scholarly journals Possibilities of non-hormonal therapy of uterine fibroids in women of reproductive age

2018 ◽  
Vol 0 (41) ◽  
pp. 38-41
Author(s):  
А. Г. Корнацька ◽  
Г. В. Чубей ◽  
М. А. Флаксемберг ◽  
О. О. Ровенько
Keyword(s):  
Hormonal Therapy ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Women Of Reproductive Age

Pathogenetic mechanisms of endometrial hyperplasia in women of reproductive age

2020 ◽  
Vol 19 (5) ◽  
pp. 44-50
Author(s):  
I.M. Ordiyants ◽  
◽  
A.A. Kuular ◽  
A.A. Yamurzina ◽  
D.S. Novginov ◽  
...  
Keyword(s):  
Estrogen Receptors ◽  
Pyruvate Kinase ◽  
Endometrial Hyperplasia ◽  
Uterine Fibroids ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Pyruvate Kinase M2 ◽  
Pathogenetic Mechanisms ◽  
Group I

Objective. To analyze pathogenetic mechanisms underlying the development of endometrial hyperplasia in women of reproductive age. Patients and methods. We have examined 143 women of reproductive age with endometrial hyperplasia (EH). Study participants were divided into three groups: Group I included EH patients without atypia; Group II included patients with atypical hyperplasia of the endometrium; Group III (control group) comprised 56 women with abnormal uterine bleeding, in whom we excluded adenomyosis, uterine fibroids, endometrial hyperplasia, endometrial cancer, and iatrogenic causes of uterine bleeding. Genomic DNA was isolated using phenol-chloroform extraction. Real-time polymerase chain reaction (RT-PCR) was used to detect microRNA-210, -18a, -221, and -222. The detection of tumor pyruvate kinase M2 was performed using the ScheBo® Tumor M2-PK kit designed for quantitative assessment of this metabolic cancer marker in plasma and endometrial tissue samples. Results. Significant risk factors triggering the pathogenetic mechanism of EH development in reproductive age include extragenital disorders (obesity, thyroid diseases, diseases of the urinary system, hypertension) and gynecological diseases (pelvic inflammatory diseases, adenomyosis, benign breast dysplasia, uterine fibroids). Alterations affecting estrogen receptors lead to changes in microRNA messengers, which, in turn, affect target genes and cause changes in the adaptive abilities of the cell. Expression of pyruvate kinase M2 in this chain confirms proapoptotic changes in the cell and the risk of its atypia. Conclusion. The pathogenesis of EH is based on the following factors: polymorphism of the ERS1 and PRG genes, increased expression of miRNA-210, -18a, and -222, decreased expression of miRNA-221, and overexpression of pyruvate kinase M2. Key words: endometrial hyperplasia, miRNA, pyruvate kinase M2, progesterone receptors, estrogen receptors

scholarly journals Understanding the Impact of Uterine Fibroids on Human Endometrium Function

2021 ◽  
Vol 9 ◽  
Author(s):  
Antonia Navarro ◽  
Maria Victoria Bariani ◽  
Qiwei Yang ◽  
Ayman Al-Hendy
Keyword(s):  
Transforming Growth Factor ◽  
Vascular System ◽  
Uterine Fibroids ◽  
Transforming Growth Factor Β ◽  
Uterine Wall ◽  
Reproductive Age ◽  
Menstrual Bleeding ◽  
Women Of Reproductive Age ◽  
Myometrial Cells ◽  
The Impact

Uterine fibroids (leiomyomas) are the most common benign gynecological tumors in women of reproductive age worldwide. They cause heavy menstrual bleeding, usually leading to severe anemia, pelvic pain/pressure, infertility, and other debilitating morbidities. Fibroids are believed to be monoclonal tumors arising from the myometrium, and recent studies have demonstrated that fibroids actively influence the endometrium globally. Studies suggest a direct relationship between the number of fibroids removed and fertility problems. In this review, our objective was to provide a complete overview of the origin of uterine fibroids and the molecular pathways and processes implicated in their development and growth, which can directly affect the function of a healthy endometrium. One of the most common characteristics of fibroids is the excessive production of extracellular matrix (ECM) components, which contributes to the stiffness and expansion of fibroids. ECM may serve as a reservoir of profibrotic growth factors such as the transforming growth factor β (TGF-β) and a modulator of their availability and actions. Fibroids also elicit mechanotransduction changes that result in decreased uterine wall contractility and increased myometrium rigidity, which affect normal biological uterine functions such as menstrual bleeding, receptivity, and implantation. Changes in the microRNA (miRNA) expression in fibroids and myometrial cells appear to modulate the TGF-β pathways and the expression of regulators of ECM production. Taken together, these findings demonstrate an interaction among the ECM components, TGF-β family signaling, miRNAs, and the endometrial vascular system. Targeting these components will be fundamental to developing novel pharmacotherapies that not only treat uterine fibroids but also restore normal endometrial function.

