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Marco A, Gargallo M, Ciriza J, Shikanov A, Baquedano L, García Pérez-Llantada J, Malo C. Current Fertility Preservation Steps in Young Women Suffering from Cancer and Future Perspectives. Int J Mol Sci 2024; 25:4360. [PMID: 38673945 PMCID: PMC11050570 DOI: 10.3390/ijms25084360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Childhood cancer incidence, especially in high-income countries, has led to a focus on preserving fertility in this vulnerable population. The common treatments, such as radiation and certain chemotherapeutic agents, though effective, pose a risk to fertility. For adult women, established techniques like embryo and egg freezing are standard, requiring ovarian stimulation. However, for prepubescent girls, ovarian tissue freezing has become the primary option, eliminating the need for hormonal preparation. This review describes the beginning, evolution, and current situation of the fertility preservation options for this young population. A total of 75 studies were included, covering the steps in the current fertility preservation protocols: (i) ovarian tissue extraction, (ii) the freezing method, and (iii) thawing and transplantation. Cryopreservation and the subsequent transplantation of ovarian tissue have resulted in successful fertility restoration, with over 200 recorded live births, including cases involving ovarian tissue cryopreserved from prepubescent girls. Despite promising results, challenges persist, such as follicular loss during transplantation, which is attributed to ischemic and oxidative damage. Optimizing ovarian tissue-freezing processes and exploring alternatives to transplantation, like in vitro systems for follicles to establish maturation, are essential to mitigating associated risks. Further research is required in fertility preservation techniques to enhance clinical outcomes in the future. Ovarian tissue cryopreservation appears to be a method with specific benefits, indications, and risks, which can be an important tool in terms of preserving fertility in younger women.
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Affiliation(s)
- Alicia Marco
- Faculty of Medicine, University of Zaragoza, 50018 Zaragoza, Spain;
| | - Marta Gargallo
- Institute for Health Research Aragón (IIS Aragón), 50009 Zaragoza, Spain; (M.G.); (J.C.)
| | - Jesús Ciriza
- Institute for Health Research Aragón (IIS Aragón), 50009 Zaragoza, Spain; (M.G.); (J.C.)
- Tissue Microenvironment (TME) Lab, Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain
| | - Ariella Shikanov
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA;
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
- Cellular and Molecular Biology Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - Laura Baquedano
- Department of Gynecology, University Hospital Miguel Servat, 50009 Zaragoza, Spain;
| | | | - Clara Malo
- Institute for Health Research Aragón (IIS Aragón), 50009 Zaragoza, Spain; (M.G.); (J.C.)
- Tissue Microenvironment (TME) Lab, Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain
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Coronado PJ, Gómez A, Iglesias E, Fasero M, Baquedano L, Sánchez S, Ramírez-Polo I, de la Viuda E, Otero B, Llaneza P, Mendoza N, Lubián DM. Eligibility criteria for using menopausal hormone therapy in breast cancer survivors: a safety report based on a systematic review and meta-analysis. Menopause 2024; 31:234-242. [PMID: 38385734 DOI: 10.1097/gme.0000000000002317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
IMPORTANCE Menopause hormone therapy (MHT) effectively alleviates menopausal symptoms. However, it is generally not recommended for breast cancer survivors, although the scientific evidence is scarce. OBJECTIVE This study aimed to establish eligibility criteria for use of the MHT in breast cancer survivors based on a systematic review and meta-analysis of the literature. EVIDENCE REVIEW We conducted exhaustive literature searches until June 2022 in MEDLINE, The Cochrane Library, and EMBASE, using a tailored strategy with a combination of controlled vocabulary and search terms related to breast cancer survivors and MHT. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessed the risk of bias using the Cochrane and Risk of Bias in Non-randomized Studies - of Interventions tools. The quality of the evidence was graded according to grading quality of evidence and strength of recommendations criteria (A, high; B, moderate; C, low; and D, very low). We categorized MHT use into four levels: category 1 (no restrictions on use), category 2 (the benefits outweigh the risks), category 3 (the risks generally outweigh the benefits), and category 4 (MHT should not be used). FINDINGS A total of 12 studies met the eligibility criteria. Analysis of the three randomized clinical trials using combined MHT or tibolone revealed no significant differences concerning tumor recurrence (relative risk [RR], 1.46; 95% CI, 0.99-2.24). A combined analysis of randomized clinical trials, prospective, and retrospective trials found no elevated risk of recurrence (RR, 0.85; 95% CI, 0.54-1.33) or death (RR, 0.91; 95% CI, 0.38-2.19). The eligibility criteria for patients with hormone receptor (HR)-positive tumors fell into categories 3B and 3C for combined MHT or estrogen alone and 4A for tibolone. For HR-negative tumors, the category was 2B and 2C. CONCLUSIONS AND RELEVANCE Our findings suggest that MHT could be a viable treatment alternative for breast cancer survivors experiencing menopausal symptoms, especially those with HR-negative tumors. Personalized management is recommended for each peri/postmenopausal woman facing a diminished quality of life because of menopause symptoms. Further randomized trials are needed before considering changes to current standards of care.
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Affiliation(s)
- Pluvio J Coronado
- From the Women's Health Institute, Hospital Clinico San Carlos, IdISSC, School of Medicine, Complutense University, Madrid, Spain
| | - Ana Gómez
- Service of Gynecology and Obstetrics, Hospital General of Segovia, Spain
| | - Eva Iglesias
- Service of Gynecology and Obstetrics, Hospital de Valme, Sevilla, Spain
| | - María Fasero
- Corofas Menopause Clinic, Universidad Francisco de Victoria, Madrid, Spain
| | - Laura Baquedano
- Service of Obstetrics and Gynecology, Hospital Miguel Servet, Zaragoza University, Spain
| | - Sonia Sánchez
- Department of Obstetrics and Gynecology, Quiron Salud Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Isabel Ramírez-Polo
- Salud Sexual y Reproductiva, Unidad de Gestión Clínica Cayetano Roldan, San Fernando, Cádiz, Spain
| | - Esther de la Viuda
- Department of Obstetrics and Gynecology, Hospital Universitario de Guadalajara, Universidad de Alcalá de Henares, Spain
| | - Borja Otero
- Department of Obstetrics and Gynecology, Hospital de Cruces, University of the Basque Country, Bilbao, Spain
| | - Plácido Llaneza
- Department of Obstetrics and Gynecology, Hospital Central de Asturias, Faculty of Medicine, Oviedo University, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, Faculty of Medicine, Granada University, Spain
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Bharathan R, Polterauer S, Lopez-Sanclemente MC, Trukhan H, Pletnev A, Heredia AG, Gil MM, Bakinovskaya I, Dalamanava A, Romeo M, Rovski D, Baquedano L, Chiva L, Schwameis R, Zapardiel I, On Behalf Of Sarcut Study Group. Prognostic Value of Lymph Node Ratio in Patients with Uterine Carcinosarcoma. J Pers Med 2024; 14:155. [PMID: 38392588 PMCID: PMC10890673 DOI: 10.3390/jpm14020155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/13/2023] [Accepted: 11/25/2023] [Indexed: 02/24/2024] Open
Abstract
Uterine carcinosarcoma is a rare high-grade endometrial cancer. Controversy has surrounded a number of aspects in the diagnosis and management of this unique clinicopathological entity, including the efficacy of adjuvant therapy, which has been questioned. An unusual surgico-pathological parameter with prognostic significance in a number of tumour sites is the lymph node ratio (LNR). The availability of data in this respect has been scarce in the literature. The primary aim of this collaborative study was to evaluate the prognostic value of LNR in patients with uterine carcinosarcoma. LNR is a recognized lymph node metric used to stratify prognosis in a variety of malignancies. In this European multinational retrospective study, 93 women with uterine carcinosarcoma were included in the final analysis. We used t-tests and ANOVA for comparison between quantitative variables between the groups, and chi-square tests for qualitative variables. A multivariate analysis using Cox regression analysis was performed to determine potential prognostic factors, including the LNR. Patients were grouped with respect to LNR in terms of 0%, 20% > 0% and >20%. The analysis revealed LNR to be a significant predictor of progression-free survival (HR 1.69, CI (1.12-2.55), p = 0.012) and overall survival (HR 1.71, CI (1.07-2.7), p = 0.024). However, LNR did not remain a significant prognostic factor on multivariate analysis. Due to limitations of the retrospective study, a prospective large multinational study, which takes into effect the most recent changes to clinical practice, is warranted to elucidate the value of the pathophysiological metrics of the lymphatic system associated with prognosis.
