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 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prevalence rates of various side effects were studied comparatively among 3 oral contraceptive preparations containing 50 mcg of the estrogen component. Norinyl 1/50, Ovral, and Norlestrin 1 were each randomly assigned to groups of 160 healthy women who had consented to participate in the study designed to quantitate probabilities of experiencing specific side effects and of their continuing into the subsequent cycles. Acne, breast discomfort, nausea, abdominal bloating, headache, fatigue, depression, irritability, vaginal discharge, and breakthrough bleeding were the specific side effects studied; only breakthrough bleedings showed a statistical difference in prevalence. The rate of breakthrough bleeding associated with Ovral use in the 1st 3 cycles (16.6%) was significantly (P .05) lower than that associated with using either Norinyl or Norlestrin (46% and 51.7%, respectively). Norelestrin, aside from breakthrough bleeding, was reported as generally freer of side effects than the other 2 preparations. The probabilities of side effects being experienced in the 2nd or 3rd cycle after the effect(s) was experienced in the 1st cycle showed that overall, for all 3 combination pills, the probabilities significantly decreased from the 2nd to the 3rd cycle (P .05). Also examined was the probability that a side effect would occur in the 2nd or 3rd cycle if the user had not experienced such an effect in the 1st cycle. In each instance, the probabilities are significantly lower (P .05) than the corresponding probabilities where the symptom had been experienced in a previous cycle. These data support the contention that side effects experienced on inititation of oral contraceptives should not prohibit its continuation because the majority of symptoms will disappear as the patient becomes accustomed to the hormonal preparation.
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PMID:The probability of side effects with ovral, norinyl 1/50 and norlestrin. 16 Aug 60

Cyproterone acetate (CPA) has been discovered more than 25 years ago and it was the first antiandrogen suitable for clinical use. CPA inhibits the action of endogenous and exogenous androgens at all androgen target organs; these include the prostate, seminal vesicles, testes, and the vas deferens. However, this antiandrogen also antagonizes less sex-specific effects of androgens, for example ossification of the epiphyseal cartilage, sebaceous gland function and skin thickness. Indications for CPA: Prostate cancer, androgen induced disorders of the skin (acne, seborrhoea, hirsutism, alopecia), precocious puberty and sexual disorders in men. Concerning sexual deviations clinical trials started in 1966. CPA leads to loss of libido and the ability to achieve erection, followed by the inability to achieve orgasm, after about 14 days of treatment (100-200 mg daily orally or 300 mg weekly i.m.). These effects are reversed in the same order as the onset. About 75 to 80% of patients respond to this therapy. CPA is generally well tolerated. Tiredness, lack of drive, listlessness and depressive moods have been reported as non-specific side-effects. Slight gynecomastia occurs in about 20% of patients. There are no good alternatives in this indication. Pure antiandrogens are unsuitable, because these are unable to inhibit libido sufficiently. Tranquilizers are not very effective, high doses of estrogens are associated with severe (cardiovascular) side effects. Orchidectomy is an irreversible intervention, LHRH analogues are associated with hot flushes and the initial increase in testosterone (flare phenomenon).
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PMID:Cyproterone acetate in the treatment of sexual disorders: pharmacological base and clinical experience. 183 80

Some 3,500 adolescents answered a questionnaire anonymously. The sample represented 85% of the students between the ages 13 to 16 and 65% of the students between 17 to 18 in the three communities studied. The students all had middle class backgrounds. Self-reported illness differed considerably from data found in epidemiological surveys. The self-reported medical panorama was dominated by concerns about acne, tiredness, headaches, stomach pains, sports injuries and allergic disorders. One quarter to one third of the students reported such problems. Overall, 85% of the students reported that they were "completely healthy", at the same time as they also reported an average of 3.1 medical complaints. Self-initiated appointments with physicians were reported with an average of 5.5 during the last year, which is high. About 40% of the students had one complaint for which they wanted to see a physician. About 15% reported that they had had suicidal thoughts.
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PMID:Self-reported health status and use of medical care by 3,500 adolescents in western Sweden. I. 195 4

Four weeks after the introduction of a therapeutic regimen with 80 mg 13-cis-retinoic acid/day, a 16-year-old male patient developed oozing hypergranulation with vulnerable masses within acne lesions. These local symptoms were accompanied by fever, fatigue, weight loss, polyarthralgia and myalgia, similar to acne fulminans. In spite of these unusual reactions treatment was continued. Local steroid ointments were additionally applied. Within a short period of time regression of granulations and normalization of the general health condition was observed. After 4 months, therapy was discontinued. The patient's acne had totally healed and did not relapse within an observation period of 2 years.
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PMID:[Acne conglobata: unusual course in 13-cis-retinoic acid therapy]. 293 99

