A rare case of endometriosis in Turner's syndrome

Endometriosis is defined by the presence of functional endometrial tissue outside the uterine cavity and musculature. It has a prevalence rate as high as 35e50% in women experiencing pain or infertility [1] and sometimes has a peculiar and rare onset [2,3]. Endometriosis is a common disease in menstruating women [4,5] but has also been reported in postmenopausal or surgically castrated women on hormone replacement therapy (HRT) [6]. The common denominator of all such cases is exposure to female hormones [7]. However, endometriosis, a common and important clinical problem in women of reproductive age, has rarely been described in prepubertal girls. In patients with Turner's syndrome or other ovarian dysgenesis, endometriosis is very rare. Some cases are subclinical, and endometriosis is an incidental finding during routine examination. Although endometriosis was described in the medical literature at the end of the 19th century, and the first theories regarding its hystogenesis were developed at the beginning of the 20th century, the real pathogenesis of endometriosis remains unknown. Most studies about the etiology of endometriosis claim that the main possible causes of endometriosis are probably multifactorial. Three theories of histogenesis have been proposed. (1) The metastatic theory [8] proposes the transplantation of endometrial tissue via retrograde menstrual implantation, vascular/lymphatic spread, and intraoperative implantation. (2) The coelomic metaplastic theory [9] suggests that the germinal epithelium of the ovary can be transformed by metaplasia into endometrium. This theory, which initially explained only ovarian endometriosis, has since been extended to the peritoneal serosa, as embryologic studies have indicated that Mullerian ducts, th

A new long-term reversible contraception method: sexual and metabolic impact

Background: data relating to the influence of hormonal contraception on sexual life are conflicting and mostly they refer to oral contraceptives. In this study we evalueted the effect of a long-acting contraceptive on sexual finction, metabolism and bleeding pattern variations. Methods: 23 women with a permanent partner and an active sexual life completed a specific questionnaire at the start of the study and after cycles 3 and 6 of contraceptive use; a blood sample was performed oor metabolic evaluation and a "bleeding calendar" was compiled by the patients. Conclusion: There is an increase of quality and frequency of sexual function after 6 month of contraception; there aren't significant change in metabolic parameters and is detectable a modification of bleeding patterns

The sexuological impact of hormonal contraceptives based on their route of administration

Evidence on the effects of hormonal contraceptives on female sexuality is conflicting. We enrolled 556 women, divided into six groups: two composed of subjects using a combined hormonal contraceptive (COC) containing 0.020 (â\u80\u9cCOC20â\u80\u9d) and 0.030 (â\u80\u9cCOC30â\u80\u9d) mg of ethynyl estradiol (EE), â\u80\u9cnaturalâ\u80\u9d, using COC containing 1.5 mg of estradiol (E2), â\u80\u9cringâ\u80\u9d, using a vaginal ring releasing each day 0.015 mg of EE + 0.120 of etonogestrel, â\u80\u9csubcutaneousâ\u80\u9d, using a progestin only subcutaneous contraceptive implant releasing etonogestrel and â\u80\u9ccontrolsâ\u80\u9d, using no hormonal contraceptive methods. The subjects were required to answer to the McCoy female sexuality questionnaire and were subjected to a blood test for hormonal evaluation. An ultrasound evaluation of the dorsal clitoral artery was also performed. The higher McCoy sexological value were recorded in the subdermal group; significant differences were recorded among the groups in terms of hormone distribution, with the higher levels of androstenedione in subdermal and control groups. The ultrasound evaluation of dorsal clitoral artery shows a significative correlation between pulsatility and resistance indices and orgasm parameters of McCoy questionnaire. The recorded difference in the sexual and hormonal parameters among the studied hormonal contraceptives may guide toward the personalization of contraceptive choice