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At least 649 records · Page 36Linked to original sources
PubMed1990

The interaction of phenytoin and carbamazepine with combined oral contraceptive steroids.

Patients taking oral contraceptive steroids (OCS) are known to suffer contraceptive failure while taking anticonvulsants such as phenobarbitone, phenytoin and carbamazepine. We have studied the single dose kinetics of ethinyloestradiol (EE2); 50 micrograms, and levonorgestrel (Ng); 250 micrograms in groups of women before and 8-12 weeks after starting therapy with phenytoin (n = 6) and carbamazepine (n = 4). The area under the plasma concentration-time curve (AUC) was measured over a 24 h period for each steroid and significant reductions were seen with both anticonvulsants. Phenytoin reduced the AUC for EE2 from 806 +/- 50 (mean +/- s.d.) to 411 +/- 132 pg ml-1 h (P less than 0.05) and for Ng from 33.6 +/- 7.8 to 19.5 +/- 3.8 ng ml-1 h (P less than 0.05). Carbamazepine reduced the AUC for EE2 from 1163 +/- 466 to 672 +/- 211 pg ml-1 h (P less than 0.05) and for Ng from 22.9 +/- 9.4 to 13.8 +/- 5.8 ng ml-1 h (P less than 0.05). These changes are compatible with the known enzyme inducing effects of phenytoin and carbamazepine. Patients taking these anticonvulsants will need to be given increased doses of OCS (equivalent to 50-100 micrograms EE2 daily) to achieve adequate contraceptive effects.

Adolescent↗
PubMed1998

Cutaneous malignant melanoma in women and the role of oral contraceptives.

The role of oral contraceptives (OC) in the aetiology of cutaneous malignant melanoma (CMM) has been controversially discussed over the last two decades. In an extensive literature search we identified 18 case-control studies, published between 1977 and 1996, offering information on this relationship. Using a meta-analytical approach we combined the study-specific risk estimates and derived a summary odds ratio of 0.95 (95% confidence interval: 0.87-1.04). Based on the data of 3796 cases and 9442 controls, we thus found no evidence for an aetiological role of OC use in the development of CMM.

Case-Control Studies↗
PubMed1999

The safety and contraceptive efficacy of a 24-day low-dose oral contraceptive regimen containing gestodene 60 microg and ethinylestradiol 15 microg.

OBJECTIVE: The safety and contraceptive efficacy of a new 24-day regimen of an oral contraceptive combination containing gestodene (GTD) 60 microg and ethinylestradiol (EE) 15 microg was evaluated in an open-label, multicenter study. METHODS: Adult women received GTD 60 microg/EE 15 microg from day 1 to 24 and 4 days of placebo during a 28-day cycle for either 13 or 19 cycles. RESULTS: Of the 1515 subjects enrolled, 1496 were included in the intent-to-treat analysis. A total of three pregnancies were reported during the 18 194 treatment cycles of the study, yielding a Pearl index of 0.21. Life-table analysis, based on 16 954 cycles, gave an accidental pregnancy rate of 0.0033. The most frequent adverse events were headache (reported in 35% of subjects), absence of bleeding (16%), flu-like syndrome (15%), pharyngitis (15%) and abdominal pain (15%). The most frequent reasons for withdrawal from the study were metrorrhagia, flu syndrome and absence of bleeding. Analyses of withdrawal and intermenstrual bleeding and spotting indicated acceptable cycle control. CONCLUSIONS: The 24-day GTD 60 microg/EE 15 microg regimen appears to be a well-tolerated and effective method for low-dose oral contraception. The current formulation offers an ultra-low steroidal dosage combined with a reduced pill-free interval to improve contraceptive efficacy.

Adult↗
PubMed1977

Comparison of ethinylestradiol and mestranol in sequential-type oral contraceptives in their effects on blood glucose and serum insulin in oral glucose tolerance tests.

