To study the profile of menopausal women, particularly age, reproductive history body mass index, abdominal circumference, smoking history, duration of menopause in years, type and duration of use of hormone replacement therapy, calcium intake, frequency of exercise, history of fracture and their bone mineral density.
Human ; Female ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; OSTEOPOROSIS ; WOMEN ; ;

Estrogen replacement therapy (ERT) is known to significantly decrease menopausal health risks, thus, a survey of 200 women attending a tertiary hospital was conducted. Assess their attitudes toward menopause and ERT to determine factors that might increase its use revealed that women taking their ERT were more likely to know that decreased estrogen hormone causes osteoporosis. All groups however believed that natural approaches to menopause are more preferable and ERT should be reserved for women with distressing symptoms. The study suggests that a systematic educational approach could increase awareness and use of ERT especially if the recommended therapy will not cause vaginal bleeding and will cost minimally.
Human ; MENOPAUSE ; ESTROGEN REPLACEMENT THERAPY

A case of successful twin pregnancy following severe ovarian hyperstimulation syndrome (OHSS) is reported. Ignorance of this complication of ovulation induction may result to serious morbidities, and even mortality. With awareness of this condition, preventive measures can be instituted. Similarly, early recognition and prompt treatment may result to a reduction in the rate of its progression to a severe, potentially fatal stage. Consequently, a favorable outcome may be achieved.
Human ; Female ; Adult ; OVARIAN HYPERSTIMULATION SYNDROME ; PREGNANCY, MULTIPLE

Objective: To determine which of the following factors at initial surgery-such as diameter of largest endometriotic cyst, number of cysts, diseases severity, type of surgery (laparoscopy versus laparotomy), or postoperative medical therapy-best correlated with the time of recurrence of ovarian endometrioma. Design: A retrospective descriptive study was performed on 25 patients who underwent initial surgical excision of endometriotic cyst and had cyst recurrence demonstrated either on ultrasound or repeat surgery. The clinical presentation of cyst recurrence was described. The operative findings of the first and second surgeries were compared. Factors which may affect the time of cyst recurrence were evaluated. Results: Cyst recurrence was demonstrated by ultrasound in 24 (96 percent) cases; repeat surgery for recurrence was done in only 10 (40 percent) cases. The different factors in the initial surgery: type of operation, size, number, and laterality of the endometriotic cyst, disease severity, adhesions and postoperative medical therapy, did not influence the time of recurrence of ovarian endometrioma. Disease severity was a significant factor on repeat surgery. Conclusion: The different factors aforementioned, which were present in the first surgery, did not influence the time of recurrence of ovarian endometrioma.
Human ; Female ; Adult ; ENDOMETRIOSIS ; RECURRENCE

Objectives: To compare the effects of clomiphene citrate with conjugated equine estrogen (early or beginning day 2 of menses vs. late or beginning day 7 of menses) and clomiphene citrate alone on endometrial thickness and pattern (i.e. trilaminar or non-trilaminar) among patients for induction of ovulation. Study Design: Prospective, randomized Setting: tertiary care hospital Inclusion criteria: Women aged 25-40 years old with infertility of at least 2 years duration who are candidates for ovulation induction. Exclusion criteria: Women on hormonal treatment 1 month prior to ovulation, with ovarian cysts, mullerian abnormalities, myomas or uterine cavity abnormalities. Results: Fifty-four women were included in the study with mean age 31.093 years +/- 4.655 (range 21 to 40 years), duration of infertility 4.954 +/- 3.228 (range 2 to 20 years), and day of the cycle when dominant follicle was noted was 11.907 +/- 1.751 (range of 8 to 16 days). Mean endometrial thickness was 0.960 cm in group I, 1.053 cm in group II and 0.850 cm in group III with a p value of 0.040625. There was significant improvement in thickness from baseline with a p value of 0.015166. There was no significant effect on endometrial pattern (p value = 0.236146). Conclusion: The addition of conjugated equine estrogens in ovulation induction with clomiphene citrate improves endometrial thickness.
Human ; Female ; Adult ; ESTROGENS, CONJUGATED (USP) ; CLOMIPHENE ; ENDOMETRIUM

