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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Irregular menstrual cycles are common in young adolescent females. Some young women suffer from hyperandrogenemia, which results in acne, increased body hair, and increased body weight. If left untreated, severe hirsutism and polycystic ovary might ensue. This paper reviews literature on the usefulness of oral contraceptives (OCs) in treating hyperandrogenemic adolescent women. In these adolescent women, serum luteinizing hormone (LH) and testosterone (T) levels are significantly higher than in sexually mature women. In adolescent women with a menstrual cycle lasting more than 37 days, the serum concentration of pituitary gonadotropins and sex hormones was significantly higher than in adolescent women with normal-length (26-32 days) cycles. Multi-microcystic ovaries have been found in 35% of adolescent women with normal cycles, in 57.9% of women with irregular menstruation, and in 84.6% of women with amenorrhea. These polycystic ovaries were thought to be at increased risk of developing infertility and endometrial cancer. Treatment with low-dose OCs containing progestin had fewer androgenic side effects and proved useful. Low-dose estrogen-based OCs were also effective but had greater androgenic reactivity. In conclusion, low-dose OCs are suitable for treating a variety of adolescent menstrual irregularities.
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PMID:Clinical usefulness of low-dose oral contraceptives for the treatment of adolescent hyperandrogenemia. 781 Nov 85

The aim of our study was to verify the efficacy of transvaginal ultrasound scanning as an indicator of the endometrial status in healthy menopausal women. One hundred eighty five healthy women in natural menopause were examined by vaginal sonography; the endometrial patterns were analyzed and the influence on it of body weight, menopausal age, and hormonal therapy was considered. The presence of irregular and the endometrial histology were related to the ultrasound findings. 38% of the women assumed estrogen plus progestin replacement treatment since one-two years, for menopausal complaints. 17% of all patients reported irregular bleeding during the last month. The majority of women (90%), regardless of the hormone assumption, presented en endometrial thickness less than 10 mm. 10% of untreated and treated women had an endometrial thickness between 10 and 20 mm. Among the subjects with elevated menopausal age is more frequent the imaging of endometrial layer minor than 5 mm in comparison with women in early menopause. 4% of untreated and 10% of treated women without irregular bleeding had an endometrial thickness higher than 10 mm, while 67% of women with irregular bleeding presented an endometrial layer higher than 10 mm. In treated group all women with endometrial thickness greater than 10 mm had amenorrhoea. 86% of patients had endometrial atrophy detected by biopsy; hyperplastic endometrium or endometrial cancer was not demonstrated. In conclusion, vaginal sonography is a simple and reliable method in the study of the endometrial pattern in healthy menopausal women.
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PMID:[Echographic monitoring of the endometrium with a transvaginal probe in the menopause. A clinical study of 185 women in the menopause]. 783 11

Depot medroxyprogesterone acetate (DMPA) is the only injectable contraceptive available in the United States. After more than 20 years of regulatory review, the Food and Drug Administration approved DMPA for contraceptive use in 1992 after the publication of reassuring data about its possible association with breast cancer. It has been used by 30 million women in more than 90 countries. The recommended dosage, 150 mg intramuscularly every 3 months, has a contraceptive efficacy exceeding 99%. After a 150 mg dose, ovulation is inhibited for at least 14 weeks. Almost all users experience menstrual changes, typically episodes of unpredictable irregular spotting and bleeding, particularly during the first year of use. With continued use, spotting and bleeding decrease, and amenorrhea becomes common. Although ovulation suppression may rarely persist for as long as 18 months after the last injection, DMPA does not permanently affect fertility. Long-term DMPA use reduces menstrual blood loss, has been associated with a decreased incidence of candidal vulvovaginitis and pelvic inflammatory disease, and dramatically lowers the risk of endometrial cancer. Prolonged DMPA use may be associated with reversible reduction in bone density, probably related to suppression of endogenous production of estrogen. The most recently published data suggest that long-term use of DMPA induces moderate changes in lipid metabolism that are unfavorable in terms of risk of atherosclerosis. DMPA should be considered a highly effective, safe, convenient, and reversible contraceptive option for appropriately selected patients.
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PMID:Long-acting injectable contraception with depot medroxyprogesterone acetate. 817 4

