Potential Effects of Melatonin on the Development of Uterine Fibroids in Women of Reproductive Age (Review of Literature)

2021 ◽  
Vol 6 (5) ◽  
pp. 45-50
Author(s):  
B. V. Sokolov ◽  
◽  
O. M. Yuzko
Keyword(s):  
Uterine Leiomyoma ◽  
Reproductive Potential ◽  
Uterine Fibroids ◽  
Current Data ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Foreign Literature ◽  
New Approaches ◽  
Long Time ◽  
The Impact

For a long time, Ukraine has been showing negative dynamics between birth and death rates. The demographic situation in any country is an important indicator. Therefore, the issue of women's health and ability to reproduce is significant and urgent. The purpose of the study was to analyze current data from domestic and foreign literature on provoking factors, etiology and pathogenesis of uterine fibroids, new approaches to treatment and the impact of this pathology on a woman's reproductive potential. Hyperplastic processes of the uterus in women of reproductive age are among the most common gynecological diseases. Uterine leiomyoma is the most common benign proliferative pathology. The presence of uterine leiomyoma leads to disorders of women's reproductive health, is one of the causes of infertility, in addition, significantly affects the quality of life of the patient due to constant pain, excessive uterine bleeding, dysfunction of adjacent organs. Many studies confirm the unfavorable course of pregnancy and the postpartum period in women with fibroids, namely: complicated pregnancy, reproductive losses, birth defects and postpartum complications. Despite the intensive work of scientists, the implementation of a large number of studies, the pathogenesis to this day remains multifaceted and poorly understood. Results and discussion. After analyzing current data from domestic and foreign literature on provoking factors, etiology and pathogenesis of uterine fibroids, the review article presents data on current opportunities, new approaches to treatment and the impact of this pathology on a woman's reproductive potential. For a long time, the pineal gland with the hormone melatonin has not been studied. During the scientific research, the review of the current domestic and foreign literature on the potential inhibitory effect of melatonin on uterine fibroid cells, and the direct and indirect effect on fertility was reviewed and analyzed. As a result of analysis of experimental and clinical data presented in the literature, it can be argued that melatonin has the ability not only to regulate biological rhythms, but also that it is promising to study metabolic and immunomodulatory effects, as well as antitumor effects, which gives us a chance to reduce surgery of this group of patients. Conclusion. The information presented in the review suggests that melatonin has the potential as a therapeutic agent for clinical trials against uterine leiomyoma in women of reproductive age. Therefore, there is a need to study deeply the etiopathogenesis of uterine leiomyoma and in particular the effect of melatonin on growth, reduction of surgical interventions, the impact on the pre- and postoperative period, and to determine melatonin as a therapeutic drug

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.

Clinical case the combination of uterine leiomyoma and pregnancy

2017 ◽  
pp. 65-68
Author(s):  
M.V. Makarenko ◽  
◽  
D.O. Hovsieiev ◽  
L.I. Martynova ◽  
K.V. Mesropyan ◽  
...  
Keyword(s):  
Trisomy 21 ◽  
Uterine Leiomyoma ◽  
Clinical Case ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Choice Of Treatment ◽  
Fetal Malformations ◽  
History Of ◽  
Medical Examinations

This article describes the clinical case mix uterine fibroids and pregnancy 11–12 weeks diagnosed with trisomy 21 in the fetus hrosomi. The history of the study of uterine fibroids, current views on the pathogenesis, etiology and treatment. Highlighted describes the practical value that indicates the need for regular preventive medical examinations of women of reproductive age, the importance of planning pregnancy and choice of treatment for fetal malformations and tumors of the uterus. Key words: uterine fibroids, pregnancy, surgery.

Evaluation of the effectiveness of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 19-23
Author(s):  
Yanina A Lebedeva ◽  
Inna I Kovalenko ◽  
Oleg L Molchanov ◽  
Dmitrii V Baibuz ◽  
Natalia V Kulikova
Keyword(s):  
Reproductive Potential ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Results Of Treatment ◽  
High Prevalence ◽  
Group 2 ◽  
Group 1

Relevance. Due to the high prevalence of uterine fibroids in young women and the possible effect on reproductive potential, the development, implementation and application of the most benign treatment methods are a priority. Aim. To evaluate the effectiveness of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age. Materials and methods. A comparative analysis of the results of treatment of patients of reproductive age with uterine myoma has been carried out. Group 1 (n=38) included patients who underwent conservative myomectomy and/or hysteroresectoscopy without subsequent anti-relapse drug therapy. The average age is 31.5 years (4.6). Group 2 (n=43) included patients after conservative myomectomy who received mifepristone as anti-relapse therapy after surgery. The average age is 31.9 years (4.5). Results. Mifepristone therapy, as an adjuvant treatment after conservative myomectomy, can significantly reduce the risk of recurrence, stabilize the size of the uterus, reduce the severity of clinical manifestations in the form of pain syndrome and heavy menstruation associated with relapse, thereby improving the reproductive health of women. Conclusions. The use of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age is a very effective method for treating uterine fibroids and can be considered as a therapy of choice in such patients.

