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

Medroxyprogesterone acetate injections (Depo-Provera) were given to 625 women at 3 monthly intervals involving 693 episodes. Ages at entry to the study ranged from 15-51 years with the majority in their 20s and a mean age of 30. Length of exposure ranged from 3-168 cycles. 4 women have received more than 160 continuous cycles of DMPA. Of the medication-induced reasons for discontinuing DMPA, bleeding was the most common with an incidence of 10.5% followed by depression (1.4%), weight gain (1.4%), and loss of libido (1.6%). No patient ceased treatment because of headaches, recurrent vaginal infections, mastalgia, nausea, chloasma, hypertension, or other vascular illnesses. The 59 women who move away or were lost to follow-up accounted for 405 cycles of treatment. The solitary unplanned pregnancy occurred in a 28-year-old obese woman who had previously had other method failures, once with an IUD and once with oral contraceptives (OCs). No association was found with carcinoma of the cervix. Of 80 women ceasing treatment to become pregnant, only 1 women has required the assistance of chlomiphene and conceived 2 years after ceasing DMPA. Amenorrhea was the side effect most appreciated by the women using DMPA. Due to the problem of irregular bleeding, it is wise to warn prospective patients about the lack of bleeding control that they have 1 chance in 10 of having relative menorrhagia. Women using OC subject to frequent vaginal moniliasis had a marked reduction in episodes after switching to DMPA. Chloasma, 1 of the minor stigmas of OC, was not induced in any of the patients. DMPA is a safe and efficient reversible method of contraception for women who have various gynecological conditions or problems associated with using OCs.
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PMID:Medroxyprogesterone acetate as an injectable contraceptive. 296 70

Experience with the oral contraceptive Ovostat (.1 mg mestranol and 1 mg lynestrenol) in 324 women (5714 cycles) is reported. Only 1 pregnancy was observed, in a patient who had forgotten several pills. Side effects included headache (11 patients), nervousness (5 patients), amenorrhea (4 patients), and chloasma (3 patients). Breakthrough bleeding and spotting were rare. Cervical mucus (samples on Days 9-11 and 13-15 in 50 women) was uniformly inhospitable to sperm: low viscosity, negative Farn test, constant pH. Endometrial biopsy showed tissue typical of "suppressed" endometrium.
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PMID:[Clinical studies on Ovostat--a combined oral contraceptive with a low dose of lynestrenol]. 460 4

Medical histories of 436 patients treated with Ovulen after childbirth or an abortion were examined in order to collect a sample of women who had taken the orals for 6-12 cycles. A group of 70 patients was thus formed. The following parameters were investigated: weight variation; blood pressure; nausea and vomiting; varicosities; variation in menstrual flow and length of period; breast-related side effects; jaundice; psychic alteration, i.e., nervousness, anxiety, or depression; changes in libido; headaches; skin changes; and pregnancy. Results are presented both in graph and table form. Weight change was found to tend more to loss than to gain. No statistically significant changes in blood pressure were observed. Nausea and associated symptoms tended to disappear after the 9th cycle. Edema was present in only 6% of all cycles. The most common side effect was varicosities, present in 25% of the sample, but in no instance did thrombosis occur nor was varicosity a cause for discontinuation in any case. Breast-related side effects were more common at the outset. No jaundice was observed. Psychic alterations were not common and were mostly insignificant and tended to occur more frequently at the outset. 12% of the sample had headaches from the beginning of treatment up until the 8th month, after which they began to disappear. Only 1 patient had chloasma and then only during the 1st 2 cycles. There was a marked tendency toward menorrhagia which was thought to be beneficial due to the prevalence of anemia in the group. Changes in libido were minimal and tended to disappear after the 8th cycle. None of the patients became pregnant.
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PMID:[Secondary effects of ethynodiol diacetate plus mestranol]. 535 18

