Endometrial thickness after menopause: effect of hormone replacement

Article Abstract:

Many women choose to undergo hormone replacement therapy with either estrogen or a combination of estrogen and progesterone following menopause. This therapy can help prevent many of the problems postmenopausal women encounter, such as osteoporosis (loss of bone density). Replacement therapy can have side effects of its own. When estrogen is given alone, there is an increased risk for thickening of the endometrium, the layer that lines the uterine wall, and there is an increased risk for uterine cancer. Progesterone can counter the negative effects of estrogen, but it can also cause side effects, such as vaginal bleeding, which is also a symptom of endometrial thickening and of uterine cancer. When symptoms that indicate a possibility of cancer are seen, a sample of uterine tissue is often obtained for examination. Changes in endometrial thickness can be detected with ultrasound (US) imaging. This study examined the normal ranges of endometrial thickness in postmenopausal women, grouped by which type of replacement therapy, if any, they were undergoing. Women in each group were designated for uterine biopsy for further evaluation depending on the endometrial thickness, as determined by US. Four groups of women were examined. Group 1 consisted of 58 women receiving no hormones, group 2 included 10 women receiving estrogen alone, group 3 comprised 9 women receiving continued combined therapy, and group 4 consisted of 35 women receiving sequential therapy. The average endometrial thickness was not significantly different between any of the groups (0.52 cm, 0.68 cm, 0.53 cm, 0.66 cm, respectively). In 16 women - 7 (12 percent) from group 1, 3 ( 30 percent) from group 2, and 6 (17 percent) from group 4 - thickness was greater than 1.0 cm. Biopsy results were available for eight of these women. Uterine cancer was diagnosed in one of the women. The results indicate that women receiving either estrogen alone or continuous estrogen and progesterone should have a biopsy if endometrial thickness according to US is greater than 0.8 cm, and any woman with a thickness of greater than 1.5 cm should have a biopsy, regardless of therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hormone therapy, Estrogen, Estrogens, Progestational hormones, Endometrial hyperplasia

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Prevalence of simple adnexal cysts in postmenopausal women

Article Abstract:

The prognosis for ovarian cancer is usually poor because it is usually not detected until it has reached an advanced stage. Early detection is difficult as there are usually no symptoms until the latter stages of the disease and it is hard to detect an increase in the size of the ovaries during a normal pelvic examination. Ultrasound (US) imaging has been suggested for use in detecting ovarian cancer in its early stages and differentiating it from noncancerous ovarian cysts, which are frequently seen in premenopausal women. Cysts detected in postmenopausal women are more likely to be cancerous and surgery is usually performed when they are found. This study sought to examine the use of US in detecting noncancerous cysts in postmenopausal women and the effects of hormone replacement therapy on the development of such cysts. US examination was performed on 149 women at least one year past menopause who had no symptoms of ovarian problems. Data on hormone replacement therapy, time since menopause began, and other characteristics were obtained. Simple cysts that were not cancerous were found by US in 22 subjects. The presence of such cysts did not correlate with either the use of or the type of hormone replacement therapy. There was no correlation between the time since menopause occurred and the presence of these cysts. These results indicate that noncancerous cysts are also common in postmenopausal women and that US may be useful in characterizing them. This can decrease the incidence of unnecessary surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Ovarian cancer, Postmenopausal women, Cysts

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Disparity of amniotic fluid volume and fetal size: problem of the stuck twin - US studies

Article Abstract:

Ultrasound (US), the use of soundwaves to image anatomic details, has been used effectively to follow the progress of pregnancies. US can be used to diagnose the grave prognostic finding of 'stuck twin'; this is diagnosed by a shared chorion, and individual amniotic sacks (the chorion and amnion are fetal membranes). There is also a marked disparity of fluid surrounding each of the twins. The twins are also at greater risk due to the additional complication of twin transfusion syndrome (TTS). TTS results from a shared vascular connection between the twins and the possibility that one of the twins acts as a donor of blood to the larger fetus. US evidence is clear and allows the course of a stuck twin pregnancy to be followed in a non-invasive manner. The current study reports on the US findings and clinical resolution of 25 cases of stuck twin. In a series of 307 twin pregnancies, 16 cases (five percent) of stuck twin were reviewed. This result is probably higher than the general occurrence since this hospital setting is a center for high risk pregnancies. The paper develops the criteria for the sonographic diagnosis of stuck twins, and establishes the correlation of this condition with TTS. The fact that this class of pregnancy has a characteristic appearance allows the method to be used as an important adjunct to the therapeutic management of such cases.

Case studies, Medical examination, Birth defects, Pregnancy, Complications of, Pregnancy complications, Amniotic fluid, Multiple birth, Diagnosis, Ultrasonic, Diagnostic ultrasonography, Prenatal ultrasonography, Ultrasonics in obstetrics

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