Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy of a new estrogen-progestin contraceptive agent Ovidon was evaluated in 65 women. The women were taking the contraceptive for 47 cycles (each Ovidon pill contained 0.25 mg of D-norgestrel and 0.05 mg of ethinyl estradiol). Prior to the Ovidon treatment, 15 women did not use any contraceptive agents or devices, 5 used hormonal contraceptives, 2 used IUDs, 4 used mechanical devices, 20 practiced coitus interraptus, and 9 used a biological method. Ovidon administration provided a 100% contraceptive effect. Side effects of Ovidon included fatigue (15 women), headache (4), irritability (3), fullness of the breast (27), hemorrhage (12), vaginal discharge (6), and changes in libido (22). Ovidon administration did not induce amenorrhea. A 1-3 kg weight gain was observed in 5 women. Laboratory studies showed no changes in hemoglobin levels, leukocyte count, cholesterol, and alkaline phosphatase levels. These findings indicated the safety and contraceptive efficacy of Ovidon.
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PMID:[Clinical trial of the combined contraceptive preparation, Ovidon]. 39 Oct 67

Panic attacks occur more often in females than males with onset usually in the late 20s. A 27-year old woman who experienced a panic attach (heart palpitations, fatigue, bodily shaking, labored breathing, and feelings of terror and being out of control) after she stopped taking a combined oral contraceptive (COC) (.5 norgestrel and .05 mg ethinyl estradiol) was admitted to Osaka Medical College in Takatsuki, Japan. She experienced depression at 18 and took limited amounts of antidepressants for only 1 year. When she started taking the COC at 27, she experienced feelings of unreality and fear, hyperventilation, and heart palpitations. Laboratory results showed lower than normal levels of plasma luteinizing hormone (LH) and follicle stimulating hormone (FSH) and a low estradiol level. Yet the plasma cortisol level was much high than normal (22.5 mcg/d1 vs. 3-15.2 mcg/d1). Administration of 200 mg sulpiride/day and 1.2 mg alprazolam/day alleviated almost all symptoms. She did experience mild phobic avoidance and anxiety, however. After successful treatment in the hospital, she discharged herself. Because she was concerned that the panic attacks would recur, she was provided with information on her disorder. She agreed to continue the medication. 1 possible explanation for this case is rapid endocrinological change induced by the ingestion and stopping of the COC which in turn induced a sympatho-adrenal response (her high cortisol levels) to several simple physiological stimuli. Another possible explanation is the COC induced rapid endocrinological changes that may have brought on an anxiotropic effect in someone who had earlier experienced depression.
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PMID:A case of panic disorder induced by oral contraceptive. 131 8

In the Netherlands, researchers compared data on 195 16-45 year old women who had never used oral contraceptives (OS) and started taking the low-dose OC Minulet (75 mcg gestodene and 30 mcg ethinyl estradiol) (starters) with data on 363 16-45 year old women who had used another OC, then began taking Minulet (switchers), and with data on 139 16-45 year old women who had not used and were currently not using any OC (controls) to examine Minulet's effect on mood. Switchers had higher scores on the Amsterdam Mood Questionnaire (AMQ) for tiredness, depression, moodiness, anxiety, and anger (i.e., a worse mood) than both the starters and controls. Yet, after taking Minulet, the same AMQ scores for switchers fell significantly (i.e., an improved mood). On the other hand, the scores of both the controls and the starters were the same for all 3 measurements (before use, 1 month after use, and 3 months after use). Further, the original Sickness Impact Profile (SIP) scores of switchers revealed significantly more problems with emotional behavior, social interaction, and alertness than the controls. Only the initial social interaction score was significantly different compared to that of starters. After using Minulet, the switchers' SIP scores improved, while the SIP scores of the controls and starters remained the same. Therefore, Minulet did not affect the mood of the starters and significantly improved the psychosocial functioning of women who had used other OCs.
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PMID:Use of a monophasic, low-dose oral contraceptive in relation to mental functioning. 148 74

