Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

447 women were treated with either norethindrone, norethindrone acetate or norethindrone with ethinyl estradiol to prevent conception. The total length of time patients remained under treatment varied from 1 to 60 months for an over-all total experience of 8308 cycles. Only 1 woman conceived, and she had not followed instructions. 4 others were pregnant when treatment was instituted, as learned by hindsight. 58 women conceived within 1 to 12 months after they discontinued medication taken previously for periods of time ranging from 1 to 31 months. Most conceived within 3 months. None of the women suffered thrombophelbitis. Breakthrough uterine bleeding was more common with the administration of norethindrone or norethindrone acetate than with norethindrone acetate combined with ethinyl estradiol. Nausea, retention of fluid, and mastalgia were more common with the progestin-estrogen combination. Ophthalmologic examinations, 17-ketosteroid studies, follicle-stimulating hormone analysis, and blood cholesterol determinations on patients selected at random and after varying periods of treatment were within normal limits.
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PMID:Control of fertility with oral medication. 1230 56

The article is primarily a general discussion of the pill's medical aspects, prefaced by a discussion of the normal human menstrual cycle. Aspects of oral contaceptives reviewed include mechanisms, effectiveness, product formulation, instructions for use, adverse reactions, contraindications, and current developments. Oral contraceptive mechanisms include 1) blockage of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) release, 2) alteration of motility in the fallopian tubes 3) modification of endometrial maturation, and 4) rendering the cervical mucus hostile to sperm migration. Mild side effects of various oral contraceptives include nausea, mastalgia, edema, psychological changes, headaches, and failure of withdrawal bleeding. Moderate side effects include breakthrough bleeding, androgenic side effects, patches of increased skin pigmentation, and prolonged amenorrhea and infertility. Severe side effects include impaired liver function and jaundice, hypertension, and thromboembolic disorders. Topics of current research in steroidal contraception include depot therapy, continuous low-dose progestogen therapy, and postcoital estrogen therapy.
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PMID:Pharmacology of contraceptive agents - new compounds with new problems? 1230 37

489 women from Sweden (n = 296) and from Great Britain and Germany (n = 193) took part in a test of 2 O.C. (oral contraceptive) preparations. 254 women used the triphasic SH B 264 AB preparation, while 235 women used Neovletta. A total of 2777 cycles was observed, during which no pregnancies occurred. The mean menstrual duration decreased nearly 2 days among Neovletta patients and 1 1/2 days among SH B 264 AB users (p .001). The rate of amenorrhea after 3 and 6 cycles was 1.6% and .5% respectively among SH B 264 AB users and 1.4% and 2.1% respectively among Neovletta users. Menstrual bleeding decreased. The rate of amenorrhea was significantly (p .001) greater among Neovletta users. The volume of menstrual bleeding decreased for users of both preparations. The incidence of bleeding irregularities was greater among those using Neovletta. 14.7% of the women discontinued O.C. use during the study, ca. 8% due to medical reasons, at about the same rate for both preparations. SH B 264 AB users more often reported side effects; the most frequent side effects for both preparations were headaches, mastodynia, and nausea.
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PMID:[Fertility regulation using triphasic administration of ethinyl estradiol and levonorgestrel in comparison with the 30 plus 150 mcg fixed dose regime (Author's transl)]. 1230 81

