- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Abnormal uterine bleeding (AUB) is a broad term that describes irregularities in the menstrual cycle involving frequency, regularity, duration, and volume of flow outside of pregnancy. Up to one-thir...
Abnormal uterine bleeding (AUB) is a broad term that describes irregularities in the menstrual cycle involving frequency, regularity, duration, and volume of flow outside of pregnancy. Up to one-third of women will experience abnormal uterine bleeding in their life, with irregularities most commonly occurring at menarche and perimenopause. A normal menstrual cycle has a frequency of 24 to 38 days, lasts 7 to 9 days, with 5 to 80 milliliters of blood loss. Variations in any of these 4 parameters constitute abnormal uterine bleeding. Older terms such as oligomenorrhea, menorrhagia, and dysfunctional uterine bleeding should be discarded in favor of using simple terms to describe the nature of the abnormal uterine bleeding. Revisions to the terminology were first published in 2007, followed by updates from the International Federation of Obstetrics and Gynecology (FIGO) in 2011 and 2018. The FIGO systems first define the abnormal uterine bleeding, then give an acronym for common etiologies. These descriptions apply to chronic, nongestational AUB. In 2018, the committee added intermenstrual bleeding and defined irregular bleeding as outside the 75th percentile. Abnormal uterine bleeding can also be divided into acute versus chronic. Acute AUB is excessive bleeding which requires immediate intervention to prevent further blood loss. Acute AUB can occur on its own or superimposed on chronic AUB, which refers to irregularities in menstrual bleeding for most of the previous 6 months.
- [Additional non-contraceptive effects of contraception: CNGOF Contraception Guidelines]. [Journal Article]
- GOGynecol Obstet Fertil Senol 2018 Nov 07
- Hormonal and intrauterine contraceptive methods provide women with highly efficient protection against undesired pregnancy. Additional non-contraceptive effects are now well documented. Combined horm...
Hormonal and intrauterine contraceptive methods provide women with highly efficient protection against undesired pregnancy. Additional non-contraceptive effects are now well documented. Combined hormonal contraceptives use, either through the oral transdermal and vaginal route, allow a reduction in menorrhagia, dysmenorrhea, functional ovarian cysts, benign breast and uterine disease, endometriosis-related pain and recurrence. A reduction in ovarian cancer risks, including in women with BRCA syndrome, endometrial and colon cancer is documented. This effect is prolonged for years after contraception discontinuation. Non-contraceptive benefits of progestin-only contraceptives are less documented. Use of the levonorgestrel IUD is associated with a reduction in menorrhagia, dysmenorrhea including in case of endometriosis. Copper IUD use is associated with a decrease in cervix and endometrial cancer risk.
- Diagnosis and Management of an Adenomatoid Uterine Tumor: Ultrasound, Magnetic Resonance Imaging, Surgical Appearance, and Pathology Correlation. [Journal Article]
- BOBiores Open Access 2018; 7(1):159-164
- Adenomatoid uterine tumors are rare, and their appearance on medical imaging modalities is not well established. We present a case of an adenomatoid uterine tumor reviewing a unique sonographic prese...
Adenomatoid uterine tumors are rare, and their appearance on medical imaging modalities is not well established. We present a case of an adenomatoid uterine tumor reviewing a unique sonographic presentation, magnetic resonance imaging (MRI), gross surgical appearance of the tumor, and microscopic pathology images. A 29-year-old gravida 0 Caucasian woman presented with dysmenorrhea, menorrhagia, and desire to conceive. Transvaginal ultrasound revealed a 2.7 cm round, well-circumscribed posterior intramural uterine mass. The mass was hyperechoic centrally with a thin hypoechoic rim. Color Doppler imaging revealed a prominent vascular rim around the periphery of the mass as well as central vascularity not typical for a leiomyoma. MRI, with and without intravenous gadolinium, was obtained showing a 2.7 cm posterior fundal mildly enhancing uterine mass suggestive of leiomyoma. The mass had a heterogeneous signal pattern on T2-weighted images, and no fat component was noted within the mass. Repeat transvaginal ultrasound showed interval growth of the mass to 3.5 cm with a lipomatous appearance. Adenomatoid uterine tumors are rare and may be mistaken for uterine leiomyomata. Unique features include sonographic appearance of central hyperechogenicity with a hypoechoic rim and prominent peripheral and central vascularity in conjunction with MRI revealing a heterogeneous signal pattern on T2-weighted images without fat component. Gross surgical appearance reveals a nondiscrete capsule and secretion of mucoid material when the mass is exposed. We present a case of adenomatoid tumor providing sonographic, MRI, surgical, and pathological correlation. The patient subsequently conceived spontaneously and delivered at term by cesarean section. The patient underwent a preoperative evaluation with complete blood count, comprehensive metabolic panel, blood type with antibody screen, and pregnancy test. She underwent laparoscopic excision with robotic assistance for removal of the tumor. Grossly, the uterine mass had a very soft consistency atypical for a uterine leiomyoma making dissection more challenging. During dissection the mass diffusely secreted a mucoid material although the capsule was not disrupted. The lesion was excised intact and was removed from the peritoneal cavity in an endocatch bag without internal morcellation. Microscopic examination revealed an adenomatoid tumor.
