Endometrium at menopause: The pathologist's view

Swain, Meenakshi; Kulkarni, Aditya

doi:10.4103/jmh.jmh_218_21

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Post-menopause, endometrial walls may exhibit proliferative activities, including atrophy, simple hyperplasia, complex hyperplasia, atypical hyperplasia, or endometrial cancer. These observations are also evident in histological examinations using hematoxylin-eosin (H.E) staining methods (Otify et al, 2015;Swain & Kulkarni, 2021).…”

Section: Introductionmentioning

confidence: 76%

The Impact of Phaleria macrocarpa Fruit Flavonoid Extract on Endometrial Thickness in Mice Menopausal Model

Wijaya,

Wulandari,

Sutrisno

et al. 2024

Med.Lab.Tech.J.

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This study aims to determine how the effect of flavonoid phaleria macrocarpa fruit extract on the endometrial thickness of Mus musculus which is used as an experimental animal with a menopause model. This study employed a randomized post-test-only control group design on 32 female mice. Ovariectomy simulated menopause, followed by treatment with flavonoid from Phaleria macrocarpa fruit extract. Post-observariectomized, follicle-stimulating hormone levels indicated menopausal status. Hematoxylin-Eosin methods assessed endometrial thickness. The result indicated reduced endometrial thinning in the positive control group (K+). Conversely, the treatment group (P1-P4) exhibited increased endometrial thickness post-flavonoid extract administration. Ovariectomized-induced estrogen decline resulted in reduced endometrial thinning, mimicking menopausal conditions. Statistically, flavonoid extract administration increased endometrial thickness in ovariectomized-induced menopausal mice, with optimal effect observed at 7.5 mg/mice/day for 14 days. The preferred intervention dose for altering endometrial thickness in menopausal conditions was identified as P1 (3.75 mg/mice/day). In conclusion, a flavonoid from Phaleria macrocarpa fruit extract mitigates endometrial thinning in the menopausal mice model. For implication in menopausal women, clinical trials need to be conducted to evaluate the dosage of these flavonoids for their potential as a natural SERM (Selective Estrogen Receptor Modulator) before clinical application in managing endometrial health. Additionally, research on molecular effects particularly regarding ER (Estrogen Receptors) in the endometrial organ, is needed to confirm their phytoestrogenic effect.

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Section: Introductionmentioning

confidence: 76%

The Impact of Phaleria macrocarpa Fruit Flavonoid Extract on Endometrial Thickness in Mice Menopausal Model

Wijaya,

Wulandari,

Sutrisno

et al. 2024

Med.Lab.Tech.J.

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“…For example, some newborns exhibit a sparsely studied withdrawal bleed (neonatal uterine bleeding) upon removal from the hormonerich in utero environment at parturition (reviewed in Benagiano et al 2021). In addition, there is much to discover about the endometrium during childhood, perimenopause, and menopause, which may evoke different regenerative strategies and vulnerabilities compared to the reproductive years (Metcalf et al 1981, Swain & Kulkarni 2021. While much remains unknown about the balance between regenerative and nonregenerative healing in the uterus, uncovering the secret to the remarkable resilience of this organ holds the potential to inform far-reaching fields, from wound healing and regeneration to inflammation and beyond.…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of Regeneration and Fibrosis in the Endometrium

Ang,

Skokan,

McKinley

2023

Annu. Rev. Cell Dev. Biol.

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The uterine lining (endometrium) regenerates repeatedly over the life span as part of its normal physiology. Substantial portions of the endometrium are shed during childbirth (parturition) and, in some species, menstruation, but the tissue is rapidly rebuilt without scarring, rendering it a powerful model of regeneration in mammals. Nonetheless, following some assaults, including medical procedures and infections, the endometrium fails to regenerate and instead forms scars that may interfere with normal endometrial function and contribute to infertility. Thus, the endometrium provides an exceptional platform to answer a central question of regenerative medicine: Why do some systems regenerate while others scar? Here, we review our current understanding of diverse endometrial disruption events in humans, nonhuman primates, and rodents, and the associated mechanisms of regenerative success and failure. Elucidating the determinants of these disparate repair processes promises insights into fundamental mechanisms of mammalian regeneration with substantial implications for reproductive health.

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“…12 PMB can also have non-gynecologic causes (such as the urethra, bladder, or GI tract) that are misdiagnosed as vaginal bleeding. 13 Postmenopausal haemorrhage frequently has the following underlying reasons: 5,6,13,14 Vaginal or endometrial atrophy; urogenital infections (such as endometrial tuberculosis, vaginitis, cystitis, or cervicitis); endometrial polyps; uterine leiomyomas; genital tract cancers; vaginal foreign bodies; genitourinary atrophy; endometrial hyperplasia with or without atypia and medications (such as oestrogen, tamoxifen, and anticoagulants).…”

Section: Etiologymentioning

confidence: 99%

Strategies for managing postmenopausal bleeding: a clinician's perspective

Gupta,

Kalwaniya

2024

Int J Res Med Sci

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Postmenopausal bleeding (PMB) poses a diagnostic challenge due to the varied presentation of endometrial pathologies ranging from benign endometrial atrophy to the possibility of endometrial carcinoma. Although the incidence varies with patient characteristics, it warrants thorough evaluation. Risk factors such as obesity and hormone use should guide assessment. Bleeding may originate from various gynecological and non-gynecological sites, demanding meticulous history-taking and examination. Transvaginal sonography (TVS) is typically the initial step, yet its accuracy in excluding carcinoma remains debated. Invasive procedures like hysteroscopy and endometrial sampling offer higher accuracy but are more intrusive. The optimal diagnostic strategy remains uncertain, necessitating focused research for enhanced accuracy. TVS-guided assessment with an endometrial thickness (ET) threshold of >4 mm prompts evaluation and endometrial sampling. Progestogen therapy mitigates endometrial cancer risk associated with estrogen use, with atypia-hyperplasia necessitating vigilant monitoring and possible hysterectomy. Patient counselling on treatment options is crucial. In summary, PMB warrants a systematic approach integrating imaging, histological assessment, and tailored therapy guided by risk factors, final diagnosis and patient preferences.

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Endometrium at menopause: The pathologist's view

Cited by 4 publications

References 13 publications

The Impact of Phaleria macrocarpa Fruit Flavonoid Extract on Endometrial Thickness in Mice Menopausal Model

The Impact of Phaleria macrocarpa Fruit Flavonoid Extract on Endometrial Thickness in Mice Menopausal Model

Mechanisms of Regeneration and Fibrosis in the Endometrium

Strategies for managing postmenopausal bleeding: a clinician's perspective

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