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

The colony-formation of Ishikawa cells, which originate from well differentiated endometrial cancer, and produce progestogen receptors (PR), was inhibited by high concentrations of medroxyprogesterone acetate (MPA). However, the colony-formation was not inhibited by norethindrone (ENT), as a luteohormone or 17 beta-hydroxy-11 beta-(4-dimethylaminophenyl-1)-17 alpha(prop-1-ynyl)-estra-4, 9-dien-3-one (RU-486), as an antiprogestogen. Colony-formation in cells treated with MPA alone was not significantly different from that in those treated with MPA combined with either ENT or RU-486. ENT and RU-486 have high affinity with PR as does MPA. If the suppressive effect by MPA on colony-formation is mediated via PR, then this suppression should be competitively inhibited by ENT or RU-486. Our findings indicate that the effect of MPA is not mediated via PR.
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PMID:Mechanism of antitumoral activity of medroxyprogesterone acetate for endometrial cancer. 253 82

Women throughout the world and throughout time have ingested substances such as mercury, diluted copper ore, and various noxious solutions in the mistaken belief that these substances would prevent pregnancy. The era of modern contraception began in 1937 with the discovery that the administration of progesterone could halt ovulation in rabbits. During the next decade, work proceeded on finding an easy and less expensive way to synthesize progesterone and to develop the synthetic estrogens mestranol and ethinyl estradiol. Initial trials in humans proved that these hormones could prevent ovulation. In 1950, with support from Margaret Sanger and Katharine Dexter McCormick, Gregory Goodwin Pincus developed the first oral contraceptive (OC), which consisted of supplemental progestin and 0.5 mg norethindrone. In the early 1990s, the Ortho Pharmaceutical Corporation introduced an OC that combined the synthetic progesterone norgestimate and 35 mcg of ethinyl estradiol. By 1988, several noncontracepting health benefits of the OC were recognized, including decreased rates of ovarian cancer, endometrial cancer, pelvic inflammatory disease, ovarian cysts, benign breast disease, iron deficiency anemia, and dysmenorrhea. These health benefits outweigh risks even in nonsmoking women over 40. In the US, 80% of women have used the OC at one time, and they are using this most popular form of reversible contraception longer than ever.
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PMID:A history of oral contraception: from evolution to revolution. 767 Apr 17

Endometrial biopsies were obtained from one hundred Thai NET-EN users who were treated for at least 5 yrs. Seventy-four and 26 per cent of them were obtained twelve and 1 wk after last injection, respectively. The endometrium gave an inactive progestational pattern in 75 per cent, proliferative phase 23 per cent and secretory phase 2 per cent. No endometrial carcinoma occurred in this study.
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PMID:Endometrial pattern in long-term users of NET-EN. 808 39

Gynecologists use either oral or parenteral progestogens either alone or in combination with estrogens to treat various conditions. Parenteral routes of progestogen delivery are intramuscular injections, intravaginal pessaries, subcutaneous implants, and vaginal rings. Progestogens treat dysfunctional uterine bleeding by first controlling the acute bleeding episode and then by establishing normal ovulatory cycles. 1-2 tablets of medroxyprogesterone acetate (MPA)/day or 1-3 tablets of norethindrone/day should stop uterine bleeding in 72 hours. If not, 25 mg intravenous premarin should control it in 6-24 hours. Cyclical progestational (e.g., MPA) therapy for 3-6 cycles should establish normal ovulatory cycles. After appropriate laparoscopic staging by double puncture technique, progestogens can be used to treat mild-moderate endometriosis. Gynecologists should consider the following criteria when selecting the ideal progestin for hormone replacement therapy: adjustment of dosage of progestin and estrogen over 3-6 months to maintain the beneficial effects of the estrogen and to minimize the adverse effects of the progestin, progestin dosage sufficient to protect against endometrial hyperplasia and cancer, economical progestin, and minimization of weight gain, depression, oral intolerance, and androgenic action. Hydrogesterone and MPA meet these criteria. Oral contraceptives with a progestin and the smallest possible dose of estrogen are well-tolerated, cause no break-through bleeding, produce minimal side effects, and protect against pregnancy (99% contraceptive effectiveness rate). They also protect against endometrial cancer, endometriosis, premenstrual tension, dysmenorrhea, and irregular cycles. Intramuscular injections of progestins (MPA, NET-EN), subcutaneous levonorgestrel implant, and the levonorgestrel IUD are new contraceptive developments and provide a high degree of contraceptive efficacy. MPA at very high doses cause remission of breast endometrial lesions.
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PMID:Progestogens in gynaecological practice. 1217 92

