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Gynaecology, Fertility and Family Planning
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Kopal Singhal Agarwal, Chawan Baran, Lauren Laws, Maria Garcia de Frutos, Black Benjamin
Patients present with:menorrhagia – heavy or prolonged vaginal bleedingmetrorrhagia – irregular bleeding or bleeding unrelated to mensespost-menopausal bleeding.
The Reproductive System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Because the suffix -algia normally indicates pain, one might assume that menorrhalgia is synonymous with dysmenorrhea, but it is not. Menorrhalgia describes distress associated with menstruation, including dysmenorrhea, premenstrual tension, and pelvic vascular congestion. Epimenorrhea (also called polymenorrhea) denotes that the period of flow is abnormally frequent, and hyperinenorrhea or Menorrhagia indicates that the amount of flow is greater than usual but the period is normal; thus epimenorrhagia is the term applied to a flow that is both abnormally frequent (epi- prefix) and excessive (-agio suffix), although the term menorrhagia is also sometimes used instead of epimenorrhagia. If the flow of uterine bleeding is normal in amount but occurs at completely irregular intervals, the bleeding is called metrorrhagia.
The female reproductive system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Metrorrhagia This is a condition of irregular and unpredictable periods with a menstrual cycle falling outside the normal 28 (±5) days. Frequently, irregular periods are the result of systemic hormonal upset. In young women, ‘polycystic ovaries’ is the most common finding, so ask about excessive hair growth with male distribution, caused by increased circulating androgens.
Teprotumumab for the treatment of thyroid eye disease
Published in Expert Opinion on Biological Therapy, 2023
Poupak Fallahi, Francesca Ragusa, Sabrina Rosaria Paparo, Giusy Elia, Eugenia Balestri, Valeria Mazzi, Armando Patrizio, Chiara Botrini, Salvatore Benvenga, Silvia Martina Ferrari, Alessandro Antonelli
All events of alopecia were mild in severity, except for one event of moderate severity. 23% of menstruating women experienced menstrual disorders (amenorrhea, metrorrhagia, dysmenorrhea). Teprotumumab may increase blood sugar (10%), so it is necessary to evaluate glycemia before the start of the treatment, and glycemic levels should be tracked during the treatment. However, hyperglycemia might be transient and can recover after the end of the treatment, or with a specific therapy. Another possible side effect is related to hearing problems, that are present in about 10% of patients and in some cases can persist after the end of the treatment. Hearing impairment includes deafness, eustachian tube dysfunction, hyperacusis, hypoacusis, and autophony. A case of a woman with chronic teprotumumab-associated sensorineural hearing loss has been recently reported [67]. The patient had chronic TED with proptosis and diplopia. After three doses of teprotumumab she developed tinnitus, followed by hearing loss after five doses. The audiogram showed bilateral mild to moderate-severe hearing loss, significantly worse with respect the baseline audiogram. Teprotumumab was immediately interrupted, however 6 weeks later the audiogram showed no amelioration. Due to the potentially irreversible sensorineural hearing loss, close monitoring with regular audiometric tests before, during and after treatment with teprotumumab is recommended, and it may be important to consider potential treatment to recover from any hearing problems [67].
Clinical evaluation of HIFU combined with GnRH-a and LNG-IUS for adenomyosis patients who failed to respond to drug therapies: two-year follow-up results
Published in International Journal of Hyperthermia, 2021
Yan Peng, Yu Dai, Guiyuan Yu, Xiaorong Yang, Cuili Wen, Ping Jin
Adenomyosis, characterized by the invasion of endometrial glands and stroma in the uterine myometrium, is a common benign gynecologic disease. The main symptoms of adenomyosis are hypermenorrhea, dysmenorrhea, and subfertility, which can seriously affect the patient’s quality of life [1,2]. Drug therapies, for example, GnRH-a, dienogest and LNG-IUS can relieve symptoms effectively. However, after the withdrawal of the drugs, the symptoms of adenomyosis and uterine enlargement returned [3,4]. The adverse effects of GnRH-a (such as menopausal symptoms and the risk of osteoporosis) limited its long-term use. Dienogest is generally well tolerated. However, massive metrorrhagia is a major reason for discontinuing treatment with dienogest [5]. LNG-IUS can continuously release intrauterine levonorgestrel and is suitable for long-term treatment. However, spontaneous expulsion of LNG-IUS is the main reason for the failure of LNG-IUS [6,7]. Although GnRH-a combined with LNG-IUS can reduce the LNG-IUS expulsion rate, the expulsion rate at 12 months after insertion is still 14% [8]. Patients with adenomyosis who failed to respond to drug therapies are often recommended for adenomyomectomy or hysterectomy. In fact, the only hysterectomy can radically cure adenomyosis [9]. Due to the unclear boundary of the adenomyotic lesion, recurrence is found as early as within one year after adenomyomectomy [10].
Gorham–Stout disease: good results of bisphosphonate treatment in 6 of 7 patients
Published in Acta Orthopaedica, 2020
Kristian Nikolaus Schneider, Max Masthoff, Georg Gosheger, Sebastian Klingebiel, Dominik Schorn, Julian Röder, Tim Vogler, Moritz Wildgruber, Dimosthenis Andreou
Another treatment option for GSD patients reported in the literature is sirolimus, an mTOR inhibitor that acts as a down-regulator of cellular proliferation and angiogenesis (García et al. 2016). García et al. (2016) described a successful sirolimus treatment in a 43-year-old female patient with GSD of her left hemithorax accompanied by a left-sided chylothorax. Despite achieving remission within 4 weeks, treatment had to be discontinued due to metrorrhagia. We initiated sirolimus treatment additionally to bisphosphonate treatment in our 2 patients who developed a chylothorax. However, 1 patient developed recurrent aphthous ulcerations that required discontinuation of the treatment, while the other patient’s chylothorax progressed under treatment and required surgery. In the first patient, the chylothorax remains asymptomatic and stable, so that the sirolimus treatment was not resumed.