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1. Levens ED, Potlog-Nahari C, Armstrong AY, Wesley R, Premkumar A, Blithe DL, Blocker W, Nieman LK: CDB-2914 for uterine leiomyomata treatment: a randomized controlled trial. Obstet Gynecol; 2008 May;111(5):1129-36
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] CDB-2914 for uterine leiomyomata treatment: a randomized controlled trial.
  • During treatment, hemoglobin was unchanged, and the median estradiol was greater than 50 pg/mL in all groups.
  • One CDB-2914 woman developed endometrial cystic hyperplasia without evidence of atypia.
  • CDB-2914 treatment resulted in improvements in the concern subscale of the Uterine Fibroid Symptom Quality of Life assessment.
  • Thus, there may be a role for CDB-2914 in the treatment of leiomyomata.
  • [MeSH-major] Leiomyoma / drug therapy. Norpregnadienes / therapeutic use. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Adult. Female. Health Status Indicators. Hematocrit. Humans. Magnetic Resonance Imaging. Middle Aged. Quality of Life. Treatment Outcome


2. Wang H, Isaksson E, Von Schoultz B, Cline JM, Sahlin L: The effect of long-term treatment with steroid hormones or tamoxifen on oestrogen receptors (alpha and beta) in the endometrium of ovariectomized cynomolgus macaques. J Endocrinol; 2002 Dec;175(3):673-81
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  • [Title] The effect of long-term treatment with steroid hormones or tamoxifen on oestrogen receptors (alpha and beta) in the endometrium of ovariectomized cynomolgus macaques.
  • Ovariectomized macaques (Macaca fascicularis) were used to study the regulation of ERalpha and ERbeta in the endometrium by immunohistochemistry and in situ hybridization after long-term hormone treatment.
  • Treatment with CEE/MPA down-regulated ERalpha in the superficial glands.
  • ERbeta immunostaining was faint with minor variation in response to treatment, but increased in the superficial stroma after MPA treatment.
  • The ratio of ERbeta/ERalpha increased in superficial stroma and gland after CEE/MPA treatment, and also in stroma after MPA and TAM.
  • Cystic endometrial hyperplasia was observed in TAM-treated animals, in combination with a high level of ERalpha protein expression.
  • The present data show that long-term hormone treatment affects the ERalpha and ERbeta protein levels in the endometrium.
  • [MeSH-major] Endometrium / metabolism. Estrogen Antagonists / pharmacology. Estrogen Replacement Therapy. Receptors, Estrogen / drug effects. Tamoxifen / pharmacology
  • [MeSH-minor] Animals. Down-Regulation. Estrogen Receptor alpha. Estrogen Receptor beta. Estrogens, Conjugated (USP) / pharmacology. Female. Macaca fascicularis. Medroxyprogesterone / pharmacology. Models, Animal. Ovariectomy. Progesterone Congeners / pharmacology. Time Factors

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  • (PMID = 12475378.001).
  • [ISSN] 0022-0795
  • [Journal-full-title] The Journal of endocrinology
  • [ISO-abbreviation] J. Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Estrogen Antagonists; 0 / Estrogen Receptor alpha; 0 / Estrogen Receptor beta; 0 / Estrogens, Conjugated (USP); 0 / Progesterone Congeners; 0 / Receptors, Estrogen; 094ZI81Y45 / Tamoxifen; HSU1C9YRES / Medroxyprogesterone
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3. Ioffe OB, Zaino RJ, Mutter GL: Endometrial changes from short-term therapy with CDB-4124, a selective progesterone receptor modulator. Mod Pathol; 2009 Mar;22(3):450-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endometrial changes from short-term therapy with CDB-4124, a selective progesterone receptor modulator.
  • Selective progesterone receptor modulators are a class of drugs with progesterone antagonist activity that may confer therapeutic benefit for reproductive disorders in premenopausal women.
  • Endometrial structure, which is dynamically controlled by circulating sex hormones, is likely to be perturbed by progesterone receptor modulators through their progesterone antagonist properties.
  • We examined endometrial histology in 58 premenopausal women treated with the progesterone receptor modulator CDB-4124 (also known as Proellex) for endometriosis or uterine leiomyomata in two clinical trials.
  • Endometrial biopsies obtained after 3 or 6 months with doses of 12.5, 25, or 50 mg daily oral CDB-4124 were reviewed independently by three pathologists.
  • Consensus diagnoses using the World Health Organization hyperplasia scoring system, comments on specific histologic features, and clinical annotation were collected and analyzed.
  • The majority of the endometrial biopsies (103 of 174 biopsies) contained histologic changes that are not seen during normal menstrual cycles.
  • With increasing treatment dose and duration, the cysts became predominant and their lining inactive or atrophic.
  • Cystic glands in the CDB-4124-treated subjects correlated with increased endometrial thickness by ultrasound.
  • None of the CDB-4124-treated patients developed endometrial carcinoma or hyperplasia while on therapy.
  • CDB-4124 therapy for 3-6 months produces histologic changes that are sufficiently novel that they might easily be misinterpreted by pathologists, particularly as disordered proliferative or hyperplastic endometrium.
  • Knowledge of the constellation of endometrial changes associated with this agent and other progesterone receptor modulators, including cystic architecture and mixed non-physiologic epithelial changes will prevent misdiagnosis.
  • [MeSH-major] Endometriosis / drug therapy. Endometrium / drug effects. Endometrium / pathology. Leiomyoma / drug therapy. Norpregnadienes / therapeutic use. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Adult. Female. Humans. Premenopause. Receptors, Progesterone / drug effects

