Pub Date : 2024-05-09DOI: 10.1177/22840265241249239
Takashi Matsushima, A. Nagashima, Eika Harigane, Asako Watanabe, Hiroki Shinmura, N. Ouchi, Ryuhei Kurashina, Shunji Suzuki, Shinya Iida
To determine the effects of relugolix administration for uterine adenomyosis on uterine volume and subjective symptoms. This retrospective observational study included 30 patients with clinical symptoms of endometriosis complicated with uterine adenomyosis who were treated with 40 mg/day of relugolix orally for >16 weeks. The uterine volume was calculated pre- and post-administration, and the volume percentage post-administration. Furthermore, the presence or absence of subjective post-administration symptoms and adverse effects were also examined. The median (interquartile range) long diameter, short diameter, width, and volume of the patients’ uteri pre- and post-administration of relugolix significantly decreased from 9.63 (9.02–11.00) to 8.00 (6.84–9.12) cm, 6.47 (5.58–8.02) to 5.00 (4.26–5.63) cm, 6.91 (5.68–8.46) to 5.49 (4.58–6.00) cm, and 221.04 (146.52–390.26) to 111.90 (71.59–165.84) cm3, respectively ( p < 0.001 for all four items). Additionally, the uterus volume post-administration was 48.30% (33.88–62.54%) of that pre-administration. Heavy menstrual bleeding, dysmenorrhea, and chronic pelvic pain occurred in 23 (76.7%), 21 (70.0%), and 13 (43.3%) of the 30 patients, respectively; however, all patients experienced resolution of all symptoms. Nine, three, and one patients had hot flashes, mild arthralgia, and a mild headache, respectively. No cases of persistent irregular or heavy bleeding were observed during treatment. Relugolix contributes to volume reduction and eliminates subjective symptoms of uterine adenomyosis, suggesting that it is an effective treatment for uterine adenomyosis.
{"title":"Gonadotropin-releasing hormone antagonist (relugolix) for treatment of uterine adenomyosis with symptomatic endometriosis","authors":"Takashi Matsushima, A. Nagashima, Eika Harigane, Asako Watanabe, Hiroki Shinmura, N. Ouchi, Ryuhei Kurashina, Shunji Suzuki, Shinya Iida","doi":"10.1177/22840265241249239","DOIUrl":"https://doi.org/10.1177/22840265241249239","url":null,"abstract":"To determine the effects of relugolix administration for uterine adenomyosis on uterine volume and subjective symptoms. This retrospective observational study included 30 patients with clinical symptoms of endometriosis complicated with uterine adenomyosis who were treated with 40 mg/day of relugolix orally for >16 weeks. The uterine volume was calculated pre- and post-administration, and the volume percentage post-administration. Furthermore, the presence or absence of subjective post-administration symptoms and adverse effects were also examined. The median (interquartile range) long diameter, short diameter, width, and volume of the patients’ uteri pre- and post-administration of relugolix significantly decreased from 9.63 (9.02–11.00) to 8.00 (6.84–9.12) cm, 6.47 (5.58–8.02) to 5.00 (4.26–5.63) cm, 6.91 (5.68–8.46) to 5.49 (4.58–6.00) cm, and 221.04 (146.52–390.26) to 111.90 (71.59–165.84) cm3, respectively ( p < 0.001 for all four items). Additionally, the uterus volume post-administration was 48.30% (33.88–62.54%) of that pre-administration. Heavy menstrual bleeding, dysmenorrhea, and chronic pelvic pain occurred in 23 (76.7%), 21 (70.0%), and 13 (43.3%) of the 30 patients, respectively; however, all patients experienced resolution of all symptoms. Nine, three, and one patients had hot flashes, mild arthralgia, and a mild headache, respectively. No cases of persistent irregular or heavy bleeding were observed during treatment. Relugolix contributes to volume reduction and eliminates subjective symptoms of uterine adenomyosis, suggesting that it is an effective treatment for uterine adenomyosis.","PeriodicalId":503661,"journal":{"name":"Journal of Endometriosis and Pelvic Pain Disorders","volume":" 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.1177/22840265241248488
Panagiota Tragantzopoulou
Endometriosis, a chronic condition affecting women worldwide, remains a complex and enigmatic disease. Despite its appearance and debilitating symptoms, the lack of sufficient information about endometriosis often leads to misconceptions and stigmatization of women. This literature review aims to shed light on the phenomenon of stigma surrounding endometriosis and its profound impact on the mental health of affected women. The search for relevant literature was conducted in the databases PubMed, ScienceDirect, and Scopus. Inclusion criteria for the studies were as follows: patients with endometriosis, exploration of the phenomenon of stigma in this sample, qualitative or quantitative design, publication after 2000, and written in English. Out of the total of 478 articles identified from the three databases, 6 articles met the inclusion criteria for this literature review. The review’s findings indicate that women with endometriosis encounter stigma from an early age, extending from their school years into adulthood. Employers and family members often question the severity of their pain, while menstrual pain is unjustly normalized as something women should endure. The impact of this stigma and criticism on the mental health of these women is profound, leading to feelings of despair, social exclusion, and even suicidal thoughts. In conclusion, this literature review underscores the pressing need for increased awareness and efforts to address the stigma surrounding endometriosis.
