Disease relevance of Menorrhagia

• A disturbance in the oestrogen/progesterone ratio as a consequence of localised hypertension at the ovary, when the utero-ovarian arterial loop is occluded at tubal ligation, is proposed as a possible cause of oestrogen deficiency syndrome, dysfunctional uterine bleeding, and menorrhagia after tubal ligation [1].
• After hysterectomy for menorrhagia due to atypical endometrial hyperplasia, the finding of myometrial lipofuscinosis led to a demonstration of vitamin E deficiency [2].
• We describe a 42-year-old woman who developed superior sagittal and left transverse sinus thrombosis associated with prolonged epsilon-aminocaproic acid therapy for menorrhagia [3].
• von Willebrand's disease diagnosed after menorrhagia worsened from levonorgestrel intrauterine system [4].
• Recently we have found that the use of levonorgestrel-releasing intrauterine system (IUS) is effective in the long-term contraception and management of menorrhagic women with uterine myomas because of a striking reduction in menorrhagia [5].

High impact information on Menorrhagia

• The levonorgestrel-releasing intrauterine system (IUS) is an effective medical treatment for menorrhagia [6].
• Hypermenorrhea associated with ritonavir [7].
• Can nifedipine provoke menorrhagia [8]?
• Naproxen in menorrhagia [9].
• Ethamsylate in treatment of menorrhagia [10].

Chemical compound and disease context of Menorrhagia

• Tranexamic acid: a review of its use in the management of menorrhagia [11].
• Tranexamic acid 1.5 g three times daily for 5 days also significantly reduced menstrual blood loss in women with intrauterine contraceptive device-associated menorrhagia compared with diclofenac sodium (150 mg in three divided doses on day 1 followed by 25 mg three times daily on days 2-5) or placebo [11].
• Tranexamic acid and mefenamic acid are among the most effective first-line drugs used to treat menorrhagia [12].
• Prostaglandin synthetase inhibitors can be useful, with up to a third of women with menorrhagia benefiting from a reduction of between 25% and 35% in blood loss [13].
• CONCLUSIONS: Desmopressin may be a useful therapeutic tool for many women with IUD-related menorrhagia [14].
• Pending ongoing comparative trials in bleeding disorder-related menorrhagia of intranasal desmopressin (DDAVP), tranexamic acid and further study of the levonorgestrel intrauterine device, specific recommendations cannot be made at present regarding whether one intervention is superior to the other [15].

Biological context of Menorrhagia

• Down-regulation of angiopoietin-1 expression in menorrhagia [16].
• Fibroblast growth factor receptor-1 is a critical component for endometrial remodeling: localization and expression of basic fibroblast growth factor and FGF-R1 in human endometrium during the menstrual cycle and decreased FGF-R1 expression in menorrhagia [17].
• Cyclic changes in endometrial tissue plasminogen activator and plasminogen activator inhibitor type 1 in women with normal menstruation and essential menorrhagia [18].
• Effects of mefenamic acid on menstrual hemostasis in essential menorrhagia [19].
• If von Willebrand disease is suspected (because of menorrhagia with or without other mucous membrane bleeding, a positive family history, and a prolonged activated partial thromboplastin time), more specific laboratory tests for this disease should be done [20].

Anatomical context of Menorrhagia

• These results suggest that the angiopoietin/Tie-2 system promotes vascular remodeling in endometrium and loss of normal Ang-1 expression may contribute to the excessive blood loss observed in menorrhagia [16].
• Endometrial vascular smooth muscle oestrogen and progesterone receptor distribution in women with and without menorrhagia [21].
• The data indicate an increased ability of the endo- and myometrium from women with menorrhagia to produce prostaglandins with vasodilator and platelet anti-aggregatory properties, viz., prostacyclin and prostaglandin E2 [22].
• Use of goserelin depot, a gonadotropin-releasing hormone agonist, for the treatment of menorrhagia and severe anemia in women with leiomyomata uteri [23].
• The effect of electric stimulation of the uterine cervix on vasopressin and prolactin secretions was investigated in 16 patients with uterine myomas and/or hypermenorrhea [24].

Gene context of Menorrhagia

• Finally, the role of VEGF in menorrhagia is assessed [25].
• We found that the frequency of GSTM1 null in the menorrhagia and case groups was not significantly different [26].
• The aim of this study was to measure NO production in women with and without menorrhagia to detect nitric oxide synthase (NOS) isoforms in uterine cells and to investigate any steroid effects on myometrial NOS expression [27].
• There were also a twofold higher number of arterioles, which were VEGFR-2 positive in the menorrhagia group [28].
• Herein, we report the expression and localization of both basic fibroblast growth factor (FGF-2) and its receptor (FGF-R1; flg) in human endometrium and demonstrate the markedly decreased FGF-R1 levels in menorrhagia [17].

Analytical, diagnostic and therapeutic context of Menorrhagia

• 22 patients complaining of primary menorrhagia or menorrhagia associated with an intrauterine device (I.U.C.D.) were studied in a double blind trial with crossover of ethamsylate and placebo [29].
• The main indications for tranexamic acid are the prevention of excessive bleeding after tonsillectomy, prostatic surgery, and cervical conisation, and primary and IUD-induced menorrhagia [30].
• METHODS: Hysteroscopies were performed on 34 women using the levonorgestrel contraceptive implant system (Norplant(TM)) and in a comparison group of 20 women complaining of menorrhagia due to ovulatory dysfunctional bleeding [31].
• Treatment of menorrhagia in women undergoing hematopoietic stem cell transplantation [32].
• PATIENTS AND TECHNIQUES: Seventy-seven women with menorrhagia (71 with dysfunctional bleeding; six with additional small intramural myomas) underwent hysteroscopic rollerball endometrial ablation by coagulation diathermy during 1.5% glycine irrigation, after a two-month period of hormonal suppression [33].

References