A morphometric study of the effect of oral norethisterone or levonorgestrel on endometrial blood vessels

Evaluation of pattern of angiogenesis in various menstrual disorders in different district in Gujarat, India.

“…The increased density of blood vessels combined with the fragile nature of these vessels may be responsible for the hormone-induced breakthrough bleeding. Therefore, except for pill endometrium and complex hyperplasia, no significant difference was found in the concentration of blood vessels in curettage and hysterectomy specimens of DUB cases as compared to control which was in agreement with those of Rees et al, [9] Hourihan et al, [5] Sahasrabudhe et al, [4] and Mints et al [2] Therefore, it is possible that excessive bleeding in DUB may be related to other qualitative changes in the blood vessels.…”

“…[11] Similar finding was noted by Nayha et al and they indicated that this microvascular density is associated with malignant transformation later. [8] The difference in the blood vessel mean (6.21 ± 0.27)of pill endometrium as compared to control (3.86 ± 0.36) was significantly higher as claimed by Hourihan et al [5] and Hickey et al [12] However, the blood vessels were thin walled and congested. This effect reflects a combined estrogen progesterone effect which typically produces a weakly secretory pattern characterized by under developed non-coiled glands set within a spindled, vaguely predeciduated stroma containing thin-walled vascular channels.…”

“…[2] In the present study, the endometrial blood vessels were evaluated using light microscopy on sections stained by H and E stain. This method was chosen because in the routine set-up, it provides maximum information and utility and can be readily applied in the study of endometrial vasculature as observed by Upadhyay and Mishra [3] and Sahasrabudhe et al [4] The method used for the counting of blood vessels was obtained from Hourihan et al [5] and Sahasrabudhe et al [4] The endometrium in the control group was dated as early proliferative, late proliferative, early secretory, mid secretory and late secretory. The average number of blood vessels per HPF for hysterectomy cases was 3.54 ± 0.20, which was comparable to that observed by Sahasrabudhe et al [4] but lower as compared to the study of Shaw et al [6] The blood vessels were concentrated more in the basal layer in proliferative endometrium and were distributed more in the functional layer by mid to late secretory phase, which was in agreement with those of Fanger and Barker, [7] Sahasrabudhe et al, [4] and Nayha et al [8] This is because, the spiral arterioles are extremely sensitive to the changes in levels of ovarian hormones and changes occur in the vessel density as the cycle progresses.…”

Changes in Uterine Microvessels as a Possible Pathogenic Factor in the Development of Adenomyosis Induced by Pituitary Grafting in Mice.

“…It has been reported that, in women treated with progesterone, the dilated venules increased in number and the density of microvessels decreased in the endometrium when compared with those in controls [4,14,16].…”

The Management of Dysfunctional Uterine Bleeding

“…Histologically there is a decrease in the number and turtuoisity of spiral arterioles and many of the subepithelial microvessels are dilated and lined by a very thin endothelial cell layer (Hickey et al, 2000). Since the basement membrane is poorly formed or absent, and there are gaps between endothelial cells, pools of extravasated red blood cells are often seen (Hourihan et al, 1986). These structural alterations and vascular fragility lead to breakdown and bleeding.…”