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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

How a weakened immune system affects the female's reproductive system is explained. The female's endocrine system controls the menstrual and reproductive systems, and the immune system attacks harmful substances and organisms. The hypothalamus stimulates the pituitary gland to produce the hormones FSH and LH, which in turn signal the ovaries to produce estrogen and progesterone. These hormones cause a mature egg to be released. If fertilized, the egg remains within the uterus; if not, menstruation occurs. HIV-positive females often complain of menstrual cycle changes, such as irregular periods, depression, or pain. The virus, other complications, or medications, such as AZT, may cause these symptoms. Estrogen therapy may help those with suppressed immune systems who have premature menopause. Oral contraceptives offer protection against pregnancy, but not HIV. It is not known if the pill reacts adversely with AIDS treatment drugs. Lists are provided showing the pros and cons of oral contraceptives and hormone therapy.
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PMID:[Women, immunity and sexual hormones]. 1136 3

Women have a higher incidence of inflammatory disorders than men and also appear to perceive painful stimuli differently. It has been suggested that neuroinflammation plays a role in painful bladder disorders of uncertain etiology, such as interstitial cystitis. Nerve growth factor (NGF) is a neurotrophin produced in peripheral tissues that can also mediate pain and inflammation. We found that treatment of mice with the estrogen antagonist ICI 182,780 had no effect on bladder NGF content but decreased bladder NGF messenger RNA. Using immunohistochemistry, we demonstrated that the mucosa is the primary source of NGF in the mouse bladder, and the bladder mucosa also expresses estrogen receptor (ER)-alpha, ER-beta, and the high-affinity NGF receptor tyrosine kinase A. Estrogen may also modulate neurogenic inflammation by interaction with other substances and cells that participate in the pathogenesis of neurogenic inflammation, including substance P, bradykinin, and mast cells. Collectively, these observations indicate that estrogen has the capacity to influence the onset and course of neurogenic inflammation of the bladder.
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PMID:Estrogen and neuroinflammation. 1137 49

The vast majority of people experience tension-type headache during their lifetimes. Boys experience tension-type headache slightly more than girls during preadolescent years. During adolescence and adult years, tension-type headache occurs more commonly in females. Tension-type headache changes in women occur in relation to gynecologic changes, including menses, pregnancy, and menopause. These changes are related to estrogen fluctuations. Estrogen fluctuations cause changes in neurochemicals important for pain signal transmission, including serotonin, gamma-aminobutyric acid, and enkephalins.
Curr Pain Headache Rep 2001 Oct
PMID:Estrogen and tension-type headache. 1156 Aug 10

Changes in body weight and the incidence of estrogen-related side effects with low-dose oral contraceptives (OCs) containing 20 microg ethinyl estradiol (EE) have not been demonstrated in placebo-controlled trials. Two placebo-controlled, randomized trials demonstrated the efficacy of a low-dose OC for the treatment of acne in healthy females (n = 704; >or=14 years old) with regular menstrual cycles and moderate facial acne. Patients were randomized to receive 20 microg EE/100 microg levonorgestrel (LNG) or placebo for six cycles. Body weight was measured at baseline and during Cycles 1, 3, and 6. The occurrence of adverse events was recorded at each visit. Mean changes in weight from baseline were similar with 20 microg EE/100 microg LNG [0.72 kg +/- 2.64 (SD; n = 349)] and placebo [0.56 kg +/- 2.64 (SD; n = 355; p > 0.05)] for the last measured weight of each patient. Rates of headache, nausea, weight gain, and breast pain, side effects commonly attributed to OCs, were also similar between groups (p > 0.05). No serious, unexpected, drug-related adverse events occurred during the study. The low-dose OC containing 20 microg EE/100 microg LNG is safe, well tolerated, and does not cause weight gain.
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PMID:Weight change and adverse event incidence with a low-dose oral contraceptive: two randomized, placebo-controlled trials. 1167 50

Besides their well-established actions on reproductive functions, estrogens exert a variety of actions on many regions of the nervous system that influence higher cognitive function, pain mechanisms, fine motor skills, mood, and susceptibility to seizures; they also appear to have neuroprotective actions in relation to stroke damage and Alzheimer's disease. Estrogen actions are now recognized to occur via two different intracellular estrogen receptors, ER-alpha and ER-beta, that reside in the cell nuclei of some nerve cells, as well as by some less well-characterized mechanisms. In the hippocampus, such nerve cells are sparse in number and yet appear to exert a powerful influence on synapse formation by neurons that do not have high levels of nuclear estrogen receptors. However, we also find nonnuclear estrogen receptors outside of the cell nuclei in dendrites, presynaptic terminals, and glial cells, where estrogen receptors may couple to second messenger systems to regulate a variety of cellular events and signal to the nuclear via transcriptional regulators such as CREB. Sex differences exist in many of the actions of estrogens in the brain, and the process of sexual differentiation appears to affect many brain regions outside of the traditional brain areas involved in reproductive functions. Finally, the aging brain is responsive to actions of estrogens, which have neuroprotective effects both in vivo and in vitro. However, in an animal model, the actions of estrogens on the hippocampus appear to be somewhat attenuated with age. In the future, estrogen actions over puberty and in pregnancy and lactation should be further explored and should be studied in both the hypothalamus and the extrahypothalamic regions.
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PMID:Invited review: Estrogens effects on the brain: multiple sites and molecular mechanisms. 1171 47

