Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Estrogen-related cardiovascular dysfunction was noted in 23 out of 30 patients with prostatic cancer (PC). Coronary subjects with PC suffered from cardiac pain evident on ECG necessitating correction by effective doses of coronary active drugs. PC patients with essential hypertension exhibited frequent headache, progressive edema of the legs, drastic hypertensive reactions. It is held that estrogen therapy for prostatic cancer should be preceded and monitored by therapeutic evaluation responsible for optimal conditions to prevent and early diagnose cardiovascular complications.
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PMID:[Diagnosis and therapeutic correction of changes in the cardiovascular system of patients with prostatic cancer treated with estrogens]. 208 39

A 21-year old woman using an oral contraceptive, the combination preparation Trigynon containing levonorgestrel (LNG) and ethinyl estradiol (EE), since June 1987 had experienced pain in the groin. In September 1988 she had a single occurrence of bleeding, a sign of lessened effectiveness of the OC. She was treated with 50 mg of minocycline/day as of April 1989, and for inguinal acne conglobata with locally applied clindamycine (10 mg/ml of clindamycine hydrochloride lotion). She switched to another OC, and the next month timely, normal menstruation ensued. A few days later the dose of minocycline was raised to 100 mg/day. Subsequently she had a regular breakthrough bleeding followed by a missed cycle and a positive pregnancy test. There have been several recent reports about the interaction between antibiotics and OCs (breakthrough bleeding and contraceptive failure). Rifampicin and griseofulvin are known to reduce the activity of OCs via induction of liver enzymes. Between 1968-84 there was a total of 62 failures of OCs (15 using OCs with 50 mcg of EE) reported in the UK. The suspected cause was the combined use with antibiotics (70% penicillin and tetracycline). In the Netherlands 6 cases of possible interactions were reported during 1980-86: 2 cases caused by nitrofurantoin and/or trimethoprim, and 1 case by sulfamethoxazol with trimethoprim. The interference of minocycline with the intestinal flora can occur as 34% of it is excreted in feces, and its antibacterial spectrum corresponds to that of tetracycline hydrochloride (reduction of beta-glucuronidase in the feces). The failure of Trigynon cannot be irrefutable ascribed to minocycline as unintended pregnancy also occurs while using OCs without antibiotics. Clindamycine could have also influenced the intestinal flora percutaneously.
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PMID:[Inefficacy of oral contraception during use of minocycline]. 214 63

The effectiveness of a monophasic oral contraceptive was compared to that of a triphasic for relief of primary dysmenorrhea in an open crossover study in 30 women who had been previously taking triphasics. The pills formerly used contained ethinyl estradiol and either norethisterone (3) or levonorgestrel (27). Women took the monophasic pill containing 150 mcg desogestrel and 30 mcg estradiol [sic] for 3 months, then resumed their former prescription. Dysmenorrhea pain, marked on 10 mm scale, was lessened in 18 and increased in 4 women during monophasic intake (p0.01). Total duration of pain was reported as 2081 hours on the monophasic, and 2237 hours on the triphasic. The amount of bleeding reported as light, medium or heavy on a calendar was less on the monophasic for 18 women, the same in 2 and less on the triphasic for 4 women. Analgesic use during the monophasic was reported as less by 13, the same by 1, and more by 6 women. 19 women expressed a desire to continue with the monophasic after the study. It is likely that monophasic pills relieve dysmenorrhea more effectively because of their more consistent inhibition of ovulation.
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PMID:Modern oral contraceptives and dysmenorrhoea. 214 96

Mechanisms for the therapeutic effect of oral contraceptives in dysmenorrhea were studied by recording intrauterine pressure on the first day of menstrual bleeding in women with moderate to severe symptoms and after three weeks of oral contraceptive therapy (150 micrograms levonorgestrel + 30 micrograms ethinyl estradiol, daily). Spontaneous uterine activity and reactivity to intravenous injections of vasopressin (6 pmol/kg body weight; n = 8) or prostaglandin F2 alpha (12 nmol/kg body weight; n = 9) at the two sessions were compared. During the first recording when all women had dysmenorrhea, the uterine activity and reactivity to both agonists were pronounced. After therapy, when the women felt essentially no pain, a statistically significant decrease in spontaneous uterine activity in terms of total pressure area, frequency and amplitude of contractions was observed. The agonist injections induced less pain at the second recording, although the magnitude of responses, superimposed on the much smaller uterine activity at this time, were not significantly different from those at the first recording during dysmenorrhea. The mechanism of pain relief by oral contraception in dysmenorrhea could be a lesser impact of the decreased contractile activity on uterine blood flow, abolishing the local ischemia. A reduced uterine reactivity to agonists might also to some extent contribute to the therapeutic effect.
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PMID:Effect of an oral contraceptive in primary dysmenorrhea--changes in uterine activity and reactivity to agonists. 250 70

