Uterine fibroid

The first SPRM to reach the advanced stage of clinical development for treatment of endometriosis and uterine fibroids, asoprisnil, is expected to receive FDA approval this year. The therapeutic effect of asoprisnil stems from its PR antagonist/ antiproliferative activity in the endometrium and breast. Unlike classical PR antagonists however, this compound does not induce labor in animal models of pregnancy and parturition. Recent structural studies... 

A 57-year-old woman is scheduled for an abdominal hysterectomy due to uterine fibroids. She is very anxious about her surgery. 

Uterine fibroids Hypertension x 6 years Hypercholesterolemia x 6 years... 

Uterine Fibroids Adenomyosis Endometrial polyps Gynecologic cancers Alteration of endometrium, changes in uterine contractility Alteration of endometrium, changes in uterine contractility Alteration of endometrium Various dysplastic alterations of endometrium, uterus, cervix... 

The most significant mechanism for primary dysmenorrhea is the release of prostaglandins in the menstrual fluid and possibly vasopressin-mediated vasoconstriction.5,17 Causes of secondary dysmenorrhea may include cervical stenosis, endometriosis, pelvic infections, pelvic congestion syndrome, uterine or cervical polyps, and uterine fibroids.20... 

Nausea, breasttenderness, headaches, cyclic weight gain due to fluid retention Dysmenorrhea, menorrhagia, uterine fibroid growth... 

Undiagnosed abnormal genital bleeding Uterine fibroids... 

Notwithstanding these somewhat discouraging data, a clinical trial has been designed to study the efficacy of tamoxifen in women affected by uterine fibroids (Sadan et al. 2001). In this, the most recent, study, Sadan et al. demonstrated that 20mg/d tamoxifen confers no benefit in premenopausal women with symptomatic leiomyomas. 

Kertel LM, Murphy AA, Morales AJ, Yen SS (1994) Clinical efficacy of antiprogesterone RU 486 in the treatment of endometriosis and uterine fibroids. Hum Reprod 9 116-120... 

Lumsden MA, West CP, Baird DT (1989a) Tamoxifen prolongs luteal phase in premenopausal women but has no effect on the size of uterine fibroids. Clin Endocrinol 31 335-343... 

Palomba S, Zullo F, Orio F Jr, Lombardi G (2004a) Does raloxifene inhibit the growth of uterine fibroids Fertil Steril 81 1719-1720... 

Uterine leiomyomas, or fibroids, are the most common type of solid tumors in adult women, clinically apparent in at least 25% of those of reproductive age [24-26]. Abnormal menstrual bleeding, pelvic pain, and infertility are the most commonly experienced symptoms in these women. Uterine fibroids are the leading cause of hysterectomies performed in the United States, accounting for over 200,000 of these procedures each year. Other invasive surgical interventions for the treatment of uterine fibroids include myomectomy and uterine artery embolization. Leiomyomas are estrogen-responsive tumors that can be treated... 

Zhou XD, Ren XL, Zhang J, He GB, Zheng MJ, Tian X, Li L, Zhu T, Zhang M, Wang L, Luo W (2007) Therapeutic response assessment of high intensity focused ultrasound therapy for uterine fibroid utility of contrast-enhanced ultrasonography. European Journal of Radiology 62 289-294. 

Tamoxifen is an oestrogen-receptor antagonist indicated as adjuvant hormonal treatment in oestrogen-receptor-positive breast cancer in postmenopausal women. Common side-effects include alopecia and uterine fibroids. 

Q80 Women receiving tamoxifen should be advised to have routine gynaecological monitoring. Uterine fibroids and endometrial changes may occur v/ith tamoxifen. 

The administration of tamoxifen necessitates routine gynaecological monitoring since uterine fibroids and endometrial changes may occur with its use. Prior to starting treatment, patients should be informed of the small risk of endometrial cancer associated with tamoxifen therapy. 

Ulcerative colitis chronic inflammatory disease affecting the large intestine and the rectum Urticaria a skin condition characterised by pruritus Uterine fibroids fibrous tissue growth in the uterus Verrucas viral skin infection, wart... 

