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

The possible role of estrogens in the pathogenesis of pruritus gravidarum and cholestatic jaundice of pregnancy was examined. 13 women of childbearing age who had been studied during at least 1 of their previous pregnancies were the subjects in the investigation. 7 of these women had symptoms during pregnancy; 3 had pruritus gravidarum and 4 cholestatic jaundice. 6 women who had been free of symptoms during pregnancy served as controls. A dose of .5 mg twice daily was given to 10 subjects; 2 received .5 mg daily, and 1, .5 mg, 3 times a day. 10 subjects recieved estrogen for 2 weeks, but in 3 who had been symptomatic during pregnancy, the development of severe symptoms or jaundice necessitated earlier cessation of hormone administration. In women with normal pregnancies the only symptom during estrogen treatment was mild early-morning nausea and liver function was not significantly impaired. In those with a history of itching or jaundice during pregnancy, ethinyl estradiol administration precipitated symptoms similar to those experienced during pregnancy. In these women liver function was significantly impaired by estrogen.
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PMID:Idiopathic cholestasis of pregnancy. The response to challenge with the synthetic estrogen, ethinyl estradiol. 608 Nov 43

Progress in new drug developments is discussed in relation to newly registered drugs and drugs in the animal and/or clinical research stage. Of central nervous system drugs new neuroleptics, antidepressants, tranquilizers, psychotropics, antiparkinson and anticonvulsant agents are discussed in terms of chemical structure, pharmacokinetics and toxicity. Likewise for anti-infective drugs such as antibiotics, antifungal, and antiparasitic agents. New synthetic antiinflammatory glucocorticoids are being developed and tested for toxicity and clinical effect. Estrogen and gestagen research continues but few new substances with more effective action than currently-used compounds have been found. Initial clinical testing of Tibolon shows it to prevent postmenopausal osteolysis and hot flashes. ST-1435 is still being tested as an implantable contraceptive. It causes amenorrhea and reduces plasma estradiol and progesterone. No progress is seen in research on nonhormonal substances with contraceptive action, except for prostaglandins although no new derivatives with high tissue selectivity for uterine smooth muscle, nor early applicable abortifacients, have been found. Metenprost is being studied as a self-administered abortifacient: in one study 98% of completed abortions were seen with 30-40% adverse effects (nausea, vomiting, fever). DL204-IT and L-11,204 are triazoloisoindole and triazoloisoquinolone derivatives which have been tested in various dosages and dosage forms on animals in various pregnancy stages. Optimum contraceptive action occurs in the early blastocyst stage. The plant extracts Zoapatanol and Montanol show dose-dependent inhibition of implantation in animal studies but the contraceptive action mechanism is not known. Oxendolone shows an unmistakable antiandrogenic effect. Action mechanism is assumed to be inhibition of the 5 alpha-reduction of testosterone. It has a long plasma half-life in rats (3.6 days). It has been clinically tested in Japan (weekly intramuscular injection of 200-400 mg) in prostatic hypertrophy. Longterm studies are not yet available.
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PMID:[Progress in the area of drug development. 15]. 613 42

Postcoital contraceptives, the so-called "morning after pill," are agents used as emergency treatment to prevent pregnancy after unprotected intercourse or contraceptive accidents. In the 1960s and early 1970s high doses of estrogens were used in 5-day courses such as diethylstilbestrol 25-50 mg a day or ethinyl estradiol 0.5-5 mg a day begun within 72 hours after coitus. Although effective, a considerable drawback of the associated nausea and vomiting as well as an increased risk of menstrual disturbance during the treatment cycle. Norgestrel alone in various dosages has been used postcoitally. Quingestanol has been used as a continuing postcoital agent in Latin America but proved unacceptable owing to nausea and irregular bleeding. In China "visiting pills" have been devised containing anordrin. In the West regimens of this sort have been superseded by the Yuzpe treatment of 100 mcg ethinylestradiol and 0.5 mg levonorgestrel initially, repeated after precisely 12 hours. The treatment must be initiated within 72 hours of exposure. Postcoital contraceptives act by combinations of mechanisms--the function of the corpus luteum is disrupted, tubal motility may be affected, and changes in endometrial biochemistry prevent ovoimplantation. In a multicenter trial involving 602 women Yuzpe reported a pregnancy rate of 1.6%. Other workers show comparable figures of 0-3%. The primary side effects of the current hormonal method are nausea, which occurs in 61% of cases, and vomiting, 20% of cases. Both are mild and of short duration. All postcoital methods carry a risk of ectopic pregnancy should the treatment fail. 3 ectopic pregnancies were recorded with diethylstilbestrol and 1 recently with the Yuzpe regimen. There have been no reports of thromboembolic complications. If a hormonal form of postcoital treatment fails, the theoretical possibility of the pregnancy being harmed cannot be ruled out. The patient needs to be counseled about this, and careful records should be kept. Also important is the taking of an accurate menstrual and coital history to exclude exposures earlier in the menstrual cycle. Lippes and coworkers showed the efficacy of copper IUDs as postcoital agents. These can be used up to 5 days from intercourse. An IUD is preferred if hormones are contraindictated, if exposure was more than 72 hours beforehand, if the woman desires the most effective method, and if she wants the IUD for longterm contraception. Postcoital contraception, however defined, raises ethical questions. Postcoital methods could be classed as contraceptive rather than abortive within the maximum period (defined by medical scientific consensus) that may elapse between intercourse and nidation.
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PMID:Postcoital contraception. 613 82