Outlined is a protocol for the administration of emergency contraceptive pills. The indication for such treatment is unprotected intercourse within the past 72 hours. Absolute contraindications include the possibility of an existing pregnancy and a family history of stroke, heart attack, thrombophlebitis, breast or endometrial cancer, or liver tumor. Possibly excluded, depending on evaluation by a physician, are women with abnormal vaginal bleeding, active hepatitis, active gallbladder disease, high blood pressure, acute focal migraine, breastfeeding women, and those unable to understand instructions. The recommended regimen consists of six tablets of Ovral (two taken immediately, two more in 12 hours) or 12 tablets of Lo/Ovral, Nordette, or Levlen (four taken immediately, repeat dosage in 12 hours). The extra pills are to be used in cases of vomiting within three hours of pill ingestion. Women with a history of oral contraceptive-related nausea and vomiting should be provided with Compazine. Women should be informed that this method is effective in only about 92% of cases. All women who receive emergency contraception should be counseled that this is strictly a back-up method and helped to formulate a long-term birth control strategy.
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PMID:Emergency contraceptive pills (ECP) protocol. 1228 80

Progestin-only injectables are among the most effective and safe of all contraceptives, yet they are not widely used in many countries. This limited use is in part due to a lack of accurate information about health concerns, inadequate counseling for users about managing side effects, and their limited availability. Where they are available, progestin-only injectables rapidly become one of the preferred methods. Depot-medroxyprogesterone acetate (DMPA) and norethindrone enanthate (NET-EN) are the two progestin-only injectables in use worldwide. The former drug is sold under the brand name Depo-Provera, and the latter as Noristerat. DMPA is delivered in a water-based, crystalline suspension and absorbed gradually by the body. The normal injection of 150 mg is intended to be administered every three months, but contraceptive protection continues for an additional two weeks to provide a grace period for women who are late receiving their next injection. NET-EN is an oily solution which requires a larger needle than DMPA for injection. A 200 mg injection of NET-EN is usually administered every two months. Both of these safe, highly effective drugs are injected in either the upper arm or buttocks. DMPA and NET-EN can be distributed easily in nonclinical settings where nonphysicians can provide them to clients. The main disadvantage of the method is the disruption of the menstrual cycle, but that is generally not a serious medical problem. Focusing mainly upon DMPA, this article includes discussion of menstrual irregularity, the reduced risk of endometrial cancer among DMPA users, and method availability.
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PMID:Progestin-only injectables offer many advantages. 1228 28

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

Among 30-40 year old women, 40% of pregnancies are unplanned, which is indicative of the unreliability of the birth control methods they are using. The 1992 Ortho Birth Control Study interviewed almost 7000 women, of whom 8% listed withdrawal and 4% listed the rhythm method. These two methods have failure rates of 24% and 19%, respectively. Birth control methods often disappoint the users and increasingly they turn to sterilization. 48% of married women aged 15-44 had themselves been sterilized or had a sterilized partner in the Ortho survey. Although reversal of tubal ligation succeeds in 43-88% of cases, conception cannot be guaranteed. For women over the age of 30 who are healthy and do not smoke, low-estrogen or no-estrogen oral contraceptive pills are considered safe. Taking the pill also helps prevent ovarian and endometrial cancer. The failure rate is 6%. Barrier methods also offer protection from sexually transmitted diseases including HIV. Condoms are favored by 33% of unmarried women and 19% of married women. Sexually active 40-44 year old unmarried women run a 14-19% risk of contracting a sexually transmitted disease (STD) in a 12-month period. Diaphragms offer some protection against STDs, but their failure rate is 18%. IUDs are regaining popularity, but only 1% of women use them (ParaGard T380A or Progestasert). Pelvic inflammatory disease is the reason: a 1992 study showed that 0.97% of women developed it within 20 days of use. Norplant is a long-term implant containing levonorgestrel with a failure rate of 0.5%. A 1993 study followed 1253 implant users over 12 months and found a very low rate of pregnancy, but 75% experienced some side effects during the first year. About half of the women using Norplant removed it after 2.5 years because of irregular bleeding. Depo-Provera is an injectable administered every 3 months, but after removal it can take up to a year for ovulation to return. Side effects may include hair loss and weight gain; and links to breast cancer have also been suggested.
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PMID:Birth control over 30. 1229 85

