Role of adjuvant hormonal therapy in restoring reproductive function in women after endosurgical treatment of ovarian follicular cysts

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. 68-72
Author(s):  
Farkhad I. Shukurov ◽  
Farida M. Aiupova
Keyword(s):  
Menstrual Cycle ◽  
Adjuvant Therapy ◽  
Hormone Therapy ◽  
Ethinyl Estradiol ◽  
Reproductive Function ◽  
Ovarian Cysts ◽  
Adjuvant Hormone Therapy ◽  
Menstrual Function ◽  
Chlormadinone Acetate ◽  
Immunohistochemical Studies

In the structure of the causes of female infertility, follicular ovarian cysts make up 710% of cases. Despite the studies on the reproductive health of women undergoing endosurgical treatment of follicular ovarian cysts, the problem of restoring reproductive function has not yet been resolved. Aim. To assess the effectiveness of a preparation containing 0.03 mg of ethinyl estradiol and 2 mg of chlormadinone acetate in the restoration of reproductive function in women after endosurgical treatment of follicular ovarian cysts. Materials and methods. The study group included 100 women, of whom 70 patients (the main group) received adjuvant therapy with a drug containing 0.03 mg of ethinyl estradiol and 2 mg of chlormadinone acetate after endosurgery, and a comparison group of 30 patients who did not receive adjuvant therapy. The diagnosis of follicular ovarian cysts was established on the basis of hormonal, ultrasound, endoscopic and immunohistochemical studies. The levels of gonadotropic hormones (LH, FSH), steroid hormones estradiol and progesterone were determined twice at the beginning of the follicular (35 day) and secretory phase (2022 day) of the menstrual cycle. An ovarian ultrasound was performed at the beginning of the follicular phase and on days 2022 of the menstrual cycle. Immunohistochemical studies of estrogen and progesterone receptors in the ovaries were carried out using a Bond-max immunostimulator from Leica (Germany) using monoclonal antibodies: clone 1D5 and clone 1A6 Dako (USA). Results. Menstrual irregularities were detected in 36 (51.4%) patients, of which: irregular menstruation in 18.0%, algomenorrhea in 15.1%, polymenorrhea in 11.0%, and menorrhea in 7.3% of patients, infertility was observed in 34 (48.6%) patients. Endosurgical treatment of follicular ovarian cysts was performed for all examined patients. Adjuvant hormone therapy with a drug containing 0.03 mg of ethinyl estradiol and 2 mg of chlormadinone acetate was received by 70 patients. Menstrual function was restored in 70 (100%) patients. Pregnancy occurred in 60 (86.0%) of them. Conclusion. Adjuvant hormone therapy with a drug containing 0.03 mg of ethinyl estradiol and 2 mg of chlormadinone acetate allowed to restore menstrual function (100% of cases), pregnancy at 4.3 times (86.0% of cases), which confirms its high efficiency in the restoration of reproductive function in women after endosurgical treatment of follicular ovarian cysts.

New paradigms in adjuvant systemic therapy of breast cancer.

2003 ◽  
pp. 75-89 ◽  
Author(s):  
E Thomas ◽  
G N Hortobagyi
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Hormone Therapy ◽  
Current Practice ◽  
Tumor Stage ◽  
Substantial Effect ◽  
Published Data ◽  
Adjuvant Hormone Therapy ◽  
Prognostic Features ◽  
Made In

Since the initial studies of adjuvant therapy in the 1970s, it has become increasingly clear that chemotherapy and hormone therapy have had a substantial effect on the survival of women with early breast cancer. It was originally assumed that only women with high-risk features would derive benefit from adjuvant therapy, but it is now apparent from numerous studies that adjuvant therapy improves survival in all subgroups of women with invasive breast cancer, although the absolute benefit varies depending on tumor stage and other prognostic features. Considerable progress has been made in elucidating effective adjuvant therapy regimens, but there continue to be many unanswered questions that are being addressed in ongoing clinical trials of adjuvant hormone therapy and chemotherapy. This paper reviews the current paradigms in adjuvant therapy, the published data that have affected current practice patterns, and the current controversies.

