RESUMO
This article reviews publications dating back more than a century describing investigations of the endometrium, including those examining the relationship between endometrial hyperplasia and carcinoma, the influence of estrogens on the endometrium, and strategies for protecting the endometrium from unopposed estrogen stimulation. Endometrial hyperplasia and carcinoma studies date from before 1900. The influence of endogenous estrogens on the endometrium became evident with observations of endometrial hyperplasia and/or carcinoma in women with estrogen-secreting tumors or polycystic ovarian disease. Later, observational studies and randomized, controlled trials suggested a relationship between unopposed estrogens and endometrial cancer and hyperplasia. The first, and to date only, effective clinical strategy for protecting the endometrium from unopposed estrogen stimulation has been the use of progestins. A new approach for endometrial protection in menopausal therapy is the pairing of a selective estrogen receptor modulator (SERM) with estrogen(s), also known as a tissue selective estrogen complex (TSEC). Effective protection of the endometrium as well as treatment of menopausal symptoms and prevention of osteoporosis would be key elements for a clinically useful TSEC.
Assuntos
Hiperplasia Endometrial , Neoplasias do Endométrio , Endométrio , Terapia de Reposição de Estrogênios , Estrogênios , Moduladores Seletivos de Receptor Estrogênico , Hiperplasia Endometrial/história , Neoplasias do Endométrio/história , Terapia de Reposição de Estrogênios/efeitos adversos , Terapia de Reposição de Estrogênios/métodos , Estrogênios/efeitos adversos , Estrogênios/sangue , Estrogênios/metabolismo , Feminino , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Neoplasias Ovarianas/metabolismo , Pós-Menopausa , Progestinas/efeitos adversos , Fatores de RiscoAssuntos
Ginecologia/história , Baltimore , Canadá , Hiperplasia Endometrial/história , Endometriose/história , Feminino , Educação em Saúde/história , História do Século XX , Humanos , Leiomioma/história , Mentores/história , Gravidez , Gravidez Ectópica/diagnóstico , Gravidez Ectópica/história , Neoplasias Uterinas/históriaRESUMO
Los autores revisan los criterios microscópicos del adenocarcinoma endometrial y de las lesiones relacionadas (hiperplasia y metaplasia) y analizan los factores patológicos de significado pronóstico del carcinoma endometrial (AU)
