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Vaginal estrogen use and chronic disease risk in the Nurses’ Health Study
Conclusions: Vaginal estrogen use was not associated with a higher risk of cardiovascular disease or cancer. Our findings lend support to the safety of vaginal estrogen use, a highly effective treatment for genitourinary syndrome of menopause.
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Hormone therapy in menopausal women with fibroids: is it safe?
Menopause is an important transition in the life of women. It has been estimated that by the year 2030, worldwide 1.2 billion women will be menopausal. The most bothersome symptoms of menopause are believed to be due to declines in estrogen levels in postmenopausal women. Thus, hormone therapy is an effective treatment option for menopausal women, although prolonged use of hormone therapy is associated with a slightly increased risk of breast cancer, thromboembolism, and stroke. A literature search for studies evaluating the effects of hormone therapy in menopausal women with asymptomatic fibroids demonstrated variable eff...
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Personal Perspective Source Type: research

Pancreatic Cancer in Pregnancy Presenting with Thromboembolic Events: Case Report and Review of the Literature
We describe the case of a healthy 31-year-old G2P1 who presented with visual changes and dysarthria during pregnancy. Imaging showed cerebral infarcts. Her thrombophilia evaluation was negative. During delivery, she was diagnosed with fulminant Budd-Chiari Syndrome. Hepatic ultrasound suggested malignancy or metastasis, and postpartum CT scan and biopsy confirmed the diagnosis of Stage IV pancreatic cancer. Although rare in pregnancy, a new diagnosis of malignancy should be considered in patients with recurrent unexplained hypercoagulable complications. We propose an evidence-based algorithm for evaluation of occult malign...
Source: Gynecologic and Obstetric Investigation - June 8, 2018 Category: OBGYN Source Type: research

Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women's Health Initiative Observational Study
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 - January 1, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Estrogen alone and health outcomes in black women by African ancestry: a secondary analyses of a randomized controlled trial
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 - January 28, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Prevalence of menopausal symptoms among mid-life women: findings from electronic medical records
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 - August 13, 2015 Category: OBGYN Authors: Matthew SussmanJeffrey TrocioCraig BestSebastian MirkinAndrew BushmakinRobert YoodMark FriedmanJoseph MenzinMichael Louie Source Type: research

Managing menopause.
Authors: Reid R, Abramson BL, Blake J, Desindes S, Dodin S, Johnston S, Rowe T, Sodhi N, Wilks P, Wolfman W, Menopause and Osteoporosis Working Group, Fortier M, Reid R, Abramson BL, Blake J, Desindes S, Dodin S, Graves L, Guthrie B, Khan A, Johnston S, Rowe T, Sodhi N, Wilks P, Wolfman W Abstract OBJECTIVE: To provide updated guidelines for health care providers on the management of menopause in asymptomatic healthy women as well as in women presenting with vasomotor or urogenital symptoms and on considerations related to cardiovascular disease, breast cancer, urogynaecology, and sexuality. OUTCOMES: Lifestyle...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - December 2, 2014 Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research

Risk of thrombosis in women with malignancies undergoing ovarian stimulation for fertility preservation
CONCLUSIONS The available evidence on the risks of thrombosis for women undergoing ovarian stimulation for fertility preservation due to a malignancy is reassuring. However the avoidance of the early form of OHSS in women preserving oocytes/embryos due to malignancy is crucial. For these cycles, we advocate the use of a regimen of ovarian stimulation with gonadotrophin releasing hormone (GnRH) antagonists using GnRH agonists to trigger ovulation, an approach that has been shown to markedly reduce the risk of OHSS. Antithrombotic prophylaxis should be administered only to selected subgroups of women such as those with other...
Source: Human Reproduction Update - October 14, 2014 Category: OBGYN Authors: Somigliana, E., Peccatori, F. A., Filippi, F., Martinelli, F., Raspagliesi, F., Martinelli, I. Tags: Reviews Source Type: research

FDA Approval of Paroxetine for Menopausal Hot Flushes
ABSTRACT: In June 2013, the Food and Drug Administration (FDA) approved paroxetine (Brisdelle, Noven) for the treatment of moderate to severe hot flushes (vasomotor symptoms) associated with menopause. Brisdelle is the only nonhormonal treatment approved by the FDA for this indication. Prior to approval of Brisdelle, FDA-approved treatments for hot flashes were hormones containing either estrogen alone or estrogen plus a progestin. Hormonal therapy is highly effective for treating vasomotor symptoms. However, the use of hormonal therapy dropped substantially after initial findings of the Women’s Health Initiative randomi...
Source: Obstetrical and Gynecological Survey - October 1, 2014 Category: OBGYN Tags: Gynecology: Office Gynecology Source Type: research

Lessons Learned From the Women's Health Initiative Trials of Menopausal Hormone Therapy.
Abstract We re-evaluate the Women's Health Initiative findings and their implications for clinical practice. Menopausal hormone therapy (HT) was effective for relief of vasomotor symptoms, and the risk of coronary heart disease (CHD) tended to be reduced in women close to menopause compared with the increased risk in women more distant from menopause. In recently menopausal women, short-term absolute risks of stroke and venous thromboembolism were small. Estrogen plus progestin therapy, but not estrogen therapy, increased the risk of breast cancer with a suggestion of greater risk when initiated close to the menop...
Source: Obstetrics and Gynecology - January 1, 2013 Category: OBGYN Authors: Rossouw JE, Manson JE, Kaunitz AM, Anderson GL Tags: Obstet Gynecol Source Type: research