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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A double-blind, randomized, multicenter study compared 2 combined oral contraceptives containing 150 mcg desogestrel and either 30 mcg (Marvelon/Desolett) or 20 mcg (Mercilon) of ethinyl estradiol, focusing on reliable pregnancy prevention and cycle control. The women were 300 Norwegians, 500 Swedes, and 200 Danes, 52% of whom switched from a prior brand of pill. Women completed bleeding diaries: all bleeding that did not start in the 7-day tablet-free interval and last for 7 or fewer days was considered irregular bleeding, either breakthrough bleeding or spotting. The 2 groups were similar except that those taking the 150/20 combination were slightly older. There were 2 pregnancies with the 20 mcg combination and 3 with the 30 mcg pill, 2 of which were considered method failures. In 8573 cycles analyzed there were more instances of irregular bleeding and amenorrhea with the 20 mcg pill than with the 30 mcg pill. Duration of breakthrough bleeding was not significantly different. Irregular bleeding was also more common n women switching from another brand of pill to a lower estrogen dose pill. Blood pressure decreased slightly on the 20 mcg ill and body weight rose slightly on the 30 mcg pill, but hemoglobin did not change. More women dropped out or chose not to continue taking the 150/20 mcg pill because of side effects, usually irregular bleeding, mood changes, dizziness, or weight gain. Despite these differences, there were enough women who tolerated the lower dose combination pill to merit continuing to take it.
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PMID:Comparative profiles of reliability, cycle control and side effects of two oral contraceptive formulations containing 150 micrograms desogestrel and either 30 micrograms or 20 micrograms ethinyl oestradiol. 821 4

Use of vitamin B-6 has been recommended for the treatment of side effects associated with combined oral contraceptive (OC) use. To evaluate this recommendation, a randomized, triple-blinded controlled trial of 124 women recruited from 2 health centers in Zacatecas, Mexico, was conducted. 62 women received 150 mg of vitamin B-6 daily for 30 days, while the remaining 62 received a placebo. All cases and controls were new or continuing users of an OC containing 30 mcg of norgestrel and 30 mcg of ethinyl estradiol. Women rated the severity of 6 common OC side effects (nausea, headache, vomiting, dizziness, depression, and irritability) on a scale from 0 to 3 at baseline and 30 days after admission. There was a decrease in the severity of all 6 symptoms in both groups. Although higher proportions of women in the vitamin B-6 group reported decreases in OC-related side effect severity between admission and the 30-day follow-up visit, these differences were appreciable only for headache and dizziness and none was statistically significant. No evidence of vitamin B-6 toxicity was observed. However, this study failed to substantiate a clinically important pharmacologic effect of vitamin B-6 on OC side effects.
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PMID:Effect of vitamin B6 on the side effects of a low-dose combined oral contraceptive. 917 57

A cross-sectional study involving 60 women from Sydney, Australia, and 99 women from Los Angeles, California (US), evaluated the impact of three different insertion regimens on the transient nausea associated with the contraceptive vaginal ring. The ring released 20 mcg of ethinyl estradiol and 1 mg of norethindrone acetate per day. 128 women completed the 6-month study, providing 831 woman-months of exposure. The one pregnancy recorded during the 6-month study occurred during the 7-day break between cycles 5 and 6. 53% of women experienced nausea in at least one cycle. No significant differences in side effects were noted based on insertion group: 1) early evening (5-7 p.m.); 2) late night (10 p.m. to midnight); and 3) early evening insertion, removal at bedtime, and reinsertion the next morning. In each insertion group, the incidence of nausea was greatly reduced (to 6-9%) in the second cycle of use. 9% of women experienced transient vomiting in the 24 hours after first insertion of a new ring. The remaining side effects--headache, dizziness, uterine cramps, breakthrough bleeding, weight gain, and expulsion--were rare and occurred with equal frequency in all three insertion groups. Women at both study sites expressed a high degree of satisfaction with the vaginal ring, primarily because of its convenience and effectiveness. Overnight soaking of the ring before first use has the potential to reduce the side effect of transient nausea, presumed attributable to the accumulation of ethinyl estradiol on the ring surface during storage.
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PMID:Effect of different insertion regimens on side effects with a combination contraceptive vaginal ring. 940 4

A study supported by the World Health Organization's Task Force on Postovulatory Methods of Fertility Control compared the efficacy of the Yuzpe and levonorgestrel-only methods of emergency contraception (EC). Enrolled in this double-blind, randomized trial were 1998 women from 21 centers around the world who requested EC within 72 hours of unprotected intercourse. The pregnancy rate was 1.1% for levonorgestrel alone and 3.2% for the combined ethinyl estradiol-levonorgestrel regimen. The crude relative risk of pregnancy was 0.36 (95% confidence interval, 0.18-0.70) for levonorgestrel compared with the Yuzpe regimen. The former method prevented 85% of expected pregnancies, while the latter prevented only 57%. Finally, side effects such as nausea, vomiting, dizziness, and fatigue were significantly less common in the levonorgestrel group. Although these findings document the superiority of the levonorgestrel regimen for EC, the 0.75 mg tablets are not currently manufactured in the US.
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PMID:Combined oral contraceptives versus levonorgestrel for emergency contraception. 1062 86

