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

In addition to oral contraceptives (OCs), the morning-after pill, the minipill, and depot preparations also belong to hormonal contraceptives. The latter two contraceptives have not become established among young women because of inadequate cycle control. For postcoital contraception in Austria, Neogynon and Stediril-D, consisting of 0.05 mg of ethinyl estradiol (EE) + 0.25 mg of levonorgestrel, are used within 48 hours of unprotected intercourse. Lower dose OCs have considerably reduced the risks of side effects. Micropills are the optimal OCs with EE under 50 mcg combined with the new generation of gestagens. The beneficial effects include menstrual regularity and the prevention of anemia, ovarian cysts, and fibrocystic mastopathy. Nausea, headache, spotting, and weight gain do occur in individual cases, even among young people. The potential risk of thromboembolism is the most important, although arterial cardiovascular risk is minimal in young age. The probability of postpill amenorrhea is less than 1%. Micropills can be used by young diabetics provided the disease is not beyond 10 years' duration and there is no angiopathy. Acne, seborrhea, and hirsutism are beneficially influenced by a combination of 0.035 mg of EE with 2 mg of cyproterone acetate. The relative risk of endometrial and ovarian cancer are only about half as high among OC users as among nonusers. The risk of breast cancer in young OC users has not been conclusively explained. Regular colposcopy and cytology is recommended for young OC users to preclude the risk of malignancies of the genital tract. Sex education and the use of OCs that are the most suitable and effective for young people can reduce the number of unwanted pregnancies and abortion. The comparison of two 5-year periods in the 1970s and 1980s at the University Obstetrical-Gynecological Clinic in Graz showed that the incidence of births among women under 18 years of age decreased from 3.6% (778) to 1.6% (353).
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PMID:[Benefits and risks of hormonal contraception]. 146 64

The Royal Army Medical Corps (RAMC) of the UK is considering offering women in the Army the option of inducing amenorrhea especially those in war. Logistics problems of supplying sufficient sanitary protection makes inducing amenorrhea in these women an advantage. It is important that the Royal Army not force servicewomen ready for war to agree to chemical induction of amenorrhea, however. A survey of civilian women shows that 80% liked the notion of eliminating menstruation. continuous combined oral contraceptive (COC) therapy induces amenorrhea, but it poses some side effects including bleeding and spotting, 2 kg weight gain, breast tenderness, depression, and headaches. 12 weeks of COC therapy costs range form 2 to 6 pounds. The synthetic androgen used to treat endometriosis, danazol, may also induce amenorrhea at daily doses of 800 mg. It causes various side effects including reduced breast size, flushing, sweating, loss of libido, acne, weight gain, edema, hirsutism, and voice change. 12-week danazol therapy costs about 200 pounds. Another drug with androgenic, antigonadotrophic, antiestrogenic, and antiprogestogenic properties which is also used to treat endometriosis, gestrinone, in another possible amenorrhea inducer at 2 doses of 2.5-5 mg/week. Side effects are similar to those of danazol. In 1 study, all 20 patients developed acne and seborrhea. Its 12 week costs are considerably more than danazol and COC therapy (450 pounds). Intermittent administration of 2 gonadotropin releasing hormone (GnRH) analogues, buserelin and goserelin, suppresses production of gonadotropins. Health workers need to inject 3.6 mg goserelin every 28 days while they administer buserelin subcutaneously or intranasally. the leading side effect on both GnRH analogues is not flushes. 12-week therapy is about 375 pounds. Fertility is restored after discontinuation of all the aforementioned therapies. The GnRH analogue goserelin is the most effective therapy, but the cost factor causes the Royal Army to favor COCs.
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PMID:The induction of amenorrhoea. 153 75

28 patients with polycystic ovary syndrome were treated for 12 months with the new preparation SH B 209 AE, consisting of 0.035 mg of ethinyl estradiol and 2 mg of cyproterone acetate. This was the first clinical trial of estroprogestational therapy on a homogeneous sample of women with polycystic ovary syndrome. Endocrine findings indicated a significant decrease in all hormonal parameters, the invariableness of prolactinemia, a considerable increase in sex hormone binding globulin (SHBG) at the 6th treatment cycle examination, a continuous significant decrease in 17 beta E2 and androstenedione from the 6th to the 12th treatment cycles. In terms of clinical findings, there was a significant decline in the severity of acne, seborrhea, and hirsutism during drug administration. The menstrual cycle in the 28 study subjects remained under control during treatment, and there were no pregnancies. Side effects such as weight gain, nausea, headache, and changes in libido were not reported. Overall, the findings of this study suggest that administration of the new monophasic contraceptive association SH B 209 AE can normalize endocrine patterns in polycystic ovary syndrome and improve its androgenic symptomatology. The low content of estrogen, the changes in clinical and hormonal parameters, the low incidence of side effects, and the good control of the menstrual cycle provided by this treatment make SH B 209 AE deserving of more widespread application.
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PMID:A new association of ethinylestradiol (0.035 mg) cyproterone acetate (2 mg) in the therapy of polycystic ovary syndrome. 294 60

