Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: DrugBank:APRD00691 (EE2)
 7,802 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A multicenter randomized double-blind trial was conducted to compare 55 women using Loestrin-20 (20 ug ethinyl estradiol and 1 mg norethisterone acetate) as an oral contraceptive with a like number of women using Microgynon-30 (30 ug ethinyl estradiol and 150 ug levonorgestrel). 7 family planning clinics agreed to collaborate in the trial and enrollment of patients which began in November 1974. The number of participating clinics was increased to 12 at a later date. 133 patients were recruited between November 1974 and September 1976. 23 were excluded from the analysis. 55 of the remaining 110 patients were admitted to each of the 2 treatment groups. It was found that women who used Loestrin-20 discontinued treatment because of abnormal bleeding more frequently that women using Microgynon-30, but that the discontinuation rates for other reasons were closely similar in the 2 treatment groups. Of the 13 women who stopped using Loestrin-20 because of abnormal bleeding, 6 complained of oligomenorrhea or amenorrhea while the other 7 complained of irregular bleeding. Of the 2 women who stopped using Microgynon-30 because of bleeding problems, 1 complained that the bleeding was irregular and the other that it was prolonged. Although the sample size is small, Loestrin-20 clearly provides poor cycle control and consequently is less acceptable than Microgynon-30. Loestrin-20 may be less effective than Microgynon-30, but the difference in the accidental pregnacy rates is not statistically significant.
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PMID:A randomized double-blind trial of two low dose combined oral contraceptives. 37 92

Gynecological endocrinologists at J.W. Goethe University in Frankfurt am Main, Germany, compared serum data on 34 20-39 year old women who used either the oral contraceptive Marvelon (30 mcg ethinyl estradiol [EE] and 150 mcg desogestrel [DG] or Lovelle (20 mcg EE and 150 mcg DG) to observe their pharmacokinetics and some pharmacodynamic parameters. Both formulations had the same DG levels. Between days 1 and 10, peak levels and areas under the curve (AUC) of EE rose by about 100% (p .05). During the washout cycle, EE levels were as high as 75 pg/ml (Lovelle) and 136 pg/ml (Marvelon). The corresponding AUC stood at 464 pg x h/ml and 840 pg x h/ml). Keto-DG (KDG) levels rose by almost 300% between day 1 and 21 (1.7 ng/ml vs. 4.5 ng/ml; p .01). Yet, considerable differences in the AUC of EE and KDG existed within the same women. Further, there was no association between EE levels and KDG levels. Marvelon resulted in 16% higher sex hormone-binding globulin levels and 12% higher corticosteroid-binding globulin levels than Lovelle on day 21 (p .05 and p .01, respectively). The decrease following the morning peak levels of cortisol was less pronounced in women taking Marvelon than in those taking Lovelle, resulting in a significantly higher AUC of cortisol (252 mcg x h/dl vs. 231 mcg x h/dl; p .05). No relationship between serum levels of EE and/or KDG existed between the 2 groups. In addition irregular bleeding patterns were similar for both treatment groups (44% for Lovelle and 50% for Marvelon). In fact, 7 of the 10 women who experienced irregular bleeding did so with both formulations, suggesting they were predisposed to irregular bleeding. In conclusion, the contraceptive steroids suppressed hepatic steroid metabolism, resulting in a rise in EE levels and some rise in progestogen levels.
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PMID:Oral contraceptives containing 20 or 30 micrograms ethinylestradiol and 150 micrograms desogestrel: pharmacokinetics and pharmacodynamic parameters. 182 82

