Topical treatment of vulvodynia, dyspareunia and pudendal neuralgia: A single clinic audit of amitriptyline and oestriol in organogel.

Background: Vulvodynia and pudendal neuralgia comprise significant contributors to vulvar-related pain and its impact on daily life.

Aim: A retrospective clinical audit was conducted at the Women's Health & Research Institute of Australia, Sydney, to determine the pattern of use and the efficacy of the application of topical amitriptyline 0.5% plus oestriol 0.

Asherman syndrome: Audit of a single-operator cohort of 423 cases.

Background: The diagnosis of Asherman syndrome, or 'intra-uterine adhesions' is often overlooked when the symptoms of amenorrhea and hematometra are missing.

Aims: This audit reviews the clinical data of a large cohort of patients treated by a single operator.

Materials And Methods: From July 1998 till the end of December 2017, 423 patients with intra-uterine adhesions were treated by a single operator.

Medication Use and Pain Management in Pregnancy: A Critical Review.

Background: Pain during pregnancy is common, and its management is complex. Certain analgesics may increase the risk for adverse fetal and pregnancy outcomes, while poorly managed pain can result in adverse maternal outcomes such as depression and hypertension. Guidelines to assist clinicians in assessing risks and benefits of exposure to analgesics for the mother and unborn infant are lacking, necessitating evidence-based recommendations for managing pain in pregnancy.

Sacral neuromodulation for pelvic pain and pelvic organ dysfunction: A case series.

Background: The use of neuromodulation is growing and it is an established therapy for conditions such as bladder dysfunction. It is an increasingly used therapy for the management of chronic perineal pain but little research is currently available looking at its efficacy.

Aim: We present a series of 52 patients who underwent placement of a neuromodulator, the majority of whom suffered from perineal pain, with most placements via the sacral hiatus.

The endometrial and breast safety of menopausal hormone therapy containing micronised progesterone: A short review.

For a significant minority of women, menopausal symptoms can be very unpleasant; however, many are worried about taking menopausal hormone therapy (MHT) for fear of causing breast cancer. Micronised progesterone (mP4) has been available in Europe since the 1990s and clinical trials have shown that 100 mg oral daily, 200 mg oral sequentially or 100 mg vaginal every second day effectively protect the endometrium from the stimulatory effects of oestrogen. MHT containing mP4 has a significantly lower breast cancer risk than those containing progestins.

DHEA replacement for postmenopausal women: placebo or panacea?

In adults, dehydroepiandrosterone (DHEA) is the most abundant steroid found in serum and its levels fall with age. It can be converted into androgens and estrogens by peripheral tissues. Thus it may be considered to be a pro-hormone.

Menopausal status, adipose tissue, and breast cancer risk: impact of estrogen replacement therapy.

The seeds of breast cancer are likely sown in the first two or three decades of life. Rapid weight gain and height in infancy predict breast cancer risk in later life. The age at first pregnancy is also a strong predictor for breast cancer; the earlier the first full-term pregnancy, then the lower the risk of breast cancer in later life.

Lignocaine plasma levels following topical gel application in laparoscopic and hysteroscopic procedures.

The study aim was to determine plasma lignocaine concentrations resulting from topical application of a newly formulated, sterile two-pack lignocaine gel in laparoscopic and hysteroscopic procedures. This was an open label single-centre study in which six female patients underwent laparoscopy and six underwent hysteroscopy. One venous blood sample was extracted pre-gel application, followed by 10 samples over a 24 hour period following application.