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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Many recent advances in fertility control have involved progestin-only contraception. The progestin-only oral contraceptive, which has a failure rate of 1-2.5%, is especially suited to women who are breastfeeding or cannot tolerate estrogen. The levonorgestrel implant, Norplant, is effective for 5 years and has a 1.5% failure rate. Currently under development is Norplant-2--a system that requires 2 rather than 6 capsules, lasts for 3 years, and is as effective as Norplant-1. Also under development is a biodegradable progestin-only implant. However, there are many side effects associated with these methods. Irregular bleeding occurs in 60-70% of Norplant acceptors and leads 12-20% of these women to discontinue implant use. Headaches and acne occur in 5-20% of users of levonorgestrel methods. More significant are concerns that progestin tends to increase low density lipoprotein levels. Although initial human trials have indicated a drop of 5-15% in both these levels, studies in macaque monkeys have found that progestin-only contraception is more likely to cause atherosclerosis than an estrogen-progestin formulation.
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PMID:Progestin-only contraception. 202 98

As part of a longterm surveillance of the progestogen-only Norplant implant system, the metabolic functions in a representative Southeast Asian population of 100 Singaporean women were investigated. Prior research has identified the increased risk of arterial atherosclerosis complications and changes in serum lipids due to progestogens in contraceptives. Differences in liver function, lipid metabolism, and carbohydrate metabolism were recorded for this population of healthy, nonsmoking, nonalcohol drinking, and nonlactating women. Medical testing methods are identified and statistical differences are reported as the paired t test, and observation of % changes between pre- and postinsertion levels. Skewed results are subjected to the Wilcoxon signed rank test of significance suing median distribution. The resulting analyses found that the mean levels of bilirubin, total protein, and globulin remained within the normal clinical range, and no individual values fell outside the normal range. There was a highly significant increase in bilirubin during the 1st year of use, a decline in the 2nd, increase in the 3rd, and stabilization at increased levels after 4 years, suggesting that the system is returning to normal. Most prior studies have shown no significant changes in liver function. Total triglycerides and total cholesterol had a highly significant decrease in 4 years, which is comparable to other published results. The LDL cholesterol was decreased after 2 years and then reached preinsertion levels after 3 years and stabilized. Preinsertion levels of HDL cholesterol were reached after 2 years, then a decrease and stabilization in year 4. These HDL changes have been observed in other studies. HDL to total cholesterol ratio returned to preinsertion levels after 2 years after a reassuring and significant increase after 1 year, and decreased to .255 after 4 years. The ratio always remained above .200. It does not appear that lipid metabolism contributes to increased cardiovascular risk. It is cautioned that without controls for nonsteroid use the observed changes may be related to extraneous environmental effects. The absolute levels in the oral glucose intolerance test showed no clinically significant changes for 4 years. Only in years 1 and 2 on a paired basis were there differences after 1 hour.
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PMID:Metabolic changes in Singapore women using Norplant implants: a four year review. 1228 15