Thirty-six children with epilepsy resistant to conventional treatment were treated with bromides in addition to the current therapy. Six out of 19 cases with prevailingly or exclusively generalized tonic-clonic seizures became seizure-free and in 9 cases a reduction in seizure frequency of more than 50% was achieved. Freedom from seizures could not be obtained in 13 cases, who had frequent minor seizures in addition to generalized tonic-clonic seizures. In some, minor seizures were even activated. Tonic and focal seizures showed no response. Side effects were observed in one-third of the cases (acne, loss of appetite, loss of weight, fatigue) but in no case they did become intolerable. Fifty to 80 mg potassium bromide per kg body weight seems to be an effective daily dose range. There is a preferential indication of bromides for patients suffering from early onset epilepsy with generalized tonic-clonic seizures and/or alternating hemi-grand mal, for whom other treatment is ineffective. This disorder is characterized by a high familial incidence of epileptic seizures, onset between 6 months and 3 years of age, normal development until the onset of seizures, generalized tonic-clonic seizures and often alternating hemi-grand mal, seizure precipitation by fever, and occasional combination with or transition to myoclonic-astatic and/or myoclonic seizures. EEG is often normal or shows slight slowing in the initial phase; later it shows theta rhythms and generalized spikes and waves. Especially, if the onset is during the first year of life, the course of the epilepsy is often unfavourable.
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PMID:Bromides were effective in intractable epilepsy with generalized tonic-clonic seizures and onset in early childhood. 321 12

History of diagnosed illnesses, medical symptoms, and reproductive outcomes and their relation to combat intensity and herbicide exposure were studied, via a mailed questionnaire, among 6810 American Legionnaires who served during the Vietnam War (42% in Southeast Asia, 58% elsewhere). Heart disease, venereal disease, and benign fatty tumors were reported significantly more often by Vietnam veterans than by controls. Combat intensity was significantly dosage-related to history of high blood pressure, ulcers, arthritis and rheumatism, genito-urinary problems, nervous system disease, major injury, hepatitis, and benign fatty tumors. Agent Orange exposure was significantly dosage-related to history of benign fatty tumors, adult acne, skin rash with blisters, and increased sensitivity of eyes to light. Rates of the latter two conditions and of change in skin color were especially elevated in men whose military occupations involved direct handling of herbicides. Five "symptom complex" scales were constructed via factor analysis to measure degrees of feeling faint, fatigue or physical depression, body aches, colds, and skin irritation. Means of all five scales were significantly higher in Vietnam veterans compared to controls, and in herbicide handlers compared to nonhandlers. Both combat and Agent Orange exposure were significant, independent predictors of each of the five scales. Neither combat nor Agent Orange exposure was associated with difficulty in conception, time to conception of first child, or to birthweight or sex ratio of offspring, but maternal smoking was strongly related to reduced birthweight. The percentage of spouses' pregnancies which resulted in miscarriages was significantly higher for Vietnam veterans than controls (7.6% vs 5.5%, P less than 0.001). Logistic regression analysis showed that Agent Orange exposure and maternal smoking were both independently and significantly associated with miscarriage rates in a dose-related manner.
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PMID:Health and reproductive outcomes among American Legionnaires in relation to combat and herbicide exposure in Vietnam. 326 69

Seventeen patients with irregular menstrual periods and androgenic symptoms such as excessive hair growth, acne, and oily skin were treated with spironolactone. The basal levels of serum testosterone (T), dihydrotestosterone (DHT), estradiol (E2), and luteinizing hormone (LH) were significantly higher in the patients than in the controls. After a 4-week treatment with spironolactone, serum T and DHT showed significant decreases. Before treatment, the serum sex hormone binding globulin (SHBG) levels were significantly lower in the patients than in the controls. After initiation of the spironolactone treatment, the SHBG levels tended to increase but not significantly. Spironolactone treatment resulted in the improvement or disappearance of acne in 4 of 5 patients who suffered from this ailment. Improvement of hirsutism was obtained in 2 of 10 patients. Although 4 oligomenorrheic patients and 6 amenorrheic patients showed anovulatory bleeding but did not ovulate, 2 patients in the amenorrheic group ovulated. Two patients complained of tiredness and weakness, and 2 others of polyuria and polydipsia. Both groups showed only temporary symptoms, so treatment was not interrupted. Spironolactone has beneficial effects on ovarian function and few side effects, so it may prove to be an effective anti-androgen, especially for hyperandrogenic anovulatory patients.
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PMID:Spironolactone therapy for hyperandrogenic anovulatory women--clinical and endocrinological study. 395 Apr 64

