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Women with advanced-stage endometriosis had lower BMIs than those with minimal or mild disease, and BMI was significantly associated with disease severity.

The presence of vasomotor symptoms is associated with metabolic syndrome in Korean postmenopausal women. Lipid abnormalities and obesity seem to be important metabolic components associated with these symptoms. Vasomotor symptoms, if validated in longitudinal studies, may possibly serve as warning signs for identifying women at high risk for metabolic syndrome and cardiovascular disease.

Dienogest (DNG) is a progestin with highly selective progesterone activity and minimal androgenic activity and is helpful in reducing endometriosis-related pain. This study assessed the long-term efficacy and safety and recurrence rate of endometrioma with DNG use beyond 12 months of treatment. A retrospective cohort study was conducted with data collected from 7 university-affiliated hospitals and included a total of 514 women with ovarian endometrioma. All patients received 2 mg of oral DNG daily for at least 48 weeks postoperatively. During continuation of DNG, the recurrence rate of ovarian endometrioma on ultrasound, adverse events, changes in menstrual pattern, and pain score (visual analogue scale) were analyzed. The average period of DNG administration in this study was 72.2 ± 5.2 weeks (range: 48-164). The recurrence rate of endometrioma was 1.8% (9 of 514), and the median duration to recurrence was 58 weeks (range: 24-76). Pain was described as overall improved by 82.2% of patients; 61.6% stated the pain was "improved" and 20.6% reported "much improved." The mean VAS score was 4.9 at baseline and significantly decreased to 2.68, 2.2, 1.6, and 2.6 at 12, 24, 48, and 96 weeks. Amenorrhea rate was 58.3% in the first 12 weeks and increased to 86.4% at 72 weeks. Prolonged daily administration of 2 mg DNG followed by surgery was associated with a lower recurrence rate of ovarian endometrioma and a reduced pain score and symptoms.

We investigated the effects of the estrogen receptor-α (ERα) and -β (ERβ) in the regulation of leptin, resistin, and adiponectin expression in 3T3-L1 adipocytes. Mature adipocytes were exposed to estradiol (E2), ERα agonist (PPT (4,4',-pyrazole-1,3,5-triyl)trisphenol)), ERβ agonist (DPN (2,3-bis(4-Hydroxyphenyl)-propionitrile)), E2 with ERα antagonist (MPP (1,3-Bis(4-hydroxyphenyl)-4-methyl-5-[4-(2-piperidinylethoxy)phenol]-1H-pyrazole dihydrochloride)), and E2 with ERβ antagonist (R,R-THC ((R,R)-5,11-diethyl-5,6,11,12-tetrahydro-2,8-chrysenediol)) at different concentrations. To clarify the expression and regulation of adipokines by ER subtypes, total RNA was extracted from cells and measured using quantitative PCR. Western blot analysis was performed to evaluate the protein expression of adipokines, ERα, and ERβ. The leptin expression was significantly increased in the cells treated with high concentrations (10 −5 and 10 −6 mol/l) of the PPT (P < 0.01, P < 0.05). By contrast, the leptin expression decreased in a dose-dependent manner in the MPP-treated groups (P < 0.05). High concentrations (10 −5 mol/l) of R,R-THC with E2 (10 −7 mol/l) caused a significant increase of the leptin expression (P < 0.01). The leptin mRNA levels were positively correlated with the ERα mRNA levels (r = 0.584, P < 0.01) and negatively correlated with the ERβ mRNA levels (r = −0.236, P = 0.03) in the adipocytes. The ratio of the ERα to ERβ mRNA levels in the adipocytes was significantly associated with leptin mRNA levels (r = 0.454, P < 0.01). ERα induced leptin expression and ERβ inhibited its expression in 3T3-L1 adipocytes. The ratio of the ERα-to-ERβ expression in 3T3-L1 adipocytes may be an important potential regulatory factor in leptin expression.

Successful implantation and pregnancy is dependent on sufficient endometrial growth during each reproductive cycle. Here we report the therapeutic effect of either bone marrow-derived cells or the stem cell chemo-attractant CXCL12 on endometrial receptivity in a murine ethanol induced thin endometrium model. Endometrial epithelial area was significantly increased in mice treated with BMDCs, CXCL12 or by co-treatment with both compared with PBS treated controls. Ki-67 and CD31 immunoreactivity was significantly higher in mice treated with either BMDCs, CXCL12 or both. The mRNA expression levels of endometrial receptivity markers leukemia inhibitory factor, interleukin-1β, and integrin beta-3 were increased in mice treated with either BMDCs, CXCL12 or both. The mRNA levels of matrix metalloproteinase-2 and -9 were significantly decreased by BMDCs but not by CXCL12. Pregnancy rates and litter size were increased after either treatment. Both BMDCs and CXCL12 displayed a comparable efficacy on endometrial regeneration in mice with thin endometrium. Our findings indicate the potential therapeutic effects of BMDCs and CXCL12 on infertility related to thin endometrium.

Adolescent pregnancy may be a predictor of osteoporosis in postmenopausal women.