Results are presented of a phase 3 international multicenter trial to study the effect of a new, low-dose oral contraceptive (OC) containing 20 mcg ethinyl estradiol and 150 mcg desogestrel (Mercilon) with regard to efficacy, cycle control, blood pressure, and acceptability. In total, 1684 women from 12 European countries were included in the study. 4 pregnancies occurred, 3 of them patient failure and 1 tablet failure. The overall Pearl Index was 0.20. The frequency of irregular bleeding was comparable to that recorded with other commonly used low-dose OCs. No serious side effects occurred. The incidence of the most frequently reported subjective side effects, i.e., headache, nausea, and breast tenderness, was already low after the 1st cycle of treatment and decreased to below pretreatment levels with continued use. There was a small increase in mean body weight, which was confined essentially to young women. The preparation did not affect the mean systolic or diastolic blood pressure. This new preparation has thus far proven to be an effective, safe, and well-accepted ultra low-dose OC.
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PMID:Phase III clinical trial with a new oral contraceptive containing 150 micrograms desogestrel and 20 micrograms ethinylestradiol. 183 99

This discussion of vaginal bleeding in adolescents reviews the causes of dysfunctional uterine bleeding (complications of pregnancy, pelvic inflammatory disease and/or complications of the use of oral contraceptives or IUDs, blood dyscrasias, trauma and foreign bodies, tumors, and other causes) as well as the diagnosis and treatment of dysfunctional uterine bleeding. Menstrual irregularities are the most common cause of abnormal vaginal bleeding in adolescence and can be managed easily in the office. On occasion an adolescent needs to be hospitalized for acute menorrhagia; very rarely a surgical procedure such as dilatation and curettage is necessary. Dysfunctional uterine bleeding is defined as abnormal uterine bleeding without local anatomic causes. It is a diagnosis of exclusion and requires an adequate examination of the vagina, cervix, and other pelvic organs. Some local bleeding presents as irregular vaginal bleeding in adolescents and is diagnosed as dysfunctional bleeding. The diagnosis of pregnancy and related complications (threatened abortion, incomplete or complete abortion, ectopic pregnancy, and postabortal trophoblastic disease) may present as irregular bleeding in the practitioner's office. A teenager may give a history of pregnancy if she is questioned about it closely and confidentially. A high index of suspicion will help the clinician to make this diagnosis. Salpingitis should be suspected in any teenager who presents with low abdominal tenderness, pain, abnormal bleeding, low grade fever, and tenderness on cervical movement. Approximately 10% of teenagers with blood dyscrasias present with cyclic hypermenorrhea. Vaginal ulcerations and objects introduced into the vagina occasionally cause irregular bleeding. Such tumors as clear cell adenocarcinoma of the vaginal and sarcoma botyroides may present as metrorrhagia. These etiologic factors comprise as most only about 5% of adolescents who complain of irregular vaginal bleeding. The most common cause of such bleeding is anovulation or oligoovulation due to the noncyclic release of follicle stimulating hormone (FSH) and luteinizing hormone (LH) during adolescence. Although the most common cause of this cyclic disturbance is the hypothalamic pituitary ovarian axis, some well known endocrine disorders can also produce this picture. 95-97% of adolescents will have no organic reason for their irregular bleeding. The diagnosis of dysfunctional uterine bleeding is then made. Detailed suggestions are provided on how to proceed which will prevent grave errors in the diagnosis and treatment of dysfunctional uterine bleeding in adolescents. The patient who has been bleeding very heavily and has a hematocrit less than 30 may have to be hospitalized. A medical D and C can be done with a progestational agent. Such patients may need a transfusion of packed cells and should be kept on oral iron. They also need cycling with Ovral for 2-3 months and must be followed carefully.
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PMID:Vaginal bleeding in adolescents. 674 72

