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At least 811 records · Page 45Linked to original sources
PubMed1986

Dysfunctional uterine bleeding.

Dysfunctional uterine bleeding is defined as abnormal uterine bleeding in the absence of organic disease. It is the result of anovulation or the abnormal local production of prostaglandins, and in each case the primary fault is inappropriate hormone formation. There are two approaches to diagnosis. The traditional one is primarily concerned with the exclusion of cancer of the endometrium; this concern results in the frequent resort to uterine curettage. The second approach is to limit curettage to patients whose symptoms are not ameliorated by medical therapy. The aim of medical treatment is either to produce secretory change in the endometrium or to decrease the formation of uterine prostaglandins. Intermittent progesterone treatment is used to cause secretory changes in the endometrium. Decreased production of the prostaglandins is achieved indirectly by causing atrophy of the endometrium or directly through the use of prostaglandin synthetase inhibitors. Surgery in the form of dilatation and curettage has no long-term therapeutic effect; hysterectomy is definitive therapy.

Adult↗
PubMed1983

Medroxyprogesterone acetate as a contraceptive for female drug addicts.

A study of 69 female drug addicts is presented who have been given depomedroxyprogesterone acetate (DMPA) as a contraceptive for 1 680 woman-months. No pregnancies were reported during the treatment period with DMPA. After stopping treatment, 60 pregnancies with 43 births were recorded, 12 with low birth weight. In 3 cases pregnancy ended with spontaneous abortion, and in 14 cases legal abortion were performed. During the study, regular liver function tests revealed no hepatotoxic effects from DMPA in this group of patients where one would expect a high frequency of a serum hepatitis. Neither coagulation nor blood pressure were affected. The most frequent side effect was amenorrhoea, which seems to be accepted well in this group. Metrorrhagia is often a reason for withdrawing the drug. A very high frequency of venereal or other gynaecological infection is presumably the explanation for the very high number of atypical inflammation cells found at vaginal cytological examination. In the series, two cases of carcinoma in situ have been demonstrated by cervical biopsy. Both cases are possibly related to these women's early sexual activity, very promiscuous life and to the poor environment of the drug addict.

Adolescent↗
PubMed1983

The 150/30 formulation. Experience in the United Kingdom.

Oral contraceptive agents (OCs) containing levonorgestrel, 150 micrograms, and ethinyl estradiol, 30 micrograms, account for almost half the sales of such agents in the United Kingdom. The remarkable success of this formulation has occurred primarily because it provides extremely low doses of both hormonal constituents yet still gives most users a very acceptable bleeding pattern: the incidence of breakthrough bleeding is about 6% and of amenorrhea, less than 3%. Approximately 90% of users have cycle lengths of 28 +/- 3 days. The risk of serious side effects is significantly lower than with formulas containing higher doses of progestogen and/or estrogen. Minor side effects occur in only a small percentage of cycles. Headache is reported in approximately 10% of all cycles and should be regarded as a potential indicator of increased risk. If it presents as focal migraine, use of the combined OC should be discontinued. The contraceptive effectiveness of the 150/30 formulation is similar to that of the 50 micrograms formulations among compliant women; in less compliant women the margin of error is reduced, and the possibility of an increased risk of accidental pregnancy must be considered.

Adult↗
PubMed1986

Contraception in hypertensive women using a vaginal ring delivering estradiol and levonorgestrel.

Contraception with a vaginal ring (CVR) that delivers estradiol and levonorgestrel was used during a mean of 15.6 menstrual cycles in 12 hypertensive women. Blood pressure (BP) was measured 5 times on each visit during 2 pretreatment control cycles; during the 1st, 2nd, 4th, 6th, and from the 9th to 12th cycles of CVR use; and again after a 1-month recovery period. No significant change in BP occurred during CVR use in any of the subjects. Plasma renin substrate and antithrombin III activity did not vary significantly, which suggests the utility of administering natural estradiol via the vagina, thus avoiding the first pass effect that occurs with oral contraceptives. Significant decreases in plasma sex hormone-binding globulin, cholesterol, high density lipoprotein cholesterol, phospholipids, and triglycerides occurred, indicating an androgenic effect of levonorgestrel. We conclude that the CVR is a method of contraception that does not elevate BP in hypertensive women.