Vaginal administration of oral contraceptives (OCs) has been shown to be an acceptable and effective method of contraception. The most widely tested vaginal contraceptive pill (VCP) contains 500 mcg of d-1 norgestrel and 50 mcg of ethinyl estradiol (EE) and is administered on the same 21-day schedule as the oral contraceptive. Other combination OCs used vaginally include 1 mg of norethisterone plus 50 mcg of mestranol, 250 mcg of levonorgestrel plus 50 mcg of EE, and 2 mg of cyproterone acetate plus 50 mcg of EE. Gestrinone, a potent antiestrogenic progestin, has also been used with success. Comparative studies of the various combination pills and Gestrinone revealed that plasma levels of the progestins rose at a slower pace and to a lower peak value after vaginal administration than after ingestion, but ovulation was suppressed in most cycles. Fertility control compared favorably with most low-dosage combined pills taken by mouth. No pregnancies occurred in a group of 124 women who used the vaginal route for 6-20 months totalling 1438 woman-months of use. Cycle control was good, and bleeding episodes occurred following discontinuation and lasted 3-5 days in 98% of cycles. Amenorrhea was rare, and breakthrough bleeding and spotting occurred in fewer than 10% of women. 22% of the women gained more than 2 kg and 9% lost weight. Blood pressure remained unchanged in most women, and fewer than 10% had headache, nausea, acne, nervousness, or mastalgia. Fewer than 20% had vaginal discharge requiring treatment, with Trichomonas vaginalis being the most common pathogenic agent. In 1 study, 44 women discontinued VCP use before completing 1 year of use, 7 for medical reasons (2 for mastalgia, 2 for vaginal irritation, 3 for vaginal discharge unresponsive to treatment), 6 to achieve pregnancy, and the remaining 31 to avoid daily vaginal insertion. The VCP achieved the same results as OCs with a minimum of side effects due to the low steroid levels and because VCPs bypass the liver on the 1st pass. The vaginal ring shares these advantages of the VCPs, but the bulky silastic rubber structure of the ring may cause erosion of the vaginal wall, interfere with coitus, and absorb release unpleasant odors. Problems with vaginal rings also include expulsion, difficulty of insertion and removal, and storage. The VCP may be a better alternative than the OC as the 1st prescribed contraceptive for family planning clinics because the low blood levels of steroid will reduce the occurrence of side effects in longterm use.
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PMID:The vaginal contraceptive pill. 1233 69

More than 60% of the women in both groups suffered from premenstrual syndrome (PMS) symptoms, such as anxiety, mastalgia, insomnia, nausea and gastrointestinal disorders, whereas a smaller number of women suffered from phobic disorders, premenstrual headaches and migraines. There were three women from the first group and seven women from the second group who continued the medication treatment with progestins, whereas one woman from the first group and nine women from the second group continued to take fluoxetine. In the first group, nine women stopped having PMS symptoms after two AP treatments, eight women stopped having them after three treatments and one woman stopped having them after four treatments. In four women from the first group and 16 women from the second group, PMS symptoms appeared during the following period (cycle) or continued even after four treatments, so the medication was continued. In the first group, one woman had a smaller subcutaneous hematoma after the AP acupoint Ren 6. There was a statistical and relevant reduction in PMS symptoms with the AP treatments in the first group (P<0.001), whereas their reduction was irrelevant in the placebo AP group (P>0.05). The success rate of AP in treating PMS symptoms was 77.8%, whereas it was 5.9%. in the placebo group. The positive influence of AP in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions. The initial positive results of PMS symptoms with a holistic approach are encouraging and AP should be suggested to the patients as a method of treatment.
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PMID:Using acupuncture to treat premenstrual syndrome. 1241 Mar 69

Due to the long-term health risks now associated with hormone replacement therapy, many menopausal women are actively seeking alternative treatments. One such alternative is black cohosh (Actaea racemosa, syn. Cimicifuga racemosa), which has been used in the United States for the treatment of gynecologic complaints for more than 100 years. Review of the published clinical data suggests that black cohosh may be useful for the treatment of menopausal symptoms, such as hot flashes, profuse sweating, insomnia, and anxiety. Results from the most recently published trial, however, indicate that black cohosh is not effective for the treatment of menopausal symptoms in breast cancer survivors being treated with tamoxifen. Because the overall quality of the published clinical trials is low, two new randomized, double-blind, placebo-controlled clinical trials are currently underway in the United States. To date, only one standardized black cohosh extract has been tested clinically; the current recommended dose is 40-80 mg per day. At least 4-12 weeks of treatment may be required before any therapeutic benefits may be apparent. Adverse reactions such as nausea, vomiting, headaches, dizziness, mastalgia, and weight gain have been observed in clinical trials. No drug interactions are reported in the medical literature. The estrogenic effects of black cohosh are controversial, and the more recent data indicate that black cohosh extracts may have an anti-estrogenic activity. Owing to potential effects on sex hormones, however, black cohosh should not be administered to children or during pregnancy and lactation.
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PMID:Black cohosh: an alternative therapy for menopause? 1255 11