Uterine fibroids Preexisting uterine leiomyomata (uterine fibroids) may increase in size. However, there is no evidence of this with low-dose hormonal contraceptives. Depression The incidence of depression in OC users ranges from less than 5% to 30%. Pyridoxine deficiency may be a factor in the depression. Women who become significantly depressed when using hormonal contraceptives should stop the... 

Cerebellar haemangioblastoma Massive uterine fibroids Androgen-secreting tumours Phaechromocytoma Autonomous red cell proliferation Primary proliferative polycythaemia... 

Menispermum palmatum L. Pulegone, pinenes, limonene, lauric acid, myristic acid, palmitic acid, beta-methyl-adipic acid, phenol, cresols, eugenal.100 For uterine tumors, uterine fibroids, indurations of the uterus. 

N.A. Trillium erectum L. Saponins (trillin), tannin, resin, fixed oil, volatile oil." For heavy menstrual or intermenstrual bleeding, treat bleeding associated with uterine fibroids. 

Any consideration of major issues relating to the balance of benefit and harm, such as cancer or mortality rates, should be supplemented by a consideration of less prominent ones, for example, a reduction in disorders of the menstrual cycle (such as dysmenorrhea, menorrhagia, and the premenstrual syndrome) and the reduced risks of iron deficiency anemia, functional ovarian cysts, uterine fibroids, benign breast disease, pelvic inflammatory disease, and ectopic pregnancy (10,11). 

Uterine fibroids and endometrial polyps (sometimes with bleeding) have been reported in menopausal women who had taken tamoxifen for periods of months or years (SEDA-16, 466) (92,93). In view of this, the question of whether tamoxifen increases the risk of endometrial cancer has been widely discussed. The authors of a 1993 review of the outcome of six major trials tended strongly to the conclusion that tamoxifen can cause both endometrial hyperplasia and endometrial cancer proportional to the total dose (94) the figures pointed to an overall incidence of endometrial cancer of 0.5 % in tamoxifen users and 0.1% in controls. Another major review up to 1992 concluded that in the world literature there were 70 cases of uterine malignancies with tamoxifen, including 61 cases of adenocarcinoma of the endometrium and four cases of uterine sarcoma (95). 

One of 66 women randomized to receive goserelin acetate for uterine fibroids withdrew from the study owing to severe pelvic pain (78). 

Case (v) A 35-year-old female had primary infertility with secondary amenorrhea, ceasation of ovarian function and uterine fibroid tumour on the posterior wall at the junction of upper one-third and lower two-third of the uterus. Symptoms Amenorrhea for the last two years, obase, sweaty palms and soles, craving for eggs, irregular menstruation earlier. 

Case (ii) A 25-year-old female suffering from uterine fibroid tumour. Symptoms Pain in abdomen, dismenorrhea, menorrhagia, fastidious, likes milk and traveling. 

Women with endometriosis receive treatment courses of 6 months duration. Concomitant low-dose hormone replacement therapy has been reported to diminish bone loss without significantly decreasing clinical effectiveness. Women with uterine fibroids that are symptomatic (menorrhagia, anemia, pain) receive treatment courses of 3 months, by which time women have amenorrhea or reduced menorrhagia uterine fibroids are reduced in size an average of 37%. Intramuscular depot preparations containing 3.75 mg (monthly) or 11.5 mg (every 3 months) are used. 

Nafarelin nasal spray has been used to shrink uterine fibroids and reduce menometrorrhagia, dysmenorrhea, and pelvic discomfort. Required doses range from 50 vg to 400 ug intranasally twice daily for 3-6 months. 

Copper deficiency Copper imbalance causes health disorders that include arthritis, fatigue, adrenal burnout, insomnia, scoliosis, osteoporosis, heart disease, cancer, migraine headaches, seizures, fungal and bacterial infections, gum disease, tooth decay, skin and hair problems, and female organ conditions including uterine fibroids and endometriosis. Copper deficiency is associated with atherosclerosis and other cardiovascular conditions, aneurysms, gout, and anemia. - - ... 

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