Adolescent↗
PubMedDate not supplied

Heterogeneity of sperm density profiles following 16-week therapy with continuous infusion of high-dose LHRH analog plus testosterone.

LHRH agonist analogs have been investigated as potential male contraceptives. It has been shown that the LHRH agonistic analog [D-Trp6,Pro9-NEt] LHRH (LHRHA) given to men in single doses up to 500 micrograms daily for up to 20 weeks with the coadministration of testosterone enanthate produces reversible oligozoospermia. Individual responses to the treatment, however, were variable. In this study, we gave the same analog to eight normal male volunteers as a continuous infusion of 500 micrograms daily for 16 weeks. Testosterone enanthate, 100 mg, was given by injection every second week. Six of the subjects became oligozoospermic but the other two retained sperm counts that were greater than 20 million/ml, although their treatment continued for 20 weeks. The reasons for this variability of response are not clear. Serum immunoreactive LH values increased during the infusion period whereas testosterone declined. FSH values fell during treatment in all subjects except the two non-responders. The acute pituitary response to LHRHA during the treatment or shortly thereafter (48 h) was completely abolished, and bioactive LH values were suppressed totally. FSH, LH, testosterone and sperm counts returned to normal in all subjects following discontinuation of LHRHA infusion. Continuous infusion of 500 micrograms of LHRHA daily for 16 weeks with 100 mg of testosterone enanthate every 2 weeks induced desensitization of the pituitary, loss of LH bioactivity, and decreases of FSH and testosterone. This mode of administration, however, did not improve sperm density results obtained earlier by single daily injections of the analog. Heterogeneity of sperm density profiles still persists for reasons that are not yet clear.

Adult↗
PubMed1982

Effect of chronic oral contraceptive steroids on theophylline disposition.

The effect of chronic oral contraceptive (OC) usage on the disposition of theophylline was examined. Aminophylline solution (4 mg/kg) was given orally to 8 healthy female non-OC users and to 8 healthy women who were chronic (greater than 6 months) OC users. The OC user group had a significantly lower total plasma clearance of theophylline than women not using OC (35.1 +/- 5.6 vs. 53.1 +/- 14.5 ml/h/kg). The t1/2 was also significantly prolonged in the OC group (9.79 +/- 1.43 vs. 7.34 +/- 1.75 h) while the volume of distribution was similar between the 2 groups. The serum ethinylestradiol (EE) concentrations after oral OC administration were measured simultaneously. The apparent clearance of EE was about 30% lower in the OC users. A significant positive correlation was found between the apparent clearance of EE and the plasma clearance of theophylline. The effects of OC are predominantly due to chronic use with decreased elimination of both theophylline and EE.

Adult↗
PubMed1988

Early abortion with a single dose of the antiprogestin RU-486.

RU-486 is a synthetic progesterone antagonist that is abortifacient in early pregnancy. This trial evaluated the effectiveness and safety of a single 600 mg oral dose given to 50 healthy women less than or equal to 49 days from their last menstrual period. Efficacy was inversely related to the initial beta-subunit of human chorionic gonadotropin level, ranging from 100% at less than 5000 mIU/ml to 81% at greater than 20,000 mIU/ml (p less than 0.05). Uterine bleeding was the most serious side effect. However, the mean change in the hemoglobin value 14 days after treatment was -0.4 gm/dl, and no patient required blood transfusion. This regimen appears to be simple, effective, and safe.

Abortifacient Agents↗
PubMed1982

Serum high density lipoprotein cholesterol levels in Chinese healthy subjects and patients with certain diseases.