Raloxifene, a selective estrogen receptor modulator (SERM) licensed for the prevention of non-traumatic vertebral fractures in postmenopausal women at increased risk of osteoporosis, was launched in the UK in August 1998. The aim of the study was to monitor the safety of raloxifene prescribed in the primary care setting in England using prescription-event monitoring (PEM). Patients were identified by means of prescription data supplied by the Prescription Pricing Authority between September 1998 and November 2000. Demographic and clinical event data were collected from questionnaires posted to primary care physicians (GPs) at least 6 months after the date of the first prescription for each patient. Information on medical events, suspected adverse drug reactions (ADRs), reasons for stopping treatment, pregnancies, and causes of death was requested. Event rates [Incidence Densities (IDs): no. first reports /1000 patient-months of treatment] were calculated. Differences between IDs for events reported in month one (ID(1)) and months 2-6 (ID(2-6)) of treatment were examined. The cohort comprised 13,987 patients [median age 62 years (IQR 55,69); 99.8% female]. The major indication was osteoporosis (40.9%, n=5725). Flushing was the event with the highest ID in month 1 (22.8), reported most frequently by GPs as an ADR to raloxifene (67/461 reports) and as the reason for stopping (700/4592 reports). Events associated with starting treatment included flushing, malaise/lassitude, headache/migraine, nausea/vomiting, sweating, cramp, pain abdomen, dizziness, diarrhea, mastalgia and vaginal hemorrhage. Less common events reported during treatment included deep vein thrombosis (n=13), pulmonary embolism (n=13), thrombophlebitis (n=31) and visual disturbance (n=29). In this study, there were 122 (0.9%) confirmed deaths, of which 32 causes of death were unknown. This study shows that raloxifene is generally well tolerated when used in general practice in England. Potential signals of unrecognised ADRs requiring further evaluation included gastrointestinal adverse symptoms and vaginal hemorrhage. There were also a small number of reports of events associated with venous thromboembolism and visual disorders that require further investigation.
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PMID:Safety profile of raloxifene as used in general practice in England: results of a prescription-event monitoring study. 1530 82

Vitex agnus castus L. (VAC) [Verbenaceae] is a deciduous shrub that is native to Mediterranean Europe and Central Asia. Traditionally, VAC fruit extract has been used in the treatment of many female conditions, including menstrual disorders (amenorrhoea, dysmenorrhoea), premenstrual syndrome (PMS), corpus luteum insufficiency, hyperprolactinaemia, infertility, acne, menopause and disrupted lactation. The German Commission E has approved the use of VAC for irregularities of the menstrual cycle, premenstrual disturbances and mastodynia. Clinical reviews are available for the efficacy of VAC in PMS, cycle disorders, hyperprolactinaemia and mastalgia, but so far no systematic review has been published on adverse events or drug interactions associated with VAC. Therefore, this review was conducted to evaluate all the available human safety data of VAC monopreparations. Literature searches were conducted in six electronic databases, in references lists of all identified papers and in departmental files. Data from spontaneous reporting schemes of the WHO and national drug safety bodies were also included. Twelve manufacturers of VAC-containing preparations and five herbalist organisations were contacted for additional information. No language restrictions were imposed. Combination preparations including VAC or homeopathic preparations of VAC were excluded. Data extraction of key data from all articles reporting adverse events or interactions was performed independently by at least two reviewers, regardless of study design. Data from clinical trials, postmarketing surveillance studies, surveys, spontaneous reporting schemes, manufacturers and herbalist organisations indicate that the adverse events following VAC treatment are mild and reversible. The most frequent adverse events are nausea, headache, gastrointestinal disturbances, menstrual disorders, acne, pruritus and erythematous rash. No drug interactions were reported. Use of VAC should be avoided during pregnancy or lactation. Theoretically, VAC might also interfere with dopaminergic antagonists. Although further rigorous studies are needed to assess the safety of VAC, the data available seem to indicate that VAC is a safe herbal medicine.
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PMID:Vitex agnus castus: a systematic review of adverse events. 1578 41