- Correlation of LOX‑5 and COX‑2 expression with inflammatory pathology and clinical features of adenomyosis. [Journal Article]
- MMMol Med Rep 2018 Nov 01
- Adenomyosis is a common benign disease of women of childbearing age. The typical clinical features are prolonged menstruation, menorrhagia and ingravescent dysmenorrhea. In the present study, the sev...
Adenomyosis is a common benign disease of women of childbearing age. The typical clinical features are prolonged menstruation, menorrhagia and ingravescent dysmenorrhea. In the present study, the severity of dysmenorrhea was assessed using the visual analogue scale system as follows: 0, No pain; 1‑3, minimal pain; 4‑6, moderate pain; and 7‑10, severe pain. Menstrual blood loss was evaluated using the pictorial blood loss assessment chart (PBAC). Menorrhagia was defined as excessive menstrual blood loss >80 ml (PBAC >100) per period. Specimens of eutopic endometrium (EU) and ectopic endometrium (EC) were collected from 20 patients with adenomyosis to evaluate the association between lipoxygenase‑5 (LOX‑5) and cyclooxygenase 2 (COX‑2) and inflammatory pathology and clinical features of adenomyosis. For that purpose, the expression levels of LOX‑5, COX‑2, interleukin (IL)‑6 and IL‑8 in the EU and EC of patients with adenomyosis were determined, and clinical data including dysmenorrhea and menstruation were analyzed. Differences in expression levels of LOX‑5 and COX‑2 were detected, and the correlations between LOX‑5, COX‑2, IL‑6 and IL‑8 in different groups were analyzed. In addition, the correlations between LOX‑5, COX‑2 and clinical features of adenomyosis were investigated. The present study demonstrated that LOX‑5 and COX‑2 are overexpressed in EU and EC, and they have positive correlations with IL‑6 and IL‑8, suggesting that adenomyosis lesions are present in inflammatory pathological conditions. The expression levels of LOX‑5 and COX‑2 exhibited a correlation with dysmenorrhea and menstruation.
- RhoA/ROCK/ARHGAP26 signaling in the eutopic and ectopic endometrium is involved in clinical characteristics of adenomyosis. [Journal Article]
- JIJ Int Med Res 2018 Nov 02; :300060518789038
- CONCLUSIONS: RhoA, ROCK1, and ROCK2 expression is upregulated, and ARHGAP26 expression is downregulated in adenomyosis. The RhoA/ROCK-mediated signaling pathway is associated with dysmenorrhea and menstrual capacity in adenomyosis.
- Naturopathic Medicine for the Management of Endometriosis, Dysmenorrhea, and Menorrhagia: A Content Analysis. [Journal Article]
- JAJ Altern Complement Med 2018 Oct 31
- CONCLUSIONS: The findings of this article provide insights into the documented historical and contemporary treatments within naturopathic medicine for endometriosis, dysmenorrhea, and menorrhagia. While philosophical principles remain the core of naturopathic practice, the therapeutic armamentarium appears to have changed over time, and a number of the original naturopathic treatments appear to have been retained as key elements of treatment for these conditions. Such insights into naturopathic treatments will be of particular interest to clinicians providing care to women, educators designing and delivering naturopathic training, and researchers conducting clinical and health service naturopathic research.
- Early vaginal replacement in cloacal malformation. [Journal Article]
- PSPediatr Surg Int 2018 Oct 30
- CONCLUSIONS: Early vaginal replacement in CM is feasible. Patients with inadequate introitus may suffer from menorrhagia. A regular follow-up is mandatory.
- Frequency of presentation and characteristics of chronic pelvic pain at the gynecologic consultation [Journal Article]
- RMRev Med Inst Mex Seguro Soc 2018 10 25; 56(3):226-230
- CONCLUSIONS: The frequency of CPP was similar to that reported by other groups.
- Predisposing factors for predicting the therapeutic response of adenomyosis after uterine artery embolization: serum CA125 levels and accompanying endometriosis. [Journal Article]
- DIDiagn Interv Radiol 2018; 24(6):364-371
- CONCLUSIONS: Symptom relief of dysmenorrhea and menorrhagia for patients with complete necrosis was significantly better than that for patients with incomplete necrosis. Serum CA125 levels and accompanying endometriosis can effectively distinguish complete necrosis from incomplete necrosis.
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- Weak correlation of bleeding scores to platelet electron microscopy: A retrospective chart review of pediatric patients with delta-storage pool disorder. [Journal Article]
- PBPediatr Blood Cancer 2018 Oct 21; :e27505
- CONCLUSIONS: Patients with more dense granules per platelet had higher bleeding scores than those with fewer dense granules per platelet. The current body of evidence does not favor the use of PEM in routine clinical practice, and results are difficult to interpret. In patients with severe mucocutaneous bleeding symptoms and normal platelet aggregation studies, consideration should be given to an alternative diagnosis and further evaluation is warranted.