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  • (PMID = 19136935.001).
  • [ISSN] 1530-0285
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Norpregnadienes; 0 / Receptors, Progesterone; 1K9EYK92PQ / telapristone acetate
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4. Garuti G, Cellani F, Colonnelli M, Garzia D, Gonfiantini C, Luerti M: Hysteroscopically targeted biopsies compared with blind samplings in endometrial assessment of menopausal women taking tamoxifen for breast cancer. J Am Assoc Gynecol Laparosc; 2004 Feb;11(1):62-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hysteroscopically targeted biopsies compared with blind samplings in endometrial assessment of menopausal women taking tamoxifen for breast cancer.
  • STUDY OBJECTIVE: To determine the validity of tissue sampling accomplished by hysteroscopically targeted or blind biopsies in the assessment of endometrial morbidity associated with tamoxifen treatment.
  • PATIENTS: One hundred seventy-six menopausal women who had an endometrial stripe of more than 4 mm on transvaginal ultrasonography.
  • INTERVENTION: Review of histopathologic reports of patients undergoing hysteroscopy followed by targeted (94 samplings) or blind (82 samplings) endometrial biopsies.
  • MEASUREMENTS AND MAIN RESULTS: Histopathology was considered the reference test to assess endometrial morbidity, and correlates with hysteroscopic findings were made to evaluate the validity of the two sampling procedures.
  • Overall, in 23 women (13.0%) tissue samples were insufficient for pathologic evaluation.
  • Functional or atrophic endometrium and cystic atrophy were found in 51 (28.8%) and 37 patients (21.0%), respectively.
  • Blind biopsies failed to detect 5 of 5 polyps and 33 of 37 cystic atrophies, and in 34.1% of cases provided insufficient tissue for diagnosis; however, no hyperplasias or carcinomas were undetected.
  • All specimens collected under vision were pathologically evaluable; 34 of 38 hysteroscopic reports of cystic atrophy were confirmed, and neither endometrial polyps nor hyperplasias and carcinomas were undetected.
  • In distinguishing between normal and abnormal endometrium, hysteroscopy showed sensitivity and negative predictive value of 100% regardless of sampling modality.
  • We found better specificity (80.0% vs 68.9%) and positive predictive value (68.9% vs 43.7%) for hysteroscopic diagnosis when tissue was collected under vision compared with blind sampling.
  • CONCLUSION: In women taking tamoxifen, endometrial evaluation performed by blind sampling is safe in excluding hyperplasias or carcinomas.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Biopsy, Needle. Breast Neoplasms / drug therapy. Endometrium / pathology. Hysteroscopy. Postmenopause. Selective Estrogen Receptor Modulators / adverse effects. Tamoxifen / adverse effects
  • [MeSH-minor] Aged. Atrophy. Endometrial Neoplasms / chemically induced. Endometrial Neoplasms / pathology. Female. Humans. Hyperplasia. Middle Aged. Polyps / chemically induced. Polyps / pathology. Predictive Value of Tests. Sensitivity and Specificity

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  • (PMID = 15104834.001).
  • [ISSN] 1074-3804
  • [Journal-full-title] The Journal of the American Association of Gynecologic Laparoscopists
  • [ISO-abbreviation] J Am Assoc Gynecol Laparosc
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Selective Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen
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5. Fong K, Causer P, Atri M, Lytwyn A, Kung R: Transvaginal US and hysterosonography in postmenopausal women with breast cancer receiving tamoxifen: correlation with hysteroscopy and pathologic study. Radiographics; 2003 Jan-Feb;23(1):137-50; discussion 151-5
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  • Tamoxifen citrate therapy increases the prevalence of benign and malignant uterine lesions.
  • At transvaginal ultrasonography (US), the finding of a thickened central endometrial complex, with or without cystic changes, is often nonspecific and may be caused by an endometrial polyp, submucosal leiomyoma (fibroid), endometrial hyperplasia, carcinoma, or cystic atrophy.
  • In addition, because of an increased prevalence of adenomyosis or adenomyosis-like changes in women receiving tamoxifen, proper transvaginal US assessment of endometrial thickness and abnormalities is difficult in some women.
  • Hysterosonography, as an adjunct to transvaginal US, allows identification of intracavitary lesions and focal and diffuse endometrial abnormalities and helps determine whether an abnormality is endometrial or subendometrial.
  • Endometrial polyps may be seen at transvaginal US as nonspecific thickening of the endometrial complex, with or without cystic changes.
  • Submucosal leiomyomas may protrude into the endometrial cavity, causing false endometrial thickening at transvaginal US.
  • Hysterosonography shows a round structure arising from the myometrium with a thin, overlying endometrium.
  • At transvaginal US, when the endometrium cannot be accurately measured or when there is a nonspecific thickened central endometrial complex, hysterosonography can provide additional information and can help in the triage for hysteroscopic versus nondirected endometrial biopsy.
  • [MeSH-major] Breast Neoplasms / drug therapy. Breast Neoplasms / ultrasonography. Endometrial Neoplasms / ultrasonography. Estrogen Antagonists / therapeutic use. Tamoxifen / therapeutic use
  • [MeSH-minor] Carcinoma / ultrasonography. Endometrial Hyperplasia / ultrasonography. Endometriosis / ultrasonography. Endometrium / pathology. Female. Humans. Leiomyoma / ultrasonography. Middle Aged. Postmenopause. Ultrasonography / methods

