports on an experiment with 490 women receiving pellets of oral conjugated estrogens in a monthly step-down fashion, reducing the number of pellets every 6 months, from 4 to 3 to 2 to 1 and after that 1 pellet every 6 months. Of these women 4 pregnancies occurred in 1540 women-years with minimal side effects. Another method, the postponement of menses after ovulation has already occurred, has been accomplished with 20-30 mg norethindrone administered daily beginning as late as day 24 of the cycle. The induction of ovulation with an antiestrogen (MER 25) was 1st reported in 1960; this was believed to have great potential as a contraceptive agent, but tests did not confirm this. It was found in 1961 that clomiphene citrate had a luteotropic effect. It has since been used successfully in cases of secondary amenorrhea, dysfunctional uterine bleeding, polycystic ovarian disease, and others. The incidence of successfully induced ovulation varies from 58-90%. Studies have also revealed markedly elevated levels of androgens and particularly testosterone in women with polycystic ovaries in comparison with normal controls. It appears that an inherent capacity for androgen production by the adrenal gland upsets hypothalamic-pituitary ovarian relations, stimulating the growth of follicles, luteinizing the theca and often certain cellular elements in the stroma. Another drug, danazol, is a new synthetic derivative of the 1st orally effective progestogen, ethisterone, and has proven to have an antiendometrial or endometrial-suppressing activity. It has proven effective in relieving the common symptoms of dysmenorrhea, pelvic pain, dyspareunia, mazoplasia, and mastodynia. It is currently used to reduce breast lumpiness.
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PMID:Dwarfs, standing on the shoulders of giants, see further. 716 94

In this study we present 41 cases of endoscopy surgery in gynecology done in Saint Charles Hospital for: extra-uterine pregnancies (GEU), pelvic abscess, pelvic endometriosis, ovarian cysts (KO), polycystic ovaries (PKO), primary amenorrhea, postoperative pelvic adhesions, uterine fibroma and appendicitis. These patients consulted for infertility, irregular menses and pelvic pain. The procedures done were the following: salpingectomy, endo-tubal aspiration, pelvic abscess drainage and IUD removal, endometrial implants coagulations, excision of ovarian cysts, multiple ovarian punctures (MPO), wedge resection of ovaries, ovarian biopsies, adhesiolysis, myomectomies, hysterectomies and appendectomies. The final results and smooth post-operative course are in favour of the technical and therapeutic advantages of the endoscopic surgery in gynecology as a conservative, functional and preventive procedure.
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PMID:[Gynecologic endoscopic surgery at Saint-Charles Hospital. Review of the literature]. 762 32

Five hundred and nine Laparoscopic examinations performed between 1987-91, (147 procedures for evaluation of gynaecologic pelvic pain and 313 for infertility) revealed ectopic pregnancy (27%), twisted ovarian cyst (18%) and acute pelvic inflammatory disease (14%) in cases of acute gynaecologic pain, and endometriosis (17%) and chronic pelvic inflammatory disease (16%) in chronic pelvic pain. Adhesions (20%), tubal block (15%), endometriosis (9%) and polycystic ovary (7%) were common findings in cases of infertility. These data support the usefulness of this minimally invasive procedure in accurate diagnosis of gynaecological disorders and provides insight into the spectra of diseases seen in Pakistani women with pelvic pain and infertility.
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PMID:Laparoscopic appraisal of infertility and pelvic pain in Pakistani women: a 5 years audit. 804 Sep 92

A sizeable literature corroborates the multiple health benefits of oral contraceptive use. The first estrogen/progestin combination pills were marketed to treat a variety of menstrual disorders. Although currently used oral contraceptives no longer carry FDA-approved labeling for these indications, they remain important therapeutic options for a variety of gynecologic conditions. Well-established gynecologic benefits include a reduction in dysmenorrhea and menorrhagia, iron-deficiency anemia, ectopic pregnancy, and PID. Although older, higher-dose pills reduced the incidence of ovarian cysts, low-dose pills suppress follicular activity less consistently. Nevertheless, cycle-related symptoms, including functional cysts, dysmenorrhea, chronic pelvic pain, and ovulation pain (mittelschmerz), generally improve. Women with polycystic ovary syndrome note improvement in bleeding patterns and a reduction in acne and hirsutism. Symptoms from endometriosis also improve with oral contraceptive therapy. Current data suggest that oral contraceptive therapy increases bone density and that past use decreases fracture risk. Oral contraceptives also improve acne, a major health concern of young women. Oral contraceptives provide lasting reduction in the risk of two serious gynecologic malignancies--ovarian and endometrial cancer. The data with respect to ovarian cancer are compelling enough to recommend the use of oral contraceptives to women at high risk by virtue of family history, positive carrier status of the BRCA mutations, or nulliparity, even if contraception is not required. Health care providers must counsel women regarding these benefits to counteract deeply held public attitudes and misconceptions regarding oral contraceptive use. Messages should focus on topics of interest to particular groups of women. The fact that oral contraceptives increase bone mineral density and reduce ovarian cancer is of great interest to women in their forties and helps influence use and compliance in this group. In contrast, the beneficial effects of oral contraceptives on acne resonates with younger women. Getting the good news out about the benefits of oral contraceptives will enable more women to take advantage of their positive health effects.
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PMID:Health benefits of oral contraceptives. 1109 85