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Affiliation(s)
- Rasiah Bharathan
- Department of Obstetrics and Gynecology, Medical University Vienna, 1090 Vienna, Austria
| | - Stephan Polterauer
- Department of Obstetrics and Gynecology, Medical University Vienna, 1090 Vienna, Austria
| | | | - Hanna Trukhan
- N.N. Alexandrov National Cancer Center, 223040 Minsk, Belarus
| | - Andrei Pletnev
- N.N. Alexandrov National Cancer Center, 223040 Minsk, Belarus
| | - Angel G Heredia
- Clinica de Especialidades de la Mujer, Mexico City 03810, Mexico
| | - Maria M Gil
- Gynecologic Oncology Unit, La Paz University Hospital, 28046 Madrid, Spain
| | | | | | - Margarita Romeo
- Instituto Catalan de Oncologia Badalona, 08916 Barcelona, Spain
| | - Dzmitry Rovski
- N.N. Alexandrov National Cancer Center, 223040 Minsk, Belarus
| | | | - Luis Chiva
- Obstetrics and Gynecology Department, Clinica Universidad de Navarra, 28027 Madrid, Spain
| | - Richard Schwameis
- Department of Obstetrics and Gynecology, Medical University Vienna, 1090 Vienna, Austria
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, 28046 Madrid, Spain
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Cancelo MJ, Sánchez Borrego R, Palacios S, Baquedano L, Corbacho Garza T, Fernández Aller N, García Ferreiro C, Quijano Martín JJ, González Calvo AJ. Vulvovaginal atrophy in the CRETA study: the healthcare professionals' perception. Gynecol Endocrinol 2023; 39:2264405. [PMID: 37811796 DOI: 10.1080/09513590.2023.2264405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/21/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVES The objective is to assess the perception of gynecologists regarding patients' adherence to vulvovaginal atrophy (VVA) treatments, to evaluate the gynecologists' opinions on what their patients think about treatment adherence, and to compare the gynecologists' opinions with the patients' own perceptions within the CRETA study. METHODS Spanish gynecologists who participated in the CRETA study were asked to fill out an online 41-item questionnaire to evaluate their views on VVA management. RESULTS From 29 centers across Spain, 44 gynecologists completed the survey. Their mean age was 47.2 years old, two-thirds of them were women, and the average professional experience was over 20 years. According to the gynecologists, the therapy most frequently used by VVA-diagnosed women was vaginal moisturizers (45.5%), followed by local estrogen therapy (36.4%) and ospemifene (18.2%). Nevertheless, ospemifene was viewed as the therapeutic option with the most efficacy, easiest route of administration, shorter time to symptom improvement, lower percentage of dropouts, and higher treatment adherence. CONCLUSIONS Spanish gynecologists are in general agreement with their patients regarding VVA treatment preferences and the main issues for adherence and effectiveness. However, there is an opportunity for doctor-patient communication improvement. Among the three therapeutic options evaluated, ospemifene is regarded as offering some competitive advantages.
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Affiliation(s)
- María J Cancelo
- Department of Obstetrics and Gynecology, University Hospital of Guadalajara, Guadalajara, Alcalá University, Spain
| | | | - Santiago Palacios
- Department of Obstetrics and Gynecology, Palacios Institute of Women's Health, Madrid, Spain
| | - Laura Baquedano
- Department of Gynecology, University Hospital Miguel Servet, Zaragoza Health Research Institute of Aragon (IISA), Zaragoza, Spain
| | - Tanit Corbacho Garza
- Department of Obstetrics and Gynecology, Quiron Salud Hospital, Torrevieja, Alicante, Spain
| | - Noelia Fernández Aller
- Department of Obstetrics and Gynecology, Gynecologic Center of León, HM San Francisco, León, Spain
| | - Carmen García Ferreiro
- Department of Obstetrics and Gynecology, Gynecologic Center of León, HM San Francisco, León, Spain
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Fiol G, Lete I, Nieto L, Santaballa A, Pla MJ, Baquedano L, Calaf J, Coronado P, de la Viuda E, Llaneza P, Otero B, Sánchez-Méndez S, Ramírez I, Mendoza N. Associations between Menopausal Hormone Therapy and Colorectal, Lung, or Melanoma Cancer Recurrence and Mortality: A Narrative Review. J Clin Med 2023; 12:5263. [PMID: 37629305 PMCID: PMC10455141 DOI: 10.3390/jcm12165263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/31/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Objective: to develop eligibility criteria for use in non-gynecological cancer patients. Methods: We searched all the articles published in peer-reviewed journals up to March 2021. We utilized the PICOS standards and the following selection criteria: menopausal women with a history of non-gynecological and non-breast cancer who underwent hormone replacement therapy (HRT) using various preparations (oestrogens alone or in combination with a progestogen, tibolone, or tissue selective oestrogen complex) and different routes of administration (including oral, transdermal, vaginal, or intra-nasal). We focused on randomized controlled trials as well as relevant extension studies or follow-up reports, specifically examining recurrence and mortality outcomes. Results: Women colorectal cancer survivors who use MHT have a lower risk of death from any cause than those survivors who do not use MHT. Women who are skin melanoma survivors using MHT have a longer survival rate than non-MHT survivors. There is no evidence that women lung cancer survivors who use MHT have a different survival rate than those who do not use MHT. Conclusions: MHT is safe for women who have a history of colorectal, lung, or skin melanoma cancers.
