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

Metabolic effects of long-term (at least 5 years) estrogen replacement therapy were studied. 301 patients were treated with replacement estrogen and 309 patients were untreated. Incidence figures for various metabolic diseases present at entry, and both during and after estrogen therapy were compared by statistical adjustments for certain group differences (Mantel-Haenszel statistics) and by statistical analysis. Long-term administration of estrogen to these women with hypoestrogenism was associated with significantly lower rates of development of cardiovascular disease (p .001), hypertension (p .001), osteoporosis (p .001), and fractures (p .01). The detrimental effects included a higher rate of abnormal uterine bleeding (47% of 207 women with uteri in situ) and an increase in the likelihood of developing adenocarcinoma of the endometrium. Cyclic adminsitration of estrogen did not seem to protect from the risk of endometrial carcinoma, however the addition of progesterone to sequential estrogen treatment did. It is believed that long-term estrogen therapy is of benefit for the woman deprived of estrogen function, particularly if this loss occurs at a relatively young age.
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PMID:Effects of long-term estrogen replacement therapy. I. Metabolic effects. 44 93

Estrogen treatment of postmenopausal women is effective in relieving the symptoms of vasomotor instability and urogenital atrophy; estrogen treatment is effective in preventing accelerated bone loss and osteoporosis in young women following castration, but in postmenopausal women aging is a more important determinant of accelerated bone loss than is decreased estrogen secretion. Low-dose estrogen treatment of postmenopausal women neither prevents nor increases the risk of arteriosclerotic cardiovascular disease or cerebral vascular disease. It cannot be definitively established that estrogen treatment of postmenopausal women causes an increased incidence of breast tumors, but it is clear that such treatment does not prevent these tumors. It is established that estrogen treatment of postmenopausal women increases the risk ratio of endometrial carcinoma.
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PMID:Estrogen treatment of postmenopausal women. Benefits and risks. 57 21

There is increasing epidemiological evidence that nutrition plays a dominant role in the pathogenesis of several types of human cancers. There is considerable epidemiological evidence showing that alcoholism in part because of associated nutritional deficiencies, significantly increases the risk of smokers for cancer of the alimentary tract. There is also some suggestion that nutritional deficiencies may relate to cancers of the stomach, cervix, and thyroid. Of particular importance, and based on relatively new concepts, are data indicating that overnutrition significantly affects the development of certain cancers, including cancers of the colon and pancreas, kidney, breast, ovary endometrium, and prostate. Except for cancer of the endometrium, and kidney cancer in women, there is no significant relationship to obesity. Rather, the evidence suggests both epidemiologically and experimentally that the etiological factors relate to a high intake of fats and possibly other variables associated with high fat intake. While we are investigating the mechanistic nature of the epidemiological and experimental observations, the question that needs to be asked is whether it is not prudent for us to associate ourselves with the recommendation of our colleagues in the cardiovascular disease field who call on both individuals and the food industry to practice a "Prudent Diet," i.e., one that is lower in total calories, total fat, saturated fats and cholesterol than is the present American diet.
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PMID:Nutrition and cancer. 77 Feb 4

Research and development in contraception has only limited interest in women over 35 years old, so we know little about safety, side effects, and effectiveness of contraceptives in this age group. In addition, clinical trials use healthy women which further limits our knowledge about contraceptives in women who have cardiovascular problems, diabetes, and liver conditions. Research does indicate, however, that women with high blood pressure should not take oral contraceptives (OCs) after the age of 35. It also shows that healthy and nonobese women over 35 who do not smoke and have no family history of cardiovascular disease before age 45 can take OCs with 30 mcg of ethinyl estradiol. Practitioners should provide these women with balanced and up-to-date information on the link between OCs and breast cancer and their apparent protective effect against endometrial cancer. The pregnancy rate for 35-39 year old married women using the diaphragm for at least 5 months stands at 1.1/100 women years. Contrary to popular belief, barrier methods can be harmful, e.g., urinary tract infections are more frequent in women who use the diaphragm than in those who do not. Women older than 35 should consider the condom because of its ability to reduce the risk of acquiring HIV or sexually transmitted diseases. Considerable research exists on women over 35 who use copper releasing IUDs. These IUDs are safe in women who do not have heavy menstrual bleeding. The levonorgestrel releasing IUDs are well tolerated in women over 35 since they reduce the amount and duration of menstrual bleeding. Besides users of these IUDs are less likely to have pelvic inflammatory disease and endometritis than those using copper releasing IUDs. Older women in developing countries often undergo hysterectomy for contraceptive purposes and because of heavy bleeding. Tubal ligation is a significant family planning method for older women in developing countries.
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PMID:Contraception after thirty-five. 131 37

A history of endometrial cancer has long been considered a contraindication to estrogen replacement therapy. Yet women with such a history, like other women when postmenopausal, often suffer vasomotor symptoms that could easily be relieved with estrogen. In fact there is no good evidence that estrogen significantly increases the risk of recurrence after treatment for endometrial cancer. Some studies now suggest that estrogen plus a progestin may actually decrease the risk of cancer recurrence in these patients. The benefits of estrogen in preventing osteoporosis and cardiovascular disease in postmenopausal women is substantial.
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PMID:Recommendations regarding estrogen replacement therapy after treatment of endometrial cancer. 138 38

