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Query: UMLS:C0018681 (headache)
56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ovamin 30, a new low-dose oral contraceptive (OC) containing 30 mcg of ethinyl estradiol and 2 mg of ethynodiol diacetate, was evaluated for efficacy and acceptability in a group of women (504 patients; 3236 woman months of use) requesting OCs from their general practitioner. 39 patients withdrew from the study because of side effects which could reasonably be associated with the pill (excessive/irregular bleeding, amenorrhea, depression/headache, and breast discomfort/weight gain), and only 18 of these were menstrual disorders. 12 patients withdrew from the trial to conceive. 1 involuntary pregnancy occurred, and 58 patients were lost to follow-up. An early establishment of acceptable bleeding cycles was maintained in later cycles. The pregnancy rate for this preparation by the Pearl Index was .4/100 woman years with 95% confidence limits of .01-2.24. Ovamin 30 appeared to be an effective and well tolerated low-estrogen OC, and further studies may determine whether side effects are reduced with 30-mcg products as opposed to those containing 50 mcg of estrogen.
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PMID:An open assessment of a new low dose oestrogen combined oral contraceptive. 62 4

A WHO sponsored comparative trail (9 centers) studied the bleeding patterns and side effects experienced by 1678 women using injectable (every 12 weeks) norethisterone enanthate (NOR) and depot-medroxyprogesterone (DMPA). 388.8 women-years of menstrual experience with NOR and 372.5 with DMPA were studied. The percentage of women with total amenorrhea with DMPA was significantly higher than with NOR for all injection intervals. The porportion of women with total amenorrhea increased significantly over time with both drugs (chi-square=33.9 for NOR and 73.4 for DMPA; P .001). After 1 year, 35% of DMPA and 8.6% of NOR users had total amenorrhea. With NOR, the cycle length distribution changed markedly over time, with the percentage of short cycles under 25 days diminishing as the percentage of long cycles in excess of 46 days increased. In contrast, DMPA held cycle length patterns more or less constant. Length of bleeding and spotting episodes were significantly greater with DMPA. The mean number of bleeding/spotting days decreased over time with both drugs; the difference from the 1st to 4th injection was statistically significant (P .001). Though the overwhelming majority of women experienced abnormal cycles with both drugs, the percentage of normal cycles remained fairly constant during consecutive intervals. Headache was the most frequently reported complaint: 10.7% of DMPA and 6.9% of NOR users. Other nonmenstrual side effects were reported with similar frequencies in both groups.
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PMID:Multinational comparative clinical evaluation of two long-acting injectable contraceptive steroids: noresthisterone oenanthate and medroxyprogesterone acetate. 2. Bleeding patterns and side effects. 65 7

A case is presented and 11 others are reviewed in which symptomatic pituitary tumor enlargement occurred during pregnancies that resulted from induced ovulation. The syndrome is usually characterized by headache and visual disturbances with bitemporal visual field abnormalities, but may present with ocular muscle palsies. The cases are divided into two groups. The patients in one group had a shorter duration of amenorrhea (3.8 years), developed symptoms before the 14th week of pregnancy, and were usually treated by tumor removal. Patients in the second group had a longer period of amenorrhea (10.2 years), developed symptoms after the 24th week of pregnancy, and their symptoms regressed with delivery of the infant. Tumor removal or termination of the pregnancy both resulted in resolution of symptoms. All pregnancies resulted in normal infants. This series provides guidelines for management of future cases.
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PMID:Symptomatic pituitary tumor enlargement after induced pregnancy. Case report. 67 Oct 82

Five hundred Black Rhodesian women given injections of 150 mg Depo-Provera every 3 months (group A) and 500 women given an injection of 450 mg Depo-Provera every 6 months (group B) were reviewed after 6 months. Group B had a significantly lower rate of defaulters. There was no significant difference between the groups with regard to weight gain, systolic and diastolic blood pressure increase, overall abnormal bleeding patterns and complaints of side-effects. Among those women who reported abnormal bleeding patterns, significantly more in group B had amenorrhoea. There was no significant increase of prolonged bleeding in group B. Among those women who complained of side-effects, significantly more in group B complained of headaches and a bloated abdomen. No pregnancies occurred in either group. The increased annual cost of the 450 mg injections, which was the main reason for women not accepting this regimen, is outweighed by convenience and reduced travel costs. Depo-Provera 450 mg given by 6-monthly injection is well tolerated and effective, and appears to be even more satisfactory as regards continued acceptance than 150 mg given every 3 months.
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PMID:Efficacy and acceptability of injectable medroxyprogesterone. A comparison of 3-monthly and 6-monthly regimens. 69 38