Most antiandrogens appear to act by binding to the androgen receptor and competitively inhibiting the binding of testosterone and cihydrotestosterone to the receptor. Focusing on those compounds which appear to inhibit androgen receptor mediated responses, this review discusses the chemistry of those antiandrogens which have been studied to the extent that their mechanism of action is at least partially understood, outlines the mechanism of androgen action as it is currently understood and suggests how antiandrogens might fit in with this mechanism, indicates the major metabolites of several important antiandrogens, and discusses the clinical applications of several antiandrogens. Cyproterone acetate has been studied extensively as a potential male contraceptive. Although it was recognized that 100 mg of cyproterone acetate per day inhibited spermatogenesis, that dose also reduced libido and potency. Following the administration of 10 or 20 mg of cyproterone acetate per day to 15 males for 26 weeks, the following observations were made: the number of motile sperm was reduced; the quality of their motion was impaired; and the ability of the sperm to penetrate cervical mucus was decreased. Sperm density was also suppressed, but neither it nor sperm motility were inhibited to the extent necessary for contraception. Antiandrogens have been demonstrated to be beneficial in treating 5 clinical syndromes or diseases: acne, seborrhea, hirsutism with or without menstrual abnormalities; precocious puberty; benign prostatic hypertrophy; cancer of the prostate; and sexual deviates. Since 3 of these conditions are very common, effective and safe treatment would have a large market. At this time, antiandrogens are widely used in Europe for treatment of seborrhea, acne, and hirsutism and a large Veterans Administration Cooperative Study in the US was approved but has not yet been funded to compare antiandrogens with other treatments for cancer of the prostate. Studies to assess antiandrogen interaction with other hormones or drugs have been limited. Side effects in the female have been best evaluated when cyproterone acetate was administered in combination with ethinyl estradiol. In 46 women followed over 317 cycles, side effects were similar to those reported with estrogen-progestin contraceptives. Administration of 10-20 mg of cyrproterone acetate per day to males caused no significant side effects, but 100 mg or more/day has caused loss of libido, impotence, gynecomastia, tiredness, weakness, decreased efficiency, weight gain, drying and desquamation of skin over the legs, and loss of hair on the trunk and pubic area.
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PMID:Androgen antagonists in androgen target tissues. 620 9

The premenstrual syndrome (PMS) is a complex of symptoms that usually occurs seven to ten days before menses in large numbers of women. These symptoms typically cease during the 24 hours after the onset of menses. PMS affects many areas of the body, with each afflicted woman having her personal set of symptoms. Frequently encountered signs and symptoms include breast tenderness and swelling, weight gain, headache, abdominal cramping and bloating, food cravings, thirst, nausea, joint pain, acne, dizziness, hyperalgesia and one or more psychologic symptoms: irritability, lethargy and fatigue, depression, anxiety, hostility and aggression. Theories relating PMS to hormonal imbalance, vitamin deficiency or psychosomatic aberration have failed to explain this condition fully. Treatments using hormones, vitamins, oral contraceptives or diuretics have failed to relieve all the symptoms of PMS. The prostaglandin (PG) theory proposes that these nearly ubiquitous substances, produced in pathophysiologic amounts in brain, breast, gastrointestinal tract, kidney and reproductive tract, can trigger many of the PMS symptoms. If that is true, then a PG inhibitor could counteract excessive PG production and successfully control those PMS symptoms related to prostaglandin excess or imbalance. Therapy based upon this theory can proceed to the use of PG inhibitors in conservative steps. First, permanent deletion of xanthine-containing beverages (coffee, tea, cola and chocolate) from the diet can reduce nervousness, irritability and breast tenderness. Luteal phase salt restriction, with a mild diuretic used if necessary the last week before menses, adds to this effect. For the 20-25% of women who need more help, either a PG inhibitor or natural progesterone (to oppose the action of PGs), given when PMS begins, brings relief. In women with depressive PMS complaints, small daily doses of an antidepressant may prove helpful.
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PMID:The use of prostaglandin inhibitors for the premenstrual syndrome. 635 May 80

76 women with virilizing features (68 women suffering from hirsutism and 8 from acne) were treated on average for 25 months according to different models of Androcur medication. Success of treatment was clinically assessed as good in 3/4 of the cases and slight in the remaining 1/4. However, treatment is more successful in cases of adrenal hirsutism than in idiopathic hirsutism. Moreover, success of treatment seems to be better in women below 35 than over 35 years of age. Side effects, mostly bleeding anomalies and fatigue, were found in 31 women; these must be attributed to the gestagenic component of cyproterone acetate. By contrast, 12 women showed positive side effects such as weight reduction, improvement in depression states and reversal of hair loss, which must be attributed to the antiandrogenic component. The selected continuation rate in all subjects was 86% and the unselected 72%, over a treatment period of 4.5 years. Furthermore, hormonal controls were carried out under treatment. These showed, on average, a depression of plasma androstendione of 17%, of total plasma testosterone of 47%, as well as an inhibition of the testosterone/sex hormone-binding globulin quotient of 58%. These inhibition effects speak in favour of alterations taking place in steroid metabolism. However, by inhibition of androgenic serum levels, the mechanism of cyproterone acetate is only assisted, while the main mechanism is based on peripheral receptor inhibition. Furthermore, as additional component in this action a slight increase in plasma binding capacity was found during combined cyproterone-oestrogen treatment.
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PMID:[Long-term treatment of virilized women with cyproterone acetate (author's transl)]. 645 62


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