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

Detailed interview information was obtained from 515 women in connection with a Swedish-Norwegian comparative investigation on possible connections between use of oral contraceptives (OCs) and premenopausal breast cancer. The Norwegian data was reviewed to ascertain the occurrence of mild side effects and how these side effects influence the use of OCs. In all, 63% of those interviewed had used OCs. Side effects were reported in 55.6% of the 629 use periods. The most frequent side effects were weight gain (17.8%), irregular menses (14.0%), nausea (8.9%) and tender breasts (8.8%). The respondents also reported depression, aggressiveness, decreased libido, headache and migraine. Differences in side effects were found for various OCs depending upon quantity of hormone and composition. Estrogen related complaints such as tender breasts and weight gain increased in relation to the estrogen dosage in the pill. Users of the minipills often reported irregular menses. Reports of psychological problems were relatively evenly distributed but users of minipills reported significantly lower rates of side effects for such complaints. Although relatively few use periods were reported for triphasic pills, these also appear to be involved with a number of side effects. 2 out of 5 women who began taking OCs reported that they had to stop because of side effects. This reduced the value of OCs as an effective and easily obtainable means of contraception.
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PMID:[Mild side-effects of oral contraceptives]. 320 63

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

A 15 year old female began to suffer from a headache 12 hours prior to admission to a hospital in Broken Hill, N.S.W., Australia. Several hours after the onset of the headache, she had a generalized tonic-clonic seizure. Upon arrival at the hospital, she was lethargic, but did respond to commands. Her speech was slurred and the right side of her body was paralyzed. She had no fever and blood pressure was normal. Despite attempts to treat her with intravenous dexamethasone, she slipped into an unconscious state. A CT scan uncovered a left parietal hypodense lesion. Her pupils quickly dilated the next day. The right pupil did respond slightly to light, however. Physicians made a burr hole in the parietal area of her skull which exposed underlying necrotic tissue. After the operation, her brain stem failed to function. She died the following day, 3 days after the symptoms began. Other than a febrile convulsion at 10 months, she had been in good health. She had been taking a combined oral contraceptive (COC) made of 125mcg levonorgestrel and 50mcg ethinyl estradiol for 2 weeks. Pathologists found an area of necrosis in the left temporo-parietal region of the brain and an occlusive thrombosis near the left middle cerebral artery. Further, a pronounced segmental necrotizing vasculitis of the left middle cerebral and right posterior cerebral arteries existed. Based on other documented cases and this case, the physicians point to evidence that vessel size in vasculitis has an effect on the severity of the disease. Vasculitis in small vessels has a tendency to cause a gradual progression of the disease, while this disease in medium and large vessels may cause a rapid progression of the disease, as in this case. The researchers suspect that the COC may have precipitated the disease.
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PMID:Isolated angiitis of the brain in a young female on the contraceptive pill. 345 Dec 35

A trial of a triphasic oral contraceptive in 13 women with polycystic- ovary syndrome is presented, backed up with data on levels of sex hormone binding globulin (SHBG), testosterone, androstenedione, 17-OH-progesterone and other hormones. This illness is really a hyperandrogenic response of the ovary secondary to high gonadotropin levels and unopposed estrogens with low SHBG. Only mediocre results have been reported with low-dose oral contraceptive treatment, compared to earlier high-dose pills. The pills used here contained 50 mcg levonorgestrel (LNG) with 30 mcg ethinyl estradiol (EE) for 6 days, 75 mcg LNG and 40 mcg EE for 5 days, and 125 mcg LNG with 30 mcg EE for 10 days. After 3 months of treatment LH levels fell from 29.7 to 3.6 mIU/m1; FSH fell from 12.3 to 2.6 mIU/m1, and the LH/FSH ratio decreased from 2.34 to 1.38. All androgens declined significantly (p0.01), into the normal range. Serum cortisol rose significantly from 16.9-36.7 mcg/100 ml. SHBG rose from 1.67-3.0 mcg/100 ml, the high limit of normal. Hirsutism and acne improved in all but 1 patient. 1 woman dropped out because of weight gain, and another because of nausea and headache. These results suggest that triphasic oral contraceptives may be safe and effective for chronic anovulatory syndrome.
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PMID:SHBG, testosterone, androstenedione, 17-OH-Progesterone plasma levels in PCO affected women treated with a triphasic oral contraceptive. 345 1

