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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Studies have shown that estrogens and progestogens can cause immuno-depression. Oral contraceptives (OCs) have also been linked with viral and urinary tract infections. In developing countries, women have higher risks of developing these infections because of undernutrition and anemia. This study evaluates cell-mediated immunity (CMI) and one parameter of hormonal immunity--serum hemolytic complement--in undernourished Indian women using OCs. The study population consisted of a random sample of urban women of low income status, between 20 and 30 years of age, mean weight of 45.2 kg. and mean height of 151.2 cm., and mean hemoglobin level of 13.2 g/dl (none had hemoglobin levels below 8 g/dl). 52 of the women were taking OCs (150/ug. of d. norgestrol and either 30 or 50/ug. ethinyl estradiol). The T and B lymphocytes, hemolytic complement in serum (CH50), PHA-induced lymphocyte transformation (PILT) were measured. Results revealed a wide scatter of values in all 4 parameters--% of T cells; % of B cells; 3H-thymidine incorporation, and CH50 levels even in the control group. No significant differences in % of B and T lymphocytes subpopulation or PILT were observed between OC users and the control group. CH50 levels were significantly lower, however, in OC users. Generally, clinical experience of pill users suggests that there is no need for undue concern for potential immune-associated problems in OC users.
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PMID:Immune studies in oral contraceptive users. 31 58

Normal pregnancy changes include physiologic anemia, leukocytosis, and thrombocytopenia. Cardiac rate and stroke volume increase, vascular resistance falls, and creatinine clearance markedly rises. Thyroid binding globulin and cortisol binding globulin both increase, as do complement proteins and fibrinogen, the latter resulting in a normally high erythrocyte sedimentation rate. Estrogen and progesterone rise dramatically. Low back pain, hip and sacroiliac complaints are common. The cytolytic activity of natural killer (NK) cells is decreased, as are adhesion and chemotaxis of phagocytic cells. Antibody responses are normal. CD4 cells proportionately decrease. A large number of circulating proteins suppression lymphocyte proliferation, and T-cell interleukin-2 (IL-2) production may be suppressed. In studies of pregnant patients, controls must include normal pregnant women.
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PMID:Physiologic adaptations of pregnancy. 128 59

In addition to oral contraceptives (OCs), the morning-after pill, the minipill, and depot preparations also belong to hormonal contraceptives. The latter two contraceptives have not become established among young women because of inadequate cycle control. For postcoital contraception in Austria, Neogynon and Stediril-D, consisting of 0.05 mg of ethinyl estradiol (EE) + 0.25 mg of levonorgestrel, are used within 48 hours of unprotected intercourse. Lower dose OCs have considerably reduced the risks of side effects. Micropills are the optimal OCs with EE under 50 mcg combined with the new generation of gestagens. The beneficial effects include menstrual regularity and the prevention of anemia, ovarian cysts, and fibrocystic mastopathy. Nausea, headache, spotting, and weight gain do occur in individual cases, even among young people. The potential risk of thromboembolism is the most important, although arterial cardiovascular risk is minimal in young age. The probability of postpill amenorrhea is less than 1%. Micropills can be used by young diabetics provided the disease is not beyond 10 years' duration and there is no angiopathy. Acne, seborrhea, and hirsutism are beneficially influenced by a combination of 0.035 mg of EE with 2 mg of cyproterone acetate. The relative risk of endometrial and ovarian cancer are only about half as high among OC users as among nonusers. The risk of breast cancer in young OC users has not been conclusively explained. Regular colposcopy and cytology is recommended for young OC users to preclude the risk of malignancies of the genital tract. Sex education and the use of OCs that are the most suitable and effective for young people can reduce the number of unwanted pregnancies and abortion. The comparison of two 5-year periods in the 1970s and 1980s at the University Obstetrical-Gynecological Clinic in Graz showed that the incidence of births among women under 18 years of age decreased from 3.6% (778) to 1.6% (353).
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PMID:[Benefits and risks of hormonal contraception]. 146 64