Twenty-three patients with laparoscopically diagnosed endometriosis and pelvic pain were allocated randomly to treatment with cyproterone acetate 27 mg plus ethinyl estradiol 0.035 mg/day (11 patients) or danazol 600 mg/day (12 patients). All women received treatment for 6 months, except for one in the cyproterone group who suspended treatment for nonmedical reasons and was excluded from analysis of the results. The clinical condition and pain symptoms were monitored in all patients for 1 year after treatment suspension. The intensity of pelvic pain at diagnosis, during treatment, and at follow-up was evaluated by a multidimensional verbal score and an analogue scale. At the end of treatment, a repeat laparoscopy was performed in those patients who agreed (four in the cyproterone group, five in the danazol group); the results showed a partial regression of endometriotic lesions in both groups, with no significant differences between them. Dysmenorrhea disappeared in all patients during treatment. At 6 months after suspension, dysmenorrhea recurred in 66% of the cyproterone group and 58% of the danazol group, and at 1 year in 89 and 92%, respectively. Intermenstrual pelvic pain improved markedly during treatment in both groups; 6 months after treatment withdrawal it was present in four cyproterone subjects and four danazol group patients, whereas after 1 year, only one woman in the danazol group did not have this symptom. Deep dyspareunia was less affected by treatment, and 6 months later had recurred in all the women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of cyproterone acetate and danazol in the treatment of pelvic pain associated with endometriosis. 252 84

2 cases of thromboembolism in young women with no risk factors except use of triphasic oral contraceptives are reported. A 21-year old White woman, Gravida I Para I, presented to the emergency room with a painful, blue, mottled right lower leg after pain in the hip and buttock for 1 week. She had taken a triphasic oral contraceptive containing 35 mcg ethinyl estradiol and 0.5, 0.75, 1 mg norethindrone for 1 month, and had no other related history. Doppler and venogram tests showed thrombosis of the ileal, femoral, popliteal and infrapopliteal veins. She was treated with heparin, streptokinase, and urokinase without success and recovered after ileal, femoral and popliteal thrombectomy. The 2nd case was a 30-year-old Gravida III Para I Black woman who had taken a pill containing 50 mcg ethinyl estradiol and 500 mcg norgestrel for 13 years and had recently switched to the triphasic pill described above. She had dull midepigastric pain, nausea, vomiting, diarrhea and chills, for 1 week. Physical exam was negative except for abdominal tenderness and a heart murmur. Abdominal ultrasound revealed portal venous thrombosis extending to the splenic and superior mesenteric veins. She was treated with transhepatic urokinase without effect and celiotomy was performed. She was discharged with an occluded right branch of the portal vein. These cases point out the fact that the estrogen dose in triphasic pills is not lower than that in low dose combined oral contraceptives.
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PMID:Idiopathic thromboembolism associated with triphasic oral contraceptives. 281 53

In this article we investigate the impact of estrous cycle, ovariectomy, and estrogen replacement on both opioid and nonopioid stress-induced analgesia. Stage of estrous strongly influenced analgesia. Diestrus females exhibited the typical male pattern produced by the analgesia inducing procedures used--strong nonopioid analgesia following 10-20 tailshocks, and strong opioid analgesia following 80-100 tailshocks. In these experiments the nonopioid analgesia was slightly attenuated during estrus, but the opioid analgesia was markedly reduced. The role of estrogen in producing these changes was studied with estrogen replacement in ovariectomized subjects. Ovariectomy only slightly altered nonopioid analgesia but eliminated opioid analgesia, which suggests that some estrogen might be necessary to maintain the integrity of the system(s) underlying opioid analgesia. Estrogen administration restored opioid analgesia, but further estrogen suppressed opioid analgesia, duplicating the estrus pattern. It did not suppress nonopioid analgesia. Opioid analgesia was enhanced 102 hr after estrogen replacement, thus duplicating the diestrus pattern. Estrogen thus appears to be responsible for the impact of estrous cycle on opioid but not on nonopioid analgesia. These results suggest that ovarian hormones may modulate the impact of stressors on endogenous pain inhibition and other stress-responsive systems.
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PMID:The estrous cycle and estrogen modulate stress-induced analgesia. 284 93