Starting from the anatomopathological assumption that endometrial thickness in postmenopausal women never exceeds 3 mm, and in view of the reliability of measurements made using an echographic probe, the authors evaluated the value of transvaginosonography (TVS) as a mass screening method for postmenopausal endometrial pathologies. A group of 74 patients were examined who were recruited from those attending the out-patient menopause clinic. All subjects conformed to the following admission criteria: amenorrhea for the past two years; absence of oestroprogestin therapy for at least six months; absence of vaginal blood loss. A 5 MHz probe was used to measure maximum endometrial thickness on the longitudinal plane; values were divided by two if the surfaces were adjacent. Patients were monitored according to the following protocol: endometrial thickness under 1 mm control every 12 months; thickness between 1-3 mm--control every 3 months; thickness equal to or over 4 mm--hysteroscopy, targeted biopsy, possible scraping and TVS control after 3 months. The group was subdivided as follows: 65 patients (87.8%) were without risk; 3 patients (4%) belonged to the intermediate risk group; 6 patients (8.2%) belonged to the high risk group. Of the latter, 4 revealed an endometrial polyp, one presented uterine polymyomatosis and one a proliferative-type endometrium. The authors' experience is still limited but the absence of false positives encourages them to continue their research using this simple and well tolerated method. It might represent a valid alternative to hysteroscopy as a screening method in the asymptomatic population at risk for endometrial carcinoma.
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PMID:[Transvaginal sonography as a screening method for the identification of patients at risk of postmenopausal endometrial pathology]. 841 40

Since their introduction nearly 30 years ago, oral contraceptives have been widely researched regarding their contraceptive and noncontraceptive effects. With proper usage, oral contraceptives provide highly effective contraception. In addition, oral contraceptives confer significant noncontraceptive health benefits, including prevention of ovarian and endometrial cancer and reduction in the incidence of pelvic inflammatory disease, endometriosis, benign breast disease, and dysmenorrhea, among others. Today's low-dose oral contraceptives have an improved safety profile when contrasted with their early higher dose counterparts. Yet oral contraceptive use continues to be associated with a variety of minor side effects, which range from menstrual changes such as breakthrough bleeding, spotting, or amenorrhea, to androgenic effects, including weight gain and acne. These androgenic effects are important factors in patient discontinuation of oral contraceptives. Progestins with increased selectivity have the potential to cause fewer androgenic side effects while retaining appropriate progestin suppression of the endometrium and hypophyseal-pituitary-ovarian axis. A combination oral contraceptive (30 micrograms of ethinyl estradiol with 150 micrograms of desogestrel) has been evaluated extensively by European investigators. This literature suggests that a low-dose oral contraceptive formulated with the selective progestin desogestrel offers a favorable profile of reduced androgenic side effects while retaining the cycle control associated with low-dose oral contraceptives currently marketed in the United States.
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PMID:Combined oral contraception with desogestrel/ethinyl estradiol: tolerability profile. 844 56

The US Food and Drug Administration finally approved the injectable contraceptive Depo-Provera (DMPA) in October 1992, 25 years after its introduction. Women return to a health facility every 90 days for an intramuscular injection of 150 mg DMPA, which provides them 99% effective contraception. Menstrual changes and spotting are the leading reasons for DMPA discontinuation. Eventually, more than 50% of DMPA users develop amenorrhea. During the first year, women gain about 2 kg and weight increases as time passes. Weight gain is the second leading reason for DMPA discontinuation. DMPA may adversely affect glucose tolerance in women at risk for diabetes, but it does not affect cardiovascular or metabolic functions. It may increase the risk of osteoporosis. A rare side effect is convulsions. 1-10% of DMPA users have other central nervous system effects, such as headaches, dizziness, and depression. Itching and rashes may develop. Fertility returns within 1 year after discontinuation. DMPA is linked to low birth weight. It apparently does not harm breast-fed infants or hinder lactation. A World Health Organization study shows that DMPA users less than 35 years old experience a slight increase in breast cancer but a reduced incidence of endometrial cancer. Nurses are instrumental in guiding women as they choose DMPA and in informing them about its potential side effects, including breast cancer risk. They must screen women for pregnancy and evaluate their risk of breast cancer. They must determine whether women are able to return every 3 months for DMPA injections. Women who select DMPA must use other contraception, e.g., barrier protection, within the first 24 hours after initial injection. Nurses should counsel them about the likely menstrual changes to reduce the likelihood of dissatisfaction. They should recommend a daily dose of 1200 mg of elemental calcium and daily exercise of long bones to minimize the risk of developing osteoporosis.
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PMID:Depo-Provera. 849 47

In the period between 1985 and 1991, 83 postmenopausal women with endometrial cancer were examined by transvaginal sonography. None of them were on hormone replacement therapy and all had amenorrhea of more than 2 years. Twenty-two were asymptomatic and had an endometrial cancer detected by transvaginal sonography and 61 showed atypical bleeding as their only clinical symptom. Women with asymptomatic endometrial cancers detected by transvaginal sonography exhibited significantly less mean myometrial tumor infiltration and more well-differentiated tumors than those with atypical bleeding (4 mm and 45% compared with 10 mm and 18%, respectively). In 75% of the cases the estimation by transvaginal sonography of tumor stage completely agreed with the histological staging. These preliminary data show that asymptomatic endometrial cancers screened by transvaginal sonography are likely to have a better prognosis than symptomatic cancers. Furthermore, transvaginal sonography can be used as a reliable tool for tumor staging prior to surgery or radiotherapy.
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PMID:Prognostic value of transvaginal sonography in asymptomatic endometrial cancers. 853 11