Current interceptive methods of contraception utilizable between ovulation and nidation include hormonal methods and IUDs. Since the 1st clinical study of the use of high doses of estrogen as a postcoital contraceptive appeared in 1967, the remarkable efficacy of the method has been confirmed by numerous other studies. The most important series used 50 mg diethylstilbestrol (DES) or 5 mg ethinyl estradiol (EE) per day for 5 days beginning within 72 hours of unprotected intercourse. The mechanism by which estrogens exercise their interception are unclear, but there are probably several factors involved including luteolysis and anomalies in endometrial development. The method is highly effective but rates of nausea, vomiting, breast tenderness, and to a lesser degree menorrhagia are high. The incidence of extrauterine pregnancy is about 1 per 10 intrauterine pregnancies for any postcoital method. Estrogen postcoital contraception is preferable to DES because of the fear of genital adenosis or vaginal adenocarcinoma in case of failure of DES. Opinion is divided as to the teratogenic risks of high doses of estrogens in general. Postcoital contraception with a progestin, levonorgestrel, which renders the endometrium inhospitable to nidation, was 1st described in 1973. The efficacy of norgestrel alone depends on the dose used. The most common secondary effects are spotting and cycle shortening. The method has the advantage of requiring a very small dose, but the disadvantage of requiring administration in the 12 hours following intercourse. Several combinations of estrogens and progestins have been proposed for postcoital use, of which the most interesting consists of 1 mg of dl-norgestrel and 100 mcg of EE repeated exactly 12 hours later. The treatment should be administered within 12 hours of unprotected intercourse. A multicenter study of 692 women treated with this method gave a pregnancy rate of 1.6%, which would have been lower if 4 women not meeting the conditions of treatment had been excluded. 52.7% of women treated had nausea or vomiting. Compared to estrogens alone, the EE-Norgestrel combination takes less time, requires 4 pills instead of 50 or 60, is better tolerated overall, and requires much less estrogen. Postcoital insertion of an IUD is very effective and has the advantages that it can be used later than 72 hours following intercourse, it is the only method currently available in case OCs are contraindicated, it allows subsequent longterm effective contraception, and it is 100% effective. The major disadvantages are pain on periovulatory or postovulatory insertion and the risk of infection. Possible future hormonal methods of postcoital contraception based on use of anti-progesterone steroids, especially RU486, or of luteinizing hormone releasing hormone agonist are currently under development.
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PMID:[Post-coital contraception]. 1228 Feb 7

Between the fall of 1991 and the fall of 1992, 1500 physicians from throughout France followed 5989 women, 13-56 years old, using the combined oral contraceptive (OC) Moneva (30 mcg ethinyl estradiol and 75 mcg of the new generation progestogen, gestodene) for 3-6 months for a total of 29,000 cycles. Moneva was prescribed in 60% of the cases because the women did not tolerate a previous OC. Moneva effectively prevented pregnancy. It reduced the rate of abnormal cycles (5.4% of cycles vs. 0.9% at 3 months and 0.6% at 6 months). Intermenstrual bleeding also decreased in frequency from 13.8% to 6.1% at 6 months. Amenorrhea occurred less often with Moneva (2.8% vs. 1.1% at 3 and 6 months). Moneva also reduced the length of the menstrual period (20.7% of women with long period vs. 3.3% at 6 months) and excessive menstruation (1.4% vs. 0.2% at 6 months). Pain during menstruation, breast tenderness, and secondary effects occurred less frequently as well (37.1% vs. 13.5% at 3 months and 9/7% at 6 months, 13% vs. 7.9% at 6 months, and 15.1% vs. 11.1% at 3 months and 9% at 6 months, respectively). Secondary effects included headaches, nausea, and heavy legs. Moneva did not affect body weight or arterial blood pressure. 95% of women who took Moneva for 6 months were satisfied with it. 83.8% said that they would continue to use it. In conclusion, Moneva is an effective, safe, tolerable, and acceptable OC for women of all ages.
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PMID:[Oral contraception with Moneva: findings of a cohort study of 6000 women]. 1231 72

