Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

100 women used the sequential preparation Physiostat for a total of 1029 cycles. 65 were between 20 and 40 years of age, 24 were nulliparae, and 59 were workers or employees. No pregnancies were reported. After 6-12 cycles of use, very few menstrual irregularities were reported, and 99% had no spotting after the first cycle of use. In one case, the preparation had to be discontinued due to vascular disorders. There were 5 cases of headaches, one of nausea. 9% reported no change in weight. 6 women reported improvement of an acne condition. 2 women discontinued Physiostat use due to a reduction in libido; 18 reported that their libido increased during Physiostat use.
 ...
PMID:[Physiostat: normophasic oral contraceptive]. 1226 83

Phasic oral contraceptives (OCs) provide a physiological approach to contraception and most closely approximate the ideals of a combined OC with the lowest possible doses to avoid the metabolic risks of estrogens and progestins, maximal contraceptive protection, and satisfactory cycle control. Earlier studies have demostrated the decline in myocaridal infarct and thromboembolic disease with reduction of ethinyl estradiol (EE) from 50 to 30 mcg, the correlation between progestin dose and cardiovascular and cerebrovascular deaths, and the effects of progestins derived from 19 nortestosterone in reducing the beneficial high density lipoprotein (HDL) cholesterol. The preparation SH B 264 AB for example provides a 1st phase daily dose of 30 mcg EE and 50 mcg levonorgestrel, a sufficient dosage because of the low probability of ovulation but 1 which attempts to mimic the follicular secretion needed for endometrial growth. Daily doses in the 2nd phase increase to 40 mcg EE and 75 levonorgestrel, each of which is capable alone of inhibiting ovulation. The progestin causes a supplementary hypothalamic inhibition and renders the cervical mucus too viscous for sperm penetration, while the EE augments the hypothalamic inhibitory effect of the progestin, prevents release of luteinizing hormone releasing hormone, and suppresses the luteinizing hormone peak by increasing the pituitary threshold to hypothalamic stimulation. The total dose of SH B 264 AB is at least 30% less than that of other OCs. The Pearl index is 0.0-0.6, not quite as good as that of normal dosed OCs. The duration of menstrual bleeding appears unchanged even after prolonged use, while the amount of bleeding is slightly decreased. Amenorrhea and intermenstrual bleeding are rare. The good cycle control occurs because the steroid levels administered in the triphasic pill mimic those of ovarian secretion, leading to better endometrial development. The effects of triphasic pills on glycemia and insulin levels are very weak and are not statistically significant, while their slight estrogen dominance means that they have very slight effects on the level of HDL cholesterol. They cause a slight increase in triglyceride levels, minimal variation in coagulation parameters, a weak variation in factors VII, VIII, X, and plasminogen, and a slight decrease of antithrombin III. Triphasic OCs induce minimal augmentation in activity of the renin-angiotensin system, and in most cases do not affect blood pressure. Because of their estrogenic dominance, triphasic pills improve acne but may be associated with breast problems, water retention, dysmenorrhea, and premenstrual syndrome with irritability, nervousness, and headache. Triphasic pills are indicated for women beginning OCs, women with poor cycle control under other OCs, women at high cardiovascular risk, women with acne, and women whose current OCs cause oily skin, hirsutism, reduced libido or other symptoms. Contraindications for the triphasic pill in addition to the usual factors include benign breast disease, premenstural syndrome, dysmenorrhea, or polycystic ovarian syndrome.
 ...
PMID:[Pros and cons of triphasic oral contraception]. 1226 12

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.
 ...
PMID:Long-term administration of norethindrone in fertility control. 1227 4

The main advantage of the triphasic oral contraceptive (OC) is its reduced corticosteroid content, which is accompanied by a reduction in metabolic impact. Triphasic pills differ according to their components and according to whether or not their estrogen dose is constant. The Triella pill has a constant dose of 35 mcg ethinyl estradiol (EE) and a dose of norethisterone that increases from .50 to 1 mg, while Triquilar-Trinordiol mimics the preovulatory estrogen peak while also varying the progestin content. In a study of 22,728 cycles, the Pearl index was only .06/100 woman years for triphasic pills. Comparisons with existing monophasic pills indicate that triphasics may offer improved cycle control, but the fact should be emphasized to patients that cycle control is an inappropriate criterion for choice of pills. Metabolic effects or possible carcinogenic effects are more important qualities. Triphasic pills have been found to improve acne, not to affect weight or blood pressure, and to reduce the frequency of headaches, nervousness, and breast tenderness. Studies have shown that triphasics containing levonorgestrel produce minimal effects on lipid metabolism, while less rigorous studies on triphasics containing norethisterone have also yielded favorable results. It is true however that knowledge of the relationship between alterations in plasma cholesterol caused by Triella use and the etiology of certain diseases remains incomplete. Low dose triphasic pills appear to have fewer deleterious effects on glucose metabolism than higher dose pills, but they are not entirely without effect and should not be prescribed for women at risk of developing diabetes. Studies examining modifications of the intima and coagulation factors have given reassuring results, and neither triphasics with levonorgestrel nor those with norethisterone modify the blood pressure. Triphasics entail a reduction in the levels of estradiol and testosterone and a slight increase of plasma renin activity but no modification in plasma aldosterone. The subtle effects on the gonodotropic axis are considered especially fitting for young women in whom post-pill ovulatory function is preserved. Endometrial biopsies show that the state of the endometrium with OC use is not well understood and highly variable. The triphasic pill approaches as closely as possible the normal physiology of the endometrium while still suppressing ovulation.
 ...
PMID:[The triphasic pill]. 1228 Feb 9