Five study centers enrolled 1,311 women seeking postcoital contraception methods. Ethinyl estradiol was administered at 5 mg/day and conjugated estrogens at 30 mg/day for five consecutive days starting within 72 hours of unprotected coitus. Eleven pregnancies occurred in the 976 women who had a single unprotected coitus at midcycle. Based on published information, 69 pregnancies would have been expected if no contraceptives were used. Although both treatments were effective in preventing pregnancy, ethinyl estradiol seemed to be more effective. At the two centers alternately prescribing both drugs, none of 137 women treated with ethinyl estradiol became pregnant, while six of the 132 given conjugated estrogens became pregnant. Women whose treatment commenced on the first postcoital day seemed to have lower pregnancy rates than those whose medication was delayed to the second or third postcoital day regardless of which drug was used. Side effects were mainly limited to nausea that occurred in 70% and vomiting that was experienced by 33% of all women treated.
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PMID:Ethinyl estradiol and conjugated estrogens as postcoital contraceptives. 625 Dec 88

Compilation of recent data on 1130 female volunteers from 17 US sites enrolled in a study of a new low dose combination oral contraceptive (OC) containing .15 mg levonorgestrel and .03 mg ethinyl estradiol are reported. All clients had complete histories and physical examinations at entrance and at 6 month intervals during treatment, and about 20% also had blood sugar, blood urea nitrogen, and liver profile determinations. Follow-up evaluation was performed after the 1st and 3rd cycles and every 3 cycles thereafter to determine patterns of pill taking, bleeding episodes, untoward effects, and concomitant medication. Clients ranged in age from 15-40 with mean age of 23.6; 76.1% were white, 11.9% black, 7.5% Hispanic, and 4.4% Oriental. 61.9% were of proven fertility and 92% had regular cycles. 48.1% of the study population had not used female hormones or been pregnant within 60 days of enrollment. A total of 11,064 cycles over a maximum 31 cycles of treatment are reported. Despite 1-6 or more missed pills in 1623, or 14.7% of the cycles, only 3 pregnancies were reported, only 1 presumed to be a method failure, for a use-effectiveness Pearl index of .35/100 women years of usage. Use of the formulation resulted in a mean cycle length of 28.5 days. 92.7% of cycles ranged from 26-30 days, almost equal to pretreatment values. The frequency of light menstrual flows increased. Breakthrough bleeding was reported in 669 cycles, or 6.0%, while spotting occurred in 852 cycles, or 7.7%. Amenorrhea was reported after 194 cycles (1.8%). No reports of post-pill amenorrhea were made. Incidence of side effects was very low. Only acne, breast discomfort, dysmenorrhea, gastrointestinal symptoms, headache, nausea, and vaginal discharge were reported in more than 1.0% of cycles. The pill had essentially no effect on weight or blood pressure, and produced no clinically significant laboratory abnormalities in hematology, urine, blood sugar, blood urea nitrogen, or liver profile determination. A total of 515 subjects (45.6%) discontinued use of the drug for various nonmedical reasons. Another 146 women (12.9%) discontinued use and gave medical reasons; 132, or 11.7%, were commonly reported side effects of OCs such as breakthrough bleeding, headache, and nausea. Clinical trials with the formulation have shown it to be a safe and effective ultra-low dose combined OC agent whose mode of action is primarily gonadotropin suppression and subsequent anovulation.
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PMID:A new ultra-low-dose combination oral contraceptive. 640 5