Symptoms of Parkinsonism, most likely induced by an oral contraceptive, were greatly reduced by combined therapy of nicergoline and bromocriptine. A 38-year-old housewife had taken an oral contraceptive, which contained .05 mg of ethinyl estradiol and .5mg of norgestrel per tablet, for 7 years, when she presented took the following symptoms: she stumbled easily, took short, quick dancing/skating steps without arm movement, and found it increasingly difficult to keep slippers on while walking. In the afternoons she experienced extreme fatigue and rigidity in her lower limbs. After a while, languor spread to other parts of her body as well, and she was examined on April 5, 1991. The patient's face was mask-like, and her body was bent forward with her forearms flexed. She showed frozen gait and lowered initiation in her movement. Muscle rigidity was found in both upper and lower extremities, and especially on the right side. A brain MRI showed lacunar infraction with small patches of high signal intensities in the white matter of the bilateral frontal lobes and high signal intensities in the left periventricular white matter. Urine was normal; blood cholesterol and iron were slightly raised. Hormonal examinations showed lowered LH, FSH, progesterone and 24-hr 17-KGS. CT was normal. She was ordered to stop taking pills and to take nicergoline and bromocriptine, which greatly reduced these symptoms except during the first menstruation following the treatment. When mask-like facial expressions, demarche a petit pas, and languor in her lower extremities did not recur during the next menstruation, bromocriptine treatment was discontinued. Four months later nicergoline therapy was also discontinued.
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PMID:[A case of parkinsonism induced by an oral contraceptive]. 156 36

A 22-year old unmarried healthy woman was admitted to the Swedish department with low fever, tiredness, SR 75 mm, positive uricult, but no urinary tract symptoms. Urinary tract infection was suspected and treatment was started with norfloxacin. Nevertheless, the urine culture proved to be negative. A few weeks later she had increasing trouble with stiff knee and shoulder joints and the left foot became swollen. The subfebrile status continued, and tonsillitis was suspected and diagnosed. V-penicillin and cefaklor treatment was applied. She was transferred to the infectious diseases ware, where fever was confirmed with leukocytosis (19 x 1 billion/1), C-reactive protein at 66 (normal value 10) mcg/ml, pronounced blood pressure increase (160/130 mm Hg), anemic signs, and pathological liver status with increased transaminases (ASAT 6.3-10.4 and ALAT 8.,8-16 ukat/1). ALP increased slightly to 6 ukat/1. The symptoms of weight loss indisposition, and muscles and joints aches, especially in foot ache continued. Collagen disease was suspected, and she was transferred to the internal medicine department. She regularly had tachycardia and high blood pressure. She had to use crutches for mobility because of the pain. S-albumin was 32 (normal 36- 50) g/l and S-hepatoglobin was 2.7 (normal value .4-1.8) g.l. Various others tests were normal. Ulnaris neuropathy was suspected on the left hand. Intensive blood pressure reducing combination treatment was started with 200 mg x 1 of metoprolol, 10 mg x 2 nifedipin, and 20 mg x 1 enalapril. The Desolett oral contraceptive (containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel) she had been taking for a few months were discontinued. Quick improvement of clinical and laboratory parameters followed. SR and leukocytosis became normal. The values of ALP, ASAT, and ALAT became normal some days later. She was discharged shortly thereafter, and blood pressure medication was gradually discontinued. In the 1940s there were reports about the hepatotoxic effects of synthetic estrogens followed by carbohydrate, lipid, and protein metabolism alterations. Jaundice has also been reported, and the Swedes have an ethnic susceptibility to it. The global incidence rate is 1/10.000 vs. 1/100 and 1/4000 in Sweden induced by high-dose OCs containing more than 50 mcg ethinyl estradiol, but with low-dose OCs this rate is much lower. Both estrogens and gestagens can increase blood pressure. A 1969 study reported that 22 young women developed arthritis, arthralgia, and myalgia after taking pills for 3- 12 months. Rheumatic symptoms were also recorded with pill use. Thus, it is very likely that OCs were responsible for the patient's symptoms, especially since her status rapidly improved after discontinuing them.
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PMID:[Were the severe adverse effects on several organs and the marked blood pressure increase caused by oral contraceptives?]. 182 62

Confirmation of a causal relationship between hemolytic-uremic syndrome (HUS) and verotoxin-producing Escherichia coli (VTEC) infection is provided by the case of a 22-year-old West German woman. The patient presented with fatigue, nausea, and headache. Ultrasonography revealed enlarged kidneys, and laboratory investigations showed uremia, hemolytic anemia, lactate dehydrogenase, haptoglobin below the detection limit, and thrombocytopenia. She received hemodialysis and drug treatment (heparin, dopamine, and furosemide). To investigate the kinetics of the humoral response to verotoxin, the patient was followed for 3 months. Fecal specimens on day 23 yielded E coli serotype 0111:NM, and stool filtrates on days 16 and 23 showed highly cytotoxic activity for HeLa cells. While the patient's initial serum showed a high IgM immune response against purified Shiga toxin, there was a steady decline in IgM and steady increase in IgG antibodies over the ensuing 3 months. These findings are suggestive of a recent infection by a verotoxin-producing organism. This is the 1st reported case of VTEC-associated HUS with e coli 0111 infection in an adult, and the patient's 4-year history of oral contraceptives (OCs)--ethinyl estradiol and chlormadinoneacetate--is considered to be of etiologic significance. The diminished antibody coating of bacteria in the urinary tract of OC users may have facilitated invasion of verotoxin across the mucosal barrier in this patient. Severe hypertension has been reported previously in OC users with HUS. It is speculated that verotoxin may trigger HUS in longterm OC users, initiating vasoconstriction and microangiopathic hemolysis.
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PMID:Hemolytic-uremic syndrome associated with an infection by verotoxin producing Escherichia coli 0111 in a woman on oral contraceptives. 328 32