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.
 ...
PMID:[Treatment of acne with an antiandrogen containing contraceptive (Diane 35)]. 1228 88

Although information on contraception is readily available and a 1974 French law allows adolescents to receive contraceptives in family planning centers at no cost and without parental consent, over 1/2 of French adolescents have their 1st sexual intercourse with contraceptive protection and 13,000 adolescents under 17 become pregnant each year. Factors in the imperfect access of adolescents to contraception include conflicts with adult sources of contraception information, faulty perception of the risk of pregnancy, and presentation of contraceptive information in rational and technical terms to the exclusion of affective and relational aspects. Practical difficulties in finding a physician and paying for the consultation and fear of the examination itself are obstacles for some adolescents. The ambivalence of family planning providers faced with very young clients can be a significant barrier to access. At the 1st consultation, the adolescent should be seen alone. A complete medical consultation should be carried out including discussion of the adolescent's activities, habits, and affective life. Information on sexually transmitted diseases should be provided in a straightforward way, with possible symptoms included. The consultation usually ends in prescription of a combined oral contraceptive (OC), but for undecided adolescents or those with episodic sex lives several prescriptions may be given to provide a choice between OCs, condoms and spermicides, or the morning-after pill. Follow-up usually entails evaluation of weight and blood pressure, a gynecological examination with annual Pap smear, and management of secondary effects. A breast examination is necessary because of the sensitivity of breasts to estrogen at this age. OCs with a progestin dominance should be chosen for adolescents. In case of menstrual headaches the OC should be modified or terminated. Minor side effects such as acne are often the cause of termination and should not be ignored. Follow-up should be frequent and regular in the 1st year. Very young adolescents should be given standard-dose OCs. In case of absolute contraindications to combined OCs, a low-dose progestin pill may be selected. A low-dose pill and dietary counselling may be provided in case of weight gain, and an estrogen-dominant pill may help in case of moderate acne. OCs should be stopped in the event of hepatitis or expected surgery. Combined OCs are usually without medical contraindications and well tolerated by adolescents.
 ...
PMID:[Contraception in adolescents. Taking responsibility and indications]. 1228 74

Some scientists added the progestin levonorgestrel to the vaginal ring which must be removed every 3 weeks to address the problem of irregular bleeding, but it adversely altered lipoprotein levels and caused too many hemorrhaging problems. On the other hand, scientists in the laboratory at Organon have conducted various studies of a vaginal ring with ethinyl estradiol and 3-keto-desogestrel at different doses which have yielded favorable results. A multicenter European study was conducted with 400 women aged 18-40 years wearing a vaginal ring with 0.120 mg keto-desogestrel and 0.015 mg ethinyl estradiol every day for 9 months. 10% had slight bleeding 15 days after insertion of the vaginal ring. In 10 women tested, the plasmal levels of progesterone and estrogen decreased by 4 nmol/l and 0.010 nmol/l, respectively. The first French study was conducted at the Gynecology College of Bordeaux and the South-West in 1988 and included 40 women followed for 9 cycles. The vaginal ring consisted of 2 compartments: the biggest compartment contained only 3-keto-desogestrel and the other also contained ethinyl estradiol. It remained in the vagina for 21 days, then was removed to be rinsed, dried, and placed in a box. It was reinserted on the 5th or 7th day of the cycle. This ring reduces the volume of blood during menses and eliminates abdominal cramps, nausea, and headaches. Women tolerate the vaginal ring better than they do oral contraceptives (OCs); for example, it does not cause them to gain weight, they tolerate glucose well, it brings about favorable changes in lipoproteins, it does not bring about conditions favorable to thrombophlebitis, and it can improve the skin for acne-sufferers. Young women accept vaginal rings enthusiastically. The efficacy of vaginal rings with 2 steroids is the same as that of OCs.
 ...
PMID:[Vaginal contraception with steroids]. 1228