Fifty-one female patients with prolactin producing tumors (PRL 1100 to 88,000 microU/ml) and 26 male patients with prolactin producing tumors (PRL 6500 to 400,000 microU/ml) were studied. Only 25% of the females had visual field defects which were present in 70% of the males. All females had amenorrhea but only 35 had galactorrhea. Hypopituitarism was rarely seen in the females but in most of the male patients. Twenty-four females and all male patients were operated (transphenoidal or transfrontal operation). PRL normalized in only eight females and in none of the males. Two patients became pregnant postoperatively, four after postoperative treatment with bromocriptine. Bromocriptine induced regular menses in 4 other patients operated by transsphenoidal route. Eight patients with microadenoma (PRL less than 4000 microU/ml) were treated with bromocriptine alone of whom two became pregnant. The males were also treated with bromocriptine leading to a significant fall of the PRL level accompanied by improvement of libido, sexual potency and headache. Two patients received radiation postoperatively, which led to a fall of PRL and improvement of visual fields. Since PRL levels remained low after withdrawal of bromocriptine for several months an antiproliferative effect of this drug is suggested. Thus differential therapy of PRL producing tumors is possible: In females selective neurosurgery can alone or combined with medical therapy normalize PRL secretion and ovarian function. In patients with microadenoma bromocriptine alone can be successful. In patients with inoperable large tumors radiation should be advocated. Additional bromocriptine therapy may be helpful to stop tumor growth and alleviate the effects of hyperprolactinemia.
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PMID:Treatment of patients with prolactinomas. 75 42

6 3 cm polydimethylsiloxane capsules containing 30 mg each of R-2323 were implanted subdermally in each of 38 women to assess their effect upon fertility, menstrual pattern, some aspects of metabolism, and the incidence of side effects associated with the use of this hormonal contraceptive. There were zero pregnancies in a total of 292 months of exposure. The longest duration of use was 12 months and the median was between 8-9 months. Amenorrhea and signs of androgenicity such as acne and hyperthricosis were common complaints and a frequent reason for closure. Headache and nervousness also were reported by a high proportion of patients. Blood and urine analysis were normal with the exception of elevated transaminases in 20 out of 27 patients after the 3rd month of treatment. Side effects and elevation of the serum transaminase levels disappeared promptly after removal of the implants in all cases. It is concluded that R-2323 implants at the dose tested are potent inhibitors of fertility in women. The high incidence of treatment-associated adverse reactions impose limitations on their use in Chilean women.
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PMID:Clinical trial with subdermal implants of the progestin R-2323. 91 13

This study was undertaken to determine the prevalence of radiologically detectable pituitary tumors among patients seen initially in a gynecology clinic for a complaint of secondary amenorrhea. In a group of 144 women with secondary amenorrhea of more than 6 months' duration, 13 had radiologic abnormalities of the sella turcica detectable with standard skull films without tomography. These gynecologic patients composed more than half of the women in the reproductive age group who were diagnosed at this medical center as having a pituitary tumor. Only one patient with oligomenorrhea or secondary amenorrhea of less than 2 years' duration had a detectable tumor. Thus, for patients with short-term amenorrhea, the risk of having a pituitary tumor is small, especially in the absence of galactorrhea, headache, or changes in vision. However, 12 of 71 patients with amenorrhea longer than 2 years (17%) had detectable tumors and the risk appears to increase progressively with time. Assay of adrenal and thyroid hormones did not discriminate between patients with and without pituitary tumors. Early detection of these tumors is aided by serial sella x-rays, tomograms, prolactin assays, and newer pituitary function tests. Patients presenting with postpill amenorrhea and postpartum amenorrhea illustrate the hazard of interpreting a temporal relationship as a causal one.
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PMID:Pituitary tumors in patients with secondary amenorrhea. 93 1

