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Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the mid 1950s, when Pincus developed norethynodrel to reproduce a climate comparable to the female luteal phase or pregnancy, he added a synthetic estrogen to avoid uterine bleeding. The 1st pill contained estrogens to block gonadotropic activity and suppress the side effects of progestins used alone. But newer progestin compounds combine strong antigonadotropic activity with minimal androgenic effects and better control of uterine bleeding. The indications, advantages, and side effects of the newer high-dose progestin-only formulations should be weighed carefully in making decisions about their benefits. High-dose progestins are little used in France, but are widely known. They are appropriate for use in women with contraindications to estrogen such as uterine fibroids, endometrial hyperplasia, endometriosis, severe premenstrual syndrome, and polycystic breast disease. Another indication may be poor tolerance of combined oral contraceptives. It appears that high-dose progestins may be most useful for women over 40 who present the indicating conditions with some frequency. The most bothersome side effects are menstrual irregularities including metrorrhagia and amenorrhea. It has been estimated that fewer than 30% of users are effected by menstrual problems. Progestins derived from nortestosterone are anabolizing compounds and may cause significant weight gain. Norpregnane derivatives may be associated with a lower frequency and significance of weight gain, estimated to affect 10-15% of users. Nortestosterone derivatives are known to have atherogenic metabolic effects. But the 3rd generation of progestins do not seem to cause the same metabolic effects as the nortestosterone derivatives. It has not yet been determined whether they are suitable for obese and diabetic women. Neither is it known whether high-dose progestins may be suitable for women with histories of breast cancer. Although the Pearl index has not been well established, high-dose progestin contraception does not appear to be as effective as that achieved with combined formulations.
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PMID:[Macroprogestative contraception: side effects]. 1231 11