Advice is provided for nurses and midwives who are asked about the safety and efficacy of the newer oral contraceptives (OCs). The trend toward ever smaller amounts of estrogen in new formulations effectively halted when the quantities of estrogen became insufficient to suppress the hypothalamic-pituitary axis or drug interactions with barbiturates or oral antibiotics resulted in insufficient estrogen, both conditions resulting in higher pregnancy rates. The newest generation of OCs follows 2 basic approaches, phasic OCs and improved progestogens. The triphasic pills Logynon and Trinordiol come in memo-packets with pills of 3 different progestogen-estrogen balances to be taken for 21 days. They contain 30 g less total monthly hormone than any other combined pill, give excellent cycle control and high reliability, and produce minimal metabolic changes. Bi-Novum, a biphasic pill with 35 mcg estrogen, gives cycle stability and minimal nausea, weight gain, and breast tenderness, comparable to results with 50 mcg estrogen. The progestogen used in Bi-Novum produces minimal changes in lipid metabolism and glucose tolerance safety factors. Another new formulation, Marvelon, is a conventional combined type pill containing a new progestogen, desogestrel, which favorably affects high density lipoprotein-cholesterol ratios, remobilizes cholesterol deposits from arterial walls, and reduces the risk of cardiovascular disesase. The progestogen-only formulation Femulen, with a daily dose of 5 mg of ethynodiol diacetate, has high efficacy and a relatively low dropout rate due to irregular bleeding and other causes.
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PMID:When patients ask about the latest and safest oral contraceptive. 692 41

A double-blind, randomized, multicenter study compared 2 combined oral contraceptives containing 150 mcg desogestrel and either 30 mcg (Marvelon/Desolett) or 20 mcg (Mercilon) of ethinyl estradiol, focusing on reliable pregnancy prevention and cycle control. The women were 300 Norwegians, 500 Swedes, and 200 Danes, 52% of whom switched from a prior brand of pill. Women completed bleeding diaries: all bleeding that did not start in the 7-day tablet-free interval and last for 7 or fewer days was considered irregular bleeding, either breakthrough bleeding or spotting. The 2 groups were similar except that those taking the 150/20 combination were slightly older. There were 2 pregnancies with the 20 mcg combination and 3 with the 30 mcg pill, 2 of which were considered method failures. In 8573 cycles analyzed there were more instances of irregular bleeding and amenorrhea with the 20 mcg pill than with the 30 mcg pill. Duration of breakthrough bleeding was not significantly different. Irregular bleeding was also more common n women switching from another brand of pill to a lower estrogen dose pill. Blood pressure decreased slightly on the 20 mcg ill and body weight rose slightly on the 30 mcg pill, but hemoglobin did not change. More women dropped out or chose not to continue taking the 150/20 mcg pill because of side effects, usually irregular bleeding, mood changes, dizziness, or weight gain. Despite these differences, there were enough women who tolerated the lower dose combination pill to merit continuing to take it.
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PMID:Comparative profiles of reliability, cycle control and side effects of two oral contraceptive formulations containing 150 micrograms desogestrel and either 30 micrograms or 20 micrograms ethinyl oestradiol. 821 4

A leading patient complaint is headaches which tend to occur more often in women than men. Nonvascular headache is the most common and is caused by tension or muscle contraction. Oral contraceptives (OCs) do not affect nonvascular headaches. They can also be safely used in women who experience common migraines whose symptoms do not become more severe or frequent during OC use. On the other hand, women who have classic migraine (headache accompanied by focal neurologic symptoms) or common migraine with symptoms becoming more severe or frequent during OC use should discontinue OC use. Instead, they should use a barrier method or the IUD. Estradiol treatment appears to be effective in treating menstrual migraine. Since the data are inconclusive about the effect of OCs on young women who have experienced a stroke or transient ischemic attacks, it would be best for them to use a barrier method. Most antiepileptic drugs (phenobarbital, phenytoin, paramethadione, and carbamazepine) cause enzyme induction which may be linked to decreased levels of estrogen and increases in irregular bleeding, thereby increasing the likelihood of an epileptic OC user becoming pregnant. Possible contraceptive failure exposes a developing fetus to the teratogenic properties of the antiepileptic drugs. Thus, physicians should prescribe OCs with 50 mcg of ethinyl estradiol rather than 35 mcg ethinyl estradiol. Epileptic women can also use Depo-Provera, because it is not only effective in preventing pregnancy but reduces seizure frequency. It is important for any contraceptive method chosen for epileptic women to be effective because pregnancy intensifies seizures which in turn can damage the mother and/or fetus and cause neonatal distress.
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PMID:Contraceptive methods for women with neurologic disorders. 851 48

