Changes in migraine before and after menopause in Japanese climacteric women.

Introduction We conducted a questionnaire survey of Japanese women with migraine who presented at neurology and gynecology headache clinics to assess how the frequency and severity of migraine in pre-, peri-, and postmenopausal women changed as compared with what they experienced in their 20s and 30s. Methods The study group comprised 171 women with migraine (mean age 48.5) at the time of the survey. They were requested to fill out a self-administered questionnaire. Results (1) The current frequency and severity of migraine were claimed to be higher than that in their 20s and 30s. (2) More than 50% of postmenopausal women responded that migraines were currently less frequent than in their 20s and 30s. (3) The largest proportion of postmenopausal women responded that migraine was currently less severe than during any other period. Conclusions Our survey demonstrated that there are trends toward fewer migraine attacks and milder symptoms in postmenopausal Japanese women.

A vaginal fibroepithelial stromal polyp: a case report with magnetic resonance images.

A fibroepithelial stromal polyp is a benign soft tissue tumour that can occur in the vagina, vulva and uterine cervix. Magnetic resonance imaging (MRI) findings have been reported in patients with vulvar fibroepithelial stromal polyps, not in those with vaginal polyps. We present MRI findings of vaginal fibroepithelial stromal polyp in a postmenopausal female. A 1 to 2 cm firm vaginal mass arising from the left side of the vaginal wall with hypointense signal changes on T1W MRI was identified. A well-defined vaginal mass (1 cm diameter) was detected with inhomogeneous signal intensity on T2W images. However, a major portion had high signal intensity on diffusion-weighted images. A benign vaginal lesion with oedematous changes or myxoid degeneration was suspected. Vaginal resection was performed, and fibroepithelial stromal polyp was pathologically diagnosed. MRI may be a useful non-invasive modality for preoperatively diagnosing vaginal fibroepithelial stromal polyps.

Epithelioid leiomyoma of the uterus: A case report with magnetic resonance imaging findings.

Epithelioid leiomyoma of the uterus is rare, and its prognostic factors have not been well established. Moreover, radiologic findings of this disease have not been previously documented. This is a case of a 49-year-old woman with epithelioid leiomyoma of the uterus. Magnetic resonance imaging (MRI) revealed a heterogeneous high-intensity mass with multiple ordinary uterine leiomyomas. The mass showed a slightly diffusion-restricted site. Since benign tumors could not be confidently diagnosed using these MRI findings, total abdominal hysterectomy with bilateral salpingectomy was performed, and a pathological diagnosis of epithelioid leiomyoma of the uterus was established. Microscopically, this lesion showed edematous changes and cyst formation, causing a heterogeneous appearance on T2-weighted images. In addition, the diffusion-restricted site is considered to be consistent with areas of solid and dense proliferation of tumor cells. The patient survived and was well 10 months after the surgery. It is important to recognize this benign variant of leiomyoma with an unusual appearance, to provide appropriate therapeutic management.

Two case reports of less invasive surgery using interceed (oxidized regenerated cellulose) absorbable adhesion barrier for vaginoplasty in Meyer-Rokitansky-Küsterhauser syndrome.

The objective of this case study is to present our experiences of a surgical innovative approach for vaginal agenesis using Interceed. The present report involved two subjects diagnosed to have vaginal agenesis due to Mayer-Rokitansky-Kiister-Hauser syndrome. Operation procedure involved the creation of a neovaginal tunnel and then a mold wrapped with Interceed was placed in the neovagina. The duration of surgery was around 30 min with minimal blood loss. Hospitalization stay was only 2 days after the procedure, with no operative and postoperative complications. Epithelialization of the neovagina was achieved within a month after surgery. The patients were satisfied with the outcome. The neovagina created with this procedure was the same with the normal adult vagina histologically and physiologically. In conclusion, the creation of a neovagina using Interceed resulted in favorable outcome and this approach may be a potential alternative to the management of vaginal agenesis.

Prescription pattern and trend of oral contraceptives in Japan: A descriptive study based on pharmacy claims data (2006 - 2014).

OBJECTIVE: The use of combined oral contraceptives (COC) as a contraceptive method is still limited in Japan, used only by 1.1% of women of reproductive age. The usage pattern of COC, such as continuation and preparation switch, between COC generations was investigated using large datasets. METHODS: This descriptive study spanning from 2006 to 2014 used nationwide prescriptions based on administrative databases, including both reimbursed and non-reimbursed drugs. All the first-time COC users were included as a cohort. Usage patterns considering trends, continuation, and switch of COC generations were also investigated. RESULTS: Of the 38,123 patients, the overall mean age at initial use of COC was 32.9 years. Of the first-time users, 51.2%, 23.7%, 5.6%, and 19.5% received first-, second-, third-, and fourth-generation COCs, respectively. The overall rate of continuation was 59.1%, and the rate of first-time use with switching to other generations within 180 days was 3.1%. CONCLUSION: We revealed the actual usage of COC in Japan with frequent prescriptions of first- or fourth-generation COCs and relatively high age at initial use. Moreover, the COC continuation rate was low, and switch was limited. Further studies into its proper usage are recommended.

Association study between epidermal growth factor receptor and epidermal growth factor polymorphisms and endometriosis in a Japanese population.

OBJECTIVE: We investigated a possible association between endometriosis and polymorphisms in the genes encoding epidermal growth factor (EGF) receptor (EGFR) and EGF in a Japanese population. METHODS: We compared the distribution of the Egfr+2073 A/T and Egf+61 G/A polymorphisms by polymerase chain reaction-restriction fragment length polymorphism analysis in 146 affected women and 181 controls. RESULTS: No significant differences in the frequency and genotype distribution of the Egfr+2073 A/T and Egf+61 G/A polymorphisms were found between endometriosis patients with all disease stages and controls. Stratification by disease stage had no effect on the results. CONCLUSION: The Egfr+2073 A/T and Egf+61 G/A polymorphisms are not associated with an increased risk of endometriosis in a Japanese population.