Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This literature review compares the merits and disadvantages of the levonorgestrel-releasing IUD made by Leiras Pharmaceuticals, Turkey, Finland (LNG-IUD-20), with the Nova-T, Copper-T (TCu) and 220C, and Copper-T-38-Ag (TCu-380Ag). This IUD releases 20 mcg levonorgestrel daily from a Silastic sleeve on the vertical shaft containing 52 mg. The plasma level stabilized after a month at about 0.2 ng/ml, about half as high as that seen with Norplant implants. It is identical in size to the Nova-T. The Cu-T IUDs differ with respect to copper wire or sleeves, or silver-cored wire. The chief studies reviewed here were 2 multi-center trails primarily in European countries, and a 2 large multi-center trials in India. Cumulative pregnancy rates were 0.0 to 0.6 per 100 users for the LNG IUD, compared to slightly higher failures for inert or copper IUDs. While removal rates for bleeding, pain and pelvic inflammatory disease were lower for the LNG-IUD-20, removals for oligomenorrhea, amenorrhea and hormonal side effects were higher than for the other IUDS. In the Indian trials, removals for amenorrhea and irregular bleeding were much higher than rates reported in the European studies, resulting in significantly lower continuation rates overall. The results pointed to district benefits for the LNG-IUD-20, such as lower blood loss and anemia, relief of dysmenorrhea and menorrhagia, as well as possible lower risks of ectopic pregnancy in case of failure, less PID (pelvic inflammatory disease), and the claim by the maker that strictly correct placement is not necessary. Disadvantages of the LNG-IUD-20 are more difficult insertion due to the wider diameter; oligomenorrhea, amenorrhea and irregular bleeding; hormonal side effects such as acne, weight gain, nausea, headache and breast tension; and potential risk of functional ovarian cysts. The LNG-IUD-20 is considered comparable to copper IUDs in effectiveness, safety, longevity, and return to fertility after removal. Users should be counseled that the oligomenorrhea or amenorrhea is neither a medical problem or indicative of infertility, is common for the 1st 2 months, is reversible on removal, may signal an improved hemoglobin profile, relief of dysmenorrhea, and may be preferred to heavy bleeding from other IUDS. The program implications of this IUD are potential lower incidence of ectopic pregnancy and PID. The effect of its use on breast feeding, cost-effectiveness compared to Norplant, in-country manufacture, and cultural acceptance need to be determined in specific locales.
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PMID:An evaluation of the levonorgestrel-releasing IUD: its advantages and disadvantages when compared to the copper-releasing IUDs. 177 15

375 physicians from Russia completed a questionnaire at 3 symposia on modern contraceptive and human reproduction. Of these 375 physicians, 98% were obstetrician-gynecologists, 67% has no experience in family planning (FP). 44.5% had no training in FP, 83% were women, and their mean age was 37 years. Most frequently prescribed modern contraceptives were oral contraceptives (OCs) (50% often) and the IUD (59% often). More than 75% of respondent considered OCs, the IUD, and male and female sterilization to be very reliable. 41% and 92% respectively, did not know the efficacy of injectables/implants and the cervical mucus method. At least 50% considered the rhythm method, withdrawal, cervical mucus method, and vaginal douches to be not very reliable. 73% considered abortion to be an unsafe method. 30% did not know about the level of safety of injectables/implants. They perceived the IUD, OCs, injectables/implants, and female and male sterilization to be the most convenient methods. At least 60% considered withdrawal, abortion, abstinence, vaginal douches, and vaginal barriers to be inconvenient methods. Just 27% knew how OCs work. 13% considered OCs to never be safe. 65% thought the low-dose OCs are safe for nonsmokers under 35 years old. Most physicians considered the IUD and OCs to be the most suitable methods for all women. Woman's age contributed the most to physician opinions on contraception with female sterilization. Leading perceived side effects of OCs were gain (71%) and irregular bleeding (14%). The major perceived risks of OC use were thrombosis (35%), bleeding problems (21%), cardiovascular disease (16%), and depression (15%). 63% considered heavy menstrual blood loss to be the most disturbing side effect of IUD use. The leading perceived increased risks of IUD use were pelvic inflammatory disease (63%), ectopic pregnancy (54%), and anemia (27%). The misperceptions about modern contraception indicate a need for an exchange of information and skills between FP organizations in Western Europe and those in Russia.
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PMID:Contraception in Russia: attitude, knowledge and practice of doctors. 1228 5