Serum high density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and triglycerides (TG) were determined, and values of low density lipoprotein cholesterol (LDL-C), HDL-C/TC (%), and the LDL-C/HDL-C (ratio) were calculated in 1101 healthy Chinese men and women, 77 patients with coronary heart disease (CHD), 70 patients with cerebral vascular disease (CVD), 64 patients with diabetes mellitus (DM), 40 bilaterally oophorectomized women and 95 women using oral contraceptives. Serum HDL-C levels seemed higher and LDL-C levels lower in the healthy Chinese population as compared with those previously reported from European and American whites. Serum HDL-C was significantly higher in fertile females than in males of comparable ages. We failed to demonstrate any sharp fall in HDL-C after the menopause or bilateral oophorectomy. Serum HDL-C levels were significantly lower in both CHD and CVD patients than in healthy subjects of comparable sex and age. Concomitant increases in serum TC, LDL-C and TG, however, were found in CHD patients but not in CVD patients. No abnormality in the mean serum HDL-C level was found in DM patients. However, those complicated with CHD had significantly lower HDL-C than those without CHD. A striking serum HDL-C lowering effect was found with some kinds of oral contraceptives.

Adult↗
PubMed1983

The epidemiology of endometrial cancer in young women.

A case-control study was conducted in Los Angeles County, California, of 127 endometrial cancer cases aged 45 years or less at diagnosis, to investigate the role of fertility, obesity and exogenous oestrogens in the development of the disease in young women. Use of sequential oral contraceptive (SOCs) or oestrogen replacement therapy (ERT) for greater than or equal to 2 years was strongly associated with increased risk of endometrial cancer. After excluding these cases, since the SOC or ERT use was probably the cause of their disease, we were left with 110 case-control pairs for further study. Among these remaining case-control pairs increasing parity was strongly associated with decreased risk (relative risk of 0.12 for women of parity 3 compared to nulliparous women, P less than 0.001). Current weight was associated with increased risk (relative risk of 17.7 for women weighing greater than or equal to 190 lbs compared to women weighing less than 130 lbs, P less than 0.001). Combination oral contraceptive (COC) use was associated with a decreased risk, which decreased with duration of COC use (relative risk of approximately 0.28 at 5 years of use, P less than 0.001), but the estimate of the protective effect was reduced and became statistically non-significant when allowance was made for weight and parity. The protective effect of COC use was only clearly evident in women who had less than 3 live-births and weighed less than 170 lbs. These results provide further support for the "unopposed" oestrogen hypothesis of the aetiology of endometrial cancer.

Adenocarcinoma↗
PubMed1986

Clinical evaluation of drugs used in fertility regulation.

The clinical evaluation of drugs used in fertility regulation is initially assessed in Phase I, II and III trials. The design of each phase and the investigative staff must be adequate. In Phase I, normal, healthy human volunteers meeting specific guidelines are usually studied. Numbers vary between 20 and 80 and the purpose is to determine the acute toxicity of the compound. In Phase II, efficacy and safety are examined in a clinical target population, and emphasis may be placed on pharmacological and mechanistic studies. Usually between 50 and 200 patients are involved. In Phase III, large-scale clinical studies for local registration and the introduction of drugs to various countries are included. This paper describes the evaluation of various drugs used in contraception, including NORPLANT implants, and considers the efficiency, safety and acceptability of such drugs. Phase IV studies are usually needed to reveal chronic toxicities or rare events.

Clinical Trials as Topic↗
PubMed1988

Recovery of sperm production following the cessation of gossypol treatment: a two-centre study in China.

A number of variables were investigated in 46 men who had stopped taking gossypol for their predictive association with the degree and time of recovery of spermatogenesis. Thirty-nine (87%) of the men were azoospermic at cessation of gossypol treatment. In those with sperm present the geometric mean concentration and total sperm count were 8.3 X 10(6)/ml and 30.7 X 10(6), respectively. Twenty-eight men (61%) recovered to a defined threshold of spermatogenic function (sperm concentration greater than or equal to 20 X 10(6)/ml), with a median recovery time of 1.1 years. However, 18 men (39%) had not recovered to this degree of spermatogenic function after a median follow-up of 1.9 years and, of these, 10 (22%) remained azoospermic. The influence of individual baseline variables on the time to defined recovery was examined using Kaplan-Meier curves for groups and their joint effect by Cox's regression model. The failure of recovery was strongly associated with longer treatment, greater total dose of gossypol, smaller testicular volume, elevated FSH concentrations and, to a lesser extent, with greater body weight.

China↗