Ten women with essential hirsutism were treated for one year with cyclic administration of cyproterone acetate and ethinyl estradiol. Biochemical and clinical control took place after 1, 3, 6 and 12 months of treatment. In 4 patients great improvement of hirsutism was noted, but only after 6 months of therapy. In 4 patients there was some improvement, while 2 were resistant. Side effects included reduced libido in 4 cases, mental depression in 3, dry skin and itching in 4 and transient nausea in one, but never necessitated cessation or interruption of treatment. Several changes in endocrine function took place during treatment: testosterone secretion rate diminished together with the urinary excretion of 17-KS and 17-KGS, while the serum concentration of testosterone binding globulin increased. There was a reduction in the serum concentration of total endogenous estrogens and progesterone as well as LH. No changes in hepatic, renal or hematologic parameters were found except for a slight increase in plasma prothrombin time. Clinical outcome of therapy could not be correlated with a pretreatment endocrine "profile", nor with the changes that this therapy induced in endocrine function. It is concluded that the anti-androgenic effect is probably the most important in this drug regimen, but that reversibility of hirsutism may depend upon factors not directly related to androgen influence.
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PMID:The treatment of essential hirsutism in women with cyproterone acetate and ethinyl estradiol. Clinical and endocrine effects in 10 cases. 645 99

Postcoital contraception, or "interception" of the blastocyte before it implants in the uterus, is an effective method of contraception which is recommended for more frequent use, though only as indicated in emergencies such as rape, rupture of condom, 1st sexual experience without contraception, and isolated sexual relations without contraception. General contraindications include already existing pregnancy and multiple risk of pregnancy in a single menstrual cycle. There are 3 types of accepted hormonal postcoital contraception--estragens alone, progestagens alone, and combined estrogen and progestagen-- which must begin within 48-72 hours after intercourse. Estrogens most commonly suggested are 1) diethylstilbestrol (DES), 50 mg daily for 5 days, 2) conjugated estrogens, 10 mg daily for 5-6 days, and 3) ethinyl estradiol (EE), 5 mg daily for 5 days. The high dosages required for effectiveness can cause complications, the most severe being ectopic pregnancy, but the failure rate of this method is only .7%. The failure rate using progestagens alone is inversely proportional to the administered dose (i.e., 1% for 1 mg of D-norgestrel or levonorgestrel). Norgestrel and quingestanol are used most frequently with the most severe complication being disturbance of the cycle. Oral administration of the combination pill containing .05 mg EE and .25 mg D-norgestrel, at a 12-hour interval is the most widely accepted hormonal method, as the short treatment period assures patient compliance, the low estrogen dosages reduce the occurrence of side effects, although 40-50% still experience nausea, and the contraindications are the same as for general estrogens-progestagens. Intrauterine postcoital contraception involves insertion of a coil, which prevents implantation of the blastocyte in the uterus, and has been shown to be 100% effective, although no extensive series have been publicized as compared with the hormonal methods. Where postcoital contraception is used, a detailed history should be obtained to determine risk of pregnancy and possible contraindications, and the patient should be informed of the side effects and procedural methods.
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PMID:[Postcoital contraception (without prostaglandins)]. 648 43

Low dose estrogen tablets, containing less than 50 mcg of ethinyl estradiol, were formulated because of the recognized dose response relationship with the steroid content of the tablet and side effects. These new oral contraceptives (OCs) are as effective as the older high-dose OCs, and available evidence reports fewer side effects. This discussion reviews pharmacology of these new OCs, the mechanism of action, contraindications, side effects, and problems with the low-dose estrogen OC. Ethinyl estradiol is the only estrogen used in the low-dose combination OC. There are several synthetic progestins: norethindrone, norethindrone acetate, norgestrel, levonorgestrel, and ethynodiol diacetate. These progestins have different potencies so the pharmacologic activity cannot be accurately predicted based on the amount present in the tablet. The synthetic steroids in OCs are absorbed in the small intestine, metabolized in the liver, excreted in the bile and feces with a half-life of 24 hours. The low-dose estrogen combination preparation is taken 3 out of every 4 weeks. Its contraceptive effect is primarily a result of hypothalamic mediated gonadotropin suppression with subsequent inhibition of ovulation. Contraindications to taking the low-dose OC are the same as for the higher dose OC: thromboembolic or cardiovascular disease, estrogen dependent neoplasia, markedly impaired liver function, undiagnosed genital bleeding, congenital hyperlipidemia, pregnancy, and women over age 30 who smoke. Relative contraindications include hypertension, diabetes mellitus, migraine headaches, uterine myomas, and epilepsy. The often quoted 2-5-fold increased incidence of thromboembolic disease, myocardial infarction, and stroke is based on large epidemiologic studies involving patients taking the older higher dose OCs. Current data from patients taking the newer low-dose medication demonstrate minimal if any increased incidence of these problems in young women who do not smoke. The low-dose estrogen OCs have minimal effect on lipid levels. Early reports of patients using the low-dose OC have shown little if any increased incidence of hypertension. The low-dose contraceptives have little effect on glucose tolerance, and there is no evidence to show an increased incidence of overt diabetes in OC users. There is no evidence that use of the combination OC causes an increase in cancer of the cervix, uterus, or ovaries. Clinical complaints of nausea, breast discomfort, chloasma, weight changes, and depression are reduced with the low-dose estrogen preparation. Hypomenorrhea while taking the OC occasionally occurs because the lower dose of estrogen is insufficient to stimulate the endometrial growth in face of the predominant progestin-atrophy effect.
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PMID:Oral contraceptives in 1984. 649 Mar 38