201 patients with skin problems caused in their own opinion by working with visual display terminals (VDTs) were referred and examined. 18% claimed that their condition improved overnight and 21% that it did so over the weekend. In 25 patients, the skin problems occurred mainly on the cheek turned towards the VDT. Half the patients had rosacea, but their subjective skin symptoms were generally more severe than those in ordinary cases of rosacea, i.e., severe pain, itching and burning. The rest of the patients mainly had common facial dermatoses such as seborrhoeic eczema, acne vulgaris and atopic dermatitis. The patients' skin types, judged by their response to ultraviolet light, did not differ from those of a control population. 18% had non-specific skin problems, e.g., itching and redness. This latter group of patients most closely resembles those cases previously described amongst VDT-workers. An attempt to correlate skin problems with VDTs' electrostatic field strength was unsuccessful because of difficulties in eliminating it. Of 52 electrostatic shields placed in front of patients' VDTs, 38 were defective and 9 were wrongly earthed. The prevalence of migraine-like headache was 40%, which is much higher than in a control population. There was no great use of cosmetics by the study population. When followed up after an average of 8 months, 2/3 of the patients had fewer skin complaints. The question of whether the prevalence of skin problems in general is higher amongst individuals using VDTs than in a control population is addressed in a current study.
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PMID:Skin problems in workers using visual display terminals. A study of 201 patients. 297 51

21 women with endometriosis were treated with Danazol, a derivative of 17-alpha-aethinyltestosteron in an open study over a period of 6 months. 20 women had previously undergone an operation because of the spread of endometriosis and its symptoms, in no case was it possible to remove the source of the endometriosis entirely. Histological confirmation of the endometriosis was ensured in each case. The initial dose was 600 mg Danazol daily. In 17 cases the dose was reduced in the course of 6 months and in 5 cases treatment had to be stopped between the 4th and 6th month. An improvement of the symptoms arising occurred under this treatment. Side-effects, observed during the treatment with Danazol, such as acne vulgaris, seborrhoea, flushes and headaches occurred in 6 respectively 5 cases (28,6 respectively 23,8%). Very occasionally pain in the joints was reported. Almost all women put on weight. The effect of this treatment on fat- and glycometabolism, on liver- and kidney function, on blood-coagulation as well as bloodpressure was examined, no divergence from the norm was observed.
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PMID:[Treatment of endometriosis, Clinical trial with danazol]. 645 71

The efficacy and tolerability of treatment of adenomyosis-related menorrhagia with a levonorgestrel-releasing IUD were investigated in a prospective study of 25 women recruited from a tertiary care center in Italy. All women reported recurrent menorrhagia of at least 6 months' duration and underwent abdominal and transvaginal ultrasonography, hysteroscopy, and endometrial biopsy before study entry. An IUD releasing 20 mcg/day of levonorgestrel was inserted within 7 days of the onset of menses and follow-up examinations were conducted 3, 6, and 12 months after insertion. 1 woman experienced IUD expulsion 2 months after insertion and another requested removal at 4 months because of persistent irregular blood loss. 6 months after IUD insertion, amenorrhea was observed in 2 women, oligomenorrhea in 1 woman, and occasional spotting in 7 women; the remaining 13 women had scanty but regular periods. At 12 months, 2 women reported amenorrhea, 3 had oligomenorrhea, 2 had spotting, and 16 had regular periods. All menstrual anomalies were well tolerated. IUD-related side effects included headache (24%), breast tenderness (16%), seborrhea or acne (24%), and weight gain (28%). Significant increases in hemoglobin, hematocrit, and serum ferritin were recorded; there were no changes in lipid metabolism or clotting variables. These findings suggest that insertion of a levonorgestrel-releasing IUD represents a viable alternative to hysterectomy in the treatment of adenomyosis. It is speculated that the IUD produces deciduation and subsequent marked hypotrophy of eutopic endometrium.
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PMID:Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device. 931 8

The contraceptive safety and efficacy of long-term use of the oral contraceptive Belara (30 mcg ethinyl estradiol and 2 mg chlormadinone acetate) were assessed in an open, noncontrolled phase III study. Of particular interest was the effect of the anti-androgenic activity of this formulation on clinical signs of androgenization. Belara was taken by 1655 German women (mean age, 25.9 years), for a total of 22,337 cycles. A total of 12 pregnancies occurred, yielding a theoretical Pearl index of 0.269 (95% confidence interval, 0.109-0.600). No withdrawal bleeding occurred in 1655 cycles (7.4%), while spotting was documented in 2565 (11.5%) and breakthrough bleeding in 786 (3.5%). After 12 cycles of use, acne on the face/neck improved in 64.1% of affected women and completely disappeared in 53.4%. Seborrhea improved after 12 cycles in 67.9% of affected women and was cured in 58.0%. Side effects included headache (37.4%), nausea (23.1%), breast tenderness (21.7%), and vaginal discharge (19.4%). Of the 62 serious adverse events reported by 59 women, only the 2 cases of deep venous thrombosis could be linked to Belara use. Overall, these findings suggest that Belara is a well-tolerated oral contraceptive with minor side effects comparable to those associated with use of other low-dose pills.
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PMID:Efficacy and safety of the new antiandrogenic oral contraceptive Belara. 958 37

