Endometriosis, one of the most common gynecologic pathologies, is defined as an inflammatory, estrogen-dependent disease characterized by the growth of endometrial stroma and glands outside the uterine cavity. It is a multifactorial disease, conditioned by genetic and immune factors and triggered by hormonal and environmental factors. Estrogen receptors (ER) and progesterone receptors (PR) expression is significantly modified in endometriotic tissue, compared to normal endometrium. We performed a prospective study that included 16 patients with endometriosis: 9 patients that underwent progesterone treatment with 0.075 mg desogestrel, daily for 24 weeks prior to the surgical procedure, and 7 patients that did not follow any kind of treatment. The purpose of the study was to evaluate the changes that occurred in the expression of ER, PR, B-cell lymphoma 2 (Bcl-2) and Ki-67 from the endometriotic tissue. Oral 0.075 mg desogestrel administration proved its benefits in the management of endometriomas.

Many women spend a third of their lives in postmenopause, and it’s a given that sexual life must go on after menopause since its benefits were vastly proven. A number of factors influence sexuality in postmenopause: the age at which menopause sets in, how menopause sets in, physical and mental state, quality of sexual life in perimenopause and the quality and duration of the relationship with the partner. The hypoestrogenism that characterizes menopause leads to a decrease in libido, to changes in the genital apparatus (vaginal atrophy, dyspareunia) or other changes (hot flushes, impaired urination, depression), which negatively affect sexual health. Assessing sexual dysfunction is not easy. The interplay between the types of factors that predispose, precipitate and maintain sexual dysfunction requires preparation on the part of the clinician in identifying the elements of interest and indicating appropriate therapy. Research on the quantification of sexual dysfunction in women has led to the development of various scales or questionnaires to assess the impact of menopausal-related changes on sexual function and quality of intimate life. The ultimate goal of the clinician is to find an optimal method of treatment that will improve the condition and enhance the quality of sexual life. The available knowledge about menopausal sexuality may still be the tip of the iceberg in both medical practice and society and further research and information campaigns are greatly needed.

Menopause, defined as the permanent cessation of menstruation resulting from the loss of the ovarian function, has gradually become a fundamental health concern. Menopause hormonal replacement therapies (HRT) were initially developed with the purpose to alleviate the estrogen deficiency induced symptoms. Currently, HRT is approved by the FDA (Food and Drug Association) for four indications: bothersome vasomotor symptoms (VMS); prevention of bone loss; hypoestrogenism caused by hypogonadism, castration, or premature ovarian failure and genitourinary symptoms. For patients younger than 60 years or within the first 10 years from menopause onset and without contraindications, the benefit-risk ratio should be favorable for treatment of VMS and for preventing bone loss and related fractures. For women who initiate HRT more than 10 / 20 years from menopause onset (or aged 60 years or older), the benefit-risk balance seems to be less favorable than for younger patients because of greater absolute risks of cardiovascular disease, stroke and VTE. Even though the management of menopausal symptoms through pharmacological and cognitive-behavioral therapy improves quality of life of affected women in the short term, there is a need for the development of strategies to modify menopausal health risks, in the long term.

Colorectal deep infiltrative endometriosis (DIE) can have a major impact on patient’s health and quality of life. Surgical treatment of colorectal DIE varies depending on the location and characteristics of the lesions, which is why the preoperative non-invasive diagnosis needs to be correct and complete. Multiple imaging methods are currently available, but their usefulness is still being studied, as none of them has proven itself perfect. In the present study we wanted to find out to what extent the combined use of magnetic resonance imaging (MRI), endorectal ultrasound (ERUS) and computed tomography-based virtual colonoscopy (CTC) helps perform the preoperative mapping of lesions. We conducted a retrospective study of prospectively collected data that included 49 patients operated for colorectal DIE. In identifying rectal nodules, MRI as a single diagnostic method was the most useful. When ERUS or CTC was added, the concordance between intraoperative and imaging results was very strong. CTC was the most useful in identifying sigmoid nodules. ERUS evaluates the depth of rectal nodules best. CTC assesses best the stenosis for both rectal and sigmoid nodules. Each method contributed to the completion of the diagnosis, so performing ERUS and CTC in addition to MRI seems to be preferable in patients with colorectal DIE.