Estro-progestin and progestogen intake: What's the impact on hysteroscopic imaging?
Journal
Facts, views & vision in ObGyn
ISSN: 2032-0418
Titre abrégé: Facts Views Vis Obgyn
Pays: Belgium
ID NLM: 101578773
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
medline:
4
4
2023
entrez:
3
4
2023
pubmed:
4
4
2023
Statut:
ppublish
Résumé
In current literature there is no report aimed to evaluate the effects of exogenous steroids on hysteroscopic imaging. To evaluate the hysteroscopic features of endometrium in women undergoing female hormones administration. We reviewed video-records of hysteroscopies carried-out in women taking estro-progestins (EP), progestogen (P) and Hormonal Replacement Therapy (HRT). All women underwent biopsies resulting in atrophic, functional, or dysfunctional pathological reports. Description of hysteroscopic pictures related to each schedule of therapy. The study included 117 women. We evaluated 82, 24 and 11 women treated by EP, P and HRT, respectively. In EP users, imaging indistinguishable from physiological pictures was found when high oestrogen dosage and low-potency progestogen as 17-OH progesterone derivatives were administered. By enhancing progestogen potency with 19-norprogesterone and 19-nortestosterone derivatives we observed a promotion of progestogen differentiation such as polypoid-papillary pseudo-decidualisation, spiral artery differentiation, inhibition of gland-proliferation and endometrial atrophy. In P users we distinguished two patterns, depending on continuous or sequential schedules. Continuous therapy resulted in atrophic or proliferative-secretory features whereas sequential ones led to endometrial overgrowth reflecting stromal pseudo-decidualisation. Women undergoing HRT showed atrophic features in combined continuous and polypoid overgrowth in sequential schedules. In women taking Tibolone we found pictures ranging from atrophic to hyperplastic appearances. Exogenous steroids lead to significant endometrial moulding. Depending on schedule, hysteroscopic-view appears predictable and often showing overgrowths mimicking proliferative pathologies. In this case biopsy is recommended but in common practice physicians should gain awareness with hysteroscopic pictures induced from hormone administration. Systematic assessment of hysteroscopic pictures during estro-progestins intake.
Sections du résumé
Background
UNASSIGNED
In current literature there is no report aimed to evaluate the effects of exogenous steroids on hysteroscopic imaging.
Objectives
UNASSIGNED
To evaluate the hysteroscopic features of endometrium in women undergoing female hormones administration.
Materials and Methods
UNASSIGNED
We reviewed video-records of hysteroscopies carried-out in women taking estro-progestins (EP), progestogen (P) and Hormonal Replacement Therapy (HRT). All women underwent biopsies resulting in atrophic, functional, or dysfunctional pathological reports.
Main outcome measures
UNASSIGNED
Description of hysteroscopic pictures related to each schedule of therapy.
Results
UNASSIGNED
The study included 117 women. We evaluated 82, 24 and 11 women treated by EP, P and HRT, respectively. In EP users, imaging indistinguishable from physiological pictures was found when high oestrogen dosage and low-potency progestogen as 17-OH progesterone derivatives were administered. By enhancing progestogen potency with 19-norprogesterone and 19-nortestosterone derivatives we observed a promotion of progestogen differentiation such as polypoid-papillary pseudo-decidualisation, spiral artery differentiation, inhibition of gland-proliferation and endometrial atrophy. In P users we distinguished two patterns, depending on continuous or sequential schedules. Continuous therapy resulted in atrophic or proliferative-secretory features whereas sequential ones led to endometrial overgrowth reflecting stromal pseudo-decidualisation. Women undergoing HRT showed atrophic features in combined continuous and polypoid overgrowth in sequential schedules. In women taking Tibolone we found pictures ranging from atrophic to hyperplastic appearances.
Conclusions
UNASSIGNED
Exogenous steroids lead to significant endometrial moulding. Depending on schedule, hysteroscopic-view appears predictable and often showing overgrowths mimicking proliferative pathologies. In this case biopsy is recommended but in common practice physicians should gain awareness with hysteroscopic pictures induced from hormone administration.
What is new?
UNASSIGNED
Systematic assessment of hysteroscopic pictures during estro-progestins intake.
Identifiants
pubmed: 37010336
doi: 10.52054/FVVO.15.1.056
pmc: PMC10392115
doi:
Types de publication
Journal Article
Langues
eng
Pagination
61-67Références
J Minim Invasive Gynecol. 2005 May-Jun;12(3):247-53
pubmed: 15922983
Facts Views Vis Obgyn. 2022 Jun;14(2):103-110
pubmed: 35781106
Pharmacol Ther. 2021 Jun;222:107789
pubmed: 33316287
J Minim Invasive Gynecol. 2015 Nov-Dec;22(7):1215-24
pubmed: 26140830
J Minim Invasive Gynecol. 2006 Jul-Aug;13(4):325-30
pubmed: 16825075
Methods Mol Biol. 2016;1366:1-10
pubmed: 26585122
J Mol Endocrinol. 2016 Feb;56(2):R55-71
pubmed: 26826253
J Am Assoc Gynecol Laparosc. 2001 May;8(2):207-13
pubmed: 11342726
Expert Opin Ther Targets. 2016 Sep;20(9):1045-54
pubmed: 27138351
Maturitas. 2004 Aug 30;48 Suppl 1:S30-40
pubmed: 15337246