Comparison of indicators quality of life in women after operative rehabilitation on uterine fibroids

2016 ◽  
pp. 94-97
Author(s):  
O. Makarchuk ◽  
◽  
G. Gavrilyuk ◽  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Uterine Fibroids ◽  
The Body ◽  
Reproductive Age ◽  
Control Group ◽  
Psychosomatic Disorders ◽  
Women Of Reproductive Age ◽  
Surgical Recovery

One of the most common benign hyperproliferative diseases of the female reproductive organs are uterine leiomyoma, the frequency of which, according to various literature in women of reproductive age is between 20% and 40%, and is the main indication for surgery, including removal of the organ. Long-term effects of surgical interventions for uterine fibroids have been the subject of numerous debates. In modern literature is not much research on the assessment of the quality of life both in organ treatment of uterine fibroids, and after surgical recovery. Quality of life have undoubtedly significant prognostic value and can be used in selecting the optimal treatment of uterine fibroids, as well as the development of individual approach to postoperative rehabilitation of patients. The objective: was the study of quality of life and the search for possible ways to improve in women after surgical healing uterine fibroids. Materials and methods. A survey of 80 women of reproductive age (study group), which was conducted without hysterectomy applications. Clinical and laboratory examination conducted in the dynamics of the postoperative period and at 6, 12 months and 3 years after surgical recovery. Assessment of comparative analysis require further formation of two groups comparing 20 patients with myoectomy and 20 women with no uterus amputation supravaginal applications. The control group consisted of 20 healthy patients. Assessment of quality of life survey conducted by using common clinical trials and monitoring at the individual questionnaire MOS 36- Item Short-Form Health Survey- MOS SF-36. Statistical analysis of the survey results was carried out using the software package Microsoft Office Excel and Statistica 6.0 for Windows. Results. In women, the main indicators of psycho-emotional and vegetative manifestations were most pronounced immediately after surgery and remained stable in three years with no significant deviations in the comparison group. Among the most frequently observed fatigue (76.25%), sleep disorders (88.75%), irritability and mood changes (76.25%) and emotional lability, anxiety and depressive symptoms. Of The results of evaluation of quality of life should be noted that first disturbed functioning role of women because of poor physical and emotional state, as evidenced by the significant differences obtained on the scale of General Health (GH) (overall health). Three years after the rapid improvement in women’s core group established stable condition posthisterektomy pronounced effect on quality of life. Thus, in total 33.75% of the principal groups characterized as low quality of life, compared with 5.0% of patients in the control group and 10,0% of women with myoectomy. Conclusions. The highest level of dissatisfaction with life studied patients presenting in health – 28.75% (23) cases, slightly less professional – 22.5% (18), emotional – 17.5% (17) and as in the sexual sphere – 13.75% (11) cases. That associated complications related symptoms posthisterektomy syndrome, increases the level of stress and hysterectomy as the body creates prerequisites for psychosomatic disorders. This action provides additional risk factors for the development of psychosocial distress in this group of patients. Key words: uterine fibroids, hysterectomy, posthisterektomy syndrome, psychosomatic disorders, quality of life.

scholarly journals Specific Aspects of Life Quality Estimation and Ways of Rehabilitation in Women Who Underwent Uterine Surgery

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
H. M. Havrylyuk ◽  
O. M. Makarchuk
Keyword(s):  
Blood Supply ◽  
Ovarian Function ◽  
Internal Iliac Artery ◽  
Life Quality ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Internal Iliac