A 1997 Contraceptive Technology Update survey of 145 US family planning practitioners found that oral contraceptives (OCs) remain the leading reversible contraceptive method, chosen by 85% of adult women and 78% of teenagers. Ortho Tri-Cyclen is the first choice among OC brands, presumably because of its recent US Food and Drug Administration endorsement for acne control. Ortho Tri-Cyclen is the first low-dose OC to be indicated for noncontraceptive use. 11% of adult women and 17% of teenagers preferred Depo-Provera in 1997, compared with 6% and 11%, respectively, in 1996. Another study, commissioned by the US Association of Reproductive Health Professionals, indicated 85% of current OC users are very satisfied with the method and 50% of former users still prefer it over other forms of birth control; 75% would advise a young woman to use OCs. Although weight gain, severe headaches, and mood swings may affect users of OCs, Depo-Provera, and Norplant, OC users are less likely to discontinue method use because of these side effects than users of implants and injectables.
 ...
PMID:Oral contraceptives hold top position as leading choice for women. 1229 67

All medications have side effects in certain patients; none is 100% "safe" and the physicain must determine the benefit-to-risk ratio of each contraceptive method for a particular patient. 81% of white, nonCatholic women aged 20-24 who are college graduates use oral contraceptives, an extraordinary acceptance level for a method not even available in 1960. The various preparations available in the U.S, amount of estrogen and progestogen in each, and side effects are then surveyed. Estrogen irritates the gastric mucosa and diminishes rate of sodium excretion by the kidneys; this causes the nausea, edema, general bloating, tension, and headaches which most commonly cause women to discontinue the medication. The patient with full breasts who menstruates normally should not be overloaded with estrogen while a high-estrogen compound might benefit the woman with small breasts and scanty menses. Estrogens are known stimulants for the growth of uterine leiomyomas; if such lesions are present an antiestrogenic progestogen is indicated. High estrogen pills are more likely to stimulate breast growth and increase discomfort from fibrocyctic disease while a progestin-dominant combination will reduce this discomfort. The "19-nor" progestins are essentailly variants of testosterone and may produce hirsutism, alopecia, acne, hypomenorrhea, or even amenorrhea. T hey also may increase appetite and cause excessive weight gain. The total effect is complicated by such factors as the particular progestin used. The 19-norsteroid compounds are partly metabolized to estrogen and increase the estrogenic effect while norgestrel produces antiestrogenic activity. Newer marketing methods have tried to simplify administration by inserting 7 iron tablets or 7 placebos so the user takes a pill every day for 28 days. For patients who have noted side effects during the 7-day interval they are not taking the pill (undoubtedly related to temporary estrogen insufficiency) .02 mg ethinyl estradiol may be used. The sequential method more closely simulates the normal menstrual cycle and can be used to advantage in women who suffer prolonged anovulation after cessaton of combination therapy and in women past 35 in whom the increased risk of pregnancy is offset by declining fertility potential. Both serious and minor adverse reactions to various forms of therapy are detailed. These include cutaneous, nervous system, metabloic, and endocrine system changes.
 ...
PMID:Present status of oral contraceptives: 1. effectiveness; basis for selection; side effects; metabolic changes. 1230 85

Progestins in oral contraceptives (OCs) produce potential complications, as well as noncontraceptive benefits, according to Robert A. Hatcher, MD, MPH, professor of gynecology and obstetrics, Emory University Medical School. Hatcher told CTU that lowering the progestin content in an OC may decrease complications, but could also decrease the benefits experienced by women. "The extent to which that will happen remains to be seen," he said. Hatcher cited the following potential complications of progestins in OC: hypertension; decreased levels of high density lipoproteins; acne; oily skin; headaches between pill cycles; dilated leg veins; pelvic congestion syndrome; thrombosis of superficial leg veins; gallstones; Monilia vaginitis; cholestatic jaundice; and depression, fatigue, and decreased libido. Progestins, according to Hatcher, also produce these noncontraceptive benefits: protection against PID; decreased dysmenorrhea; decreased menstrual blood loss, decreased iron deficiency anemia; protection against endometrial cancer; protection against fibrocystic breast disease, and fibroadenomas of the breast; decreased bleeding from fibroids; decreased growth of fibroids. When ovulation is suppressed, Hatcher emphasized, additional benefits that may occur include the following: decreased risk of functional ovarian cysts; elimination of mittleschmerz pain; decreased rick of ovarian cancer; protection against endometriosis.
 ...
PMID:Potential risks, benefits of progestins in birth control pills outlined. 1231 83


<< Previous 1 2 3 4 5 6 7 8 9 10