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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of the depot preparations medroxyprogesterone acetate (MPA) (Depo-provera) and norethindrone (Norigest) is discussed. MPA is administered in dosages of 150 mg every 3 months. It inhibits ovulation, probably by affecting cyclical gonadotropin secretion. It also causes atrophy of the endometrium, affects cervical secretions and ciliogenesis. MPA has a Pearl index of .348. Norethindrone works to inhibit ovulation, but its effectiveness is also dependant on changes in cervical secretions. Dosage is 200 mg every 84 days, and it is not as effective as MPA. MPA use usually causes oligoamenorrhea or amenorrhea. Gain in weight, headaches, and nervousness are side effects of MPA use, and it can also affect carbohydrate metabolism. The restoration of fertility after discontinuing MPA use generally takes a few months. MPA is counterindicated for women with unexplained vaginal bleeding, liver function disturbances, and diabetes mellitis. It can be used during the lactation period or in cases of endometriosis. MPA can often be used when the side effects of other contraceptive agents or methods are unacceptable.
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PMID:[Pharmacological and clinical application of progestational hormone depot preparations]. 56 21

Statistics from various studies are compiled to present an overview of the somatic complications of induced abortions. These complications are divided into 2 groups, the 1st consisting of ''early'' complications that arise during the abortion or for 30 days afterwards. From 1970 to 1974, 1-9 deaths/100,000 induced abortions are registered in studies from various countries. A study from England and Wales shows that patient deaths after abdominal uterotomy are 3-9 times more numerous than vacuum and instrumental evacuation of the uterus and that abortions performed after the 12th week are 1.25-4.0 times more prevalent than during the first 12 weeks. ''Early'' complications are then divided into 2 categories, ''serious complication,'' e.g., uterine perforation, loss of blood requiring a transfusion, and ''complication'' exemplified by pyrexia. In various studies from throughout the world, ''complications'' arose in 4-25.6% of the cases and ''serious complications'' in 1.1-7.6%. In women with a somatic illness (e.g., diabetes) during an abortion, a greater percentage have complications. Patients having extirpation of the uterus, uterotomy, and sterilization, or salt water instillation had at least 3 times as many complications as those having vacuum aspiration or dilatation and curettage. The 2nd type of complication, the ''late'' complications, are permanent (e.g., sterility), or occur 30 days after the abortion (e.g., endometriosis). These complications are generally poorly documented and researched. The frequency of sterility as a ''late'' complication ranges from 1-6% in 1 study to 53% in another. There are indications that previous induced abortion can cause premature birth or spontaneous abortion, although there is contradicting evidence. These ''late'' complications are caused by cervical insufficiency caused by the induced abortion. More documentation is needed to make statements about the ''late'' complications.
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PMID:[Somatic complications following induced abortions]. 125 10

Insulin-dependent diabetes mellitus developed in a young woman 8 weeks after the initiation of danazol for treatment of pelvic endometriosis. After discontinuation of danazol the diabetes completely resolved. We suspect a possible cause-and-effect relationship, which has not previously been reported in the literature.
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PMID:Insulin-dependent diabetes mellitus associated with danazol. 200 64

Since promising immunological concepts for treatment of patients with three or more miscarriages have been introduced, an exact clarification of all possible etiological factors has become even more urgent, because an infection risk associated with leucocyte therapy cannot be ruled out. Own experiences with 47 couples with a history of habitual abortion who had been diagnostically evaluated in a special screening program in our hospital between 1985-1988 are discussed in the light of surveys of the recent literature. A critical revision of several factors which had been classified as etiological factors of habitual abortion in the past, seems important. While genetic factors are undoubtedly the most important cause of miscarriages in the first trimenon, the role of anatomical uterine anomalies (amongst our patients in 7 per cent), luteal insufficiency (among our patients in 9 per cent) and endometriosis cannot be evaluated with certainty yet because different diagnostic criteria have been established for diagnosis in the literature. Based on newly published data immunological factors seem to become etiologically more important; other anomalies, like infections or diabetes do not seem to be associated with an increased risk for habitual abortion. According to our experiences, habitual abortion may present as a problem involving different pathogenetic factors (among our patients in 79 per cent) so that sequential therapeutic steps may be required for treatment of a-possibly-multifactorial disease.
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PMID:[Diagnosis in patients with habitual abortion]. 264 7

20-30 million women use oral contraceptives. The estrogen component, either ethinyl estradiol or mestranol, inhibits the release of the ovum and affects the cervical secretions, the endometrium, the ovaries, and the Fallopian tubes. The gestagen component is derived from 19-nortestosterone or 17-hydroxyprogesterone, and the metabolism of the gestagen component is not fully known. Disposition to thrombosis, liver illness, diabetes, hypertension, amenorrhea, oligo menorrhea, or tumorous changes in the uterus or breasts should not use oral contraceptives. Menstrual disturbances and endometriosis can be controlled by the use of oral contraceptives. Urine samples, blood pressure, and weight should be monitored during oral contraceptive use.
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PMID:[What do oral contraceptives do? What are oral contraceptives?]. 513 57