The well-recognized benefits of hormone replacement therapy include relief of vasomotor symptoms, alleviation of psychogenic manifestations, prevention of atrophic vaginitis, prevention and treatment of osteoporosis, and prevention of cardiovascular disease. Risks can be minimized by proper evaluation and appropriate hormone replacement. When an adequate dosage of estrogen is given, the added progestogen does not adversely affect lipid levels. When progestogens are added to estrogen replacement therapy, the incidence of endometrial cancer is lower in postmenopausal women receiving this form of therapy than in untreated postmenopausal women. Although the risk of breast cancer is a matter of controversy, it does not seem to increase with estrogen therapy; the addition of progestogen may decrease the risk for some women. The prognosis for breast cancer is improved in women receiving hormone replacement therapy.
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PMID:Update on hormone replacement therapy. 144 75

As women approach the climacteric period, many changes are occurring in their bodies. Many of the physiologic changes are related to a decrease in estrogen production by ovaries. Hormone replacement therapy has been proposed to help relieve many of the manifestations associated with menopause. Before they begin hormone replacement therapy, women need to be informed about the advantages and disadvantages of this treatment. Decreasing the risk of cardiovascular disease and preventing further development of osteoporosis are primary reasons for administering hormone supplementation to postmenopausal women. The risk of breast cancer is not increased with low-dose estrogen, and by adding progesterone, the risk of endometrial cancer is virtually eliminated. Not every woman is a potential candidate for hormone replacement therapy. Contraindications exist, and some women experience discomforting side effects. Withdrawal bleeding with combination therapy is the main reason women do not comply with treatment protocols. Although supplementation may prove helpful for the postmenopausal woman, each individual needs to evaluate her own personal situation carefully. Accurate knowledge about normal changes due to decreased estrogen production, the pros and cons of therapy, and personal health status assists in the decision as to whether hormone replacement therapy is appropriate for a particular postmenopausal woman.
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PMID:Women at midlife. Hormone replacement therapy. 144 69

The relatively restricted use of hormone replacement therapy in the United Kingdom has frequently been noted. It is possible that low prescribing rates may, in part, be due to the difficulty in interpreting the wealth of research evidence relating to the risks and benefits of hormone replacement therapy. Conflicting conclusions from research can cause considerable uncertainty and confusion. This paper reviews the evidence relating to hormone replacement therapy and the risks of breast cancer, endometrial cancer and cardiovascular disease and discusses the issues which require critical assessment. This should add to the information base available to general practitioners and thus assist in decision-making in the context of uncertainty.
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PMID:Hormone replacement therapy and breast cancer, endometrial cancer and cardiovascular disease: risks and benefits. 149 29

Studies show that OCs have several benefits besides prevention of pregnancy. They protect against ovarian and endometrial cancer, pelvic inflammatory disease, and ectopic pregnancy. OCs also prevent iron deficiency anemia, primary dysmenorrhea, functional ovarian cysts, and benign breast disease. They may even protect against some benign uterine tumors, osteoporosis, toxic shock syndrome, and rheumatoid arthritis. Despite many concerns, some large studies have not identified an overall effect of OCs on breast cancer, but subgroup analyses showed increased risk in 30-34 year old women and in women with 1 child. A reanalysis of a large US study indicated an increase risk of breast cancer in nulliparous women with increasing use of OCs by young women. Cervical cancer is the leading cancer of women in developing countries which emphasizes the need to examine the link between OC use and cervical cancer. Several studies show an increased risk of cervical cancer. Several studies show an increased risk of cervical cancer in long term OC users. In 1 study, long term use meant 5 years. Yet these studies did not adequately address confounding factors such as smoking and sexual behavior. 3 case control studies in the US and the UK found an increased risk of liver cancer among OC users, yet a large case control study in developing countries did not find a link between OC use and liver cancer. Studies of high dose OCs found considerable increased risks of cardiovascular disease in OC users, but they did not take into account cigarette smoking which indeed increases the risk. Further health practitioners today do a more thorough job of identifying underlying medical problems before prescribing OCs. Moreover estrogen doses have fallen 10 fold since the original OCs. Finally, despite a transient delay, women who take OCs experience a return to fertility at the same rate as those who use other contraceptives.
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PMID:The safety of oral contraceptives: epidemiologic insights from the first 30 years. 160 84

Menopausal symptoms and signs associated with the reduction of ovarian function include an increased incidence of cardiovascular disease and loss of bone mass as well as less serious but more uncomfortable symptoms such as vasomotor flushes and atrophy of the vaginal wall. Although unopposed estrogen effectively reverses these and other menopausal symptoms, it is well established that without the addition of progestin there is an unacceptably high risk of developing hyperplasia or cancer of the endometrium. Depending on the type and dose of progestin added, however, this addition may reverse estrogen's beneficial cardiovascular effects and produce unwanted side effects. Lower doses and newer progestins, such as norgestimate, gestodene, and desogestrel, have demonstrated a decreased potential to reverse the positive cardiovascular effects of estrogen while still eradicating persisting or de novo endometrial hyperplasia.
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PMID:Introduction to steroids in the menopause. 160 88


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