Assessment of quality of life after hysterectomy with uterine myoma

2020 ◽  
pp. 59-63
Author(s):  
I. Ventskivska ◽  
◽  
О. Proshchenko ◽  
Ya. Vitovsky ◽  
S. Markitanyuk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radical Surgery ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Sexual Disorders ◽  
Women Of Reproductive Age ◽  
Urogenital Dysfunction ◽  
The Impact

Hysterectomy, performed in reproductive age, undoubtedly causes a decrease in all parameters of quality of life and contributes to the development of imbalance of hormonal homeostasis, psycho-emotional, vegetative-neurotic symptoms, increasing sexual and urogenital dysfunction, impeding psycho-social adaptation in the family,the professional and intellectual spheres of a woman’s life. This aspect is often overlooked by surgeons when evaluating the effectiveness of treatment, although it has a significant impact on recovery from surgery. The article presents data on experimental psychological research, evaluation of the severity of urogenital dysfunction using a standardized POP-Q system, characteristics of quality of life parameters both at the stage of preoperative observation and within 1, 3 and 5 years after surgery in 80 women of reproductive age with uterine fibroids who have undergone vaginal hysterectomy. The comparison group included 60 patients with hysterectomy performed by abdominal access. According to the results of this study, in women of reproductive age after radical surgery for fibroids, it was determined that the leading violations of quality of life after hysterectomy are general somatic symptoms, psycho-emotional disorders, genitourinary and sexual disorders. Radical operations for uterine fibroids cause an increase in the proportion of urogenital disorders, among which the most important are urinary incontinence and prolapse, the clinical manifestations of which have a negative impact on, including the psychosocial sphere, while reducing quality of life. Today there is no consensus on the degree of impact of radical surgery for uterine fibroids on the versatility of metabolic and hormonal homeostasis, the formation of psychovegetative symptom complex, and as a consequence, the impact on quality of life, which necessitates a validated method of quality of life optimization of the rehabilitation program with personalized consideration of the leading factors of status comorbidity when planning surgical treatment. Keywords: uterine fibroids, hysterectomy, quality of life parameters.

scholarly journals UTERINE FIBROIDS IMPACT ON FERTILITY AND PREGNANCY OUTCOME

2020 ◽  
Vol 2 ◽  
pp. 52-58
Author(s):  
Olena Doroha ◽  
Mykola Iarotskyi ◽  
Iryna Iarotska ◽  
Liudmyla Semeniuk ◽  
Olga Nikitina
Keyword(s):  
Sex Hormones ◽  
Uterine Leiomyoma ◽  
Uterine Fibroids ◽  
Statistical Processing ◽  
Main Group ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Healthy Women ◽  
Obstetric History

The clinical confirmation of the relationship between uterine leiomyoma and female infertility is of interest to scholars. The aim of our research was to study obstetric history and the level of sex hormones in women of reproductive age with leiomyoma. Materials and methods. The main group consisted of 90 women of reproductive age with uterine leiomyoma, the control group - 45 healthy women. Gynaecological and obstetric history, hormone content in peripheral blood and pelvic vessels (estradiol, progesterone) were analysed. Statistical processing of clinical material was performed using Microsoft Excel, Statistica 7.0, and Statistica 8.0 for Windows. Results. The frequency of infertility in the surveyed women with LM was 18.9 %. One in three patients in the main group (33.3 %) did not give birth, which was statistically different from the healthy women group. In this case, 25.6 % of women in the main group did not use any methods of contraception. It was found that 51.11 % of patients with LM had threatened miscarriage in their history, 37.5 % – complicated delivery. Pathological changes in the concentrations of estradiol and progesterone in the preferential blood and blood vessels of women with fibroids have been identified. We have found that the content of sex hormones in the local bloodstream has a reliable relationship with the location of the myomatous node. Conclusion. The obtained results may indicate that leiomyoma contributes to the reduction of fertility. This is evidenced by the fact that women with LM are more likely to have the risk of miscarriage, complicated delivery and delivery by caesarean section, including complicated one. The findings have made a significant contribution to the further development of effective strategies for the prevention and treatment of infertility in women with fibrotic uterine lesions.