The effectiveness and side effects of Marvelon (0.150 mg desogestrel and 30 mcg ethinyl estradiol) were evaluated in a multicenter study of 1570 women for a total of 22,158 menstrual cycles. Half the women in the study were under age 25. Only 1 pregnancy was reported, and this was due to patient failure. The frequency of spotting and breakthrough bleeding decreased steadily from 22.3% in the 1st treatment cycle, 14.9% in the 2nd, 8.4% in the 6th, 5.6% in the 12th, to 2.8% in the 21st and then rose slightly from 3.6% in the 24th cycle. This pattern of irregular bleeding during the early cycles is common to all oral contraceptive preparations. Changes in body weight were almost negligible and restricted to women under age 20. There was no change in average blood pressure when compared with pretreatment values. Superficial thrombophlebitis occurred in 7 women. Side effects, including nausea, headache, nervousness, depression, and breast tenderness, declined to negligible levels as treatment progressed. Levels of plasma protein sex-hormone-binding globulin (SHBG) appear to be higher with Marvelon than with a similar preparation containing levonorgestrel and ethinyl estradiol. Other studies have noted significantly higher serum high density lipoprotein (HDL) cholesterol levels with Marvelon than with combined levonorgestrel and ethinyl estradiol. This is attributed to the lack of androgenicity of desogestrel in the clinical dosage used in this study. SHBG and serum HDL levels are increased by estrogens and decreased by androgens.
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PMID:Desogestrel and ethinyloestradiol. 1227 90

The efficacy and clinical acceptability of a new oral contraceptive (OC) Mercilon (20 mcg ethinyl estradiol + 150 mcg desogestrel) was investigated in 235 women during 1305 cycles in an open, noncomparative, multicenter study carried out by 37 French gynecologists. No pregnancies occurred and cycle control was good. Only 5.5% of the women studied discontinued this OC because of irregular bleeding. The incidence of subjective side effects such as breast tenderness, known to be estrogen-dependent, was very low. Total continuation rate for Mercilon was very high for a low-dose contraceptive at 86%. Because of its clinical characteristics, along with its already proven excellent metabolic acceptability, this OC can be prescribed as a 1st choice for women without contraindication against combined OCs. (author's modified)
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PMID:[The 20 mcg ethinylestradiol and 150 mcg desogestrel pill: six month, multicenter study in 235 women]. 1228 54

More than 300 subscribers of Contraceptive Technology Update (CTU) completed the questionnaire for the 1994 Pill Survey. Most respondents (68%) were nurse practitioners followed by physicians (11%), registered nurses (9%), and physician assistants (4%). 92% of respondents considered oral contraceptives (OCs) (especially Ortho-Cept and Ortho Novum 7/7/7) as the leading hormonal contraceptive choice among adolescents and adults. Among teens, Depo-Provera was the second choice (4%). Among adults, Depo-Provera and the contraceptive implant, Norplant, fared equally as well (2% each). Headaches, mood swings, and weight gain continued to be complaints for all hormonal contraceptives. Progestins are potent depressants. Norplant produced the most complaints. About 20% of providers reported that at least 20% of their patients wanted Norplant implants removed because of significant side effects, especially irregular bleeding. Most Norplant users had the implants for no more than 12 months. The providers realized that they were providing insufficient counseling to Norplant users about irregular bleeding before insertion. A physician noted that some women experience infertility for as long as two to three years after their last Depo-Provera injection. Some providers discourage women from using Norplant based on the many complaints they have received from past users.
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PMID:Depo-Provera and Norplant implants prove no competition for no. 1 choice, OCs. The 1994 pill survey. 1228 3


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