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  • [Copyright] Copyright RSNA, 2003.
  • (PMID = 12533649.001).
  • [ISSN] 0271-5333
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Estrogen Antagonists; 094ZI81Y45 / Tamoxifen
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6. Ebert AD, Rosenow G, David M, Mechsner S, Magalov IS, Papadopoulos T: Co-occurrence of atypical endometriosis, subserous uterine leiomyomata, sactosalpinx, serous cystadenoma and bilateral hemorrhagic corpora lutea in a perimenopausal adipose patient taking tamoxifen (20 mg/day) for invasive lobular breast cancer. Gynecol Obstet Invest; 2008;66(3):209-13
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  • BACKGROUND: For women taking tamoxifen, recent data strongly support the estrogen agonist role of tamoxifen as a causal factor for the increased risk of endometriosis, but also of leiomyomata, endometrial polyps, and endometrial hyperplasia.
  • The ultrasonographic examination showed a regular endometrium of less than 6 mm thickness, a uterine myoma (approximately 3 cm in diameter), a right-sided sactosalpinx (7.7 x 3.6 x 5.7 cm), an ovarian cyst on the right side (approximately 4 cm), and a left-sided ovarian cyst (approximately 3 cm in diameter) without any malignancy criteria.
  • In the cystic ovary (right side), a serous cystadenoma close to a hemorrhagic corpus luteum (HCL) was diagnosed.
  • [MeSH-major] Breast Neoplasms / drug therapy. Cystadenoma, Serous / chemically induced. Endometriosis / chemically induced. Fallopian Tube Diseases / chemically induced. Leiomyoma / chemically induced. Tamoxifen / adverse effects. Uterine Neoplasms / chemically induced
  • [MeSH-minor] Antineoplastic Agents, Hormonal / adverse effects. Antineoplastic Agents, Hormonal / therapeutic use. Carcinoma, Lobular / drug therapy. Carcinoma, Lobular / surgery. Corpus Luteum / drug effects. Corpus Luteum / pathology. Female. Hemorrhage / chemically induced. Humans. Immunohistochemistry. Middle Aged. Ovarian Diseases / chemically induced


7. Taïeb S, Ceugnart L, Chevalier A, Cabaret V, Leblanc E, Fournier C, Besson P: [Value of MRI in symptomatic patients treated with tamoxifen]. J Radiol; 2003 Jan;84(1):33-9
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  • [Transliterated title] Apport de l'IRM chez les patientes symptomatiques traitées par tamoxifène.
  • RESULTS: Endometrial thickness at sonography ranged from 5 to 48 mm (mean thickness 19 mm), and on T2-weighted imaging ranged from 3 to 50 mm (mean=25 mm).
  • Pattern 1 (13 patients) was defined as homogeneous high signal intensity of the endometrium on T2W images, and signal void in the lumen on gadolinium-enhanced images.
  • Pattern 2 (8 patients) was defined as heterogeneous endometrial signal on T2W images, and latticelike enhancement traversing the endometrial canal on gadolinium-enhanced images.
  • In pattern 1 we found 13 atrophic endometrium, in addition there were 4 polypoid glandulo-cystic proliferation (PGCP), and 1 adenomyosis.
  • In pattern 2 we found 3 PGCP, 4 atrophy and 1 polyp without hyperplasia.
  • The 2 carcinomas and the polyps with hyperplasia were found in pattern 3 (11 patients).
  • [MeSH-major] Antineoplastic Agents, Phytogenic / adverse effects. Breast Neoplasms / drug therapy. Endometrial Hyperplasia / chemically induced. Endometrial Hyperplasia / diagnosis. Endometrial Neoplasms / chemically induced. Endometrial Neoplasms / diagnosis. Magnetic Resonance Imaging / methods. Polyps / chemically induced. Polyps / diagnosis. Tamoxifen / adverse effects
  • [MeSH-minor] Aged. Algorithms. Atrophy. Biopsy. Contrast Media. Decision Trees. Female. Humans. Hysterectomy. Meglumine. Middle Aged. Organometallic Compounds. Prospective Studies

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  • (PMID = 12637885.001).
  • [ISSN] 0221-0363
  • [Journal-full-title] Journal de radiologie
  • [ISO-abbreviation] J Radiol
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Validation Studies
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Contrast Media; 0 / Organometallic Compounds; 0 / gadoterate meglumine; 094ZI81Y45 / Tamoxifen; 6HG8UB2MUY / Meglumine
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8. Sesti F, Patrizi L, Ermini B, Palmieri G, Orlandi A, Piccione E: High-grade endometrial stromal sarcoma after tamoxifen therapy for breast cancer. Gynecol Obstet Invest; 2005;60(2):117-20
Hazardous Substances Data Bank. TAMOXIFEN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] High-grade endometrial stromal sarcoma after tamoxifen therapy for breast cancer.
  • A case of high-grade endometrial stromal sarcoma, confined into an intrauterine polypoid growth, in a woman with a history of breast cancer who was treated with adjuvant tamoxifen.
  • Based on the findings, a high-grade endometrial stromal sarcoma was diagnosed.
  • The endometrium showed patterns of glandular cystic hyperplasia.
  • In deciding if tamoxifen therapy is warranted, all potentially life-threatening adverse events associated with tamoxifen should be considered, including endometrial adenocarcinoma or uterine sarcoma.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Neoplasms, Second Primary / chemically induced. Sarcoma, Endometrial Stromal / chemically induced. Tamoxifen / adverse effects. Uterine Neoplasms / chemically induced


9. Trasch K, Wehrend A, Bostedt H: Follow-up examinations of bitches after conservative treatment of pyometra with the antigestagen aglepristone. J Vet Med A Physiol Pathol Clin Med; 2003 Sep;50(7):375-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Follow-up examinations of bitches after conservative treatment of pyometra with the antigestagen aglepristone.
  • The aim of this study was to determine the therapeutic success of the medical treatment of canine pyometra with the antigestagen aglepristone and to document the recurrence rate in relation to the time interval after treatment with antigestagens.
  • In 48 (92.8%) of the 52 treated bitches, healing could be achieved within the first 3 weeks after the treatment had been started.
  • In these three patients, ovarian and endometrial cysts were present.
  • Four animals developed a recurrence (9.8%).
  • In three bitches ovarian cysts and cystic endometrial hyperlasia could be found intra operationem.
  • Seven animals developed a pyometra again (18.9%).
  • Two received a repeated treatment with aglepristone and have been free from recurrence for over 12 months.
  • In 22 bitches next heat started at the expected time, in seven animals heat started too early.
  • The presented data show that treatment of pyometra by aglepristone results in a high healing rate.
  • The recurrence rate can be minimized by the selection of bitches without ovarian cysts and cystic endometrial hyperplasia.
  • [MeSH-major] Cysts / veterinary. Dog Diseases / drug therapy. Endometrial Hyperplasia / veterinary. Estrenes / therapeutic use
  • [MeSH-minor] Animals. Dogs. Female. Follow-Up Studies. Progestins / antagonists & inhibitors. Recurrence. Treatment Outcome