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Affiliation(s)
- Gabriel Fiol
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Iñaki Lete
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Laura Nieto
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Ana Santaballa
- Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica), 28001 Madrid, Spain;
| | - María Jesús Pla
- Gynecological Oncology Section of the Spanish Society of Gynecology and Obstetrics (Sección de Oncología Ginecológica de la Sociedad Española de Ginecología y Obstetricia), 28036 Madrid, Spain;
| | - Laura Baquedano
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Joaquín Calaf
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Pluvio Coronado
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Esther de la Viuda
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Plácido Llaneza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Borja Otero
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Sonia Sánchez-Méndez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Isabel Ramírez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Nicolas Mendoza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
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Zapardiel I, Gracia Segovia M, Macuks R, Mancari R, Achimas-Cadariu P, Corrado G, Bartusevicius A, Sukhin V, Muruzabal JC, Coronado Martín PJ, Gardella B, Piek JM, Concin N, Arab C, Papatheodorou D, Polterauer S, Iacoponi S, Nieto T, Lopez-Sanclemente MC, Trukhan H, Gil MM, Bakinovskaya I, Dalamanava A, Cucurull M, Rovski D, Baquedano L, Chiva L, Mardas M, Mavrichev SA, Klat J, Lopez de la Manzanara CA, Yildirim Y. Prognostic factors in patients with uterine sarcoma: the SARCUT study. Int J Gynecol Cancer 2023:ijgc-2022-004204. [PMID: 37192761 DOI: 10.1136/ijgc-2022-004204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVE Uterine sarcomas are a rare and heterogeneous group of malignancies that include different histological sub-types. The aim of this study was to identify and evaluate the impact of the different prognostic factors on overall survival and disease-free survival of patients with uterine sarcoma. METHODS This international multicenter retrospective study included 683 patients diagnosed with uterine sarcoma at 46 different institutions between January 2001 and December 2007. RESULTS The 5-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma, and adenosarcoma was 65.3%, 78.3%, 52.4%, and 89.5%, respectively, and the 5-year disease-free survival was 54.3%, 68.1%, 40.3%, and 85.3%, respectively. The 10-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma and adenosarcoma was 52.6%, 64.8%, 52.4%, and 79.5%, respectively, and the 10-year disease-free survival was 44.7%, 53.3%, 40.3%, and 77.5%, respectively. The most significant factor associated with overall survival in all types of sarcoma except for adenosarcoma was the presence of residual disease after primary treatment. In adenosarcoma, disease stage at diagnosis was the most important factor (hazard ratio 17.7; 95% CI 2.86 to 109.93). CONCLUSION Incomplete cytoreduction, tumor persistence, advanced stage, extra-uterine and tumor margin involvement, and the presence of necrosis were relevant prognostic factors significantly affecting overall survival in uterine sarcoma. The presence of lymph vascular space involvement and administration of adjuvant chemotherapy were significantly associated with a higher risk of relapse.
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Affiliation(s)
- Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | | | - Ronalds Macuks
- Riga East Clinical University Hospital Latvian Oncology Center, Riga, Latvia
| | - Rosanna Mancari
- Gynecologic Oncology Department, IRCCS, Milan, Italy
- Gynecologic Oncology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patriciu Achimas-Cadariu
- Gynecologic Oncology Department, The Oncology Institute 'Prof Dr Ion Chiricuta' Cluj-Napoca, Cluj-Napoca, Romania
| | - Giacomo Corrado
- Policlinico Universitario Agostino Gemelli Dipartimento Scienze della Salute della Donna e del Bambino, Roma, Italy
| | - Arnoldas Bartusevicius
- Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vladyslav Sukhin
- Oncology, Radiology and Radiation Medicine, V N Karazin Kharkiv National University, Harkiv, Ukraine
- Oncogynecology, Grigoriev Institute for Medical Radiology NAMS of Ukraine, Harkiv, Ukraine
| | - Juan C Muruzabal
- Gynecologic Oncology Unit, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Barbara Gardella
- Gynecologic Oncology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Jurgen M Piek
- Gynecologic Oncology Department, Catharina Hospital and Catharina Cancer Institute, Eindhoven, Netherlands
| | - Nicole Concin
- Department of Gynecology and Obstetrics, Innsbruck Medical Univeristy, Innsbruck, Austria
- Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Clemente Arab
- Gynecologic Oncology Department, Hospital Luis Tisné. Universidad de Chile, Santiago, Chile
| | | | - Stephan Polterauer
- Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology, Vienna, Austria
| | - Sara Iacoponi
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Teresa Nieto
- Gynecologic Oncology Department, Hospital Universitario Santa Cristina, Madrid, Spain
| | - Martha C Lopez-Sanclemente
- Gynecologic Oncology Department, Torrecárdenas Hospital Complex, Almeria, Andalucía, Spain
- Gynecologic Oncology Department, Clinica Diatros, Barcelona, Spain
| | - Hanna Trukhan
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Maria M Gil
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Irina Bakinovskaya
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Alena Dalamanava
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Marc Cucurull
- Catalan Institute of Oncology, L'Hospitalet de Llobregat, Catalunya, Spain
| | - Dzmitry Rovski
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Laura Baquedano
- Gynecologic Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Luis Chiva
- Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
| | - Marcin Mardas
- Department of Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | | | - Jaroslav Klat
- Obstetrics and Gynecology Department, University Hospital Ostrava, Ostrava, Moravskoslezský, Czech Republic
| | | | - Yusuf Yildirim
- Gynecologic Oncology Department, Tepecik Training and Research Hospital Clinics, Konak, Izmir, Turkey
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Baquedano L, Rejas-Gutiérrez J, Coronado PJ. Development and psychometric properties of a measurement to ascertain the impact of genitourinary symptoms on health-related quality of life in menopausal women: the Cervantes-GSM questionnaire. Menopause 2023; 30:512-520. [PMID: 36917753 DOI: 10.1097/gme.0000000000002171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
OBJECTIVE The Cervantes-GSM questionnaire is a novel tool currently being developed to examine the impact of genitourinary symptoms on health-related quality of life in adult women with genitourinary syndrome of menopause (GSM). METHODS A literature review and cognitive debriefing were conducted in women with GSM, which provided the basis for creating a draft questionnaire. This draft version was pilot-tested to check participant comprehension and ease of completion. The initial draft was then refined to obtain a 15-item version with five domains whose initial psychometric properties were analyzed in 130 adult women with GSM. The psychometric properties tested in this study were factorial structure, feasibility, reliability, and construct validity. RESULTS The Cervantes-GSM 15-item questionnaire consists of five domains: vulvovaginal symptoms, urinary symptoms, psychological (emotions), interference with daily activities, and sexuality. The instrument was shown to be feasible and easy to complete, regardless of age or educational level. Internal consistency was high (Cronbach α = 0.88). Construct validity was supported by convergent-divergent validity showing higher correlation coefficients between items in their own domain (>0.70) than with the other items and domains in the questionnaire. Cervantes-GSM also showed known group validity with significant differences in total score and most domains (13-20 points, P < 0.01) regardless of whether women chose local treatment of their genitourinary symptoms. CONCLUSION This study presents a novel questionnaire capable of assessing health-related quality of life in menopausal women with GSM. The tool has shown acceptable preliminary psychometric properties, including feasibility, factor structure, construct validity, and internal consistency.