Symptoms due to estrogen deficiency begin in the perimenopausal years and progress as serum levels of this hormone decrease Vasomotor instability, manifested by hot flushes or night sweats, may persist for several months to a few years. Psychologic symptoms include anxiety, tension, depression, insomnia, palpitations, and headaches. Atrophy of the genital epithelium may result in senile vaginitis with symptoms of irritation, burning, pruritus, dyspareunia, and even vaginal bleeding. Even the lower urinary tract mucosa is dependent upon estrogen. Postmenopausal osteoporosis affects 25 to 50% of older women and increases the risk for vertebral, hip, and other fractures. Estrogen therapy for menopausal complaints has received adverse publicity because several reports have indicated that unopposed estrogens increase the risk of endometrial cancer. Added progestogen not only negates this risk but reduces the incidence of endometrial adenocarcinoma in estrogen-progestogen users to less than that observed in untreated women. Estrogen replacement therapy does not increase the risk of breast cancer; the incidence of this malignancy, however, was also less in the estrogen-progestogen users when compared with either the untreated women or from that expected from the national cancer surveys. In evaluating postmenopausal women for hormone replacement, the benefits of estrogen-progestogen therapy must be weighed against possible risks.
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PMID:The menopause. 351 23

Three studies directly evaluated the effects of oral contraceptive (OC) use on migraine headache frequency. The Walnut Creek Study in 1980 was unable to demonstrate a higher frequency of migraine headache in OC users discharged from the hospital as compared with nonusers. Another study in 1978 evaluated the effect of 0.5 mg of norgestrel and 50 mcg of ethinyl estradiol (Ovral) on 40 migraine sufferers. 20 patients received this preparation for the first 2 months of the study, the other 20 did not. 29 patients experienced worsening of their headaches with OC use. However, one-third of the patients did note improvement in their headaches. A third study in 1976 of women suffering from migraine suggested that about one-third of women noted worsening of their headaches while taking OCs. The risks of cerebrovascular accident (CVA) include advancing age, smoking, and the use of high-dose pills. Increase in blood pressure, platelet aggregatability, and cholesterol deposition are the three known mechanisms of the risk of stroke. No blind study of the subject has even been made, and a significant minority of OC users reported improvements in their migraine headaches. Circumstantial evidence suggests that there is an increased risk of stroke in OC users, although these case control studies differed with regard to the degree of relative risk. Two of three cohort studies were unable to demonstrate the increased risk of CVA among these women. The absolute risk of thrombotic stroke remains small for OC users, and the absolute risk is probably very small even for those taking OCs. However, the risk of hemorrhagic stroke may increase fivefold in those smoking. For nonsmokers, OC use is probably safer in all age groups than no contraception. A 1977 study showed that 40-44 year old nonsmokers taking OCs had an estimated death rate of 7/100,000. In contrast, those who used no method of contraception had a higher mortality rate of 23/100,000.
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PMID:Relationship of migraine headache and stroke to oral contraceptive use. 354 Feb 97

To collect data on clinical and laboratory effects of the oral contraceptives (OCs) marketed in Hungary, a prospective study was initiated in January 1983. Patient data were collected in regular intervals using standard statistical forms. During the first 2 years of the study, data were collected on 1256 women. A complete segment of the data was selected to be reported in this paper and included 1844 cycles of 121 women using a biphasic OC compared to 1940 cycles of 142 women using a classical formulation pill. The biphasic preparation was characterized by a very low levonorgestrel content with an average ethinyl estradiol dose; the reference preparation was a relatively high dose classical OC. No biologically significant difference was found between hormone and receptor levels. The basis of the comparison of the 2 preparations was the termination of OC use in the 2 groups as a function of time. The primary reasons for stopping administration of these preparations were unwanted pregnancy, medical reasons, critical age above 35, planned pregnancy, and other personal reasons. The difference between the 2 groups proved significant according to the life table method only in the category of medical reasons. Slightly more patients were lost to followup in the higher dose group. In the category of medical reasons, digestive tract complaints like nausea, vomiting, menstrual bleeding anomalies, too frequent bleeding-spotting, episodes of amenorrhea, weight gain, psychic disturbances, headache, breast tenderness, and swelling were prominent. These symptoms were most frequent in the first 3-4 months of OC use. The difference was due to the significantly higher rate of amenorrhea/hypomenorrhea, weight gain, and headache in the high dose monophasic pill group. The biphasic pill group was characterized by a slightly higher rate of gastrointestinal complaints and breast swelling. The overall difference favored the latter preparation. The biphasic OC did not cause a thrombotic change in homeostasis despite the fact that it was estrogen dominated. The basal levels of luteinizing hormone and follicle stimulating hormone were less affected in the biphasic OC users compared to the classical formulation OC users. Estradiol levels did not change significantly. The inhibition of ovulation was about the same with both treatment regimens.
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PMID:Clinical and endocrine effects of long-term hormonal contraception. 358 64