135 women who had had at least 1 child were treated with 80 mg of mestranol and 1 mg of lynestrenol on a 22 day on, 6 day off basis for a total of 800 cycles of observation. Follow-up was done monthly. Endometrial and cervical biopsies were done and levels of pregnanediol in the urine were tested. Cycles were between 25-31 days with an average of 28. Flow averaged 3 days' duration and was slight in 53.1% of the cycles, normal in 39.3% and heavy in 2.1%. 48.3% of the cycles were characterized by no dysmenorrhea, 35.7% by slight, 11% by moderate, and 1.8% by severe. Incidence of spotting and breakthrough bleeding was slight. Side effects were also slight; nausea was present in 7.6% of the cycles, hypogastric tension in 6.6%, chloasma in 5.9%, and severe headache in 4.3%. Headaches were the only side effect reported with any regularity. No pregnancies occurred. Only 14 patients discontinued. Test results indicated that under medication the amount of pregnanediol diminished, the endometrium modified its ovulatory functions, the cervical mucus lost it ability to crystallize or stretch, and vaginal shedding was slightly modified.
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PMID:[Clinical study of a mestranol lynestrenol combination of 1 mg. (preliminary report)]. 537 9

To study the safety and efficacy of a norgestrel-ethinyl estradol oral contraceptive compound, 300 Mexican women, 16-42 years of age were orally administered .5 mg norgestrel and .05 mg ethinyl estradiol (Ovral) daily over a total of 3175 study cycles. Most of the women were poor., uneducated and of high parity. None of the patients in the study became pregnant, even in the cycles where 1 or more doses were omitted. The menstrual cycle remained basically unaltered with breakthrough bleeding or spotting sometimes reported, usually when doses were missed. Unexplained amenorrhea occurred in 1.2% of the cycles. Though 5% of the women were ovulatory at one time of another as determined by pregnandiol levels, no pregnancy resulted, which is probably explained by changes in the cervical mucus caused by the pills making an inhospitable environment for sperm migration. Psychosomatic-related side-effects included nausea, headache and decreased libido in less than 1% of the cycles. Chloasma aggravated by poor dietary intake occurred in .5% of the cycles. No malignant, peripheral vascular or other serious disease occurred during the treatment and no significant endometrial alterations were seen.
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PMID:Norgestrel and ethynyl estradiol: a new low-dosage oral agent for fertility control. 563 91

There is little absolute data in the form of prospective studies in patients with specific illnesses who are on oral contraceptives (OCs). Consequently, the clinician must depend on well-founded empiric decisions in prescribing the pill for these patients. The basis for the decision should be a firm understanding of the pathophysiology and laboratory effects of OCs. This needs to be juxtaposed with an understanding of the efficacy and effects of the estrogen and progestational components of the birth control pill and their interactions with maintenance medications. Available evidence is reviewed for the following medical disorders: central nervous system disorders (depression, Wilson's disease, headaches, epilepsy, multiple sclerosis, and the eye); immunologic and connective tissue diseases; diseases of the endocrine system, the gastrointestinal system, the genitourinary system, the memopoietic system; and skin disorders. 7% of women on OCs have increased or newly reported depression. Whether these are primarily psychogenic or metabolically derived is yet to be definitively determined. Wilson's disease can be exacerbated by OCs because of increased plasma ceruloplasmin and increased absorption of copper from the gastrointestinal tract. Headaches can be either a vague or a specific symptom, such as migraines, but 1/3 of these patients will become worse on OCs. There is good evidence that the headaches are caused by falling estrogen levels. There is no good evidence that epilepsy, in general, becomes worse on OCs. OCs have relatively no effect on the longterm prognosis in multiple sclerosis. Increased corneal sensitivity has been observed with OC use, and this has usually presented an intolerance to the use of contact lenses. This is primarily the result of increased edema of the cornea and changing of its contour. By inference, OCs cause some basic universal changes in the immunologic system. OCs have been reported as a cause of a rare form of rheumatoid arthritis, but the Royal College reports a decrease in incidence of cell-mediated immunologic disease, specifically rheumatoid arthritis in its more familiar form. There is no evidence that OCs markedly influence thyroid disease, but they do markedly alter thyroid function testing. OCs do not produce a chronic addisonian state nor do they inhibit the ability of the adrenal-pituitary axis to respond to stress. OCs can be used in thyroid disease but with some caution in hypothyroid states. They should not be used in patients with Cushing's syndrome and are not recommended in patients with adenomas. In general, estrogen works as an irritant to the gastric mucosa, but there is no increase in peptic ulcer diseases associated with OC use, and the incidence of duodenal ulcer disease is decreased. The most striking liver disease seen with OCs is cholelithiasis. The incidence is increased 2-fold. OCs should not be prescribed for patients with chronic renal disease because of the vascular effects as well as the reported increased risk of urinary tract infection. The Royal College report has shown a decreased incidence of iron deficiency anemia in patients on OCs. Various skin changes have been reported in women using OCs. The most common of these is chloasma. In all the diseases studied thus far, the use of OCs has not precipitated a catastrophic change.
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PMID:The use of birth control pills in women with medical disorders. 702 14

