Document Detail


Immunohistochemical and hysteroscopic assessment of postmenopausal women with uterine bleeding whilst taking Tibolone.
MedLine Citation:
PMID:  8735758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The gonadomimetic steroid Tibolone, is currently widely used for the treatment of menopausal symptoms. Up to 20% of women have been reported to have episodes of bleeding whilst on therapy. We investigated 37 cases who experienced bleeding episodes whilst on Tibolone and compared these to six cases who experienced no bleeding whilst on therapy and who underwent similar investigations in the course of a clinical study. All women underwent a diagnostic hysteroscopy and an endometrial biopsy, under a local anaesthetic. The endometrium was assessed by histology and with immunohistochemical markers for cellular proliferation (Ki67, PCNA), Heat Shock Protein 27 (HSP27) and bcl-2. There were 17 women with intracavitary lesions on hysteroscopy (including one in the control group), 10 with polyps, five with fibroids, two with congenital uterine anomalies. Histological diagnosis was not obtained in 16 cases. The high incidence of uterine polyps in the group who bled on Tibolone suggests an etiologic relation. The staining pattern with HSP27 demonstrated an oestrogenic effect. There were no differences in the bcl-2 immunoreactivity between those who bled and those who did not bleed on treatment which suggests absence of a link. Similarly, there were no differences in the expression of the proliferation markers. We conclude that episodes of bleeding in patients receiving Tibolone for hormone replacement therapy, whilst warranting investigation, should not cause undue concern.
Authors:
M Habiba; J Ramsay; A Akkad; D M Hart; F al-Azzawi
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  66     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-11-14     Completed Date:  1996-11-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  45-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, University of Leicester School of Medicine, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anabolic Agents / therapeutic use*
Case-Control Studies
Evaluation Studies as Topic
Female
Humans
Hysteroscopy*
Immunohistochemistry
Middle Aged
Norpregnenes / therapeutic use*
Uterine Hemorrhage / chemically induced*
Chemical
Reg. No./Substance:
0/Anabolic Agents; 0/Norpregnenes; 5630-53-5/tibolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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