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

It is estimated that 10-15 million women use oral contraceptives in the U.S. The 2 types of pills available are combination products containing both an estrogen and progestin, and single entity products with only progestin. Although more side effects are associated with estrogen, combination pills are the preferred prescription. Most often side effects are mild and disappear after continued use or switching to another type of pill. Some of the side effects are nausea; weight gain; chloasma; cervical extrophia and leukorrhea; hypermenorrhea; spotting and breakthrough bleeding; galactorrhea and pituitary tumors; choreiform movement disorder; endometrial cancer; and, hepatic effects. Fetal exposure to exogenous estrogens and progestins has been reported to result in increased risk for the heart and neural tube defects. Teratogenic effects subsequent to discontinuation of OCs does not appear to be a risk. The beneficial side effects of oral contraceptives are that the incidence of menorrhagia, benign breast neoplasm, dysmenorrhea, iron-deficiency anemia, premenstrual tension, acne, and ovarian cysts are lower in OC users. Thryoid diseases may be reduced by OCs.
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PMID:Side effects of oral contraceptives. 50 75

The most important short-term uses of estrogen are in the control of vasomotor disturbances, often called hot flashes, and in the therapy of athrophic vaginitis. Dosage should be as low as possible and on a cyclic basis. Estrogens can be employed cyclically but for an unpredictable term in the case of hypogonadism, female castration, and especially in the treatment of osteoporosis. The synthetic estrogen diethylstilbestrol (DES) is used as a contraceptive after coitus, in a large dose and within 72 hours, since it inhibits implantation of the fertilized ovum in the uterus. The use of estrogens in controlling some of the emotional conditions prior to menopause is not advisable, but they can be helpful in controlling acne and to arrest uterine bleeding. Conversely, estrogens have been shown to be associated with vaginal adenosis, and with clear cell carcinoma in girls whose mothers had been given DES during pregnancy; also with endometrial carcinoma in postmenopausal women who had taken the drug for years. The association between estrogens and breast cancer is still not clear, since the drug produces different results in different patients. Since estrogens increase blood coagulability their use is associated with an increased risk of thromboembolism and cardiovascular accidents. In prescribing estrogens physicians must evaluate each patient carefully, and require regular visits at six month intervals.
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PMID:Estrogens: their function, uses and hazards. Part 2. 62 3

The effectiveness of monophasic and multiphasic oral contraceptives (OCs) depends on their ability to suppress ovulation, change endometrial growth and ovum receptivity, and reduce cervical mucus receptivity to sperm. They are all more than 99% effective, but, depending on the type and dose of hormone components, they have different side effects. The estrogen component (ethinyl estradiol) of most new OCs is between 30 and 35 mcg, which reduces the risk of estrogen side effects, especially thromboembolism and hypertension. The Food and Drug Administration does not recommend use of an OC with an estrogen component for lactating mothers, while the American College of Obstetrics and Gynecology and the American Academy of Pediatrics believe it is fine. Estrogen may protect against coronary artery disease, yet the estrogen component of today's OCs is so low that the progestin component may cancels this beneficial effect. It also prevents breakthrough bleeding. The most frequently used progestins in OCs are norethindrone and norgestrel. They prevent ovum implantation, sperm penetration through the cervical mucus, and ovulation. Progestins, especially norgestrel, increase the risk of coronary artery disease. Other side effects include acne and weight gain. Progestin benefits are reduced menstrual blood loss, pain during menstruation, premenstrual tension, and endometrial cancer risk. The ideal estrogen-progestin balance depends on the individual, but the estrogen component should be between 30 and 35 mcg, and the progestin component should be the lowest possible dose to reduce metabolic side effects. If an OC user with a well stabilized cycle who takes another recently prescribed drug experiences unexpected breakthrough bleeding or spotting, this change may indicate a drug interaction. Absolute and/or possible contraindications of OC use are smoking after age 35, history of breast or endometrial cancer, liver disease or impaired liver function, cardiovascular risk factors, and diabetes mellitus.
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PMID:Benefits and risks of oral contraceptive use. 143 13

The new generation of oral contraceptives (OCs) contains less than 50 mcg of estrogen compared to previous levels of 100-150 mcg, and as a result have fewer undesirable side effects. In addition, it appears that the newer OCs decrease the susceptibility to many diseases. For example, the pill decreases by 40% the risk that a woman under 55 years of age will develop ovarian cancer. The risk of endometrial cancer is reduced by 50% in OC users. The pill also significantly lowers the risk of pelvic inflammatory disease--a condition that is involved in almost 20% of all gynecologic problems and is a leading cause of infertility. OC use reduces the risk of ectopic pregnancy. Further, by decreasing menstrual blood flow, the pill protects against iron-deficiency anemia. The pill is claimed to decrease premenstrual tension, menstrual cramps, and even acne. It has a protective effect against ovarian cysts and benign breast cancer. Finally, there is the possibility that OCs protect against the development of rheumatoid arthritis and duodenal ulcers.
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PMID:Oral contraceptives come of age. 385 23