Eighteen centers took part in this prospective study into which 930 eligible patients were recruited. The selection criteria for admission were atypical bleeding after at least 6 months of postmenopausal amenorrhea, and absence of hormonal therapies for at least 6 months. The sonographic measurement of the maximum bi-endometrial thickness was made in a longitudinal plane. Sonographic measurements were always performed within 3 days prior to histological evaluation. In these patients the mean number of years from menopause (25-75th centile) was 6 (range 2-16). The prevalence of endometrial carcinoma was 11.5% and the prevalence of atrophy was 49.2%. The area under the receiver operator characteristic curves generated by sonographic thickness measurements reached the level of 85%, both for cancer and atrophy. The likelihood ratio for cancer, yielded by an endometrial thickness of < or = 4.0 mm, was 0.05, and for atrophy it was 7.1. This cut-off of > 4.0 mm yielded a sensitivity for the detection of cancer of 98% and a negative predictive value of 99%. The overall sensitivity and positive predictive value for atrophy achieved by this cut-off were 57.2% and 87.3%, respectively. A multivariate logistic model showed that age and body mass index were independent variables associated with a significantly higher risk of endometrial cancer. The post-test probabilities for cancer and atrophy were recalculated on the basis of the integration of age, body mass index and endometrial thickness. The estimated reduction of invasive procedures on the basis of this integration was 31%. Transvaginal sonographic measurement of endometrial thickness, integrated with individual risk factors, can help in the management of postmenopausal patients with atypical bleeding, with regard to either the need for histological evaluation in high risk cases, or the choice of possible expectant management. We have shown that an endometrial thickness of < or = 4.0 mm safely predicts endometrial atrophy and justifies expectant management when the patient understands the need for proper follow up. This could be achieved with a reduction in the use of invasive procedures without unwanted delay in cancer diagnosis.
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PMID:Sonographic endometrial thickness: a useful test to predict atrophy in patients with postmenopausal bleeding. An Italian multicenter study. 877 95

Reproductive function was investigated in 155 females who had undergone organ-saving surgery for early forms of cervical carcinoma. Ninety-nine patients had their appendages unilaterally removed as part of therapy for ovarian malignancies, stage 1a. and 19 more who had received gestagen therapy for pre- and cancer of the endometrium. Menstrual function remained unimpaired in 99.3%. Changes in this function were observed postoperatively in 31 (20%) cases of cervical carcinoma. Paliative treatment for ovarian malignancies was followed by amenorrhea in 2 cases while changes in menstrual function-in 28 (28.3%). After hormone therapy those changes were registered in 11 (57.9%). One hundred and seven pregnancies in 75 (48.4%) patients were reported in group 1, 131 pregnancies in 72 (72.7%) -in group 2 and 16 pregnancies in 10 (52.6%) patients-in group 3. One hundred and thirteen babies were born after organ-saving surgery for early forms of cancer of the internal genitals perinatal mortality reaching 4.4%. Organ-saving therapy for early malignancies of the ovary, endometrium and cervix uteri has been found to be an effective means of treating the disease and maintaining certain specific functions of the female organism.
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PMID:[Possibilities of preserving reproductive function after therapy for early malignancies of the cervix uteri, endometrium and ovaries]. 881 23

Tamoxifen is reported to increase the risk of endometrial cancers mostly in postmenopausal women. In the Royal Marsden chemoprevention programme, we noted that premenopausal women at the start of tamoxifen/placebo who developed amenorrhea may be at special risk of endometrial cancer. The aim of this report was to investigate recently amenorrheic women by measuring plasma estradiol (E2), follicular stimulating hormone (FSH), and endometrial thickness (ET) by transvaginal ultrasound (TVUS). ET readings and E2 levels were available in the same proportion of women on tamoxifen or placebo. Women on placebo developed amenorrhea with upper limit of E2 readings of 450 pmol/L. In both postmenopausal women and recently amenorrheic women with low E2 (< or = 450 pmol/L), tamoxifen significantly increased endometrial thickening (p < 0.0001 and < 0.005 respectively). Conversely, tamoxifen did not result in endometrial thickening in women with high E2 (> 450 pmol/L), with a trend to lower ET readings (p = 0.07). Finally, all five women who developed endometrial cancer were premenopausal at the start of tamoxifen/placebo. Two of these five women were asymptomatic with increased ET readings (17 mm and 17 mm) and low E2 levels (32 and 51 pmol/L). These results indicate that women who develop amenorrhea on tamoxifen may be at special risk of endometrial cancer. Tamoxifen causes endometrial thickening in amenorrheic women with low E2 but has an opposite antiestrogenic effect in women with high E2. We recommend that women who develop amenorrhea on tamoxifen especially in the presence of endometrial thickening, low E2 levels, and/or gynaecological symptoms warrant further investigations.
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PMID:Variation in endometrial thickening in women with amenorrhea on tamoxifen. 954 Nov 92


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