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  • (PMID = 14633233.001).
  • [ISSN] 0931-184X
  • [Journal-full-title] Journal of veterinary medicine. A, Physiology, pathology, clinical medicine
  • [ISO-abbreviation] J Vet Med A Physiol Pathol Clin Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Estrenes; 0 / Progestins; 0UT4JLE1CM / aglepristone
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10. Mourits MJ, van der Zee AG, Willemse PH, Hollema H, de Vries EG: [The effects of tamoxifen on the female genital tract]. Ned Tijdschr Geneeskd; 2003 Nov 22;147(47):2315-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • In postmenopausal women tamoxifen has an oestrogen agonistic effect on the vaginal epithelium, the uterine myometrium and the endometrium.
  • It may induce benign cystic hyperplasia of the endometrial stroma and cause an increase in poly formation.
  • The risk of endometrial cancer increases 2-3-fold after an exposure of up to 5 years.
  • However, if there is postmenopausal bleeding, then transvaginal ultrasonography and histology of the endometrium are indicated.
  • Tamoxifen has an antagonistic effect on the endometrium in premenopausal women and is associated with hot flushes and impaired sexual functioning.
  • Despite its gynaecological side effects, the benefits of tamoxifen in breast-cancer treatment outweigh the risks.
  • [MeSH-major] Breast Neoplasms / drug therapy. Estrogen Antagonists / adverse effects. Genitalia, Female / drug effects. Selective Estrogen Receptor Modulators / adverse effects. Tamoxifen / adverse effects
  • [MeSH-minor] Endometrial Neoplasms / chemically induced. Estradiol / blood. Female. Hot Flashes / chemically induced. Humans. Menopause. Ovarian Cysts / chemically induced. Risk Factors. Sexual Dysfunctions, Psychological / chemically induced

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  • (PMID = 14669536.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Estrogen Antagonists; 0 / Selective Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen; 4TI98Z838E / Estradiol
  • [Number-of-references] 31
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11. Knottenbelt CM, Herrtage ME: Use of proligestone in the management of three German shepherd dogs with pituitary dwarfism. J Small Anim Pract; 2002 Apr;43(4):164-70
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  • Treatment resulted in development of an adult hair coat, increased bodyweight and elevated insulin-like growth factor-1 concentration.
  • Two dogs received thyroid supplementation during proligestone therapy.
  • Adverse effects (cystic endometrial hyperplasia and acromegaly) were reported in two cases.
  • [MeSH-major] Dog Diseases / drug therapy. Dwarfism, Pituitary / veterinary. Progesterone / analogs & derivatives. Progesterone / therapeutic use. Progesterone Congeners / therapeutic use
  • [MeSH-minor] Acromegaly / chemically induced. Acromegaly / veterinary. Animals. Body Weight / drug effects. Dogs. Endometrial Hyperplasia / chemically induced. Endometrial Hyperplasia / veterinary. Female. Growth Hormone / blood. Hair / drug effects. Insulin-Like Growth Factor I / analysis. Male

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  • (PMID = 11996393.001).
  • [ISSN] 0022-4510
  • [Journal-full-title] The Journal of small animal practice
  • [ISO-abbreviation] J Small Anim Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Progesterone Congeners; 4G7DS2Q64Y / Progesterone; 55772LJ01V / proligestone; 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone
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12. Hickey M, Higham J, Fraser IS: Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation. Cochrane Database Syst Rev; 2007;(4):CD001895
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • In anovulatory DUB with acyclic (irregular) oestrogen production there will be no progesterone withdrawal from oestrogen primed endometrium and so cycles are irregular.
  • Prolonged oestrogen stimulation may cause a build up of endometrium with erratic bleeding as it breaks down and is expelled.
  • Continuous progestogen is intended to induce endometrial atrophy and hence to prevent oestrogen-stimulated endometrial proliferation.
  • Progestogens, and oestrogens and progestogens in combination are already widely used in the management of irregular or excessive bleeding due to DUB but the regime, dose and type of progestogen used varies widely, with little consensus about the optimum treatment approach.
  • SELECTION CRITERIA: All randomised controlled trials of progestogens (via any route) alone or in combination with oestrogens in the treatment of irregular bleeding associated with anovulation.
  • One randomised study compared the effects of two progestogens on endometrial histology in women with a variety of menstrual symptoms, half of whom had cystic glandular hyperplasia.
  • AUTHORS' CONCLUSIONS: There is a paucity of randomised studies relating to the use of progestogens and of oestrogens and progestogens in combination in the treatment of irregular bleeding associated with anovulation.
  • Further research is needed to establish the role of these treatments in the management of this common gynaecological problem.
  • [MeSH-major] Anovulation / complications. Estrogens / therapeutic use. Menorrhagia / drug therapy. Progestins / therapeutic use
  • [MeSH-minor] Adult. Drug Therapy, Combination. Female. Humans

