If you are a female, 18-45 years old, and have been diagnosed with endometriosis, you may qualify for this study of endometriosis pain. Participants may receive study-related medication, lab tests, exams, and compensation for time and travel.
The research site is in Moorestown, NJ.
More information
Please see
http://www.centerwatch.com/patient/studies/cat60.html.
Wednesday, January 31, 2007
Tuesday, January 30, 2007
93 Pound Cyst Removed From Kellyville Woman
KOTV - 1/29/2007 10:21 AM - Updated 1/29/2007 5:04 PM
A Tulsa doctor makes a startling discovery, a giant tumor growing inside one of her patients. News on 6 reporter Emory Bryan has the story.
Taquela Hilton believes she literally owes her life to her doctor, Jennifer Cameron. It was Doctor Cameron who finally believed Taquela had something that was making her gain weight. Hilton's problems, including diabetes, high blood pressure and obesity, are all connected to a single problem that was undiagnosed for at least a dozen years.
"I quit going to doctors, every one I went to told me to lose weight and I had tried every diet I could think of," patient Taquela Hilton said.
It was just 20 days ago that doctors operated and removed the problem, a benign tumor, an ovarian cyst that weighed 93 pounds.
"This was just like a big balloon, a big beach ball," Dr. Jennifer Cameron said.
No one is sure how long the cyst had been growing, but Taquela believes her weight hasn't matched her diet since childhood. She's 32 now, and both she and her doctor are optimistic.
“And I really truly believe that all these complications won't require a whole lot more intervention,” said Dr. Cameron.
"I know the weight affected my marriage, it affected a lot of things,” Hilton said. “I had faith that something would be found and it happened."
Taquela and her doctor aren't sure what will happen once her body adjusts to not having the cyst inside of her, but they are delaying a planned gastric bypass, and thinking of cosmetic skin removal surgery instead. Taquela says she drove a car for the first time in years this past week, and she's hoping to shop for some new smaller clothes soon.
Source
A Tulsa doctor makes a startling discovery, a giant tumor growing inside one of her patients. News on 6 reporter Emory Bryan has the story.
Taquela Hilton believes she literally owes her life to her doctor, Jennifer Cameron. It was Doctor Cameron who finally believed Taquela had something that was making her gain weight. Hilton's problems, including diabetes, high blood pressure and obesity, are all connected to a single problem that was undiagnosed for at least a dozen years.
"I quit going to doctors, every one I went to told me to lose weight and I had tried every diet I could think of," patient Taquela Hilton said.
It was just 20 days ago that doctors operated and removed the problem, a benign tumor, an ovarian cyst that weighed 93 pounds.
"This was just like a big balloon, a big beach ball," Dr. Jennifer Cameron said.
No one is sure how long the cyst had been growing, but Taquela believes her weight hasn't matched her diet since childhood. She's 32 now, and both she and her doctor are optimistic.
“And I really truly believe that all these complications won't require a whole lot more intervention,” said Dr. Cameron.
"I know the weight affected my marriage, it affected a lot of things,” Hilton said. “I had faith that something would be found and it happened."
Taquela and her doctor aren't sure what will happen once her body adjusts to not having the cyst inside of her, but they are delaying a planned gastric bypass, and thinking of cosmetic skin removal surgery instead. Taquela says she drove a car for the first time in years this past week, and she's hoping to shop for some new smaller clothes soon.
Source
Aberrant Expression of Leptin in Human Endometriotic Stromal Cells Is Induced by Elevated Levels of Hypoxia Inducible Factor-1
Elevated expression of leptin in endometriotic tissue results in an increase in stromal cell proliferation and may contribute to the development of endometriosis. However, the underlying mechanism responsible for aberrant expression of leptin is not known. We hypothesize that aberrant expression of leptin in endometriotic stroma may be regulated by increased levels of hypoxia-inducible factor-1 (HIF-1), the master transcription factor that controls gene expression in response to hypoxia. Herein we show that the mRNA and protein levels of HIF-1 were greater in ectopic endometriotic tissue compared with its eutopic counterpart. Exposure of eutopic endometrial stromal cells under hypoxic conditions or treated with desferrioxamine (DFO, chemical hypoxia) resulted in a time-dependent increase in leptin gene expression. A promoter activity assay demonstrated that HIF-1 induced leptin promoter activity after DFO treatment. Chromatin immunoprecipitation assay further demonstrated that binding of HIF-1 to leptin promoter was evident after DFO treatment. Finally, depletion of HIF-1 by short interference RNA abolished leptin expression in ectopic endometriotic stromal cells. Taken together, our data demonstrate that aberrant expression of leptin in ectopic endometriotic stromal cells is induced, at least in part, by an elevated level of HIF-1 in these cells, providing new insights into the etiology of endometriosis.
Source , authors and references
Source , authors and references
Baby joins the Spice mums
Former Spice Girl Emma Bunton has revealed that she is about to join Victoria, Mel and Geri in becoming a mum.She and long-term boyfriend Jade Jones are expecting the arrival this summer and are understandably thrilled at the prospect of having a 'Baby' all of their own.The news is particularly joyous for Emma after she revealed that she was concerned that her health problems could affect her fertility. Emma had pre-cancerous cells removed from her cervix in 2000 and then discovered that she was suffering from endometriosis, a condition where tissue similar to the lining of the uterus is also found elsewhere in the body, mainly in the abdominal cavity
Read the rest...
Read the rest...
From Blogsphere: Introduces ovarian
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Search Article IDs Search Article IDs Search Article IDs Search Article Titles Search Articles Search Expert Authors Search Article IDs Search Article Keywords ... Ovarian Cysts ... Latest News; Enlarged Ovaries Common in Healthy Teen Girls (11/03/2006, Reuters Health ... An ovarian cyst is a functional ovarian cyst? - An - ovarian cyst is a sac filled with fluid or a semisolid material that ... Welcome to the Web site of Beth Israel cyst ovarian pregnant while Introduces ovarian cysts, infertility, weight loss ... To get your "Foundation of Health E-Book" written by. Dr Marilyn Glenville simply register ... Please tell us about yourself, your medical problem(s) and any other information that may help us send you the appropriate material. *This information you are about to fill out is treated with the ... Ovarian Cysts ... Ovarian Cysts ... 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http://auroraxeoel.blogspot.com/2007/01/introduces-ovarian.html
http://auroraxeoel.blogspot.com/2007/01/introduces-ovarian.html
Endometriosis in the male.
An 83-year-old man with an endometrioma of the lower abdominal wall has been reported. This occurred following the administration of 25 mg of TACE for a period of about 10 years for what was thought to be carcinoma of the prostate. A second transurethral resection done by Dr. R. C. Thompson proved to be adenocarcinoma. Subsequent to this he was continued on TACE. A review of the more commonly accepted theories of the development of endometriosis in the female has been presented. It is pointed out that the separation between the male and female urogenital systems occurs in the embryo between the eighth week and the fourth month. There is always a possibility for remnants of the opposite sex to remain in individuals. No such was seen in the case which is herein reported. Normal phenotype male was demonstrated in the chromosomal evaluation. A review of the literature on endometriosis in the male reveals several cases which have occurred; the origin of which is though to be from the prostatic utricle which is a remnant of the uterus existing in the male. After a prolonged course the patient reported was followed until he died in 1979. There was no recurrence of the abdominal wall mass but persistent low grade carcinoma of the prostate remained. The terminal process was related to cardiovascular disease and not carcinoma of the prostate. There was delay in publication of this unusual case. The original plan was to await final confirmation of the exact pathologic nature of this condition; unfortunately this was never done since a postmortem examination was not performed.(ABSTRACT TRUNCATED AT 250 WORDS)
PMID: 4014886 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4014886&dopt=Abstract
PMID: 4014886 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4014886&dopt=Abstract
Friday, January 26, 2007
TAP Pharmaceuticals -Annoying spam -Endometriosis
Most of spam is purely annoying. None more so than done by big Pharamaceutical companies like TAP. Their current campaign, cleverly called EndoKnow, is being pushed by a company called Silver Coffer, who's broken web site should offer the prospect of stopping the onslaught.
Pushing some sort of drug via email isn' t new, but something about a transnational proffering pills for endometriosis is just plain galling. We'd let readers know how to get a hold of Silver Coffer, but their broken website doesn't offer up a phone number.
Read More
Tap make the scandle ridden drug lupron.
Pushing some sort of drug via email isn' t new, but something about a transnational proffering pills for endometriosis is just plain galling. We'd let readers know how to get a hold of Silver Coffer, but their broken website doesn't offer up a phone number.
Read More
Tap make the scandle ridden drug lupron.
Lung & Colon Endometriosis Website Launched by Former Major USAF and Author Dr. Glynis D. Wallace; Icon Pictures Portray ‘Universal’ Military Healthca
Dr. Wallace’s CatamenialPneumothorax.org Site For Global Outreach; Provides Hope and Help for Women and Healthcare Providers
Disease Flow Chart Animations From Website Now Featured On ‘You Tube’ and Other Social Media Sites Worldwide
LOS ANGELES--(BUSINESS WIRE)--Today marks the launch of http://catamenialpneumothorax.org, the brainchild of Glynis D. Wallace, DMD. Dr. Wallace created the patient and physician education website after receiving worldwide accolades from readers of her book, “Living with Lung and Colon Endometriosis,” September 2005, a tribute to her plight, and her enormous ability to story tell with honesty her maze-like healthcare journey. The book is available in eight countries, and details her phenomenal military-based healthcare journey to win the battle with pulmonary endometriosis.
According to Dr. Wallace, the mission of the website is heartfelt. “My mission is to make every woman in every country, and the physicians who treat them, aware of this disease and treatment options!”
The website advances a global call to action and is the first of its kind to alert the nation and global healthcare community to the prevalence, hardship, and treatment options of this rare disease from a patients’ perspective. Dr. Wallace’s real-life experience is captured using “universal” animated icon and text-based web pages, designed for everyone, regardless of their ability to read, or to read English.
Adds Dr. Wallace, “The website helps educate a global patient and provider community to better understand the prevalence, hardship, and treatment options of this rare disease, and create global understanding among a cross section of medical subspecialties, ultimately leading to quicker, easier, and more widespread global diagnosis, and subsequent treatment regimes.”
About CatamenialPneumothorax.org
The tremendous worldwide interest in Dr. Wallace's book "Living With Lung and Colon Endometriosis: Catamenial Pneumothorax," demonstrated the need for a call to action. Catamenial Pneumothorax.org serves to alert the global health care community to the prevalence, hardship, and treatment options that can make Catamenial Pneumothorax/Lung and Colon Endometriosis, well known and understood among a cross section of medical specialties. The goal of the website and Dr. Wallace’s efforts is to spearhead quicker, easier, and more widespread global diagnosis, and subsequent treatment regimes. http://catamenialpneumothorax.org.