Early-stage breast cancer patients reporting difficulty sleeping, mood issues, or pain are more likely to refuse adjuvant hormone therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12065-e12065
Author(s):  
Christian A. Thomas
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Stage I ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Adjuvant Hormone Therapy

e12065 Background: Adjuvant hormone therapy is a crucial part of the treatment for patients with early stage breast cancer and an important quality measure for programs such as QOPI and the oncology care model (OCM). However, it is not known which factors influence some patients with early stage breast cancer to decline adjuvant hormone therapy. We hypothesized that specific self-reported symptoms might impact a patient’s decision to accept or decline adjuvant hormone therapy. Methods: Patients with stage 0 or I breast cancer were identified by chart review from 2011-2016 and de-identified. On the day patients received a recommendation for adjuvant treatment the following patient reported outcome measures (PROs) were analyzed: difficulty sleeping (DS), fatigue (F), mood (M such as anxiety and depression), and pain (P) on a 0-4 symptom scale based on CTCAE v. 4. PROs were then linked with a patient’s decision to accept or decline adjuvant therapy. Results: A total of 287 patients with stage 0 (n = 80) or stage I (n = 207) breast cancer were identified. 38 stage O and 103 stage I patients had evaluable PROs on the same day a recommendation for adjuvant hormone therapy was made. Overall 18/38 (47.4%) of stage 0 patients and 90 of 103 (87.4%) of stage I patients accepted adjuvant treatment. Stage 0 patients declining adjuvant therapy reported any grade of PROs: DS (40%, n = 8), F (35%, n = 7), M (35%, n = 7), P (20%, n = 4). Stage 0 patients accepting treatment reported: DS (22%, n = 4), F (44%, n = 8), M (6%, n = 1), P (20%, n = 4). Stage I patients who declined treatment reported: DS (54%, n = 7), F (46%, n = 6), M (38%, n = 5), P (62%, n = 8). Stage I patients accepting treatment reported: DS (41%, n = 37), F (49%, n = 44), M (31%, n = 28), P (36%, n = 32). Conclusions: Early stage breast cancer patients declining adjuvant hormone therapy are more likely to self report symptoms such as difficulty sleeping, mood disturbances (anxiety, depression), and pain than those accepting treatment.

Hormonal contraception as a method of social adaptation of women in modern society

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 17-21
Author(s):  
Tatyana Yu Pestrikova ◽  
Elena A Yurasova ◽  
Igor V Yurasov ◽  
Tamara D Kovaleva
Keyword(s):  
Ethinyl Estradiol ◽  
Hormonal Contraception ◽  
Modern Society ◽  
Well Being ◽  
Social Adaptation ◽  
Female Employment ◽  
Hormonal Contraceptives ◽  
Aim Analysis ◽  
Positive Effects ◽  
Chlormadinone Acetate

Relevance. Currently, women make up more than 40% of the global workforce and more than half of students studying at universities around the world. Women's education, especially at a high level, tends to increase female employment. The mismatch of the style and rhythm of modern life with a genetically determined and working millennium reproductive program requires the choice of a specific approach to social adaptation. Aim. Analysis of literary sources on the use of hormonal contraception as a method of social adaptation. Materials and methods. To write this review, domestic and foreign publications were searched in Russian and international search systems (PubMed, eLibrary, etc.) for the last 2-10 years. The review included articles from peer-reviewed literature. Results. The review describes the features of modern hormonal contraceptives. Their non-contraceptive effects are presented. The individual non-contraceptive effects of a combined oral contraceptive containing 30 mg of ethinyl estradiol and 2 mg of chlormadinone acetate were determined. It has been established that the use of this contraceptive helps to improve the well-being and mood of patients, which allows you to actively use this contraceptive in routine clinical practice with premenstrual syndrome, dysmenorrhea, without the use of analgesics. Conclusions. The numerous positive effects of ethinyl estradiol and chlormadinone acetate allow the use of the drug as a means to increase social adaptation, and, consequently, improve the quality of life.