The case of a 27-year-old woman treated with oral contraceptives (most recently with Anovlar) who developed intracranial hypertension is reported. The woman presented with visual disturbances, fatigue, and headaches. Oculo-circulatory and cerebral neoplastic diseases were not present, but high intracranial pressure was noted; no etiological clarification could be found. Discontinuation of contraceptive medication was followed by near-normalization of vision and disappearance of other symptoms. During a 3-year follow-up period no neurological disorders apart from mild limitation of the visual field could be observed. A connection between the elevated intracranial pressure and oral contraception seems probable.
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PMID:[Benign increase in intracranial pressure during oral contraception (author's transl)]. 474 74

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

102 patients using Trinordiol, a triphasic oral contraceptive (OC) containing ethinyl estradiol and d-norgestrel, were followed for 932 cycles in a study of secondary effects. Follow-up visits were scheduled after 1,3, and 6 months and every 6 months thereafter. 26 patients discontinued use of the pills during the study after using them for a total of 159 cycles. 5 discontinued because of abdominal pain, 1 for breast tenderness, and 1 because of headaches or migraines. 7 discontinued because of metrorrhagia, 4 for weight gain, 3 for amenorrhea, 2 for nausea and vomiting, and 1 each for nervousness, water retention, acne, desire for pregnancy, leaving the country, hypertension, and unknown motivation. the average age of patients was 23.6 years, with a range from 14-48. 76% were aged 15-29 years. 52.9% were nulliparas. 58.8% were Belgian, 21.6% were from Mediterranean Europe, 10.8% were Moroccan, and 7.9% were from black Africa. Only 1 patient, a 37 year old, developed hypertension. 15 patients gained more than 2 kg and 17 lost more than 2 kg. 15.8% complained of spotting during the 1st cycle compared to 3.1% during the 6th cycle, 5.2% during cycle 7-12, and 9.1% during cycle 13-30. Among 35 patients who did not discontinue treatment, 7 complained of amenorrhea and 1 of scanty menstrual bleeding, 14 of pain including 7 cases of pelvic pain, 2 of dysmenorrhea, 3 of breast tenderness, and 2 of headaches, 15 of leukorrhea, 3 of nausea, 2 of dizziness, and 1 each of fatigue, acne, galactorrhea, and cutaneous pruritus. 1 case of myoma at the level of the uterine cornu was identified after 24 cycles of treatment. In all, 61 patients had some complaint, while 41 were totally satisfied. No patient became pregnant during the study.
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PMID:[Clinical study of the secondary effects associated with taking a triphasic anti-ovulatory contraceptive]. 670 4

2 strengths of a new low-dose, combined oral contraceptive were tested to determine their efficacy and any untoward side effects or complications. The new contraceptive agent formulation, Ovysmen, contains either .5 mg or 1 mg or norethisterone combined with .35 mg of ethinyl estradiol. A total of 36 nonselected patients, aged 16-35 years, were studied. 3 were parous, and the remainder were nonparous; few had histories of hormonal contraception. The patients were divided into 2 groups, and 1 was administered Ovysmen 1/35 and the other was given Ovysmen .5/35. The contraceptives were administered in a cyclic manner. Patients were tested for various clinical parameters at intervals of 3, 6, and 12 months from start of therapy; no irregularities were reported. There were no pregnancies in this study. In the Ovysmen .5/35 group, 7 of 18 patients continued through 12 months, without menstrual irregularities, 4 continued 6-9 months, and 7 discontinued use after only 3 months. Most early discontinuers were switched to the 1-mg preparation. In contrast, 16 or 18 subjects in the Ovysmen 1/35 group continued for 12 months without irregularities. On Ovysmen .5/35, 11 subjects experienced intermenstrual bleeding, 2 experienced amenorrhea, 1 reported fatigue, 1 reported diminished libido, and 7 complained of vaginal discharge; in the Ovysmen 1/35 group, 6 subjects experienced intermenstrual bleeding, 1 was hypermenorrheic, 3 reported diminished libido, and 6 complained of vaginal discharge. Both formulations were judged safe and effective.
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PMID:Experiences with the new oral contraceptive Ovysmen. 735 10


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