Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tibolone appears to be at least as efficacious as other forms of hormonal replacement therapy (HRT) on climacteric symptoms. It does not cause withdrawal bleeding when used in women with at least 1 year of amenorrhea. It is, therefore, not indicated in perimenopause because it may cause irregular bleeding. The androgenic action of tibolone may have a two-fold benefit: on the one hand, it may help depression and libido more than other forms of HRT, while, on the other hand, it may improve some lipid parameters such as Lp(a), and triglycerides. However, this androgenic action, may also be responsible for the reduction of HDL cholesterol, that may thus reduce the beneficial effect of tibolone on lipids. It is estimated that only 30% of cardiovascular risk protection of HRT is due to improvement of classical lipids parameters while a great role is played by the direct effect of estrogen on vessels. Tibolone, as well as estrogen, has been shown to induce peripheral vasodilatation and also has a direct effect on vascular reactivity thus increasing peripheral blood flow with no changes in blood pressure or cardiac output. Tibolone seems to exert a similar effect as other forms of HRT on markers of bone metabolism and bone mass, but no data is yet available on fracture prevention.
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PMID:Tibolone: a review. 988 30

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

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

The injectable contraceptive depot-medroxyprogesterone acetate (DMPA) dissolves slowly and is released over 3 months to suppress ovulation. It is more than 99% effective at preventing pregnancy. More than 30 million women in 90 countries have used DMPA and none have died from using it. A World Health Organization [WHO] study showed that DMPA did not significantly increase the risk of breast cancer or other cancers. One study points to a small reduction in bone density with DMPA use, but the reduction did not become larger with long-term use and may even be reversible. The US Food and Drug Administration (FDA) thoroughly reviewed these studies and the experiences of DMPA users. This review resulted in the FDA's approving DMPA as a contraceptive in October, 1992. Almost all DMPA users experience menstrual changes with irregular bleeding and spotting occurring during the 1st few months. After 12 months, at least 50% of DMPA users experience amenorrhea, which some women consider a benefit. Other possible but rare side effects are weight gain, headache, breast tenderness, loss of libido, depression, nervousness, and fatigue. It takes longer for past DMPA users to conceive after stopping DMPA use than users of other contraceptive methods, but by 18 months more than 90% of past DMPA users who wanted to become pregnant conceived. DMPA does not protect users from sexually transmitted diseases (STDs) or HIV/AIDS. They need to use latex condoms to prevent STD/HIV transmission. DMPA users must return to their health care provider every 3 months for another injection. DMPA is a viable contraceptive for women wanting a safe, reliable, long-term, reversible contraceptive. Any woman wanting to use DMPA should discuss it with her provider.
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PMID:Facts about injectable contraception. 1228 37


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