Adult ; China ; Contraceptive Agents, Female ; therapeutic use ; Data Collection ; Female ; Humans ; Intrauterine Devices ; Levonorgestrel ; therapeutic use ; Patient Education as Topic ; statistics & numerical data

OBJECTIVETo investigate the clinical efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis.

METHODSSeventy patients with adenomyosis diagnosed according to clinical symptoms, magnetic resonance imaging (MRI) findings, laparoscopy and/or color-Doppler ultrasound imaging were treated with LNG-IUS, and the menstrual blood volume, dysmenorrhea, uterine volume, hepatic function and serum lipids were observed and evaluated.

RESULTSIn the first month of treatment, the menstrual blood size was reduced significantly to (35-/+12)% of that before treatment (P<0.01), and further to (7-/+4)% in the twelfth month (P<0.01). The average uterine volume was decreased by 18.6% (P<0.05) after the treatment, and dysmenorrhea was obviously relieved or completely disappeared alleviated. The condition of anemia was also improved rapidly, and no obvious side-effects on hepatic function and serum lipids were observed.

CONCLUSIONLNG-IUS is an effective and safe therapy for adenomyosis.

Adult ; Contraceptive Agents, Female ; administration & dosage ; therapeutic use ; Endometriosis ; drug therapy ; pathology ; Female ; Follow-Up Studies ; Humans ; Intrauterine Devices, Medicated ; Levonorgestrel ; administration & dosage ; therapeutic use ; Treatment Outcome

Contraceptive Devices ; utilization ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; drug therapy ; surgery ; therapy ; Female ; Humans ; Medicine, Chinese Traditional ; Reproductive Control Agents ; therapeutic use

This study evaluated the efficacy of a stepwise regimen of estradiol valerate for height control in girls with Marfan syndrome. Eight girls with Marfan syndrome who had completed estrogen treatment for height control were included. Estradiol valerate was started at a dose of 2 mg/day, and then was increased. The projected final height was estimated using the initial height percentile (on a disease-specific growth curve for Korean Marfan syndrome [gcPFHt]), and the initial bone age (baPFHt). After the estrogen treatment, the projected final height was compared to the actual final height (FHt). The median baseline chronological and bone age were 10.0 and 10.5 years, respectively. After a median of 36.5 months of treatment, the median FHt (172.6 cm) was shorter than the median gcPFHt (181.0 cm) and baPFHt (175.9 cm). In the six patients who started treatment before the age of 11 years, the median FHt (171.8 cm) was shorter than the median gcPFHt (181.5 cm) and baPFHt (177.4 cm) after treatment. The median differences between the FHt and gcPFHt and baPFHt were 9.2 and 8.3 cm, respectively. In two patients started treatment after the age of 11, the differences between FHt and gcPFHt, and baPFHt after treatment were -4 and 1.4 cm, and -1.2 and 0 cm for each case, respectively. A stepwise increasing regimen of estradiol valerate may be an effective treatment for height control in girls with Marfan syndrome, especially when started under 11 years old.
Body Height ; Child ; Contraceptive Agents/*therapeutic use ; Estradiol/*analogs & derivatives/therapeutic use ; Female ; Growth Disorders/pathology ; Humans ; Marfan Syndrome/diagnosis/*drug therapy ; Treatment Outcome

BACKGROUND: Many experimental and observational studies have suggested that hormone replacement therapy (HRT) in postmenopausal women is cardioprotective. However, the results of randomized controlled trials have been discouraging. We attempted to evaluate the influence of overweight, a frequent risk factor for coronary artery disease, on the lipid-modifying effects of HRT. METHODS: A total of 345 postmenopausal women were divided into 2 groups according to body mass index (BMI) : the control group; BMI < 25 Kg/m2 (n=248) and the overweight group; BMI > or=25 Kg/m2 (n=97). All women received either 0.625 mg conjugated equine estrogen (CEE) (n=139), CEE plus 5 mg medroxyprogesterone acetate (MPA) (n=97) or CEE plus 10 mg MPA (n=109). Lipid profiles were measured before and 12 months after HRT. RESULTS: In both the control and overweight groups, HRT reduced low density lipoprotein cholesterol (LDL-C) (p=0.000 and p=0.000 respectively) and lipoprotein (a) [Lp (a) ] levels (p=0.000 and p=0.000 respectively) and raised high density lipoprotein cholesterol (HDL-C) levels (p=0.000 and p=0.002 respectively). However, the elevation of the HDL-C level was higher in the control group than in overweight group (17.5% vs. 10.4%, p=0.015), and this was significant after adjusting for changes in body weights (p=0.016). There were no differences in the reduction of LDL-C (p=0.20) and Lp (a) (p=0.09) levels between the two groups. CONCLUSION: HRT had less favorable effects on HDL-C levels in overweight postmenopausal women than in women with normal body weight. This finding may be partially associated with no cardioprotective effect of HRT in postmenopausal patients at a high risk due to multiple risk factors including obesity.
Contraceptive Agents, Female/therapeutic use ; *Estrogen Replacement Therapy ; Estrogens/therapeutic use ; Estrogens, Conjugated (USP) /therapeutic use ; Female ; Humans ; Lipoproteins/*blood ; Medroxyprogesterone 17-Acetate/therapeutic use ; Middle Aged ; Obesity/*blood ; Postmenopause/*physiology