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  • [UpdateIn] Cochrane Database Syst Rev. 2012;9:CD001895 [22972055.001]
  • [UpdateOf] Cochrane Database Syst Rev. 2000;(2):CD001895 [10796833.001]
  • (PMID = 17943761.001).
  • [ISSN] 1469-493X
  • [Journal-full-title] The Cochrane database of systematic reviews
  • [ISO-abbreviation] Cochrane Database Syst Rev
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Estrogens; 0 / Progestins
  • [Number-of-references] 19
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13. Strauss HG, Wolters M, Methfessel G, Buchmann J, Koelbl H: Significance of endovaginal ultrasonography in assessing tamoxifen-associated changes of the endometrium. A prospective study. Acta Obstet Gynecol Scand; 2000 Aug;79(8):697-701
Hazardous Substances Data Bank. TAMOXIFEN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Significance of endovaginal ultrasonography in assessing tamoxifen-associated changes of the endometrium. A prospective study.
  • BACKGROUND: A prospective study was conducted investigating the value of endovaginal ultrasound in the assessment of tamoxifen-associated changes of the endometrium in patients with breast cancer.
  • Those with bleeding disorders and/or an endometrial thickness of > or =10 mm found on ultrasonography underwent hysteroscopy and dilatation and curettage (D&C) for further histological evaluation.
  • RESULTS: 82% of the 22 patients with positive sonographic findings had a glandular-cystic hyperplasia or a glandular-cystic polyp.
  • No adenomatous hyperplasia or endometrial cancer was observed in our series.
  • CONCLUSION: Vaginal ultrasound represents a useful diagnostic tool to detect tamoxifen-associated changes of the endometrium.
  • A threshold of 10 mm endometrial thickness appears suitable to identify endometrial abnormalities while reducing the rate of false-positive findings to an acceptable level.
  • However, the role of vaginal ultrasound in screening for endometrial cancer or premalignant lesions remains uncertain.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Endometrium / drug effects. Tamoxifen / adverse effects. Vagina / ultrasonography
  • [MeSH-minor] Aged. Aged, 80 and over. Breast Neoplasms / drug therapy. False Positive Reactions. Female. Humans. Middle Aged. Prospective Studies

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  • (PMID = 10949237.001).
  • [ISSN] 0001-6349
  • [Journal-full-title] Acta obstetricia et gynecologica Scandinavica
  • [ISO-abbreviation] Acta Obstet Gynecol Scand
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] DENMARK
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
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14. Dallenbach-Hellweg G, Schmidt D, Hellberg P, Bourne T, Kreuzwieser E, Dören M, Rydh W, Rudenstam G, Granberg S: The endometrium in breast cancer patients on tamoxifen. Arch Gynecol Obstet; 2000 Apr;263(4):170-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The endometrium in breast cancer patients on tamoxifen.
  • We restudied histologically and immunohistochemically 17 endometrial carcinomas, 2 malignant mixed tumors and 180 endometria with benign changes during or after tamoxifen therapy.
  • Endometrial biopsies were taken only if the endometrial thickness was > 8 mm sonographically, when a polyp was seen, or for postmenopausal bleeding.
  • About half of the endometrial specimens showed simple or cystic atrophy, 55-76% had cystic-atrophic polyps or regressive hyperplasia.
  • 68-70% revealed diffuse extensive fibrosis of the endometrial stroma.
  • None of 11 patients biopsied before starting tamoxifen therapy had advanced endometrial glandular proliferation in the second endometrial biopsy after tamoxifen treatment.
  • None of the 19 endometrial neoplasms after tamoxifen therapy was of the endometrioid type: 11 were mucinous adenocarcinomas, 4 clear cell carcinomas, 2 serous-papillary carcinomas, one carcinosarcoma and one malignant Mullerian mixed tumor.
  • The reasons for discrepancies between suspicious sonograms and endometrial atrophy are discussed.
  • [MeSH-major] Adenocarcinoma, Mucinous / pathology. Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Endometrial Neoplasms / pathology. Endometrium / drug effects. Tamoxifen / adverse effects

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  • (PMID = 10834325.001).
  • [ISSN] 0932-0067
  • [Journal-full-title] Archives of gynecology and obstetrics
  • [ISO-abbreviation] Arch. Gynecol. Obstet.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] GERMANY
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
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15. Schotanus BA, de Gier J, van der Lugt JJ, Okkens AC: Estriolum treatment in the bitch: a risk for uterine infection? Reprod Domest Anim; 2008 Apr;43(2):176-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Estriolum treatment in the bitch: a risk for uterine infection?
  • The inflammation is due to either cystic endometrial hyperplasia (CEH) induced primarily by progesterone from remnant ovarian tissue or exogenous progestagens, or it is due to the presence of unabsorbed suture material.
  • No remnant ovarian tissue was found by abdominal ultrasonography, laparotomy, or histological examination of mesovarian pedicles.
  • Instead, it is hypothesized that the long-term treatment with estriolum was a causative factor.
  • [MeSH-minor] Animals. Diagnosis, Differential. Dogs. Female. Hysterectomy / veterinary. Ovariectomy / veterinary. Urinary Incontinence / drug therapy. Urinary Incontinence / veterinary