{"title":"Endometriosis and stigmatization: A literature review","authors":"Panagiota Tragantzopoulou","doi":"10.1177/22840265241248488","DOIUrl":"https://doi.org/10.1177/22840265241248488","url":null,"abstract":"Endometriosis, a chronic condition affecting women worldwide, remains a complex and enigmatic disease. Despite its appearance and debilitating symptoms, the lack of sufficient information about endometriosis often leads to misconceptions and stigmatization of women. This literature review aims to shed light on the phenomenon of stigma surrounding endometriosis and its profound impact on the mental health of affected women. The search for relevant literature was conducted in the databases PubMed, ScienceDirect, and Scopus. Inclusion criteria for the studies were as follows: patients with endometriosis, exploration of the phenomenon of stigma in this sample, qualitative or quantitative design, publication after 2000, and written in English. Out of the total of 478 articles identified from the three databases, 6 articles met the inclusion criteria for this literature review. The review’s findings indicate that women with endometriosis encounter stigma from an early age, extending from their school years into adulthood. Employers and family members often question the severity of their pain, while menstrual pain is unjustly normalized as something women should endure. The impact of this stigma and criticism on the mental health of these women is profound, leading to feelings of despair, social exclusion, and even suicidal thoughts. In conclusion, this literature review underscores the pressing need for increased awareness and efforts to address the stigma surrounding endometriosis.","PeriodicalId":503661,"journal":{"name":"Journal of Endometriosis and Pelvic Pain Disorders","volume":"99 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141022043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-19DOI: 10.1177/22840265241231722
Nanda Yuli Rahmawati, Fadhil Ahsan, Budi Santoso, Alfin Firasy Mufid, A. Sa’adi, S. Dwiningsih, Arif Tunjungseto, M. Y. A. Widyanugraha
TNF-α, LT-α, and sCD40L belong to the TNF superfamily and play a pivotal role in chronic inflammatory disease. Yet, these soluble molecules are largely unexplored in endometriosis cases with infertility. The present study aimed to evaluate serum and peritoneal fluid levels of these molecules and correlate its level to the endometriosis severity. Peripheral blood and peritoneal fluid samples were obtained from 87 infertility cases who underwent laparoscopy, consisting of 44 endometriotic women and 43 non-endometriotic women. The levels of TNF-α, LT-α, and sCD40L were determined using ELISA. Serum and peritoneal TNF-α levels were significantly elevated in the endometriosis group compared to the control group ( p = 0.028; p = 0.027), but not the sCD40L and LT-α level. Serum and peritoneal TNF-α levels were significantly different between late-endometriosis (stage III or IV) compared to the control group ( p = 0.026, p = 0.041, respectively). Moreover, the serum LT-α level was significantly higher in late-endometriosis cases compared to the early-endometriosis (stage I or II) cases ( p = 0.03) and showed a positive correlation with endometriosis rASRM score ( p = 0.001). ROC curve analysis showed a significant diagnostic value of serum LT-α in differentiating the late cases to the early endometriosis patients (AUC = 0.751, p = 0.007). A negative correlation between LT-α and total Endometriosis Fertility Index (EFI) score was also observed ( p = 0.012). Severe endometriosis and lower EFI score are associated with higher serum LT-α level. Serum LT-α is a potential staging biomarker among endometriosis cases. Serum and peritoneal TNF-α levels were elevated in women with severe endometriosis among infertility cases. Further study should address the role and predictive value of LT-α in endometriosis-related infertility.
{"title":"Role of TNF superfamily members lymphotoxin-α, sCD40L, and TNF-α in endometriosis-related infertility","authors":"Nanda Yuli Rahmawati, Fadhil Ahsan, Budi Santoso, Alfin Firasy Mufid, A. Sa’adi, S. Dwiningsih, Arif Tunjungseto, M. Y. A. Widyanugraha","doi":"10.1177/22840265241231722","DOIUrl":"https://doi.org/10.1177/22840265241231722","url":null,"abstract":"TNF-α, LT-α, and sCD40L belong to the TNF superfamily and play a pivotal role in chronic inflammatory disease. Yet, these soluble molecules are largely unexplored in endometriosis cases with infertility. The present study aimed to evaluate serum and peritoneal fluid levels of these molecules and correlate its level to the endometriosis severity. Peripheral blood and peritoneal fluid samples were obtained from 87 infertility cases who underwent laparoscopy, consisting of 44 endometriotic women and 43 non-endometriotic women. The levels of TNF-α, LT-α, and sCD40L were determined using ELISA. Serum and peritoneal TNF-α levels were significantly elevated in the endometriosis group compared to the control group ( p = 0.028; p = 0.027), but not the sCD40L and LT-α level. Serum and peritoneal TNF-α levels were significantly different between late-endometriosis (stage III or IV) compared to the control group ( p = 0.026, p = 0.041, respectively). Moreover, the serum LT-α level was significantly higher in late-endometriosis cases compared to the early-endometriosis (stage I or II) cases ( p = 0.03) and showed a positive correlation with endometriosis rASRM score ( p = 0.001). ROC curve analysis showed a significant diagnostic value of serum LT-α in differentiating the late cases to the early endometriosis patients (AUC = 0.751, p = 0.007). A negative correlation between LT-α and total Endometriosis Fertility Index (EFI) score was also observed ( p = 0.012). Severe endometriosis and lower EFI score are associated with higher serum LT-α level. Serum LT-α is a potential staging biomarker among endometriosis cases. Serum and peritoneal TNF-α levels were elevated in women with severe endometriosis among infertility cases. Further study should address the role and predictive value of LT-α in endometriosis-related infertility.","PeriodicalId":503661,"journal":{"name":"Journal of Endometriosis and Pelvic Pain Disorders","volume":"94 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140452226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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