A 73 year old woman was hospitalized for recurrent occult gastrointestinal bleeding. She had been treated with iron replacement for a microcytic anemia at the age of 67 years remaining on iron and was well until 1989, when she again was hospitalized with symptomatic anemia (hemoglobin 5.4 9um/dl). Urea, electrolytes, liver function, serum vitamin B12 and red cell folate tests were normal. The gastrointestinal blood loss continued, and she became dependent on transfusions, receiving 60 unites of blood over the course of a year. Investigation confirmed iron deficiency with occult blood loss, and showed antibodies to gastric parietal cells, with a title of 1:160. At gastroscopy a series of longitudinally arrayed red streaks were seen radiating to the pylorus, the typical appearances of antral vascular ectasia or watermelon stomach. The diagnosis was confirmed histologically. Prednisolone therapy, initially at a dose of 30 mg, successfully stopped the bleeding and other drugs were withdrawn except from carbimazole and tolbutamide. Prednisolone also restored the gastric acid secretion to normal (basal acid output 2.7 mEq/hour, peak acid output 14 mEq/hour) with a corresponding fall in gastrin to 70 pg/ml. However, prednisolone caused hyperglycemia even at a reduced dose of 10 mg/day. It was replaced by a standard estrogen-progesterone pill (loestrin 30) containing 30 mcg of ethinyl estradiol and 1.5 mg of norethisterone taken daily for 3 weeks each month. After an endoscopic antral biopsy she received 4 units of blood, but otherwise maintained her hemoglobin concentration on iron alone over this period with a considerable reduction in gastrointestinal bleeding.
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PMID:Gastric antral vascular ectasia: maintenance treatment with oestrogen-progesterone. 161 93

In a study carried out in Germany between 1985-89 unintended pregnancy was found in 7.9% of girls aged 15-21 in 1985 and in 5.2% in 1989. A study of 2905 young people aged 14-18 in Austria indicated that 75% of girls and 55% of boys had sexual intercourse by age 18 making contraception vital for adolescents. Among oral contraceptives (OCs) micropills with 20 mcg ethinyl estradiol barely affect the follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels, but the gestagen component can induce bleeding, spotting, and breast symptoms. Discontinuation quickly restores the normal connection of the hypophysis and ovary without affecting later pregnancy. 5.1 years after the end of high-dose combination OC use for 9-46 months only 3 out of 13 women did not become pregnant. OCs reduce bleeding disorders, anemia, and dysmenorrhea, ovarian cancer, and endometrial cancer. Their effect on breast cancer is not clear. Phenobarbital and rifampicin accelerate OC metabolism, and OCs reduce the effect of anticonvulsives and tolbutamide (for hypoglycemia). Neogynon and Stediril D are postcoital pills used within 48 hours of intercourse. IUDs are not recommended, as adnexal infection is 1.5-2 times higher in girls 14018 using IUDs. The effectiveness of the diaphragm and condom depend on motivation; creams and vaginal sponges are useful but they may cause irritation. The Billings method produced only a 2.9 Pearl-index reliability in 7000 cycles, thus natural methods often fail. Before age 14 girls must have parental consent for prescription of OCs, after 14 the physician is not liable for OC prescription, but induced abortion still requires parental consent until age 18.
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PMID:[Contraception in adolescents]. 174 70

Ethinyl estradiol administered in vivo to female rats resulted in a mild anemia with a 120% increase in reticulocytosis. Consistent with a previous study, the red blood cell cholesterol-to-phospholipid molar ratio was decreased by 25%, whereas fatty acyl incorporation was significantly increased into phosphatidylethanolamine (PE) and not into phosphatidylcholine (PC), the major acyl acceptor in red blood cells. Analysis of this estrogen-dependent acylation increase as a function of cell age indicated that it was not expressed in reticulocytes but in erythrocytes and was associated with cell aging. Estrogen was further shown to increase the red blood cell susceptibility to peroxidation generated by incubation with H2O2. Altogether, the results suggest that estrogen indirectly increases phospholipid acylation in red blood cells by decreasing protection against oxidative damage, thereby favoring the action of endogenous phospholipases against oxidized substrates. This occurs predominantly in PE of oldest cells because 1) PE, being more unsaturated than PC, is more sensitive to oxidation, and 2) susceptibility to oxidation increases with cell age.
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PMID:Estrogen modulates phospholipid acylation in red blood cells: relationship to cell aging. 188 70

