Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of tamoxifen among women with breast cancer or at high risk of the disease has greatly expanded over the past several decades. Tamoxifen has a complex effect on the female reproductive tract and several tamoxifen-associated changes have been described among tamoxifen users. These include endometrial thickening, cervical and endometrial polyps, endometrial hyperplasia, endometrial adenocarcinoma, uterine sarcoma, increase in the size of uterine leiomyomata, exacerbation of endometriosis and ovarian cysts. The most common uterine change associated with tamoxifen is endometrial polyps. The annual incidence of endometrial cancer among women on tamoxifen is 2 per 1000 and seems to be related to the cumulative tamoxifen dose. It is not clear whether endometrial cancer occurring among women on tamoxifen is of worse prognosis than endometrial cancer occurring among women not receiving tamoxifen. Tamoxifen is associated with several sonographic changes which make the use of ultrasound in surveillance of these patients difficult. There is no indication to implement routine screening for endometrial cancer among all women on tamoxifen. However, endometrial biopsy, preferably via hysteroscopy, should be considered in women with uterine bleeding.
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PMID:Tamoxifen and the female reproductive tract. 1158 20

Ever since a gradual but significant reduction in the estrogenic and progestogenic components of oral contraceptives (OCs) was made, there has been a corresponding decrease in adverse effects associated with the pill. The beneficial effects include prevention of pregnancy, reduction in pelvic inflammatory disease, protection against ovarian/endometrial cancer and benign breast tumors and ovarian cysts, reduction in the occurrence of rheumatoid arthritis among OC users, and regulation of the menstrual cycle. The adverse effects include diseases of the circulatory system (myocardial infarction, venous thromboembolism, subarachnoid hemorrhage, hypertension), possible carcinogenicity (breast, cervix, melanoma), pituitary adenomas, liver disorders, glucose metabolix effects (diabetes), vitamin status alteration, delay in return of menstruation and fertility, and a number of minor side effects (nausea, vomiting). Contraindications to OC use include history of malignancy of the breast or genital tract, venous thromboembolism, cerebrovascular accident, undiagnosed abnormal vaginal bleeding, focal migraine, or familial hyperlipidemia. The following situations require medical assessment before OCs are prescribed, and medical supervision if OCs are prescribed: age 40+, smoking and age over 35, mild hypertension or a history of hypertensive disease of pregnancy (toxemia), epilepsy, diabetes mellitus, history of bouts of depression, history of oligomenorrhea or amenorrhea in nulliparous women, and gallbladder disease. Problems could occur with OC use in the following situations: 1) lactation (ideally, OCs should be withheld until the child is weaned but if not possible, OCs should not be given until lactation is established); 2) drug interaction (other contraceptive form should be used when the patient is taking antibiotics or anticonvulsants); 3) tropical diseases (studies are still underway); 4) adolescence (very young girls should use other contraceptive method until regular menstruation is established); 5) postcoital contraception (limited use of steroids in emergency situation); and 6) hormonal pregnancy tests (use of oral steroids for pregnancy testing is not recommended). The 3 main types of OCs currently used are the combined estrogen and progestagen, the progestagen-only OC, and the triphasic OC. The lowest effective dose of a compound should be used, and healthy women may continue to use OCs for many years.
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PMID:Statement on steroidal oral contraceptives. 1226 73

