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OBJECTIVE: Any diagnostic workup should be based on appropriateness criteria. Diagnostic hysteroscopy is a procedure widely used in endometrial pathology. Its high outpatient feasibility frequently leads to misuse. However, it can...
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OBJECTIVE: Any diagnostic workup should be based on appropriateness criteria. Diagnostic hysteroscopy is a procedure widely used in endometrial pathology. Its high outpatient feasibility frequently leads to misuse. However, it can cause discomfort and, albeit rarely, complications. The present study aimed to provide an estimate of unnecessary examinations based on variables associated with atrophic endometrium in postmenopausal women referred to diagnostic hysteroscopy. PATIENTS AND METHODS: One-hundred and sixty-six postmenopausal women undergoing hysteroscopy were retrospectively analyzed. All included women had a final histological reference standard. The sample was divided into women with atrophic endometrium vs. women with endocavitary lesions (benign/premalignant/malignant). Univariate and multivariate analysis was performed to assess those patient characteristics associated with atrophic endometrium. Furthermore, based on the likelihood ratios, a post-test probability analysis was performed to provide an estimate of atrophy according to the presence of specific variables. RESULTS: Sixty-one postmenopausal women (36.7%) undergoing diagnostic hysteroscopy showed atrophic endometrium at final histology. Multivariate analysis showed that the independent variables associated with atrophy were the absence of abnormal uterine bleeding [Odds Ratio (OR)=6.43, Confidence Intervals (CI) 2.087 to 19.822], and endometrial thickness (criterion < 7 mm) (OR=0.417, CI 0.300 to 0.578). In women showing both variables associated with negative endometrial outcome, post-test probability analysis resulted in an atrophic endometrium rate of 89.13%, from a pre-test probability of 36.7%. CONCLUSIONS: About 90% of asymptomatic postmenopausal women with endometrial thickness <7 mm resulted in an atrophic endometrium at hysteroscopy. Every gynecologist should know and consider these data before referring such women to further examinations. In these cases, diagnostic hysteroscopy is not cost-effective leading to a high number of false positives.
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Oestrogen plays a vital role in maintaining a normal vulvovaginal epithelium, vaginal lubrication, as well as a healthy microbiome to ensure an acidic pH. The decrease in oestrogen levels in women going through menopause results i...
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Oestrogen plays a vital role in maintaining a normal vulvovaginal epithelium, vaginal lubrication, as well as a healthy microbiome to ensure an acidic pH. The decrease in oestrogen levels in women going through menopause results in both physiological and physical changes of the genitourinary system, and more specifically the vulva. We conducted a literature review on the effects of low oestrogen levels on the physiology and function of the vulva and the vulvovaginal epithelium. 'Genitourinary syndrome of menopause' (GSM) is the term used to describe the signs and symptoms of a low oestrogen state. The symptoms and signs of GSM can overlap or coexist with other vulval dermatoses. Expert opinion is needed to diagnose and manage vulval dermatoses in menopause. This article will discuss the signs and symptoms of GSM, as well as the different management options available. Other vulval dermatoses that can be affected by hypo-oestrogenism are also reviewed.
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Versatile, mild and high yielding methods for nucleophilic aromatic substitution of 2-dialkylamino-1-ethoxides and related nucleophiles on 3-aroyl-2-arylbenzothiophene nuclei are presented. A short synthesis of raloxifene is detai...
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Versatile, mild and high yielding methods for nucleophilic aromatic substitution of 2-dialkylamino-1-ethoxides and related nucleophiles on 3-aroyl-2-arylbenzothiophene nuclei are presented. A short synthesis of raloxifene is detailed. (C) 1999 Elsevier Science Ltd. All rights reserved. [References: 26]
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Background: Phthalates are ubiquitous endocrine disrupting chemicals present in a wide variety of consumer products. However, the personal characteristics associated with phthalate exposure are unclear.Objectives: We sought to des...