Injectable hormonal contraception with 2 longacting steroidal preparations--norethisterone enanthate (NET-EN) and depot medroxyprogesterone acetate (DMPA)--provides an effective means of fertility regulation and has become an important method of family planning. DMPA and NET-EN have several advantages which make them particularly appropriate for some women and acceptable in family planning programs. A single injection can provide highly effective contraception for 2 or more months, delivery is simple, independent of coitus, and ensures periodic contact with medical or other trained health personnel. Currently, DMPA is registered as a therapeutic agent in nearly all countries and as a contraceptive agent in over 80 developed and developing countries. NET-EN is registered as a contraceptive in 40 countries. Administered by intramuscular injection in an aqueous microcrystalline suspension, DMPA exerts its contraceptive effect primarily by suppression of ovulation, but its effects on the endometrium, the uterine tubes, and the production of cervical mucus may also play a role in reducing fertility. DMPA as a contraceptive agent is generally given at a dosage of 150 mg every 90 days. NET-EN when administered as an intramuscular injection of an oil preparation at a dose of 200 mg inhibits ovulation. It should be administered at 8 weekly intervals for the 1st 6 months of use, then at intervals of 8 or 12 weeks. Longterm animal studies with DMPA have been completed mainly on beagle bitches and rhesus monkeys, and similar studies with NET-EN are nearing completion. None of the findings in beagles is considered applicable to human populations because the beagle responds differently than humans to steroidal hormones. None of the deaths among rhesus monkeys was attributable to effects of the drug. Endometrial carcinoma was found in 2 of the replacement monkeys but the number of animals was too small for statistically significant studies, and it is not possible to conclude whether DMPA or NET-EN caused these cancers or instead failed to prevent them. Despite more than 18 years of use and an estimated 13 million women who have ever used DMPA or NET-EN, no case has been recorded of an endometrial malignancy in women so exposed. There is no evidence at this stage of a causal association, either anecdotal or scientific. No evidence of an increased risk of malignant and premalignant disease of the uterine cervix has been found in DMPA users. There is sufficient evidence from investigations in several countries that DMPA and NET-EN may increase both milk production and the duration of lactation. The only clinical metabolic effect attributed to DMPA is weight gain. NET-EN and DMPA are associated with disruption of the menstrual cycle and irregular bleeding.
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PMID:Statement on injectable contraception. 1233 11

Belgium is 1 of the few countries where sequential oral contraceptives are still commercially available. The authors investigated the endometrial effect of Ortho-Novum SQ (14 tablets of 100 mcg mestranol and 7 tablets of 100 mcg mestranol + 2 mg norethisterone) in 222 biopsy specimens obtained from 184 asymptomatic Caucasian women (mean +or- s.d, age and parity, 34.6 +or- 6.7 and 2.0 +or- 1.0, respectively) who had used this sequential OC during an average of 52.5 months. Notwithstanding predominantly longterm use of Ortho-Novum SQ, 43% of the tissue samples had normal proliferative or luteal endometrium. The data suggest a positive correlation between the endometrial response and the duration of pill use. No premalignant or malignant changes were found. In 15 of 24 subjects for whom multiple biopsy specimens were available, the histological picture was static; 7 showed regression and only in 2 were the changes progressive, although never more severe than minor 'class 2' lesions. These results, which are at variance with those reported for users of other sequential brands (mainly Oracon), suggest that prolonged use of Ortho-Novum SQ does not enhance the risk of endometrial cancer in premenopausal women having no additional risk factors for the development of this type of neoplasia.
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PMID:Endometrial response to the use of a sequential oral contraceptive. 1234 12


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