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  • (PMID = 17986174.001).
  • [ISSN] 1439-0531
  • [Journal-full-title] Reproduction in domestic animals = Zuchthygiene
  • [ISO-abbreviation] Reprod. Domest. Anim.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] FB33469R8E / Estriol
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16. Varras M, Polyzos D, Akrivis Ch: Effects of tamoxifen on the human female genital tract: review of the literature. Eur J Gynaecol Oncol; 2003;24(3-4):258-68
Hazardous Substances Data Bank. TAMOXIFEN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Tamoxifen is a non-steroidal triphenylethylene derivate, with clear antioestrogenic effects on the breast, that is orally administrated for the treatment of breast cancer and its prevention in a high-risk population.
  • It has been found that tamoxifen causes oestrogenic changes of the vaginal and cervical squammous epithelium and increases the incidence of cervical and endometrial polyps.
  • The action of tamoxifen on the human endometrium in postmenopausal women is connected with simple oestrogenic effects including hyperplasia, while in others with endometrial cystic atrophy.
  • In cases where tamoxifen induces endometrial polyps and hyperplasia, the extensive fibrosis accounts for difficulties in obtaining endometrial biopsy or resecting the polyps.
  • In premenopausal patients tamoxifen disrupts the menstrual cycles and causes ovarian cysts, while in postmenopausal patients it induces ovarian cystic tumors and endometriomas.
  • In addition, randomized trials have shown a link between tamoxifen use in breast cancer patients and the development of endometrial carcinomas.
  • Moreover, of note is the fact that the association of tamoxifen therapy with uterine mesenchymal neoplasms is higher than expected.
  • In conclusion, the most worrying gynaecological side-effect of tamoxifen is the well-known increased risk of endometrial carcinomas.
  • Women with breast cancer treated with tamoxifen should undergo annual gynaecological examination, but endometrial sampling should be obtained only in the event of endometrial bleeding.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Genitalia, Female / drug effects. Ovarian Neoplasms / chemically induced. Tamoxifen / adverse effects. Uterine Neoplasms / chemically induced
  • [MeSH-minor] Administration, Oral. Breast Neoplasms / drug therapy. Dose-Response Relationship, Drug. Drug Administration Schedule. Endometrial Neoplasms / chemically induced. Endometrial Neoplasms / diagnosis. Endometrial Neoplasms / epidemiology. Endosonography. Female. Humans. Hysteroscopy. Long-Term Care. Monitoring, Physiologic / methods. Prognosis. Risk Assessment

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  • (PMID = 12807236.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
  • [Number-of-references] 103
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17. Hickey M, Higham J, Fraser IS: Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation. Cochrane Database Syst Rev; 2000;(2):CD001895
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • In anovulatory DUB with acyclic (irregular) oestrogen production there will be no progesterone withdrawal from oestrogen primed endometrium and so cycles are irregular.
  • Prolonged oestrogen stimulation may cause a build up of endometrium with erratic bleeding as it breaks down and is expelled.
  • Continuous progestogen is intended to induce endometrial atrophy and hence to prevent oestrogen-stimulated endometrial proliferation.
  • Progestogens, and oestrogens and progestogens in combination are already widely used in the management of irregular or excessive bleeding due to DUB, but the regime, dose and type of progestogen used varies widely with little consensus about the optimum treatment approach.
  • SELECTION CRITERIA: All randomised controlled trials of progestogens (via any route) alone or in combination with oestrogens in the treatment of irregular bleeding associated with anovulation.
  • One randomised study compared the effects of two progestogens on endometrial histology in subjects with a variety of menstrual symptoms, half of whom had cystic glandular hyperplasia.
  • REVIEWER'S CONCLUSIONS: There is a paucity of randomised studies relating to the use of progestogens and of oestrogens and progestogens in combination in the treatment of irregular bleeding associated with anovulation.
  • Further research is needed to establish the role of these treatments in the management of this common gynaecological problem.
  • [MeSH-major] Anovulation / complications. Estrogens / therapeutic use. Menorrhagia / drug therapy. Menorrhagia / etiology. Progestins / therapeutic use
  • [MeSH-minor] Adult. Drug Therapy, Combination. Female. Humans

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  • [UpdateIn] Cochrane Database Syst Rev. 2007;(4):CD001895 [17943761.001]
  • (PMID = 10796833.001).
  • [ISSN] 1469-493X
  • [Journal-full-title] The Cochrane database of systematic reviews
  • [ISO-abbreviation] Cochrane Database Syst Rev
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Estrogens; 0 / Progestins
  • [Number-of-references] 2
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18. Jurka P, Max A, Hawryńska K, Snochowski M: Age-related pregnancy results and further examination of bitches after aglepristone treatment of pyometra. Reprod Domest Anim; 2010 Jun;45(3):525-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Age-related pregnancy results and further examination of bitches after aglepristone treatment of pyometra.
  • The cystic endometrial hyperplasia and pyometra complex is one of the most common uterine diseases in bitches.
  • The appearance of pharmacological preparations containing anti-progestagens created new possibilities for pyometra treatment.
  • The aim of this study was to evaluate the curative effect of the anti-progestagen aglepristone treatment of pyometra in bitches of different ages.
  • Information about the general reproductive health was collected up to 54 months after anti-progestagen treatment.
  • Remission of clinical symptoms and return of blood chemistry results and total leucocyte count to referential values were achieved in all cases within 14 days of treatment.
  • Bitches were naturally mated at the first, and when unsuccessful, the second oestrus after treatment.
  • In conclusion, the basic indication for conservative pharmacological treatment of pyometra is preserving female fertility and obtaining offspring.
  • The important conditions for successful aglepristone treatment are: the young age (up to 5 years) and the lack of detectible ovarian cysts.
  • It seems necessary to mate bitches in the first or second oestrus after finishing treatment.
  • The efficacy of treatment can be measured by the after-treatment pregnancy rate.
  • [MeSH-major] Aging. Dog Diseases / drug therapy. Estrenes / therapeutic use. Pregnancy Outcome. Progestins / antagonists & inhibitors. Pyometra / veterinary
  • [MeSH-minor] Animals. Dogs. Female. Fertility / drug effects. Leukocyte Count. Pregnancy. Treatment Outcome. Uterus / ultrasonography