Triphasil, a low-dose combination oral contraceptive containing levonorgestrel and ethinyl estradiol, was tested in four Planned Parenthood clinics on 317 women between 18 and 34 years of age (mean, 23) for a total of 4,692 cycles, or 361 woman-years of usage. Approximately half these volunteers (165) were nulligravidas, and 309 (97.5%) were white. Despite instructions on proper tablet usage, there were 416 cycles (8.9%) in which one or more tablets were missed. Only one pregnancy occurred, in a cycle in which a total of four tablets was missed, for an uncorrected Pearl index of 0.28 pregnancies per 100 woman-years of usage. No pregnancy resulted from method failure, indicating a 100% efficacy rate for Triphasil when taken properly. The mean length of the menstrual cycle with Triphasil was 27.9 days; the mean length of menses, 4.4 days; and the mean latency period, 2.1 days. Menstrual flow was average in 64.1% of the subjects, light in 34.1%, heavy in 1.3% and variable in 0.5%. Amenorrhea during the tablet-free interval occurred in only 0.6% of the 4,692 cycles in which Triphasil was used. Breakthrough bleeding occurred in 6.9% of first cycles and 3.2% of total cycles; spotting, in 10.7% of first cycles and 4.4% of total cycles. Other symptoms that occurred with an incidence of greater than or equal to 1% were acne (1.0%), appetite increase (1.2%), breast discomfort (2.8%), breast enlargement (1.3%), gastrointestinal symptoms (1.7%), simple headache (1.4%) and nausea (1.1%). A total of 44 women (13.9%) discontinued treatment for medical reasons.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Planned Parenthood experience with triphasil. 365 99

At this time 3 triphasics are widely used in the US: Ortho-Novum 7/7/7, Tri-Norinyl, and Triphasil. Ethinyl estradiol is the preferred estrogenic agent for the triphasic products. Torethindrone and levonorgestrel were chosen as the progestins for the triphasic products. It is the combined effects of estrogen and progestin in the triphasics that provide their contraceptive action. Triphasil increases both the estrogen and the progestin at midcycle; Tri-Norinyl and Ortho-Novum 7/7/7 elevate the progestin only. The midcycle surges of estrogen and luteinizing hormone are dampened, and ovulation is inhibited. The triphasics represent a 98.7% reduction in total steroid content since oral contraceptives (OCs) were introduced. An estrogen dose of 30-50 mcg will inhibit ovulation, and side effects with such a dose are considered tolerable. The triphasic OCs are in this range. An estrogen dose of 20 mcg has been tested but is slightly less effective and is not recommended. Contraceptive failures have occurred with the triphasic products. In 1486 women studied, 6 pregnancies have occurred. Of these failures, one may have been because of a drug interaction with a barbituate. 1 pregnancy was due to patient failure; 3 consecutive pills were missed. Only 2 pregnancies were certain drug failures. Because of the gentle suppression of ovarian function, it has been observed that the menstrual flow is less affected than by standard OCs. Due to the fact that less total steroid is delivered and more endometrial shedding occurs, it is hoped that the triphasic preparations will have less of a "lingering" effect on the return to functional fertility. Most of the published data on side effects is available from the UK, North America, and Europe on the formulation known in the US as Triphasil. Nausea, vomiting, breakthrough bleeding, weight gain, and breast tenderness appear to be the most common side effects. The major medical reasons for triphasic discontinuation include breast tenderness, weight gain, breakthrough bleeding, nausea and vomiting, headache, and increased bleeding during the 1 week of withdrawal. Rifampin and phenobarbital are examples of drugs found to decrease pill efficiency, including triphasics. Also, a triphasic may interfere with the action of another drug. The new triphasics are appropriate when starting new patients on OCs. Patient counseling is essential. Due to the low margin of error as a consequence of lesser suppression of ovarian function, the patient needs to be well instructed in how to take the pill and advised of the consequences of missed tables.
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PMID:The triphasics: insights for effective clinical use. 382 67

The efficacy and safety of a new triphasic oral contraceptive (OC) were evaluated in a trial involving 120 women ages 18-33 years for a total of 901 woman-months of observation. 1 monthly cycle of this triphasic OC provides 6 tablets of 30 mcg ethinyl estradiol (EE) and 50 mcg levonorgestrel (LNg), 5 tablets of 40 mcg EE and 75 mcg LNg, and 10 tablets of 30 mcg EE and 125 mcg NNg. No pregnancies were reported during treatment. Cycle duration was significantly shorter during than before treatment. Before treatment, 88.6% of subjects had cycles of 29-32 days; after treatment, 74.3% had cycles of 20-28 days. The duration of menstruation was 2-5 days in 96.9% of treatment cycles, and the amount of flow was light to moderate in 94.2%. Breakthrough bleeding occurred in 0.4% and spotting in 1.0% of cycles; there was no amenorrhea. Side effects most frequently reported were headache (13.3%) and dizziness (8.2%). Changes in body weight and blood pressure were minimal.
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PMID:Clinical assessment of a new triphasic oral contraceptive. 391 71


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