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Immediate repair before radiotherapy
Published in Steven J. Kronowitz, John R. Benson, Maurizio B. Nava, Oncoplastic and Reconstructive Management of the Breast, 2020
Steven J. Kronowitz, John R. Benson, Maurizio B. Nava
However, one may expect breast asymmetry due to different aging processes between the two breasts. The non-irradiated side may become more ptotic as compared to the irradiated one. On the other hand, the irradiated side may show sign of total breast atrophy. When the breast asymmetry becomes obvious, fat grafting alone or with contralateral breast remodeling is indicated.
The Adrenal Glands
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
In the females, the virilizing syndrome can be caused by ovarian or adrenal lesions. The adrenal lesions can be adenoma, hyperplasia of both glands, or carcinomas. Adenocarcinomas of the adrenal glands are rare but they can constitute up to 10% of the malignant adrenal tumors. A lower percentage occurs solely, but about 6% is accompanied by malignant Cushing’s syndrome.4 Besides the masculinizing features, amenorrhea and breast atrophy are common features. The diagnosis can be suspected by the administration of 2 mg dexamethasone, three to four times per day which will not suppress urinary 17-ketosteroids if the condition is due to carcinoma.
Chronic Pelvic Pain
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
Andrea J. Rapkin, Candace Howe
Progestins induce decidualization and decrease the proliferation of endometriotic tissues. Medroxyprogesterone acetate in a 50 mg oral daily dose has been found to be just as effective at reducing pelvic pain as danazol, as danazol and an oral contraceptive, and as compared with a GnRH-a in randomized trials, although the effects regress after 6 to 12 months (Fedele et al., 1989; Vercellini et al., 1993; Walton & Batra, 1992). A Cochrane Review article recently concluded that both continuous progestins and antiprogestins (mifepristone, RU-486) are effective in the treatment of painful symptoms of endometriosis. Progestins given in the luteal phase have not been shown to be effective (Prentice et al., 2003). Mifepristone, 50 to 100 mg/day, was shown to decrease pain scores and induce amenorrhea without hypoestrogenism in small, openlabel, cohort studies (Kettel et al., 1996). Progestin side effects include weight gain, breast atrophy, hot flushes, and hirsutism (Rice, 2002).
Hyperthecosis: an underestimated nontumorous cause of hyperandrogenism
Published in Gynecological Endocrinology, 2021
Blazej Meczekalski, Anna Szeliga, Marzena Maciejewska-Jeske, Agnieszka Podfigurna, Paulina Cornetti, Gregory Bala, Eli Y. Adashi
The most prominent clinical features of OH is severe hirsutism and virilization, which of themselves are a more advanced clinical manifestation of hyperandrogenemia. OH classically manifests primarily with severe hirsutism with additional features such as male pattern baldness, deepening of the voice, acne, virilization (clitoromegaly, enlarged labia minora), breast atrophy, squaring of the jawline/muscular hypertrophy and muscular enlargement causing changes in body shape in a previously unaffected woman. When occurring in pre-menopausal women, OH is almost always associated with amenorrhea [22]. Among premenopausal women who present with hyperandrogenism, the vast majority have polycystic ovary syndrome, and only rarely ovarian hyperthecosis.
Sexual Function in Postmenopausal Women and Serum Androgens: A Review Article
Published in International Journal of Sexual Health, 2019
Soheila Nazarpour, Masoumeh Simbar, Fahimeh Ramezani Tehrani
Reduced levels of estrogen is also associated with various symptoms in the lower urinary tract, including polyuria, urge incontinence, nocturia, stress incontinence, and recurrent urinary-tract infections (Robinson et al., 2013). Urogenital infections, breast atrophy, and vasomotor instability could be correlated with the loss of libido and hence the dissatisfaction of menopausal women and their partners (Ambler et al., 2012).