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

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

The aim of this chapter is to familiarize the radiologists with the evolutive morphological features of the female genital apparatus, as it can be seen during the puberty, and to view the pathologies panel which may occur in ths period of life. This chapter is going to illustrate the morphological sonographic modifications from the childhood to the adolescence, emphasing the signs of pubertal maturation (uterus and ovaries shape, size and vascularization). Through clinical signs (delayed sexual maturation, primary or secondary amenorrhea, menstrual dysfunction, acute, cyclic, chronic pelvic pain and pelvic mass) the different pathologies are viewed, illustrating the important role of ultrasonography, but not an exclusive role.
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PMID:[Imaging of the female pelvis in adolescence]. 1191 46

Ultrasound of the adolescent female pelvis is the imaging method of choice for most medical problems presenting with symptoms and signs referable to this area. Recognizing the transition from child to mature female and its manifestations are crucial in directing the workup and interpreting the sonographic findings. A description of the normal anatomy and physiology of the pelvic organs is followed by a discussion of the clinical and imaging findings in primary and secondary amenorrhea, pelvic pain, and pelvic masses.
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PMID:Ultrasonography of the adolescent female pelvis. 1297 98

Menstrual patterns differ even in nongenital tuberculosis. Our objective is to determine whether nongenital tuberculosis makes menstrual dysfunction, before and sustain after treatment. Menstrual patterns were compared in women with pulmonary or extrapulmonary but nongenital tuberculosis with healthy nursing students and also with themselves, before and after treatment in a retrospective cohort study. Subjects were selected by convenient nonrandomized sampling but control groups were selected by random allocation among volunteers of nursing students. Case and control subjects were matched in age group. Menstrual patterns including amount, duration, interval, cessation of period, any menstrual irregularity, and pelvic pain were evaluated. Among 100 cases of proven tuberculosis, 90 patients had pulmonary and 10 cases had extrapulmonary tuberculosis. Secondary amenorrhea (P < or = .001, RR: 22), spotting during menstrual period (P < or = .0001, RR: 4.5), decreasing in amount (P < or = .001, RR: 7.8), shorter duration of menstrual period (P < or = .001, RR: 12), and pelvic pain (P < or = .001, RR: 8.6) were more prevalent and significantly different in the cases compared to control subjects (with CI:95% and P < .001), but excessive or prolong vaginal bleeding was not observed. Menstrual disorders occur even in nongenital tuberculosis, but it is manifested with cessation or decrease in menstrual bleeding flow and period.
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PMID:Menstrual disorders in nongenital tuberculosis. 1709 48

Amenorrhea in adolescents can be primary, with or without breast development, or secondary. Whether amenorrhea is primary or secondary, height, body mass index, food intake, the level of physical activity per week, the presence of hirsutism or galactorrhea, pelvic pain and past history of intercourse need to be investigated. Initially, blood tests should include hCG, FSH, estradiol, testosterone and prolactin serum levels. This screening will discriminate between hypogonadotropic hypogonadism and amenorrhea from primary ovarian insufficiency (POI). In case of primary amenorrhea, hypogonadism may be due to congenital hypogonadotropic hypogonadism (HH) or more rarely acquired HH. If FSH is elevated, amenorrhea is due to primary ovarian failure, mainly related to Turner syndrome. If pubertal development is normal, a pelvic ultrasound should be performed. It may visualize a hindering of menses output or less frequently an absence of uterus, as in Rokitansky syndrome or androgen insentivity syndrome. The most frequent etiologies of secondary amenorrhea are polycystic ovarian syndrome (PCOS), functional hypothalamic amenorrhea and less frequently POI and hyperprolactinemia. The differential diagnoses of PCOS are late-onset 21-hydroxylase deficiency and very rare ovarian or adrenal tumors. When contraception is not necessary, hormonal replacement therapy, including estrogen and progestins should be administered in order to avoid hypoestrogenism. In case of PCOS, sequential progestins can be prescribed. A contraceptive pill can be considered when contraception is needed and/or when hyperandrogenism needs to be treated.
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PMID:[Diagnosis and management of amenorrhea in adolescent girls]. 2372 74

This report presents an exceptional case of uterine avulsion following a cold-knife conization, an unprecedented surgical complication of a common gynecological procedure. Furthermore, it describes the outcomes of the conservative laparoscopic reconstruction that was performed. A 30-year-old nulliparous was referred to our department with secondary amenorrhea and cyclic pelvic pain following a cold-knife conization performed 9 months previous in another institution. The patient underwent a diagnostic laparoscopy, which confirmed that the cervix had been completely resected and that the uterine and vaginal cavities were no longer in contact. We performed an end-to-end utero-vaginal anastomosis followed by a prophylactic cerclage. No intraoperative or postoperative complications were observed. One month after surgery the patient was asymptomatic with normal withdrawal bleeding and remained asymptomatic during her 12-month follow-up consult. To our knowledge, this is the first time that this serious complication with a potential for irreversible damage to reproductive function is reported as a complication of cervical conization. Although our conservative surgical correction repaired the anatomy and reestablished menstruation outflow, further follow-up is necessary to confirm the extent to which reproductive function was restored.
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PMID:Laparoscopic re-anastomosis of a uterine avulsion following cold-knife conization. 2453 81

Vaginal stenosis or gynatresia is a congenital disease and it is part of Mayer-Rokitansky-Kustner-Hauser syndrome. Acquired vaginal stenosis is a rare complication of vaginal delivery and may be caused by an infection, charlatans, birth injury or postpartum hypoestrogeny. We report a case of postpartum complete vaginal stenosis secondary to vaginal injuries as a result of medical negligence. The study involved a 19 year old patient, who had had dead child born vaginally at home, presenting with a two-year history of secondary amenorrhea associated with chronic pelvic pain. The patient reported the occurrence of multiple not sutured vaginal tears. Pelvic MRI showed complete extended vaginal stenosis of about 25mm with upstream haematological retention and bilateral hematosalpinx. The patient underwent release of vaginal adhesions followed by regular vaginal dilation. Only two cases have been reported in the literature. Pain and dyspareunia were the most common symptoms. All cases were treated by a release of the synechias and vaginal dilation.
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PMID:[Acquired vaginal stenosis: about a case and literature review]. 3215 15