Objective: To detail the experience and evaluate the effectiveness of hysteroscopy in the Philippine General Hospital. Setting: Tertiary care center Study population: All available records of patients admitted for hysteroscopy from July 1996 to December 2000. Results: There were 240 records available for review with a mean patient age of 39.4 +/- 14.2 years (range 15-75). There was an increasing number of hysteroscopy cases, especially operative cases performed through the years. Bleeding was the most common complaint. Indications for hysteroscopy were: endometrial mass (49 percent), abnormal uterine bleeding (16 percent), infertility (10 percent), and thickened endometrium (7 percent). There were 6 cases of lost IUD. A total of 58.7 percent intracavitary abnormalities were noted during hysteroscopy and were observed in the following subgroups: 65.7 percent in those with premenopausal bleeding, 46.7 percent in those with postmenopausal bleeding, 28.9 percent in infertility, and 74.5 percent with the diagnosis of an intracavitary mass. Conclusion: A summary of hysteroscopy cases done at a tertiary care center in the Philippines was presented. This review demonstrates the utility of hysteroscopy in the diagnosis of intracavitary abnormalities and in the removal of IUDs.
HYSTEROSCOPY ; UTERINE HEMORRHAGE ; MENORRHAGIA

A 32 year old female with 8 weeks of amenorrhea presented with vaginal spotting and a cul de sac mass. Pre-operatively, the patient was suspected case of heterotopic pregnancy because of a suspicious ultrasound finding. The patient underwent exploratory laparotomy. The diagnosis of heterotopic pregnancy was confirmed histopathologically. Diagnostic, current medical and surgical management options are discussed. A review of pathogenesis, risk factors and epidemiology of the disease are also included as well as reported local Philippine experience.
Human ; Female ; Adult ; PREGNANCY ; LAPAROTOMY

D.R. presented with hirsutism, virilization and polycythemia. Hormonal assays, imaging studies and laparotomy revealed a steroid cell tumor of the ovary. The coexistence of ovarian tumor and polycythemia is discussed.
Human ; Female ; Adult ; POLYCYTHEMIA ; HIRSUTISM ; OVARY

Objective: To determine the ovulatory response of a cystectomized ovary sonographically in the first three cycles post-op in terms of the number and diameter of pre-ovulatory follicles, development of 18 mm follicle, development of corpus luteum, and their correlation to the type of operation, use of cautery, type of ovarian pathology, and use of ovulatory drugs. Design: Prospective study Methods: Thirty (30) patients who underwent ovarian cystectomy either by laparoscopy of laparotomy from February to May 1998 were included in the study. These patients had follicular monitoring for three cycles post-op at days 14, 16 and 18. The number of pre-ovulatory follicles (/- 12 mm), the diameter (mm) of the largest follicle, onset of development of 18 mm follicle, and onset of development of corpus luteum were noted. The onset of development of 18 mm follicle was correlated to the type of operation (laparoscopy versus laparotomy), use of cautery, type of ovarian pathology (endometrial versus dermoid), and use of ovulatory drugs post-op. Statistical analysis used was student t-test. Results: The mean number of pre-ovulatory follicles (/- 12 mm) during the first three cycles was 1-2 follicles. The mean diameter of the largest follicle during the first cycle post-op was 12-16 mm and increased to 14-18 mm during the second and third cycles. The earliest 18 mm follicle was observed on day 14 of the first cycle but 75.1 percent of patients had an 18 mm follicle by day 18 of the first cycle. The type of operation, use of cautery, type of ovarian pathology, and use of ovulatory drugs post-op did not significantly alter the onset of development of an 18 mm folicle. The earliest corpus luteum was noted on day 18 of the first cycle. Conclusion: There is an adequate ovulatory response after ovarian cystectomy in the first three cycles post-op.
CYSTECTOMY

This is a documented case report of a Mosaic Turner Syndrome. Diagnostic modalities and treatment options are briefly discussed.
TURNER SYNDROME ; AMENORRHEA