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At least 379 records · Page 21Linked to original sources
PubMed1998

[Rationale for prescribing oral contraceptives].

Strategies for prescribing oral contraceptives (OC) are explained with particular emphasis on individual conditions which can be helpful to optimize the selection process out of the numerous on the market. While contraceptive efficacy unequivocally is regarded as high additional non-contraceptive benefits become substantial criteria for an individual decision. Antiandrogenic properties of progestogens like cyproteroneacetate clearly determine their preference in the presence of unwanted clinical signs and symptoms of hyperandrogenism. In most of the non androgen-related conditions the estrogenicity of a preparation as a result of the dose of ethinylestradiol and dose as well as antiestrogenic potency of the progestogen accounts for the majority of non contraceptive effects. Different progestogens are evaluated with respect to their antiestrogenic property. It is suggested to start treatment after selection of an appropriate progestogen with the lowest daily dose of both hormonal components and to continue intake at least for 3 to 4 cycles as long as no serious adverse events occur. In cases of persisting problems i.e. bleeding irregularities doses or dosing-schemes should be altered preferentially without switching to another gestagen.

Androgen Antagonists↗
PubMedDate not supplied

Oral contraceptive hypertension and thromboembolism.

Oral contraceptives (OCs) are a highly effective and widely accepted means of avoiding pregnancy, but they also worsen the major atherogenic cardiovascular risk factors to some degree in all women. Some OC users may suffer severe hypertensive episodes or massive hypertriglyceridemia with pancreatitis. Mild or severe adverse effects could eventually have serious consequences beyond the childbearing years. OC use would appear imprudent for women with a history of hypertension, gestational hypertension and a family history of hypertension. Special care is needed with blacks, diabetics and women with renal disease. OCs may also affect blood clotting, fibrinolysis and platelet adhesiveness. Also, histochemical and anatomical changes in blood vessels have been noted. Both may precipitate thromboembolic events while the OC user is still at the childbearing age and may also contribute to accelerated atherogenesis in subsequent years. There is a need for more specific guidelines for monitoring women on OCs for a worsening of their cardiovascular risk profile and changes in blood coagulation. Indications and contraindications for OC use in relation to the hazard of thromboembolic sequelae need to be more explicitly defined.

Adult↗
PubMed2001

[Low-dose oral contraception and bone density].

Oral contraceptives (OC) with 20 or 30 mcg Ethinyl-Estradiol (EE) inhibit bone remodeling in all age groups investigated until today as far as the biochemical parameters are considered. In perimenopausal women, OC with 20 or 30 mcg EE reduce the decrease in bone density and may, depending on the starting point, induce an increase in bone density. OC with 20 mcg EE might impede the formation of a physiological peak bone mass in very young women (probably women less than 20 years of age) by a reduction of bone metabolism. This possibility provoked a certain insecurity. However, it should not lead to the consequence that a safe contraceptive method is refused to young women. Unfortunately, there is still a lack of reliable studies allowing a final statement on the effect of low-dose OC on bone density in teenagers. Such studies are urgently needed so that we are able to guarantee in very young women that a reasonable contraception has not to be payed by a long-term risk for the skeletal health. The administration of a progestagen-only pill might be an alternative method for contraception in adolescence. A preparation containing 30 mcg of Levonorgestrel, nearly out of use today, could be of particular interest. A British study (20) has shown that during regular peroral administration of 30 mcg Leveonorgestrel per day, mean serum estradiol concentration decreased only slightly, from 653 to 500 pmol/l. This Estradiol concentration should still allow a normal bone metabolism and therefore a normal formation of the peak bone mass. However, the data actually available do not point convincingly to the conclusion that OC with 20 mcg EE or less might result in an insufficient estrogen concentration for normal bone metabolism. To reach peak bone mass, other factors than estrogens only are needed, such as Calcium, Vitamin D and physical activity.

Adolescent↗
PubMed2006

Anxiety's relationship to inconsistent use of oral contraceptives.

Five percent of typical oral contraceptive users experience an unintended pregnancy every year. Inconsistent use of oral contraception may be a leading contributor to the high rate of unintended pregnancy among oral contraceptive users. Previous medical research also suggests that anxiety may play a role in medication compliance, yet no known studies have examined the relationship between anxiety and oral contraceptive use. To test this relationship, the authors analyze data from the National Survey of Family Growth Cycle V (NSFG-V), restricting their sample to sexually active women currently taking oral contraceptives. They find that women who report multiple episodes of anxiety lasting at least 6 months have a greater probability of inconsistent use. The authors suggest goals for future research and discuss the role of health care professionals in addressing oral contraception compliance in light of their findings.

Adolescent↗
PubMed1980

An incremental-dose combined oestrogen-progestogen oral contraceptive: cycle control and endometrial changes.

A study of bleeding patterns and endometrial histology was made in women using an incremental-dose combined oestrogen-progestogen formulation. The proliferative activity during the first 11 days of treatment was less well-developed, and there was an early appearance of secretory changes (transitional pattern). The increased dose of d-norgestrel resulted in an endometrium showing either early or deficient secretory changes. Menstrual patterns were very satisfactory in terms of cycle length and duration of bleeding.

Biopsy↗
PubMed1995

The effect on blood pressure of a monophasic oral contraceptive containing ethinylestradiol and gestodene.

To obtain an overview of the effect of monophasic gestodene on blood pressure and to determine the frequency of "OC elevated BP/hypertension," the results of blood pressure monitoring from four clinical studies of contraceptive efficacy and safety have been retrospectively analyzed. A total of 1930 women took part in the studies, which recorded BP for up to 24 cycles. Analysis of results revealed that 97 women (5.0%) showed an increase in blood pressure from previously normal to elevated values while taking monophasic gestodene, with only 26 (1.35%) fulfilling the criteria of "OC elevated BP/hypertension." Only four women dropped out of the trials due to hypertensive blood pressure values, while 67 women (3.5%) experienced a normalization of previously elevated blood pressure measurements. In conclusion, this analysis has confirmed that gestodene has a negligible effect on blood pressure, with increased BP a relatively rare event.

Adolescent↗