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1. Fieni F: Clinical evaluation of the use of aglepristone, with or without cloprostenol, to treat cystic endometrial hyperplasia-pyometra complex in bitches. Theriogenology; 2006 Oct;66(6-7):1550-6
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  • [Title] Clinical evaluation of the use of aglepristone, with or without cloprostenol, to treat cystic endometrial hyperplasia-pyometra complex in bitches.
  • The aim of the study was to evaluate the efficacy of aglepristone (10 mg/kg on days 1, 2 and 8) for the treatment of metritis or pyometra in bitches (n = 67) either alone for cases of metritis (n = 15), or in cases of pyometra (n = 52) with (n = 32) or without (n = 20) the addition of low doses (1 microg/kg) of cloprostenol for 5 days (days 3-7).
  • Examinations performed on day 90, in addition to days 8, 14 and 28, determined that treatments had been curative in the long term in 54/67 bitches (80.6%).
  • Amongst the 52 bitches with open (n = 35) or closed (n = 17) pyometra, the additional treatment with cloprostenol from days 3 to 7, significantly improved the overall success rate at day 90, which was 27/32 (84.4%), compared to 12/20 (60.0%) in bitches without cloprostenol (P < 0.05).
  • The leucocyte count and plasma progesterone concentrations significantly decreased over the course of treatment.
  • [MeSH-major] Cloprostenol / therapeutic use. Dog Diseases / drug therapy. Dog Diseases / pathology. Endometrial Hyperplasia / drug therapy. Endometrial Hyperplasia / veterinary. Estrenes / therapeutic use
  • [MeSH-minor] Animals. Dogs. Drug Therapy, Combination. Endometritis / drug therapy. Endometritis / pathology. Endometritis / veterinary. Female. Leukocyte Count / veterinary. Progesterone / blood. Uterine Diseases / drug therapy. Uterine Diseases / pathology. Uterine Diseases / veterinary

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  • (PMID = 16563489.001).
  • [ISSN] 0093-691X
  • [Journal-full-title] Theriogenology
  • [ISO-abbreviation] Theriogenology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Estrenes; 0UT4JLE1CM / aglepristone; 4208238832 / Cloprostenol; 4G7DS2Q64Y / Progesterone
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2. 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
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  • [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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3. 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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  • [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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4. Spitz IM: Mifepristone: where do we come from and where are we going? Clinical development over a quarter of a century. Contraception; 2010 Nov;82(5):442-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • In contrast, weekly administration of 25 or 50 mg does not consistently block ovulation but has contraceptive potential by delaying endometrial development.
  • Administration of mifepristone for 4-6 months or longer may lead to endometrial thickening.
  • Endometrial histology reveals cystic glandular dilation together with admixed estrogen (mitotic) and progestin (secretory) epithelial effects.
  • This histological pattern does not represent endometrial hyperplasia.
  • [MeSH-minor] Abortifacient Agents, Steroidal / administration & dosage. Abortifacient Agents, Steroidal / adverse effects. Abortifacient Agents, Steroidal / pharmacology. Abortion, Legal. Animals. Antineoplastic Agents, Hormonal / administration & dosage. Antineoplastic Agents, Hormonal / adverse effects. Antineoplastic Agents, Hormonal / pharmacology. Contraceptives, Postcoital, Synthetic / administration & dosage. Contraceptives, Postcoital, Synthetic / adverse effects. Contraceptives, Postcoital, Synthetic / pharmacology. Female. Genital Diseases, Female / drug therapy. Humans. Pregnancy. Women's Health

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  • [Copyright] Copyright © 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20933118.001).
  • [ISSN] 1879-0518
  • [Journal-full-title] Contraception
  • [ISO-abbreviation] Contraception
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Abortifacient Agents, Steroidal; 0 / Antineoplastic Agents, Hormonal; 0 / Contraceptives, Postcoital, Synthetic; 0 / Receptors, Progesterone; 320T6RNW1F / Mifepristone
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5. 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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6. 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
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  • [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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7. 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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8. Gürbulak K, Pancarci M, Ekici H, Konuk C, Kirşan I, Uçmak M, Toydemir S: Use of aglepristone and aglepristone + intrauterine antibiotic for the treatment of pyometra in bitches. Acta Vet Hung; 2005;53(2):249-55
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Use of aglepristone and aglepristone + intrauterine antibiotic for the treatment of pyometra in bitches.
  • In this study, the efficacy of aglepristone and/or intrauterine antibiotic administration for the treatment of bitches with cystic endometrial hyperplasia/pyometra complex was investigated.
  • In Group II (n = 11), intrauterine antibiotic treatment was performed according to the antibiogram on days 1, 2, 4, 6, 8 in addition to aglepristone given as in Group I.
  • [MeSH-major] Anti-Bacterial Agents / administration & dosage. Cervix Uteri. Dog Diseases / drug therapy. Endometrial Hyperplasia / veterinary. Estrenes / administration & dosage
  • [MeSH-minor] Animals. Dogs. Drug Therapy, Combination. Female. Injections, Subcutaneous / veterinary. Severity of Illness Index. Treatment Outcome


9. 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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10. 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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  • [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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11. 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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  • 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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12. 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
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  • [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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13. Corrada Y, Arias D, Rodríguez R, Tortora M, Gobello C: Combination dopamine agonist and prostaglandin agonist treatment of cystic endometrial hyperplasia-pyometra complex in the bitch. Theriogenology; 2006 Oct;66(6-7):1557-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Combination dopamine agonist and prostaglandin agonist treatment of cystic endometrial hyperplasia-pyometra complex in the bitch.
  • Cystic endometrial hyperplasia-pyometra (CEH-P) complex is a progesterone-dependent disease that requires medical treatment in bitches intended for breeding.
  • To test the efficacy and safety of a combined protocol and to assess the effect of age, stage of cycle, previous steroid hormone administration and parity on treatment, 29 bitches diagnosed with CEH-P complex were treated daily with cabergoline 5 microg/kg PO and cloprostenol 1 microg/kg SC for 7-14 days, along with supportive antibiotic and hydration therapies.
  • Before treatment, and on Days 3, 7 and 14, all bitches were evaluated clinically and uterine horn diameter measured during trans-abdominal ultrasonography.
  • Clinical signs related to pyometra began to improve markedly as early as Day 2 of treatment.
  • Uterine diameters decreased (P < 0.05) by Day 3 of treatment, and continued to gradually decrease, reaching normal size by Day 14.
  • Pregnancy was achieved in one of the two young bitches bred after treatment.
  • Although no variables affecting treatment results could be identified, this combination of compounds was found to be an efficient and safe for treatment of CEH-P.
  • [MeSH-major] Cloprostenol / therapeutic use. Dog Diseases / drug therapy. Dog Diseases / pathology. Dopamine Agonists / therapeutic use. Endometrial Hyperplasia / veterinary. Ergolines / therapeutic use. Prostaglandins, Synthetic / therapeutic use
  • [MeSH-minor] Animals. Dogs. Drug Therapy, Combination. Endometritis / drug therapy. Endometritis / ultrasonography. Endometritis / veterinary. Female. Uterine Diseases / drug therapy. Uterine Diseases / ultrasonography. Uterine Diseases / veterinary

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  • (PMID = 16458958.001).
  • [ISSN] 0093-691X
  • [Journal-full-title] Theriogenology
  • [ISO-abbreviation] Theriogenology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Dopamine Agonists; 0 / Ergolines; 0 / Prostaglandins, Synthetic; 4208238832 / Cloprostenol; LL60K9J05T / cabergoline
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14. 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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15. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • 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


16. 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


17. 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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