A double-blind, randomized controlled trial conducted at 21 centers in 14 countries compared the effectiveness and side effects of the traditional Yuzpe method of emergency contraception (200 mcg of ethinyl estradiol and 1 mg of levonorgestrel divided into 2 equal doses) and levonorgestrel alone (2 doses of 0.75 mg each). 1955 women (979 in the Yuzpe group and 976 in the levonorgestrel group) completed the study. 42 women had subsequent pregnancies, although at least 4 women were pregnant at the time of treatment. The pregnancy rate was 1.1% (95% confidence interval [CI], 0.6-2.0) for the levonorgestrel group and 3.2% (95% CI, 2.2-3.5) for the Yuzpe regimen. The relative risk of pregnancy was 0.36 (95% CI, 0.18-0.70). Levonorgestrel prevented 85% of expected pregnancies while the Yuzpe method prevented only 57%. Efficacy increased when the regimen was initiated within 24 hours and decreased as the time after unprotected intercourse approached 72 hours. Women in the levonorgestrel group reported less nausea, vomiting, dizziness, and fatigue than their counterparts in the Yuzpe group. Overall, 57% of women started bleeding within 3 days of their expected menses and the mean duration of menses of 4.7 days in both groups. Results of this study support use of levonorgestrel alone as an alternative for emergency contraception.
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PMID:Levonorgestrel versus the "Yuzpe" regimen. New choices in emergency contraception. 1009 1

In every year since 1984, cardiovascular disease has claimed the lives of more females than males. More than 450,000 women succumb to heart disease annually, and 250,000 die of coronary artery disease. Despite the proportions, most women believe they will die of breast cancer. The perception that heart disease is a man's disease and that women are more likely to die of breast cancer is alarming. Although women develop heart disease about 10 years later than men, they are likely to fare worse after a heart attack. The poorer outcomes are due, in part, to the failure to identify heart attack symptoms. Approximately 35% of heart attacks in women are believed to go unnoticed or unreported. However, because of increased age, women are more likely to have co-morbid diseases such as diabetes and hypertension. In women, not only is "tightness" or discomfort in the chest a warning sign, but in addition, nausea and dizziness are common indicators of myocardial ischemia. Other symptoms include breathlessness, perspiration, a sensation of fluttering in the heart, and fullness in the chest. In comparison to men, women are less likely to undergo tertiary care interventions such as cardiac catheterization, angioplasty, thrombolytic therapy, and bypass surgery; to participate in cardiac rehabilitation; and to return to work full-time after myocardial infarction. In the past, most research about treatments for heart disease focused on men, and gender differences have been ignored. Recent studies are enrolling enough women to test if there are differences between men and women in outcomes. One of the major areas of research relates to estrogen and hormonal replacement therapy to reduce the relative risk of heart attack and stroke. The Women's Health Initiative is a major NIH-sponsored trial that addresses the issue of primary prevention of cardiac disease by hormonal replacement therapy. The results will be available in 2004. The Heart Estrogen/Progestin Replacement Study (HERS), disappointingly, did not show a significant reduction of coronary events in women taking hormonal replacement therapy, nor did the Estrogen Replacement and Atherosclerosis (ERA) trial of 309 postmenopausal women who underwent coronary angiography. New insight into the role of vitamins, phytoestrogens and other natural sources, and selective estrogen receptor modulators may provide other options for management. Until then, modification of risk factors and healthy life style choices are recommended for reducing the risk of cardiac disease. In fact, the key to a healthy heart in the year 2000 appears closely tied to life style choices. Prevention of disease is the key, and current recommendations are simply to stop smoking, or do not start; treat and control blood pressure >140/90 mm Hg; manage elevated lipids by diet, exercise, and cholesterol-lowering medications (if necessary); treat diabetes; lose weight so that BMI is <25; walk for 20-30 minutes at least three times a week; and take an aspirin tablet daily.
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PMID:Heart disease in women. 1114 May 44

Clinical experience, and a pathology study, of 184 women on Neogynon (.25 mg d-norgestrel and .05 mg of 17-ethinyl estradiol, micro 20) was assessed for a total of 3129 cycles. 53 women were nursing babies before use of the pill, and 44 continued to do so throughout pill usage. Endometrial biopsies were taken premenstrually, during the period of full hormonal effect, for 40 cases before and then 6-12 months after initiation of pill usage; biopsies were studied for effect of the combined steroid on the building up of endometrium. The combination pill was 100% effective, with no failures. 23 cases (12.5%) failed to continue through the 18th cycle. 4 cases stopped after the 2nd cycle and 6 more after the 4th; the remaining stopped after the 12th cycle. No change in menstrual pattern was noticed in 136 (73.9%) of the cases; 14 presented with menorrhagia and endometrial biopsy of one of these showed regressive and mixed endometrial changes. 2 cases of intermenstrual spotting were reported. Hypomenorrhea was reported in 16 cases. Side effects were generally effects on the central nervous system: 7 cases of headache and dizziness, 7 cases of mild depression, and 3 cases of sexual anorexia. No gastrointestinal side effects were reported. 44 cases (of 53) continued lactation, and 9 noticed a progressive decrease in the amount of milk produced. 8 cases gained weight and 13 lost, 2 enough to quit using the pills. Hair loss was a noticeable complaint in 5 cases. Endometrial biopsies revealed grades of arrest of endometrial development. 85% showed a resting endometrial pattern, whereas 15% were atrophic. Endometrial response was rather irregular and mainly of the mixed type in 90% of the cases and about 10% were proliferative.
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PMID:A clinico-pathological study of Neogynon as a new oral contraceptive steroid. 1226 40

