Breast cancer is one of the most common malignant tumors in women. The systematic therapy of breast cancer may affect the endometrium and ovarian function, such as abnormal endometrial hyperplasia and abnormal uterine bleeding caused by ovulation disorders. If we do not consider the patients suffering from breast cancer, we can use progesterone drugs to stop bleeding, regulate menstruation, and protect the endometrium. But there is no consistent conclusion on the safety of progesterone drugs in breast cancer patients. This article reviews the security of progesterone drugs in breast cancer survivors from the perspective of basic and clinical research. At present, whether the use of progesterone drugs in breast cancer survivors increases the risk of disease may be related to the type, dosage, and method of use of progesterone drugs. At the same time, it is also related to the type of breast cancer the patient has. Based on the available data, it is safe to use natural progesterone or dydrogesterone for the short term in patients with breast cancer. More studies are needed to evaluate other approaches.
Abnormal uterine bleeding with ovulatory dysfunction (AUB-O) is a common reproductive endocrine disease with complex and variable clinical manifestations. This disease has a long course and large individual differences. Difficulties in diagnosis and treatment and nonstandardized management are common in primary hospitals. In order to improve the diagnosis and treatment efficiency of AUB-O in primary hospitals, the gynecological endocrinologists in western China proposed this primary diagnosis and treatment norms and referral recommendations for gynecological outpatient clinics in primary hospitals, including the key points of diagnosis, hemostasis and cycle adjustment strategies, adjuvant treatment, and the principle of two-way referral. In particular, individualized treatment recommendations were proposed for young adolescents and menopausal transition patients. This recommendations are expected to serve as an important reference for AUB-O diagnosis, treatment and two-way referral of primary hospitals in western China.
ObjectiveTo indirectly compare the efficacy and safety of bipolar radiofrequency ablation versus hysterectomy in abnormal uterine bleeding by using network meta-analysis. MethodsThe PubMed, EMbase, Web of Science, Cochrane Library, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of different surgical methods in abnormal uterine bleeding from inception to May 20, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Network meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 39 RCTs involving 3 307 patients were included. The results of network meta-analysis showed that hysterectomy was superior to bipolar radiofrequency ablation in terms of amenorrhea rate and reintervention rate, while the hospital stay and patient satisfaction rate were opposite. ConclusionCurrent evidence shows that bipolar radiofrequency ablation has more advantages in terms of hospital stay and satisfaction rate, while hysterectomy has more advantages in terms of amenorrhea rate and reintervention rate. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.