Multiple Cerebral Infarctions in a Patient with Adenomyosis on Hormone Replacement Therapy: A Case Report

A 59-year-old woman was admitted to our hospital because of repeated episodes of bilateral hand weakness. She had a 10-year history of combined estrogen –progestin therapy for menopausal symptoms. Magnetic resonance imaging on admission showed multiple hyperintense lesions in bilateral cerebral and cerebellar cortices on diffusion-weighted imaging. Transesophageal echocardiography showed thrombus formation on the aortic valve and moderate aortic i nsufficiency. Laboratory test demonstrated elevated CA125 (334.8 U/mL) and D-dimer (7.0 µg/mL) levels.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Studies Source Type: research

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Authors: Lello S, Capozzi A, Scambia G Abstract The tissue-selective estrogen complex (TSEC) pairs conjugated estrogens (CE) with a selective estrogen receptor modulator (SERM), bazedoxifene acetate (BZA). A 2-year treatment with the TSEC improved vasomotor symptoms, quality of life, and vaginal atrophy in healthy postmenopausal women. In addition, the TSEC prevented vertebral and hip bone loss without increasing mammographic density, breast tenderness, the risk of myocardial infarction, stroke, or venous thromboembolism. Finally, the BZA 20 mg/CE 0.45 mg dose did not increase the risk of endometrial ...
Source: International Journal of Endocrinology - Category: Endocrinology Tags: Int J Endocrinol Source Type: research
Conclusions:The risks of cardiovascular disease and cancer were not elevated among postmenopausal women using vaginal estrogens, providing reassurance about the safety of treatment. Objective: To determine the association between use of vaginal estrogen and risk of a global index event (GIE), defined as time to first occurrence of coronary heart disease (CHD), invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, or death from any cause. Methods: For this prospective observational cohort study, we used data from participants of the Women's Health Initiative Observat...
Source: Menopause - Category: OBGYN Tags: Original Articles Source Type: research
This study, the first to examine potential adverse health effects in users of vaginal estrogen compared with non-users, suggests that vaginal estrogen therapy is a safe treatment for genitourinary symptoms such as burning, discomfort, and pain during intercourse associated with menopause.AUTHORSThe paper ’s authors are Dr. Carolyn Crandall of UCLA; Kathleen Hovey of the State University of New York at Buffalo; Christopher Andrews of the University of Michigan; Dr. Rowan Chlebowski of City of Hope; Marcia Stefanick of Stanford University; Dr. Dorothy Lane of the State University of New York at Ston y Brook; Dr. Jan Sh...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
Abstract: The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and a...
Source: Menopause - Category: OBGYN Tags: Position Statement Source Type: research
Authors: Parish SJ, Gillespie JA Abstract This review describes the evolving role of oral hormone therapy (HT) for treating menopausal symptoms and preventing osteoporosis, focusing on conjugated estrogens/bazedoxifene (CE/BZA). Estrogens alleviate hot flushes and prevent bone loss associated with menopause. In nonhysterectomized women, a progestin should be added to estrogens to reduce the risk of endometrial cancer. Use of HT declined since the Women's Health Initiative (WHI) studies showed that HT does not prevent coronary heart disease (CHD) and that conjugated estrogens/medroxyprogesterone acetate increased th...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
Conclusions: In black postmenopausal women with prior hysterectomy, estrogen alone significantly reduced breast cancer incidence with no adverse influence on CHD, venous thromboembolism, or all-cause mortality. Favorable estrogen-alone global index effects in younger black women warrant further study.
Source: Menopause - Category: OBGYN Tags: Original Articles Source Type: research
CONCLUSIONS: Women with intolerable menopausal symptoms may wish to weigh the benefits of symptom relief against the small absolute risk of harm arising from short-term use of low-dose HT, provided they do not have specific contraindications. HT may be unsuitable for some women, including those at increased risk of cardiovascular disease, increased risk of thromboembolic disease (such as those with obesity or a history of venous thrombosis) or increased risk of some types of cancer (such as breast cancer, in women with a uterus). The risk of endometrial cancer among women with a uterus taking oestrogen-only HT is well docu...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
Introduction Hormone therapy (HT) is commonly prescribed for the relief of climacteric symptoms in post-menopausal women; 54% (620490) of women enrolled in the Million Women Study1 in the UK (mean age 56 years) have tried it and 31% (358252) use it. Observational studies have shown oral HT is associated with lower rates of cardiovascular disease in post-menopausal women2; however randomised controlled trials (RCTs) have presented mixed results. The 2002 publication of the Women's Health Initiative I (WHI I) reported an association between combined oestrogen and progestin use and increased rates of both coronary heart...
Source: Heart - Category: Cardiology Authors: Tags: Drugs: cardiovascular system, Cochrane Corner, Acute coronary syndromes, Venous thromboembolism, Epidemiology Editorials Source Type: research
Conclusion: Our findings provide recent data on the types of menopausal symptoms experienced by mid-life women prescribed HT. Electronic medical records may be a rich source of data for future studies of menopausal symptoms in this population.
Source: BMC Women's Health - Category: OBGYN Authors: Source Type: research
According to this study: * Hormone therapy in women who have reached menopause confers little protection against cardiovascular disease, but it significantly increases the risk of stroke and venous thromboembolic events. * A subgroup analysis showed some cardiovascular benefit when treatment was started less than 10 years after the onset of menopause.
Source: AJN - Category: Nursing Tags: Journal Watch Source Type: research
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