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Combs A, Singh B, Nylander E, Islam MS, Nguyen HV, Parra E, Bello A, Segars J. A Systematic Review of Vitamin D and Fibroids: Pathophysiology, Prevention, and Treatment. Reprod Sci 2023; 30:1049-1064. [PMID: 35960442 DOI: 10.1007/s43032-022-01011-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/12/2022] [Indexed: 10/16/2022]
Abstract
Uterine fibroids are the most common tumor of reproductive-age women worldwide and cause significant morbidity in affected women. Vitamin D has emerged as a potential therapy for uterine fibroids based on experimental and epidemiologic evidence. The objective of this systematic review was to evaluate the role of vitamin D in the pathophysiology of uterine fibroids and its efficacy for prevention and treatment of fibroids. A comprehensive search was conducted of Cochrane Library, Embase, PubMed, Scopus, and Web of Science from inception to March 2022. English-language publications that evaluated vitamin D and uterine fibroids in humans, whether experimental or clinical, were considered. The search yielded 960 publications, and 89 publications met inclusion criteria: 23 preclinical studies, 25 clinical studies, and 41 review articles. Preclinical studies indicated that the vitamin D receptor was decreased in fibroid cells. Vitamin D treatment of fibroid cells decreased proliferation, extracellular matrix protein expression, and Wnt/β-catenin signaling. Fourteen clinical studies (n = 3535 participants) assessed serum vitamin D level in women with ultrasound-proven fibroids, and all found an inverse correlation between serum vitamin D level and presence of fibroids. Five clinical studies (n = 472 patients) evaluated treatment of fibroids with vitamin D. Four of five studies showed vitamin D significantly inhibited fibroid growth. One pilot study (n = 109 patients) of vitamin D for secondary prevention of fibroids demonstrated smaller recurrent fibroids in the treated group. These studies provide evidence for vitamin D as a therapy for uterine fibroids and underscore the need for well-designed, randomized, placebo-controlled clinical trials.
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Affiliation(s)
- Abigail Combs
- Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Bhuchitra Singh
- Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Ross Research Building, 720 Rutland AvenueRoom 624, Baltimore, MD, USA
| | - Elisabeth Nylander
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Md Soriful Islam
- Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Ross Research Building, 720 Rutland AvenueRoom 624, Baltimore, MD, USA
| | - Ha Vi Nguyen
- Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Ross Research Building, 720 Rutland AvenueRoom 624, Baltimore, MD, USA
| | - Elissa Parra
- Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Ross Research Building, 720 Rutland AvenueRoom 624, Baltimore, MD, USA
| | - Ameerah Bello
- Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Ross Research Building, 720 Rutland AvenueRoom 624, Baltimore, MD, USA
| | - James Segars
- Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Ross Research Building, 720 Rutland AvenueRoom 624, Baltimore, MD, USA.
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Duman İ, Tiftik RN, Ün İ. Effects of Vitamin D Analogs Alfacalcidol and Calcitriol on Cell Proliferation and Migration of HEC1A Endometrial Adenocarcinoma Cells. Nutr Cancer 2020; 73:273-281. [PMID: 32400204 DOI: 10.1080/01635581.2020.1764066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Endometrial carcinoma is the most diagnosed among infiltrating tumor of the female genital tract. Vitamin D has antiproliferative and immunomodulatory properties besides its classical effect on calcium and phosphate. We aimed to demonstrate whether alfacalcidol and calcitriol have any effect on proliferation and migration. Endometrial adenocarcinoma HEC1A was used as a cancer cell line. The effect of alfacalcidol (1α-hydroxyvitamin D3) and calcitriol (1α,25-dihydroxyvitamin D3) on proliferation was demonstrated by real-time cell analysis device and migration was shown by a wound healing model. 10-11-10-9M alfacalcidol and calcitriol reduced both proliferation and migration. In contrast, the high concentration of alfacalcidol and calcitriol (10-8-10-6M) increased proliferation and migration. The proliferative effects of alfacalcidol (0-12 h) immediately started earlier than calcitriol (12-48 h). In contrast, the antiproliferative effects of calcitriol (12-24 h) have begun earlier than alfacalcidol (48-60 h). While the high concentrations of alfacalcidol and calcitriol increased the migration relatively earlier (12-24 h), low concentrations decreased the migration at late times (24-48 h). Lower concentrations of vitamin D prevent proliferation and migration in endometrial adenocarcinoma HEC1A cells. In contrast, high concentrations of vitamin D increase proliferation and migration.
