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

Drug companies have been at work throughout the 1960s, 1970s, and 1980s trying to reduce the steroid content of their oral contraceptives (OCs). Researchers have been successful in reducing steroid content while maintaining effectiveness, thereby making OCs safer. In the 1st half of the natural menstrual cycle, a woman secretes estrogen as the dominant steroid product. In the 2nd half, estrogen is the principal reproductive hormone. Estrogens inhibit ovulation, possibly by inhibiting implantation, altering ovum transplant, or in some way preventing corpus luteum function, which is necessary to maintain early pregnancies and the endometrium. There are still only 2 estrogens and 6 progestins on the market today. They are probably the most thoroughly studied chemical ever seen in the history of pharmacy or medicine. 1 of the estrogens, mestranol, is really a drug of the past. In the body, mestranol is converted to ethinyl estradiol, the other estrogen on the market. Consequently, there is no reason to use mestranol itself. Within the dose range of 50-100 mcg, there's little difference in contraceptive effect. Progestins are the other active ingredient in the combination OC. Their principal action is the thickening of the cervical mucus, which prevents sperm penetration. Also, with sufficient progesterone, ovulation is inhibited, but this happens in only 40% of those patients taking, for instance, the "mini-pill" (which consists of progesterone only). The progestins and the estrogens work in concert to make OCs a highly effective contraceptive method. Recent surveys conducted by the Centers for Disease Control and National Cancer Institute looked into the relative effectiveness of OCs. Nordette had a use effectiveness failure rate of 3.5; Ovral, 3.6. Loestrin 1/20 -- norethindrone acetate, 1 mg, and estinyl estradiol, 20 mcg -- shows a failure rate of 4.5. This indicates that the threshold for an effective dose of estinyl estradiol in OCs is 30 mcg. For 1 mini-pill, Ovrette, the failure rate is 9.5 -- much higher. Depo-Provera has a failure rate of 0.7. The primary complaint from women taking OCs is spotting and breakthrough bleeding during the cycle. 30-50% of women given OCs stop taking them within a year. OC side effects include nausea, fluid retention, breast tenderness, leukorrhea, hypomenorrhea, headaches, spotting around the face, hypertension, and visual changes. 1 of the risks of birth control pills may be cervical dysplasia -- changes in the cells of the cervix. The relative risk of cervical cancer with OCs after 5-9 years is approximately 1.8. Clinical cases of deep vein thrombosis number 1/1000 per year among nonusers of OCs. Among users, the rate is 3 times as high: 3/1000. The most serious potential adverse effect is myocardial infarction. Of the excess deaths attributed to OCs (23.3 total per 100,000 users), 22.7 are due to myocardial infarctions and hemorrhage. The discussion also briefly reviews other methods of contraception -- Depo-Provera, male contraceptives, implants, the diapragm, and IUDs.
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PMID:Prescription contraceptives: countering the risks. 405 Jun 70

A study was conducted to determine the effects of an oral contraceptive containing 250 mcg of d-norgestrel with 50 mcg of ethinyl estradiol on lactation and other functions. 134 healthy women of childbearing age who were breast feeding their young completed more than 3 cycles each, for a total of 1377 cycles for the study. The reported side effects were 1) 12 instances of disturbances in menstruation, 2) 4 instances of abdominal distress, 3) 55 instances of weight change, 4) 11 cases of headache and giddiness, and 5) some dermatitis, pruritus, and breathlessness, none of which was severe enough to warrant discontinuance of therapy. A random sample of 21 women was taken to determine the effect on lactation. 18 of the 21 reported no change in milk production and continued to lactate until the end of the treatment period. Lactation decreased in the other 3 women. Further intensive studies are required before any definitive conclusion can be reached on the effect of this combination on the quality of the breast milk and duration of lactation.
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PMID:Effects of "Nordiol' on fertility and lactation: some preliminary observations. 427 7

Ovostat, sold in Belgium as Pregnon 28 (1 mg lynestrenol and 50 mcg ethinyl estradiol) was taken by 146 women for up to 12 cycles without any pregnancies. The patients ranged in age from 17-51, and included 80 without and 66 with oral contraceptive experience. Pill cycles tended to have lighter and shorter flow, a 2-3 day latency period, and duration of 3-5 days in 90%. 25 incidents of amenorrhea were reported and 3 patients stopped because of spotting or breakthrough bleeding. 18 (12.3%) experienced nausea, 13 (8.9%) headache, 14 (9.6%) breast pain, and 19 (13%) depression or nervousness. 8 dropped out for drug-related reasons and 17 for personal reasons.
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PMID:[Clinical study of a new oral contraceptive: ovostat]. 458 59

The case of a 27-year-old woman treated with oral contraceptives (most recently with Anovlar) who developed intracranial hypertension is reported. The woman presented with visual disturbances, fatigue, and headaches. Oculo-circulatory and cerebral neoplastic diseases were not present, but high intracranial pressure was noted; no etiological clarification could be found. Discontinuation of contraceptive medication was followed by near-normalization of vision and disappearance of other symptoms. During a 3-year follow-up period no neurological disorders apart from mild limitation of the visual field could be observed. A connection between the elevated intracranial pressure and oral contraception seems probable.
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PMID:[Benign increase in intracranial pressure during oral contraception (author's transl)]. 474 74

