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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The feasibility and effectiveness of local application of Antilysin in the treatment of IUD-induced irregular bleeding is discussed. Antilysin is a protease inhibitor. Its active agent is a natural, low-molecular, basic polypeptide. 3 ml of Antilysin were injected intrauterinally with a disposable syringe. When properly performed, the injection was painless. Antilysin injections were given to 128 women immediately following insertion of an IUD. Subsequently, 105 of the patients had normal menstrual cycles with an average duration of 4.4 days. 20 women menstruated for more than 7 days; 3 patients developed metrorrhagia. In the control group, who were injected with a physiological solution instead of Antilysin, only 32 of 115 women had normal menstrual cycles. Local injections with smaller doses of Antilysin were more effective than oral application. Due to the smaller dose, intrauterine injections of Antilysin caused no nausea, vomiting, or allergic reactions.
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PMID:[The effect of Antilysin on irregular bleeding after IUD insertion]. 620 85

Highlights of papers presented at an international symposium on advantages and risks of oral contraceptives, and the details of the results of 2 studies are discussed. 1 study compared the effects of a combination of 30 mcg of ethinyl estradiol and 150 mcg of levonorgestrel with a reduced dose 3-phase combination of these hormones; it involved 489 women with 2777 menstrual cycles for a 6-month period. No pregnancies occurred. Missed menstruation occurred in 0.9% of the cycles with the 3-phase combination, contrasted with 2.3% of the 30/150 mcg combination group. Bleeding disorders were more frequent in the 30/150 pill group (15.7% vs. 10.1%). Spotting occurred in 8% of cases in both groups. The 3-phase pills proved to be safe and were preferred because they caused less bleeding. Another study compared the effects of 2 Swedish-made contraceptives by administering Neovletta (N) to 50%, Trionetta (T) to 25%, and Trionetta 28 (T 28) to another 25% of the 862 women with 6472 menstrual cycles who participated at 12 family planning centers in Sweden. T and N contain the same amount of estrogens, but T contains 40% less gestagen than N. The T 28 treatment also included 7 placebo tablets. Results showed that only 1 pregnancy occurred in the T group, despite a high rate of failure to take the pills (8.1-9.4%). Menstruation was normalized in both the N group (90.4%) and the T group (94.2%) reaching the normal 28 (+ or - 2) days cycle. Missed menstruation occurred in 0.6% of the T group as opposed to 2.3% of the N group. There was a significant difference in spotting and irregular bleeding between the 2 groups: 6.3%-15.8% for N and 3.0-9.0% for T. Also, there was a higher rate of bleeding problems for T 28 than for T. 8.6-8.8% of women in both groups quit the experiment because of complications, e.g., bleeding, nausea, headache, and hypertension. Both pills proved to be reliable and safe, but the new 3-phase preparation, T, is recommended because it does not reduce the beneficial HDL cholesterol as does N.
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PMID:[Report from an international symposium about advantages and risks of oral contraceptives. Amsterdam, March 1982]. 692 Nov 98

Advice is provided for nurses and midwives who are asked about the safety and efficacy of the newer oral contraceptives (OCs). The trend toward ever smaller amounts of estrogen in new formulations effectively halted when the quantities of estrogen became insufficient to suppress the hypothalamic-pituitary axis or drug interactions with barbiturates or oral antibiotics resulted in insufficient estrogen, both conditions resulting in higher pregnancy rates. The newest generation of OCs follows 2 basic approaches, phasic OCs and improved progestogens. The triphasic pills Logynon and Trinordiol come in memo-packets with pills of 3 different progestogen-estrogen balances to be taken for 21 days. They contain 30 g less total monthly hormone than any other combined pill, give excellent cycle control and high reliability, and produce minimal metabolic changes. Bi-Novum, a biphasic pill with 35 mcg estrogen, gives cycle stability and minimal nausea, weight gain, and breast tenderness, comparable to results with 50 mcg estrogen. The progestogen used in Bi-Novum produces minimal changes in lipid metabolism and glucose tolerance safety factors. Another new formulation, Marvelon, is a conventional combined type pill containing a new progestogen, desogestrel, which favorably affects high density lipoprotein-cholesterol ratios, remobilizes cholesterol deposits from arterial walls, and reduces the risk of cardiovascular disesase. The progestogen-only formulation Femulen, with a daily dose of 5 mg of ethynodiol diacetate, has high efficacy and a relatively low dropout rate due to irregular bleeding and other causes.
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PMID:When patients ask about the latest and safest oral contraceptive. 692 41