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Affiliation(s)
- İbrahim Duman
- Department of Medical Pharmacology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - R Nalan Tiftik
- Department of Medical Pharmacology, Faculty of Medicine, University of Mersin, Mersin, Turkey
| | - İsmail Ün
- Department of Medical Pharmacology, Faculty of Medicine, University of Mersin, Mersin, Turkey
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Marian S, Hermanowicz-Szamatowicz K. Endometriosis - a decade later - still an enigmatic disease. What is the new in the diagnosis and treatment? Gynecol Endocrinol 2020; 36:104-108. [PMID: 31607185 DOI: 10.1080/09513590.2019.1675045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Endometriosis is a common disease in women of reproduction age. It causes pain and difficulty in getting pregnant. However the exact causes of infertility associated with endometriosis still remain controversial. The treatment of endometriosis consists of medical treatment of pain as well as medical and surgical treatment of infertility caused by endometriosis and assisted reproduction techniques. Since the treatment of endometriosis is often connected with diminishing ovarian reserve, the techniques for ovarian tissue preservation and oocyte and embryo freezing are used to maintain the ability for childbearing.
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Affiliation(s)
- Szamatowicz Marian
- Faculty of Health Services PWSIiP in Lomża, Department of Reproductive and Gynecological Endocrinology, Medical University, Bialystok, Poland
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Watanabe Z, Nishigori H, Tanoue K, Tanaka K, Iwama N, Satoh M, Murakami T, Nishigori T, Mizuno S, Sakurai K, Ishikuro M, Obara T, Tatsuta N, Saito M, Tachibana M, Fujiwara I, Arima T, Takeda T, Kuriyama S, Nakai K, Yaegashi N, Metoki H. Preconception dysmenorrhea as a risk factor for psychological distress in pregnancy: The Japan Environment and Children's Study. J Affect Disord 2019; 245:475-483. [PMID: 30428448 DOI: 10.1016/j.jad.2018.11.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 09/28/2018] [Accepted: 11/03/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Dysmenorrhea influences emotional distress as well as physical suffering in young non-pregnant women. The aim of this study was to assess the potential association between preconception dysmenorrhea and the development of psychological distress during pregnancy. METHODS This study was a part of the Japan Environment and Children's Study (JECS), a nationwide birth cohort study conducted between 2011 and 2014 in Japan. A total of 87,102 pregnant Japanese women with no psychological distress (Kessler 6-item psychological distress scale [K6] score ≤ 12) in early pregnancy were eligible. Among these, 7626 had mild and 1638 had severe preconception dysmenorrhea. The prevalence and risk of maternal psychological distress (K6 scores ≥ 13) in the second or third trimester were compared among preconception dysmenorrhea severity groups. RESULTS A higher percentage of women with mild (2.6%) or severe preconception dysmenorrhea (3.6%) suffered psychological distress during pregnancy compared to that in women without dysmenorrhea (2.1%). A multilevel logistic regression model, adjusting for baseline characteristics and the K6 score at enrollment, showed that the severity of dysmenorrhea was associated with psychological distress (mild dysmenorrhea: adjusted odds ratio [aOR], 1.154; 95% confidence interval [95% CI], 0.980-1.359; and severe dysmenorrhea: aOR, 1.457; 95% CI, 1.087-1.951). LIMITATIONS Information about dysmenorrhea was obtained during early pregnancy. The JECS did not have clear diagnostic criteria for dysmenorrhea. CONCLUSIONS Preconception dysmenorrhea is associated with an elevated incidence of psychological distress during pregnancy. Additionally, expectant mothers with a history of severe dysmenorrhea symptoms before pregnancy have a higher risk of developing psychological distress.
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Affiliation(s)
- Zen Watanabe
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hidekazu Nishigori
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Kaou Tanoue
- Department of Obstetrics and Gynecology, Japanese Red Cross Ishinomaki Hospital. 71 Nishimichishita Hebita, Ishinomaki, Miyagi 986-8522, Japan
| | - Kosuke Tanaka
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Department of Obstetrics and Gynecology, Osaki Citizen Hospital. 3-8-1 Furukawahonami, Osaki, Miyagi 989-6183, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine. 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine. 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan
| | - Toshie Nishigori
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Satoshi Mizuno
- Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Kasumi Sakurai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Mami Ishikuro
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Taku Obara
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Nozomi Tatsuta
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Masahito Tachibana
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Ikuma Fujiwara
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Takashi Takeda
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University. 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - Shinichi Kuriyama
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Division of Disaster Public Health, International Research Institute for Disaster Science, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Kunihiko Nakai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine. 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan.
