scholarly journals Hormone therapy after endometrial cancer.

2004 ◽  
Vol 11 (2) ◽  
pp. 305-314 ◽  
Author(s):  
A O Mueck ◽  
H Seeger
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Endometrial Cancer ◽  
Hormone Therapy ◽  
Endometrial Carcinoma ◽  
Low Dose ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Increased Risk ◽  
Climacteric Complaints

Endometrial carcinoma is listed under the absolute contraindications to hormone therapy (HT). According to current opinion, HT after stage I or II is still considered an option, and continuous combined oestrogen/progestogen replacement therapy (CCEPT) would be recommended. However, up to now, only observational studies have been put forward. Although none of these studies have established an increased rate of recurrence or mortality, alternatives such as phytopreparations and tibolone, or particular psychotherapeutic drugs, such as venlafaxine, should be considered for the relief of climacteric complaints. Progestogen-only therapy (PT) particularly has been considered. However, the currently discussed possible progestogen effects regarding an increased risk of breast cancer have to be taken into account. Indeed, the wider discussion about the gestagen effects regarding the risk of breast cancer is to be considered. Generally, after hysterectomy, at least for patients with cardiovascular risk factors, the preference today is to use low-dose oestrogen therapy (patches or gels) instead of CCEPT, and this is also now recommended for patients after endometrial cancer. This is to be noted because of the risk factors for endometrial carcinoma, such as hypertension, obesity, polycystic ovary syndrome (PCO) and diabetes mellitus. However, each form of HT should be only exceptionally recommended, and the patients must be informed about the risks that exist and the use of alternatives.

scholarly journals High BMI and Insulin Resistance Are Risk Factors for Spontaneous Abortion in Patients With Polycystic Ovary Syndrome Undergoing Assisted Reproductive Treatment: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 11 ◽  
Author(s):  
Yi-Fei Sun ◽  
Jie Zhang ◽  
Yue-Ming Xu ◽  
Zi-Yu Cao ◽  
Yi-Zhuo Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Spontaneous Abortion ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Abortion Rate ◽  
Ovary Syndrome ◽  
Assisted Reproductive Treatment ◽  
Increased Risk ◽  
High Bmi

BackgroundThe risk of spontaneous abortion in patients with polycystic ovary syndrome (PCOS) undergoing assisted reproductive treatment (ART) is higher than that in patients without PCOS, however, no definitive risk factors have been confirmed to associate with the high spontaneous abortion rate in PCOS patients undergoing ART. This study was performed to assess the impact of relevant risk factors on spontaneous abortion in patients with PCOS. Clinical questions were formulated and organized according to the PICOS principle.MethodsA systematic review and meta-analysis were conducted on all published studies on PCOS and spontaneous abortion in Embase, PubMed, Web of Science and Cochrane Library. Related risk factors included body mass index (BMI), age, insulin resistance (IR), hyperandrogenism, and chromosome aberrations. All patients were diagnosed as PCOS using the Rotterdam criteria. The primary endpoint was miscarriage and live birth rate. Fixed-effect models were used to analyze homogeneous data, and subgroup and sensitivity analyses were performed on heterogeneous data. The source of heterogeneity was evaluated, and the random effect model was used to summarize the heterogeneity.ResultsAmong 1836 retrieved articles, 22 were eligible and included in the analysis with 11182 patients. High BMI (OR = 1.48, 95% CI [1.32, 1.67], MD = 1.35, 95% CI [0.58,2.12]) and insulin resistance (MD = 0.32, 95% CI [0.15, 0.49]) were associated with an increased risk of spontaneous abortion in PCOS patients undergoing ART. Older age (OR = 0.29, 95% CI [0.29, 0.44], MD = 2.01, 95% CI [0.04, 4.18]), embryonic chromosomal aberrations (OR = 0.75, 95%CI [0.31,1.77]), and hyperandrogenism (MD = 0.10, 95% CI [- 0.02, 0.22]) were not associated with the high spontaneous abortion rate in patients with PCOS. A subgroup analysis of BMI showed that there was no statistically significant difference in the effect between overweight and obesity on spontaneous abortion in PCOS patients undergoing ART (OR = 1.34, 95% [0.97, 1.85]).ConclusionHigh BMI and insulin resistance are two risk factors for an increased risk of spontaneous abortion in PCOS patients undergoing ART, and losing weight and mitigating insulin resistance may decrease the spontaneous abortion rate in these patients undergoing ART.

scholarly journals Endocrine Risk Factors of Endometrial Cancer: Polycystic Ovary Syndrome, Oral Contraceptives, Infertility, Tamoxifen

