Endometriosis: Conventional Treatment Approaches

Medical treatment of endometriosis includes both pharmaceutical and surgical approaches. Pharmaceutical treatments provide only suppression of the disease; they do not exact a cure. Decisions regarding treatment are based on endometriosis severity and staging, symptom picture, and ultimately, the woman’s needs and goals, for example, desire for children in the future. For women experiencing mild symptoms (or none) and for women who are close to menopause, the appropriate treatment may be to do nothing. For women with mild to moderate symptoms, and those who desire pregnancy, the appropriate pharmacologic therapy should be considered, and if necessary, can be combined with conservative surgery. It should be noted that, in spite of medical treatment, endometriosis has a high recurrence rate of 5% to 20% unless total hysterectomy and bilateral oophorectomy are performed. With pharmacologic interventions, pain typically resumes upon cessation of medications, although initially with pain that is less intense than prior to treatment. Pain relief, pregnancy rates, and recurrence rates are similar with all treatment methods. The goal of pharmaceutical treatment is to interrupt patterns of endometrial stimulation and bleeding. Read more […]

Fibrocystic Breast

Fibrocystic Breasts And Breast Pain Benign breast conditions are a common finding in clinical practice, with fibrocystic breast changes and fibroadenomas occurring in 60% to 90% of all women. The hallmark of fibrocystic breast changes is that the cysts fluctuate in size and shape, may entirely disappear and reappear cyclically, and are associated with hormonal changes in the menstrual cycle. Women with this condition describe their breasts as feeling lumpy, “ropey,” and tender. The changes occur bilaterally. Fibroadenomas are mobile, solid, firm, rubbery masses that typically occur singly, and are not usually painful. They are second only to fibrocystic changes as the most common of the benign breast conditions, and are commonly found in women in their 20s. Breast tenderness that accompanies the menstrual cycle is known as cystic mastalgia.’ Cyclic mastalgia may be associated with other premenstrual complaints. The terms benign breast disorder and benign breast disease are unfortunate misnomers, as they are neither a disorder nor disease. In only a small percentage of cases are the atypical ductal and lobular hyperplasias associated with increased risk of breast carcinoma. Practitioners consulting with women for Read more […]

ANABOLIC AGENTS

ANABOLIC AGENTS promote tissue growth by increasing metabolic processes involving protein synthesis. Most anabolic agents are androgens with a modified structure to enhance anabolic effects, and minimize others. Many have been produced. Stanozolol is a steroid which can be used to treat hereditary angio-oedema. Oxymetholone is used to treat aplastic anaemia. Nandrolone is similar to testosterone (though with far fewer masculinizing effects), and can be used to treat osteoporosis and aplastic anaemia. Some other agents with andbolic-androgenic steroid activity are danazol, fluoxymesterone, metandienone, methyltestosterone and oxandrolone. Anabolic steroids are also used, usually illegally, by some athletes as an ergogenic aid (a technique or substance used for the purpose of enhancing performance). The doses used for these purposes are many times the therapeutic dose, and some products may be used that are licensed only as ‘growth-promoters’ in cattle rearing. The health risks are considerable and well documented. A number of different agents are used as growth promoters, and use and licensing varies greatly between countries. In the USA, the Food and Drug Administration has allowed androsterone, estradiol, progesterone, Read more […]