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Affiliation(s)
- Laura Baquedano
- From the Department of Gynecology, University Hospital Miguel Servet, ISSAragon, Zaragoza, Spain
| | | | - Pluvio J Coronado
- Women's Health Institute, Hospital Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain
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Baquedano L, Coronado P, De la Viuda E, Sánchez S, Otero B, Ramírez I, Llaneza P, Mendoza N. Population-based survey on menopausal symptoms and treatment use. Climacteric 2023; 26:47-54. [PMID: 36351874 DOI: 10.1080/13697137.2022.2139598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This article aimed to study the use of menopausal hormone therapy (MHT) among Spanish perimenopausal and postmenopausal women, the presence of menopausal symptoms and the sources of information. METHODS The epidemiological study using a survey included Spanish perimenopausal or postmenopausal women aged between 40 and 70 years in August 2021. RESULTS A total of 1254 women were included. In the postmenopausal group, 86% reported one or more menopausal symptoms; the most frequent was vulvovaginal dryness (57%). Among the symptomatic women, 15.2% used some treatment. Vasomotor symptoms (p = 0.001), vulvovaginal atrophy (p < 0.001) and symptoms related to sexuality (p < 0.001) were associated with greater use of treatments; 2.5% of postmenopausal women used MHT. In the perimenopausal group, 75.1% were symptomatic, hot flashes being the most frequent. Only insomnia was related to greater use of some treatment (p = 0.021); 1.6% of perimenopausal women used MHT. The most common reason for women's rejection of MHT was the fear of side effects, especially cancer. The gynecologist was the most frequently used source of information. CONCLUSIONS Although there is a high prevalence of symptoms, the use of MHT in Spanish perimenopausal and postmenopausal women is very low.
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Affiliation(s)
- L Baquedano
- IIS Aragon, Hospital Universitario Miguel Servet, Zaragoza University, Madrid, Spain
| | - P Coronado
- Instituto de Salud de la Mujer, Hospital Clinico San Carlos, IdISSC, Complutense University, Madrid, Spain
| | - E De la Viuda
- Department of Obstetrics and Gynecology, Hospital Universitario de Guadalajara, Guadalajara, Spain.,Universidad de Alcalá de Henares, Madrid, Spain
| | - S Sánchez
- Department of Obstetrics and Gynecology, Quiron Salud Hospital Universitari General de Catalunya, Barcelona, Spain
| | - B Otero
- Department of Obstetrics and Gynecology, Hospital de Cruces, University of the Basque Country, Bilbao, Spain
| | - I Ramírez
- Salud Sexual y Reproductiva, Unidad de Gestión Clínica Cayetano Roldan, San Fernando, Cadiz, Spain
| | - P Llaneza
- Department of Obstetrics and Gynecology, Hospital Central de Asturias, Faculty of Medicine, Oviedo University, Spain
| | - N Mendoza
- Department of Obstetrics and Gynecology, Faculty of Medicine, Granada University, Spain
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Mendoza N, Ramírez I, de la Viuda E, Coronado P, Baquedano L, Llaneza P, Nieto V, Otero B, Sánchez-Méndez S, de Frutos VÁ, Andraca L, Barriga P, Benítez Z, Bombas T, Cancelo MJ, Cano A, Branco CC, Correa M, Doval JL, Fasero M, Fiol G, Garello NC, Genazzani AR, Gómez AI, Gómez MÁ, González S, Goulis DG, Guinot M, Hernández LR, Herrero S, Iglesias E, Jurado AR, Lete I, Lubián D, Martínez M, Nieto A, Nieto L, Palacios S, Pedreira M, Pérez-Campos E, Plá MJ, Presa J, Quereda F, Ribes M, Romero P, Roca B, Sánchez-Capilla A, Sánchez-Borrego R, Santaballa A, Santamaría A, Simoncini T, Tinahones F, Calaf J. Eligibility criteria for Menopausal Hormone Therapy (MHT): a position statement from a consortium of scientific societies for the use of MHT in women with medical conditions. MHT Eligibility Criteria Group. Maturitas 2022; 166:65-85. [PMID: 36081216 DOI: 10.1016/j.maturitas.2022.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/21/2022] [Accepted: 08/17/2022] [Indexed: 11/26/2022]
Abstract
This project aims to develop eligibility criteria for menopausal hormone therapy (MHT). The tool should be similar to those already established for contraception A consortium of scientific societies coordinated by the Spanish Menopause Society met to formulate recommendations for the use of MHT by women with medical conditions based on the best available evidence. The project was developed in two phases. As a first step, we conducted 14 systematic reviews and 32 metanalyses on the safety of MHT (in nine areas: age, time of menopause onset, treatment duration, women with thrombotic risk, women with a personal history of cardiovascular disease, women with metabolic syndrome, women with gastrointestinal diseases, survivors of breast cancer or of other cancers, and women who smoke) and on the most relevant pharmacological interactions with MHT. These systematic reviews and metanalyses helped inform a structured process in which a panel of experts defined the eligibility criteria according to a specific framework, which facilitated the discussion and development process. To unify the proposal, the following eligibility criteria have been defined in accordance with the WHO international nomenclature for the different alternatives for MHT (category 1, no restriction on the use of MHT; category 2, the benefits outweigh the risks; category 3, the risks generally outweigh the benefits; category 4, MHT should not be used). Quality was classified as high, moderate, low or very low, based on several factors (including risk of bias, inaccuracy, inconsistency, lack of directionality and publication bias). When no direct evidence was identified, but plausibility, clinical experience or indirect evidence were available, "Expert opinion" was categorized. For the first time, a set of eligibility criteria, based on clinical evidence and developed according to the most rigorous methodological tools, has been defined. This will provide health professionals with a powerful decision-making tool that can be used to manage menopausal symptoms.