The Society for Drug Research, based in the UK organized a 1 day symposium in London during December 1982 entitled "Fertility Control in the 21st Century." The meeting's objective was to stimulate further research into fertility regulation. Professor Carl Djerassi of Stanford University, California eloquently supported the case for postcoital contraception. He focused on teenagers who failed to use reliable contraceptive methods as an example of a subgroup of society who would particularly benefit from postcoital contraception. Djerassi presented a profile of the ideal contraceptive, which emphasized the potential for postcoital contraception. Characteristics of his "ideal" contraceptive included a need to focus on women, independence from coitus, and in the case of systemic contraception, short term exposure to the drug. Djerassi also reviewed the rigorous drug trial procedures that any new contraceptive had to undergo. Professor Martin Vessey of Oxford University focused his comments on the benefits and risks of oral contraceptives (OCs). In addition to the high efficacy of OCs, other benefits included the suppression of pelvic inflammatory disease, endometrial cancer, functional ovarian cysts, and benign breast disease. Regarding the association between OCs and benign breast tumors, Vessey stated that it appeared that it was only the most benign form that was suppressed. The protective effect against ovarian cancer appeared to persist in former users, seemed to be apparent across the spectrum of age groups, and appeared to be most pronounced in nulliparous women. 1 risk associated with OCs, according to Vessey, was the association between hepatocellular adenoma and OC. Dr. Malcolm Potts directed his comments to discussion of contraception in the 3rd world, demonstrating with a series of slides the variety of social and economic circumstances in which family planning services were needed. Other contributors to the symposium discussed new uses for old steroids, prostanoids in fertility control, immunization against fertility, and contraception in the male.
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PMID:Fertility regulation in the 21st century. 1226 52

This article reviews several different articles which have contributed to an understanding of the harmful or beneficial effects of oral contraceptives (OCs) on various diseases. The Royal College of General Practitioners study found that current OC users compared to women who had never used OCs had relative risks of .52 for menorrhagia, .37 for dysmenorrhea, .65 for irregular cycles, .72 for intermenstrual bleeding, and .71 for premenstrual syndrome. Several studies found combined OCs to offer protection against ovarian cysts. Microdose progestin only pills did not ameliorate most menstrual problems and aggravated ovarian cysts. Despite some theoretical grounds for suspecting an association between pituitary prolactinomas and OC use, recent studies have failed to find an increased relative risk for prolactinomas in women using OCs for contraceptive purposes, although 1 study found an increased risk in women using OCs for cycle control. 1 study reported 11 pregnancies in 30 diabetic women in 15 months of IUD use; the high rate was attributed to abnormal patterns of mineral deposit on the IUD surface. The 11 pregnancies occurred with 5 Gravigardes, 5 Saf-T-Coils, and 1 Dalkon Shield. Other studies on the contrary have noted no difference in pregnancy rates among 103 diabetic women using Copper Ts or 118 diabetic women using Lippes loops. Combined OCs appear to reduce the incidence of rheumatoid arthritis by 1/2 among current OC users and to protect former users as well. Combined OCs aggravate lupus erythmatous but synthetic progestins alone are effective without aggravating the condition. It has recently been argued that low dose OCs are not contraindicated in cases of sickle cell disease and may even offer protection against thromboembolic vascular accidents for women with sickle cell anemia. Estimates of relative risk of pelvic infection among IUD users vary from 1.5 to 6.5, with the risk apparently greatest for women under 25. Recent studies have indicated that copper IUDs do not have the bactericidal power formerly attributed to them. Numerous in vitro studies and statistical comparisons of the effect of spermicides in vivo have demonstrated that local methods provide protection against sexually transmitted diseases. OCs may favor vaginal infection, but some recent studies have indicated that they offer protection against pelvic infections. The protective effect of the condom against sexually transmitted diseases is well known. It has been estimated that, relative to non-users of OCs, each 100,000 users will have 235 fewer cases of benign breast disease, 35 fewer of ovarian cysts, 320 fewer of iron deficiency anemia, 600 fewer of pelivc infection, 117 fewer of extrauterine pregnancy, 32 fewer of rheumatoid arthritis, 1 fewer of endometrial cancer, and 3 fewer of ovarian cancer.
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PMID:[Disease and contraception. Recent aspects]. 1228 Feb 11