Forty 3-hour oral glucose tolerance tests (OGTTs) were performed in 10 assumedly healthy female volunteers 19 to 30 years old, each serving four times as her own control. Each subject was taking a sequential type oral contraceptive containing either 50 microgram of ethinylestradiol or 80 microgram of mestranol alternatingly in four consecutive treatment cycles. The OGTTs were performed on the 6th day of each cycle, during pure estrogen medication. Blood glucose and serum insulin values did not differ significantly under either estrogen as tested by the t-test for paired observations. Our results do not support the findings of others that mestranol has a more pronounced or even exclusively adverse effect on glucose tolerance as compared with ethinylestradiol.

Adult↗
PubMed1990

Oral contraception in disease states.

Oral contraceptives are clearly contraindicated in patients with a history of thromboembolic disease, ischemic heart attack, or cerebral stroke. Patients requiring long-term anticoagulant treatment can be treated with gonadotropin-releasing hormone analogs to prevent ovulation, because ruptured follicles can cause massive intraperitoneal bleeding. Patients with essential hypertension and severe liver diseases should also discontinue treatment 4 weeks before major elective surgery. Migraine and diabetes mellitus are regarded as relative contraindications, depending on the individual situation. Long-term diseases, such as Crohn's disease, epilepsy, and sickle cell anemia, also require individualized consultation.

Cerebrovascular Disorders↗
PubMed1999

Oral contraception: current use and attitudes.

Oral contraception (OC) has been available for almost four decades. During this time, changes in contraceptive use in general and OC in particular have occurred. Knowledge and attitudes about OC may not always reflect trends in use. Contraceptive use data from 1965-1995 show that OC continue to be the method chosen consistently by more than one-quarter of women contraceptors. Probably even more women would use the pill if they had more accurate information regarding the higher failure rates with barrier methods (especially the condom), if misperceptions about OC safety were put to rest, and if greater awareness of the noncontraceptive health benefits of OC could be achieved. Increased education and awareness of women as well as their healthcare providers has the potential to positively affect future contraceptive use.

Breast Neoplasms↗
PubMed1984

Vitamin metabolism and the effects of multivitamin supplementation in oral contraceptive users.

The effect of combined oral contraceptives containing 158 micrograms of levonorgestrel and 38 micrograms of ethinyl estradiol on vitamin B-1, B-2, B-6, B-12, folates, vitamin A, carotenoids, vitamin E and tryptophan load test was studied in a group of 34 healthy non-lactating women. This was compared to an identical study conducted in another group of 19 subjects who used IUCDs for contraception, and also in two other groups of subjects who were given an additional multivitamin preparation on a daily basis (33 subjects) and on the days when OC was not taken (29 subjects). Assessments were made prior to, and during the third week of the 4th, 7th and the 13th cycles of OC treatment. Urinary xanthurenic acid excretion (XA), plasma vitamin A and the folate content of the sera and red blood cells were significantly increased by OC treatment, although this excessive XA excretion was adequately corrected with 18 mg of daily vitamin B-6 supplementation. The metabolism of the rest of the vitamins was not significantly altered by OC usage. This suggests that a routine use of multivitamin supplement may not be necessary.

Adult↗
PubMed1980

The effect of ampicillin on oral contraceptive effectiveness.

The effectiveness of oral contraceptives with concomitant use of ampicillin has been questioned. Eleven volunteer subjects were studied during 2 consecutive menstrual cycles; they were given Demulen with placebo or ampicillin during each of the cycles. Serum estradiol (E2), progesterone (P4), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were evaluated on days 13 and 19 of each cycle. Testosterone-binding globulin (TeBG) capacity and ferning of cervical mucus were evaluated on day 13 of each cycle. Subjective symptoms were recorded. All cycles appeared to be anovulatory. Steroid suppression was present in 10 of 11 patients during both cycles. Estrogen-dependent TeBG was not affected by ampicillin. It is possible that cervical mucus ferning was improved by concurrent ampicillin administration. Ampicillin appears unlikely to diminish the effectiveness of the oral contraceptive studied.