The efficacy, safety, and patient acceptance of an oral contraceptive containing 150 mcg d-norgestrel and 30 mcg ethinyl estradiol (150/30) were studied in 99 women who completed 754 cycles of medication between late 1971 and October 1973. 1 pregnancy occurred giving a pregnancy rate of 1.6 per 100 woman-years. This woman's previous history indicated unreliability in pill taking. The mean pretreatment length of menses was 4.9 days and during treatment, 4 days. Although intermenstrual bleeding and amenorrhea were noted in early cycles, there was a decrease in the usual incidence of headaches, nausea, vomiting, and depression. Results of the study and patients' acceptance suggest that the 150/30 combination may be used as the oral contraceptive of first choice.
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PMID:Clinical assessment of a low-dose oestrogen, low-dose progestogen combined oral contraceptive. 482 25

An approach to the management of the climacteric and postmenopausal patient is outlined. Menopause refers to the time at which menstruation ceases; climacteric, the period of transition. Neither is pathological. After the functional life of the ovary terminates when the supply of primary oocytes is exhausted, the feedback mechanism with FSH is disrupted leading to high blood and urinary levels of FSH. Estrogen often continues to be produced for about 10 years postmenopausally. Hormone therapy is indicated to treat vasomotor instability, such as hot flashes, numbness and tingling, vertigo, cold hands and feet, palpitations and headache, dysfunctional uterine bleeding, and senile vaginitis. The psychological changes often noted are functional and not due to estrogen withdrawal. There is currently no proof of the efficacy of long term estrogen replacement as a means of preventing heart diseases or osteoporosis.
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PMID:Management of the climacteric and postmenopausal woman. 503 99

3 cases of women becoming hypertensive while taking oral contraceptives are presented. The first was a 35-year-old mother of 4 who had developed hypertensive kidney disease in her last pregnancy. Before contraception her blood pressure was 130/75; it rose to 140/80 in 3 months and 160/100 in 6 months after taking Ovariostat (2.5-mg lynestrenol and .075-mg mestranol, combined). 2 months after discontinuing usage her pressure was 140/80. The second was a 45-year-old mother of 2 whose pressure climbed from 120/70 to 180/120 within 3 months of starting Planor (2-mg norgestrienone and .05-mg ethinyl estradiol, combined), and fell to 130/80 3 weeks after discontinuing usage. The third was a 32-year-old woman with blood pressure of 120/70 before taking Ovaristat. Within 15 days her pressure was 170/90, accompanied by severe headaches. 1 month after discontinuing usage it returned to 120/70. The discussants mention several cases in their experience, and agree with the authors that women with hypertension in pregnancy, obesity, or diabetes should not be given the pill. Normal patients should be followed carefully and advised to keep a low salt diet and normal weight.
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PMID:[Arterial hypertension during treatment with estro-progestative drugs]. 515 54

100 patients of a private gynecologic practice took Planovine (4 mg megestrol acetate 50 mcg ethinyl estradiol) for 1-26 cycles, starting in 1968. The group was composed of 17 nulliparas, 57 who had 1-3 abortions, 69 taking Planovine for various gynecologic indications, and 40 using contraception for the 1st time. The menstrual flow was usually the same, but diminished in 19 women, became more regular in 10 women, but intermenstrual bleeding occurred in 18 women during 1 to 7 cycles. 38 gynecologic disorders were improved. Side effects included nausea or stomach pain (15 cases), weight gain (27), weight loss (40), headache (5), and nervous complaints (11). Although 15 women initially had mild venous disorders such as swollen veins, heavy limbs, and varicosities, no further circulatory complications appeared. 19 representative endometrial biopsies are described.
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PMID:[Clinical study of Planovine in gynecologic practice]. 556 16

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

264 women (about 50% private patients), all less than 40 years old and none with history contraindicating oral contraception, were started on a regimen with Ovral (.5 mg norgestrel and .05 mg ethinyl estradiol). Medication started on Day 5 of a menstrual cycle. Then therapy followed a 3 weeks on, 7 days off schedule. Patients continued for 1-22 cycles (mean 7 cycles) for a total of 1918 cycles. Despite the omission of 42 doses by 32 patients, no pregnancies occurred. The percentages of cycles with average flow, spotting, breakthrough bleeding, and dysmenorrhea were 74.4, 2.5, .4, and .6, respectively. The incidence of amenorrhea, .2%, was spectacularly low in comparison with findings in other studies. Papanicolaou smears (483) were all normal (Class I or II). Morphologic changes seen at endometrial biopsy (61) were similar to those produced by other available progestogen-estrogen compounds. No significant variation from control findings (1878) were found in 1463 laboratory studies. The studies included leukocyte and differential counts (724), and determinations of hemoglobin and hematocrit (388), fasting blood sugar and blood urea nitrogen (114), bilirubin and liver function (61), and renal function (176). Minor symptoms (nausea, vomiting, headache, etc.) were few and disappeared after the first few cycles. The preparation suppresses ovulation (probably through action of the estrogen), probably alters the cervical mucus to inhibit sperm penetration, possibly interferes with nidation, and may interfere with follicular development.
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PMID:Norgestrel, a low dose, oral progestogen for fertility contro. Supplementary report. 564 94


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