Disease Flow Chart Animations From Website Now Featured On ‘You Tube’ and Other Social Media Sites Worldwide
LOS ANGELES--(BUSINESS WIRE)--Today marks the launch of http://catamenialpneumothorax.org, the brainchild of Glynis D. Wallace, DMD. Dr. Wallace created the patient and physician education website after receiving worldwide accolades from readers of her book, “Living with Lung and Colon Endometriosis,” September 2005, a tribute to her plight, and her enormous ability to story tell with honesty her maze-like healthcare journey. The book is available in eight countries, and details her phenomenal military-based healthcare journey to win the battle with pulmonary endometriosis.
According to Dr. Wallace, the mission of the website is heartfelt. “My mission is to make every woman in every country, and the physicians who treat them, aware of this disease and treatment options!”
The website advances a global call to action and is the first of its kind to alert the nation and global healthcare community to the prevalence, hardship, and treatment options of this rare disease from a patients’ perspective. Dr. Wallace’s real-life experience is captured using “universal” animated icon and text-based web pages, designed for everyone, regardless of their ability to read, or to read English.
Adds Dr. Wallace, “The website helps educate a global patient and provider community to better understand the prevalence, hardship, and treatment options of this rare disease, and create global understanding among a cross section of medical subspecialties, ultimately leading to quicker, easier, and more widespread global diagnosis, and subsequent treatment regimes.”
About CatamenialPneumothorax.org
The tremendous worldwide interest in Dr. Wallace's book "Living With Lung and Colon Endometriosis: Catamenial Pneumothorax," demonstrated the need for a call to action. Catamenial Pneumothorax.org serves to alert the global health care community to the prevalence, hardship, and treatment options that can make Catamenial Pneumothorax/Lung and Colon Endometriosis, well known and understood among a cross section of medical specialties. The goal of the website and Dr. Wallace’s efforts is to spearhead quicker, easier, and more widespread global diagnosis, and subsequent treatment regimes. http://catamenialpneumothorax.org.
Surgical Treatment
Only surgery can properly diagnose and stage the disease.
Endometriosis in its early stages can be treated at the time of laparoscopic (surgical) diagnosis. During laparoscopy, a thin viewing tube (called a laparoscope) is passed through a small incision in the abdomen. A second incision may be made on the lower abdomen to provide an additional opening for surgical instruments.Using the laparoscope, the surgeon inspects the outside of the uterus, ovaries, fallopian tubes and nearby organs. The laparoscope can also be fitted with surgical devices for taking tissue samples or removing scar tissue.Endometrial lesions (implants of endometrial tissue outside of the endometrium) can be cut away (excised) or burned away using a high-energy heat source, such as a laser (ablation). Treatment with laparoscopy is more difficult with advanced disease that involves large areas of the rectum or larger lesions.An endometrioma is a mass of tissue (noncancerous cyst or tumor) that contains shreds of endometrial tissue. Endometriomas most frequently occur in the ovary, in a part of the peritoneum (sac around the internal organs) between the rectum and uterus, the wall (septum) between the rectum and vagina, and the outside of the uterus.Several surgical treatments are available for endometriomas:
Simple puncture - This procedure is completed by draining the fluid from the cyst. Endometriomas have been shown to recur in about 50 percent of the patients treated with simple puncture. However, a more aggressive surgical approach, such as cutting away the mass, can cause extensive adhesions (scar tissue) that may prevent the ovary from releasing an egg.
Ablation - To drain the cyst and remove its base with laser or electrosurgery. However, heat can also damage the ovary.
Cutting away of the cyst wall - This is the procedure of choice to decrease recurrence of disease. This procedure can also damage the outer layer of the ovary that contains the eggs.
Draining, drug therapy, and surgery - Endometriomas can also be drained, treated with medication, and later removed by surgery. Endometriomas recur in 8 percent of the patients treated with this procedure. Results from several different prospective studies have reported pregnancy rates of 50 percent over 3 years. There are no randomized clinical trials comparing these different treatment methods. The most challenging surgery by laparoscopy or by laparotomy (traditional abdominal surgery, which requires a large incision) is the management of advanced endometriosis within the pelvic cavity and the rectum and vagina. Several studies have reported pregnancy rates over 2 years of 50 to 60 percent of cases treated with surgery. According to several reports, endometriosis may recur in 20 percent of the cases.Please see "Intestinal Endometriosis" by Dr. David Redwine.Adhesions are fibrous bands connecting structures that normally are separate. Adhesions develop as a response of normal tissue to some type of injury or trauma (as in surgery). In most cases, patients who undergo surgery for endometriosis will form new adhesions at the site of the surgery. Adhesion formation may cause infertility by impairing the function of the ovaries and fallopian tubes. Adhesions also may cause pelvic pain and small bowel obstruction.There are some newer preventive treatments that can be used during surgery to help prevent adhesions from forming. These include rinsing the pelvic cavity with special solutions and placing a piece of protective material (such as Interceed) into the pelvic area to serve as a barrier. The barrier keeps the surfaces from rubbing together after surgery, which can lead to adhesion formation. The barrier dissolves and is absorbed when it is no longer needed.In some cases, a woman will have to undergo additional surgery to remove adhesions formed from previous surgery. Fortunately, the advancement of laparoscopic surgery and the development of these new preventive treatments can reduce the chances of adhesion formation.Please see "A Patients Guide to Adhesions and Related Pain" by Dr. David M. Wiseman.
Source
Endometriosis in its early stages can be treated at the time of laparoscopic (surgical) diagnosis. During laparoscopy, a thin viewing tube (called a laparoscope) is passed through a small incision in the abdomen. A second incision may be made on the lower abdomen to provide an additional opening for surgical instruments.Using the laparoscope, the surgeon inspects the outside of the uterus, ovaries, fallopian tubes and nearby organs. The laparoscope can also be fitted with surgical devices for taking tissue samples or removing scar tissue.Endometrial lesions (implants of endometrial tissue outside of the endometrium) can be cut away (excised) or burned away using a high-energy heat source, such as a laser (ablation). Treatment with laparoscopy is more difficult with advanced disease that involves large areas of the rectum or larger lesions.An endometrioma is a mass of tissue (noncancerous cyst or tumor) that contains shreds of endometrial tissue. Endometriomas most frequently occur in the ovary, in a part of the peritoneum (sac around the internal organs) between the rectum and uterus, the wall (septum) between the rectum and vagina, and the outside of the uterus.Several surgical treatments are available for endometriomas:
Simple puncture - This procedure is completed by draining the fluid from the cyst. Endometriomas have been shown to recur in about 50 percent of the patients treated with simple puncture. However, a more aggressive surgical approach, such as cutting away the mass, can cause extensive adhesions (scar tissue) that may prevent the ovary from releasing an egg.
Ablation - To drain the cyst and remove its base with laser or electrosurgery. However, heat can also damage the ovary.
Cutting away of the cyst wall - This is the procedure of choice to decrease recurrence of disease. This procedure can also damage the outer layer of the ovary that contains the eggs.
Draining, drug therapy, and surgery - Endometriomas can also be drained, treated with medication, and later removed by surgery. Endometriomas recur in 8 percent of the patients treated with this procedure. Results from several different prospective studies have reported pregnancy rates of 50 percent over 3 years. There are no randomized clinical trials comparing these different treatment methods. The most challenging surgery by laparoscopy or by laparotomy (traditional abdominal surgery, which requires a large incision) is the management of advanced endometriosis within the pelvic cavity and the rectum and vagina. Several studies have reported pregnancy rates over 2 years of 50 to 60 percent of cases treated with surgery. According to several reports, endometriosis may recur in 20 percent of the cases.Please see "Intestinal Endometriosis" by Dr. David Redwine.Adhesions are fibrous bands connecting structures that normally are separate. Adhesions develop as a response of normal tissue to some type of injury or trauma (as in surgery). In most cases, patients who undergo surgery for endometriosis will form new adhesions at the site of the surgery. Adhesion formation may cause infertility by impairing the function of the ovaries and fallopian tubes. Adhesions also may cause pelvic pain and small bowel obstruction.There are some newer preventive treatments that can be used during surgery to help prevent adhesions from forming. These include rinsing the pelvic cavity with special solutions and placing a piece of protective material (such as Interceed) into the pelvic area to serve as a barrier. The barrier keeps the surfaces from rubbing together after surgery, which can lead to adhesion formation. The barrier dissolves and is absorbed when it is no longer needed.In some cases, a woman will have to undergo additional surgery to remove adhesions formed from previous surgery. Fortunately, the advancement of laparoscopic surgery and the development of these new preventive treatments can reduce the chances of adhesion formation.Please see "A Patients Guide to Adhesions and Related Pain" by Dr. David M. Wiseman.
Source
My heavy periods were a sign I was at risk of infertility
By ISLA WHITCROFT
Last year, Julia Bradbury, a presenter on BBC1's Watchdog, underwent surgery for endometriosis. This painful condition affects up to two million women in the UK and can cause infertility. Although it is treatable, some don't discover they have the condition until it is too late.
Here, Julia, who is single and lives in London, tells ISLA WHITCROFT how she discovered that she had the condition:
Back in October 2005, I popped into the Viveka Well Woman clinic in London for a check-up. I didn't have any specific health concerns - my hectic life as a TV presenter doesn't really give me any time to be ill - but at the ripe old age of 33, I felt it would be a good time to check that I was still in working order.
Like millions of women in their 30s who haven't yet settled down and started having babies, I wanted to know I was still fertile - that my eggs were still making a monthly appearance and, should I want to, I could still conceive and carry a baby.
I wasn't anticipating any problems, but chatting to the doctor I mentioned casually that since I'd turned 30 my periods had been getting heavier. He sent me for an ultrasound scan of my womb and within an hour I was listening with disbelief as the radiologist explained that I had clear and extensive signs of endometriosis.
Read More
Last year, Julia Bradbury, a presenter on BBC1's Watchdog, underwent surgery for endometriosis. This painful condition affects up to two million women in the UK and can cause infertility. Although it is treatable, some don't discover they have the condition until it is too late.
Here, Julia, who is single and lives in London, tells ISLA WHITCROFT how she discovered that she had the condition:
Back in October 2005, I popped into the Viveka Well Woman clinic in London for a check-up. I didn't have any specific health concerns - my hectic life as a TV presenter doesn't really give me any time to be ill - but at the ripe old age of 33, I felt it would be a good time to check that I was still in working order.
Like millions of women in their 30s who haven't yet settled down and started having babies, I wanted to know I was still fertile - that my eggs were still making a monthly appearance and, should I want to, I could still conceive and carry a baby.
I wasn't anticipating any problems, but chatting to the doctor I mentioned casually that since I'd turned 30 my periods had been getting heavier. He sent me for an ultrasound scan of my womb and within an hour I was listening with disbelief as the radiologist explained that I had clear and extensive signs of endometriosis.
Read More
Thursday, January 25, 2007
Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 10
Hum Reprod. 2006 Aug 26;: 16936305
Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients.