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Affiliation(s)
- Nicolás Mendoza
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain.
| | - Isabel Ramírez
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | | | - Pluvio Coronado
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Laura Baquedano
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Plácido Llaneza
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Verónica Nieto
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Borja Otero
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | | | | | - Leire Andraca
- Sociedad Española de Farmacia Comunitaria (SEFAC), Spain
| | | | - Zully Benítez
- Federación Latino Americana de Sociedades de Climaterio y Menopausia (FLASCYM)
| | - Teresa Bombas
- Red Iberoamericana de Salud Sexual y Reproductiva (REDISSER)
| | | | - Antonio Cano
- European Menopause and Andropause Society (EMAS)
| | | | | | - José Luis Doval
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - María Fasero
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Gabriel Fiol
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Nestor C Garello
- Federación Latino-Americana de Sociedades de Obstetricia y Ginecología (FLASOG)
| | | | - Ana Isabel Gómez
- Sociedad Española de Senología y Patología Mamaria (SESPM), Spain
| | - Mª Ángeles Gómez
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Silvia González
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | | | | | | | - Sonia Herrero
- Sociedad Española de Trombosis y Hemostasia (SETH), Spain
| | - Eva Iglesias
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Ana Rosa Jurado
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Spain
| | - Iñaki Lete
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Daniel Lubián
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | | | - Aníbal Nieto
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Laura Nieto
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | | | | | | | | | - Jesús Presa
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | | | - Miriam Ribes
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Pablo Romero
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | - Beatriz Roca
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
| | | | | | | | | | | | | | - Joaquín Calaf
- Asociación Española para el Estudio de la Menopausia (AEEM), Spain
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Sánchez S, Baquedano L, Cancelo MJ, Jurado AR, Molero F, Nohales F, Mendoza N, Palacios S. Managing vulvar and vestibular pain in postmenopausal women: recommendations from the Spanish Menopause Society, Sociedad Española de Ginecología y Obstetricia, Sociedad Española de Medicos de Atención Primaria y Federación Española de Sociedades de Sexología. Gynecol Endocrinol 2022; 38:263-266. [PMID: 34519600 DOI: 10.1080/09513590.2021.1963954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Background: Relieving vulvar pain caused by atrophy in postmenopausal women is a challenge in our clinical practice. We know more and more about the vulva, its anatomy and physiology and we are realizing that it is different from the vagina. The importance of the vulvar approach in the management of vulvar or vestibular pain (VP) due to atrophy in postmenopausal women is becoming increasingly important. A panel of experts from several Spanish scientific societies (Spanish Menopause Society, AEEM; Spanish Federation of Sexology Societies, FESS; Spanish Society of Primary Care Physicians, SEMERGEN; and the Spanish Society of Gynecology and Obstetrics) held a meeting to discuss treatment recommendations for women with vulvar and VP based on the best available evidence, creating a report to describe grades of recommendations.
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Affiliation(s)
- Sonia Sánchez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia -AEEM), Barcelona, Spain
- Sociedad Española de Ginecología y Obstetricia (SEGO), Zaragoza, Spain
| | - Laura Baquedano
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia -AEEM), Barcelona, Spain
- Sociedad Española de Ginecología y Obstetricia (SEGO), Zaragoza, Spain
| | - Ma Jesús Cancelo
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia -AEEM), Barcelona, Spain
- Sociedad Española de Ginecología y Obstetricia (SEGO), Zaragoza, Spain
| | - Ana Rosa Jurado
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia -AEEM), Barcelona, Spain
- Sociedad Española de Ginecología y Obstetricia (SEGO), Zaragoza, Spain
| | - Francisca Molero
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia -AEEM), Barcelona, Spain
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Madrid, Spain
- Federación Española de Sociedades de Sexología (FESS), Madrid, Spain
| | - Francisco Nohales
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia -AEEM), Barcelona, Spain
- Sociedad Española de Ginecología y Obstetricia (SEGO), Zaragoza, Spain
| | - Nicolás Mendoza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia -AEEM), Barcelona, Spain
- Sociedad Española de Ginecología y Obstetricia (SEGO), Zaragoza, Spain
| | - Santiago Palacios
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia -AEEM), Barcelona, Spain
- Sociedad Española de Ginecología y Obstetricia (SEGO), Zaragoza, Spain
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Baquedano L, Fasero M, Gabasa L, Coronado P, Presa J, Mendoza N. What do Spanish women know about menopause? COMEM study. J OBSTET GYNAECOL 2022; 42:1448-1454. [PMID: 35019792 DOI: 10.1080/01443615.2021.1998892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of the study was to evaluate the level of knowledge that women have about menopause and to analyse whether sociodemographic aspects can influence it. For this, a multi-centre observational study was conducted in Spain using a survey including 2500 women between 35 and 75 years. Participants were administered a 10-question questionnaire with a maximum score of 45 points. The responses of 2355 women were analysed. The median age was 52 years (IQR 45-59) and the median of knowledge score was 22 points (IQR 16-27). Age (p < .001), menopausal status (p = .030), early menopause (p = .001), educational level (p < .001), type of healthcare (p < .001) and sources of information on menopause (p < .001) were factors related to the score on the questionnaire. We conclude that Spanish women have limited knowledge about menopause and it is urgent to implement training programs that can improve it.IMPACT STATEMENTWhat is already known on this subject? The knowledge and attitudes about menopause among women can vary across countries and also according to sociocultural context. It also seems that negative attitudes towards menopause and poor knowledge of the physiology and the most frequent symptoms have an increasing effect on the severity of the specific symptoms of menopause that cause further discomfort.What do the results of this study add? There are very few available reports or research on the issue of postmenopausal health in Spain. We believe that it is appropriate to explore the level of knowledge of women in our country. We have verified that the level of knowledge of Spanish women is low and that some sociodemographic aspects can influence itWhat are the implications of these findings for clinical practice and/or further research? Taking into account our results, it is a priority to implement health training programs to improve knowledge about menopause in Spanish women and overcome false myths and wrong beliefs.
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Affiliation(s)
- Laura Baquedano
- Gynecology Department of Miguel, Servet University Hospital, Zaragoza, Spain
| | - María Fasero
- Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Lourdes Gabasa
- Gynecology Department of Miguel, Servet University Hospital, Zaragoza, Spain
| | - Pluvio Coronado
- Women's Health Institute of the Hospital Clínico San Carlos, IdISSC, Complutense University, Madrid, Spain
| | - Jesus Presa
- Service of Obstetrics and Gynecology, University Hospital Jaén, Jaén, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Spain
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Coronado PJ, Monroy M, Fasero M, Baquedano L, Mendoza N, Llaneza P, Rejas J, Ruiz MA. Predictive and criterion validity of the Cervantes-SF menopause quality of life questionnaire. Menopause 2021; 28:935-942. [PMID: 33973543 DOI: 10.1097/gme.0000000000001790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the predictive and criterion-based validity of the Cervantes-SF scale that measures the impact of menopause on Health-Related Quality of Life. METHODS We recruited a noninstitutionalized sample of peri/postmenopausal women aged 40 to 65 years, who had their last menstrual cycle 12+ months prior to inclusion in the study of the psychometric validity of the Cervantes-SF scale. Predictive validity of the scale was confirmed for various health outcome measures administered concomitantly (years of disability-free life expectancy, work productivity and impact on daily activities, economic impact arising from loss of work productivity, hours of undisturbed sleep each day, and the utilization of healthcare facilities), whilst criterion validity was determined by the likelihood of identifying a moderate-to-severe vasomotor or genital syndrome requiring specific treatment. RESULTS A sample of 308 peri/postmenopausal women with a mean age of 55.7 years (SD: 5.3 y) was analyzed in this study. A score >25 points on the dimension of vasomotor problems (or menopausal health) showed values of sensitivity and specificity > 80% for identifying women with moderate-severe vasomotor syndrome requiring pharmacological treatment. Predictive validity was confirmed for menopause-related health outcomes. A change of 6.7 points in the scale score, equivalent to the value of its minimal difference, is indicative of a significant increase in the degree of disability regarding work/day-to-day activities, greater economic loss due to decreased work productivity, fewer years of life expectancy without disability, fewer hours of undisturbed sleep, and more visits to the physician per year due to menopausal symptoms. CONCLUSIONS These results confirm the criterion and predictive validity of the Cervantes-SF scale in peri/postmenopausal women.