This report addresses the balance of benefits and risks from changes in ovarian and endometrial function from hormonal contraception. The main mode of action of hormonal contraception is inhibition of ovulation, due chiefly to the dose of oestrogen in combined oral contraceptives. With 20 microg dosages of ethinyl oestradiol follicular activity is more common so that contraception depends on suppression of the LH surge or disruption of the endometrial cycle. In polycystic ovary syndrome (PCOS) treated with oral contraceptives, cysts become smaller and in time the ovarian volume is reduced, ovarian testosterone secretion is reduced and there are potentially favourable effects on carbohydrate and lipid metabolism. Typical oral contraceptive users in the 1980s had a lower incidence of ovarian cysts, but modern oral contraceptives do not appear to affect the incidence of functional cysts or benign epithelial cysts. Moreover, randomized controlled trials indicate that oral contraception prescriptions are unlikely to prevent the development of functional cysts or to hasten their disappearance. Oral contraceptives, however, greatly reduce pelvic pain in women with symptomatic endometriosis and improve the health-related quality of life. Bleeding is a common response with all types of hormonal contraception, but current methodology is inadequate to make accurate comparisons of different products or of different phasic formulations. With continuing use, however, combined oral contraception is associated with endometrial atrophy, the biological plausibility for a reduced risk of endometrial carcinoma. With progestin-only contraception, a number of endometrial changes are considered as possible mechanisms of the associated bleeding but it remains largely unexplained. Oral contraceptives are frequently used for treatment of dysfunctional uterine bleeding, although only one trial has been reported. Oral contraceptive use confers protection from endometrial [relative risk (RR) 0.5] and ovarian (RR 0.4) cancers and in both cases, the protection lasts for up to 2 decades after stopping use.
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PMID:Ovarian and endometrial function during hormonal contraception. 1142 42

Endometriosis, menorrhagia, chronic pelvic pain, and polycystic ovary syndrome are major sources of psychologic morbidity and can negatively affect quality of life. Although comparative studies have been published on the measurement of health-related quality of life for gynecologic malignancies, a similar review for these benign gynecologic conditions has not been conducted. Consequently, we searched the literature systematically to identify the impact of symptoms and treatments for these conditions on health status and to report on the types and psychometric properties of the instruments used. Papers were retrieved by systematically searching 6 electronic databases and hand-searching relevant reference lists and bibliographies. Forty-six studies used a questionnaire to measure health status: 34 studies (74%) used standardized instruments; of these, 23 studies (68%) used generic tools. Although a meta analysis was not possible, it appears that women with chronic pelvic pain and conditions that are associated with pelvic pain (such as endometriosis) report worse health-related quality of life. Despite the development of disease-specific questionnaires, only 2 questionnaires were generated from interviews of patients with the condition of interest, and few questionnaires are being used to evaluate the outcomes of treatment on subjective health status.
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PMID:Health-related quality of life measurement in women with common benign gynecologic conditions: a systematic review. 1219 50

Chronic pelvic pain is a common condition. The sources of pelvic pain are multifactorial, and their causes are difficult to determine. Pelvic congestion syndrome (PCS) is associated with varicose ovarian veins and/or varicose veins in the pelvis. The syndrome is associated with constant dull pelvic pain, abnormal menstrual bleeding, tenderness to touch in lower abdomen, pain during intercourse, painful menstrual periods, vaginal discharge, PCOS. The specific diagnosis of Pelvic Congestion Syndrome is made using several tests which include ultrasound, CAT, MIR, MDCT (multidetector) and venogram. The ultrasound is the first test of choice. It can assess the uterus and other organs in the pelvis. Doppler ultrasound can also help visualize the blood flow and asses the presence of varicosities in the pelvis.
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PMID:[Current echography diagnosis of pelvic congestion syndrome]. 2323 72

Radiological examinations are required for the assessment of complex or indeterminate ovarian masses, mainly using MRI and CT-scan. MRI provides better tissue characterization than Doppler ultrasound or CT-scan (LE2). Pelvic MRI is recommended in case of an indeterminate or complex ovarian ultrasonographic mass (grade B). The protocol of a pelvic MRI should include morphological T1 and T2 sequences (grade B). In case of solid portion, perfusion and diffusion sequences are recommended (grade C). In case of doubt about the diagnosis of ovarian origin, pelvic MRI is preferred over the CT-scan (grade C). MRI is the technique of choice for the difference between functional and organic ovarian lesion diagnosis (grade C). It can be useful in case of clinical diagnostic uncertainty between polycystic ovary syndrome and ovarian hyperstimulation and multilocular ovarian tumor syndrome (grade C). No MRI classification for ovarian masses is currently validated. The establishment of a presumption of risk of malignancy is required in a MRI report of adnexal mass with if possible a guidance on the histological diagnosis. In the absence of clinical or sonographic diagnosis, pelvic CT-scan is recommended in the context of acute painful pelvic mass in non-pregnant patients (grade C). It specifies the anomalies and allows the differential diagnosis with digestive and urinary diseases (LE4). Given the lack of data in the literature, the precautionary principle must be applied to the realization of a pelvic MRI in a pregnant patient. A risk-benefit balance should be evaluated case by case by the clinician and the radiologist and information should be given to the patient. In an emergency situation during pregnancy, pelvic MRI is an alternative to CT-scan for the exploration of acute pelvic pain in case of uncertain sonographic diagnosis (grade C).
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PMID:[MRI and CT-scan in presumed benign ovarian tumors]. 2421 Feb 36


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