The regular medical surveillance provided to oral contraceptive (OC) users, which allowed early diagnosis or even prevention of some serious disorders, was recognized as 1 of the primary benefits of combined OCs from their earliest use. Another benefit is protection against functional ovarian cysts resulting from the suppression of pituitary hormone secretion. Combined OCs can be used to treat polycystic ovarian dystrophy. It now appears clear on the basis of extensive epidemiological study that OCs afford protection against epithelial cancer of the ovary. The relative risk of ovarian cancer is .4 to .6 for women using OCs relative to women who have never used them. The protective effect appears to begin after 2-3 years of use, to persist for several years after termination of use, and to be independent of the formulation used. As with functional cysts, the protective effect of OCs against ovarian cancer appears to depend on the suppression of ovulation and inhibition of follicle stimulating hormone and luteinizing hormone secretions. Synthetic estrogens and progestins have the same effects on the target tissues as do the endogenous hormones. A true inhibition of ovarian secretions and a balance between the estrogen and progestin are needed to prevent hyperplasia or atrophy of the breast and endometrium. Use of low dose progestins is often associated with incomplete inhibition of gonadotrophins and relative hyperestrogenism, while sequential pills are too strongly dosed in estrogen and also lead to hyperestrogenism. Otherwise, combined pills often provide a more stable hormone balance than that found in spontaneous cycles. A well chosen combined pill can be used to treat premenstrual syndrome, regularize cycles, and protect against benign breast disease. Most epidemiological studies have concluded that use of combined OCs is without influence on the relative risk of breast cancer. Contraindications based on individual or family medical history must however be respected and OC users should receive careful periodic surveillance. OC users have 2 times less risk of endometrial cancer than nonusers. The protective effect appears after 12 months, apparently persists for 15-20 years after termination of use, and is provided by combined OCs at standard or low doses. New pill formulations are being sought which have fewer metabolic and vascular effects without loss of the protective effects of standard dose pills. Low dose pills containing currently used progestins have been accused of providing incomplete ovarian inhibition. A triphasic OC containing the new progestin gestodene offers the strong antigonadotrophic effect of gestodene along with a good balance between the estrogen and progestin. It appears reasonable to expect that this triphasic will offer the same protection against ovarian and endometrial cancer as more strongly dosed OCs.
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PMID:[Oral contraception and its beneficial gynecological effects]. 1228 88

Oral contraceptives (OCs) remain the leading choice of reversible contraception for American women. In the 1999 Contraceptive Technology Update Contraceptive survey, more than 60% of the providers say that 50 or more women leave their offices each month with pill prescriptions in hand. Of the available OCs in the market, a 20-mcg Alesse pill and 20- and 30-mcg Loestrin pills are the top choices among older nonsmoking women because they help them through the perimenopausal stage. Among younger nonsmoking women, the 35-mcg Ortho Tri-Cyclen pill is the top choice because it is effective, leads to few complications and side effects, and has easy-to-use packaging. Research has established that OCs protect women against dysmenorrhea and menorrhagia, menstrual cycle irregularities, iron deficiency anemia, ectopic pregnancy, pelvic inflammatory disease, ovarian cysts, benign breast cancer disease, endometrial cancer, and ovarian cancer. Aside from the noncontraceptive health benefits, OCs have proven valuable in the management of a variety of gynecologic disorders. Providers are moving toward prescription of OCs specifically for noncontraceptive benefits, but respondents are still unwilling to see OCs offered as over-the-counter drugs.
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PMID:Pills remain the top choice among reversible contraceptive options. 1229 Mar 80

New types of contraception approved for use in the US include two long-lasting, hormone-based contraceptives, Depo-Provera and Norplant, and the female condom. The female condom is made of polyurethane, which is thinner, stronger, and a better conductor of heat than latex. Its inner ring fits over the cervix and the outer ring protects the labia and the base of the penis. Its typical-use and perfect-use failure rates are 21-26% and around 5%, respectively. One injection of Depo-Provera blocks ovulation for 3 months. Irregular periods are common with Depo-Provera use. Fertility may not return for 6-12 months after discontinuation. Depo-Provera may protect against endometrial cancer. The 6-capsule system Norplant is inserted subdermally in the arm and releases levonorgestrel for up to 5 years. Since its arrival on the US market, more than 900,000 women have used Norplant. Contraindications to Norplant are liver disease, blood clots, inflammation of the veins, history of breast cancer, or breast feeding in the first 6 weeks postpartum. More than 600,000 US women undergo sterilization annually. 25% of all heterosexually active, fertile women of reproductive age and 60% of these women ages 35-44 have had a tubal ligation. Vasectomy is less risky than tubal ligation. Both vasectomy and tubal sterilization are more than 99% effective. Oral contraceptives (OCs) suppress ovulation. 28% of US women of reproductive age use OCs. OCs are more than 99% effective. OCs appear to increase the risk of blood clots, heart attack, and stroke for smokers over 35. Health benefits of OCs include protection against ovarian cancer, endometrial cancer, pelvic inflammatory disease, ovarian cysts, and benign breast tumors. Barrier methods keep sperm from joining the egg. Latex condoms protect against sexually transmitted diseases (STDs). IUDs interfere with sperm transport and egg fertilization. In the US, there is a perception that IUD use is unsafe. Women with new or multiple partners should use condoms to protect against STDs.
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PMID:Choosing a contraceptive. What's best for you? 1229 May 58