[My paper] P Vercellini , L Fedele , G Aimi , G Pietropaolo , D Consonni , P G Crosignani
BACKGROUND: The association between lesion type, disease stage and severity of pain was studied in a large group of women with endometriosis to verify whether endometrial implants at different sites determine specific complaints and to evaluate the validity of the current classification system in women with symptomatic disease. METHODS: A total of 1054 consecutive women with endometriosis undergoing first-line conservative or definitive surgery were included. Data on age at surgery, disease stage according to the revised American Fertility Society (AFS) classification, anatomical characteristics of endometriotic lesions, and type and severity of pain symptoms were collected and analysed by multiple logistic regression. RESULTS: Minimal endometriosis was present in 319 patients, mild in 139, moderate in 292 and severe in 304. A significant inverse relationship was demonstrated between age at surgery and moderate-to-severe dysmenorrhoea, dyspareunia and non-menstrual pain. A strong association was found between posterior cul-de-sac lesions and pain at intercourse [Wald chi (2) = 17.00, P = 0.0001; odds ratio (OR) = 2.64, 95% confidence interval (CI) = 1.68-4.24]. A correlation between endometriosis stage and severity of symptoms was observed only for dysmenorrhoea (Wald chi (2) = 5.14, P = 0.02) and non-menstrual pain (Wald chi (2) = 5.63, P = 0.018). However, the point estimates of ORs were very close to unity (respectively, 1.33, 95% CI = 1.04-1.71, and 1.01, 95% CI = 1.00-1.03). CONCLUSIONS: The association between endometriosis stage and severity of pelvic symptoms was marginal and inconsistent and could be demonstrated only with a major increase in study power.
Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients.
[My paper] P Vercellini , L Fedele , G Aimi , G Pietropaolo , D Consonni , P G Crosignani
BACKGROUND: The association between lesion type, disease stage and severity of pain was studied in a large group of women with endometriosis to verify whether endometrial implants at different sites determine specific complaints and to evaluate the validity of the current classification system in women with symptomatic disease. METHODS: A total of 1054 consecutive women with endometriosis undergoing first-line conservative or definitive surgery were included. Data on age at surgery, disease stage according to the revised American Fertility Society (AFS) classification, anatomical characteristics of endometriotic lesions, and type and severity of pain symptoms were collected and analysed by multiple logistic regression. RESULTS: Minimal endometriosis was present in 319 patients, mild in 139, moderate in 292 and severe in 304. A significant inverse relationship was demonstrated between age at surgery and moderate-to-severe dysmenorrhoea, dyspareunia and non-menstrual pain. A strong association was found between posterior cul-de-sac lesions and pain at intercourse [Wald chi (2) = 17.00, P = 0.0001; odds ratio (OR) = 2.64, 95% confidence interval (CI) = 1.68-4.24]. A correlation between endometriosis stage and severity of symptoms was observed only for dysmenorrhoea (Wald chi (2) = 5.14, P = 0.02) and non-menstrual pain (Wald chi (2) = 5.63, P = 0.018). However, the point estimates of ORs were very close to unity (respectively, 1.33, 95% CI = 1.04-1.71, and 1.01, 95% CI = 1.00-1.03). CONCLUSIONS: The association between endometriosis stage and severity of pelvic symptoms was marginal and inconsistent and could be demonstrated only with a major increase in study power.
Heavy Periods Have Other Remedies, Not Necessarily Hysterectomy
Almost one in four women, experience heavy periods at some stage in life, but only half of them really see a medical specialist. This is because of overriding fear that it would lead to a hysterectomy. Excessive menstrual bleeding may arise due to several conditions like Endometriosis, fibroids and hormonal imbalance. Many a time, there are no identifiable causes. Yet, heavy periods happen to be one of the important reasons for anemia in the developed nations. Such problems do have simple solutions - drugs and minor surgery. So, women should come forward and seek help rather than put up with the misery, fearing hysterectomy. Today, there are a host of treatments to the aid of such women. A small medicinally treated plastic instrument is implanted in the womb, equipped to convey progestogen, which slows the growth of the lining in the womb. Apart from this, many oral remedies are also available. Endometrial ablation, a surgical option, employs heat or microwave to wipe the lining of the womb, clean. These varied options have relegated hysterectomy to be the last and final resort, when all other treatment measures have failed to produce results. Professor Mary Ann Lumsden, chair of the NICE guideline group and consultant in gynecology in Glasgow said, ‘It affects well over a million women each year and means that some women can't get out of the house one or two days a month. It does cause a lot of misery. Women need to know what is on offer so they can make an informed choice that is for them.’
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Wednesday, January 24, 2007
Progestogens and estroprogestins in the treatment of pelvic pain associated with endometriosis.
Minerva Ginecol. 2006 Dec ;58(6):499-510 17108880
Progestogens and estroprogestins in the treatment of pelvic pain associated with endometriosis.
[My paper] R Daguati , E Somigliana , P Viganò , P Vercellini
We performed a MEDLINE and EMBASE search to identify all studies published in the English language literature on the use of progestogens for the treatment of endometriosis. The aim of our review was to clarify the biological rationale for treatment and define the drugs that can be used. It has been demonstrated that progestogens may prevent implantation and growth of regurgitated endometrium by inhibiting the expression of matrix metalloproteinases and angiogenesis, and they have several anti-inflammatory in vitro and in vivo effects that may reduce the inflammatory state generated by the metabolic activity of the ectopic endometrium. Oral contraceptives increase the abnormally low apoptotic activity of the endometrium of patients with endometriosis. Moreover, anovulation, decidualization, amenorrhoea and the establishment of a steady estrogen-progestogen milieu contribute to disease quiescence. Progestogens are able to control pain symptoms in approximately three out of four women with endometriosi. Different compounds can be administered by the oral, intramuscular, subcutaneous, intravaginal or intrauterine route, each with specific advantages or disadvantages. Medical treatment plays a role in the therapeutic strategy only if administered over a prolonged period of time. Given their good tolerability, minor metabolic effects and low cost, progestogens must therefore be considered drugs of choice and are currently the only safe and economic alternative to surgery. However, their contraceptive effectiveness limits their use to women who do not wish to have children in the short-term.
Progestogens and estroprogestins in the treatment of pelvic pain associated with endometriosis.
[My paper] R Daguati , E Somigliana , P Viganò , P Vercellini
We performed a MEDLINE and EMBASE search to identify all studies published in the English language literature on the use of progestogens for the treatment of endometriosis. The aim of our review was to clarify the biological rationale for treatment and define the drugs that can be used. It has been demonstrated that progestogens may prevent implantation and growth of regurgitated endometrium by inhibiting the expression of matrix metalloproteinases and angiogenesis, and they have several anti-inflammatory in vitro and in vivo effects that may reduce the inflammatory state generated by the metabolic activity of the ectopic endometrium. Oral contraceptives increase the abnormally low apoptotic activity of the endometrium of patients with endometriosis. Moreover, anovulation, decidualization, amenorrhoea and the establishment of a steady estrogen-progestogen milieu contribute to disease quiescence. Progestogens are able to control pain symptoms in approximately three out of four women with endometriosi. Different compounds can be administered by the oral, intramuscular, subcutaneous, intravaginal or intrauterine route, each with specific advantages or disadvantages. Medical treatment plays a role in the therapeutic strategy only if administered over a prolonged period of time. Given their good tolerability, minor metabolic effects and low cost, progestogens must therefore be considered drugs of choice and are currently the only safe and economic alternative to surgery. However, their contraceptive effectiveness limits their use to women who do not wish to have children in the short-term.
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Tuesday, January 23, 2007
Women Undergoing In Vitro Fertilization Needed for Two Stanford Studies
STANFORD, Calif.--(BUSINESS WIRE)--Of the tens of thousands of women who visit infertility clinics every year, some will never get pregnant, and doctors often can’t explain why. Researchers at the Stanford University School of Medicine are launching two studies they hope will help women undergoing in vitro fertilization and shed light on what factors affect their outcome.
For one study, researchers in the Department of Obstetrics and Gynecology are seeking 76 women who have been diagnosed with endometriosis and need IVF. Endometriosis, a condition in which tissue from the inside of the uterus grows outside the uterus, is associated with inflammation, pain and infertility.
“Some people think up to half of infertile women may have endometriosis,” said Lynn Westphal, MD, associate professor of obstetrics and gynecology and lead researcher of the studies. Doctors aren’t sure why endometriosis so frequently causes fertility problems, except that in an extreme case it can distort the anatomy of a woman’s pelvis. In more mild cases, doctors hypothesize that inflammation somehow changes the normal environment of the uterus, fallopian tubes or ovaries.
The researchers will be testing the effects of rosiglitazone, a drug currently on the market to treat diabetes, on the success rate of IVF in women with endometriosis. “Potentially, we may improve their outcome,” said Westphal. “We think the rosiglitazone could help with the inflammatory effect.”
Currently, Westphal said, women with endometriosis are treated no differently than other women undergoing IVF.
For a second study, researchers are recruiting 30 women undergoing their first IVF cycle. They will analyze how factors including age, hormone levels and fertility diagnoses affect IVF success.
“We know fertility declines with age, but no one has done this type of prospective study before,” said Westphal. “They’ve been mostly retrospective.” She thinks that designing a controlled experiment will give researchers a better understanding of the factors affecting IVF outcome, rather than just analyzing statistics.
One portion of the study will look at whether using birth control pills to manipulate a woman’s cycle before IVF influences the final outcome. Though it seems counterproductive, it is common for doctors to prescribe birth control in the month leading up to IVF. This gives women control over their schedules, and also reduces the chance of ovarian cysts.
“The majority of fertility centers in the United States rely on using birth control pills,” said Westphal.
The Stanford researchers will also collect blood from the patients, which they hope to eventually use to identify genetic markers that influence the outcome of IVF.
“If we find that there are genetic factors that predict how someone’s going to respond, then we can tailor the protocol more specifically to individual patients and improve pregnancy rates that way,” said Westphal.
In the long run, Westphal hopes the studies improve the success rates of IVF and make the process easier for women. She stressed that for IVF, as with many health issues, educating women about how and when to seek help is important.
“Even if patients aren’t thinking about needing IVF right now, if they’ve been trying to get pregnant for more than six months and they’re 35 or older, they really should think about getting an evaluation sooner rather than later,” she said.
To participate in either study, women must be under age 40 and able to visit the Stanford clinic on a regular schedule. For more information, call the IVF clinic at (650) 498-7911.
Stanford University Medical Center integrates research, medical education and patient care at its three institutions — Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children’s Hospital at Stanford.
For more information, please visit the Web site of the medical center’s Office of Communication & Public Affairs at http://mednews.stanford.edu.
Stanford University Medical CenterLouis Bergeron, 650-723-0272 (Print Media)louisb3@stanford.edu
M.A. Malone, 650-723-6912 (Broadcast Media)
mamalone@stanford.edu
For one study, researchers in the Department of Obstetrics and Gynecology are seeking 76 women who have been diagnosed with endometriosis and need IVF. Endometriosis, a condition in which tissue from the inside of the uterus grows outside the uterus, is associated with inflammation, pain and infertility.