The familial occurrence of brain tumors are exceedingly rare except in cases with phacomatosis. We encountered pituitary adenomas in two sisters of a family, so far presenting no evidence of multiple endocrine adenomatosis (MEA). Case 1, K. O. a 26-year-old woman was admitted to our Hospital on September 10, 1970 with visual acuity and field disturbance, irregular menstruation and acromegaly. Neurological examination: Her visual acuity was Vd 0.6 and Vs 0.3, visual field was bitemporal hemianopsia, and ther was papilledema bilaterally. She had left exophthalmos and left abducens palsy. Roentgenogram of the skull, brain scanning, cerebral angiogram, pneumoencephalogram suggested the presence of a pituitary tumor. On Sep. 17, 1970, through a left frontotemporal craniotomy the tumor was removed subtotally. The pathological diagnosis was pituitary adenoma (chromophobe). Case 2, M. T. a 31-year-old woman, sister of case 1, was admitted to the Hospital on September 19, 1973, with mild headache, left visual field disturbance and amenorrhea. She had a child, and a past history of pulmonary tbc. Neurological examination: Her visual acuity was Vd 1.2 and Vs 0.03, and visual field of the right eye was temporal lower quandrant anopsia. There was optic nerve atrophy in the left eye. Plain X-ray craniogram, brain scanning, cerebral angiogram and pheumoencephalogram suggested the presence of a pituitary tumor. On Sep. 28, 1973, a right frontal craniotomy was performed. The tumor tissue with capsule was removed subtotally. The pathological diagnosis was pituitary adenoma (mixed type). In the literatures about familial brain tumors with histological diagnosis, glioma and glioblastoma are common, meningioma is relatively rare. Pituitary adenoma with no evidence of MEA is exceedingly rare. The two sisters presented in this paper, have no evidence of hyperparathyroidism, pancreas adenoma and peptic ulcer. So, we consider, at present, these cases should not be field in MEA.
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PMID:[Familial occurrence of pituitary adenoma (author's transl)]. 94 79

The amenorrhea-galactorrhea syndrome which occurs at a time other than the post-partum period is most often seen in association with a tumor of the pituitary gland; the symptoms are caused by a hypersecretion of prolactin. Among a series of 19 patients in Tel Aviv who underwent surgery for treatment of pituitary tumors, 2 presented with the amenorrhea-galactorrhea syndrome. The first patient, a 16 year old, presented with headaches, nausea, and diplopia; she underwent a series of 3 surgical procedures and died of a respiratory arrest in the third post-operative period. The second patient was a 39 year old woman who had borne 5 children; she presented with loss of vision, underwent surgery, and did well post-operatively. The authors point out that whereas either amenorrhea or galactorrhea alone may be associated with a number of disorders, the combination of the two symptoms is characteristic of pituitary tumors. Both patients who were presented in this article had chromophobe adenomas of the pituitary. The authors also discuss the various biologic actions of prolactin and its interrelationships with other hormones.
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PMID:[Pituitary tumors manifesting with amenorrhea-galactorrhea]. 96 24

854 women received C49'249-Ba for contraceptive purposes over a total of 4478 cycles (average 5.3 cycles each patient). No pregnancies occurred during the treatment. 50% of the women tolerated the drug without any undesirable side effects. 8% of the women discontinued treatment because of negative side effects. 26 negative side effects were reported in 309 (36.6%) of the patients, in a total of 766 (17.1%) cycles. Amenorrhea was observed in 4.1% of the women in 1.3% of the cycles. 24.4% of the patients reported bleeding disorders. Other symptoms were nausea (7.4% of the cycles), fatigue (2.4%), headache (5.4%). Weight gains, elevated blood pressure, libido changes, and disorders in liver, blood coagulation, or lipid serum were slight. Most of these undesired side effects appeared in the early cycles of therapy and decreased or disappeared after continuation of the treatment. Pregnanediol tests showed that the contraceptive effect of C49'249-Ba occurs through changes in the cervix mucus membrane, endometrium as well as by means of ovulation inhibition. In spite of the low estrogen dose, this preparation offers reliable contraceptive protection.
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PMID:[A review of international clinical experience with a low-oestrogen oral contraceptive (author's transl)]. 98 Nov 63


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