Endometrial morphology and peripheral steroid levels in women with and without intermenstrual bleeding during contraception with the 300 μg norethisterone (NET) minipill

Johannisson, E.; Landgren, Britt-Marie; Diczfalusy, E.

doi:10.1016/0010-7824(82)90015-4

Cited by 45 publications

(17 citation statements)

References 16 publications

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“…Likewise, the endometrium is fully restored after ovariectomy and endometriotomy (22). It has been suggested that normal wound-healing mechanisms play a role in the reconstruction of the endometrium during menses and that this is facilitated by proliferative factors other than estrogen (23). However, it has not been possible to remove all estrogenic sources from women, as has been done in this study in the mouse.…”

Section: Discussionmentioning

confidence: 65%

Estrogen Is Not Essential for Full Endometrial Restoration after Breakdown: Lessons from a Mouse Model

2007

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The current dogma surrounding endometrial regeneration after menses includes a critical need for estrogen-primed proliferation. Although some evidence suggests that estrogen may not be required for the initial reepithelialization of the uterine surface, it is widely believed that it is essential for successful stromal renewal. This study aimed to identify proliferating cell types during endometrial repair and to examine whether estrogen is required for successful repair using a previously developed mouse model. In the model, decidualization is artificially induced, and progesterone support withdrawn; the endometrial tissue progressively breaks down by 24 h after progesterone withdrawal and by 48 h has usually undergone complete repair. Although the mice are ovariectomized, restoration of both the stromal and epithelial components proceeds rapidly after breakdown and results in what appears to be a normal endometrium. However, potential estrogenic influences from extraovarian sources (particularly the diet and fat) remain. In this study, complete removal of extraovarian estrogen was achieved by maintenance of animals on a soy-free diet and administration of aromatase inhibitor letrozole. No significant differences in uterine weight or estrogen-responsive genes lactoferrin and progesterone receptor were observed compared with control ovariectomized but otherwise untreated mice, whereas significantly higher measurements were obtained from an estrogen-added group. Importantly, no significant difference in the rate of endometrial repair was observed in the complete absence of estrogen, demonstrating that estrogen is not essential for complete endometrial restoration in this model.

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Section: Discussionmentioning

confidence: 65%

Estrogen Is Not Essential for Full Endometrial Restoration after Breakdown: Lessons from a Mouse Model

2007

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“…A detailed study of hormonal changes in 43 women using 300 jig norethisterone daily, involving daily blood sampling, has been published [63][64][65]. A pattern of hormonal changes similar to that seen in a normal ovulation cycle was observed in 40% or ten subjects; 21% had normal follicular activity with suppressed luteal function; 23% had normal or increased follicular activity with no luteal function; and 16% showed no signs of either follicular or luteal function.…”

Section: Mechanism Of Action Effect On Pituitary-ovarian Functionmentioning

confidence: 99%

“…A detailed study of endometrial morphology in women taking 300 |ig norethisterone daily has been reported [65]. An endometrial biopsy was taken and ovarian steroid secretion assessed during a pretreatment cycle and repeated during the second cycle of treatment.…”

Section: Effect On Tubal and Uterine Functionmentioning

confidence: 99%

The progestogen-only pill

Fotherby¹

1989

Contraception

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“…The female genital tract is a notable exception, with angiogenesis being an essential part of the normal endometrial cycle 13, 14. It is characterized by rapid endometrial growth during the proliferative stage, significant growth of spiral arterioles in the secretory stage and coiling and repair of the vascular bed during menstruation 15, 16, 17, 18. This complex process involves the proteolytic degradation of extracellular matrix, proliferation and migration of endothelial cells and ultimately the formation of patent capillary tubules 12, 19.…”

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confidence: 99%

Altered extent, pattern and characteristics of microvascular density are indicators of neoplastic progression in the endometrium

Näyhä

Viitanen

Stenbäck

2005

Intl Journal of Cancer

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The occurrence, structure and extent of microvascular density were examined in normal endometria, hyperplasia of different types and adenocarcinomas of different degrees of differentiation to determine their biologic and clinical significance in tumor development and progression. Computer-assisted quantitative image analysis was carried out on 12,500 vessels in regard to vessel number, vessel volume, size, shape and extent of vessel antibody staining, with sensitivity and reproducibility exceeding 99%. The results showed the extent, pattern and characteristics of microvascular density to be intimately associated with extent of tumor development and degree of differentiation of the tumor. Vessel number increased with superficial location in normal endometrium, with increased degree of hyperplasia and atypia and with increased degree of dedifferentiation of adenocarcinoma. Increased vessel shape alterations were characteristic of atypical complex hyperplasia when compared to other types of hyperplasia. Vessel number, size and shape were similar in proliferative endometrium and simplex type hyperplasia, and microvascular density in atypical complex hyperplasia was similar to that in well-differentiated adenocarcinoma. The results indicated that vessel shape alterations occur during progression of hyperplasia and vessel size increase occurs in complex-type hyperplasia and in moderately differentiated adenocarcinomas. We conclude that microvascular density is associated with endometrial location and with specific patterns of alteration in different stages of endometrial disease. The results suggest potential clinical applications of vessel analysis for determination of clinical behavior of endometrial preneoplastic and neoplastic alterations. ' 2005 Wiley-Liss, Inc.

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Endometrial morphology and peripheral steroid levels in women with and without intermenstrual bleeding during contraception with the 300 μg norethisterone (NET) minipill

Cited by 45 publications

References 16 publications

Estrogen Is Not Essential for Full Endometrial Restoration after Breakdown: Lessons from a Mouse Model

Estrogen Is Not Essential for Full Endometrial Restoration after Breakdown: Lessons from a Mouse Model

The progestogen-only pill

Altered extent, pattern and characteristics of microvascular density are indicators of neoplastic progression in the endometrium

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