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1766 ◽  
Author(s):  
Atanas Ignatov ◽  
Olaf Ortmann
Keyword(s):  
Endometrial Cancer ◽  
Polycystic Ovary Syndrome ◽  
Oral Contraceptives ◽  
Polycystic Ovary ◽  
Gynecologic Cancer ◽  
Age At Menarche ◽  
Published Data ◽  
Ovary Syndrome ◽  
Increased Risk

Endometrial cancer is the most common gynecologic cancer and is predominantly endocrine-related. The role of unopposed estrogen in the development of endometrial cancer has been investigated in numerous studies. Different reproductive factors such as younger age at menarche, late age at menopause, infertility, nulliparity, age of birth of the first child, and long-term use of unopposed estrogens during hormone replacement therapy have been associated with an increased risk of endometrial cancer. In contrast, there is a growing body of evidence for a protective role of oral contraceptives. Most of the published data on the association between infertility and polycystic ovary syndrome are inconclusive, whereas the effect of tamoxifen on the risk of endometrial cancer has been well established. With this review, we aim to summarize the evidence on the association between infertility, polycystic ovary syndrome, oral contraceptives, and tamoxifen and the development of endometrial cancer.

Cardiovascular risk factors are reduced with a low dose of acarbose in obese patients with polycystic ovary syndrome

2007 ◽  
Vol 88 (2) ◽  
pp. 519-522 ◽  
Author(s):  
Ivan Araujo Penna ◽  
Paulo Roberto Bastos Canella ◽  
Carolina Sales Vieira ◽  
Marcos Felipe Silva de Sá ◽  
Rosana Maria dos Reis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Polycystic Ovary Syndrome ◽  
Cardiovascular Risk Factors ◽  
Low Dose ◽  
Polycystic Ovary ◽  
Obese Patients ◽  
Ovary Syndrome

scholarly journals Endometrium and polycystic ovary syndrome

2018 ◽  
Vol 67 (4) ◽  
pp. 60-66
Author(s):  
Pavel P Yakovlev ◽  
Igor Yu Kogan
Keyword(s):  
Endometrial Cancer ◽  
Polycystic Ovary Syndrome ◽  
Pregnancy Outcomes ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Endocrine Disorder ◽  
Increased Risk ◽  
Adverse Pregnancy

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Patients with PCOS present with several endometrial abnormalities possibly explaining some of the adverse endometrium-related outcomes in these women. PCOS is inconsistently associated adverse pregnancy outcomes and an increased risk of endometrial cancer. The purpose of this review is to systematize the available data on endometrial dysfunction associated with PCOS. (For citation: Yakovlev PP, Kogan IYu. Endometrium and polycystic ovary syndrome. Journal of Obstetrics and Women’s Diseases. 2018;67(4):60-66. doi: 10.17816/JOWD67460-66).

scholarly journals Young Obese Women with Polycystic Ovary Syndrome Have Evidence of Early Coronary Atherosclerosis

2007 ◽  
Vol 92 (12) ◽  
pp. 4609-4614 ◽  
Author(s):  
Rupal Shroff ◽  
Angela Kerchner ◽  
Michelle Maifeld ◽  
Edwin J. R. Van Beek ◽  
Dinesh Jagasia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Coronary Atherosclerosis ◽  
Polycystic Ovary ◽  
Fat Distribution ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Markers Of Inflammation ◽  
Increased Risk

Abstract Context: Polycystic ovary syndrome (PCOS) is associated with comorbidities that may contribute to increased risk of cardiovascular disease. PCOS is associated with increased risk of metabolic syndrome, dyslipidemia, and diabetes, but it remains unclear whether traditional cardiovascular (CV) risk factors can help predict coronary artery disease in this population. Objective: The objectives of the study were to detect early-onset subclinical coronary atherosclerosis (using coronary artery calcium as a marker) in young women with PCOS, compared with age- and body mass index-matched controls, and to compare traditional CV risk factors and inflammatory markers in the two groups. Design: This was a prospective case-control study. Setting: The study was conducted at a university hospital. Subjects: Twenty-four obese (body mass index ≥ 30 kg/m2) PCOS subjects and 24 obese controls participated. Outcome Measures: Coronary artery calcium, inflammatory markers (high-sensitivity C-reactive protein, IL-6, TNFα, adiponectin, leptin), fasting blood tests (glucose, lipids, insulin), and dual-energy x-ray absorptiometry scan for body fat distribution were measured. Results: Coronary artery calcium was detected in eight of 24 PCOS subjects (33%) and two of 24 controls (8%) (odds ratio 5.5, 95% confidence interval 1.03, 29.45, P < 0.03). Traditional CV risk factors did not differ significantly between the two groups, nor did markers of inflammation or adiposity, body fat distribution, or metabolic parameters with the exception of significantly lower quantitative insulin sensitivity check index (marker for insulin resistance) in the PCOS group (P < 0.05). Conclusions: Young, obese women with PCOS have a high prevalence of early asymptomatic coronary atherosclerosis, compared with obese controls. This increased risk is independent of traditional CV risk factors and novel markers of inflammation. These findings underscore the need to screen and aggressively counsel and treat these women to prevent symptomatic CV disease.