Recent cohort and case control studies of low-dose combined oral contraceptives (COCs) containing the new generation of progestogens have allowed classification of adverse effects into those which are rare but serious and should be considered risks and those which are more frequent but are less of a threat to health. Low-dose COCs continue to affect coagulation in a complex way, but the risk is less than with the older preparations, and it can be minimized by screening women for a personal or familial history of early or unusual thrombosis and for levels of protein C, S, and antithrombin III. Women with true migraine with focal signs should also avoid using COCs. The relative risk of myocardial infarction (MI) may increase from 4:1 in women with one risk factor (age, smoking, hypertension, hyperlipidemia, and diabetes) to 20:1 with two risk factors and 128:1 with three or more risk factors. In the absence of all risk factors, a recent study indicated that the relative risk of MI with COC use was 1.9 for current and past use. COC use also causes a slight increase in hypertension in most women, especially those who are older or have a family history of hypertension. While the COC can affect carbohydrate and lipid metabolism, the new generation of progestogens has reduced these effects. The COC may accelerate presentation of gallbladder disease in predisposed women. The COC protects against benign breast disease but may increase the risk of breast cancer and cervical cancer slightly. There is a strong link between hepatocellular adenoma and COC use, but the incidence is low. Return to fertility after use has not been a problem. Both estrogenic adverse effects (nausea, dizziness, irritability, weight gain, bloating) and progestogenic adverse effects (vaginal dryness, acne, hirsutism, weight gain, depression, loss of libido) can occur in 50% of women, but these generally disappear after a few months of use. In conclusion, the low-dose, third generation COCs are associated with minimal risks in the absence of other risk factors and have many beneficial effects such as the prevention of ovarian and endometrial cancer; a decrease in pelvic inflammatory disease and ectopic pregnancies; and protection from anemia, primary dysmenorrhea, functional ovarian cysts, and benign breast disease as well as from the morbidity and mortality associated with pregnancy.
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PMID:The combined oral contraceptive. Risks and adverse effects in perspective. 776 40

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

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

Polycystic ovary syndrome (PCOS) is probably the most prevalent endocrinopathy in women and the most common cause of menstrual disturbances during the reproductive age. It is characterised by the presence of polycystic ovaries on ultrasound examination together with clinical and biochemical signs of hyperandrogenaemia. The majority of patients will seek medical advice because of menstrual disturbances, infertility or signs of hyperandrogeneamia (hirsutism, acne, alopecia). In obese patients the therapeutic mainstay is weight reduction. Anovulatory infertility is treated by stimulation of ovulation, laparoscopic electrocautery or IVF, while patients with menstrual disturbances without a wish to conceive should be treated with cyclic gestagen therapy or oral contraceptives in order to reduce the increased life-long risk of endometrial cancer. Additionally, hirsutism may be treated by epilation or antiandrogen therapy. PCOS is a common disease with an increased risk of NIDDM, hypertension, cardiovascular disease and endometrial cancer. Polycystic ovary syndrome is thus a disease which needs attention from the health system.
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PMID:[Polycystic ovary syndrome I. Clinical presentation and treatment]. 945 93

Despite sporadic ovarian follicle development, hormonal contraception consistently and uniformly prevents steroidogenesis and ovulation. For their suppressive activity on ovarian androgen production, oral contraceptives remain the treatment of choice for acne and hirsutism in most hyperandrogenic women. Inhibition of the synthesis of endometrial estrogen receptors explains the effectiveness of hormonal contraception in the therapy of dysfunctional uterine bleeding and in the treatment of pain associated with pelvic endometriosis. Through the inhibition of ovarian cyclicity, the contraceptive pill lowers the incidence of functional ovarian cysts, benign breast disease, dysmenorrhea and premenstrual syndrome and shows a consistent and long-lasting protection against ovarian and endometrial cancer.
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PMID:Hormonal contraception and ovarian pathology. 967 75

This article presents the benefits and risks of low-dose oral contraceptives (OCs). Most OCs contain a low-dose combination of ethinyl estradiol (or= 35 mcg) and a progestogen (0.1-1.5 mg, depending on the product type). OCs are relatively safe and effective when used for years; they control fertility in women and facilitate spontaneous sexual activity. Other benefits include: 1) improvement in the regularity of menses; 2) decrease in the incidence of dysmenorrhea; 3) circulation of blood flow; 4) reduction of the risks of ovarian and endometrial cancer; 5) inhibition of rheumatoid arthritis progression from mild to severe; and 6) when using low-dose combination (not progestogen-only) OCs, acne and hirsutism are reduced. However, there are also risks in using OCs. The risks associated with OC use are mostly cardiovascular. OCs containing third-generation progestogens are linked with an increased risk of venous thromboembolism. Moreover, acute myocardial infarction risk is great among smokers with hypertension, particularly among women older than 35 years; however, the risk decreases as the dosage of ethinyl estradiol decreases.
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PMID:Benefits and risks of oral contraceptives. 1036 19


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