Objective: To evaluate different methods' efficacy of controlling acute bleeding and managing long-term menstruation in patients with heavy menstrual bleeding (HMB) associated with antithrombotic therapy. Methods: The clinical data of 22 cases with HMB associated with antithrombotic therapy admitted to Peking University People's Hospital from January 2010 to August 2022 were analyzed, aged 39 years old (26-46 years). Changes in menstrual volume, hemoglobin (Hb), and quality of life were collected after control of acute bleeding and long-term menstrual management. Menstrual volume was assessed by pictorial blood assessment chart (PBAC), and quality of life was assessed by menorrhagia multi-attribute scale (MMAS). Results: (1) Treatment of acute bleeding: of the 22 cases with HMB associated with antithrombotic therapy, 16 cases were treated in our hospital and 6 in other hospital for emergency bleeding; of the 16 cases treated in our hospital, 3 underwent emergency intrauterine Foley catheter balloon compression due to severe bleeding (Hb decreased by 20 to 40 g/L within 12 hours). Of the 22 cases with antithrombotic therapy-related HMB, 15 (including 2 cases with severe bleeding) underwent emergency aspiration or endometrial resection, and intraoperative placement of levonorgestrel-releasing intrauterine system (LNG-IUS) followed by a significant reduction in bleeding volume; 3 cases had controlled acute bleeding after rivaroxaban dose reduction and continued observation; 2 cases were given gonadotropin-releasing hormone agonists to control acute bleeding in other hospital, of which 1 case was temporarily treated with periodic blood transfusion, and the other one patient underwent total hysterectomy; and 2 cases had temporary amenorrhea with oral mifepristone after intrauterine balloon compression or oral norethindrone. (2) Long-term menstrual management: of the 22 cases with antithrombotic therapy-related HMB, 15 had LNG-IUS placement and 12 had LNG-IUS placement for 6 months, and menstrual volume was significantly reduced [PBAC scores were 365.0 (272.5-460.0) vs 25.0 (12.5-37.5), respectively; Z=4.593, P<0.001], Hb was significantly increased [91.5 g/L (71.8-108.2 g/L) vs 128.5 g/L (121.2-142.5 g/L); Z=4.695, P<0.001], and quality of life was significantly improved [MMAS scores were 415.0 (327.5-472.5) vs 580.0 (570.0-580.0), respectively; Z=-3.062, P=0.002] before placement compared with 6 months after placement. Three rivaroxaban dose reduction patients' PBAC scores decreased by 20 to 35 but remained >100, and perceived quality of life did not change significantly. Two cases with temporary amenorrhea treated with oral mifepristone felt significantly improved quality of life, and the MMAS scores increased by 220 and 180, respectively. Conclusion: Intrauterine Foley catheter balloon compression, aspiration or endometrial ablation could be used to control acute bleeding in patients with antithrombotic therapy-related HMB, and LNG-IUS for long-term management could reduce menstrual volume, increase hemoglobin, and improve the quality of life of patients.
Female ; Humans ; Adult ; Menorrhagia/etiology* ; Fibrinolytic Agents/adverse effects* ; Levonorgestrel/adverse effects* ; Amenorrhea/drug therapy* ; Mifepristone/therapeutic use* ; Quality of Life ; Rivaroxaban/therapeutic use* ; Hemoglobins ; Intrauterine Devices, Medicated/adverse effects* ; Contraceptive Agents, Female

Extract of Tripterygium wilfordi (TW) has obvious effects on anti-inflammation, anti-tumor, anti-fertility and immuno-regulation, and it is broadly applied in various clinical departments. Referred to the gynecologic diseases, clinical therapeutic trials of TW on endometriosis, leiomyoma uteri, dysfunctional uterine bleeding and some tumors of women have been carried out, and it can be proved an effective new drug for the treatment of gynecologic diseases.
Anti-Inflammatory Agents ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Contraceptive Agents, Female ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; drug therapy ; Female ; Genital Diseases, Female ; drug therapy ; Genital Neoplasms, Female ; drug therapy ; Humans ; Immunologic Factors ; therapeutic use ; Leiomyoma ; drug therapy ; Metrorrhagia ; drug therapy ; Tripterygium

Adolescent ; Amenorrhea ; diagnosis ; etiology ; Androgen Antagonists ; pharmacology ; Androgens ; blood ; Contraceptive Agents ; pharmacology ; Female ; Humans ; Hyperandrogenism ; complications ; Hypoglycemic Agents ; therapeutic use ; Insulin Resistance ; Luteinizing Hormone ; blood ; Menstruation Disturbances ; diagnosis ; etiology ; Obesity ; complications ; Ovary ; diagnostic imaging ; pathology ; Polycystic Ovary Syndrome ; diagnosis ; etiology ; therapy ; Ultrasonography ; Young Adult