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Background: Phthalates are ubiquitous endocrine disrupting chemicals present in a wide variety of consumer products. However, the personal characteristics associated with phthalate exposure are unclear.Objectives: We sought to describe personal, behavioral, and reproductive characteristics associated with phthalate metabolite concentrations in an ongoing study nested within the Women's Health Initiative (WHI).Materials and Methods: We measured thirteen phthalate metabolites in two or three archived urine samples collected in 1993-2001 from each of 1257 WHI participants (2991 observations). We fit multivariable generalized estimating equation models to predict urinary biomarker concentrations from personal, behavioral, and reproductive characteristics.Results: Older age was predictive of lower concentrations of monobenzyl phthalate (MBzP), mono-carboxyoctyl phthalate (MCOP), mono-3-carboxypropyl phthalate (MCPP), and the sum of di-n-butyl phthalate metabolites (Sigma DBP). Phthalate metabolite concentrations varied by race/region, with generally higher concentrations observed among non-Whites and women from the West region. Higher neighborhood socioeconomic status predicted lower MBzP concentrations, and higher education predicted lower monoethyl phthalate (MEP) and higher concentrations of the sum of metabolites of di-isobutyl phthalate (Sigma DiBP). Overweight/obesity predicted higher MBzP, MCOP, monocarboxynonyl phthalate (MCNP), MCPP, and the sum of metabolites of di(2-ethylhexyl) phthalate (Sigma DEHP) and lower MEP concentrations. Alcohol consumption predicted higher concentrations of MEP and Sigma DBP, while current smokers had higher Sigma DBP concentrations. Better diet quality as assessed by Healthy Eating Index 2005 scores predicted lower concentrations of MBzP, Sigma DiBP, and Sigma DEHP.Conclusion: Factors predictive of lower biomarker concentrations included increased age and healthy behaviors (e.g. lower alcohol intake, lower body mass index, not smoking, higher quality diet, and moderate physical activity). Racial group (generally higher among non-Whites) and geographic regions (generally higher in Northeast and West compared to South regions) also were predictive of phthalate biomarker concentrations.
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Objective: To compare aspects of sexual function between perimenopausal and postmenopausal women. Material and Method: One hundred forty women, 70 perimenopausal women and 70 postmenopausal patients in the menopause clinic were in...
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Objective: To compare aspects of sexual function between perimenopausal and postmenopausal women. Material and Method: One hundred forty women, 70 perimenopausal women and 70 postmenopausal patients in the menopause clinic were interviewed at a first visit regarding aspects of sexual function compared between now and during the previous one-year period. All data were compared between perimenopausal and postmenopausal women. Main outcome measure: The following sexual function including sexual thoughts/fantasies, sexual desire, frequency of sexual intercourse, sexual excitement during sex, moisture in vagina during sex, amount of vaginal lubrication during sex, pain or discomfort during sex, vaginal stretching/flexibility during sex, intensity of orgasm during sex, sexual appeal in client's opinion, overall sexual satisfaction and sexually related anxiety were compared between groups. Results: The mean age (± SD) of perimenopausal and postmenopausal women were 49.4 (± 3.0) years and 52.2 (± 2.8) years respectively in which there was no significant difference. Most women in both groups had sexual intercourse one to four times per month. There was statistically significant difference between groups in the following aspects, sexual thoughts/ fantasies, sexual desire, frequency of sexual intercourse, sexual excitement during sex, moisture in vagina during sex, amount of vaginal lubrication during sex. All items had a negative impact on sexual function but a higher impact was found in postmenopausal women. However, sexually related anxiety was unchanged in both and no significant difference was detected. Conclusion: Some sexual functions were significantly impaired in postmenopausal compared to perimenopausal women. However, the overall sexual satisfaction and sexually related anxiety were unchanged in postmenopausal women. So sexual problems are present but are not considered the most important problem among Thai women.
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For the present cross-sectional study, 595 women (330 premenopausal and 265 postmenopausal) subjects were selected by personal interview. A questionnaire was filled to know the required reproductive history of the subject. Obesity...
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For the present cross-sectional study, 595 women (330 premenopausal and 265 postmenopausal) subjects were selected by personal interview. A questionnaire was filled to know the required reproductive history of the subject. Obesity was assessed according to Body Mass Index, Waist-Circumference and Waist-Hip-Ratio. The prevalence of obesity was found more in postmenopausal women as compared to premenopausal women according to Body Mass Index, Waist Circumference as well as Waist- Hip Ratio. According to Body Mass Index, the prevalence was 70.30% and 75.09% in pre- and postmenopausal women, respectively. Similarly the prevalence of central obesity according to Waist Circumference was 75.15% and 89.05% in pre- and postmenopausal women, respectively where as according to Waist-Hip Ratio this prevalence was 74.54% in premenopausal women and 87.92% in postmenopausal women of Jalandhar District, Punjab.
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