Menstrual cycle, reproductive function, body mass index, and metabolic profiles of women with former central precocious puberty: 10–20-year longitudinal cohort study in southern Thailand

2020 ◽  
Vol 33 (7) ◽  
pp. 933-940 ◽  
Author(s):  
Pitchaya Satitpatanapan ◽  
Somchit Jaruratanasirikul ◽  
Hutcha Sriplung
Keyword(s):  
Menstrual Cycle ◽  
Precocious Puberty ◽  
Polycystic Ovary ◽  
Serum Insulin ◽  
Density Lipoprotein ◽  
Reproductive Function ◽  
Central Precocious Puberty ◽  
Lipoprotein Cholesterol ◽  
Metabolic Profiles ◽  
Model Assessment

AbstractBackgroundIn 2011, we described 64 girls diagnosed with central precocious puberty (CPP) during 1995–2009. In 2019, the former CPP patients were 16–30 years of age and had been followed-up for 6–20 years after cessation of gonadotropin-releasing hormone analog (GnRHa) treatment.ObjectivesTo determine the menstrual cycle, reproductive function, and long-term sequelae of the former GnRHa-treated and untreated CPP patients.MethodsSixty-seven former CPP women diagnosed during January 1995 to December 2010 were evaluated in 2019 for current menstrual cycle and pregnancy rate and for general health status, weight, height, blood pressure, and metabolic profiles of glucose, lipids, insulin, and testosterone.ResultsIn 2019, the former CPP women averaged 20.7 ± 2.7 years of age (range: 16.5–30). Eighty-three percent had a regular menstrual cycle. Of the 14 married women, six (43%) were fertile with 1–2 children. The untreated women had a significantly higher rate of obesity (BMI >25 kg/m2) than the GnRHa-treated women (72.1% vs. 36.6%, p < 0.01). Two women (3%) had polycystic ovary syndrome (PCOS). Fasting plasma glucose, serum high-density lipoprotein cholesterol (HDL-C), and testosterone levels were normal and similar between the GnRHa-treated and untreated participants. The serum insulin, cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), and homeostasis model assessment-insulin resistance (HOMA-IR) levels were higher in the untreated group than the GnRHa-treated group, but without significant differences.ConclusionsAt a 10–20-year follow-up, our former CPP patients had regular menstruation, normal reproductive function, and normal metabolic outcomes. The low prevalence of PCOS of 3% suggests that CPP is not a risk factor for PCOS, at least during early adulthood.

scholarly journals Twice-Daily Subcutaneous Injection of Kisspeptin-54 Does Not Abolish Menstrual Cyclicity in Healthy Female Volunteers

2013 ◽  
Vol 98 (11) ◽  
pp. 4464-4474 ◽  
Author(s):  
C. N. Jayasena ◽  
A. N. Comninos ◽  
G. M. K. Nijher ◽  
A. Abbara ◽  
A. De Silva ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Reproductive Function ◽  
Reproductive Hormones ◽  
Follicular Phase ◽  
Hypothalamic Amenorrhea ◽  
Healthy Women ◽  
Lh Pulsatility ◽  
Serum Lh ◽  
Healthy Female ◽  
Ultrasound Parameters