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Affiliation(s)
- Pluvio J Coronado
- Women's Health Institute, San Carlos Clinic Hospital, IdISSC, Complutense University, Madrid, Spain
| | - Manuel Monroy
- Faculty of Psychology, Autonoma University of Madrid, Madrid, Spain
| | - María Fasero
- Department of Obstetrics and Gynecology, Sanitas La Zarzuela Hospital, Francisco de Vitoria University, Madrid, Spain
| | - Laura Baquedano
- Department of Obstetrics and Gynecology, Miguel Servet Hospital, Zaragoza, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, School of Medicine, University of Granada, Spain
| | - Plácido Llaneza
- Department of Obstetrics and Gynecology, Central Hospital of Asturias, University of Oviedo, Spain
| | - Javier Rejas
- Department of Pharmacoeconomics and Health Outcomes Research, Pfizer SLU, Alcobendas, Madrid, Spain
| | - Miguel A Ruiz
- Faculty of Psychology, Autonoma University of Madrid, Madrid, Spain
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Sánchez S, Baquedano L, Mendoza N. Treatment of vulvar pain caused by atrophy: a systematic review of clinical studies. CLIN EXP OBSTET GYN 2021. [DOI: 10.31083/j.ceog4804128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Baquedano L, Espiau A, Fasero M, Ortega S, Ramirez I, Mendoza N. Beliefs, knowledge and the impact of COVID19 on menopause therapies in Spanish women: COMEM-treatment study. BMC Womens Health 2020; 20:277. [PMID: 33371883 PMCID: PMC7768270 DOI: 10.1186/s12905-020-01151-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/14/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To study what women think about menopause treatments and assess their knowledge about them. To analyze adherence to treatment during COVID-19 confinement as a secondary objective. METHODS A multi-center cross-sectional observational study was conducted using a survey of 2500 women between January and June 2019. This was administered following a non-probability sampling procedure including women between 35 and 75 years. An extension study was conducted during the coronavirus pandemic, between March and June 2020. RESULTS The responses of 2355 surveyed women were analyzed. Of this sample, 42% knew about menopause hormone therapy (MHT). The most frequently identified indication was the treatment of hot flashes (65.6%). The MHT risks most frequently perceived were weight gain (24.2%) and breast cancer (21.7%); the main reason for rejecting MHT was a lack of information (96.1%). Comparative analyses were conducted according to age, menopausal status, type of menopause, place of residence, type of health care and level of education. During the coronavirus confinement period, 85 women using MHT were located, of which 84.7% continued it. CONCLUSIONS Women hold certain false beliefs about menopause, and their knowledge of the available treatments is somewhat limited. Adherence to MHT during the COVID-19 confinement in Spain has been high.
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Affiliation(s)
- Laura Baquedano
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain.
| | - Andrea Espiau
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain
| | - María Fasero
- Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Silvia Ortega
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain
| | - Isabel Ramirez
- Sexual and Reproductive Health Service, UGC Dr Cayetano Roldan San Fernando Health Centre, Cadiz, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Granada, Spain
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Cano A, Ramírez I, De la Viuda E, Baquedano L, Coronado P, Llaneza P, Otero B, Sánchez S, Cancelo MJ, Páramo JA, Mendoza N. Response to "Should estrogen be used in the co-treatment of COVID-19 patients?". Maturitas 2020; 140:81-82. [PMID: 32747134 PMCID: PMC7833207 DOI: 10.1016/j.maturitas.2020.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 06/18/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Antonio Cano
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Isabel Ramírez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain.
| | - Esther De la Viuda
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Laura Baquedano
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Pluvio Coronado
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Plácido Llaneza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Borja Otero
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Sonia Sánchez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Mª Jesús Cancelo
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | | | - Nicolás Mendoza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
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Coronado PJ, Fasero M, Otero B, Sanchez S, Viuda EDL, Ramirez-Polo I, Llaneza P, Mendoza N, Baquedano L. Health-related quality of life and resilience in peri- and postmenopausal women during Covid-19 confinement. Maturitas 2020; 144:4-10. [PMID: 33358207 PMCID: PMC7521907 DOI: 10.1016/j.maturitas.2020.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/01/2020] [Accepted: 09/20/2020] [Indexed: 12/12/2022]
Abstract
Physical activity and sexual activity are associated with high quality of life and high levels of resilience. The use of antidepressants is associated with poor quality of life and low levels of resilience. Quality of life was greater among women who lived with others during Covid-19 confinement. Covid-19 status is not an independent factor for quality of life or resilience.
Objective To assess the impact of confinement due to the coronavirus (Covid-19) pandemic on health-related quality of life (HRQoL) and resilience in peri- and postmenopausal women. Material and Methods We used an online questionnaire which was sent between April 30th and May 13th, 2020 to women aged 40–70 years who were peri- or postmenopausal according to STRAW criteria. We used the 16-item Cervantes short-form scale (Cervantes-SF) to measure HRQoL, and the 14-item Wagnild and Young Resilience Scale (RS-14) to measure resilience. High scores on the Cervantes-SF indicate low HRQoL and high scores on the RS-14 indicate high levels of resilience. Covid-19 status, sociodemographic descriptors, and lifestyle variables were also evaluated. Results We included 2430 peri- and postmenopausal women with valid questionnaires. All items of the Cervantes-SF were completed in 2151 cases, whilst the RS-14 was completed in 2413 cases. There was a negative correlation between scores on the Cervantes-SF and RS-14 scales (Rho -0.350; p < 0.0001). Multiple linear regression analysis revealed a statistically significant association between Cervantes-SF scores and living with others (β-coefficient -10.2; p < 0.001), use of antidepressants (β 9.3; p < 0.001), physical activity (β -8.6; p < 0.001) and sexual activity (β -2.7; p < 0.001). Resilience was associated with the use of antidepressants (β -5.9; p < 0.001), physical activity (β 3.2; p < 0.001) and sexual activity (β 1.7; p = 0.005). According to the multivariate analysis, there were no associations between either Covid-19 or menopausal status and HRQoL or resilience scores. Conclusions During the period of mandatory Covid-19 confinement, peri- and postmenopausal women who engaged in physical and sexual activity had higher HRQoL and higher levels of resilience, whilst women who were using antidepressants had lower HRQoL and lower levels of resilience. HRQoL was greater in women who lived with others.
