Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Oroma Nwanodi
A.T. Still University, USA
Scientific Tracks Abstracts: Gynecol Obstet (Sunnyvale)
Globally, endometrial cancer is the sixth leading cause of female cancer-related deaths. Endometrial hyperplasia (EH), has a lifetime progression rate to endometrial cancer ranging from 5%, if simple without atypia, to 40%, if complex with atypia. Site specific, long-acting intrauterine devices (IUDs) provide fertility sparing, progestin-based EH management. Progesterone sensitizing metformin potentially offers outcome improvements. PubMed searches provided sufficient literature for a review of medical management of EH and early stage EC since 2012. The high-dose frameless IUD has achieved sustained regression of Grade 3 endometrial intraepithelial neoplasia for 14 years. Case series on early stage EC treatment with IUDs have 75% or greater regression rates. For simple through complex EH with atypia, the 52 mg-IUD has achieved 100% complete regression in 6-months. Metformin 1000 mg daily with Cyproterone/Ethinyl Estradiol 2 mg/35 mcg 21 days per month for 6 months achieved 100% complete regression of Stage 1A Grade 1 EC. Metformin, 500 mg twice daily has achieved 95.5% regression of simple EH through early stage EC at 3-months. IUDs show an outcome advantage over oral progestins. Outcomes from the feMMe trial for the 52 mg-IUD and metformin will fill a gap in the literature. Studies on metformin for EH, and studies of progestins or metformin for early stage EC management have been underpowered and possibly used too low dosages to achieve significant differences in, or optimal outcomes for the treatment modalities.
Oroma Nwanodi, MD, DHSc graduated from Meharry Medical College of Nashville, Tennessee in the United States of America as a Medical Doctor in May, 2001. She completed Doctor of Health Sciences at A T Still University, Mesa, Arizona, in December, 2016. She has practiced in California, Missouri, and Wyoming. Currently, she provides locum tenens services in Minnesota. She has over 20 publications. She has presented on Acupuncture and a range of Obstetrics and Gynecology subjects. Her publications and presentations may be accessed via academia.edu and researchgate.net.