“Some people think up to half of infertile women may have endometriosis,” said Lynn Westphal, MD, associate professor of obstetrics and gynecology and lead researcher of the studies. Doctors aren’t sure why endometriosis so frequently causes fertility problems, except that in an extreme case it can distort the anatomy of a woman’s pelvis. In more mild cases, doctors hypothesize that inflammation somehow changes the normal environment of the uterus, fallopian tubes or ovaries.
The researchers will be testing the effects of rosiglitazone, a drug currently on the market to treat diabetes, on the success rate of IVF in women with endometriosis. “Potentially, we may improve their outcome,” said Westphal. “We think the rosiglitazone could help with the inflammatory effect.”
Currently, Westphal said, women with endometriosis are treated no differently than other women undergoing IVF.
For a second study, researchers are recruiting 30 women undergoing their first IVF cycle. They will analyze how factors including age, hormone levels and fertility diagnoses affect IVF success.
“We know fertility declines with age, but no one has done this type of prospective study before,” said Westphal. “They’ve been mostly retrospective.” She thinks that designing a controlled experiment will give researchers a better understanding of the factors affecting IVF outcome, rather than just analyzing statistics.
One portion of the study will look at whether using birth control pills to manipulate a woman’s cycle before IVF influences the final outcome. Though it seems counterproductive, it is common for doctors to prescribe birth control in the month leading up to IVF. This gives women control over their schedules, and also reduces the chance of ovarian cysts.
“The majority of fertility centers in the United States rely on using birth control pills,” said Westphal.
The Stanford researchers will also collect blood from the patients, which they hope to eventually use to identify genetic markers that influence the outcome of IVF.
“If we find that there are genetic factors that predict how someone’s going to respond, then we can tailor the protocol more specifically to individual patients and improve pregnancy rates that way,” said Westphal.
In the long run, Westphal hopes the studies improve the success rates of IVF and make the process easier for women. She stressed that for IVF, as with many health issues, educating women about how and when to seek help is important.
“Even if patients aren’t thinking about needing IVF right now, if they’ve been trying to get pregnant for more than six months and they’re 35 or older, they really should think about getting an evaluation sooner rather than later,” she said.
To participate in either study, women must be under age 40 and able to visit the Stanford clinic on a regular schedule. For more information, call the IVF clinic at (650) 498-7911.
Stanford University Medical Center integrates research, medical education and patient care at its three institutions — Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children’s Hospital at Stanford.
For more information, please visit the Web site of the medical center’s Office of Communication & Public Affairs at http://mednews.stanford.edu.
Stanford University Medical CenterLouis Bergeron, 650-723-0272 (Print Media)louisb3@stanford.edu
M.A. Malone, 650-723-6912 (Broadcast Media)
mamalone@stanford.edu
Waiting for a miracle
By Judith Duffy, Health Correspondent
The Executive’s consultation on fertility treatment closed a year ago but has still not been published. Yet Scottish couples continue to face a postcode lottery over ever lengthening waiting times. For them, one thing is certain: every month that passes is an opportunity missed …
IT HAS been nearly 30 years since the birth of the world's first test tube baby sparked a storm of controversy. Last month the story of Louise Brown, who was born as a result of the technique known as in-vitro fertilisation (IVF), came full circle when she gave birth to her own child - a boy called Cameron, who was conceived naturally.
Since Louise's arrival in 1978, it is believed that more than three million people worldwide have been conceived via IVF and other fertility treatments. It is estimated that one child in every primary school year in the UK was conceived through IVF. Yet decades on, the use of this technology is still provoking widespread debate.
Most of the outbursts surround the use of IVF for older women. Earlier this month, it enabled a 67-year-old Spanish woman to become the world's oldest mother, after she gave birth to twins at an age more associated with being a grandparent. Last summer, Briton Patricia Rashbrook triggered a similar flurry of criticism when she gave birth to a child, her fourth, through fertility treatment at the age of 62.
These may be exceptional cases, but the everyday provision of IVF treatment for the one in seven couples who are experiencing fertility problems has been also dogged by difficulties. And the spotlight is upon the issue once more following an investigation into a leading IVF doctor by the BBC's Panorama programme.
Watchdog body the Human Fertilisation and Embryology Authority (HFEA) last week obtained warrants to inspect private London clinics run by Dr Mohamed Taranissi, amid allegations an undercover reporter was offered "unnecessary and unproven" treatment and that one of the therapies offered was also alleged to be a potential health risk to an unborn baby.
For couples who are spending thousands of pounds on fertility treatment to pursue their dream of starting a family, it's a worrying scenario. But north of the Border, the scandal is not to be found in the private clinics - which are few and far between - but instead in the long waiting times and postcode lottery that exists on the NHS. Despite pledges by the Scottish Executive to improve equality of access to services more than a year ago, no action has yet been announced.
For those who have not had to face it, it is perhaps impossible to imagine the pain of infertility and the difficulties of going through treatment. Isobel O'Neill, the infertility counsellor at the Assisted Conception Unit at Glasgow Royal Infirmary and the newly opened private clinic Glasgow Centre for Reproductive Medicine, points out that while it can be as devastating as a bereavement, it is rarely acknowledged as such.
"If you lose someone close, you have all sorts of things, like a funeral," she says. "But given that even the impact of miscarriage isn't fully appreciated, it is difficult trying to be understood about the loss of your fertility and the sense of having to have treatment.
"For people who don't have any experience of it, family and friends, they think, Well, there was never actually a baby there.' But every time a treatment fails, it's the loss of a hoped-for baby, so it is an enormous struggle."
Despite the alarm over the issues highlighted by the Panorama investigation, Sheena Young of support group Infertility Network UK points out that, unlike England, there is little private provision in Scotland: there are only two private clinics north of the Border - the Nuffield Hospital in Glasgow and the Glasgow Centre for Reproductive Medicine.
Read More
The Executive’s consultation on fertility treatment closed a year ago but has still not been published. Yet Scottish couples continue to face a postcode lottery over ever lengthening waiting times. For them, one thing is certain: every month that passes is an opportunity missed …
IT HAS been nearly 30 years since the birth of the world's first test tube baby sparked a storm of controversy. Last month the story of Louise Brown, who was born as a result of the technique known as in-vitro fertilisation (IVF), came full circle when she gave birth to her own child - a boy called Cameron, who was conceived naturally.
Since Louise's arrival in 1978, it is believed that more than three million people worldwide have been conceived via IVF and other fertility treatments. It is estimated that one child in every primary school year in the UK was conceived through IVF. Yet decades on, the use of this technology is still provoking widespread debate.
Most of the outbursts surround the use of IVF for older women. Earlier this month, it enabled a 67-year-old Spanish woman to become the world's oldest mother, after she gave birth to twins at an age more associated with being a grandparent. Last summer, Briton Patricia Rashbrook triggered a similar flurry of criticism when she gave birth to a child, her fourth, through fertility treatment at the age of 62.
These may be exceptional cases, but the everyday provision of IVF treatment for the one in seven couples who are experiencing fertility problems has been also dogged by difficulties. And the spotlight is upon the issue once more following an investigation into a leading IVF doctor by the BBC's Panorama programme.
Watchdog body the Human Fertilisation and Embryology Authority (HFEA) last week obtained warrants to inspect private London clinics run by Dr Mohamed Taranissi, amid allegations an undercover reporter was offered "unnecessary and unproven" treatment and that one of the therapies offered was also alleged to be a potential health risk to an unborn baby.
For couples who are spending thousands of pounds on fertility treatment to pursue their dream of starting a family, it's a worrying scenario. But north of the Border, the scandal is not to be found in the private clinics - which are few and far between - but instead in the long waiting times and postcode lottery that exists on the NHS. Despite pledges by the Scottish Executive to improve equality of access to services more than a year ago, no action has yet been announced.
For those who have not had to face it, it is perhaps impossible to imagine the pain of infertility and the difficulties of going through treatment. Isobel O'Neill, the infertility counsellor at the Assisted Conception Unit at Glasgow Royal Infirmary and the newly opened private clinic Glasgow Centre for Reproductive Medicine, points out that while it can be as devastating as a bereavement, it is rarely acknowledged as such.
"If you lose someone close, you have all sorts of things, like a funeral," she says. "But given that even the impact of miscarriage isn't fully appreciated, it is difficult trying to be understood about the loss of your fertility and the sense of having to have treatment.
"For people who don't have any experience of it, family and friends, they think, Well, there was never actually a baby there.' But every time a treatment fails, it's the loss of a hoped-for baby, so it is an enormous struggle."
Despite the alarm over the issues highlighted by the Panorama investigation, Sheena Young of support group Infertility Network UK points out that, unlike England, there is little private provision in Scotland: there are only two private clinics north of the Border - the Nuffield Hospital in Glasgow and the Glasgow Centre for Reproductive Medicine.
Read More
Monday, January 22, 2007
Metachronic malignant transformation of small bowel and rectal endometriosis in the same patient
Background
Malignant transformation of intestinal endometriosis is a rare event with an unknown rate of incidence. Metachronous progression of endometriosis to adenocarcinoma from two distant intestinal foci happening in the same patient has not been previously reported.
Case presentation
We describe a case of metachronic transformation of ileal and rectal endometriosis into an adenocarcinoma occurring in a 45-year-old female without macroscopic pelvic involvement of her endometriosis. First, a right colectomy was performed due to intestinal obstruction by an ileal mass. Pathological examination revealed an ileal endometrioid adenocarcinoma and contiguous microscopic endometriotic foci. Twenty months later, a rectal mass was discovered. An endoscopic biopsy revealed an adenocarcinoma. En bloc anterior rectum resection, hysterectomy and bilateral salpingectomy were performed. A second endometrioid adenocarcinoma arising from a focus of endometriosis within the wall of the rectum was diagnosed.
Conclusion
Intestinal endometriosis should be considered a premalignant condition in premenopausal women.
The development of a malignancy is a relatively common complication of endometriosis [1]. In fact, several publications have reported malignant neoplasms arising from endometriosis. Most of these publications are case reports or refer to a small series of patients presenting either ovarian carcinomas with associated endometriosis or invasive endometrioid adenocarcinomas involving adjacent pelvic structures [2]. Malignant transformation of extraovarian endometriosis, including the intestinal tract, however, has not been reported as frequently [3]. The largest reported series of neoplastic changes in gastrointesinal endometriosis includes 17 cases [4] We describe a case of metachronic malignant transformation arising from two different intestinal endometriotic sites, ileal and rectal, occurring in the same patient.
Read entire abstract
Malignant transformation of intestinal endometriosis is a rare event with an unknown rate of incidence. Metachronous progression of endometriosis to adenocarcinoma from two distant intestinal foci happening in the same patient has not been previously reported.
