Uterine fibroids in menopause and perimenopause

Uterine fibroids (UFs) are benign tumors that arise from a single genetically altered mesenchymal stem cell under the influence of gonadal hormones. UFs are the most common benign gynecologic tumors in premenopausal women worldwide. It is estimated that nearly 70% to 80% of women will develop UFs at some point during their lifetime. UFs often present with abnormal uterine bleeding (AUB), pelvic fullness, and may have deleterious effects on fertility. The natural regression of UFs begins in menopause. This is, however, a generality as this pathology may still be present in this age group. Many clinicians are concerned about hormone therapy (HT) because of UFs regrowth; nevertheless, research of this subject remains inconclusive. If UFs are present in perimenopause or menopause, they typically manifest as AUB, which represents up to 70% of all gynecological consultations in perimenopausal and postmenopausal women. As AUB is a broad symptom and may not be specific to UFs, a thorough evaluation is required for correct diagnosis and proper treatment accordingly. Understanding the unique characteristics of the available treatment modalities is crucial in deciding the appropriate treatment approach. Decision on treatment modality should be made based on selection of the least morbidity and lowest risk for each patient. Multiple modalities are available; however, surgery remains the method of choice, with the best cure rates. Various attempts to create an inexpensive, safe, and effec...
Source: Menopause - Category: OBGYN Tags: Clinical Corner: Invited Review Source Type: research

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Abstract Menopause is characterized by permanent cessation of menstrual periods and is clinically diagnosed after 12 months of complete amenorrhea. It occurs at a median age of 51 years alongside the physiological process of aging, although it can happen at an earlier age for other medical conditions or after surgery (surgical menopause). Due to reduced circulating estrogens and progesterone, the reproductive organs undergo progressive atrophy. This physiologic process of aging is also present at an endometrial level; without the cyclic hormonal actions of the menstrual cycle, the endometrium during ...
Source: Climacteric - Category: Geriatrics Authors: Tags: Climacteric Source Type: research
Objective: To examine the relationship between menopausal status and mental well-being, and whether this relationship varies as a function of physical activity (PA). Methods: Based on a hormonal analysis and bleeding diary, women aged 47 to 55 were categorized as pre (n = 304), early peri (n = 198), late peri (n = 209), or postmenopausal (n = 387). Mental well-being was assessed using the Centre for Epidemiologic Studies Depression Scale, the International Positive and Negative Affect Schedule Short Form, and the Satisfaction with Life Scale. PA was self-reported and categorized as low, medium, and hig...
Source: Menopause - Category: OBGYN Tags: Original Studies Source Type: research
Objective: The aim of the study was to evaluate the effect of a single-capsule 17β-estradiol/progesterone (E2/P4), TX-001HR, on endometrial safety, to report on amenorrhea and bleeding patterns of users, and to identify predictors of amenorrhea. Methods: The REPLENISH trial (NCT01942668) evaluated use of TX-001HR in menopausal women (40-65 y) with vasomotor symptoms (VMS) and a uterus. Women were randomized to daily E2/P4 (mg/mg: 1/100, 0.5/100, 0.5/50, or 0.25/50), or placebo for 12 months. Incidence rate of endometrial hyperplasia was calculated from endometrial biopsies conducted at screening and study complet...
Source: Menopause - Category: OBGYN Tags: Original Studies Source Type: research
Lichen sclerosus is a benign dermatologic condition of the anogenital region that is most commonly seen in prepubescent girls and post-menopausal women. Presentation is variable and includes vulvar itching, infections of the urinary tract, urinary incontinence or vulvovaginal bleeding. Long term sequelae are often minimal, however, without adequate identification and treatment girls may experience future sexual dysfunction or changes in vulvar architecture.
Source: Journal of Pediatric and Adolescent Gynecology - Category: OBGYN Authors: Source Type: research
CONCLUSIONS: There is currently an absence of evidence to indicate the effectiveness of health education interventions involving healthcare providers or individuals or both to promote early presentation and referral for women with endometrial cancer symptoms. High-quality RCTs are needed to assess whether health education interventions enhance early presentation and referral. If health education interventions can be shown to reduce treatment delays in endometrial cancer, further studies would be required to determine which interventions are most effective. PMID: 32168393 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Regular brushing and flossing are the cornerstones of good oral health. But what if you learned that your toothpaste was good for your teeth, but bad for your bones? That possibility has been raised by a recent study. The cause of this unprecedented finding may be triclosan, an antibacterial agent added to toothpaste to reduce gum infections and improve oral health. However, it may actually be causing more harm than good. Rethinking a popular germ killer Triclosan is an antibacterial agent that’s been around for decades. Not only has it been used in soaps, hand sanitizers, and deodorants, but it’s found its way...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Dental Health Osteoporosis Source Type: blogs
Abstract Epithelioid trophoblastic tumor is a rare gestational trophoblastic neoplasm arising from the intermediate trophoblasts. Although usually seen in the reproductive period, it may be encountered during the postmenopausal period. A 56-year-old woman who had given her last birth 21 years ago presented to the hospital with a complaint of postmenopausal bleeding. She had a history of eight live pregnancies and had been in menopause for 4 years. With the help of typical histopathologic and immunohistochemical findings, a diagnosis of "epithelioid trophoblastic tumor" was made. The diagnosis was made at...
Source: Indian Journal of Pathology and Microbiology - Category: Pathology Authors: Tags: Indian J Pathol Microbiol Source Type: research
Conclusion DEAC is a more aggressive histological subtype of endometrioid adenocarcinomas. Better awareness of this condition can lead to proper diagnosis and treatment.
Source: Gynecologic Oncology Reports - Category: OBGYN Source Type: research
Study finds measuring anti-M üllerian hormone gives a more accurate prediction than assessing bleeding patterns Related items fromOnMedica Early periods linked to heightened cardiovascular risk Doctors claim they can delay the menopause by 20 years DIY urine test could be cervical screening ‘game changer’ Eight in ten stillbirths might have been avoided Data don ’t support HRT for chronic disease prevention
Source: OnMedica Latest News - Category: UK Health Source Type: news
ConclusionFor patients with gynecological malignancies, rare cases such as fallopian tube cancer should never be overlooked as a differential diagnosis.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
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