scholarly journals Evidence for an Association between Metabolic Cardiovascular Syndrome and Coronary and Aortic Calcification among Women with Polycystic Ovary Syndrome

2004 ◽  
Vol 89 (11) ◽  
pp. 5454-5461 ◽  
Author(s):  
E. O. Talbott ◽  
J. V. Zborowski ◽  
J. R. Rager ◽  
M. Y. Boudreaux ◽  
D. A. Edmundowicz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Cardiovascular Risk ◽  
Polycystic Ovary Syndrome ◽  
Body Mass ◽  
Polycystic Ovary ◽  
Electron Beam Tomography ◽  
Ovary Syndrome ◽  
Increased Risk ◽  
Metabolic Cardiovascular Syndrome

Abstract Women with polycystic ovary syndrome (PCOS) exhibit an adverse cardiovascular risk profile, characteristic of the metabolic cardiovascular syndrome (MCS). The aim of this study was to determine the prevalence of coronary artery (CAC) and aortic (AC) calcification among middle-aged PCOS cases and controls and to explore the relationship among calcification, MCS, and other cardiovascular risk factors assessed 9 yr earlier. This was a prospective study of 61 PCOS cases and 85 similarly aged controls screened in 1993–1994 for risk factors and reevaluated in 2001–2002. The main outcome measures were CAC and AC, measured by electron beam tomography. Women with PCOS had a higher prevalence of CAC (45.9% vs. 30.6%) and AC (68.9% vs. 55.3%) than controls. After adjustment for age and body mass index, PCOS was a significant predictor of CAC (odds ratio = 2.31; P = 0.049). PCOS subjects were also 4.4 times more likely to meet the criteria for MCS than controls. High-density lipoprotein cholesterol and insulin appeared to mediate the PCOS influence on CAC. Interestingly, total testosterone was an independent risk factor for AC in all subjects after controlling for PCOS, age, and body mass index (P = 0.034). We conclude that women with PCOS are at increased risk of MCS and demonstrate increased CAC and AC compared with controls. Components of MCS mediate the association between PCOS and CAC, independently of obesity.

scholarly journals ENDOMETRIAL MARKERS OF POLYCYSTIC OVARY SYNDROME (A LITERATURE REVIEW)

2018 ◽  
Vol 2 (5) ◽  
pp. 21-27
Author(s):  
Эльдар Шарифулин ◽  
Eldar Sharifulin ◽  
Махарам Шарифулин ◽  
Makharam Sharifulin ◽  
Лариса Сутурина ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Polycystic Ovary Syndrome ◽  
Information Search ◽  
Polycystic Ovary ◽  
Population Sample ◽  
Receptor Expression ◽  
Sex Hormone Binding Globulin ◽  
Published Data ◽  
Ovary Syndrome ◽  
Increased Risk

Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women and has a significant impact on various aspects of their health and the quality of life. The epidemiology of PCOS is well understood, while the preva- lence of this syndrome depends on diagnostic criteria used, the characteristics of the population sample, and vary from 6–10 % to 15 % and higher. A number of studies suggest that the endometrium in women with PCOS differs from the normal endometrium morphologically and functionally. PCOS is associated with infertility problems, higher incidence of pregnancy complications and with increased risk of endometrial cancer, especially when obesity is present. The purpose of this review was to systematize the available data on molecular markers of endometrial pathology as- sociated with PCOS. The information search was conducted using Internet resources (PubMed, EMBASE); literature sources for the period 1992–2016 were analyzed. Although the available information on the pathology of the endometrium is inconsistent, as a result of the analysis of published data, several mechanisms of endometrial disorders characteristic of PCOS have been identified: changes of hormonal effects (changes in hormone receptor expression, HOXA gene expression, changes in the synthesis of sex hormone binding globulin, enzymes involved in the metabolism of sex hormones in situ in the endometrium), hyperinsulinemia and disturbance of the glucose transport system, ratio of proinflammatory and anti- inflammatory factors. Authors conclude that the majority of analyzed studies report an increased prevalence of histologically confirmed hyperplasia or endometrial cancer in women with PCOS. However, there are no clinical guidelines and approaches to prognosis of endometrial changes women with PCOS. It is still unclear if endometrial biopsy is necessary for all women with PCOS. The clinical significance of endometrial markers requires further investigation.

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