Case presentation
We describe a case of metachronic transformation of ileal and rectal endometriosis into an adenocarcinoma occurring in a 45-year-old female without macroscopic pelvic involvement of her endometriosis. First, a right colectomy was performed due to intestinal obstruction by an ileal mass. Pathological examination revealed an ileal endometrioid adenocarcinoma and contiguous microscopic endometriotic foci. Twenty months later, a rectal mass was discovered. An endoscopic biopsy revealed an adenocarcinoma. En bloc anterior rectum resection, hysterectomy and bilateral salpingectomy were performed. A second endometrioid adenocarcinoma arising from a focus of endometriosis within the wall of the rectum was diagnosed.
Conclusion
Intestinal endometriosis should be considered a premalignant condition in premenopausal women.
The development of a malignancy is a relatively common complication of endometriosis [1]. In fact, several publications have reported malignant neoplasms arising from endometriosis. Most of these publications are case reports or refer to a small series of patients presenting either ovarian carcinomas with associated endometriosis or invasive endometrioid adenocarcinomas involving adjacent pelvic structures [2]. Malignant transformation of extraovarian endometriosis, including the intestinal tract, however, has not been reported as frequently [3]. The largest reported series of neoplastic changes in gastrointesinal endometriosis includes 17 cases [4] We describe a case of metachronic malignant transformation arising from two different intestinal endometriotic sites, ileal and rectal, occurring in the same patient.
Read entire abstract
Friday, January 19, 2007
Endometriosis doesn't raise fracture risk
NEW YORK (Reuters Health) - A couple of previous studies have indicated that women with endometriosis may not develop strong bones, but a new report shows that the condition does not increase the long-term risk of suffering a fracture.
"Peak bone mass, the maximum achieved as a young adult before net bone loss ensues, is a major determinant of bone density and fracture risk later in life," Dr. L. Joseph Melton, III, and colleagues from the Mayo Clinic, Rochester, Minnesota, write in the December issue of Fertility and Sterility. "In particular, endometriosis (or its treatment) may be associated with premenopausal bone loss."
In a large, population-based study, the researchers determined if women with endometriosis had an increased risk of fracture. Using the data resources of the Rochester Epidemiology Project, the team identified 987 women with proven endometriosis between 1970 and 1989. The subjects were followed-up for any reported fractures.
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"Peak bone mass, the maximum achieved as a young adult before net bone loss ensues, is a major determinant of bone density and fracture risk later in life," Dr. L. Joseph Melton, III, and colleagues from the Mayo Clinic, Rochester, Minnesota, write in the December issue of Fertility and Sterility. "In particular, endometriosis (or its treatment) may be associated with premenopausal bone loss."
In a large, population-based study, the researchers determined if women with endometriosis had an increased risk of fracture. Using the data resources of the Rochester Epidemiology Project, the team identified 987 women with proven endometriosis between 1970 and 1989. The subjects were followed-up for any reported fractures.
Read More
Thursday, January 18, 2007
Despite Hope, Infertility Leaves Scars
UPDATED: 8:16 am CST January 17, 2007
If Lora and Ryan Jacobson didn't want to spend holidays with you or see pictures of your children, don't take it personally. It's likely you didn't understand what they were going through.The Jacobsons had tried for a year to get pregnant on their own. When that didn't work, they turned to infertility treatments. The lack of success going that route led to Lora pulling away from many friends and family.
"Those relationships and those bridges will never be built the same way. They didn't mean to pull away, and I didn't mean to pull away, but I didn't want to be around those people talking about their kids," Lora said. "I realize a lot of burned bridges were my fault, but it was my only way of coping."
Couple Not Alone
Dr. Carol Kowalczyk of the Michigan Center For Fertility and Women's Health in Warren, Mich., said that fertility treatments for patients are becoming more common.
"Two things are happening: Couples are getting older and waiting to have kids when they are more established professionally, and with getting older, there is more exposure to medical (and) environmental factors that have an impact, as well as lifestyle habits," Kowalczyk said. "Depending on the age, infertility affects 1-in-4 to 1-in-6 couples.
ReadMore
If Lora and Ryan Jacobson didn't want to spend holidays with you or see pictures of your children, don't take it personally. It's likely you didn't understand what they were going through.The Jacobsons had tried for a year to get pregnant on their own. When that didn't work, they turned to infertility treatments. The lack of success going that route led to Lora pulling away from many friends and family.
"Those relationships and those bridges will never be built the same way. They didn't mean to pull away, and I didn't mean to pull away, but I didn't want to be around those people talking about their kids," Lora said. "I realize a lot of burned bridges were my fault, but it was my only way of coping."
Couple Not Alone
Dr. Carol Kowalczyk of the Michigan Center For Fertility and Women's Health in Warren, Mich., said that fertility treatments for patients are becoming more common.
"Two things are happening: Couples are getting older and waiting to have kids when they are more established professionally, and with getting older, there is more exposure to medical (and) environmental factors that have an impact, as well as lifestyle habits," Kowalczyk said. "Depending on the age, infertility affects 1-in-4 to 1-in-6 couples.
ReadMore
La Endometriosis
La endometriosis es una de las enfermedades ginecológicas más comunes, afectando a más de 5,5 millones de mujeres sólo en América del Norte. Los dos sÃntomas más comunes de la endometriosis son el dolor y la infertilidad. Algunas mujeres tienen dolor antes o durante sus perÃodos menstruales, asà como durante o después de las relaciones sexuales. Este dolor puede ser tan intenso que afecta la calidad de vida de la mujer, desde sus relaciones hasta sus actividades diarias. Otras mujeres no tienen sÃntomas. Algunas no se enteran que tienen la enfermedad hasta que tienen dificultades en salir embarazadas.El Instituto Nacional de Salud Infantil y Desarrollo Humano (NICHD), parte de los Institutos Nacionales de la Salud (NIH), realiza y financia estudios importantes sobre la causa y los tratamientos para la endometriosis. El NICHD confÃa que a través de las investigaciones, algún dÃa podremos curar y hasta prevenir esta enfermedad tan dolorosa.
Datos Rapidos:
Nombre común:
Endometriosis
Nombre médico:
Endometriosis
Número de mujeres afectadas:
Por lo menos 5,5 millones de mujeres en América del Norte tienen endometriosis.
SÃntomas comunes incluyen (pero no están limitados a):
Cólicos o perÃodos menstruales muy dolorosos, perÃodos con sangrado fuerte, dolor crónico de la pelvis (que incluye dolor de la espalda inferior y dolor pélvico), dolor intestinal, dolor durante o después de tener relaciones sexuales, infertilidad.
Tratamientos comunes:
medicamentos para el dolor
terapia hormonal
cirugÃa: laparoscopia o laparotomÃa
Este trastorno, ¿afecta la fertilidad o capacidad de tener hijos?
Alrededor de un 30 a 40 por ciento de las mujeres con endometriosis no son fértiles, por lo cual es una de las tres principales causas de infertilidad femenina.Sin embargo, la infertilidad relacionada con la endometriosis frecuentemente se puede tratar con éxito utilizando hormonas y cirugÃa.
Datos Rapidos:
Nombre común:
Endometriosis
Nombre médico:
Endometriosis
Número de mujeres afectadas:
Por lo menos 5,5 millones de mujeres en América del Norte tienen endometriosis.
SÃntomas comunes incluyen (pero no están limitados a):
Cólicos o perÃodos menstruales muy dolorosos, perÃodos con sangrado fuerte, dolor crónico de la pelvis (que incluye dolor de la espalda inferior y dolor pélvico), dolor intestinal, dolor durante o después de tener relaciones sexuales, infertilidad.
Tratamientos comunes:
medicamentos para el dolor
terapia hormonal
cirugÃa: laparoscopia o laparotomÃa
Este trastorno, ¿afecta la fertilidad o capacidad de tener hijos?
Alrededor de un 30 a 40 por ciento de las mujeres con endometriosis no son fértiles, por lo cual es una de las tres principales causas de infertilidad femenina.Sin embargo, la infertilidad relacionada con la endometriosis frecuentemente se puede tratar con éxito utilizando hormonas y cirugÃa.
Tuesday, January 16, 2007
N.Y. doctors planning for uterus transplant
Procedure might enable pregnancy for cancer survivors, others
Associated Press Posted January 16 2007
A New York hospital is taking steps to offer the nation's first uterus transplant, a radical experiment that might allow women whose wombs were removed or are defective to bear children.
The wombs would come from dead donors, just as most other organs do, and would be removed after the recipient gives birth so she would not need anti-rejection drugs her whole life.
The hospital's ethics board has conditionally approved the plans, although the hospital's president warned women not to have false hopes because a transplant is not expected "any time in the near future."
Associated Press Posted January 16 2007
A New York hospital is taking steps to offer the nation's first uterus transplant, a radical experiment that might allow women whose wombs were removed or are defective to bear children.
The wombs would come from dead donors, just as most other organs do, and would be removed after the recipient gives birth so she would not need anti-rejection drugs her whole life.
The hospital's ethics board has conditionally approved the plans, although the hospital's president warned women not to have false hopes because a transplant is not expected "any time in the near future."
Monday, January 15, 2007
Injustice
"Injustice anywhere is a threat to justice everywhere."
Martin Luther King Jr., Letter from Birmingham Jail, April 16, 1963
Martin Luther King Jr., Letter from Birmingham Jail, April 16, 1963
Friday, January 12, 2007
Washington Post Examines Ethical Issues Of Company That Allows Parents To Select Embryo Characteristics
The Washington Post on Saturday examined the ethical issues of San Antonio, Texas-based Abraham Center of Life, which creates embryos and allows parents to select embryos after reviewing donor characteristics, such as race, education, appearance and personality. According to Post, the company enrolls egg donors who are in their 20s and have some college education and sperm donors who have advanced education. Abraham Center founder Jennalee Ryan said all donors undergo health tests and screenings to determine background and family history of mental illness, as well as answer questionnaires about their childhood temperaments, favorite books, adult hobbies and family histories. "If I do discriminate [among donors], it's that I only want healthy, intelligent people," Ryan said. According to the Post, some fertility experts and bioethicists have called the company's process a "disturbing step toward commercialization of human reproduction and 'designer babies.'"
Continue
Continue
Dioxin Alters Development of Male Reproductive System
DALLAS, Nov. 16 -- A dioxin in the Vietnam War-era herbicide Agent Orange affects the normal growth of the male reproductive system, according to researchers here.
Action Points
Explain to interested patients that the dioxins are know to be carcinogenic, but it has not been clear what effect, if any, they have on the reproductive system.
Note that this study suggests that one dioxin, found in the notorious herbicide Agent Orange, has clear effects on the normal growth and development of the male reproductive system.
Increased exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin -- or TCDD -- decreases the risk of benign prostatic hyperplasia and lowers testosterone levels, reported Amit Gupta, M.D., of the University of Texas Southwestern Medical Center in the November issue of Environmental Health Perspectives.