Postcoital contraception (PC) has become more effective in recent years and is recommended for women who have had unprotected coitus between the 8th and 17th days of their cycles. Vaginal douche using a spermicide solution is ineffective as it has resulted in a 37% pregnancy rate. Estrogens are far more effective: Diethylstilbestrol (DES), taken in doses of 25-50 mg daily for 5 days, e.g., 10 mg of conjugated estrogens 3 times daily, and 2.5 mg ethinyl estradiol 2 times daily for 5 days 24-72 hours after coitus, has resulted in a .5-1.5% pregnancy rate. Side effects, however, include nausea, vomiting, mastalgia, menorrhagia, extrauterine pregnancy, and adenocarcinoma in daughters of DES-treated women. Gestagens, such as .15-.40 mg of d-norgestrel taken 3 hours after coitus, can be used as a form of planned PC. In an experiment, an estrogen-gestagen preparation consisting of 50 mcg ethinyl estradiol and 500 mcg dl-norgestrel taken 12-72 hours after coitus produced a .9% pregnancy rate in 1300 menstrual cycles with few serious side effects. Copper 7 or copper-T IUDs also prevent the implantation of the fertilized egg, and, when used within 5 days after coitus, produced only 1 pregnancy in 727 cases. The ideal future PC would be a preparation that inhibits either ovulation or nidation and has limited side effects. Among some promising agents are a luteinizing hormone-releasing factor agonist as well as natural and synthetic prostaglandins; however, until their cardiovascular and gastrointestinal side effects have been ameliorated, their routine use is unlikely.
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PMID:[Postcoital contraception]. 661 4

102 patients using Trinordiol, a triphasic oral contraceptive (OC) containing ethinyl estradiol and d-norgestrel, were followed for 932 cycles in a study of secondary effects. Follow-up visits were scheduled after 1,3, and 6 months and every 6 months thereafter. 26 patients discontinued use of the pills during the study after using them for a total of 159 cycles. 5 discontinued because of abdominal pain, 1 for breast tenderness, and 1 because of headaches or migraines. 7 discontinued because of metrorrhagia, 4 for weight gain, 3 for amenorrhea, 2 for nausea and vomiting, and 1 each for nervousness, water retention, acne, desire for pregnancy, leaving the country, hypertension, and unknown motivation. the average age of patients was 23.6 years, with a range from 14-48. 76% were aged 15-29 years. 52.9% were nulliparas. 58.8% were Belgian, 21.6% were from Mediterranean Europe, 10.8% were Moroccan, and 7.9% were from black Africa. Only 1 patient, a 37 year old, developed hypertension. 15 patients gained more than 2 kg and 17 lost more than 2 kg. 15.8% complained of spotting during the 1st cycle compared to 3.1% during the 6th cycle, 5.2% during cycle 7-12, and 9.1% during cycle 13-30. Among 35 patients who did not discontinue treatment, 7 complained of amenorrhea and 1 of scanty menstrual bleeding, 14 of pain including 7 cases of pelvic pain, 2 of dysmenorrhea, 3 of breast tenderness, and 2 of headaches, 15 of leukorrhea, 3 of nausea, 2 of dizziness, and 1 each of fatigue, acne, galactorrhea, and cutaneous pruritus. 1 case of myoma at the level of the uterine cornu was identified after 24 cycles of treatment. In all, 61 patients had some complaint, while 41 were totally satisfied. No patient became pregnant during the study.
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PMID:[Clinical study of the secondary effects associated with taking a triphasic anti-ovulatory contraceptive]. 670 4


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