Some form of postcoital contraception for protection against unwanted pregnancy is indispensable today especially in cases of rape, failed mechanical contraception, or 1st sexual contact without contraception. A tabletform of postcoital contraceptive would be acceptable if 100% certainty is assured and it doesn't involve adverse effects. Postcoitally administered high-dose estrogens proved effective in Macaca mulatta. Diethylstilbestrol in variable dosages with or without ethinylestradiol was used in various studies and with variable results. Pregnancy rates depended on time of coitus in cycle, contraceptive dosage, and time of administration after coitus (within 72 hours). Conjugated estrogens and various progestagens or combinations of both have been tried with variable success. Another form of postcoital contraception is IUD insertion within 7 days following unprotected coitus. Advantages of this method are the time factors and absence of adverse effects of hormonal contraceptives. Postcoital hormonal contraceptives cause changes in the endometrium which prevent blastocyst implantation. They alter tubal function affecting zygote movement towards the uterus. They have an antiovulatory effect and may be luteolytic. Estrogens have more severe side effects than progestagens. Nausea, vomiting, mastodynia, fluid retention, and vaginal bleeding can result from estrogens. Progestagens can cause irregular bleeding. Combination of both can cause menstrual irregularity. Postcoital hormonal contraceptives are contraindicated in heart and liver diseases, thrombosis, and pregnancy (teratogenic and carcinogenic effects on offspring). Pregnancy despite postcoital contraception results in extrauterine pregnancy in 10% of patients. The most important reservations in evaluating publications on this subject are: 1) lack of control group; 2) estimation of pregnancy probability is not reliable because of study population used; 3) patient fertility cannot be ascertained; and 4) reliability of information provided by patient. Conclusion from literature studies is that postcoital hormonal contraception is of value but effectiveness is not proven. More research is needed and indications are that other less radical drugs may be found in near future.
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PMID:[Postcoital contraception]. 725 97

Physicians recruited 882 women into a multicenter trial of a new biphasic oral contraceptive (OC) (25 mcg + 125 mcg desogestrel and 40 mcg + 30 mcg ethinyl estradiol). Trial sites were in Belgium, Denmark, Finland, France, Germany, Norway, Sweden, and the former Yugoslavia. After 3 cycles, women who had switched from using another OC in the 2 months before the study (switchers) were less likely to continue the new OC than were women who had not used any OC in the last 2 months (starters) (6 cycles = 87.2% vs. 90.6%, 12 cycles = 74.7% vs. 79.5%; and 18 cycles = 59.8% vs. 64.9%). Withdrawal bleeding did not occur in 3.2% of all cycles. Absence of withdrawal bleeding became less common over time (cycle 1 = 7.6%, cycle 3 = 5%, cycle 6 = 3.2%, and cycle 18 = 1.8%). Duration of withdrawal bleeding was no more than 5 days in 80% of all women. More and more women had no more than 5 days of withdrawal bleeding as time passed (cycle 1 = 81.7%, cycle 6 = 85.6%, and cycle 18 = 90.6%). Irregular bleeding was more common in the first cycles of the study than in subsequent cycles (e.g., spotting during cycles 1-3 = 8.5-4.8% vs. 3.7-3.1% during cycles 6-18). By cycle 18, 96% of all women had no irregular bleeding. The drop-out rate for irregular bleeding was 2.2% at the end of the study. In 5% of cycles, at least 1 tablet was forgotten. In the first cycles, starters were somewhat more likely to complain of nausea, headache, and breast tenderness than switchers (e.g., nausea, cycle 1 = 5.8% vs. 3.4%). The gap between the 2 groups disappeared after 3 cycles. Starters were more likely to have minor complaints before OC use than after OC use (e.g., 6.5% fewer frequencies of headaches at 18 months). These findings show that the new OC has very good cycle control and a agreeable side effect profile.
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PMID:Cycle control and side effects of a new combiphasic oral contraceptive regimen. 794 27

In the Dominican Republic, clinical researchers randomly assigned 150 users of the contraceptive implant Norplant who came to Profamilia's Family Planning Clinic in Santo Domingo complaining of bleeding irregularities to one of three treatment groups. They aimed to evaluate the effectiveness of a combined oral contraceptive (OC) with 250 mcg levonorgestrel and 50 mcg ethinyl estradiol (EE) and of 50 mcg EE alone in treating bleeding irregularities. Bleeding irregularities were defined as prolonged bleeding (i.e., 8 or more continuous days of bleeding or spotting) or irregular bleeding (i.e., current bleeding episode initiated after a bleeding-free interval of less than 15 days). Age, parity, duration of Norplant use, and length of bleeding episode before treatment were similar in all three groups (i.e., OC, EE, and placebo). The OC group was significantly more likely to experience ceased bleeding within three days than the two other groups (91% vs. 67% for EE group [p 0.01 from OC group] and 15% for placebo group [p 0.0005 from both treatments]). Bleeding lasting for at least one week occurred less often in the OC group than the two other groups (2% vs. 14% for EE group and 50% for placebo group [p 0.0005 for both treatments]). Duration of bleeding was significantly lower in the OC group than the other two groups (2.6 days vs. 5.4 days for EE group and 12.3 days for placebo group; p 0.0001). Even though women in both hormonal treatment groups were more likely to experience gastralgia or nausea than the placebo group (33-40% vs. 4%; p 0.005), the side effects rarely interrupted treatment. These findings suggested that the OC is a very good effective treatment for bleeding irregularities and is a practical treatment since it is available at all Profamilia clinic sites.
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PMID:Hormonal treatment for bleeding irregularities in Norplant implant users. 863 69