Adult↗
PubMed1986

Opioid regulation of pituitary gonadotropins and prolactin in women using oral contraceptives.

To determine the effect of oral contraceptives on endogenous opioid modulation of the hypothalamic-pituitary axis, we gave a bolus dose of 10 mg of naloxone intravenously in women using Lo/Ovral-28 oral contraceptives and in normal (control) women during the follicular (days 8 to 9) and luteal (days 21 to 23) phases. Plasma follicle-stimulating hormone, luteinizing hormone, and prolactin were measured by radioimmunoassay before and after naloxone at regular intervals. In oral contraceptive users (n = 5) basal plasma follicle-stimulating hormone (3.7 +/- 0.4 mIU/ml) and luteinizing hormone (3.2 +/- 0.5 mIU/ml) levels were significantly lower than in control subjects during both follicular (10.7 +/- 0.9 and 16.7 +/- 2.0) and luteal (7.7 +/- 1.4 and 10.0 +/- 0.9, respectively) phases (p less than 0.05 to 0.001). In contrast the basal plasma prolactin level was significantly higher in oral contraceptive users (25.0 +/- 4.1 ng/ml) than in control subjects during the follicular (11.8 +/- 1.2) and luteal (11.0 +/- 0.8) phases (p less than 0.01). In control subjects, follicle-stimulating hormone, luteinizing hormone, and prolactin levels did not change significantly after naloxone in the follicular phase, but naloxone elicited a significant synchronous release of luteinizing hormone and prolactin during the luteal phase. In contrast, oral contraceptive users showed increases in luteinizing hormone and prolactin after naloxone that were not significantly different from the basal plasma levels.

Adult↗
PubMed1982

Antipyrine elimination in saliva after low-dose combined or progestogen-only oral contraceptive steroids.

1 A 'low-dose' combined oral contraceptive steroid (OCS) preparation containing 30 microgram ethinylo-estradiol and 150 microgram levonorgestrel was found to reduce significantly antipyrine clearance in a group of women acting as their own controls. 2 An OCS preparation containing only a progestogen (75 microgram norgestrel) did not reduce antipyrine clearance in a second group of women. 3 The evidence suggesting that the oestrogen component of combined OCS preparations could be responsible for the reduction in antipyrine clearance is discussed.

Adolescent↗
PubMed1993

Rational use of oral contraceptives in the perimenopausal woman.

Oral contraceptives have undergone extensive revision in their labeling over the past 10 years to remove warnings about cardiovascular and other risks and to highlight their noncontraceptive benefits. While these changes are becoming better known, the potential bone-sparing effects of oral contraceptives in the premenopausal and perimenopausal woman remain under-appreciated. Osteoporosis is a major health care problem worldwide in terms of both its associated morbidity and mortality and its economic impact. Although the benefits of postmenopausal hormone replacement therapy for the prevention and treatment of osteoporosis are generally recognized, little attention has been paid to strategies that might be used to maintain bone mass up to the time of menopause, at which time bone loss accelerates. An additional noncontraceptive benefit of oral contraceptives may be to maintain and build bone mass up to the time of menopause.

Contraceptives, Oral↗
PubMed2004

Superior cycle control with a contraceptive vaginal ring compared with an oral contraceptive containing 30 microg ethinylestradiol and 150 microg levonorgestrel: a randomized trial.