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  • (PMID = 19055567.001).
  • [ISSN] 1439-0531
  • [Journal-full-title] Reproduction in domestic animals = Zuchthygiene
  • [ISO-abbreviation] Reprod. Domest. Anim.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Estrenes; 0 / Progestins; 0UT4JLE1CM / aglepristone
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19. Schmidt D, Horn LC: [Precancerous lesion of the endometrium and endometrial morphology in patients with tamoxifen therapy]. Zentralbl Gynakol; 2002 Jan;124(1):3-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Precancerous lesion of the endometrium and endometrial morphology in patients with tamoxifen therapy].
  • [Transliterated title] Präkanzeröse Läsionen des Endometriums und Veränderungen unter Tamoxifen-Therapie.
  • The endometrioid type of endometrial adenocarcinoma,(type 1-carcinoma) is estrogen-dependent and frequently associated with endometrial hyperplasia.
  • The highest risk for metachronous carcinoma is associated with atypical hyperplasia of the endometrium as detected in fractional curettings.
  • In postmenopausal patients treatment should consist of abdominal hysterectomy.
  • The so-called type 2-carcinomas, serous-papillary and clear-cell type, do not demonstrate a similar association with precursor lesions.
  • Pathological findings in patients treated with Tamoxifen include endometrial atrophy and fibro-cystic endometrial polyps, sometimes with cellular metaplasias.
  • Patients with breast cancer and tamoxifen treatment have an increased risk of endometrial carcinoma.
  • In some of these patients it could be argued whether the carcinoma has developed in a proceeding endometrial hyperplasia.
  • [MeSH-major] Cell Transformation, Neoplastic / pathology. Endometrial Neoplasms / pathology. Neoplasms, Hormone-Dependent / pathology. Precancerous Conditions / pathology. Tamoxifen / adverse effects
  • [MeSH-minor] Endometrium / drug effects. Endometrium / pathology. Female. Humans

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  • (PMID = 11873307.001).
  • [ISSN] 0044-4197
  • [Journal-full-title] Zentralblatt für Gynäkologie
  • [ISO-abbreviation] Zentralbl Gynakol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 094ZI81Y45 / Tamoxifen
  • [Number-of-references] 38
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20. Giorda G, Crivellari D, Veronesi A, Perin T, Campagnutta E, Carbone A, Scarabelli C: Comparison of ultrasonography, hysteroscopy, and biopsy in the diagnosis of endometrial lesions in postmenopausal tamoxifen-treated patients. Acta Obstet Gynecol Scand; 2002 Oct;81(10):975-80
Hazardous Substances Data Bank. TAMOXIFEN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Comparison of ultrasonography, hysteroscopy, and biopsy in the diagnosis of endometrial lesions in postmenopausal tamoxifen-treated patients.
  • METHODS: Three hundred and ten postmenopausal patients using tamoxifen underwent vaginal ultrasonography, hysteroscopy, and endometrial biopsy; 274 were asymptomatic and 49 had abnormal bleeding.
  • Ultrasonographic endometrial thickness and echotexture were recorded.
  • Hysteroscopic endometrial appearance, presence of focal endometrial lesions and polyps were also recorded.
  • General or selective endometrial biopsy was performed.
  • RESULTS: At ultrasonography, mean endometrial thickness was 10.8 mm.
  • At hysteroscopy, cystic atrophy and suspect focal lesions were detected in 49.2% and 5.3% of women, respectively.
  • At biopsy, non-atypical hyperplasia and atypical changes were found in 4.8% and 1.3% of patients, respectively.
  • With a 6-mm cut-off value for endometrial thickness, negative and positive predictive values for ultrasonography in detecting hyperplastic or neoplastic changes were 96% and 8%, respectively; the corresponding values for hysteroscopy were 96% and 65%.
  • CONCLUSIONS: No single ultrasonographic feature (echotexture and borders) is significantly associated with the detection of endometrial hyperplasia or carcinoma; hysteroscopy, although not predictive unless revealing a focal lesion, is more accurate in detecting polyps and hyperplastic changes.
  • [MeSH-major] Antineoplastic Agents, Hormonal / adverse effects. Biopsy / methods. Endometrium / pathology. Hysteroscopy. Tamoxifen / adverse effects. Ultrasonography / methods. Uterine Diseases / diagnosis. Uterine Diseases / etiology
  • [MeSH-minor] Aged. Breast Neoplasms / complications. Breast Neoplasms / drug therapy. Female. Humans. Middle Aged. Postmenopause. Prospective Studies. Treatment Outcome

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  • (PMID = 12366490.001).
  • [ISSN] 0001-6349
  • [Journal-full-title] Acta obstetricia et gynecologica Scandinavica
  • [ISO-abbreviation] Acta Obstet Gynecol Scand
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 094ZI81Y45 / Tamoxifen
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21. Spitz IM: Clinical utility of progesterone receptor modulators and their effect on the endometrium. Curr Opin Obstet Gynecol; 2009 Aug;21(4):318-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical utility of progesterone receptor modulators and their effect on the endometrium.
  • PURPOSE OF REVIEW: In view of the spate of recent publications related to mifepristone and some second generation progesterone receptor modulators (PRMs), this appears to be an opportune time to view the clinical status of these compounds.
  • All these PRMs are effective in the treatment of uterine fibroids where they are associated with a reduction in pain, bleeding and improvement in quality of life and decrease in fibroid size.
  • Long-term treatment with PRMs may be associated with endometrial thickening on ultrasound and there have been reports of endometrial hyperplasia.
  • Several reassuring recent publications have done much to explain the mechanism underlying these endometrial changes.
  • The most common histological finding is cystic glandular dilatation often associated with both admixed estrogen (mitotic) and progestin (secretory) epithelial effects.
  • This histology has not been previously encountered in clinical practice and should not be confused with endometrial hyperplasia.
  • The endometrial thickness is related to this cystic glandular dilatation.
  • Even over this time, there is improvement of symptoms associated with fibroids and endometriosis.
  • Clinicians and pathologists need to be aware that the endometrial thickening and histological appearance do not represent endometrial hyperplasia.
  • [MeSH-major] Endometrium / drug effects. Endometrium / pathology. Hormone Antagonists / pharmacology. Receptors, Progesterone / drug effects
  • [MeSH-minor] Drug Administration Schedule. Endometriosis / drug therapy. Endometriosis / pathology. Estrenes / administration & dosage. Estrenes / pharmacology. Female. Humans. Leiomyoma / drug therapy. Leiomyoma / pathology. Mifepristone / administration & dosage. Mifepristone / pharmacology. Norpregnadienes / administration & dosage. Norpregnadienes / pharmacology. Oximes / administration & dosage. Oximes / pharmacology. Randomized Controlled Trials as Topic. Time Factors. Uterine Neoplasms / drug therapy. Uterine Neoplasms / pathology

