Hormonal treatment in nonmalignant gynaecological conditions

In: MRCOG Part One · 2015 · pp. 413–422 · doi:10.1017/cbo9781107587519.028 · W2557110104
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This paper reviews the use of hormonal treatments for nonmalignant gynecological conditions, discussing their mechanisms and clinical applications.

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This chapter reviews hormonal treatment approaches for nonmalignant gynaecological conditions, summarizing relevant pharmacologic evidence and key considerations for hormone use. It covers foundational background and references major trial and systematic review literature on hormone effects in areas such as endometrium (including risks of endometrial hyperplasia and changes in histology) and outcomes associated with estrogen/progestin therapy, while also noting that the evidence base includes randomized trials and meta-analyses. A major limitation explicitly reflected by the chapter format is that it provides a high-level educational synthesis rather than presenting original patient-level methods or outcomes. Relevance to endometriosis: endometriosis is mentioned through cited evidence on oral contraceptives for pain associated with endometriosis and broader “drug treatment of endometriosis,” though the chapter’s main focus is hormonal treatment in nonmalignant gynaecological conditions.

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Abstract

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MRCOG Part One Buy print or eBook [Opens in a new window] Your Essential Revision Guide - Your Essential Revision Guide MRCOG PART ONE - Your Essential Revision Guide MRCOG PART ONE - Copyright page - Contents - About the authors - Book part - Glossary - 1 Introduction - 2 Anatomy - 3 Biochemistry - 4 Biophysics - 5 Embryology - 6 Endocrinology - 7 Genetics - 8 Immunology - 9 Microbiology - 10 Pathology - 11 Pharmacology - Contents - Chapter 26 Pharmacokinetics, pharmacodynamics and teratogenesis - Chapter 27 Non-Hormonal Therapy in obstetrics and gynaecology - Chapter 28 Hormonal treatment in nonmalignant gynaecological conditions - 12 Physiology - 13 Statistics and epidemiology - 14 Data interpretation - Index - References from 11 - Pharmacology Published online by Cambridge University Press: 27 January 2017 Book contents - Your Essential Revision Guide MRCOG PART ONE - Your Essential Revision Guide MRCOG PART ONE - Copyright page - Contents - About the authors - Book part - Glossary - 1 Introduction - 2 Anatomy - 3 Biochemistry - 4 Biophysics - 5 Embryology - 6 Endocrinology - 7 Genetics - 8 Immunology - 9 Microbiology - 10 Pathology - 11 Pharmacology - Contents - Chapter 26 Pharmacokinetics, pharmacodynamics and teratogenesis - Chapter 27 Non-Hormonal Therapy in obstetrics and gynaecology - Chapter 28 Hormonal treatment in nonmalignant gynaecological conditions - 12 Physiology - 13 Statistics and epidemiology - 14 Data interpretation - Index - References A summary is not available for this content so a preview has been provided. Please use the Get access link above for information on how to access this content. - Type - Chapter - Information - MRCOG Part OneYour Essential Revision Guide, pp. 413 - 422Publisher: Cambridge University PressPrint publication year: 2016 Whitehead, M I, Townsend, P T, Pryse-Davies, J, Ryder, TA, King, RJB. Effects of estrogens and progestins on the biochemistry and morphology of the postmenopausal endometrium. New Engl J Med 1981;305:1599–605.10.1056/NEJM198112313052701CrossRefGoogle ScholarPubMed Lethaby, A, Irvine, G, Cameron, I. Cyclical progestogens for heavy menstrual bleeding. Cochrane Database Syst Rev 2008;(4): C D 001016.pub2.Google Scholar Farquhar, C, Brown, J. Oral contraceptive pills for heavy menstrual bleeding. Cochrane Database Syst Rev 2009;(3):C D 000154.pub2.Google Scholar Lethaby, A E, Cooke, I, Rees, M. Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding. Cochrane Database Syst Rev 2005;(2):C D 002126.pub2.CrossRefGoogle Scholar Beaumont, H, Augood, C, Duckitt, K, Lethaby, A. Danazol for heavy menstrual bleeding. Cochrane Database Syst Rev 2007;(2):C D 001017.pub2.Google Scholar Wong, C L, Farquhar, C, Roberts, H, Proctor, M. Oral contraceptive pill for primary dysmenorrhoea. Cochrane Database Syst Rev 2009(4):C D 002120.pub3.10.1002/14651858.CD002120.pub2CrossRefGoogle Scholar Davis, L, Kennedy, S S, Moore, J, Prentice, A. Oral contraceptives for pain associated with endometriosis. Cochrane Database Syst Rev 2007;(3):C D 001019.pub2.Google Scholar Schweppe, K W. Drug treatment of endometriosis. Contemporary Clinical Gynecology and Obstetrics 2001;2:167–77.Google Scholar Farmer, J E, Prentice, A, Breeze, A, et al. Gonadotrophin-releasing hormone analogues for endometriosis: bone mineral density. Cochrane Database Syst Rev 2003;(4):C D 001297.Google Scholar Beral, V, Banks, E, Reeves, G. Evidence from randomised trials on the long-term effects of hormone replacement therapy. Lancet 2002;360:942–4.10.1016/S0140-6736(02)11032-4CrossRefGoogle ScholarPubMed Beral, V, Banks, E, Reeves, G, Appleby, P. Use of H R T and the subsequent risk of cancer. J Epidemiol Biostat 1999;4:191–210.Google Scholar Furness, S, Roberts, H, Majoribanks, J, Lethaby, A. Hormone therapy in postmenopausal women and risk of endometrial hyperplasia. Cochrane Database Syst Rev 2012;(2):C D 000402.pub4.Google Scholar Brinton, L A, Hoover, R N. Estrogen replacement therapy and endometrial cancer risk: unresolved issues. The Endometrial Cancer Collaborative Group. Obstet Gynecol 1993;81:265–71.Google ScholarPubMed Grady, D, Gebretsadik, T, Kerlikowske, K, Ernster, V, Petitti, D. Hormone replacement therapy and endometrial cancer risk: a meta-analysis. Obstet Gynecol 1995;85:304–13.CrossRefGoogle ScholarPubMed The Writing Group for the P E P I Trial. Effects of hormone replacement therapy on endometrial histology in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (P E P I) Trial. J A M A 1996;275:370–5.Google Scholar Beresford, S A, Weiss, N S, Voigt, L F, McKnight, B. Risk of endometrial cancer in relation to use of oestrogen combined with cyclic progestagen therapy in postmenopausal women. Lancet 1997;349:458–61.CrossRefGoogle ScholarPubMed Rossouw, J E, Anderson, G L, Prentice, R L, LaCroix, A Z, Kooperberg, C, Stefanick, M L, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. J A M A 2002;288:321–33.Google ScholarPubMed Daly, E, Vessey, M P, Hawkins, M M, Carson, J L, Gough, P, Marsh, S. Risk of venous thromboembolism in users of hormone replacement therapy. Lancet 1996;348:977–80.Google ScholarPubMed Colditz, G A, Hankinson, S E, Hunter, D J, et al. The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. New Engl J Med 1995;332:1589–93.CrossRefGoogle ScholarPubMed Anderson, G L, Limacher, M, Assaf, A R, Bassford, T, Beresford, S A, Black, H, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial. J A M A 2004;291:1701–12.Google ScholarPubMed Rymer, J, Chapman, M G, Fogelman, I. Effect of tibolone on postmenopausal bone loss. Osteoporosis Int 1994;4:314–17.10.1007/BF01622189CrossRefGoogle ScholarPubMed Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. 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