scholarly journals Frequency of the Causes of Postmenopausal Bleeding, Results of a Tertiary Referral Center in Turkey

2019 ◽  
pp. 1
Author(s):  
Umit Yasemin Sert ◽  
Ismail Guler ◽  
Tuncay Nas
Keyword(s):  
Estrogen Replacement Therapy ◽  
Endometrial Hyperplasia ◽  
Postmenopausal Bleeding ◽  
Estrogen Replacement ◽  
Tertiary Referral Center ◽  
Histopathologic Diagnosis ◽  
Proliferative Endometrium ◽  
Malignant Lesions ◽  
Endometrium Biopsy

<p><strong>OBJECTIVE:</strong> In this study, we aimed to determine the frequency of etiologic factors that causes postmenopausal bleeding.</p><p><strong>STUDY DESIGN:</strong> For the purpose, a total number of 200 women with postmenopausal bleeding were included in the study. Medical records regarding history, physical examination, and endometrium biopsy of these cases were retrospectively analyzed. The frequency of etiologic factors and relevancy of pathological results with demographic factors were determined.</p><p><strong>RESULTS:</strong> Most frequent histopathologic diagnosis of the women with postmenopausal bleeding were established as endometrial atrophy, endometrial polyp, inadequate material, cancer, proliferative endometrium, endometrial hyperplasia, and other disorders respectively. Contrarily the previous studies, our study showed that estrogen replacement therapy was not a reason for postmenopausal bleeding.</p><p><strong>CONCLUSION:</strong> Although endometrial atrophy is the most frequent cause, postmenopausal bleeding should promptly be evaluated since endometrial hyperplasia and cancer are frequently the underlying cause. We found that premalignant and malignant lesions were related to the patients’ BMI (body mass index), duration of postmenopause, the presence of diabetes, determination of thick endometrium by ultrasonography.</p>

scholarly journals Benefits of Levonorgestrel Intrauterine Device Use vs. Oral or Transdermal Progesterone for Postmenopausal Women Using Estrogen Containing Hormone Therapy

2019 ◽  
Vol 10 (3) ◽  
pp. 7
Author(s):  
Kaylee Clark ◽  
Sarah M. Westberg
Keyword(s):  
Systematic Review ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Estrogen Replacement Therapy ◽  
Endometrial Hyperplasia ◽  
Intrauterine Device ◽  
Dosage Forms ◽  
Estrogen Replacement ◽  
Randomized Control ◽  
The Relationship

Background: Endometrial hyperplasia is a major concern for women that start estrogen replacement therapy (ERT) to control symptoms experienced during perimenopause and postmenopause.  Progesterone provides protection against endometrial hyperplasia, and there are multiple dosage forms of progesterone available.  Intrauterine progesterone may offer an appealing option with additional benefits beyond endometrial protection for patients. Objective: The overarching objective of this systematic review is to characterize the relationship between levonorgestrel containing intrauterine devices (LNG-IUD) and the prevention of endometrial hyperplasia in peri- and postmenopausal women. Specifically, this systematic review addresses whether LNG-IUD has equivalent efficacy of protecting against endometrial hyperplasia, but an improved safety profile when compared to oral progesterone in women using ERT. Methods: OVID Medline, Scopus, and Cochrane were used to find available studies that have investigated the relationship between endometrial hyperplasia prevention and varying dosage forms of progesterone. Randomized control studies comparing LNG-IUD with no treatment, placebo, or other hormonal therapy in adult females were included. In addition, due to a lack of randomized control studies, four non-comparative studies were included. Results: There were eleven total studies included that investigated LNG-IUD use in women on ERT. According to the studies, the LNG-IUD was equally effective as other routes (oral, vaginal) of progesterone administration in protecting against endometrial hyperplasia. Conclusions: The LNG-IUD prevents endometrial proliferation at least as effective as oral or vaginal forms of progesterone. LNG-IUD is a safe option for women starting estrogen replacement therapy and has added benefits due to decreased adverse effects.   Article Type: Student Project

The Effects of Transdermal Estradiol and Oral Conjugated Estrogens on Haemostasis Variables

1994 ◽  
Vol 71 (04) ◽  
pp. 420-423 ◽  
Author(s):  
Ulla-Beth Kroon ◽  
G Silfverstolpe ◽  
L Tengborn
Keyword(s):  
Replacement Therapy ◽  
Estrogen Replacement Therapy ◽  
Hormone Replacement ◽  
Plasminogen Activator Inhibitor ◽  
Estrogen Replacement ◽  
Transdermal Administration ◽  
Conjugated Estrogens ◽  
Transdermal Estradiol ◽  
Estrogen Administration ◽  
Activator Inhibitor

SummaryThe effects of oral and transdermal administration of estrogen replacement therapy (ERT) have been fairly well investigated regarding lipoprotein and carbohydrate metabolism, while the effects of different modes of estrogen administration on the haemostatic system have been less well studied.To delineate and compare the effects of perorally administered conjugated estrogens (CE) and transdermally administered estradiol (E2) in doses needed for hormone replacement therapy (HRT) on haemostasis parameters, 23 postmenopausal women were engaged in a study with an open cross-over design. The doses compared (0.625 mg CE and 50 μg E2/24h) are the lowest which, with few exceptions, eliminate climacteric symptoms. Both CE and E2 increased factor VII:C, factor VII:Ag, and the prothrombin fragment1+2. The increase in factor VII:Ag, however, was significantly higher after treatment with CE. These changes were all towards a state of hypercoagulability. Furthermore, CE decreased plasminogen activator inhibitor (PAI) and the thrombin-antithrombin complexes (TAT), as well as antithrombin (ATIII).

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