Recently, it has been noticed a great number of uterine fibroids in women with unrealized reproductive function; moreover, the number of combined forms of hyperplastic processes of the reproductive system in 20-25% of women under 30 years of age and 60% of women over 40 years of age is constantly growing creating a favourable background for cancer. It is also known that women with hyperplastic processes suffer from psycho-emotional disorders both before surgeries and after surgical recovery; many of them are diagnosed with adjustment disorder. As many researches note, the main psychotherapeutic aspects include passive view of life, increased anxiety, tendency to dependent behaviour, rejection of own body, protective behaviour and problems with self-assessment. It should also be noted that a comprehensive study of clinical and laboratory data and subjective criteria of life quality is essential in assessment of the feasibility of hysterectomy in women of reproductive age, even if they do not plan to bear children in the future. The objective of the research was to estimate life quality as well as to improve the system of dispensary observation and rehabilitation of women who underwent uterine surgery.Materials and methods. There was performed a comprehensive examination and surgical treatment of 60 women of reproductive age with uterine fibroid who underwent hysterectomy with preservation of appendages. We used modern high quality endocrinological and instrumental techniques. The assessment of the received data was made immediately after surgery, 6 and 2 months, 3 and 5 years after surgery. Quality of life was studied on the basis of a comprehensive assessment using the modified scale of the Nottingham Health Profile and the study of such important indicators as energy, sleep, emotional reactions, social isolation, physical activity, pain. All statistical analysis was performed using a standard package “Statistica for Windows – 6.0”.Results and discussion. On the basis of anamnestic data of patients we revealed health deterioration with high rates of liver and gastrointestinal tract disorders, metabolic disturbances (obesity, hypertensive disorders, fibrocystic breast disease), metabolic-endocrine changes and surgery. Reproductive health in women with uterine fibroid was characterized by long establishment of regular menstrual cycle, its breach in the period of puberty, inflammatory diseases of the genital organs, benign ovarian tumours and their surgical removal, inadequate reproductive behaviour with absent or delayed implementation of reproductive function and induced abortion. 12 months and especially 5 years after surgery there was noticed a progressive deterioration of the ovarian function, which was reflected as the reduction in their volume due to the reduction in the number and size of follicles, deterioration of blood supply to the ovaries, decreased blood flow in the internal iliac artery basin. It should also be noted the progressive hypestrogenism; in addition, there was a clear correlation with the age of the woman, who underwent surgical operation. Changes in life quality of patients with hyperplastic processes of the uterus were manifested in the postoperative period as follows: a decrease in physical activity (43.33% of cases), increased sexual dysfunction (36.66%), inhibition of mental state, conflict-orientated social behaviour, weakening of role functions and subjective deterioration of health and life quality (51.66% of cases).Conclusions. Thus, surgery on uterine fibroids with total or subtotal hysterectomy contributes to interference in a complex neuroendocrine interaction between hypothalamus, pituitary, ovaries, adrenal cortex, thyroid gland and affects the blood supply, innervation, and lymph efflux in the pelvic floor; therefore, postoperative syndromes are polyglandular and polysystemic. Long-term effects after surgery are accompanied by progressive hypestrogenism, decrease in the ovarian function (the reduction in their volume observed during ultrasound examination), reduction in the number and size of follicles, deterioration of blood supply to the ovaries, low blood supply to the internal iliac artery basin.

scholarly journals Influence of androgen deficiency on the endometrium structure in women of reproductive age

2021 ◽  
pp. 40-45
Author(s):  
L. V. Demyanenko ◽  
L. M. Semenyuk ◽  
T. Yu. Yuzvenko
Keyword(s):  
Hormonal Therapy ◽  
Androgen Receptors ◽  
Reproductive Age ◽  
Estradiol Valerate ◽  
Androgen Deficiency ◽  
Immunohistochemical Examination ◽  
Women Of Reproductive Age ◽  
Long Term Effect ◽  
Medium Level ◽  
High Level

