RESUMO
OBJECTIVE: To characterize human endometrial HOXA10 expression in patients using a copper intrauterine device (IUD). DESIGN: Case-control study. SETTING: Academic medical center. PATIENT(S): Women using copper IUDs. INTERVENTION(S): Immunohistochemical analysis of endometrial HOXA10 expression in biopsy samples obtained from 24 women using a copper Paraguard T380A as well as in samples obtained from 10 normal cycling women who were not using an IUD or hormonal contraceptives. MAIN OUTCOME MEASURE(S): Endometrial HOXA10 expression. RESULT(S): Endometrial HOXA10 expression was markedly decreased in the biopsy samples obtained from women using the IUD contraceptive when compared with controls. The mean H score for endometrial stromal cell HOXA10 expression in samples obtained from women using the Paraguard IUD was 0.21 compared with 2.2 in the control endometrial biopsy samples. Endometrial glandular expression of HOXA10 was absent in all IUD users. CONCLUSION(S): Decreased endometrial HOXA10 expression was apparent in women who use a copper IUD. Expression of HOXA10 is essential for endometrial receptivity. A novel mechanism of copper IUD action involves suppression of genes required for endometrial receptivity. The dramatic decrease of endometrial HOXA10 in response to IUD use may contribute to contraceptive efficacy.
Assuntos
Cobre , Endométrio/metabolismo , Fertilidade/fisiologia , Proteínas de Homeodomínio/metabolismo , Dispositivos Intrauterinos , Adulto , Fatores Etários , Biópsia , Endométrio/citologia , Feminino , Proteínas Homeobox A10 , Humanos , Imuno-Histoquímica , Ciclo Menstrual/metabolismo , Células Estromais/metabolismo , Adulto JovemRESUMO
Evaluation and management strategies for addressing abnormal bleeding, discharge, urinary symptoms, and sexuality amongst elderly women are presented.
Assuntos
Doenças dos Genitais Femininos , Avaliação Geriátrica , Idoso , Feminino , Doenças dos Genitais Femininos/diagnóstico , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Femininos/terapia , Humanos , Assistência de Longa Duração , Exame Físico , Sexualidade , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Dermatopatias/terapia , Incontinência Urinária/diagnóstico , Incontinência Urinária/etiologia , Incontinência Urinária/terapia , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/etiologia , Hemorragia Uterina/terapia , Descarga Vaginal/diagnóstico , Descarga Vaginal/etiologia , Descarga Vaginal/terapiaRESUMO
The objective of this study was to demonstrate the applicability of laser doppler flowmetry to pre- and posthysterectomy vaginal blood flow assessment. We used laser Doppler flowmetry to measure pre-and postoperational vaginal blood flow in 8 premenopausal women undergoing benign hysterectomies; we also measured serum E2, FSH, FT and administered a brief sexual function questionnaire. We analyzed data using two tailed t-test for paired samples. We found no significant differences at the P <.05 level of significance for vaginal blood flow. Accompanying values of estradiol, FSH, and free testosterone remained unchanged as well. A brief sexual function assessment revealed improvement or stability of libido, arousal, orgasm, and partner relatedness. Laser doppler flowmetry is an objective, reproducible measure of vaginal blood flow and may be used to investigate posthysterectomy sexual function.
Assuntos
Coito , Histerectomia , Fluxometria por Laser-Doppler , Libido , Vagina/irrigação sanguínea , Adulto , Coito/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Pré-Menopausa , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de TempoRESUMO
The validity of the practice of routine examination of mentally handicapped women under general anesthesia was evaluated via a retrospective chart review at Yale New Haven hospital for a five-year period. In the absence of a history of abnormal bleeding or discharge, this select population of low risk women had a zero incidence of gonorrhea and chlamydia, and no cervical dysplasia.