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Affiliation(s)
- Pluvio J Coronado
- Instituto de Salud de la Mujer. Hospital Clinico San Carlos, IdISSC, Complutense University, Madrid, Spain.
| | - Maria Fasero
- Department of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Universidad Franscisco de Vitoria, Madrid, Spain
| | - Borja Otero
- Department of Obstetrics and Gynecology, Hospital de Cruces, University of the Basqeu Country, Bilbao, Spain
| | - Sonia Sanchez
- Department of Obstetrics and Gynecology, Quiron Salud Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Esther de la Viuda
- Department of Obstetrics and Gynecology, Hospital Universitario de Guadalajara, Guadalajara, Spain. Universidad de Alcalá de Henares, Madrid, Spain
| | - Isabel Ramirez-Polo
- Salud Sexual y Reproductiva, Unidad de Gestión Clínica Cayetano Roldan, San Fernando, Cadiz, Spain
| | - Placido Llaneza
- Department of Obstetrics and Gynecology, Hospital Central de Asturias, Faculty of Medicine, Oviedo University, Spain
| | - Nicolas Mendoza
- Department of Obstetrics and Gynecology, Faculty of Medicine, Granada University, Spain
| | - Laura Baquedano
- Faculty of Medicine, Oviedo University, Hospital Miguel Servet, Zaragoza, Spain
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Rychlik A, Zapardiel I, Baquedano L, Martínez Maestre MÁ, Querleu D, Coronado Martín PJ. Clinical relevance of high-intermediate risk endometrial cancer according to European risk classification. Int J Gynecol Cancer 2020; 30:1528-1534. [PMID: 32817200 DOI: 10.1136/ijgc-2020-001693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Risk models in endometrial cancer define prognosis and indicate adjuvant therapy. One of the currently used classifications was designed in 2016 in collaboration with the European Society of Medical Oncology (ESMO), the European Society of Gynecologic Oncology (ESGO), and the European Society of Radiotherapy (ESTRO). A high-intermediate risk group was introduced within the intermediate risk group. The purpose of this study was to evaluate the clinical relevance of this subclassification. METHODS A multicenter retrospective study was carried out at five international tertiary institutions. Patients diagnosed with intermediate risk endometrial cancer on the basis of definitive pathology findings were included. Patients were stratified into intermediate and high-intermediate risk groups. Incidence of nodal metastases, and disease free and overall survival were compared between the two risk groups in univariate and multivariate analysis. RESULTS 477 patients were included: 325 (68%) patients were identified as intermediate and 152 (32%) as high-intermediate endometrial cancer patients. Nodal metastases were found in 18 patients (11.8%) in the high-intermediate risk endometrial cancer group and 16 patients (4.9%) in the intermediate risk group. Lymphovascular space invasion was found to be a strong predictive factor of lymph node involvement. High-intermediate risk was found to be an independent factor of disease free survival (hazard ratio (HR) 1.76; 95% confidence interval (CI) 1.00 to 3.08; p=0.050) and overall survival (HR 1.99; 95% CI 1.10 to 3.60; p=0.022) in the multivariate analysis. CONCLUSIONS The study validates the clinical significance of the intermediate risk endometrial cancer subclassification. Prognosis for high-intermediate risk endometrial cancer was significantly poorer. The prevalence of lymph node metastases was higher in this group of patients.
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Affiliation(s)
- Agnieszka Rychlik
- Gynecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Laura Baquedano
- Obstetrics and Gynecology, Hospital Universitario Miguel Servet, Zaragoza, Spain
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Ramírez I, De la Viuda E, Baquedano L, Coronado P, Llaneza P, Mendoza N, Otero B, Sánchez S, Cancelo MJ, Páramo JA, Cano A. The thromboembolic risk in covid-19 women under hormonal treatment group. Maturitas 2020; 138:78-79. [PMID: 32565010 PMCID: PMC7301135 DOI: 10.1016/j.maturitas.2020.05.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Isabel Ramírez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain.
| | - Esther De la Viuda
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Laura Baquedano
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Pluvio Coronado
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Plácido Llaneza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Nicolás Mendoza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Borja Otero
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Sonia Sánchez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Mª Jesús Cancelo
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | | | - Antonio Cano
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
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19
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Ramírez I, De la Viuda E, Baquedano L, Coronado P, Llaneza P, Mendoza N, Otero B, Sánchez S, Cancelo MJ, Páramo JA, Cano A. Managing thromboembolic risk with menopausal hormone therapy and hormonal contraception in the COVID-19 pandemic: Recommendations from the Spanish Menopause Society, Sociedad Española de Ginecología y Obstetricia and Sociedad Española de Trombosis y Hemostasia. Maturitas 2020; 137:57-62. [PMID: 32498938 PMCID: PMC7200366 DOI: 10.1016/j.maturitas.2020.04.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/25/2020] [Accepted: 04/29/2020] [Indexed: 01/17/2023]
Abstract
COVID-19 is associated with a systemic inflammatory response with activation of coagulation in symptomatic patients. The possibility of coagulopathies in peri- and postmenopausal women taking estrogen therapies makes it necessary to consider antithrombotic strategies, such as the use of low molecular weight heparins (LMWH) at specific prophylactic or treatment doses for each individual case, depending on the risk factors that each woman presents. For such reasons, a panel of experts from various Spanish scientific societies has met to develop usage recommendations for managing menopausal women taking menopausal hormone therapy (MHT) or combined hormonal contraception (CHC) during the COVID-19 pandemic.
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Affiliation(s)
- Isabel Ramírez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain.
| | - Esther De la Viuda
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Laura Baquedano
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Pluvio Coronado
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Plácido Llaneza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Nicolás Mendoza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Borja Otero
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Sonia Sánchez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | - Mª Jesús Cancelo
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
| | | | - Antonio Cano
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia - AEEM), Spain; Sociedad Española de Ginecología y Obstetricia (SEGO), Spain.
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20
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Coronado PJ, Rychlik A, Martínez-Maestre MA, Baquedano L, Fasero M, García-Arreza A, Morales S, Lubian DM, Zapardiel I. Role of lymphadenectomy in intermediate-risk endometrial cancer: a matched-pair study. J Gynecol Oncol 2018; 29:e1. [PMID: 29185259 PMCID: PMC5709519 DOI: 10.3802/jgo.2018.29.e1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 08/05/2017] [Accepted: 08/22/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the impact of lymph node dissection (LND) on morbidity, survival, and cost for intermediate-risk endometrial cancers (IREC). METHODS A multicenter retrospective cohort of 720 women with IREC (endometrioid histology with myometrial invasion <50% and grade 3; or myometrial invasion ≥50% and grades 1-2; or cervical involvement and grades 1-2) was carried out. All patients underwent hysterectomy and bilateral salpingo-oophorectomy. A matched pair analysis identified 178 pairs (178 with LND and 178 without it) equal in age, body mass index, co-morbidities, American Society of Anesthesiologist score, myometrial invasion, and surgical approach. Demographic data, pathology results, perioperative morbidity, and survival were abstracted from medical records. Disease-free survival (DFS) and overall survival (OS) was analyzed using Kaplan-Meier curves and multivariate Cox regression analysis. Cost analysis was carried out between both groups. RESULTS Both study groups were homogeneous in demographic data and pathologic results. The mean follow-up in patients free of disease was 61.7 months (range, 12.0-275.5). DFS (hazard ratio [HR]=1.34; 95% confidence interval [CI]=0.79-2.28) and OS (HR=0.72; 95% CI=0.42-1.23) were similar in both groups, independently of nodes count. In LND group, positive nodes were found in 10 cases (5.6%). Operating time and late postoperative complications were higher in LND group (p<0.05). Infection rate was significantly higher in no-LND group (p=0.035). There were no statistical differences between both groups regarding operative morbidity and hospital stay. The global cost was similar for both groups. CONCLUSION Systematic LND in IREC has no benefit on survival, although it does not show an increase in perioperative morbidity or global cost.