Aim — to identify the relationship between androgen deficiency and the development of endometrial hypoplasia in women of reproductive age, to develop an algorithm for the diagnosis and treatment of this category of women. Materials and methods. Examination of patients with androgen deficiency revealed 48 patients with endometrial hypoplasia based on the ultrasound markers. After examination for CD138 and detection of chronic endometritis during the study, 9 patients were excluded. At the second stage, an immunohistochemical examination was performed for the expression of receptors for estrogen, progesterone and androgens. According to the results, the patients were divided into 2 groups: the first group (24 patients) with a high level of expression of androgen receptors and the second group (15 patients) with a low level of expression of androgen receptors. Theexpressionof receptors to estrogens and progesterone was on medium level and comparative in both groups. Both groups of patients underwent hormonal therapy for 3 months: estradiol valerate 1 g per day in a continuous mode and 200 mg of micronized progesterone from the sixteenth to twenty-fifth days of the menstrual cycle. Additionally, patients of the first group received dehydro­epian­drosterone(DHEA)in a dose of 25 mg per day continuously in the form sublingual spray. Results. According to the data of ultrasound examination in the first group of patients, the endometrium corresponded to normal parameters both during treatment and 1 and 3 months after stopping treatment. At the same time, in the second group of patients, there was an improvement in the thickness (more than 7 mm) and structure of the endometrium during treatment and the absence of these effects after the termination of hormonal therapy. Considering the recommendations of the Association of Endocrinologists on the superiority of non-tablet forms of androgen preparations in the treatment of androgen deficiency and having a positive and long-term effect when taking sublingual DHEA, it is possible to recommend adding the above form of DHEA to systemic therapy of endometrial hypoplasia against the background of androgen deficiency. Conclusions. Women with androgen deficiency are more likely to have concomitant endometrial hypoplasia. Immunohistochemical examination of the endometrium of women of reproductive age with androgen deficiency in 24 patients (61.5 %) revealed a high level of expression of androgen receptors. The effectiveness of therapy for endometrial hypoplasia in women with androgen deficiency with addition of androgens to the standard regimens is more effective and has a long-lasting effect. The combination of estrogen-gestagenic therapy and androgens has a positive effect on the gestational potential of the endometrium in women of reproductive age with androgen deficiency.

scholarly journals Uterine artery embolization in the treatment of submucous myomatous nodes

2020 ◽  
Vol 15 (2) ◽  
pp. 107-114
Author(s):  
Dulat Tazhibayev ◽  
◽  
Bakhyt Abishev ◽  
Irina Kamyshanskaya ◽  
Makash Aliyakparov ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Common Disease ◽  
Women Of Reproductive Age ◽  
Artery Embolization ◽  
X Ray ◽  
Uterine Arteries ◽  
Endovascular Occlusion

The purpose of the article was to evaluate trends of uterine submucousal myomas after the embolization of uterine arteries. Uterine fibroids are a common disease in women of reproductive age, accounting for 10 to 30 %, according to various authors. The submucous location of the myomatous node is an unfavorable type of localization of fibroids since it almost always requires surgical treatment. In this work, we would like to report on the results of endovascular x-ray occlusion of the uterine arteries in the treatment of submucous myomatous nodes. Percutaneous through catheter occlusion of uterine arteries with submucousal myomatous nodes was performed in 21 patients where 18 of them through the femoral, and 3 of them through beam access. The patients’ age was under 32 up to 47 with average 36,5. Myomatous nodes’ size is from 3,0 till 9,0 centimeters. There were noted self-expulsions of 10 from 21 submucousal myomatous nodes after X-ray endovascular occlusion during the 7 days and until 3 months. In the gynecological department they performed removal of partially born submucosal nodes in 3 out of 21 patients within 3 months. In the remaining 8 of 21 observations (381 %), submucosal nodes underwent myolysis in the following 12 months. After X-ray endovascular occlusion there might be expulsion or myolysis of myoma nodes in different terms during the submucosal myomatous of uterine.

scholarly journals Women's reproductive health and features of eating behavior

2019 ◽  
Vol 4 (3) ◽  
pp. 48-53
Author(s):  
S. I. Yelgina ◽  
I. S. Zakharov ◽  
E. V. Rudaeva
Keyword(s):  
Breast Cancer ◽  
Eating Disorders ◽  
Food Intake ◽  
Polycystic Ovary ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
External Eating ◽  
Gynecological Diseases

Aim. To study reproductive health of women with and without eating disorders.Materials and Methods. We designed an original questionnaire, surveyed and analyzed the medical records of 200 women of reproductive age.Results. All the study participants suffered from eating disorders. Out of 200 patients, 46 (23%), 120 (63%), and 34 (17%) had emotional, restrictive, and external eating disorders, respectively. Women with normal body mass index (BMI) or overweight were more likely to have an avoidant/restrictive food intake disorder while emotional and external types prevailed among obese patients. Fibrocystic breast changes, uterine fibroids, polycystic ovary syndrome, infertility, and breast cancer were significantly more common in women with obesity (r = 0.74 for gynecological diseases in total). Pelvic inflammatory disease was more frequently diagnosed in women with emotional eating disorders while fibrocystic breast changes, uterine fibroids, and polycystic ovary syndrome were more prevalent in those with restrictive food intake disorder. Breast cancer prevailed in women with external eating disorders.Conclusion. Women of reproductive age are frequently diagnosed with different types of eating disorders. Obese women are more likely to have reproductive system disease. Each of eating disorders correlate with different gynecological diseases. 

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