Painless spontaneous haemoperitoneum secondary to a uterine leiomyoma/fibroid: unusual presentation of a life-threatening differential

2021 ◽  
Vol 14 (10) ◽  
pp. e243465
Author(s):  
Chiamaka Maduanusi ◽  
Sathiyaa Balachandran ◽  
Sahathevan Sathiyathasan ◽  
Kazal Omar
Keyword(s):  
Uterine Leiomyoma ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Haemodynamic Instability ◽  
Hypovolaemic Shock ◽  
Important Differential Diagnosis ◽  
Life Threatening ◽  
Definitive Management

This is a case of a 47-year-old woman with a spontaneous haemoperitoneum secondary to uterine leiomyomas (fibroids), an important differential diagnosis in patients with uterine fibroids and hypovolaemic shock. Uterine fibroids are very common in women of reproductive age, yet little is taught about their potential to cause hypovolaemic shock. Although it is a rare complication, given the prevalence of fibroids, it is important to bear this life-threatening differential in mind to optimise the care for these women. Presentation typically involves abdominal pain, syncope, haemodynamic instability and an intra-abdominal mass. CT of the abdomen and pelvis can be helpful in identifying the source of the haemoperitoneum, but should not delay surgery, which is the definitive management.

scholarly journals Sexual Function in Women With and Without Female Genital Mutilation in Reproductive Age in South of Iran

2021 ◽  
Author(s):  
Mahshid Bokaie ◽  
Samaneh Hatefi ◽  
Shahnaz Mojahed ◽  
Nasibeh Roozbeh
Keyword(s):  
Sexual Function ◽  
Female Genital Mutilation ◽  
Reproductive Age ◽  
Public Health Issue ◽  
P Value ◽  
Women Of Reproductive Age ◽  
Genital Mutilation ◽  
Significant Difference ◽  
The Impact ◽  
Female Genital

Abstract Objectives: Female genital mutilation (FGM) is an important public health issue, especially in developing countries and it is still done in some parts of Iran. This study aimed to investigate the effect of FGM on the sexual function of women of reproductive age in Hormozgan province/IRAN.Study design: This study is a descriptive-analytical case-control study that was conducted in 2020 on 209 married women of reproductive age (15-49) in rural areas of Minab and Sirik counties in Hormozgan province/IRAN. Main outcome measures: The reliable and valid questionnaire FSFI for assessing female sexual function in the two groups was used after to obtain informed and voluntary consent from all participants and data with SPSS v: 16 software and with using descriptive/ Analytical statistics tests with a significant level of 0.05 were examined. Results: There is a significant difference between mutilated and non-mutilated women in the total score of sexual function(22.18±3.23 versus 23.41±2.52 respectively, p=0.023) and the domains of lubrication(3.04±0.62 versus 3.3±0.53 respectively, P=0.000), orgasm(3.81±0.63 versus 4.08±0.47 respectively, P=0.003), and sexual satisfaction(5.09±0.1 versus 5.37±0.87 respectively, P=0.017) But in the domains of desire, arousal, and pain in the two groups was no significant difference(P-value>0.05). Conclusion: FGM maybe leads to sexual dysfunction. Although most women were reluctant to perform mutilation on their daughters, more educational Actions are suggested to educate women about the impact of female mutilation on their sexual function. Counseling programs are also recommended to improve the sexual function of mutilated women.

scholarly journals WOMEN'S OF REPRODUCTIVE AGE HEALTH

2020 ◽  
Vol 3 (3) ◽  
pp. 167-181
Author(s):  
Leyla N. Natsun
Keyword(s):  
Healthy Lifestyle ◽  
Age Groups ◽  
Reproductive Potential ◽  
Reproductive Age ◽  
Federal State ◽  
Sociological Research ◽  
Observation Data ◽  
Behavioral Factors ◽  
Women Of Reproductive Age ◽  
Mortality And Morbidity

The health of women of reproductive age is the basis for forming the health of new generations of the population. Reducing preventable mortality and morbidity of women with diseases that reduce their reproductive potential, as well as motivating them to lead a healthy lifestyle are urgent tasks in the field of strengthening the demographic potential of the country. The purpose of this work is to analyze themain indicators that characterize the health of women of reproductive age in Russia, as well as the characteristics of behavioral factors that affect the health of this category of population. The information base of the study was made up of the works of domestic and foreign authors, statistical data, and materials of selective observation of behavioral factors affecting the health of the population (for 2018), conducted by the Federal state statistics service. It is shown that, despite the improvement of individual indicators of health of women of reproductive age, an actual threat to it is an increase in the incidence of neoplasms and infertility. Analysis of sample observation data allowed to expand the number of problems identified in the statistics. It was found that different age groups of women of reproductive age have different combinations of behavioral factors that affect health. In the future, it is planned to expand the results obtained by adding an analysis of regional sociological research data.

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

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