Estrogen and progesterone cytoplasmic receptors (ER, PgR) were determined by radiochemical DCC technique in the endometria of 16 normal women at before child bearing age and 6 to 9 months after LNG IUD insertion. The study showed that both ER and PgR were reduced significantly after LNG IUD insertion (P less than 0.01). The decrease of ER and PgR might play an important role in gland reduction and endometrial atrophy. It may be one mechanism of the contraceptive effect and the cause of anemia or spotting between menstruation during the course of LNG IUD insertion.
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PMID:[Effect of levonorgestrel intrauterine device on human endometrial estrogen and progesterone receptors]. 193 11

Oral hormonal contraception is a low risk and safe form of contraception for women between the ages of 15-35 without risk factors such as smoking, obesity, diabetes mellitus, hypertension, or hypercholesteremia. Women over 35 years of age should take the pill only when risk factors can be excluded. In general, low dose pills with less than 50 mcg ethinyl estradiol should be used since they have the lowest impact on the metabolism. Use of the pill could in fact have positive effects on health. For example, benign mamma tumors occur less frequently, dysmenorrhea generally improves, anemia and inflammatory adnexal diseases are less common occurrences, and there appears to be a clearly protective effect against morbidity of the endometrium and ovarian cancer. (author's modified)
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PMID:[Risk-benefit analysis of contraception with steroids]. 333 Mar 69

Whether the differences in progestin-estrogen formulations of oral contraceptives (OCs) lead to any clinically significant differences is an important question, even though the concept of "tailoring the pill to the patient" has assumed less importance as the hormonal dosages have decreased. Each component can be evaluated individually, but it is often difficult to predict the result of their combined action. All of the new low-dose formulations contain the same estrogen, ethinyl estradiol (EE). Although the type of progestin in low-dose OCs is probably of little significance for efficacy and cycle control, it may be more important in regard to lipid and carbohydrate metabolism. Combined OC therapy acts simultaneously at various levels of the reproductive system, and contraceptive efficacy of pills with less than 50 mcg of estrogen probably results from these combined actions. The action of estrogen and progesterone is synergistic: the sustained estrogen component exerts negative feedback on gonadotropin secretion, provides stability to the endometrium, and increases the potency of the progestational agent, while progestin can influence only estrogen-primed tissue. The progestin suppresses luteinizing hormone secretion; in addition, progestational influence dominates estrogenic influence in affecting the remainder of the reproductive system. Previous OC usage may delay pregnancy by several months but does not impair longterm fertility potential or increase congenital anomalies or abortions if conception occurs subsequent to the 1st post-pill cycle. Breakthrough bleeding, which occurs in 15% of users, is the single most frequent cause of pill discontinuation but appears to be of no medical consequence. Breakthrough bleeding and amenorrhea may be controlled by changing the pill formulation. Depression has been reported in 5% of OC users, but pill use appears to alleviate premenstrual tension. The individual patient's risk-benefit ratio must be considered when noncontraceptive uses of the pill are contemplated. OC use has been cited as a cure for dysmenorrhea, although the mechanism is uncertain. The possible preservation of fertility or prevention of progression of endometriosis with cyclic pill use should be investigated. The controlled sloughing of a uniformily thinning endometrium prevents and controls dysfunctional uterine bleeding, endometrial hyperplasia, and the anemia that results. Use of OCs has been recommended in treatment of hirsutism to suppress ovarian function when the hypersecretion of androgens is documented. Since both adrenal and ovarian androgens are often involved in hirsutism, the combined suppressive actions of OCs frequently are beneficial. Estrogens also decrease sebum production and often result in indirect acne improvement. Cyclic estrogen-progesterone therapy is recommended for inducing sexual maturation in primary amenorrhea secondary to gonadal failure.
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PMID:Formulation and noncontraceptive uses of the new, low-dose oral contraceptive. 623 95

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) is a bleeding disorder attributed to a vascular developmental abnormality. It is transmitted as an autosomal dominant trait. A 63-year-old female was admitted because of repeated episodes of severe anemia which resulted from bleeding of telangiectases in the gastric mucosa. Conventional therapies including endoscopical microwave coagulation and ethanol injection were not effective. The persistent anemia necessitated frequent blood transfusion. Estrogen was orally administrated and blood transfusion became unnecessary. Thus, estrogen therapy should be considered as one of the effective treatments for recurrent severe anemia due to hereditary hemorrhagic telangiectasia.
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PMID:Hereditary hemorrhagic telangiectasia showing severe anemia which was successfully treated with estrogen. 754 50


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