Menopausal disorders coincide with the onset of luteal insufficiency and the resulting relative hyperestrogenism. At this stage the risks to be assessed are mainly related to a worsening of the menstrual syndrome (heaviness of the legs, abdominal distention, water retention, mastodynia, depressive syndrome), cycle changes, or various genital types of hemorrhage requiring investigation for detection of a possible fibroma, hyperplasia, endometriosis, or genital cancer. Once the menopause is settled a reduction in estrogen levels comes with reactive increases in FSM and LM levels, and the principal risk is the development of a cancer. The role of endogenous (obesity, diabetes, Stein-Leventhal, adenomatous hyperplasia) or exogenous (prolonged estrogen therapy alone) estrogens has to be evaluated in endometrial cancer. Cancer of the vulva also appears to be more frequent in menopausal women (natural or artificial), as well as cervical cancer and cancer of the breast. There is an apparent increase in cardiovascular risks in untreated menopausal women, but this is still discussed, as to the benefits of estrogen therapy.
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PMID:[Menopausal risk factors (author's transl)]. 625 25

During the past decade the World Health Organization (WHO) has embarked on a $17 million program to study different kinds of contraceptive methods and their effect on maternal health. More than 600 scientists from 85 countries are participating. These investigations have implicated abortion as a factor in miscarriage, perinatal morbidity, and perinatal mortality due to isthmus-cervical inadequacy. It is also implicated in sterility and extrauterine pregnancy, as well as other disorders of pregnancy. Hence WHO emphasizes other birth control methods, in particular the pill. But the birth control pill also has side effects, as this is the first time that hormones have been used not to treat some illness but in healthy women. Their incidence increases with age (after 30-35 years of age) and also is enhanced by smoking, high blood pressure, hyperlipoproteinemia, and diabetes. Oral contraceptives (OCs) also reduce the incidence of benign tumors of the breast, ovarian cysts, iron-deficiency anemia, and rheumatoid arthritis. They have a beneficial effect also in endometriosis, dysfunctional hemorrhages, polyposis and endometrial hyperplasia, ovulatory problems, and inflammatory conditions of the genitals. Many of the longterm effects of these contraceptives are still unknown, such as their influence on cancer or on the fetus. The WHO investigation has shown that 1/2 stop taking the birth control pill after 1 year, and 2/3 after 2 years. Another widespread technique is the IUD, used by over 60 million women. But this causes hemorrhage in some, especially the women of India, Pakistan, and other countries. Work is now being done on ways to minimize the hemorrhage associated with the IUD, to clarify its presence as a cause of inflammatory processes of the genitals, extrauterine pregnancies, and subsequent sterility. The WHO also studied the rhythm method of preventing conception and found that 35% of women ceased employing it after 13 months, while 20% became pregnant. It was decided to work on elucidating new methods of determining the onset of ovulation. The WHO is also studying the use of prostaglandins to interrupt pregnancy. A major task for the future is determining which women are at greatest risk from the various birth control techniques.
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PMID:[Modern methods of regulating generative function]. 733 55

The aim of the study was to see the function of follicular cells collected from ovaries of women suffering from endometriosis. The material was granulosa cells taken from 11 patients operated on 3rd and 4th degree of endometriosis. Antral granulosa cells were harvested from 34 medium-size (5-10 mm in diameter) follicles located on the cysts' walls or in the cysts' vicinity. Using the culture method, morphology and steroid secretion was estimated. Morphological properties of the cells in the culture did not differ significantly from that of healthy ones. All cells formed a monolayer and achieved different degrees of luteinization. Steroidogenesis of these granulosa cells was defected, particularly in the production of progesterone and testosterone.
Exp Clin Endocrinol Diabetes 1995
PMID:Morphology and steroidogenesis of cultured granulosa cells from endometrioidally changed ovaries. 758 28

Although an individual assessment of the risks and benefits is always essential, combined, low-dose oral contraceptives (OCs) are an effective method of fertility control, even for women with chronic medical problems. In addition to contraception, therapeutic uses of combined OCs include acne, anovulatory uterine bleeding, control of bleeding with blood dyscrasias, dysmenorrhea, endometriosis, hirsutism, hypothalamic amenorrhea, ovarian hormone replacement, polycystic ovarian syndrome, premenstrual syndrome, and recurrent functional ovarian cysts. This article presents guidelines for clinicians on the selection of combined OC users, counseling, contraindications, and management of adverse effects. It further outlines general considerations for the prescription of combined OCs to women with hypertension, diabetes mellitus, migraine headaches, and epilepsy.
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PMID:Combination oral contraceptives. 917 54

It is likely that endometriosis is a common multifactorial disease, like diabetes and asthma, caused by an interaction between multiple gene loci and the environment. Such conditions do not have a clear Mendelian pattern of inheritance. This chapter reviews the existing evidence, in human and non-human primates, that suggests there is a genetic basis to endometriosis. The environmental agents that have been implicated in the development of endometriosis are also reviewed. The identification of genetic loci conferring susceptibility to endometriosis using linkage analysis may lead to a better understanding of disease aetiology and, in time, improved therapeutic strategies and diagnostic methods.
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PMID:Is there a genetic basis to endometriosis? 938 40


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