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Ciebiera M, Włodarczyk M, Ciebiera M, Zaręba K, Łukaszuk K, Jakiel G. Vitamin D and Uterine Fibroids-Review of the Literature and Novel Concepts. Int J Mol Sci 2018; 19:E2051. [PMID: 30011902 PMCID: PMC6073230 DOI: 10.3390/ijms19072051] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/06/2018] [Accepted: 07/12/2018] [Indexed: 02/08/2023] Open
Abstract
This article provides a detailed review of current knowledge on the role of vitamin D and its receptor in the biology and management of uterine fibroids (UFs). Authors present ideas for future steps in this area. A literature search was conducted in PubMed using the following key words: "uterine fibroid" and "vitamin D". The results of the available studies, published in English from January 2002 up to April 2018, have been discussed. Vitamin D is a group of steroid compounds with a powerful impact on many parts of the human body. This vitamin is believed to regulate cell proliferation and differentiation, inhibit angiogenesis, and stimulate apoptosis. Nowadays, hypovitaminosis D is believed to be a major risk factor in the development of UFs. In many studies vitamin D appears to be a powerful factor against UFs, resulting in inhibition of tumor cell division and a significant reduction in its size, however, the exact role of this compound and its receptor in the pathophysiology of UFs is not fully understood. According to available studies, vitamin D and its analogs seem to be promising, effective, and low-cost compounds in the management of UFs and their clinical symptoms, and the anti-tumor activities of vitamin D play an important role in UF biology. The synergy between vitamin D and selected anti-UF drugs is a very interesting issue which requires further research. Further studies about the biological effect of vitamin D on UF biology are essential. Vitamin D preparations (alone or as a co-drugs) could become new tools in the fight with UFs, with the additional beneficial pleiotropic effect.
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Affiliation(s)
- Michał Ciebiera
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Marta Włodarczyk
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy with Division of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
- Center for Preclinical Research, Medical University of Warsaw, 02-097 Warsaw, Poland.
| | - Magdalena Ciebiera
- Students' Scientific Association at the Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland.
| | - Kornelia Zaręba
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Krzysztof Łukaszuk
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland.
- INVICTA Fertility and Reproductive Center, 80-172 Gdansk, Poland.
| | - Grzegorz Jakiel
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
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Shafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K, Missmer SA. Risk for and consequences of endometriosis: A critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol 2018; 51:1-15. [PMID: 30017581 DOI: 10.1016/j.bpobgyn.2018.06.001] [Citation(s) in RCA: 363] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/07/2018] [Indexed: 12/21/2022]
Abstract
Endometriosis affects approximately 10% of women of reproductive age. Characteristics robustly associated with a greater risk for endometriosis include early age at menarche, short menstrual cycle length, and lean body size, whereas greater parity has been associated with a lower risk. Relationships with other potential characteristics including physical activity, dietary factors, and lactation have been less consistent, partially because of the need for rigorous data collection and a longitudinal study design. Critical methodologic complexities include the need for a clear case definition; valid selection of comparison/control groups; and consideration of diagnostic bias and reverse causation when exploring demographic characteristics, medical history, and lifestyle factors. Reviewers and editors must demand a detailed description of rigorous methods to facilitate comparison and replication to advance our understanding of endometriosis.
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Affiliation(s)
- A L Shafrir
- Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA; Boston Center for Endometriosis, Boston Children's and Brigham and Women's Hospitals, Boston, MA, USA.