BACKGROUND: This trial was conducted to compare cycle control with vaginal ring a combined contraceptive vaginal ring, and a combined oral contraceptive (COC) delivering 30 mug ethinylestradiol (EE) and 150 mug levonorgestrel. METHODS: This open-label, randomized, multi-centre, Phase III study involved adult women from 11 countries. Subjects were treated with either vaginal ring or a COC for 13 cycles (12 months). RESULTS: A total of 1030 subjects (vaginal ring, n=512; COC, n=518) comprised the intention-to-treat (ITT) population. The percentage of women in the ITT population who completed the trial was 70.9% for vaginal ring and 71.2% for the COC group. The incidence of breakthrough bleeding and spotting over cycles 2-13, the primary efficacy parameter, was lower with vaginal ring (range 2.0-6.4%) than the COC (range 3.5-12.6%), and for cycles 2 and 9 the lower incidence with vaginal ring was confirmed as statistically significant (P=0.003 and P=0.002 respectively). The incidence of intended bleeding was significantly higher over all cycles with vaginal ring (58.8-72.8%) than with the COC (43.4-57.9%). CONCLUSIONS: Cycle control with vaginal ring was excellent and superior to that of a COC containing 30 mug EE.

Adult↗
PubMed1975

[Serum level of thyroxin-binding globulin under oral contraception (author's transl)].

The use of oral contraceptives results in an increase in thyroid-binding-capacity in conformity with a change of results by T3/T4-tests. Using Laurell-electrophoresis and an anti-serum produced by Behringwerke the determination of the thyroid-binding-globulin (TBG) in serum is easy to handle. TBG was determined in serum from 137 women using oral contraceptives for more than 3 months. The apllication of oral contraceptives is followed by a statistically significant increase in the TBG level in serum. Thereby oral contraceptives change the TBG-level in a different degree. Preparations with a marked estrogen potency on the average effect a higher TBG-concentration than those with progesterone activity derived by menses-delay test. The difference of TBG-level is statistically significant. According by the increase of TBG-concentration in serum is caused by estrogen, the extent of the increase is modified by the progesterone component.

Adolescent↗
PubMed1990

Oral contraceptives in risk groups: exclusion or monitoring?

Careful consideration of absolute and relative contraindications, including newly appreciated factors such as past pregnancy-related hypertension, is essential to select what is termed the "safer women." A family history of either arterial or venous thrombosis indicates preliminary blood analysis to exclude atherogenic lipid states and thrombophilias. The goal then is to prescribe "safer pills." One should also allow for biologic variation in pharmacokinetics and end-organ responses. This can be done to a limited extent in clinical practice by using bleeding from the uterus as a "threshold bioassay." Namely, by identifying for each woman the lowest dose of a chosen estrogen-progestogen combination that is just sufficient to prevent breakthrough bleeding. Thereafter, monitoring requires attention to the development of new risk factors, regular blood pressure checks, and specific attention to the important side effects of headaches and migraines, especially if there are focal (cerebral ischemic) symptoms.

Cardiovascular Diseases↗
PubMed1998

Contraceptive efficacy and acceptability of a monophasic oral contraceptive containing 30 microg ethinyl estradiol and 150 microg desogestrel in Latin-American women.

Contraceptive efficacy, subject acceptability (cycle control, side-effects, acne score and weight gain) and blood pressure of a monophasic oral contraceptive containing 30 microg ethinyl estradiol plus 150 microg desogestrel (Marvelon) were assessed in an open-label 6-cycle multicenter study in Argentina (7 centers) and Venezuela (5 centers). Of the 407 participating women, 389 (95.6%) completed six cycles of treatment, providing data for a total of 2383 cycles. No pregnancies occurred during the course of the study, confirming the high contraceptive reliability of Marvelon. Cycle control was excellent; the duration of withdrawal bleeding decreased during consecutive treatment cycles and the incidence of spotting and breakthrough bleeding was low. The desogestrel/ethinyl estradiol combination was well tolerated and the incidence of minor side-effects, which was already low in the first treatment cycle, in most cases decreased during the subsequent cycles. The preparation was effective in reducing pre-existing acne, whereas it did not induce clinically relevant changes in blood pressure and body weight. Marvelon was shown to provide effective oral contraception, with good tolerance and excellent cycle control in Latin-American women.

Acne Vulgaris↗