2 cases of functional ovarian cysts are described to illustrate an increasingly common but little studied complication of progestin-only or phasic oral contraceptives. A 20-year-old woman without previous pathology who had used a pill containing .35 mg norgestrienone for 6 months suddenly developed violent lower abdominal pain. Sonography revealed a mass that was believed to result from extrauterine pregnancy, and surgery was performed. In the 2nd case, a 39-year-old woman taking a triphasic containing levonorgestrel and ethinyl estradiol had unexplained lumbosacral pain. Sonography again revealed an ovarian cyst. The triphasic was discontinued and the cyst disappeared over the next several days. A review of the literature suggested that such cysts are common but only about 1 in 6 are painful. They appear to result from the inhibition of pituitary luteinizing hormone by the progestin while follicle stimulating hormone secretion persists. Follicular secretion of estraiol may or may not reach significant levels. The complication should be known by physicians because the pain and adnexal mass should not be mistaken for a surgical emergency. Oral contraceptive package inserts should indicate that functional ovarian cysts may occur in women using progestin or phasic pills.
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PMID:[Follicular ovarian cysts appearing during progestin or estroprogestin oral contraception at low doses]. 305 84

To learn more about the beneficial effect of combined oral contraceptives (OCs) on symptoms in primary dysmenorrhea, plasma levels of vasopressin and a prostaglandin F2-alpha metabolite in dysmenorrheic women were investigated before and during treatment with a gestagen-dominated OC. The 10 subjects were administered an OC containing 150 mcg of levonorgestrel and 30 mcg of ethinyl estradiol for 21 days. The 7 women with dysmenorrheic symptoms at the time of blood sampling during the 1st menstruation graded their pain as averaging 2.1 (moderate to severe) + or - 0.3; during the 2nd menstruation, the average value was 2.9 (severe) + or - 0.1, indicating a significant increase in pain at the start of the withdrawal bleeding. Vasopressin concentrations in samples obtained on days 1-3 of the control cycle were significantly higher than those on days 6-8, 20-22, and 24-26 of the control cycle and days 1-2 of the next menstruation. Thus, the highest concentrations were obtained at the beginning of the 2 painful menstruations and at ovulation in the control cycle. During treatment, vasopressin concentrations were consistently low, except on the 1st day of withdrawal bleeding. The concentrations of the prostaglandin F2-alpha metabolite showed less variation, again, values at withdrawal bleeding were not different from those obtained during painful menstruation. Plasma concentrations of ovarian and adenohypophysial hormones, as well as osmolality, were normal throughout. Thus, the present study provided no evidence that there is a reduced release of vasopressin and/or prostaglandin F2-alpha capable of accounting for the beneficial effect of OCs on dysmenorrhea. It is possible, however, that a difference in ovarian hormone concentrations is more pronounced in uterine tissue than in plasma.
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PMID:Plasma concentrations of vasopressin and a prostaglandin F2 alpha metabolite in women with primary dysmenorrhoea before and during treatment with a combined oral contraceptive. 312 2

The effectiveness, side effects and serum FSH, LH, prolactin, estradiol and progesterone levels were monitored in 79 women taking Anteovin for a total of 506 cycles (mean 6.4 cycles). Anteovin is a biphasic oral contraceptive with 11 tablets containing 0.05 mg levonorgestrel and 0.05 mg ethinyl estradiol, and 10 tablets containing 0.125 mg levonorgestrel and 0.05 mg ethinyl estradiol. There were no pregnancies. 11 women dropped out because of hepatomegaly (1), bleeding disorder (3), gastric pain and nausea (1), breast pain (1), nausea and vomiting (1), and personal reasons (4). 10.3% of those continuing reported minor side effects. Menses occurred every 28 days for 3-5 days, with 2 cases of breakthrough bleeding but no oversuppression. Progesterone ranged from 1.5-2.0 nmol/1, estradiol varied between 68-93 pmol/1, LH stayed constant at 6.3-11 U/1, FSH remained at 5.8-6.8 U-1 without a peak, and prolactin levels were lower than those seen in control cycles. These hormone levels all resemble those observed in anovulatory cycles. This pill is especially suitable for teens and nulliparas.
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PMID:Clinicopharmacological examination of Anteovin. 343 59


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