"Until now, we did not have very good evidence whether or not dioxins affect the human reproductive system," Dr. Gupta said. "Now we know that there is a link between dioxins and the human prostate."
Continue
Action Points
Explain to interested patients that the dioxins are know to be carcinogenic, but it has not been clear what effect, if any, they have on the reproductive system.
Note that this study suggests that one dioxin, found in the notorious herbicide Agent Orange, has clear effects on the normal growth and development of the male reproductive system.
Increased exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin -- or TCDD -- decreases the risk of benign prostatic hyperplasia and lowers testosterone levels, reported Amit Gupta, M.D., of the University of Texas Southwestern Medical Center in the November issue of Environmental Health Perspectives.
"Until now, we did not have very good evidence whether or not dioxins affect the human reproductive system," Dr. Gupta said. "Now we know that there is a link between dioxins and the human prostate."
Continue
Wednesday, January 10, 2007
AEterna Zentaris Initiates First Study of Phase 3 Program with Cetrorelix in BPH
600 Patient Trial Conducted in the United States and Canada
Posted on : Mon, 08 Jan 2007 12:10:00 GMT Author : AETERNA ZENTARIS INC.News Category : PressRelease
QUEBEC CITY, Jan. 8 /PRNewswire-FirstCall/ -- AEterna Zentaris Inc. (TSX: AEZ; Nasdaq: AEZS) today announced that the Company initiated the first of three studies in its Phase 3 program in benign prostatic hyperplasia (BPH) with its luteinizing hormone-releasing hormone (LHRH) antagonist compound, cetrorelix. The first study of the previously announced Phase 3 program titled, "Cetrorelix pamoate intermittent IM dosage regimens in patients with symptomatic BPH: a 1 year placebo-controlled efficacy study and long-term safety assessment", will assess an intermittent dosage regimen of cetrorelix as a potential safe and tolerable treatment providing prolonged improvement in BPH-related signs and symptoms, under the supervision of lead investigator, Herbert Lepor, M.D., Professor at NY University School of Medicine, New York. This first study, involving approximately 600 patients, is part of an extensive Phase 3 program enrolling a total of about 1,500 patients, which will include other large safety and efficacy studies conducted in North America and Europe. The primary efficacy endpoint of this first study is absolute change in International Prostate Symptom Score (IPSS) between baseline before beginning treatment and Week 52, while safety endpoints include changes in sexual function as well as BPH symptom progression equal to or more than 4 points and/or acute urinary retention and/or need for BPH related surgery. Other important endpoints consist of plasma levels of testosterone and changes in bone mineral density.
"We are very excited to have initiated the first study of our Phase 3 program with our flagship product candidate, cetrorelix, and look forward to first patient dosing over the next month. We are yet another step closer to bringing cetrorelix to market and not only have the potential to conveniently, safely and effectively treat men who suffer from BPH, but also create tremendous value to our shareholders," stated Gilles Gagnon, President and Chief Executive Officer at AEterna Zentaris.
Read More
http://www.earthtimes.org/articles/show/news_press_release,41278.shtml
Posted on : Mon, 08 Jan 2007 12:10:00 GMT Author : AETERNA ZENTARIS INC.News Category : PressRelease
QUEBEC CITY, Jan. 8 /PRNewswire-FirstCall/ -- AEterna Zentaris Inc. (TSX: AEZ; Nasdaq: AEZS) today announced that the Company initiated the first of three studies in its Phase 3 program in benign prostatic hyperplasia (BPH) with its luteinizing hormone-releasing hormone (LHRH) antagonist compound, cetrorelix. The first study of the previously announced Phase 3 program titled, "Cetrorelix pamoate intermittent IM dosage regimens in patients with symptomatic BPH: a 1 year placebo-controlled efficacy study and long-term safety assessment", will assess an intermittent dosage regimen of cetrorelix as a potential safe and tolerable treatment providing prolonged improvement in BPH-related signs and symptoms, under the supervision of lead investigator, Herbert Lepor, M.D., Professor at NY University School of Medicine, New York. This first study, involving approximately 600 patients, is part of an extensive Phase 3 program enrolling a total of about 1,500 patients, which will include other large safety and efficacy studies conducted in North America and Europe. The primary efficacy endpoint of this first study is absolute change in International Prostate Symptom Score (IPSS) between baseline before beginning treatment and Week 52, while safety endpoints include changes in sexual function as well as BPH symptom progression equal to or more than 4 points and/or acute urinary retention and/or need for BPH related surgery. Other important endpoints consist of plasma levels of testosterone and changes in bone mineral density.
"We are very excited to have initiated the first study of our Phase 3 program with our flagship product candidate, cetrorelix, and look forward to first patient dosing over the next month. We are yet another step closer to bringing cetrorelix to market and not only have the potential to conveniently, safely and effectively treat men who suffer from BPH, but also create tremendous value to our shareholders," stated Gilles Gagnon, President and Chief Executive Officer at AEterna Zentaris.
Read More
http://www.earthtimes.org/articles/show/news_press_release,41278.shtml
Common uterine tumors? What's a girl to do? A lot
Want to startle a man? Tell him you have tumors.
Want to make a man cringe? Tell him the tumors are in your girly part.
I've made more than a few men, as well as a few women, cringe the last few weeks by telling them of the noncancerous growths that have invaded my dear, dear uterus.
The doctors call them fibroid tumors, but I've named my triplets Frankie, Donna and little Louis. I am not alone.
Uterine fibroids are extremely common, mostly popping up when a woman is in her 30s or 40s. According to the Mayo Clinic and other sources, as many as three out of four women have them. Most women are unaware of their fibroids because their tumors cause no symptoms and don't require treatment.
For the rest of us — many in the 30 percent of women of childbearing age diagnosed with fibroids, according to the National Institutes of Health — uterine fibroids, depending on their size and location, can cause heavy or abnormal menstrual bleeding, pelvic pain and pressure, frequent urination or urine retention, fatigue, constipation or/and back and leg pain. More facts:
These tumors cause infertility in about 3 percent of patients, according to the American Society of Reproductive Medicine.
Researchers don't know exactly why uterine fibroids develop but believe their growth is related to genetics and the female hormones estrogen and progesterone.
Black women are at a three to five times greater risk than white women of developing fibroids, according to the National Institutes of Health.
About 600,000 American women have a hysterectomy — the removal of the womb — yearly, according to fibroidsecondopinion.com. About 30 percent of those hysterectomies are done to eliminate fibroids.
All that hushed talk about troubled lady parts I overheard when I was a kid made sense after I was diagnosed with fibroids. It turns out my grandmother, my mother and most of my aunts have had fibroids. Half of my female kinfolk have had hysterectomies because of fibroids.
The first doctor I spoke with told me he would recommend a hysterectomy — that is if I didn't plan on perhaps maybe having children one day.
"Hysterectomy" is a hard word to hear when you're childless, marvelously unmarried and still relatively young. Plus, a girl grows attached to her uterus. We like shopping together.
Luckily for my maybe one-day children — Hurricane, Sprinkle-Spangle and Amelia Jr. — hysterectomy is far from the only treatment for fibroid tumors.
There are a handful of approaches ranging from minimally invasive to pretty up-in-your-face slam-dance invasive, including the wait-and-watch approach, medication to shrink them temporarily, uterine artery embolization, focused ultrasound surgery and myomectomy, a surgery that removes the fibroids but leaves the uterus in place.
There are also a few ways to do a myomectomy, including a laparoscopic myomectomy, a robotic myomectomy and an open myomectomy — the procedure my second doctor believes is best for my situation.
Frankie, Donna and little Louis will be "delivered" in the near future, and I'll be on fibroid leave from work. But before that happens, I'm going to register at Target. Fibroids need presents, too. Source
Want to make a man cringe? Tell him the tumors are in your girly part.
I've made more than a few men, as well as a few women, cringe the last few weeks by telling them of the noncancerous growths that have invaded my dear, dear uterus.
The doctors call them fibroid tumors, but I've named my triplets Frankie, Donna and little Louis. I am not alone.
Uterine fibroids are extremely common, mostly popping up when a woman is in her 30s or 40s. According to the Mayo Clinic and other sources, as many as three out of four women have them. Most women are unaware of their fibroids because their tumors cause no symptoms and don't require treatment.
For the rest of us — many in the 30 percent of women of childbearing age diagnosed with fibroids, according to the National Institutes of Health — uterine fibroids, depending on their size and location, can cause heavy or abnormal menstrual bleeding, pelvic pain and pressure, frequent urination or urine retention, fatigue, constipation or/and back and leg pain. More facts:
These tumors cause infertility in about 3 percent of patients, according to the American Society of Reproductive Medicine.
Researchers don't know exactly why uterine fibroids develop but believe their growth is related to genetics and the female hormones estrogen and progesterone.
Black women are at a three to five times greater risk than white women of developing fibroids, according to the National Institutes of Health.
About 600,000 American women have a hysterectomy — the removal of the womb — yearly, according to fibroidsecondopinion.com. About 30 percent of those hysterectomies are done to eliminate fibroids.
All that hushed talk about troubled lady parts I overheard when I was a kid made sense after I was diagnosed with fibroids. It turns out my grandmother, my mother and most of my aunts have had fibroids. Half of my female kinfolk have had hysterectomies because of fibroids.
The first doctor I spoke with told me he would recommend a hysterectomy — that is if I didn't plan on perhaps maybe having children one day.
"Hysterectomy" is a hard word to hear when you're childless, marvelously unmarried and still relatively young. Plus, a girl grows attached to her uterus. We like shopping together.
Luckily for my maybe one-day children — Hurricane, Sprinkle-Spangle and Amelia Jr. — hysterectomy is far from the only treatment for fibroid tumors.
There are a handful of approaches ranging from minimally invasive to pretty up-in-your-face slam-dance invasive, including the wait-and-watch approach, medication to shrink them temporarily, uterine artery embolization, focused ultrasound surgery and myomectomy, a surgery that removes the fibroids but leaves the uterus in place.
There are also a few ways to do a myomectomy, including a laparoscopic myomectomy, a robotic myomectomy and an open myomectomy — the procedure my second doctor believes is best for my situation.
Frankie, Donna and little Louis will be "delivered" in the near future, and I'll be on fibroid leave from work. But before that happens, I'm going to register at Target. Fibroids need presents, too. Source
Tuesday, January 09, 2007
Student overcomes illness, problems to graduate early
By ERIK LINCOLN The Daily Sentinel
Monday, January 08, 2007
Despite facing numerous challenges in making it through high school, one Grand Junction teenager persevered, graduated early and will begin attending college this month.
Autumn Brown, 17, spent eight months during her freshman and sophomore years at Grand Junction High School with a cyst on her ovary, a painful and debilitating condition known as endometriosis.
She said she was in school about twice a week and felt as though her teachers didn't believe what she was telling them.
"I basically got my homework and left," Brown said. "People treated me like I was lying and like nothing was really wrong with me."