| | - L V Farland
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - D K Shah
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - H R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - M Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif Cedex, France; Gustave Roussy, Espace Maurice Tubiana, Villejuif Cedex, France
| | - K Zondervan
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; Endometriosis CaRe Centre, Nuffield Dept of Obstetrics & Gynaecology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - S A Missmer
- Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA; Boston Center for Endometriosis, Boston Children's and Brigham and Women's Hospitals, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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25-Hydroxyvitamin D Serum Levels and Endometriosis: Results of a Case–Control Study. Reprod Sci 2018; 26:172-177. [DOI: 10.1177/1933719118766259] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Paffoni A, Ferrari S, Mangiarini A, Noli S, Bulfoni A, Vigano P, Parazzini F, Somigliana E. Concordance of vitamin D peripheral levels in infertile couples' partners. Gynecol Endocrinol 2017; 33:649-652. [PMID: 28466668 DOI: 10.1080/09513590.2017.1306737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
A large number of evidence supports the role of vitamin D insufficiency in both women and men infertility. However, no studies have evaluated the rate of concordance of vitamin D status between the partners. This finding might open new scenarios in the interpretation of the available data linking vitamin D insufficiency and infertility. In the present cross-sectional study, 103 consecutive infertile couples were recruited between April and May 2014. Both partners concomitantly provided a serum sample for the assessment of 25-hydroxy-vitamin D [25-(OH)-D]. Vitamin D insufficiency was defined as serum 25-(OH)-D <20 ng/ml. One hundred-fifty subjects (73 women and 77 males) were 25-(OH)-D insufficient, corresponding to a rate of 73%. Overall, concordance was observed in 73 couples (71%), thus higher than the expected 61% (0.732 + 0.272) based on chance (p = 0.007). The Pearson coefficient of correlation R2 between the partners of the couples was 0.52 (p < 0.001). No statistically significant differences emerged when evaluating the rate of 25-(OH)-D insufficiency according to the causes of infertility. Serum 25-(OH)-D correlates within the partners of infertile couples. Further evidence is warranted to determine the clinical relevance and possible clinical applications of this finding.
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Affiliation(s)
- Alessio Paffoni
- a Infertility Unit, Fondazione Ca' Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Stefania Ferrari
- a Infertility Unit, Fondazione Ca' Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Alice Mangiarini
- a Infertility Unit, Fondazione Ca' Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Stefania Noli
- b Department of Clinical Sciences and Community Health , Università degli Studi di Milano , Milan , Italy
| | - Alessandro Bulfoni
- c Department of Obstetrics and Gynaecology , Humanitas Research Hospital , Milan , Italy , and
| | - Paola Vigano
- d Division of Genetics and Cell Biology , Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele , Milan , Italy
| | - Fabio Parazzini
- b Department of Clinical Sciences and Community Health , Università degli Studi di Milano , Milan , Italy
| | - Edgardo Somigliana
- a Infertility Unit, Fondazione Ca' Granda, Ospedale Maggiore Policlinico , Milan , Italy
- b Department of Clinical Sciences and Community Health , Università degli Studi di Milano , Milan , Italy
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Buggio L, Barbara G, Facchin F, Frattaruolo MP, Aimi G, Berlanda N. Self-management and psychological-sexological interventions in patients with endometriosis: strategies, outcomes, and integration into clinical care. Int J Womens Health 2017; 9:281-293. [PMID: 28496368 PMCID: PMC5422563 DOI: 10.2147/ijwh.s119724] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Endometriosis has a multifactorial etiology. The onset and progression of the disease are believed to be related to different pathogenic mechanisms. Among them, the environment and lifestyle may play significant roles. Diet, dietary supplements, physical exercise, osteopathy, massage, acupuncture, transcutaneous electrical nerve stimulation, and Chinese herbal medicine may represent a complementary and feasible approach in the treatment of symptoms related to the disease. In this narrative review, we aimed to examine the most updated evidence on these alternative approaches implicated in the self-management of the disease. In addition, several studies have demonstrated that endometriosis may negatively impact mental health and quality of life, suggesting that affected women may have an increased risk of developing psychological suffering as well as sexual problems due to the presence of pain. In light of these findings, we discuss the importance of integrating psychological interventions (including psychotherapy) and sexual therapy in endometriosis treatment.
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Affiliation(s)
- Laura Buggio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano.,Departmental Operating Unit of Surgical Gynecology and Endometriosis, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico
| | - Giussy Barbara
- Department of Obstetrics and Gynecology and Service for Sexual and Domestic Violence (SVSeD), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, Ospedale Maggiore Policlinico
| | - Federica Facchin
- Faculty of Psychology, Catholic University of Milan, Milan, Italy
| | - Maria Pina Frattaruolo
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano.,Departmental Operating Unit of Surgical Gynecology and Endometriosis, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico
| | - Giorgio Aimi
- Departmental Operating Unit of Surgical Gynecology and Endometriosis, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico
| | - Nicola Berlanda
- Departmental Operating Unit of Surgical Gynecology and Endometriosis, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico
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