One size doesn't fit all, when using hormone therapy to treat endometriosis

image credit: pelvicpain.com.au

Endometriosis -- a condition caused by uterine tissue growing outside of the organ -- affects 10% of reproductive-aged women, whom it causes chronic pain that is significant and debilitating. The standard first-line treatment for all women with endometriosis is hormonal, specifically progestin-based, therapy.

Yet a team of researchers at Yale has shown that the effectiveness of progestin-therapy depends on whether a woman's endometriotic lesions have the progesterone receptor (PR) present. This study appears online in the Journal of Clinical Endocrinology & Metabolism.

The researchers tested the endometriotic lesions of 52 women who had undergone surgical evaluation for endometriosis at Yale New Haven Hospital for their PR status. They found a significant association between PR status and responsiveness to progestin-therapy. Those whose endometriotic lesions were PR-positive responded much better to the progestin-therapy, while those whose lesions were PR-negative found little relief from progestin-therapy alone.

Breastfeeding reduces risk of endometriosis diagnosis

medlineplus.gov

"Endometriosis is a chronic and incurable gynecologic disorder that affects approximately 10 percent of women in the United States. Its symptoms can be debilitating and include chronic pelvic pain, painful periods and pain during intercourse. 

A new study by investigators at Brigham and Women's Hospital finds that women who breastfed for longer periods of time had significantly lower risk of being diagnosed with endometriosis, offering new insights into a condition that, up until now, has had very few known, modifiable risk factors. The team's findings are published in The BMJ.

"We found that women who breastfed for a greater duration were less likely to be diagnosed with endometriosis," said corresponding author Leslie Farland, ScM, ScD, a research scientist at the Center for Infertility and Reproductive Surgery at BWH. "Given the chronic nature of endometriosis and that very few modifiable risk factors are currently known, breastfeeding may be an important modifiable behavior to reduce the risk of endometriosis among women after pregnancy."

The team used data from the Nurses' Health Study II (NHSII), a prospective cohort study that began in 1989. In the current analysis, researchers followed thousands of women for more than 20 years. During that time period, 3,296 women in the study were surgically diagnosed with endometriosis after their first pregnancy. 

The research team examined how long each woman breastfed, exclusively breastfed (breastfed without the introduction of solid food or formula), and how much time passed before their first postpartum period..." - Read More

 

Gene sequencing study reveals unusual mutations in endometriosis

image source

"Using gene sequencing tools, scientists from Johns Hopkins Medicine and the University of British Columbia have found a set of genetic mutations in samples from 24 women with benign endometriosis, a painful disorder marked by the growth of uterine tissue outside of the womb. The findings, described in the May 11 issue of the New England Journal of Medicine, may eventually help scientists develop molecular tests to distinguish between aggressive and clinically "indolent," or non-aggressive, types of endometriosis.

"Our discovery of these mutations is a first step in developing a genetics-based system for classifying endometriosis so that clinicians can sort out which forms of the disorder may need more aggressive treatment and which may not," says Ie-Ming Shih, M.D., Ph.D., the Richard W. TeLinde Distinguished Professor in the Department of Gynecology & Obstetrics at the Johns Hopkins University School of Medicine and co-director of the Breast and Ovarian Cancer Program at the Johns Hopkins Kimmel Cancer Center.

Endometriosis occurs when tissue lining the uterus forms and grows outside of the organ, most often into the abdomen. The disease occurs in up to 10 percent of women before menopause and half of those with abdominal pain and infertility problems. In the 1920s, Johns Hopkins graduate and trained gynecologist John Sampson first coined the term "endometriosis" and proposed the idea that endometriosis resulted when normal endometrial tissue spilled out through the fallopian tubes into the abdominal cavity during menstruation..."

Learn more:

https://www.sciencedaily.com/releases/2017/05/170510174904.htm

Homeopathy for endometriosis pain?

via ycmhz.com

"Potentized estrogen is an effective treatment for reducing endometriosis-associated pelvic pain (EAPP) that has been refractory to conventional hormone therapy, according to the results of a randomized, double-blind, placebo-controlled study reported by researchers from Brazil.

Potentized estrogen is an oral preparation of 17-beta estradiol in the 12cH, 24cH and 18cH potencies formulated in an alcohol solution.2 The homeopathic treatment was investigated in a trial that included 50 women who were randomized into 2 groups to receive 3 drops twice daily of potentized estrogen or placebo alcohol solution.

To be eligible for participation, women had to be between18 and 45 years old and diagnosed with deeply infiltrating endometriosis confirmed by magnetic resonance imaging, transvaginal ultrasound after bowel preparation, or laparoscopy. In addition, they needed to have chronic pelvic pain refractory to conventional hormone treatment and a score ≥5 on an 11-point (range 0 to 10) visual analogue scale of EAPP.

Changes from baseline to week 24 in the EAPP global score and in each of its 5 components (dysmenorrhea, dyspareunia, noncyclic pelvic pain, cyclic bowel pain, and cyclic urinary pain) were analyzed as the primary efficacy endpoint. The results showed women treated with potentized estrogen had statistically significant reductions in the global EAPP and in the component scores for dysmenorrhea, noncyclic pelvic pain, and cyclic bowel pain. In the control group, neither the EAPP global score nor any of the component scores were significantly changed from baseline at week 24.

Changes in the 36-Item Short-Form Health Survey (SF-36), depression symptoms assessed with the Beckman Depression Inventory, and anxiety symptoms measured using the Beck Anxiety Inventory were analyzed as secondary endpoints. Statistically significant improvements occurred only among women in the potentized estrogen group and were seen in three of eight SF-36 domains (bodily pain, vitality, and mental health) and in the Beckman Depression Inventory..."

Read more:

http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/homeopathy-endometriosis-pain

Endocrine-disrupting chemicals may raise risk of developing endometriosis, uterine fibroids

Source: The Endocrine Society | Summary: Endocrine-disrupting chemicals may contribute to reproductive health problems experienced by hundreds of thousands of women, costing European Union an estimated 1.4 billion Euros ($1.5 billion) a year in health care expenditures and lost earning potential, according to a new study.

"Endocrine-disrupting chemicals may contribute to reproductive health problems experienced by hundreds of thousands of women, costing European Union an estimated €1.4 billion ($1.5 billion) a year in health care expenditures and lost earning potential, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

The study examined rates of uterine fibroids -- benign tumors on the uterus that can contribute to infertility and other health problems -- and an often painful condition called endometriosis where the tissue that normally lines the uterus develops elsewhere in the body. The two conditions are common, with as many as 70 percent of women affected by at least one of the disorders.

Research has linked the development of uterine fibroids and endometriosis to chemicals found in pesticides, cosmetics, toys and food containers. Past studies suggest a byproduct of the pesticide DDT, a chemical known as DDE, can raise the risk of developing uterine fibroids. Another group of chemicals called phthalates, which are found in plastic products and cosmetics, have been tied to growing risk of endometriosis..."

Read more here:

https://www.sciencedaily.com/releases/2016/03/160322133810.htm