Hormonal contraceptives include oral pills with lower steroid concentrations such as the triphasic gestodene. A dose of less than 20 mcg of ethinyl estradiol in the combined pill is effective. The use of RU-486 or mifepristone to inhibit ovulation or as a postcoital method is still being investigated. The vaginal rings that release 20 mcg of levonorgestrel (LNG) have a 97% rate of efficacy. There are newer types that release 30 mcg of LNG or desogestrel. A progesterone-releasing ring used during lactation is being studied. Among implants Norplant has been approved in many countries, including by the US Food and Drug Administration, with excellent results. In Brazil it continues to be banned. Studies have been initiated about implants, such as Norplant 11 and UNIPLANT. The studies conducted by the World Health Organization on injectables such as Cyclofem (which contains 5 mg of estradiol cypionate and 25 mg of medroxyprogesterone acetate) as well as Mesigyna (5 mg of estradiol valerate and 50 mg of norethindrone enanthate) are awaited. These two monthly injectables have minor side effects, produce regular cycles, and are highly effective. The use of GnRH analogues for ovulation inhibition are held back because of cost, dosage, and routes of administration The hormonal IUD releasing 20 mcg of LNG holds promise for high efficacy, probable protection against inflammations, and pronounced reduction of menstrual bleeding, particularly in long-term use. The frameless IUD, called Flexigard, consists of 6 fixed copper cylinders placed in the myometrium, which causes less endometrial irritation and less incidence of inflammation, pain, and bleeding. It has been in an experimental testing phase for some years. The female condom helps prevent STDs and is under the woman's control. Among male contraceptives, a hormonal method awaits development, while gossypol with the ability to inhibit HIV proliferation and the Chinese method of scalpel-free vasectomy are effective methods.
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PMID:[Information on advances in sciences and technology. Advances in contraceptive technology]. 1234 21

This randomized, double-blind, placebo-controlled exploratory study examined the efficacy and safety of a low-dose oral contraceptive (Mircette), desogestrel/ethinyl estradiol [DSG/EE] and ethinyl estradiol [EE]) in relieving the symptoms of dysmenorrhea. Twenty-three clinics in the United States enrolled 77 women (age < or =32 years) with primary dysmenorrhea documented for at least four consecutive cycles. Forty participants received DSG/EE&EE and 37 received placebo for four consecutive 28-day cycles. The intensity of menstrual-related distress was measured with the Menstrual Distress Questionnaire (MDQ). Patient diaries were used to assess number of school/work days missed as well as the use of rescue medication. Participants receiving DSG/EE&EE recorded reduced menstrual pain severity, lower total MDQ scores, and significantly less menstrual cramping. No significant change in bloating, anxiety, loneliness, weight gain, or acne was reported. The DSG/EE&EE formulation shows promise for the treatment of primary dysmenorrhea and was well tolerated by the participants in this study.
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PMID:Primary dysmenorrhea treatment with a desogestrel-containing low-dose oral contraceptive. 1249 30

The purpose of this study is to compare bleeding patterns and acceptability of a contraceptive regimen of combined 20 microg ethinyl estradiol/100 microg levonorgestrel taken with and without a hormone-free interval. Thirty-two women desiring oral contraception were randomized to six 28-day cycles (standard group) or 168 days without a pill-free interval (continuous group). Participants kept a daily bleeding calendar documenting bleeding events (none, spotting or required sanitary protection) and side effects (headache, nausea, breast tenderness, depression, premenstrual syndrome and bloating). Primary outcome was number of bleeding days. Secondary outcomes included bleeding days requiring sanitary protection, amenorrhea, patient acceptability of bleeding patterns, method satisfaction and affective side effects. There were no differences in the baseline characteristics of the two groups. Although total bleeding days were fewer in the continuous group (mean = 25.9 vs. 34.9 days), this result did not reach statistical significance. However, women in the continuous group reported significantly fewer bleeding days that required protection (18.4 vs. 33.8 days, p < 0.01), and were more likely to have amenorrhea. Although both groups reported a high level of satisfaction with bleeding patterns and side effect profiles, women in the continuous group reported significantly fewer days of bloating (0.7 vs. 11.1 days, p = 0.04), and menstrual pain (1.9 vs. 13.3 days, p < 0.01). Continuous use of 20 microg ethinyl estradiol/100 microg levonorgestrel is associated with less bleeding requiring protection, and more amenorrhea than standard administration. Taken with or without a hormone-free interval, this oral contraceptive formulation is highly acceptable with regard to bleeding patterns and side effect profile. The continuous group had fewer light and moderate bleeding days, less bloating and menstrual pain. For patients who are seeking these results, this method may be more desirable.
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PMID:Bleeding patterns and patient acceptability of standard or continuous dosing regimens of a low-dose oral contraceptive: a randomized trial. 1252 51


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