Her grades suffered from not being in class full-time, and classes where attendance was necessary, such as a science lab, couldn't be made up.
It took eight appointments and five doctors to finally diagnose Brown's condition, she said.
Read More
Monday, January 08, 2007
Despite facing numerous challenges in making it through high school, one Grand Junction teenager persevered, graduated early and will begin attending college this month.
Autumn Brown, 17, spent eight months during her freshman and sophomore years at Grand Junction High School with a cyst on her ovary, a painful and debilitating condition known as endometriosis.
She said she was in school about twice a week and felt as though her teachers didn't believe what she was telling them.
"I basically got my homework and left," Brown said. "People treated me like I was lying and like nothing was really wrong with me."
Her grades suffered from not being in class full-time, and classes where attendance was necessary, such as a science lab, couldn't be made up.
It took eight appointments and five doctors to finally diagnose Brown's condition, she said.
Read More
Monday, January 08, 2007
Neurocrine Biosciences Announces Positive Results From Second Phase II Study With Its Orally Active GnRH Receptor Antagonist in Endometriosis
SAN DIEGO, Jan. 8 -- Neurocrine Biosciences, Inc. today announced positive preliminary results from its second 'proof of concept', safety and efficacy Phase II clinical trial over a 3-month treatment period using its proprietary, orally-active nonpeptide Gonadotropin-Releasing Hormone (GnRH) receptor antagonist (NBI-56418) in patients with endometriosis. In 2006, the Company previously reported positive results from the completion of the first 3-month 'proof of concept' double-blind treatment period and additional 3-month follow up period of a parallel Phase II exploratory trial with NBI-56418 given once daily to endometriosis patients. This second exploratory study, which was also started in 2006, was designed to evaluate dose-response and twice daily dosing.
Read More
http://www.earthtimes.org/articles/show/news_press_release,41276.shtml
Read More
http://www.earthtimes.org/articles/show/news_press_release,41276.shtml
Friday, January 05, 2007
Endometriosis Prognosis
Proper counseling of patients with endometriosis requires attention to several aspects of the disorder. Of primary importance is the initial operative staging of the disease to obtain adequate information on which to base future decisions about therapy. The patient’s symptoms and desire for childbearing dictate appropriate therapy. Most patients can be told that they will be able to obtain significant relief from pelvic pain and that treatment will assist them in achieving pregnancy.
Long-term concerns must be more guarded in that all current therapies offer relief but not cure. Even after definitive surgery, endometriosis may recur, but the risk is very low (about 3%). The risk of recurrence is not significantly increased by estrogen replacement therapy. After conservative surgery, reported recurrence rates vary greatly but usually exceed 10% in 3 years and 35% in 5 years. Pregnancy delays but does not preclude recurrence. Recurrence rates after medical treatment also vary and are similar to or higher than those reported following surgical treatment.
Although many patients are concerned that endometriosis will progress inexorably, experience has been that conservative surgery avoids the necessity for hysterectomy in the great majority of cases. The course of endometriosis in any individual is impossible to predict at present, and future treatment options should greatly improve what can now be offered.
REFERENCES
http://www.health.am/gyneco/more/endometriosis-prognosis/
Long-term concerns must be more guarded in that all current therapies offer relief but not cure. Even after definitive surgery, endometriosis may recur, but the risk is very low (about 3%). The risk of recurrence is not significantly increased by estrogen replacement therapy. After conservative surgery, reported recurrence rates vary greatly but usually exceed 10% in 3 years and 35% in 5 years. Pregnancy delays but does not preclude recurrence. Recurrence rates after medical treatment also vary and are similar to or higher than those reported following surgical treatment.
Although many patients are concerned that endometriosis will progress inexorably, experience has been that conservative surgery avoids the necessity for hysterectomy in the great majority of cases. The course of endometriosis in any individual is impossible to predict at present, and future treatment options should greatly improve what can now be offered.
REFERENCES
http://www.health.am/gyneco/more/endometriosis-prognosis/
Thursday, January 04, 2007
Uterus Proposed as Transplant Candidate
By Michael Smith, Senior Staff Writer, MedPage Today Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. January 02, 2007
Additional Infertility Coverage
NEW YORK, Jan. 2 -- The next step in assisted reproduction may be a uterus transplant, according to researchers here.
Although the prospect of a uterus transplant raises ethical issues, it is technically feasible by current transplant protocols and local organ donor networks, says Giuseppe Del Priore, M.D., of New York Downtown Hospital.
Dr. Del Priore and colleagues took part in an organ donor network retrieval team for more than six months and successfully retrieved the uterus in eight of nine cases, they reported in the January issue of Obstetrics & Gynecology.
"Our hope is to eventually restore reproductive function through transplantation of a human uterus," Dr. Del Priore and colleagues said, and creating techniques to retrieve the organ is a key first step.
For the study, about 1,800 eligible organ donors were identified and multi-organ procurement surgery took place in about 150, the researchers reported. There was specific consent from the families to retrieve the uterus in nine cases.
However, one donor did not have retrieval surgery because her clinical status deteriorated before a full retrieval team could be gathered, the researchers said.
The causes of death included stroke, cardiac arrest during electrophysiologic testing, and traumatic brain injury. All donors had previously given birth, with between one and three deliveries of healthy children, and were 30 to 45 years old.
The procedure added 10 to 30 minutes of operating time, Dr. Del Priore and colleagues reported, but by the fourth patient, the average time needed for the entire uterine dissection was down to about 15 minutes.
The organs appeared to remain viable, with no histologic changes when they were kept for 12 hours in cold conditions without a blood supply.
Before the development of current assisted reproductive therapy, the researchers noted, scientists had been studying reproductive organ transplant in animals with a view to transferring the techniques to humans.
Current reproductive therapy has helped many people. Dr. Del Priore and colleagues noted, but there is little that can be done for women without a functioning uterus.
Potential mothers who wish to receive a uterus would have to take the risk of short-term immunosuppression - one or two years for one successful pregnancy, Dr. Del Priore said.
On the other hand, the situation for the fetus appears to be relatively reassuring, the researchers said, because many women who have had other forms of transplants have had successful pregnancies.
"When controlled for other factors, pregnancy outcomes appear acceptable," the researchers said. "Fortunately, long-term safety data are available because generations have now become pregnant after organ transplants."
The procedure appears likely to have many takers, Dr. Del Priore said. He and colleagues have more than one hundred candidates in the preparation process.
http://www.medpagetoday.com/Endocrinology/Infertility/tb/4783
Additional Infertility Coverage
NEW YORK, Jan. 2 -- The next step in assisted reproduction may be a uterus transplant, according to researchers here.
Although the prospect of a uterus transplant raises ethical issues, it is technically feasible by current transplant protocols and local organ donor networks, says Giuseppe Del Priore, M.D., of New York Downtown Hospital.
Dr. Del Priore and colleagues took part in an organ donor network retrieval team for more than six months and successfully retrieved the uterus in eight of nine cases, they reported in the January issue of Obstetrics & Gynecology.
"Our hope is to eventually restore reproductive function through transplantation of a human uterus," Dr. Del Priore and colleagues said, and creating techniques to retrieve the organ is a key first step.
For the study, about 1,800 eligible organ donors were identified and multi-organ procurement surgery took place in about 150, the researchers reported. There was specific consent from the families to retrieve the uterus in nine cases.
However, one donor did not have retrieval surgery because her clinical status deteriorated before a full retrieval team could be gathered, the researchers said.
The causes of death included stroke, cardiac arrest during electrophysiologic testing, and traumatic brain injury. All donors had previously given birth, with between one and three deliveries of healthy children, and were 30 to 45 years old.
The procedure added 10 to 30 minutes of operating time, Dr. Del Priore and colleagues reported, but by the fourth patient, the average time needed for the entire uterine dissection was down to about 15 minutes.
The organs appeared to remain viable, with no histologic changes when they were kept for 12 hours in cold conditions without a blood supply.
Before the development of current assisted reproductive therapy, the researchers noted, scientists had been studying reproductive organ transplant in animals with a view to transferring the techniques to humans.
Current reproductive therapy has helped many people. Dr. Del Priore and colleagues noted, but there is little that can be done for women without a functioning uterus.
Potential mothers who wish to receive a uterus would have to take the risk of short-term immunosuppression - one or two years for one successful pregnancy, Dr. Del Priore said.
On the other hand, the situation for the fetus appears to be relatively reassuring, the researchers said, because many women who have had other forms of transplants have had successful pregnancies.
"When controlled for other factors, pregnancy outcomes appear acceptable," the researchers said. "Fortunately, long-term safety data are available because generations have now become pregnant after organ transplants."
The procedure appears likely to have many takers, Dr. Del Priore said. He and colleagues have more than one hundred candidates in the preparation process.
http://www.medpagetoday.com/Endocrinology/Infertility/tb/4783
Polycystic Ovary Syndrome (PCOS)
Treatment Overview
Polycystic ovary syndrome (PCOS) is a group of health problems caused by out-of-balance hormones. It usually starts with the first teen menstrual cycles.
Regular exercise, a healthy diet, and weight control are the cornerstone of treatment for PCOS. Sometimes, also using a medicine to balance hormones is helpful.
There is no cure for PCOS, but controlling it lowers your PCOS risks of infertility, miscarriages, diabetes, heart disease, and uterine cancer.
Initial treatment
The first step in managing PCOS is getting regular exercise and eating a healthy diet. This is a medical treatment, not just a lifestyle choice. Any additional treatments depend on whether you are planning a pregnancy.
If you are overweight, a small amount of weight loss is likely to help balance your hormones and start up your menstrual cycle and ovulation. Use regular exercise and a healthy weight-loss diet as your first big treatment step. This is especially important if you're planning a healthy pregnancy.
If you are planning a pregnancy and weight loss doesn't improve your infertility, your doctor may suggest a medicine that helps lower insulin. With weight loss, this can improve your chances of ovulation and pregnancy. Fertility drug treatment may also help start ovulation. 3
If you are not planning a pregnancy, you can also use hormone therapy to help control your ovary hormones. To correct menstrual cycle problems, birth control hormones keep your endometrial lining from building up for too long. This is what prevents uterine cancer. Hormone therapy can also improve male-type hair growth and acne. 2 Birth control pills, patches, or vaginal rings are prescribed for hormone therapy. Androgen-lowering spironolactone (Aldactone) is often used with estrogen-progestin birth control pills. This improves hair loss, acne, and male-pattern hair growth on the face and body (hirsutism). 2
Taking hormones does not help with heart, blood pressure, cholesterol, and diabetes risks. This is why exercise and a healthy diet are a key part of your treatment.
For helpful information, see:
A registered dietitian who has special knowledge about diabetes.
The topic Healthy Eating.
The topic Fitness.
Physical activity for weight loss.
Walking for wellness
Additional treatments for menstrual cycle and hair and skin problems
Other treatments for PCOS problems include:
Hair removal with laser, electrolysis, waxing, tweezing, or chemicals.