Since the publication of the results of the Women's Health Initiative that described the risks of hormone replacement therapy, many women are actively seeking alternative treatments for menopausal symptoms. Black cohosh (Actaea racemosa, syn. Cimicifuga racemosa) is one such alternative that has been used in the US for over 100 years. To date only two cimicifuga extracts have been tested clinically, and the current recommended dosage is 40-80 mg/day. Review of the published clinical data suggests that cimicifuga may be useful for the treatment of menopausal symptoms, such as hot flashes, profuse sweating, insomnia, and anxiety. However, the methodology used in most of the trials is poor and further clinical assessment of cimicifuga is needed. In terms of safety, transient adverse events such as nausea, vomiting, headaches, dizziness, mastalgia, and weight gain have been observed in clinical trials. A few cases of hepatotoxicity have been reported, but a direct association with the ingestion of cimicifuga has not been demonstrated. The most recent data suggest that cimicifuga is not estrogenic.
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PMID:Black cohosh (Actaea/Cimicifuga racemosa): review of the clinical data for safety and efficacy in menopausal symptoms. 1589 23

Polycystic ovary syndrome (PCOS) is related to clinical and metabolic comorbidities that may limit the prescription of combined hormonal contraceptives, with consequent need to use progestogen-only contraceptives (POCs). Thus, the objective of the present study was to evaluate the clinical and metabolic effects of a POC, the levonorgestrel-releasing intrauterine system (LNG-IUS), in women with PCOS followed up over a period of 6 months compared to baseline and to women without PCOS. Thus, an observational, prospective, controlled study was conducted on 30 women with a diagnosis of PCOS who presented adverse effect secondary to the use of combined oral contraceptives (nausea, headache, mastalgia or vomiting; PCOS group) paired with 30 ovulatory women without PCOS (control group), both groups being free of comorbidities and having chosen the LNG-IUS as contraceptive. Clinical, laboratory, and ultrasonographic variables were evaluated immediately before LNG-IUS insertion and 6 months after the use of this method. Before LNG-IUS insertion, the PCOS group had higher total testosterone levels (P = .04), lower HDL levels (P = .04), and greater ovarian volume (P < .01) than the control group. Six months after LNG-IUS insertion, there was a 2.3% increase in abdominal circumference (P = .04) and a 3.4% increase in fasting glycemia (P = .02). On the other hand, mean ovarian volume was 10% smaller compared to the volume found before LNG-IUS insertion (P = .04), LDL levels were reduced by 5.2% (P = .03), and total cholesterol levels were reduced by 6.7% (P < .01) compared to baseline evaluation in the PCOS group. The remaining variables did not differ significantly during the 6 months of observation. The control group did not show significant changes compared to the period before LNG-IUS insertion. When the groups were compared after the 6-month follow-up, only glycemia showed a statistically significant variation between the groups, with glycemia levels increasing by 3.4% in the PCOS group and decreasing by 2.6% in the control group (P = .008). In conclusion, the use of the LNG-IUS for 6 months was not associated with relevant changes in clinical or metabolic variables of women with no comorbidities regardless of the presence of PCOS.
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PMID:Levonorgestrel-Releasing Intrauterine System for Women With Polycystic Ovary Syndrome: Metabolic and Clinical Effects. 2673


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