A one-year longitudinal study was undertaken in Kingston, Jamaica, to examine (i) the experience of side effects among female contraceptive users, (ii) the role of side effects in method continuation, and (iii) counselling regarding side effects. The study consisted of 463 women who utilized public health centres in Kingston and were either new users of contraceptives or who were switching contraceptive methods. They were recruited over a two-month period in 1998 and followed up for one year. All follow-up, interviews were done at the women's homes and complete interviews were obtained for 323 women. Information was collected about socio-economic characteristics, contraceptive history, service factors, experience with method and length of use. Forty-eight per cent of the women experienced side effects with the method accepted on recruitment to the study. Common side effects were irregular bleeding no period, headaches, nausea/dizziness and weight gain/loss. These side effects occurred mainly among pill and injection users. The occurrence of side effects had a negative impact on continuation rates. Forty-seven per cent of the women stated that they had received counselling regarding side effects. The level and impact of side effects among family planning acceptors at public health centres in Jamaica is of significance to the family planning programme. Method options need to be widened and counselling needs to be improved to ensure that women fully understand the issue of side effects and make informed choices about contraception.
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PMID:The impact of side effects on family planning use among female clients of the public health services in Jamaica. 1176 25

(1) For symptoms of oestrogen deficiency linked to the menopause, the standard treatment is an oestrogen-progestogen combination. Various dose strengths and formulations are available for continuous or sequential administration. (2) Marketing authorization has been granted in France for continuous tibolone monotherapy (without a progestogen). Tibolone, a synthetic steroid with progestogenic, oestrogenic and androgenic properties, has been available in some countries for more than 10 years. (3) The available clinical file mainly comprises data from trials with a low level of evidence. The largest trial, involving 437 patients, showed no difference in symptom relief between tibolone and continuous oestrogen-progestogen administration. (4) The most frequent short-term side effects of tibolone are irregular bleeding (in approximately 30% of women), oedema, breast tension and nausea. (5) No long-term data on the risk of breast cancer are available, and data on the risks of endometrial cancer are inadequate. The androgenic lipid profile induced by tibolone is unfavourable (reduction in HDL-cholesterol). Tibolone has a positive effect on bone density, but subsequent effects on the risk of fracture have barely been assessed. (6) In practice, tibolone has no particular advantages over oestrogen-progestogen combinations. On the contrary, it bears a poorly assessed risk of severe adverse reactions. Oestrogen-progestogen combinations remain the reference treatment for treating menopausal symptoms.
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PMID:Tibolone: new preparation. Menopausal symptoms: oestrogen-progestogen combinations are still the reference treatment. 1206 42

Long-acting injectable progestagens have been studied in field trials in Thailand, Chile, and the U.S., using doses varying from 150 mg to 300 mg. Problems associated with this treatment are irregular bleeding, amenorrhea, and inhibition of ovulation after the treatment has been discontinued. Low-dose continuous oral progestagens also create an unpredictable bleeding pattern. Serious adverse effects such as thromboembolism, liver dysfunction, and nausea are reduced. In Mexico the once-a-month pill proved successful in preventing pregnancy and was considered useful for uneducated women because of its simplicity. Problems following IUD insertion may include acute salpingitis, pelvic abscess, septic shock, and subphrenic abscess. Prepackaged inserters and devices along with strict aseptis during insertion will help to reduce septic complications. Data from Japan shows that long term use of IUDs is not associated with troublesome side effects.
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PMID:Sixth fertility and sterility congress--a review. 1225 97

The effectiveness and side effects of Marvelon (0.150 mg desogestrel and 30 mcg ethinyl estradiol) were evaluated in a multicenter study of 1570 women for a total of 22,158 menstrual cycles. Half the women in the study were under age 25. Only 1 pregnancy was reported, and this was due to patient failure. The frequency of spotting and breakthrough bleeding decreased steadily from 22.3% in the 1st treatment cycle, 14.9% in the 2nd, 8.4% in the 6th, 5.6% in the 12th, to 2.8% in the 21st and then rose slightly from 3.6% in the 24th cycle. This pattern of irregular bleeding during the early cycles is common to all oral contraceptive preparations. Changes in body weight were almost negligible and restricted to women under age 20. There was no change in average blood pressure when compared with pretreatment values. Superficial thrombophlebitis occurred in 7 women. Side effects, including nausea, headache, nervousness, depression, and breast tenderness, declined to negligible levels as treatment progressed. Levels of plasma protein sex-hormone-binding globulin (SHBG) appear to be higher with Marvelon than with a similar preparation containing levonorgestrel and ethinyl estradiol. Other studies have noted significantly higher serum high density lipoprotein (HDL) cholesterol levels with Marvelon than with combined levonorgestrel and ethinyl estradiol. This is attributed to the lack of androgenicity of desogestrel in the clinical dosage used in this study. SHBG and serum HDL levels are increased by estrogens and decreased by androgens.
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PMID:Desogestrel and ethinyloestradiol. 1227 90


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