18 young women with an average age of 21.5 years and average duration of acne symptoms of 3.6 years were treated with Diane 35, a new antiandrogen contraceptive containing 35 mcg ethinyl estradiol in addition to 2 mg cyproteroneacetate (CPA) for 12 months. Gynecological exams were carried out prior to treatment, and 6 and 12 months later. Diane was taken for 21 days with 1 week of cessation. During monthly checkups acne lesions, seborrhea, weight, blood pressure, and side effect were examined. A recidivism follow-up of several months included 11 patients no longer taking the contraceptive. 14 patients became symptomless, and 4 of them improved indicating an effective treatment for all patients. The loss of symptoms started after 4 months (2-7) and they became completely symptomless after 7-10 months. 8 of the 11 patients in the follow-up study stayed symptomless at the end of treatment. Although relapse occurred in 7 cases, their condition was still better than before treatment. Side effects occurred in 11 patients mostly in the first months of treatment: nausea, vomiting (6), headache (4), vertigo (3), chest ache (2), bleeding (4). Treatment may exceed 12 months because after 7-10 months relapse occurred. If the treatment fails to improve the symptoms, administration of 10-20 mg CPA/day in the first 10 days of cycle is suggested.
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PMID:[Treatment of acne with an antiandrogen containing contraceptive (Diane 35)]. 1228 88

A combination of 50 mcg of ethinyl estradiol (EE) and 2 mg cyproterone acetate was prescribed for 50 women seeking oral contraceptives who showed signs of hyperandrogenism. The women averaged 25 years of age and the treatments lasted an average of 12 months. Very satisfactory results were seen in 32 of the 43 cases of acne within 4 cycles, and in 6 other cases the results were slower. Results depended on the severity of the acne. Satisfactory results were obtained in 22 of 27 cases of seborrhea, usually within the 1st 4 cycles. Results with hirsutism were satisfactory in 9 of 11 cases but the improvement was slow and often incomplete due to the weak dosage of cyproterone acetate. In all 3 cases of alopecia the results were satisfactory but the improvement came slowly. Most patients reported more regular periods, 8 reported spotting, 11 reported enlargement of breasts with heaviness and sensitivity, none reported effects on the libido, 8 reported nausea which disappeared rapidly, 10 reported headaches, 7 reported heaviness of legs, 5 reported gaining 2 kilos or more but 6 reported losing, and 8 reported mood problems. The only biological change noted in the sample was elevation in triglycerides in 5 women and transitory fluctuations in 7 others. The combination of EE and cyproterone acetate appears to be an excellent choice for young women with signs of hyperandrogenism.
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PMID:[Clinical use of ethinyl estradiol in combination with cyproterone acetate. Study based on 50 cases (author's transl)]. 1233 47

Chlormadinone acetate, cyproterone acetate and dienogest are potent, orally active progestogens, which have antiandrogenic instead of partial androgenic activity. They act mainly by blocking androgen receptors in target organs, but also reduce the activity of skin 5alpha-reductase, the enzyme responsible for converting testosterone to the more potent androgen, 5alpha-dihydrotestosterone, in sebaceous glands and hair follicles. Chlormadinone acetate and cyproterone acetate also suppress gonadotropin secretion, thereby reducing ovarian and adrenal androgen production. Combined oral contraceptives (COCs) containing antiandrogenic progestogens provide highly effective contraception (gross and adjusted Pearl indices: 0-0.7 and 0-0.3, respectively) with excellent cycle control. Furthermore, COCs containing 2mg of chlormadinone acetate or cyproterone acetate plus 30 or 35 microg of ethinylestradiol produced improvement or resolution of seborrhoea in 80% of users, acne in 59-70%, hirsutism in 36% and androgen-related alopecia in up to 86%. These COCs are generally well tolerated, the main adverse effects being nonspecific or as expected for a COC (headache, breast tenderness and nausea). They have no clinically relevant effects on metabolic or liver functions or on bodyweight. Effects on mood and libido are uncommon (<3.5% and <6% of women, respectively). COCs containing antiandrogenic progestogens are likely to be particularly valuable in women with pre-existing androgen-related disorders who require contraception. They also increase the choice of products available for women with normal skin and hair who are concerned about the possibility of developing seborrhoea or acne with other COCs.
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PMID:Progestogens with antiandrogenic properties. 1260 Feb 26


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