Numerous non-contraceptive benefits of combined oral contraceptive (OC) use have been identified. The risk of endometrial cancer is reduced by 20% after 1 year of use, 50% after 4 years of use, and 71% after 12 years of use compared with the risk among non-users and this protective effect persists up to 15 years after OC discontinuation. There is a 30% overall reduction in ovarian cancer risk (50% after 5 years of OC use) and the protective effect lasts at least 10 years after ending pill use. For cervical cancer, OC use is associated with a slight increase in risk, although other causative factors may be implicated. The risk of follicular ovarian cysts is reduced by about 50%, while that of cysts from the corpus luteum declines by as much as 80%. Combined OCs also reduce the risk of fibrocystic breast disease and fibroadenomas by about 25%. Both low- and high-dose OCs reduce pelvic inflammatory disease by up to 50% and, if OC users do develop this infection, it is generally less severe than in non-users. Also recorded has been a 90% reduction in risk of ectopic pregnancy. Since OCs shorten the menstrual period and amount of blood loss, they protect against iron-deficiency anemia. Finally, OC users have a 60% reduced risk of dysmenorrhea.
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PMID:Non-contraceptive benefits of oral contraceptives. 1229

This article offers substantial information on combined oral contraceptives (COCs). It is noted that such pills contain two hormones, an estrogen and a progestin. COCs prevent ovulation and make the lining of the uterus thinner, when correctly and consistently used, with a reported failure rate of 1/1000 women. An important benefit of COC use is that it decreases a woman's risk of ovarian cancer, endometrial cancer, benign breast masses, and ovarian cysts. Other advantages include a decrease in menstrual cramps and pain, reduction of menstrual blood loss and a woman's risk for anemia, and fertility control. Some of the disadvantages of COC use include side effects and lack of protection against HIV virus. In the US, these pills are available from doctors, nurse practitioners, nurse-midwives, health departments, and family planning clinics.
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PMID:Choices: "the pill" combined oral contraceptive. 1229 82

Progestins in oral contraceptives (OCs) produce potential complications, as well as noncontraceptive benefits, according to Robert A. Hatcher, MD, MPH, professor of gynecology and obstetrics, Emory University Medical School. Hatcher told CTU that lowering the progestin content in an OC may decrease complications, but could also decrease the benefits experienced by women. "The extent to which that will happen remains to be seen," he said. Hatcher cited the following potential complications of progestins in OC: hypertension; decreased levels of high density lipoproteins; acne; oily skin; headaches between pill cycles; dilated leg veins; pelvic congestion syndrome; thrombosis of superficial leg veins; gallstones; Monilia vaginitis; cholestatic jaundice; and depression, fatigue, and decreased libido. Progestins, according to Hatcher, also produce these noncontraceptive benefits: protection against PID; decreased dysmenorrhea; decreased menstrual blood loss, decreased iron deficiency anemia; protection against endometrial cancer; protection against fibrocystic breast disease, and fibroadenomas of the breast; decreased bleeding from fibroids; decreased growth of fibroids. When ovulation is suppressed, Hatcher emphasized, additional benefits that may occur include the following: decreased risk of functional ovarian cysts; elimination of mittleschmerz pain; decreased rick of ovarian cancer; protection against endometriosis.
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PMID:Potential risks, benefits of progestins in birth control pills outlined. 1231 83


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