Skin treatments. Acne medicines can be nonprescription or prescription. Some are taken by mouth and some are applied to the skin. (For more information, see the topic Acne.) Skin tag removal is not needed unless the tags are irritating, such as a tag on an eyelid. Generally they can be removed easily by your doctor.
Teenage girls. Early diagnosis and treatment of PCOS prevents long-term complications, such as obesity, diabetes, and infertility.
Ongoing treatment
To control PCOS for the long term, keep up with regular exercise and eat a healthy diet to control body weight and your metabolism. This approach helps you fight the risks of diabetes and heart disease, as well as hair and skin problems caused by the hormones.
To correct menstrual cycle problems, hormone therapy keeps your endometrial lining from building up for too long. This is what prevents uterine cancer. Birth control pills, patches, or vaginal rings are prescribed for hormone therapy.
To improve male-type hair growth, male-pattern hair loss, and acne, hormone therapy and spironolactone (Aldactone) are often used together to lower androgen levels.
Regular checkups are important for catching any PCOS complications, such as high blood pressure, high cholesterol, uterine cancer, heart disease, and diabetes. All women with PCOS are advised to be checked for diabetes by age 30. 9
Treatment for infertility from PCOS focuses on starting ovulation:
If you have PCOS and are overweight, weight loss may be all the treatment you need. Even a small weight loss can trigger ovulation. Weight loss of as little as 5% to 7% over 6 months can lower your insulin and androgen levels. This restores ovulation and fertility in more than 75% of women with PCOS. 6
If weight loss alone does not start ovulation (or if you don't need to lose weight), an insulin-lowering medicine (metformin) may help. Several months of treatment may be needed. 10
If metformin does not trigger ovulation, adding clomiphene to stimulate the ovaries may work. Combining the two treatments can make it more likely that clomiphene will trigger ovulation in women with PCOS. 11
If metformin-clomiphene does not work, gonadotropins are sometimes used. These are similar to the hormones the body makes to start ovulation. But they also increase the chances of having a high-risk pregnancy with two or more embryos. During gonadotropin treatment, you must have daily checks of egg follicle development, using blood tests and ultrasound, to prevent ovarian hyperstimulation syndrome.
If weight loss and medicine do not work, treatment options include:
In vitro fertilization. Eggs are fertilized with sperm in a lab, grown for a few days, then put in the uterus to start a pregnancy. This treatment is complex, difficult, and expensive, but it may improve your chances of pregnancy.
Ovarian drilling, or partial destruction of an ovary. This is a surgical treatment that can trigger ovulation. It is sometimes used for women with PCOS who have tried weight loss and fertility medicine but still are not ovulating. 11
For more information, see the topic Infertility.
Women with PCOS who become pregnant have increased risks during pregnancy. Using metformin when trying to get pregnant may lower your risks of miscarriage and gestational diabetes. 2 But the risks of using metformin throughout pregnancy are not known. For more information, see the topic Gestational Diabetes.
http://health.yahoo.com/topic/reproductive/treatment/article/healthwise/tw9111
Video ~ Resection of Endometriosis
Note: these videos may require several minutes to download.
Resection of Endometriosis
As endometriosis can grow below the surface of the peritoneum, I believe that excision of endometriosis leads to better results than laser vaporization. 5.6 meg quicktime video
http://www.obgyn.net/women/women.asp?page=/industry/articles/012198_everest
Resection of Endometriosis
As endometriosis can grow below the surface of the peritoneum, I believe that excision of endometriosis leads to better results than laser vaporization. 5.6 meg quicktime video
http://www.obgyn.net/women/women.asp?page=/industry/articles/012198_everest
Wednesday, January 03, 2007
Menstrual Suppression OK, Say Doctors
Forty years ago, when birth control pills first hit the market, the recommended cycle was three weeks of active contraceptive pills followed by one week of placebos or no pills. But now, many gynecologists believe that the week without contraception - during which a woman experiences a "withdrawal bleed" that mimics the normal menstrual cycle - isn't necessary.
While there are still widespread concerns about the side-effects from hormonal birth control, many women are suppressing menstruation using new formulation pills that result in four periods a year, while others take normal birth control pills without the week of placebos or no pills.
Susan Ernst, chief of gynecology services for the University Health Service at the University of Michigan, suggests that suppressing the menstrual cycle completely is not very different from using the three-weeks-on, one-week-off cycle. "When a woman chooses to use hormonal contraceptives, she's giving her body estrogen and progesterone, and that suppresses her own hormonal fluctuations," Ernst says. "So she's already controlling her cycle by taking those hormonal contraceptives and can further control her cycle by eliminating the pill-free interval or placebo pills."
A recent survey by the Association of Reproductive Health Professionals found that 71 percent of women surveyed do not enjoy getting their period each month. But critics contend that too much remains unknown about the effects of menstrual suppression. Some say it prevents women from ridding their bodies of excess iron; that it is unnatural to suppress one's cycle; and that more needs to be known about the effects on women's bone health, heart health and cancer risks.
But Ernst says that the practice of physicians prescribing contraceptives to stop women's menstrual cycles is not new. "Gynecologists have been doing this for years," she says, "using hormonal contraception for treating women with painful, heavy or irregular periods, or painful premenstrual symptoms." Menstrual suppression has also been used among women with endometriosis, a painful condition in which tissue that normally lines the inside of the uterus grows outside of the uterus.
Ernst cautioned that there are risks related to hormonal contraception, including blood clots, hypertension, stroke and heart attack, especially among women who smoke. "A woman has to take those risks into account when thinking about using hormonal contraception for menstrual suppression," Ernst said. "Women should discuss the risks and benefits with their doctors before deciding to suppress their menstrual cycles."
Source: University of Michigan Health System
http://www.scienceagogo.com/news/20070002215549data_trunc_sys.shtml
While there are still widespread concerns about the side-effects from hormonal birth control, many women are suppressing menstruation using new formulation pills that result in four periods a year, while others take normal birth control pills without the week of placebos or no pills.
Susan Ernst, chief of gynecology services for the University Health Service at the University of Michigan, suggests that suppressing the menstrual cycle completely is not very different from using the three-weeks-on, one-week-off cycle. "When a woman chooses to use hormonal contraceptives, she's giving her body estrogen and progesterone, and that suppresses her own hormonal fluctuations," Ernst says. "So she's already controlling her cycle by taking those hormonal contraceptives and can further control her cycle by eliminating the pill-free interval or placebo pills."
A recent survey by the Association of Reproductive Health Professionals found that 71 percent of women surveyed do not enjoy getting their period each month. But critics contend that too much remains unknown about the effects of menstrual suppression. Some say it prevents women from ridding their bodies of excess iron; that it is unnatural to suppress one's cycle; and that more needs to be known about the effects on women's bone health, heart health and cancer risks.
But Ernst says that the practice of physicians prescribing contraceptives to stop women's menstrual cycles is not new. "Gynecologists have been doing this for years," she says, "using hormonal contraception for treating women with painful, heavy or irregular periods, or painful premenstrual symptoms." Menstrual suppression has also been used among women with endometriosis, a painful condition in which tissue that normally lines the inside of the uterus grows outside of the uterus.
Ernst cautioned that there are risks related to hormonal contraception, including blood clots, hypertension, stroke and heart attack, especially among women who smoke. "A woman has to take those risks into account when thinking about using hormonal contraception for menstrual suppression," Ernst said. "Women should discuss the risks and benefits with their doctors before deciding to suppress their menstrual cycles."
Source: University of Michigan Health System
http://www.scienceagogo.com/news/20070002215549data_trunc_sys.shtml
Tuesday, January 02, 2007
Blocking the activity of aromatase
Blocking the activity of aromatase may be the key to controlling the often-intractable pain of endometriosis. Here, pioneers in the use of aromatase inhibitors review use of the drugs in premenopausal and postmenopausal patients. Read More...
Avoiding hit-or-miss fertility treatment
Fertility Clinic Dr. Abayomi Ajayi, Nordica Fertility Center, Lagos
I HAVE heard some couples seeking fertility treatment use the expression “hit-or-miss” when talking about assisted conception methods. No doubt one question agitating the minds of almost every couple seeking treatment for one problem of infertility or the other So today I’ll be talking about how couples can avoid hit-or-miss fertility treatment . Let me begin by pointing out that taking up fertility treatment should not be seen as a gamble even in the face of the realization that the infertility experience could be more of an emotional than physical challenge.
While it could be admissible that assisted reproductive assistance may not work for everybody all the time, the approach I would recommend any couple seeking a successful outcome to adopt is to have a positive approach. It does not hurt to expect that any fertility treatment option you choose would always work for you. But a successful outcome to a treatment plan does not just happen. It is a deliberate event that begins with a positive approach and the determination to succeed.We have long established that infertility affects the couple, not just the woman or the man as an individual, thus it is important that both parties (the man and woman) learn as much about fertility problems and treatment as they can. The idea is that this approach will put them in position to ask the right questions and spot potential trouble. With a reasonable understanding of the conditions necessary for conception, you will be able to help your physician provide the best opportunity to reach your fertility potential.
Being informed about different fertility subjects like endometriosis, artificial insemination, and in vitro fertilization goes a long way in making the people directly concerned to be responsible for their own fertility treatment. The point here is that fertility treatment is team work involving you, your husband or partner and your doctor. If you work as a team, you’ll be able to design a fertility treatment plan that will work for you as a couple.
Read More:
http://www.vanguardngr.com/articles/2002/features/health/gh602012007.html
I HAVE heard some couples seeking fertility treatment use the expression “hit-or-miss” when talking about assisted conception methods. No doubt one question agitating the minds of almost every couple seeking treatment for one problem of infertility or the other So today I’ll be talking about how couples can avoid hit-or-miss fertility treatment . Let me begin by pointing out that taking up fertility treatment should not be seen as a gamble even in the face of the realization that the infertility experience could be more of an emotional than physical challenge.
While it could be admissible that assisted reproductive assistance may not work for everybody all the time, the approach I would recommend any couple seeking a successful outcome to adopt is to have a positive approach. It does not hurt to expect that any fertility treatment option you choose would always work for you. But a successful outcome to a treatment plan does not just happen. It is a deliberate event that begins with a positive approach and the determination to succeed.We have long established that infertility affects the couple, not just the woman or the man as an individual, thus it is important that both parties (the man and woman) learn as much about fertility problems and treatment as they can. The idea is that this approach will put them in position to ask the right questions and spot potential trouble. With a reasonable understanding of the conditions necessary for conception, you will be able to help your physician provide the best opportunity to reach your fertility potential.
Being informed about different fertility subjects like endometriosis, artificial insemination, and in vitro fertilization goes a long way in making the people directly concerned to be responsible for their own fertility treatment. The point here is that fertility treatment is team work involving you, your husband or partner and your doctor. If you work as a team, you’ll be able to design a fertility treatment plan that will work for you as a couple.
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http://www.vanguardngr.com/articles/2002/features/health/gh602012007.html
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