1. Post-Menopausal Vaginal Hemorrhage Related to the Use of a Hop-Containing Phytotherapeutic Product
- Author
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Florence van Hunsel, Sonja van de Koppel, Eugène van Puijenbroek, and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)
- Subjects
medicine.medical_specialty ,Abdominal pain ,medicine.medical_treatment ,endometrium hyperplasia ,alendronic acid ,Case Report ,plant medicinal product ,middle aged ,norethisterone ,Medicine ,follow up ,Pharmacology (medical) ,human ,fexofenadine ,endometrium ,vagina bleeding ,Cervix ,Vaginal Hemorrhage ,Gynecology ,medicine.diagnostic_test ,business.industry ,adult ,article ,Menopausal Syndrome ,phytotherapy ,medicine.disease ,Gynecological Examination ,Curettage ,Endometrial hyperplasia ,Surgery ,abdominal cramp ,mometasone furoate ,medicine.anatomical_structure ,cell proliferation ,female ,priority journal ,drug withdrawal ,menopausal syndrome ,uterine cervix cytology ,withdrawal bleeding ,medicine.symptom ,business ,Endometrial biopsy - Abstract
Two 54-year-old women developed abdominal cramps and vaginal hemorrhage as a result of endometrial hyperplasia during treatment with a hop-containing phytotherapeutic product (MenoCool®) for post-menopausal complaints. The women used the hop-containing phytotherapeutic product (418 mg of hop per tablet) twice daily (1 and 0.5 tablets by both patient A and B). Patient A developed abdominal cramps and vaginal hemorrhage after 2 months of use. After gynecological examination, she was diagnosed with endometrial hyperplasia. The patient was treated with a curettage. The hop-containing phytotherapeutic product was discontinued, and the patient recovered. Patient B developed abdominal pain/cramps and vaginal hemorrhage after 5 months of use. A cervix smear, internal examination, and ultrasound were performed. Due to the thickness of the endometrium, a pipelle endometrial biopsy was performed. Results showed no indication for cervix cancer. The use of MenoCool® was ceased; follow-up information received from the patient shortly thereafter indicated that she had almost entirely recovered from the abdominal pain/cramps and vaginal hemorrhage. Hop (Humulus lupulus) has phytoestrogenic properties that may be the cause of endometrial hyperplasia and subsequent vaginal hemorrhage. A Naranjo assessment score of 5 was obtained for both cases, indicating a probable relationship between the patient’s endometrial proliferation and subsequent vaginal hemorrhage and their use of the suspect drug.
- Published
- 2016