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Affiliation(s)
- Pluvio J Coronado
- Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain.
| | - Agnieszka Rychlik
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | | | - Laura Baquedano
- Service of Obstetrics and Gynecology, Hospital Miguel Servet, Zaragoza, Spain
| | - María Fasero
- Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Aida García-Arreza
- Service of Obstetrics and Gynecology, Hospital Virgen del Rocio, Sevilla, Spain
| | - Sara Morales
- Service of Obstetrics and Gynecology, Hospital Infanta Leonor, Madrid, Spain
| | - Daniel M Lubian
- Service of Obstetrics and Gynecology, Hospital de Puerto Real, Cádiz, Spain
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
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21
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Baquedano L, Coronado PJ, Martinez-Maestre MA, Judez D, Castán S, Ruiz-Conde MA. Immunohistochemical hormone receptors expression in high grade endometrial cancer. Maturitas 2017. [DOI: 10.1016/j.maturitas.2017.03.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Baquedano L, Villalobos F, Adiego I, Rubio P, Cotaina L, Ruiz-Conde MA. Synchronous endometrial and tube cancer. Maturitas 2017. [DOI: 10.1016/j.maturitas.2017.03.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Baquedano L, Coronado PJ, Martinez-Maestre MA, José Y, Ruiz-Conde MA, Judez D. Asymptomatic high grade endometrial cancer. Maturitas 2017. [DOI: 10.1016/j.maturitas.2017.03.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Coronado PJ, Sánchez-Borrego R, Ruiz MA, Baquedano L, Sánchez S, Argudo C, Fernández-Abellán M, González S, Iglesias E, Calleja J, Presa J, Duque A, Ruiz F, Otero B, Rejas J. Psychometric attributes of the Cervantes short-form questionnaire for measuring health-related quality of life in menopausal women. Maturitas 2016; 84:55-62. [DOI: 10.1016/j.maturitas.2015.10.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 09/14/2015] [Accepted: 10/24/2015] [Indexed: 01/01/2023]
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Palacios S, Baquedano L, Calleja J, Fernández M. Tratamiento de la atrofia vaginal a través de anillo con liberación de ultrabaja dosis de estradiol. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.pog.2015.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Coronado PJ, Sanchez-Borrego R, Ruiz MA, Baquedano L, Sanchez S, Argudo C, Fernandez-Abellan M, Gonzalez S, Iglesias E, Calleja J, Presa J, Duque A, Ruiz F, Otero B, Rejas J. Clinical usefulness of the menopause health-related quality-of-life (HRQoL) cervantes-short form scale. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.02.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Coronado PJ, Sanchez-Borrego R, Ruiz MA, Baquedano L, Sanchez S, Argudo C, Fernandez-Abellan M, Gonzalez S, Iglesias E, Calleja J, Presa J, Duque A, Ruiz F, Otero B, Rejas J. Burden of menopausal vasomotor symptoms on work productivity and daily-activity in a cohort of peri/post-menopausal women in daily practice in Spain. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.02.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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28
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Coronado PJ, Sanchez-Borrego R, Ruiz MA, Baquedano L, Sanchez S, Argudo C, Fernandez-Abellan M, Gonzalez S, Iglesias E, Calleja J, Presa J, Duque A, Ruiz F, Otero B, Rejas J. Predictive validity of the menopause health-related quality-of-life (HRQoL) cervantes-short form scale. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.02.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vázquez MG, Amayuelas RN, Lamarca M, Baquedano L, Ruiz SR, Vilar-Checa E, Iniesta MD. Ethinylestradiol/Chlormadinone acetate for use in dermatological disorders. Am J Clin Dermatol 2011; 12 Suppl 1:13-9. [PMID: 21895045 PMCID: PMC7382652 DOI: 10.2165/1153875-s0-000000000-00000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The diagnosis and management of four cases of dermatological disorders, most of which are related to the endocrine disorder of androgen excess, are presented. Combined oral contraceptives (COCs) may be useful when well-tolerated hormonal therapy and/or when contraception is required. A female patient with androgenetic alopecia or female pattern balding, without underlying hyperandrogenism, was treated with ethinylestradiol/chlormadinone acetate (EE/CMA) 0.03mg/2mg for 6 months and experienced stabilization of hair loss (case report 1). A patient who had previously received a COC for an irregular menstrual pattern but again experienced irregular menses and also acne after stopping treatment was diagnosed with acne associated with polycystic ovary syndrome (PCOS) [case report 2]. After 6 month’s treatment with EE/CMA 0.03mg/2 mg, this patient had fewer acne lesions and became eumenorrheic. A third patient who had excess hair since childhood was diagnosed with idiopathic hirsutism (no underlying gynecological or endocrinological disorder was found) and was treated with EE/CMA 0.03mg/2mg (case report 3). Less hair growth was reported after 6 month’s treatment. Case report 4 describes a patient who presented with oligomenorrhea and acne. She was diagnosed with PCOS with acne, seborrhea and mild hirsutism. Treatment with EE/CMA 0.03mg/2mg for 6 months resulted in improvements in her facial acne, seborrhea and hirsutism; she also became eumenorrheic. These four cases illustrate that EE/CMA may be a useful and well tolerated treatment option in the management of patients with dermatological disorders with or without hyperandrogenization.
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Affiliation(s)
- Mercedes Gómez Vázquez
- Deparment of Dermatology, Hospital Municipal of Badalona, Cami del Cementiri n12 Sant Vicenç de Montalt, 08394 Badalona, Barcelona Spain
| | - Ramón Navarra Amayuelas
- Deparment of Dermatology, Hospital Municipal of Badalona, Cami del Cementiri n12 Sant Vicenç de Montalt, 08394 Badalona, Barcelona Spain
| | - Marta Lamarca
- Department of Gynecology, Miguel Servet University Hospital, Zaragoza, Spain
| | - Laura Baquedano
- Department of Gynecology, Miguel Servet University Hospital, Zaragoza, Spain
| | - Sebastián Romero Ruiz
- Hospital of Móstoles, Department of Obstetrics and Gynecology Móstoles, 28935 Madrid, Spain
| | | | - Maria D. Iniesta
- Division of Molecular Medicine and Genetics, Department of Internal Medicine, University of Michigan, Michigan, USA
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