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  • (PMID = 19602929.001).
  • [ISSN] 1473-656X
  • [Journal-full-title] Current opinion in obstetrics & gynecology
  • [ISO-abbreviation] Curr. Opin. Obstet. Gynecol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Estrenes; 0 / Hormone Antagonists; 0 / Norpregnadienes; 0 / Oximes; 0 / Receptors, Progesterone; 1K9EYK92PQ / telapristone acetate; 320T6RNW1F / Mifepristone; 6J5J15Q2X8 / ulipristal; 72W09924WP / asoprisnil
  • [Number-of-references] 45
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22. Sukhikh GT, Zhdanov AV, Davydova MP, Slukina TV, Chernukha GE, Samoilova TE, Smetnik VP: Disorders in cytokine gene expression in endometrial hyperplasia and effect of hormone therapy. Bull Exp Biol Med; 2005 Feb;139(2):235-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Disorders in cytokine gene expression in endometrial hyperplasia and effect of hormone therapy.
  • We studied local expression of insulin-like growth factor 1, insulin-like growth factor receptor, epithelial growth factor, transforming growth factor beta2, PCNA, TNF-alpha, type I TNF receptor, Fas, FasL, IFN-gamma, IL-1beta, IL-4, IL-6, IL-8, IL-10, and IL-12 genes in intact and hyperplastic endometrium.
  • Endometrial hyperplasia was associated with reduced production of TNF-alpha (p<0.05), PCNA (p<0.05), and epithelial growth factor mRNA and enhanced production of Fas mRNA (p<0.01).
  • The expression of TNF-R1, IL-1beta, and IL-12 genes decreased only in glandular cystic hyperplasia (p<0.05 for all genes), expression of insulin-like growth factor 1 gene decreased only in adenomatous hyperplasia (p<0.05).
  • Dufaston therapy of glandular cystic hyperplasia and zoladex therapy of adenomatous hyperplasia normalized expression of Fas receptor, PCNA, and insulin-like growth factor 1 genes, while the expression of IFN-gamma and IL-6 genes, which was normal in hyperplasia, decreased (p<0.05).
  • Zoladex therapy decreased the production of transforming growth factor beta2 (p<0.05) and IL-1beta (p<0.01) mRNA, dufaston therapy decreased production of TNF-alpha (p<0.05) and IL-4 mRNA (p<0.05).
  • Hence, both apoptosis and proliferative activity were suppressed in endometrial hyperplasia, and hormone therapy created prerequisites for transition of the endometrium into the normal proliferation stage.
  • [MeSH-major] Cytokines / metabolism. Dydrogesterone / therapeutic use. Endometrial Hyperplasia / drug therapy. Goserelin / therapeutic use

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  • (PMID = 16027816.001).
  • [ISSN] 0007-4888
  • [Journal-full-title] Bulletin of experimental biology and medicine
  • [ISO-abbreviation] Bull. Exp. Biol. Med.
  • [Language] eng; rus
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cytokines; 0 / RNA, Messenger; 0F65R8P09N / Goserelin; 90I02KLE8K / Dydrogesterone
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23. Burkart C, Wight E, Pók J, Kernen B, Traber M, Haller U, Bajka M: [Ultrasound endometrium follow-up during tamoxifen treatment: Really not reliable or useful after all?]. Ultraschall Med; 2001 Jun;22(3):136-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Ultrasound endometrium follow-up during tamoxifen treatment: Really not reliable or useful after all?].
  • AIM: To investigate whether an examination of the endometrium of women treated with tamoxifen (TAM) is useful or not.
  • METHOD: 40 breast cancer patients who displayed a thickened endometrium of > 8 mm and/or vaginal bleeding were included in the study.
  • Histologic clarification by hysteroscopy and D&C was recommended for patients with an endometrium of > 8 mm or vaginal bleeding.
  • RESULTS: In our collective, the mean endometrial thickness was 13.7 +/- 5.6 mm (SD).
  • Most had a benign lesion; in 2 cases we merely found a cystic atrophy (11 mm, 18 mm), 2 displayed atypical tissue (13 mm, 25 mm) and 2 an endometrial cancer (19 mm, 33 mm).
  • All patients with atypical tissue or cancer had an endometrial thickness markedly above the norm, but 3 of them were not bleeding.
  • No linear correlation between thickness of the endometrium and duration of TAM intake was found.
  • CONCLUSION: To detect early premalignant or malignant changes of the endometrium, we recommend histological examination by hysteroscopy and dilatation and curettage when the endometrium is > 8 mm thick, even in the absence of symptoms.
  • Moreover, continuing regular screening of the endometrium for years after termination of tamoxifen-therapy is also to be recommended.
  • [MeSH-major] Breast Neoplasms / drug therapy. Endometrial Hyperplasia / chemically induced. Endometrial Neoplasms / chemically induced. Endosonography. Tamoxifen / adverse effects
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biopsy. Endometrium / drug effects. Endometrium / pathology. Endometrium / ultrasonography. Female. Humans. Middle Aged. Reference Values. Sensitivity and Specificity

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  • (PMID = 11484445.001).
  • [ISSN] 0172-4614
  • [Journal-full-title] Ultraschall in der Medizin (Stuttgart, Germany : 1980)
  • [ISO-abbreviation] Ultraschall Med
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 094ZI81Y45 / Tamoxifen
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