The results of clinical trials of vaginal contraceptive pills suggest that this is a safe, effective, and acceptable means of fertility control. Plasma levels of progesterone rise at a slower pace and to a lower peak value when contraception is administered vaginally rather than orally. Despite lower blood levels, ovulation is suppressed in the majority of cycles and fertility control compares favorably with that observed in users of low-dose combined OCs. Lower steroid blood levels and the fact that vaginal pills bypass the liver minimize the occurrence of side effects noted in some OC users such as nausea, gastric intolerance, headaches, weight gain, and dizziness. In 1 clinical trial, 124 women used a vaginal pill containing 500 mcg of d-1-norgestrel and 50 mcg of ethinyl estradiol for 6-20 months, for a total of 1438 women-months. No pregnancies occurred in this series. Bleeding generally developed 3-5 days after insertion of the last pill and lasted 3-5 days in 98% of cycles. The interval between withdrawal bleeding events was 26-30 days in 86% of cycles. Breakthrough bleeding occurred in only 6 subjects. Vaginal discharge, involving pathogenic agents similar to those found in OC users, developed in 26 (20%) of subjects. 44 women (36%) discontinued before 1 year of use: 7 cited medical reasons (mastalgia, vaginal irritation), 6 desired pregnancy, and the remaining 31 found daily insertion tedious or distasteful. No significant changes occurred in blood cell counts, hematocrit, or blood chemistry. Smaller clinical trials of both Gestrinone, an anti-estrogenic progesterone, and a vaginal pill containing 50 mcg of mestranol and 1 mg of norethindrone have obtained similar results. These findings suggest that the vaginal contraceptive pill may offer family planning clinics a better alternative than OCs as the 1st prescribed contraceptive.
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PMID:The vaginal contraceptive pill. 1226 27

Fertility control by cyclic norethindrone (Norlutin), 17 alpha-ethinyl 19-nortestosterone, plus .06 mg 3-methoxy ethinyl estradiol (Ortho-Novum) was studied in 364 women over a period of 32 months for a total of 6062 cycles. No patient who followed the instructions became pregnant. 37 patients stopped the medication for various reasons. The interval between stopping medication and becoming pregnant averaged 1.6 months. 13 of these pregnancies occurred after 11-15 cycles of treatment. Children born to these mothers were normal with no virilization observed. Findings from all Papanicolaou smears and cervical biopsies were normal. The desirable effects of diminishing the menstrual flow, reducing dysmenorrhea and regulating the menstrual cycle, plus the all-important one of contraception, far outweighed minimal and infrequent undesirable side effects (in order of frequence: chloasma, hot flashes, headache, nausea, acne, abdominal pain, dizziness and urticaria). In only 4.8% of the total 6062 cycles was some complaint made.
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PMID:Long-term administration of norethindrone in fertility control. 1227 4

A new oral contraceptive (OC) formulation containing 30 mcg ethinyl estradiol and 150 mcg of desogestrel was used by 86 women aged 19-40 years for an average of 10.5 cycles/woman. 36 of the women were nulliparas. None had experienced any significant anomalies in their menstrual cycles prior to use. 25 had never used any contraception and the remainder had used a variety of methods, mainly other OC formulations. The OCs in the present study were taken for 21 days followed by 7 pill-free days. 67 of the women used the OCs for 12 consecutive cycles. None of the patients became pregnant in a total of 907 cycles of treatment, yielding a failure rate of 0. Cycles ranged from 26-31 days and averaged 28.05. Bleeding was normal but was of slightly shorter duration, 3-4 days compared to 4-5 days before treatment. Bleeding was moderate or average in 72.65% of cycles. 27 patients had periods of amenorrhea equivalent to 2-3 consecutive cycles. 53 of the total of 907 cycles were amenorrheic. 16.64% of cycles had some spotting or staining between the cyclic bleeding. Among side effects, only breast tension, which affected 18 patients, could definitely be attributed to the method. 11 patients experienced a lessening or disappearance of problems existing prior to treatment, including nervousness, headaches, nausea, and dizziness. No significant changes in weight, blood pressure, or gynecological conditions were found. Among 38 patients studied, there were no significant changes in glycemia, triglycerides, total cholesterol or transaminases.
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PMID:[A new progestin for contraceptive combination]. 1231 51


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