Although Thailand's National Family Planning Program introduced Norplant contraceptive implants in 1986, few women infected with human immunodeficiency virus (HIV) select this method, and its efficacy, clinical effects, and side effects in this population have not been investigated. To address these issues, a prospective cohort study was conducted during 1993-96 of 41 asymptomatic HIV-infected women who presented to the Family Planning Clinic at Ramathibodi Hospital in Bangkok, Thailand, and voluntarily accepted Norplant implants. All implants were inserted within 4 weeks after delivery or abortion. 63.4% of acceptors had not used any contraceptive method prior to pregnancy. At 6 and 12 months after insertion, 26% and 23%, respectively, reported irregular menstrual periods and 24.4% and 36.6%, respectively, reported amenorrhea. Side effects, reported by 3-10% of women, included headache, acne/chloasma, anorexia, and nausea. There were no significant changes in body weight, blood pressure, and hemoglobin between insertion and the 12-month follow-up. No pregnancies occurred during the study period. These findings suggest that Norplant implants are an effective, appropriate contraceptive method for HIV-infected women who want to avoid pregnancy but are not interested in sterilization.
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PMID:Use of Norplant implants in asymptomatic HIV-1 infected women. 917 51

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

The combined oral contraceptive (OC) has become one of the most effective methods of controlling India's staggering population growth. Even the less literate of Indian women have accepted the combined OC with considerable enthusiasm, because they understand that it is a method with a 100% guarantee. As progestogen sensitivity is much more marked than sensitivity to estrogens in India, indicated by the incidence of chloasma and amenorrhea, a trial of a new low dose OC was conducted at the Family Planning Welfare Center of Medical College, Calcutta, India. Lyndiol, 1 mg (ethinylestradiol .05 mg and lynestrenol 1 mg) has low progestogen potency. The trial was initiated in July 1973 and has involved 90 patients over 375 cycles. The patients were selected from married women attending the Family Planning Welfare Center for contraceptive advice. The amount of menstrual flow was unaltered in 81 cases and in 10% of cases there was a reduction of flow as compared with pretreatment menstruation. This compared very favorably with highly progestogenic contraceptives that show a reduction of menstrual flow in over 50% of patients. Only 2 patients complained of breakthrough bleeding or spotting in early cycles. 9 patients (10%) complained of nausea and vomiting in early cycles; 5 patients complained of failure of a withdrawal bleeding in early cycles. Some weight gain was observed in 16 patients (17.7%); 4 patients noted a weight loss. Only 6 patients complained of a headache and 5 of breast engorgement. In this study, 6 patients (6.6%) showed a mean rise of systolic blood pressure of 10 mm and a diastolic pressure of 4 mm. The major risk associated with estrogen/progestogen combination is thromboembolism. In India its incidence is rather low. This trial with Lyndiol 1 mg corroborates this since no thromboembolic occurrences were noted. In sum, Lyndiol (1 mg) is an ideal OC, which is available for Indian mothers with a minimum of side effects.
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PMID:Lyndiol (1 mg)--evaluation of a new low dose oral contraceptive. 1228 Dec 47