Background: Kisspeptin is a critical hypothalamic regulator of reproductive function. Chronic kisspeptin administration causes profound tachyphylaxis in male monkeys and in women with functional hypothalamic amenorrhea. The pharmacological effects of chronic kisspeptin exposure in healthy women with normal menstrual cycles have not been studied previously. Aim: Our aim was to determine the effects of follicular-phase kisspeptin-54 treatment on menstrual cyclicity in healthy women. Methods: We performed a prospective, single-blinded, 1-way crossover study. Healthy women received twice-daily sc injections of kisspeptin (6.4 nmol/kg) or 0.9% saline during menstrual days 7–14 (n = 5 per treatment arm). Serial assessments of basal reproductive hormones, ultrasound parameters, LH pulsatility, and acute sensitivity to GnRH and kisspeptin-54 injection were performed. Results: Menstrual cyclicity persisted in all women after follicular-phase kisspeptin-54 treatment. Chronic exposure to kisspeptin-54 did not abolish acute stimulation of LH after injection of kisspeptin-54 or GnRH. In addition, kisspeptin-54 treatment was associated with a shorter mean length of the menstrual cycle (mean length of menstrual cycle was 28.6 ± 1.4 days with saline vs 26.8 ± 3.1 days with kisspeptin, P &lt; .01), earlier onset of highest recorded serum LH (mean menstrual day of highest LH was 15.2 ± 1.3 with saline vs 13.0 ± 1.9 with kisspeptin, P &lt; .05), and earlier onset of the luteal phase (mean menstrual day of progesterone increase was 18.0 ± 2.1 with saline vs 15.8 ± 0.9 with kisspeptin, P &lt; .05). Conclusion: Our data suggest that 1 week of exogenous kisspeptin-54 does not abolish menstrual cyclicity in healthy women. Further work is needed to determine whether kisspeptin could be used to treat certain anovulatory disorders.

scholarly journals Socioeconomic factors associated with adjuvant hormone therapy use in older breast cancer survivors

Cancer ◽  
2010 ◽  
Vol 117 (2) ◽  
pp. 398-405 ◽  
Author(s):  
Tina W. F. Yen ◽  
Linda K. Czypinski ◽  
Rodney A. Sparapani ◽  
Changbin Guo ◽  
Purushottam W. Laud ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Socioeconomic Factors ◽  
Hormone Therapy ◽  
Breast Cancer Survivors ◽  
Adjuvant Hormone Therapy ◽  
Factors Associated

Combined oral contraceptives and treatment of new coronavirus infection (COVID-19): aspects of drug interactions

2021 ◽  
Vol 19 (1) ◽  
pp. 149-158
Author(s):  
O.A. Limanova ◽  
◽  
L.E. Fedotova ◽  
O.A. Gromova ◽  
◽  
...  
Keyword(s):  
Drug Interactions ◽  
Oral Contraceptives ◽  
Ethinyl Estradiol ◽  
Antihypertensive Drugs ◽  
Efficacy And Safety ◽  
Antiinflammatory Drugs ◽  
Combined Oral Contraceptives ◽  
Chlormadinone Acetate ◽  
Coronavirus Infection ◽  
Oral Hypoglycemic Drugs

This article discusses the problem of drug interactions between combined oral contraceptives on the example of Belara® (30 μg of ethinyl estradiol + 2 mg of chlormadinone acetate; Gedeon Richter, Hungary) and medications recommended for the treatment of new coronavirus infection (COVID-19) and concomitant disorders at the pharmacodynamic and pharmacokinetic levels with an assessment of the efficacy and safety of therapy for females. We described safe, potentially dangerous, and dangerous combinations of these drugs. Key words: new coronavirus infection (CAVID-19), combined oral contraceptives, antiviral drugs, antibacterial drugs, antiinflammatory drugs, anticoagulants, migraine drugs, antihypertensive drugs, oral hypoglycemic drugs, essential micronutrients, pharmacodynamic and pharmacokinetic interactions

Adjuvant Hormone Therapy for Breast Cancer

2019 ◽  
pp. 479-487
Author(s):  
Andrea K. Shimada ◽  
João Victor Machado Alessi ◽  
Bruna Zucchetti ◽  
Artur Katz
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Adjuvant Hormone Therapy
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